Praying for Sleep

The rest of the day he spent with the remaining five patients, who weren’t employed or who had today, Sunday, off. The young men and women each had a psychotherapy session with Kohler and then returned to the mundane chores of ru

Then, catastrophe.

Just before di

Kohler had found Ro

“What would you like to do about the noise?” Kohler now asked.

“I don’t know!” The patient’s voice was dull as he chewed his tongue-an attempt to moisten a mouth painfully dry from his Proketazine.

Adaptation causes stress-the hardest thing for schizophrenics to cope with-and, Kohler reflected, Ro

Outside, vaguely visible in the darkness, was a lawn that had been kept perfectly mowed by the patients all summer long and was now hand-stripped of every leaf that made the mistake of falling upon it. Kohler focused on the window and saw his haggard face in the black reflection, his eyes socketlike, his chin too narrow. He thought, for the thousandth time that year, about growing a beard to flesh out his features.

“Tomorrow,” Kohler said to his unhappy patient, “we’ll do something about it.”

“Tomorrow? That’s just great. I could be dead tomorrow, and so could you, mister. Don’t forget it,” snapped the patient-sneering at the man to whom he owed not only such peace of mind as he possessed but probably his life as well.

Even before he’d decided to attend medical school, Richard Kohler had learned not to take personal offense at anything schizophrenic patients said or did. If Ro

This was one of Kohler’s clinical errors. The patient, involuntarily committed at Marsden State hospital, had responded well to his treatment there. After many trials to find a suitable medication and dosage Kohler began treating him with psychotherapy. He made excellent progress. When one of the halfway-house patients had improved enough to move into an apartment of her own, Kohler placed Ro

“I don’t trust you,” Ro

Into his perfect memory Kohler inserted a brief mental notation about Ro

“That’s what I’m getting at. There isn’t that racket there.”

“No, it’s quieter.”

“I think I’d like to go back, Doctor. I have to go back,” Ro

“We’ll do it then. Tuesday. You get some sleep now.”

Ro

Kohler walked through the ground floor of the house, saying good night to the patients who were still awake and chatting with the night orderly who sat in the living room, watching television.

A breeze came through the open window and, enticed by it, Kohler stepped outside. The night was oddly warm for November. It reminded him of a particular fall evening during his last year of medical school at Duke. He recalled walking along the tarmac from the stairs of the United 737. That year the trip between La Guardia and Raleigh-Durham airports had been like a commute for him; he’d logged tens of thousands of miles between the two cities. The night he was thinking of was his return from New York after Thanksgiving vacation. He’d spent most of the holiday itself at Murray Hill Psychiatric Hospital in Manhattan and the Friday after it in his father’s office, listening to the old man argue persuasively, then insist belligerently, that his son take up internal medicine-going so far as to condition his continuing financial support of the young man’s education on his choice of specialty.

The next day, young Richard Kohler thanked his father for his hospitality, took an evening flight back to college and when school resumed on Monday was in the Bursar’s Office at 9:00 a.m., applying for a student loan to allow him to continue his study of psychiatry.

Kohler again yawned painfully, picturing his home-a condominium a half hour from here. This was a rural area, where he could have afforded a very big house and plenty of property. But Kohler’s goal had been to forsake land for convenience. No lawn mowing or landscaping or painting for him. He wanted a place to which he might escape, small and contained. Two bedrooms, two baths and a deck. Not that it didn’t have elements of opulence-the condo contained one of the few cedar hot tubs in this part of the state, several Kostabi and Hockney canvases and what was described as a “designer” kitchen (“But aren’t all kitchens,” he had slyly asked the real-estate broker, “designed by somebody?” and enjoyed her sycophantic laughter). The condo, which was on a hilltop and looked out over miles and miles of patchwork woods and farm-land during the day and the sparkling lights of Boyleston at night, was-quite literally-Kohler’s island of sanity in a most insane world.

Yet tonight he made his way back into the halfway house and climbed the creaking stairs to a room that measured ten by twelve feet and was outfitted only with a cot, a dresser and a metal mirror bolted to the wall.

He stripped off his suit jacket and loosened his tie then lay on the cot, kicking off his shoes. He looked out the window at a dull spray of stars then, lowering his eyes, saw a ridge of clouds in the west slicing the sky in half. The storm. He’d heard it was supposed to be a bad one. Although he himself liked the rain, he hoped there wouldn’t be any thunder, which would terrify many of his patients. But this concern passed immediately from his mind as he closed his eyes. Sleep was all he could think of now. He could taste it. He felt the fatigue ache in his legs. He yawned cold tears into his eyes. And in less than sixty seconds he was asleep.