The Thanatos Syndrome

dispose of me with standard U.S. politeness, which is indeed the easiest way to get rid of people. Have a nice day—
    Or he might have decided that the ultimate putdown is this same American civility. What better dismissal than to treat someone you’ve known for forty years like a drive-up customer at Big Mac’s?
    Or: Feeling bad, tired, old, out of it, he might have drawn a blank.
    Or: Something strange has happened to him.

3. THEN ALONG CAME MY second case, which gave me my first clue that something queer might be going on hereabouts, that Mickey LaFaye was not just a solitary nut.
    Donna S—, a former patient, called to make an appointment.
    It was last Wednesday afternoon. Downtown was deserted. The banks were closed. The other doctors were playing golf. They’ve mostly moved out to the malls and the hospital parks, where they’ve built pleasant plantation-style offices with white columns and roofs of cypress shakes.
    Here I am, waiting for her, not exactly besieged by patients, sitting on the front porch of my office, my father’s old coroner’s building behind the courthouse, a pleasant little Cajun cottage of weathered board-and-batten and a rusty tin roof. It is October but it feels like late summer, the first hint of fall gentling the Louisiana heat, the gum leaves beginning to speckle. I am watching the sparrows who have taken over my father’s martin hotel. The cicadas start up in the high rooms of the live oaks, fuguing one upon the other.
    I am the only poor physician in town, the only one who doesn’t drive a Mercedes or a BMW. I still drive the Chevrolet Caprice I owned before I went away. It is a bad time for psychiatrists. Old-fashioned shrinks are out of style and generally out of work. We, who like our mentor Dr. Freud believe there is a psyche, that it is born to trouble as the sparks fly up, that one gets at it, the root of trouble, the soul’s own secret, by venturing into the heart of darkness, which is to say, by talking and listening, mostly listening, to another troubled human for months, years—we have been mostly superseded by brain engineers, neuropharmacologists, chemists of the synapses. And why not? If one can prescribe a chemical and overnight turn a haunted soul into a bustling little body, why take on such a quixotic quest as pursuing the secret of one’s very self?
    Anyhow, there I sat, waiting for Donna and making little paper P-51s and sailing them into the sparrows flocking at the martin house. I have had enough practice and gotten good enough with the control surfaces so that the little planes generally made a climbing turn, a chandelle, and came back.
    Here comes Donna, swinging along under the oaks. A stray shaft of yellow sunlight touches fire to her coppery hair.
    I watch her. She’s a big girl but not fat anymore. Not even stout or “heavy,” as one might say hereabouts. But certainly not fat in the sense that once it was the only word for her, even though physicians, who have an unerring knack for the wrong word, would describe her on her chart as a “young obese white female.”
    Then she was plain and simply fat. She was also, or so it seemed, jolly and funny, the sort described by her friends as nice as she could be. If she were put up for a sorority in college, she would be recommended as a “darling girl.” And if one of her sisters wanted to fix her up with a blind date, the word would be: She has a wonderful sense of humor. She was the sort of girl you’d have gotten stuck with at a dance and you’d have known it and she’d have known that you knew it and you’d have both felt rotten. Girls still have a rotten time of it, worse than boys, even fat boys.
    I used to see her alone at Big Mac’s: in midafternoon, I because I had forgotten to eat lunch, she because she had eaten lunch and was already hungry again; at four in the afternoon with a halfpounder, a large chocolate shake, and three paper boats of french fries lined up in front of her. Pigging out, as she called it.
    She was referred to me by more successful physicians who’d finally thrown up their hands—What do I want with her, they’d tell me, the only trouble with her is she eats too damn much, I’ve got people in real trouble, and so on—as a surgeon might refer a low-back pain to a chiropractor: He may be a quack but he can’t do you any harm. Maybe she’s got a psychiatric