Essay on Psychiatrists

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I. Invocation

It's crazy to think one could describe them—
Calling on reason, fantasy, memory, eyes and ears—
As though they were all alike any more

Than sweeps, opticians, poets or masseurs. 
Moreover, they are for more than one reason 
Difficult to speak of seriously and freely,

And I have never (even this is difficult to say 
Plainly, without foolishness or irony)
Consulted one for professional help, though it happens

Many or most of my friends have—and that, 
Perhaps, is why it seems urgent to try to speak 
Sensibly about them, about the psychiatrists.

II. Some Terms

“Shrink” is a misnomer. The religious 
Analogy is all wrong, too, and the old, 
Half-forgotten jokes about Viennese accents

And beards hardly apply to the good-looking woman 
In boots and a knit dress, or the man 
Seen buying the Sunday Times in mutton-chop

Whiskers and expensive running shoes.
In a way I suspect that even the terms “doctor” 
And “therapist” are misnomers; the patient

Is not necessarily “sick.” And one assumes 
That no small part of the psychiatrist’s 
Role is just that: to point out misnomers.

III. Proposition

These are the first citizens of contingency. 
Far from the doctrinaire past of the old ones, 
They think in their prudent meditations

Not about ecstasy (the soul leaving the body) 
Nor enthusiasm (the god entering one’s person) 
Nor even about sanity (which means

Health, an impossible perfection)
But ponder instead relative truth and the warm 
Dusk of amelioration. The cautious

Young augurs with their family-life, good books 
And records and foreign cars believe 
In amelioration—in that, and in suffering.

IV. A Lakeside Identification

Yes, crazy to suppose one could describe them—
And yet, there was this incident: at the local beach 
Clouds of professors and the husbands of professors

Swam, dabbled, or stood to talk with arms folded
Gazing at the lake ... and one of the few townsfolk there, 
With no faculty status—a matter-of-fact, competent,

Catholic woman of twenty-seven with five children 
And a first-rate body—pointed her finger 
At the back of one certain man and asked me,

“Is that guy a psychiatrist?” and by god he was! “Yes,” 
She said, “He looks like a psychiatrist.” 
Grown quiet, I looked at his pink back, and thought.

V. Physical Comparison With Professors And Others

Pink and a bit soft-bodied, with a somewhat jazzy 
Middle-class bathing suit and sandy sideburns, to me 
He looked from the back like one more professor.

And from the front, too—the boyish, unformed carriage 
Which foreigners always note in American men, combined 
As in a professor with that liberal, quizzical,

Articulate gaze so unlike the more focused, more 
Tolerant expression worn by a man of action (surgeon,
Salesman, athlete). On closer inspection was there,

Perhaps, a self-satisfied benign air, a too studied 
Gentleness toward the child whose hand he held loosely? 
Absurd to speculate; but then—the woman saw something.

VI. Their Seriousness, With Further Comparisons

In a certain sense, they are not serious.
That is, they are serious—useful, deeply helpful, 
Concerned—only in the way that the pilots of huge

Planes, radiologists, and master mechanics can, 
At their best, be serious. But however profound
The psychiatrists may be, they are not serious the way

A painter may be serious beyond pictures, or a businessman 
May be serious beyond property and cash—or even 
The way scholars and surgeons are serious, each rapt

In his work’s final cause, contingent upon nothing: 
Beyond work; persons; recoveries. And this is fitting: 
Who would want to fly with a pilot who was serious

About getting to the destination safely? Terrifying idea—
That a pilot could over-extend, perhaps try to fly 
Too well, or suffer from Pilot’s Block; of course,

It may be that (just as they must not drink liquor 
Before a flight) they undergo regular, required check-ups 
With a psychiatrist, to prevent such things from happening.

VII. Historical (The Bacchae)

Madness itself, as an idea, leaves us confused—
Incredulous that it exists, or cruelly facetious, 
Or stricken with a superstitious awe as if bound

By the lost cults of Trebizond and Pergamum ... 
The most profound study of madness is found 
In the Bacchae of Euripides, so deeply disturbing

That in Cambridge, Massachusetts the players 
Evaded some of the strongest unsettling material
By portraying poor sincere, fuddled, decent Pentheus

As a sort of fascistic bureaucrat—but it is Dionysus 
Who holds rallies, instills exaltations of violence, 
With his leopards and atavistic troops above law,

Reason and the good sense and reflective dignity
Of Pentheus—Pentheus, humiliated, addled, made to suffer 
Atrocity as a minor jest of the smirking God.

