Private Eyes

Rewarding each success with high praise and low art- cheap plastic toys that I bought in bulk at the five-and-dime. They thrilled her.

By the end of the month, she could sit in blackness- which sometimes made me lose my balance- for an entire session, free of tension, chatting about school.

Soon, she was as nocturnal as a bat. I suggested it might be a good time to work on her sleep. She smiled and agreed.

I was especially eager, because this was my bailiwick. During my internship I’d been presented with several cases of children with chronic night terrors and had been impressed with the level of disruption the episodes caused in kids and their families. But none of the psychologists or psychiatrists at the hospital knew how to treat the disorder. Officially, there was no treatment other than tranquilizers and sedatives whose effects were unpredictable in children.

I went to the hospital library, chased down references, found plenty of theory but nothing about treatment. Frustrated, I sat for a long time thinking and decided to try something outlandish: operant conditioning. Bald behavior therapy. Reward the children for not having terrors and see what happened.

Simple-minded- almost crude. Theoretically, it made no sense. As the senior staff was quick to inform me over their fuming pipes. How could unconscious behavior- arousal from profoundly deep sleep- be consciously manipulated? What could voluntary conditioning accomplish in the face of hard-wired deviance?

But research had emerged recently that suggested greater voluntary control over body function than had ever been imagined: patients learning how to raise and lower skin temperature and blood pressure, even mask severe pain. At Psychiatric Case Conference, I asked for permission to try to decondition night terrors, arguing that there was nothing to lose. A lot of head-shaking and words of discouragement, but consent was granted.

It worked. All my patients got better and stayed better. The senior staff started implementing my plan with their patients and achieved similar results. The chief psychologist told me to write it up for a scientific journal, listing him as co-author. I sent the article in, overcame skeptical reviewers with columns of numbers and statistical tests, and got published. Within a year other therapists had begun to replicate my findings. I received requests for reprints and phone calls from all over the world, was asked to give lectures.

Had been doing just that the day Eileen Wagner had approached. It was the lecture that had led me to Melissa.

And now Melissa was ready to be treated by the expert. But there was a problem: The technique-my technique- depended upon family cooperation. Someone needed to monitor the patient’s sleep pattern precisely.

I buttonholed Dutchy on a Friday afternoon, before he had a chance to dash away. He gave a resigned look and said, “What is it, Doctor?”

I handed him a pad of graph paper and two sharpened pencils and, adopting the demeanor of a full professor, gave him his orders: Before bedtime, Melissa was to practice relaxation. He wasn’t to badger or remind her; it would be her responsibility. His job was to record the occurrence and frequency of night terrors. Nights without terrors were to be rewarded the following morning with one of the trinkets she seemed to love so much. Nights following terrors were not to be commented on.

“But, Doctor,” he said, “she’s not having them.”

“Not having what?”

“The terrors. Her sleep’s been perfectly calm for weeks. The bed-wetting’s also ceased.”

I looked over at Melissa. She’d stepped behind him. Half a small face peeked out. Enough for me to see the smile.

Pure joy. Reveling in her secret, as if it were confection.

That made sense. The way she’d been brought up, secrets were the coin of the realm.

“The change has really been quite… remarkable,” Dutchy was saying. “That’s why I didn’t feel it was necessary to-”

I said, “I’m really proud of you, Melissa.”

“I’m proud of you, Dr. Delaware,” she said, starting to giggle. “We’re an excellent team.”

She continued to get better more rapidly than science could explain. Leapfrogging over my clinical games plans.

Healing herself.

Magic, one of my wiser supervisors had once said. Sometimes they’ll get better and you won’t know why. Before you’ve even started doing what you think is so goddam clever and hotshot scientific. Don’t fight it. Just put it down to magic. It’s as good an explanation as any.

She made me feel magical.

We never got into the topics I’d thought essential to explore: death, injury, loneliness. A Mikoksi with acid.

Despite the frequency of sessions, her chart was thin- I had very little to record. I began to wonder if I was functioning as anything more than a high-priced babysitter, told myself there were worse things to be. And, faced with the onslaught of difficult cases that seemed to grow each month as my practice burgeoned, I was thankful for the chance to be passive and magical for forty-five minutes a day, three times a week.

After eight months she informed me that all her fears were gone. Risking her wrath, I suggested reducing our time together to two sessions a week. She agreed so readily that I knew she’d been thinking the same thing.

Nevertheless, I expected a few backward steps as the loss sank in and she attempted to buy herself time and attention. It never happened, and at year’s end she was down to one session per week. The quality of the sessions changed, too. More casual. Lots of game-playing, no drama.

Therapy winding itself down. Triumph. I thought Eileen Wagner would like to know, made one more attempt to reach her, got a disco

Puzzling. But she wasn’t my concern. And one less report to write wasn’t something I’d mourn.

For such a complicated case, it had turned out surprisingly simple.

Patient and doctor, slaying demons.

What could be purer?

The checks from Fiduciary First Trust kept coming, three figures at a shot.

The week of her ninth birthday, she arrived with a gift. I had none for her- had decided long ago never to buy patients anything. But she didn’t seem to mind and glowed from the act of giving.

A gift too big for her to carry. Sabino brought it into my office.

Massive basket of crepe-paper-wrapped fruit, cheeses, wine samples, tins of caviar, smoked oysters and trout, chestnut paste, jars of preserves and compotes, from a gourmet shop in Pasadena.

Inside was a card.

TO DOCTOR DELAWARE, LOVE, MELISSA D.

On the reverse side was a drawing of a house. The best she’d ever done- carefully shaded, lots of windows and doors.

“This is beautiful, Melissa. Thank you very much.”

“Welcome.” Smiling, but her eyes had filled with tears.

“What’s the matter, hon?”

“I want…”

She turned around and faced one of the bookcases, hugging herself.

“What is it, Melissa?”

“I want… It’s time maybe… to… for no more…”

She trailed off into silence. Shrugged. Kneaded her hands.

“Are you saying you want to stop coming for sessions?”

Multiple rapid nods.

“There’s nothing wrong with that, Melissa. You’ve done great. I’m really proud of you. So if you want to try it on your own, I understand and I think it’s terrific. And you don’t have to worry- I’ll always be here if you need me.”

She whipped around and faced me.

“I’m nine years old, Dr. Delaware. I think I’m ready to handle things on my own.”