Composing a Life

used to force their collusion in dishonesty.
    We draw on the experiences of others and understand them better in the process. Jack had been dispossessed at Orion only a year before my problems at Amherst, so I had the examples of his desperate search for redress and Alice’s conviction that creative work would be the only real solution. I know women who have invested their emotional and financial resources in lawsuits and have been permanently crippled as a result. I have followed hostile divorces that began in betrayal and left women with impossible economic burdens and lasting bitterness. I don’t believe it is healthy to live, as some foreign wives did in Iran, with your metaphorical bags packed, but I have come to believe that when the end comes it pays to cut your losses, for there is almost always more ahead than we can guess.
    Of the women I worked with, Ellen is probably the most resiliently aware of the lack of integrity in the systems with which she has to deal. She has been very clear about her reluctance to again be a part of a large rigid institution, yet she is strongly committed. At the beginning of our friendship, when I was still aching from the Amherst experience, she was turned down for a grant. Instead of feeling personal rejection, she was ready to analyze the politics. She is deeply committed as a therapist, but she looks at her medical colleagues with a sharper eye than most physicians—for if any group protect their own claims of virtue more fiercely than professors, it is physicians.
    When Ellen talked about her decision to resign from her job as director of the emergency psychiatric service at Beth Israel Hospital, she described the difficulties of being enmeshed in the giving of inadequate or ineffective care, and the ways in which the multiplication of regulations and litigation, originally designed to improve care, makes caregiving more difficult. “Emergency rooms all over the country were coming under the gun at the point that I quit. That kind of patient care is filled with enormous frustration. You ended up participating in the dumping of patients from the poorest groups, who really needed care, and it got worse every year. We had a little revolving door between our facility and the Massachusetts Mental Health Center at the state hospital two and a half blocks away, the so-called last resort facility. We’d get the patients, and send them down the street, and then
they
wouldn’t admit them because their threshold for illness was far higher, because they were deluged, and they’d send them back. You’d often do it by ambulance, because you had to be sure nothing happened to the patient in between. And it wasn’t our fault, and it wasn’t their fault. It was just that you were caught in this insane system.
    “A large element of what I had to do as head of the emergency ward was deflecting the fire from that kind of really terrible patient care, a real kind of dumping and so-called referral of patients to places we knew they wouldn’t be allowed to stay. It was something that I think was very hard for all of us, that we couldn’t help. You know, your hands were tied. Resources were just not there. I remember many times speaking to hospital lawyers saying, ‘What do we do? We can’t just kick this patient out. There’s no place for him to go,’ and being told, ‘Just be sure you document everything.’”
    I could compare my frustrations at Amherst College with Johnnetta’s at U. Mass. and realize that the college was not really more corrupt than hundreds of other institutions. I learned for the first time, when I started this book, the details of Alice’s efforts to sustain her company through a no-win legal battle and the sexism of the Boston financial community. Joan told me what it felt like in Berkeley when one friend after another capitulated to McCarthyite pressure to sign a loyalty oath while the Eriksons, with more immediate memories of prewar Europe, held out—and how one after another, their shamefaced friends began to avoid them. I could begin to sort out the need to live in an imperfect world from the need to maintain a vision of a better one.
    “If you are going to be in the business world, there are lots of rules that you may not agree about as a human being,” Alice said, “but they are there and you have to observe them without compromising your own values or saying they shouldn’t be there. If you are going to war you have a certain obligation to