When Bacchus’s Chorus (who call him “most gentle”!) observe: 
“Ten thousand men have ten thousand hopes; some fail, 
Some come to fruit, but the happiest man is he

Who gathers the good of life day by day”—as though
Life itself were enough—does that mean, to leave ambition? 
And is it a kind of therapy, or truth? Or both?

VIII. A Question

On the subject of madness the Bacchae seems, 
On the whole, more pro than contra. The Chorus
Says of wine, “There is no other medicine for misery”;

When the Queen in her ecstasy—or her enthusiasm?—
Tears her terrified son’s arm from his body, or bears 
His head on her spear, she remains happy so long

As she remains crazy; the God himself (who bound fawnskin 
To the women’s flesh, armed them with ivy arrows 
And his orgies’ livery) debases poor Pentheus first,

Then leads him to mince capering towards female Death 
And dismemberment: flushed, grinning, the grave young 
King of Thebes pulls at a slipping bra-strap, simpers

Down at his turned ankle. Pentheus: “Should I lift up 
Mount Cithæron—Bacchae, mother and all?” 
Dionysus: “Do what you want to do. Your mind

Was unstable once, but now you sound more sane, 
You are on your way to great things.” 
The question is, Which is the psychiatrist: Pentheus, or Dionysus?

IX. Pentheus As Psychiatrist

With his reasonable questions Pentheus tries 
To throw light on the old customs of savagery. 
Like a brave doctor, he asks about it all,

He hears everything, “Weird, fantastic things” 
The Messenger calls them: with their breasts 
Swollen, their new babies abandoned, mothers

Among the Bacchantes nestled gazelles
And young wolves in their arms, and suckled them; 
You might see a single one of them tear a fat calf

In two, still bellowing with fright, while others 
Clawed heifers to pieces; ribs and hooves 
Were strewn everywhere; blood-smeared scraps

Hung from the fir trees; furious bulls
Charged and then fell stumbling, pulled down
To be stripped of skin and flesh by screaming women ...

And Pentheus listened. Flames burned in their hair, 
Unnoticed; thick honey spurted from their wands; 
And the snakes they wore like ribbons licked

Hot blood from their flushed necks: Pentheus
Was the man the people told ... “weird things,” like 
A middle-class fantasy of release; and when even

The old men—bent Cadmus and Tiresias—dress up
In fawnskin and ivy, beating their wands on the ground, 
Trying to carouse, it is Pentheus—down-to-earth,

Sober—who raises his voice in the name of dignity.
Being a psychiatrist, how could he attend to the Chorus’s warning 
Against “those who aspire” and “a tongue without reins”?

X. Dionysus As Psychiatrist

In a more hostile view, the psychiatrists
Are like Bacchus—the knowing smirk of his mask, 
His patients, his confident guidance of passion,

And even his little jokes, as when the great palace 
Is hit by lightning which blazes and stays, 
Bouncing among the crumpled stone walls ...

And through the burning rubble he comes, 
With his soft ways picking along lightly 
With a calm smile for the trembling Chorus

Who have fallen to the ground, bowing
In the un-Greek, Eastern way—What, Asian women, 
He asks, Were you disturbed just now when Bacchus

Jostled the palace? He warns Pentheus to adjust, 
To learn the ordinary man’s humble sense of limits, 
Violent limits, to the rational world. He cures

Pentheus of the grand delusion that the dark 
Urgencies can be governed simply by the mind,
And the mind’s will. He teaches Queen Agave to look

Up from her loom, up at the light, at her tall 
Son’s head impaled on the stiff spear clutched 
In her own hand soiled with dirt and blood.

XI. Their Philistinism Considered

“Greek Tragedy” of course is the sort of thing
They like and like the idea of ... though not “tragedy”
In the sense of newspapers. When a patient shot one of them,

People phoned in, many upset as though a deep,
Special rule had been abrogated, someone had gone too far. 
The poor doctor, as described by the evening Globe,

Turned out to be a decent, conventional man (Doctors 
For Peace, B’Nai Brith, numerous articles), almost
Carefully so, like Paul Valéry—or like Rex Morgan, M.D., who,

In the same Globe, attends a concert with a longjawed woman. 
First Panel: “We’re a little early for the concert! 
There’s an art museum we can stroll through!” “I’d like

That, Dr. Morgan!” Second Panel: “Outside the hospital, 
There’s no need for such formality, Karen! Call me 
By my first name!” “I’ll feel a little awkward!”

