The Diagnosis

by Diana Senechal

If it ever snowed on Sacramento Street, if one thousand and one kitchen elves took out all their snow-sifters and squeezed them slowly, creak-creak, over Prescription Hill (a nickname for the Laurel Heights neighborhood in San Francisco, where the psychiatrists come to roost), or, in another mood, fluffed out their snowy wings and flew in miniature, letting feather upon miniscule feather fall, it would be exactly what you've been waiting for me to tell you it would be: a snapshot. It would click. Any memorabilia collector would gloat.

It would please even the memory collectors: not only me, actor-diarist Julian Cole, ever nostalgic for things to come, but, even more significantly, my shrink. A lot of psychiatrists, whatever their religion, if any, have an affection for Christmas, Chanukah, candles, colored lights, fir trees, chocolates, woolen stockings, ruddy babies in foot pajamas, sundown and street lights, glittering vitrines, the counting of days, the songs and blankets, all those things that separate the warm from the cold, the home from the world, and, by the same token, wrap, lump, unostracize things, turn bayonets into round-headed puppies, pick-up-sticks into spoons, beak-nosed insights into soft-sloping evasions. Psychiatrists like opposites, the more impossible the better, in the same place at the same time, so there's another reason for snow in the neighborhood.

They (the psychiatrists; we're past the elves now) would take out their shovels if they had them. My shrink, Dr. Golovchenko, would arrive a little later than the rest, unequipped and embarrassed. He'd run across the street to the gourmet hardware store and buy one. "Mighty cold out there today," he might comment like an ordinary guy. "I'm in the market for a shovel, as you can imagine." He'd take care not to use words such as "affective" and "dysphoria" lest he intimidate the poor uneducated hardware store worker, while said hardware store worker, who happens to be the highly educated songwriter and lead singer of a clever country band I go hear a lot, guards his vocabulary as well, but for other reasons, which I think you can imagine. I'll tell you more about him later. His name's Evan. He doesn't like me very much.

At this point all the shrinks, including mine, would have shovels. They'd start hacking at the ice on their steps so none of their patients would slip (though a different kind of slip was highly desirable in their book). They'd say "good morning" ever so quasi-socialistically to the street sweepers doing their community service, those unfortunates of the petty crime world who hover between the penitentiary and functional society, missing court dates again and again, doing their time in the grime. A psychiatrist has two dreams: the first, to be one of the people; and the second, to be separate, above, beyond the people. Proof: Dr. Golovchenko wears a beanie outdoors but never in the office. So shoveling snow on the steps isn't as plebeian as it looks. The labor is elevated; the elevator, belabored. The shops no one can afford on this street are for them (they don 't actually shop there, lest their patients see them, but they appreciate the décor): the hardware store where we saw them buy their fifty-dollar shovels, the café where you are expected to tip one hundred percent, the shabby chic boutiques, the facial salon, enough royalty of fashion to gild the shovel with silver so it's not a shovel at all, but a theatre prop, a royal artifact, an ecstatic invention-but wait, this is all a fantasy. There is no snow on Sacramento Street, San Francisco. The psychiatrists rarely emerge. The elves have dissipated. The little birds have flown.

You see the patients (like me, but I'm not really one of them; I'm here for a specific, limited reason, and expect to be on my way shortly) outside with their cigarettes, out in the stairwells with the "No smoking on stairwell" signs that clearly acknowledge the eternal presence of smokers, patients having that last drag before the session, the swig of coffee, the "hello, how are you," gestures of courtesy towards their embarrassed accomplices who see them and are seen, who know which magazines they like and what they smoke-that's the action out on the steps and in the warm waiting rooms, and when winter comes, it's just another day. "It sure would be pretty if it snowed," says George, who says the same thing every time, and is here for obsessive-compulsive disorder, big surprise. I don't think the waiting room is all that good for him. He sits there for two hours rotating the same four comments (It sure would be pretty if it snowed, Your doctor is in, I'm here for OCD, Have a good day now) with smoke breaks out on the steps. I wish it would snow so he'd be shocked out of his pattern. Repetition is so much the beef of therapy and theatre that we have to resist it even as we succumb. We have to succumb even as we resist. Get my drift? No chance of anything but eternal conflict. And so, in the spirit of eternal conflict, the door squeals open, and I am invited in.

