The Thanatos Syndrome

breath, examining each muddy boot carefully. He’s getting it back, his lost temper. “Oh, I know you, old buddy!”—now smiling brilliantly, even nudging me. He has recovered himself and can wipe the smile and come close with a comradely seriousness. “God knows, I understand your intellectual curiosity, Tom—such is the stuff of great discoveries—but I’m just an ordinary clinician and must think first of my patient.”
    â€œI think she’s got a cortical deficit, probably prefrontal.”
    â€œVery interesting. Okay, okay. Let’s skip the metaphysics. You get into the prefrontal, you get into metaphysics. In any case it’s academic when it comes to managing her. That’s not why I asked you in on this.”
    â€œWhy did you ask me in, Bob?”
    â€œI thought for one thing to do you a fucking favor. Believe it or not, I thought we were friends, and as a friend I wanted you back on your feet as a working physician—entirely apart from my role as one of your probationers. As such, I don’t mind telling you it was I who got the Board of Medical Examiners to move you from a Class Three to a Class Two offense.”
    â€œWhat is that?”
    â€œIt means, Doctor, that your license is not revoked or suspended but that you are on probation. Do you think that happened by accident? We are hoping to get it down to Class One, reprimand. Tom, we want you doctoring here and not greens-keeping in Alabama. A good idea for all concerned, wouldn’t you say?”
    â€œYes.”
    â€œOkay. Now as far as LaFaye is concerned, my point is that she is neurological and not psychiatric, which puts her on my turf, right? So all we need to commit her to my program over at NIMH is your co-signature as consultant.”
    â€œI see.”
    Things have eased between us. Hands in slant pockets, he’s pushing himself off the wall by nodding his head. His spurs clink against the terrazzo. We’ve fallen into our standard medical comradeship, having gone to the same medical school, years apart. We did not know each other there but we remember the old Columbia joke which has almost become a password, a greeting, between us:
    â€œJust keep in mind, Tom, the two most overrated things in the world.”
    â€œI will.”
    â€œSexual intercourse and—”
    â€œJohns Hopkins University.”
    Bob Comeaux likes this because he knows I interned at Hopkins.
    The anger is gone, the threat withdrawn. Or did I imagine the threat? The threat: That if I don’t behave I could find myself back in the pine barrens of Alabama, driving the big John Deere.
    Bob Comeaux has always been skittish with me. The anger over Mickey LaFaye is something new and puzzling. The skittishness is old. It comes from something in his past which he is almost, but not absolutely, certain that I don’t know, can’t know. There is no reason why I should know, but the tiny possibility makes him skittish. Sometimes I catch him appraising me, wondering. It is a very small thing that I might know and it needn’t worry him, but it does. In fact I do know it, this curious little thing, and by the merest chance. It came from my reading the P & S Alumni News two years ago. You know a physician is not doing well when he has nothing better to do during office hours than read the alumni news. One’s eye skims down the listed names for someone familiar in “Necrology”—who died?—in reunions, newsy notes from alumni, honors. What my eye caught was not a name but a town, this town, in “Alumni Notes,” and opposite the name of the physician, a Dr. Robert D’Angelo Como, and the breezy note: “Bob doing yeoman work in the brain pharmacology of radioactive ions at NIH’s Feliciana Qualitarian Life Center—an appropriate name for a Qualitarian satellite, reports Bob, who describes himself as a converted Johnny Reb with his own hound dawgs, hosses, and ham hocks.” Hm. The familiar mixture here of professional seriousness and the always slightly deplorable tone of medical bonhomie. But Como? Not Comeaux? That’s what worries Bob. I can imagine what happened. It was his twenty-fifth class reunion and the secretary got his name not from his letter but from his class roster—yes, there he is on the reunion list, Dr. Robert D’Angelo Como. A small matter certainly, especially in Louisiana, where name changes were commonplace to