Final Panel: “Meanwhile ...” a black car pulls up
To City Hospital .... By the next day’s Globe, the real
Doctor has died of gunshot wounds, while for smiling, wooden,

Masklike Rex and his companion the concert has passed, 
Painlessly, offstage: “This was a beautiful experience, Rex!”
“I’m glad you enjoyed it! I have season tickets

And you’re welcome to use them! I don’t have 
The opportunity to go to many of the concerts!”
Second Panel: “You must be famished!” And so Rex

And Karen go off to smile over a meal which will pass 
Like music offstage, off to the mysterious pathos 
Of their exclamation marks, while in the final panel

“Meanwhile, In The Lobby At City Hospital”
A longjawed man paces furiously among
The lamps, magazines, tables and tubular chairs.

XII. Their Philistinism Dismissed

But after all—what “cultural life” and what 
Furniture, what set of the face, would seem adequate 
For those who supply medicine for misery?

After all, what they do is in a way a kind of art,
And what writers have to say about music, or painters’ 
Views about poetry, musicians’ taste in pictures, all

Often are similarly hoked-up, dutiful, vulgar. After all, 
They are not gods or heroes, nor even priests chosen 
Apart from their own powers, but like artists are mere

Experts dependent on their own wisdom, their own arts: 
Pilgrims in the world, journeymen, bourgeois savants, 
Gallant seekers and persistent sons, doomed

To their cruel furniture and their season tickets 
As to skimped meditations and waxen odes.
At first, Rex Morgan seems a perfect Pentheus—

But he smirks, he is imperturbable, he understates; 
Understatement is the privilege of a god, we must 
Choose, we must find out which way to see them:

Either the bland arrogance of the abrupt mountain god 
Or the man of the town doing his best, we must not 
Complain both that they are inhuman and too human.

XIII. Their Despair

I am quite sure that I have read somewhere 
That the rate of suicide among psychiatrists 
Is far higher than for any other profession.

There are many myths to explain such things, things 
Which one reads and believes without believing 
Any one significance for them—as in this case,

Which again reminds me of writers, who, I have read, 
Drink and become alcoholics and die of alcoholism 
In far greater numbers than other people.

Symmetry suggests one myth, or significance: the drinking 
Of writers coming from too much concentration, 
In solitude, upon feelings expressed

For or even about possibly indifferent people, people 
Who are absent or perhaps dead, or unborn; the suicide 
Of psychiatrists coming from too much attention,

In most intimate contact, concentrated upon the feelings 
Of people toward whom one may feel indifferent, 
People who are certain, sooner or later, to die ...

Or people about whom they care too much, after all? 
The significance of any life, of its misery and its end, 
Is not absolute—that is the despair which

Underlies their good sense, recycling their garbage, 
Voting, attending town-meetings, synagogues, churches, 
Weddings, contingent gatherings of all kinds.

XIV. Their Speech, Compared With Wisdom And Poetry

Terms of all kinds mellow with time, growing 
Arbitrary and rich as we call this man “neurotic”
Or that man “a peacock.” The lore of psychiatrists—

“Paranoid,” “Anal” and so on, if they still use
Such terms—also passes into the status of old sayings: 
Water thinner than blood or under bridges; bridges

Crossed in the future or burnt in the past. Or the terms 
Of myth, the phrases that well up in my mind: 
Two blind women and a blind little boy, running—

Easier to cut thin air into planks with a saw 
And then drive nails into those planks of air, 
Than to evade those three, the blind harriers,

The tireless blind women and the blind boy, pursuing 
For long years of my life, for long centuries of time. 
Concerning Justice, Fortune and Love I believe

That there may be wisdom, but no science and few terms: 
Blind, and blinding, too. Hot in pursuit and flight, 
Justice, Fortune and Love demand the arts

Of knowing and naming: and, yes, the psychiatrists, too, 
Patiently naming them. But all in pursuit and flight, two 
Blind women, tireless, and the blind little boy.