* * *

I see no need to tell about my therapy session with Dr. Golovchenko. It's private, for one thing, and for another, I want to save the story for Becky when she gets off work. She's a pharmacist at Walgreens, where I'm going right now to pick up my prescription. We probably never would have met if I hadn't picked up a case of giardia last year just before the opening of Teeth, a new and original high tragedy about dentists, which I co-wrote and in which I starred. It was-no, is, is, is!-a brilliant modern-day adaptation of Macbeth in a dentist's office, only the Macbeth figure here is a dental assistant Raisa (Ra-EE-sa, and trill that "r") who has learned from her tarot reader that she will be the dentist of the office one day and her name will be on the door. She gets overexcited and starts badmouthing the dentist (my role), a very kind Dr. Bonjour. Business drops off. Then Dr. Bonjour, unaware of all this, gets diagnosed with a degenerative illness and tells Raisa he would like nothing more than to hand the office over to her, since she has her certification and is ready for that sort of responsibility. He dies peacefully. Raisa starts her business, but by now Dr. Bonjour's former patients have caught on to her and are making so much noise about it, her practice fails miserably. She ends up pulling her own teeth. Quite a play. The San Francisco Weekly says it "hovers nervously on the edge of political incorrectness, never quite traversing but instead making the most of the line." They sure have a way of putting things. I mention all this because if I weren't afflicted, I'd be quite proud.

What a time to get giardia, just before opening night. Were it not for the metronidazole, I would have had to take more exits than were originally written into the play. This would have marred the tragedy. I was compassionate enough to get myself to the doctor and then to Walgreens. To bring the story around again, that's how I met Becky three years ago. I have had no prescriptions between then and now.

The pharmacist had round-rimmed glasses and sandy hair down to her shoulders. I started trying on the shades on the rack and posing with them and the first health book I spotted. I'd tilt back a little, adjust the rim, open the book, and start to read with a grin. She showed no reaction whatsoever. "Your prescription is ready, Mr. Cole," was all she said. I told her I'd be getting the shades too, and could I please keep them on? She said, "You'll have to remove them so I can scan them first." Impeccable professionalism. She went through the prescription information with me ("Call your doctor immediately if you experience any of the following: seizures, shortness of breath, dizziness or loss of coordination.") and verified my address and phone. When giving her my phone number, I made my consonants crisp; then, sliding into a slur, I said she should try calling it sometime for fun. She didn't smile. "Is there anything else I can do to enhance your consumer experience today?" she asked, deadpan. I stood and grinned at her. "Have a good day, Mr. Cole," she said. She called me that evening. We had sex that night (one of the three times we have had sex-we have been "buddies" for the most part, though this will change eventually).

I'm not much of a pill-popper, so I had few chances to visit her on the job. My excuses for going to Walgreens were strained (nail clippers, shampoo, a birthday card). When I did see her, the same impeccable standards of professionalism were maintained. She never took off her glasses. We didn' t show any outward sign that we knew each other. I was Mr. Cole, not Julian, and had no reason to pay for my items at the prescription window, since there were other cash registers open.

She went about her job with precision. I saw her catch a scammer once. "You were Mr. Koleslawski last week, sir," she said. "I'm going to have to see some ID."

Then I watched (wearing shades and reading a health book, as usual) as she got berated by her glazy-eyed supervisor, Thad for interfering with the consumer experience. "We're not the FBI here," he reminded her. "We fill prescriptions. If the consumers don't feel comfortable here, they'll go to a different store, or worse, another Walgreens branch. That makes us look bad." She could have argued with him. She could have knocked him down with arguments. She just nodded. Later she told me it was an inside joke. Play-acting, she said.

All right, so I do have to tell you a little about my session, or you won't really know what's going on. Dr. Golovchenko studied botany before switching to human medicine. He had a great love for trees. In fact, there were Ansel Adams photographs of trees in his office. "A tree is nothing without its roots," he liked to say. "Or rather, it is pure lumber." I went to him because my lower half had started to shake, and I thought my roots were coming up out of the ground-maybe it was because of the holes the dogs had dug in the yard of my life out of sheer need of something to chew. Imagine who the dogs might be. Name that pug. In any case, I had started going to alt-country shows (that's alternative country, country music with a twist, in case you're not part of that world) because my feet could be restless in those places and it looked like I was dancing. In fact, I was doing that more often than acting. The stage made me uneasy when I was up on it. I was getting shifty. The roles of dentists and kings didn't suit me any more. I was turning into an elf in a six-foot body. Sometimes, on the bus, looking out the window, I for no reason whatsoever would emit a high-pitched nonsense word like "prillergate."

