Savoring the slow walk across campus, Friedland allowed himself to bask in the admiring nods and greetings from students and colleagues. When he entered the dingy corridor to his lab in Kovell Hall, it felt like the home stretch of a victory lap. He spoke briefly with Helen Beryl, his across-the-hall colleague—or rather listened as she praised the talk he’d just given—then stepped into his office, tossing the folder with his notes on the desk. As he was hanging his new burgundy suit jacket on the hook next to the door, he heard, coming from directly behind him, a deep voice uttering something between a nervous giggle and mumbled gibberish. Alarmed, he spun around, momentarily losing his balance but recovering with an awkward shuffle.
The man sitting in one of the two old bentwood chairs against the wall slowly nodded his head, gazing at Friedland with squinty, yellowish eyes and smiling the conspiratorial grin of a childhood friend or a psychotic. The skin on his face and neck and bald head was mottled with blistery pink blotches and grayish rust spots from decades of sun damage. He’d let what hair he had at the sides and back of his head grow long enough to gather in a short ponytail, a reddish blond streaked with white and stiff with grease and dirt. Most of the rest of his upper body was draped in an oversize silk shirt whose faded floral print featured exotic lilies and butterflies. He had the husky, muscular body of an old prizefighter, but Friedland’s practiced eye judged him harmless.
“Hey man, Dr. Friedland. So, wow, yeah.” He looked familiar, was almost certainly a former patient, but not from the past couple decades—Friedland had a good memory for those he’d treated. He might not recall a name right away, but could nearly always match a face to a set of symptoms. The man in front of him wasn’t ringing any diagnostic bells. “So, yeah, how the heck are ya?” His voice, burnished with decades of cigarettes and heavy drinking, had a masculine, even charismatic rasp.
Flush with the success of a masterful performance, yet in the presence of an unfortunate soul, Friedland opted for modesty. “Oh, getting by.” He paused, trying to figure out what tack to take, not wanting to reveal his lapse. “It’s been a good while, hasn’t it.”
The man ran his fingers over the discolored skin of his head. “Jesus, yeah, long time. Like, too long. ’Cause I think about you sometimes, you know? I wonder, What is ol’ Dr. Friedland up to, I should look him up. But you know how it goes, time passes, you don’t always get around to, you know, something will come along and it’s like, hey.” He had initially figured the man to be his own age, but subtler cues—the way he spoke and gestured, his body movements, the undamaged skin on the inside of his forearms—placed him somewhere in his mid-forties, a good dozen years younger.
“Well, and how have you been?” He said it in his professional tone, friendly, curious, with the lilt of avuncular concern, though in fact he was just fishing for information that might trigger recognition. And thinking he must have seen this man back in the days on the ward at L.A. County General, or even during his fellowship at Harbor—the early years when the parade of patients, many of them down-and-out like this guy, was an overwhelming, exhausting blur. The man would have been a teenager then, which would explain the difficulty in identifying his face.
“Oh, you know. Well not so great at the moment. To be honest, pretty bad.” He paused, perhaps waiting for a prod to elaborate, but Friedland was in his attentive healer mode—engage, listen, evaluate. “But if you mean, like, generally, over the years big picture, well it’s been a pretty good ride. I mean it was terrible, way back then, for all concerned, but, and well, you know, but back then, I’m thinking, fuck, what’s the point. Like, of anything. And, you know, I moved to Hawaii.”
The man’s speech had a slight lisp and slur, possibly the result of a stroke, more likely the long-term abuse of alcohol or drugs. His thinking seemed disjointed, like a patient whose damaged working memory makes it difficult to execute a lucid narrative, or even at times a coherent sentence.
“No, I didn’t know that.” He spoke with genuine sympathy. He was still faking remembrance, but he understood that this was a man who had suffered and then fled.
“If it wasn’t for my kid, I don’t know. I might have done anything, I mean way out there, the deep end…. But he was something to live for, y’know? You never knew him, did you?”