XV. A Footnote Concerning Psychiatry Itself

Having mentioned it, though it is not 
My subject here, I will say only that one 
Hopes it is good, and hopes that practicing it

The psychiatrists who are my subject here 
Will respect the means, however pathetic,
That precede them; that they respect the patient’s

Own previous efforts, strategies, civilizations—
Not only whatever it is that lets a man consciously 
Desire girls of sixteen (or less) on the street,

And not embrace them, et cetera, but everything that was 
There already: the restraints, and the other lawful 
Old culture of wine, women, et cetera.

XVI. Generalizing, Just And Unjust

As far as one can generalize, only a few
Are not Jewish. Many, I have heard, grew up 
As an only child. Among many general charges

Brought against them (smugness, obfuscation) 
Is a hard, venal quality. In truth, they do differ
From most people in the special, tax-deductible status

Of their services, an enviable privilege which brings 
Venality to the eye of the beholder, who feels 
With some justice that if to soothe misery

Is a tax-deductible medical cost, then the lute-player, 
Waitress, and actor also deserve to offer 
Their services as tax-deductible; movies and TV

Should be tax-deductible ... or nothing should; 
Such cash matters perhaps lead psychiatrists
And others to buy what ought not to be sold: Seder

Services at hotels; skill at games from paid lessons; 
Fast divorce; the winning side in a war seen
On TV like cowboys or football—that is how much

One can generalize: psychiatrists are as alike (and unlike) 
As cowboys. In fact, they are stock characters like cowboys: 
“Bette Davis, Claude Rains in Now, Voyager (1942),

A sheltered spinster is brought out of her shell
By her psychiatrist” and “Steven Boyd, Jack Hawkins 
In The Third Secret (1964), a psychoanalyst’s

Daughter asks a patient to help her find her father’s 
Murderer.” Like a cowboy, the only child roams 
The lonely ranges and secret mesas of his genre.

XVII. Their Patients

As a rule, the patients I know do not pace 
Furiously, nor scream, nor shoot doctors. For them, 
To be a patient seems not altogether different

From one’s interest in Ann Landers and her clients: 
Her virtue of taking it all on, answering 
Any question (artificial insemination by grandpa;

The barracuda of a girl who says that your glasses 
Make you look square) and her virtue of saying, 
Buster (or Dearie) stop complaining and do

What you want ... and often that seems to be the point: 
After the glassware from Design Research, after 
A place on the Cape with Marimekko drapes,

The superlative radio and shoes, comes
The contingency tax—serious people, their capacity 
For mere hedonism fills up, one seems to need

To perfect more complex ideas of desire,
To overcome altruism in the technical sense, 
To learn to say no when you mean no and yes

When you mean yes, a standard of cui bono, a standard 
Which, though it seems to be the inverse 
Of more Spartan or Christian codes, is no less

Demanding in its call, inward in this case, to duty.
It suggests a kind of league of men and women dedicated 
To their separate, inward duties, holding in common

Only the most general standard, or no standard 
Other than valuing a sense of the conflict 
Among standards, a league recalling in its mutual

Conflict and comfort the well-known fact that psychiatrists, 
Too, are the patients of other psychiatrists, 
Working dutifully—cui bono—at the inward standards.

XVIII. The Mad

Other patients are ill otherwise, and do 
Scream and pace and kill or worse; and that 
Should be recalled. Kit Smart, Hitler,

The contemporary poets of lunacy—none of them 
Helps me to think of the mad otherwise 
Than in clichés too broad, the maenads

And wild-eyed killers of the movies ...
But perhaps lunacy feels something like a cliché, 
A desperate or sweet yielding to some broad,

Mechanical simplification, a dispersal
Of the unbearable into its crude fragments, 
The distraction of a repeated gesture

Or a compulsively hummed tune. Maybe 
It is not utterly different from chewing 
At one’s fingernails. For the psychiatrists

It must come to seem ordinary, its causes 
And the causes of its relief, after all,
No matter how remote and intricate, are no

Stranger than life itself, which was born or caused 
Itself, once, as a kind of odor, a faint wreath 
Brewing where the radiant light from billions

Of miles off strikes a faint broth from water 
Standing in rock; life born from the egg 
Of rock, and the egglike rock of death

Are no more strange than this other life 
Which we name after the moon, lunatic 
Other-life ... housed, for the lucky ones,

In McLean Hospital with its elegant, 
Prep-school atmosphere. When my friend 
Went in, we both tried to joke: “Karen,” I said,

“You must be crazy to spend money and time 
In this place”—she gained weight, 
Made a chess-board, had a roommate

Who introduced herself as the Virgin Mary, 
Referred to another patient: “Well, she must 
Be an interesting person, if she’s in here.”