I was trying to get into Yale Drama School, and had been turned down three years straight, albeit with mixed messages from my guru-to-be, Professor Michelle Cambray. This last time worried me because Cambray (whom I'll call Michelle from now on, if I end up mentioning her again, because informality gets you in the door) said in her very nice rejection letter that my application this year was "somewhat shaky," and maybe a hiatus from the application process would help me focus on the art of acting itself. Shaky was indeed a good word (a blow, but an apt one), because my handwriting had become dismal. I couldn't even hold a cup of coffee without spilling some. I avoided handshakes because of my sweat and tremors.

The country music shows seemed to offer me a home. The songs were all about sweat and tremors. That singer Evan I was telling you about, he had some great lyrics. I loved hearing him sing. I'd go to the clubs by myself and shut out all the gabbing around me, or try to, and take in that sweet sarcastic sadness. Then the show would be over, and the couples and groups of friends would stand around with their beers, talking on and on until they got kicked out. I'd usually stick around a little. Once I introduced myself to Evan. He said "nice to meet you" as though he had to do this a thousand times a day. I understood how it must be for him, being approached by a stranger, but I thought maybe we'd hit it off. Maybe we could talk about all these things that don't seem to have a place in the everyday world. So another time I asked him if he'd like to get together for a beer. He said sure, that would be great. Then he never did. Never called me. I called him a few times. It felt like a crush. It was a crush in a way. A crush on music and the person who made it. A soul. I called more than a few times. Then I got very sad. I couldn't understand why someone who could do all that onstage wouldn't be capable of the most basic honesty, of telling me he wasn't up for a beer. Every time I saw him, he slid around his own sliding, saying something like, "I got your messages, I'll call you." It never happened. I kept on going to the shows, cause I loved the music. But the little social circles there got louder and louder in my ears, and my own question, "Why am I all alone?" got louder still.

Then Becky showed up in my life. I thought I'd be less lonely. That's what I thought. Thoughts can be like paper over windows. And paper comes from lumber.

If you have any more questions about why I entered therapy, keep them to yourself, because I want to get on with my story, which now is more like a diary, because I have caught up mentally with the present moment, against which I rub and squeak most irritatingly.

"There's a syndrome observed in certain plants," began Dr. Golovchenko. "They fertilize themselves, but can't reproduce. It's very common in milkweeds. A similar disorder has been shown to exist in certain humans. It' s known as Late-Acting Self-Incompatibility. It can be best described as a post-fertilization rejection event."

"Post-fertilization?" I nearly shrieked. "I've never fertilized anyone!"

"No, but you could."

"Excuse me?" "The capacity to fertilize, in both a literal and a metaphorical sense, is clearly present. The barriers to fertilization do not originate in the physique. Hence the term 'Late-Acting.'"

"I see no barriers to my metaphorical fertilization, Doctor. I've been quite prolific, in fact."

Dr. Golovchenko cocked his head to the left.

"All right, so I haven't been."

Dr. Golovchenko cocked his head to the right.

"All right, so I've been downright unprolific."

"Over the past ten months that I have seen you, Mr. Cole, I have noticed a growing resistance to those very things that you claim to want."

"So, is there hope?"

Dr. Golovchenko straightened his head, set his eyes a-flaring and cheeks a-glowing, and told me about the new medication Arbitrol. The dose was irrelevant, but the regularity was not, he explained; it was like flipping a timed switch. I would feel instant results, but I had to take it every day at the same time, or I'd be flipping back and forth, putting myself at risk for more severe disorders.

"Will Michelle recognize my talent if I take it?"

"It won't matter. Your new productivity will make her judgements irrelevant."

"Well, I guess that would be a good thing, then. I've been in agony over my standing with her."

Dr. Golovchenko wrote me a six-month prescription.

"Have a good day now," said George as I left. He was out on the steps having a smoke.

I had every right and responsibility to go to Walgreens now. Becky had asked for a break from me, and I couldn't take it. I hadn't seen her for a week. Now we'd just have to face each other. She couldn't deny me my medicine. I could have gone to a different Walgreens, not the one on Market Street, but that would have delayed the action and caused irreparable harm to her branch and my day.

I know. It seems a little pushy to go there with a prescription just at the time when she has asked for a break from me. It seems downright annoying. But why, why, why has my presence become so unbearable? Is my existence offensive in some way? Is the stage a cliff? Do I get up on it because there's always the option of throwing myself off? Is that my attraction to drama: the precipice, the constant hint of an end to the whole damn thing? If so, why haven't I been up on stage in three months? Why do I walk among the people? And why am I so unhappy?