“I… Your son? I don’t think so, no.”
“Yeah, he was just a little guy then, he was mostly with his mother.”
Friedland was beginning to feel uncomfortable. Had he ever met this man before? Was he really a former patient? He still felt a vague familiarity, but nothing was falling into place. If anything, the information he was getting seemed to erode any sense of recognition, expanding the mystery. He wanted to go back to the beginning of the conversation, but wasn’t sure how. “Did you, uh, have an appointment?”
“Oh. Well, no, I just showed up. I know, that ain’t kosher, but I came by, like, spur of the moment, and out in the hall Ignacio, black dude, he says that’s Doc Friedland’s office, but, you know. He says everybody was over in Alexander Hall, listening to you, some big deal speech or something, and I’m thinking cool, ol’ Dr. F making a speech, but I didn’t know where Alexander Hall was. So I just like walk in and there wasn’t even a secretary, in the other office, so I figure she’s probably at the big speech which was due to be over at one-thirty so I came on in and sat down.”
Friedland smiled. He had in fact just delivered the ninth annual Walter Essermann Lecture, and that was a big deal (hence the cashmere Brioni suit he’d bought for the occasion, though he felt a little self-conscious wearing it). He had been the first person from the medical school asked to give it—the others had all come from the humanities, with the exception of John Flaherty, a physicist short-listed for the Nobel. The talk had gone well. The theme, cribbed from a chapter of his most recent book, was an elaboration of two seemingly contradictory metaphors that he believed were key to the process of understanding and diagnosing a neurological patient: the physician is both a naturalist in an exotic, remote landscape, and a method actor, intuiting his way into the subjective interior of the patient. These two approaches demand radically different mindsets and skills, and need to be used in tandem, with a constant, purposeful alternation between keen observation and deep empathy. As always, he drew from his treasure trove of weird, funny, poignant case histories to illustrate his points.
It occurred to him that this man was able to sustain a narrative when he wanted to. Or perhaps there were just arbitrary moments when he emerged from some neurochemical fog into the sunshine of coherent thought.
“Well Nancy Egan—the secretary in the next office, and yes, she was at the talk today—she can schedule you for a formal workup, but let’s just check a few of the basics. Any trouble learning new information—phone numbers, names, or driving directions?”
The man looked straight into his face but said nothing.
“You need to work with me here. How’s your balance? Why don’t you try standing and lifting one foot?”
The man didn’t move. He continued to stare, then let out a sound a little like his initial greeting, part anxious sigh, part conspiratorial giggle. “I get it.”
“Do you now?”
“Yesiree, I understand.” He paused, raising his eyebrows for effect. “You don’t remember me.”
Friedland smiled kindly. “Well, I wouldn’t put it quite like that. But I have forgotten your name. You know—lots of patients. I remember your face and I believe—”
“Lance.” He spat out the name in a near-shout, and the expectation in his face darkened, looking more like fear.
“Yes, okay, Lance.” He stared at the man, trying to make sense of his own confusion. The name did nothing for him, and now he doubted his instincts. The man could be a total stranger, a nut-job who’d stumbled in off the street.
The unfamiliar familiar face in front of him assumed a spurned, injured look. “You don’t remember me.”
Friedland shrugged, said nothing.
“Back then—what, thirteen, fifteen years?—it was Lanny. Or sometimes Spiker, on account of the needles. But Gretchen, she called me Lan or Lanneo, or mostly just Lanny. Or, like, Lanoodle or Lanifty.” The giggle again, now more discomfort than amusement.
Friedland felt something like the hand of God take hold of him, as the two names, his daughter’s and this man’s, crunched together in his chest, wrenching him back in time to the single great tragedy of his life. “Ah,” he said, his voice struggling to keep its practiced, soothing calm, though he knew the mask of complacency had dropped from his face like so much carved wood. “Lanny. Of course.” For a moment it seemed like he’d stepped outside his body, like he could see his own clenched jaw and pained eyes as the old sorrow radiated from his bones.