XIX. Peroration, Defining Happiness

“I know not how it is, but certainly I
Have never been more tired with any reading 
Than with dissertations upon happiness,

Which seems not only to elude inquiry, 
But to cast unmerciful loads of clay 
And sand and husks and stubble

Along the high-road of the inquirer.
Even sound writers talk mostly in a drawling 
And dreaming way about it. He,

Who hath given the best definition
Of most things, hath given but an imperfect one, 
Here, informing us that a happy life

Is one without impediment to virtue ....
In fact, hardly anything which we receive 
For truth is really and entirely so,

Let it appear plain as it may, and let
Its appeal be not only to the understanding, 
But to the senses; for our words do not follow

The senses exactly; and it is by words 
We receive truth and express it.”
So says Walter Savage Landor in his Imaginary

Conversation between Sir Philip Sidney 
And Fulke Greville, Lord Brooke, all three, 
In a sense, my own psychiatrists, shrinking

The sense of contingency and confusion 
Itself to a few terms I can quote, ponder 
Or type: the idea of wisdom, itself, shrinks.

XX. Peroration, Concerning Genius

As to my own concerns, it seems odd, given 
The ideas many of us have about art, 
That so many writers, makers of films,

Artists, all suitors of excellence and their own 
Genius, should consult psychiatrists, willing 
To risk that the doctor in curing

The sickness should smooth away the cicatrice 
Of genius, too. But it is all bosh, the false 
Link between genius and sickness,

Except perhaps as they were linked 
By the Old Man, addressing his class
On the first day: “I know why you are here.

You are here to laugh. You have heard of a crazy 
Old man who believes that Robert Bridges 
Was a good poet; who believes that Fulke

Greville was a great poet, greater than Philip 
Sidney; who believes that Shakespeare’s Sonnets
Are not all that they are cracked up to be .... Well,

I will tell you something: I will tell you
What this course is about. Sometime in the middle 
Of the Eighteenth Century, along with the rise

Of capitalism and scientific method, the logical 
Foundations of Western thought decayed and fell apart. 
When they fell apart, poets were left

With emotions and experiences, and with no way 
To examine them. At this time, poets and men
Of genius began to go mad. Gray went mad. Collins

Went mad. Kit Smart was mad. William Blake surely 
Was a madman. Coleridge was a drug addict, with severe 
Depression. My friend Hart Crane died mad. My friend

Ezra Pound is mad. But you will not go mad; you will grow up 
To become happy, sentimental old college professors, 
Because they were men of genius, and you

Are not; and the ideas which were vital
To them are mere amusement to you. I will not
Go mad, because I have understood those ideas ....”

He drank wine and smoked his pipe more than he should; 
In the end his doctors in order to prolong life 
Were forced to cut away most of his tongue.

That was their business. As far as he was concerned 
Suffering was life’s penalty; wisdom armed one
Against madness; speech was temporary; poetry was truth.

XXI. Conclusion

Essaying to distinguish these men and women, 
Who try to give medicine for misery, 
From the rest of us, I find I have failed

To discover what essential statement could be made 
About psychiatrists that would not apply 
To all human beings, or what statement

About all human beings would not apply 
Equally to psychiatrists. They, too, 
Consult psychiatrists. They try tentatively

To understand, to find healing speech. They work 
For truth and for money. They are contingent ... 
They talk and talk ... they are, in the words

Of a lute-player I met once who despised them, 
“Into machines” ... all true of all, so that it seems 
That “psychiatrist” is a synonym for “human being,”

Even in their prosperity which is perhaps
Like their contingency merely more vivid than that 
Of lutanists, opticians, poets—all into

Truth, into music, into yearning, suffering,
Into elegant machines and luxuries, with caroling 
And kisses, with soft rich cloth and polished

Substances, with cash, tennis and fine electronics, 
Liberty of lush and reverend places—goods 
And money in their contingency and spiritual

Grace evoke the way we are all psychiatrists, 
All fumbling at so many millions of miles 
Per minute and so many dollars per hour

Through the exploding or collapsing spaces 
Between stars, saying what we can.

© Robert Pinsky