* * *

When I gave her my prescription, she didn't do what I expected her to do. She didn't say, "One minute, Mr. Cole." Nor did she do the other thing I thought she might do: berate me for coming in. A mother was sitting behind me, telling her rambunctious Ben to stay still. Ben was jumping all around, taking things from shelves, and saying, "Mommy, Mommy, when are we going to Daddy's?" A young couple hovered nearby, fingering the vitamin bottles and smiling at each other as though the antioxidants turned them on. "Arbitrol. No. Don't do it, Julian."

"You're stepping out of role, Becky. You're on the job."

"No, you don't get it. There is no need for this. If you've got to take something, ask your doctor for something else. I've read the reports."

"What happens? Do people start growing leaves?"

"No. They-I don't know how to describe it, but it scares me. Something happens to them right away. And they seem to think it's good, though I can't tell what's so good about it at all."

There was silence around. Even little Ben was hushed. I held center stage for the moment. It wasn't what I wanted. I had been on the periphery, and Becky had stubbornly tilted me into the middle and put a megaphone before my mouth, making a mockery of my profession. I was attaining the apex of my career in a goddamn drugstore.

"Becky, you're not my doctor. I want my prescription filled."

She called Dr. Golovchenko. She sounded a little worried on the phone: "Are you sure he has this? Is there anything I should tell him about the drug?" I was getting so nervous I went from aisle to aisle looking for crayons. A damned half hour of crayon-browsing. There was a color called Algae Green. Christ. Oy vey. Finally:

"Mr. Cole, your prescription is ready."

I ran back to the counter. She held the bag up. Her hand shook a little. Her eyes were red.

"I'm sorry I've been avoiding you," she said. "I just needed a little space-I know, that's what they all say, but don't you understand what that means, Julian? Don't you understand about patience? You know, letting things sift themselves through? What about seasons? Or snow? Or hibernation?"

"Stop by tonight," I said. I was getting restless. "We can make some pie or something." I figured it might be fun to have her around that evening, giving me lots of attention while I was already feeling good. Might as well make the most of the lead while I had it.

This ends my journal. I have a feeling I won't need a journal any more. They make these wretched bottles so damn hard to open. Why? Here's my pill. Here's my precipice. Here's my school of drama.

* * *

This questionnaire is designed to gather data about Arbitrol and its effects. Please answer the questions in as much detail as possible. In addition, you may be contacted for optional interviews and clinical studies. Please describe your first physical and emotional responses to the medication. Approximately how soon after ingestion did you notice an effect? Did the effect change in any noticeable way within the first few hours? Were there any immediate changes to your daily routine? Any additional comments welcome.

I took my first pill within minutes of filling my prescription. My girlfriend (if you could call her that) was working at the pharmacy. She didn't want me to take it. I don't think she had any idea how much I was suffering and what sort of mess I had in my head. I went ahead and took it. At first I didn't feel anything. Within about five minutes there was a powerful sifting sensation in my body. I felt a release of something. It's not like I felt light or euphoric. I just felt simpler.

I had invited Becky over that evening. Truth is, after feeling normal all of a sudden, I didn't really want her around. I live in one of those artsy apartments in the seamy Tenderloin district. All sorts of actors and musicians live there because it's cheap and connected with the underbelly of life. I didn't care for that any more, but home I went.

She came at 8:30. She brought ingredients for a pumpkin pie. I was watching the basketball game (the Bucks were winning, which was how I wanted it) and having a beer. I told her to go ahead and make the pie. She started talking about things. It all sounded curly, her language. It sounded like ribbons. I wasn't paying much attention. She was like a silhouette sometimes because of the bright street lamp right outside. She'd move in and out of color, like a broken TV. This I saw out of the corner of my eye. I told her to stop moving around so much. She held up the sifter and said, "look, it's snowing!" She was sifting flour right onto the table, making a mess in my very own kitchen. This was too much. I got up, walked into the kitchen, and slapped her in the face. She shrieked. I told her to shut up and let me watch my game, or else leave. It wasn't a big deal or anything, I was just annoyed.

She quieted down. For a while anyways. I got back to my game. Then Becky came out with the unbaked pie. She showed it to me. "Look how pretty the crust is," she said. I shrugged my shoulders. It looked like a stage. One of those round stages in an amphitheater. Well, it didn't really look like a stage. More like a frog pond. It just reminded me of a stage because she made it and because she didn't know what I knew. She didn't know life could be different. I told her to put it in the oven.

I thought I could watch my game in peace at last. She started crying. She told me she missed me. She said life wasn't supposed to have quick fixes. That it was all right to feel out of sorts with the world. After a few of those rantings, I realized I had the power to shut it out. I shut it out, and shut her out. I didn't see that speck in the corner of my eye any more. I don't think the Arbitrol reaction changed. I just learned how to make the most of it. When the game was over (the Bucks won), I saw she had left. There was a note on the table saying, "Take out the pie at 10:30." Which it was. I took it out. It smelled all right. I went to bed. That was the first day, and the only time I had to slap Becky. She was gone from my life after that. Well, almost. A girl like that takes her time clearing out. She's egotistical, like I used to be. She wants to make her mark.

Please describe any further reactions to the medication, as well as changes in lifestyle, that you have experienced within the past month.

Arbitrol works well for me. Physically I feel normal. There's nothing to report. My appetite is normal, my sleep is normal, all my bodily functions are as they should be. Emotionally I'm just fine. Nothing seems like a big deal. As far as work goes, I'm finally getting on track after all those years of artistic fantasies. I've been temping at a bank, and it looks like I'll have a permanent job there soon. Then I can work on moving up. I realized that that's what having a job is all about. You get your foot in the door, you start making money, you do well, you move up. It's that simple. People throw in all sorts of idealistic baggage, but they're just making their lives more complicated that way. They want to make money too, they just don't admit it. Come on, everyone's got bills to pay. Is there anything virtuous about not being able to pay them? Sure, the world needs artists, but there are just too many of them right now. Too much self-indulgence and refusal to grow up.

I went to a country music show for old time's sake. Evan was playing that night. I brought a few work buddies. We had some beers and shot the breeze. I realized that's what people do. They go there in groups and talk during the performance. I should've done that all along. It feels just fine. You hear just enough music in the background to know you went out to a club. You don't have to bother with the goddamn angst of the whole thing. Sure, you get some entertainment out of it, but you don't make it more important than it is. After starting Arbitrol I thought of becoming an arts critic. I finally understood what critics were getting at. But then I realized I didn' t want to bother. Being a critic is like standing around and yapping in a dog park. Why go there in the first place, that's what I say.

I got a letter from Becky just yesterday. I was going to throw it away, but then decided I should read it, it would remind me how much I've changed. That's exactly what it did. It made me proud of the way I am now. Here's what it said:

In every relationship a line gets crossed just once. What happens afterwards, depends. It's the line of beauty. In the beginning, one person is enthralled by the other person's beauty, to the point where his or her own beauty is overshadowed. Not that he or she has a poor self-image or anything. That's not necessary. It's just that the other person's beauty is big and troubling and makes everything rattle. Sometimes it's mutual. Usually not quite, I don't think. Close, but not quite mutual. I think one person is always a little bit more in love than the other. Well, one day that line of beauty is crossed, and it's not that the other person is less beautiful, it's just that the beauty stops rattling things in the same way. It's the point of letdown that can either make things much better or bring them to an end. I thought you were going to reach that point with me, but you didn't wait it out. You had to rush there with the Arbitrol, so you didn't really experience it. Well, I've reached that point with you, Julian. You're still beautiful to me but it doesn't rattle me. Or maybe it rattles me a little, but not enough to throw me off kilter. And I'm sad. And I forgive you for slapping me. And I don't want to see you again. Love, Becky.

A bit too many words, I think. I've started dating a simpler sort of gal, from Colombia. She doesn't speak much English, doesn't speak much at all. She's very pretty and knows how to make me happy. We don't discuss our relationship. We just have it. I was very surprised to find out she was taking Arbitrol too. Her aunt was taking Arbitrol and said it was good for nightmares. She tried one of her aunt's pills and felt better. When the effect wore off, she went to the doctor (a "real doctor," not a psychiatrist, because she wasn't crazy) who told her she had anxiety and gave her a prescription. She has been sleeping soundly ever since.

She feels at home here, very American. We like doing the same things. She doesn't interrupt me when I'm watching my games, and she doesn't make a big deal about the things she cooks. And then I take her dancing, and she likes that. She dances better than anyone else there. Marriage is definitely in the picture. I've been putting aside some money for a ring. All in all, I have to say that Arbitrol has been a success, and that I only wish I had taken it sooner. It feels very natural. In fact, it has more of a back-to-nature quality than anything I've ever known. I'm like a tree. A walking tree, granted, but a tree nonetheless. Stable, with growth potential and lots of seeds. I could impress a forest. I have monthly fifteen-minute sessions with Dr. Golovchenko (Why talk longer, when my obsessions have been lifted?), and remind him very happily that there are no more issues. The sessions are really for his benefit, so I can remind him that I don't need them. I don't mind doing that, though. I let him cock his head. It makes him happy, and it's my way of giving back.