The man, Lanny, Gretchen’s boyfriend when she died at twenty, nodded. “Yeah.” He looked at Friedland a moment, seemed to note the radical transformation of his face. “So, yeah. I thought maybe you wouldn’t recognize me right off, but I figured that, after a moment you might… I mean, I had dinner in your house.”
“Yeah. Mrs. Friedland—she said Call me Melanie—she cooked, like, spaghetti with fish in the sauce.”
“You must have been a special guest to get that dish out of her.” He’d intended congenial irony, but his poise was disintegrating, and the words reeked of a dull bitterness. Melanie had never really recovered from the loss of their only child, and the marriage had slid into a civil, sometimes pleasant living arrangement. He tried to smile, hoping to distract this unwanted intruder from detecting his true state of mind.
Lanny leaned in, looking carefully at his face, then smiled himself, a chummy, presumptuous near-grin. “Yeah, she said Call me Melanie. I said okay sure, Yo Melanie—ha! But you were still Dr. Friedland. I used to call you Dr. F—you know, behind your back, to Gretchen. You were this tall quiet western sheriff type—kinda scared me.” He let out an almost happy laugh. “Spaghetti with fish sauce, and it was good….” He suddenly clawed at his neck, as if tiny insects were chewing on the skin. “Fucking marriage. Even when it works it doesn’t really work.”
Friedland tried to resume his matter-of-fact, interviewer’s tone. “Really.”
“Yeah, really.” When he didn’t respond, Lanny went on. “I been married more than once. More than twice. So I guess I can see a pattern.”
“A pattern for everybody, or for you?”
“Ha! That’s a good one. How the heck would I know? Except that I know. I was younger then, back when ol’ Melanie made spaghetti. Even if I was a bunch older than Gretchen. But now, it’s like I’m closer to your age. I know some things.”
He felt a chilling inside, and something like fear rising up underneath it. He didn’t want to be in this conversation with this man anymore. “Listen, Lanny. You’re right, I didn’t recognize you. I mean, you looked familiar, but… well, I’m in a working day, I have to meet with my chief resident, patients, I have a report to get out, et cetera. This isn’t the best time to be catching up.”
“Oh. Yeah sure. I understand. Okay.” He shifted in his seat, but did not stand up. “Only I came here for a reason. Because I remember you, I know you. And you were always square with me, and I appreciated that. And I hope I always did right by you.”
Friedland blinked, thinking Now there’s a load of horseshit. He had been barely aware of this man. He knew that Gretchen had a boyfriend who was too old for her, an unemployed hipster, a bad influence. He knew this mostly through Melanie, though he had a vague memory of meeting Lanny, remembered feeling annoyed that his daughter was wasting her time with someone so clearly beneath her, and unsavory to boot, though he had no recollection of the context of the encounter, no memory of a spaghetti dinner.
He stared at Lanny, assessing how he should proceed. “Well you know, maybe another time.” He grabbed a file from the stack on his desk, a routine report on safety precautions in the lab.
Lanny, shrugging and nodding, repeated himself—“Yeah. I always done right by you”—but he said it vaguely, and remained sitting.
Once again Friedland felt the persona of conviviality, something that had long since become second nature, an essential piece of his very character, begin to collapse, and he suddenly realized how much energy it took to maintain it. Well, if his face now revealed cold disdain, so be it. “Right by me? You did right by me?” His voice shook with an anger that surprised him.
“Yeah, I always felt like we had an understanding.”
“We hardly knew each other.”
“You know, as men. Honor and stuff, like in olden times. I fought in Iraq, first time around, and you—”
“Who cares whether you did right by me. What can that possibly mean?”
“I was hoping you could help—”
“It’s Gretchen you did not do right by. You got her into drugs.”
Lanny looked surprised, then hurt, and his head shook vehemently. “That’s not how it was. It wasn’t that way, Dr. Friedland.”
“You did drugs with her. You bought drugs for her. You took her money.”
“She was running with some people, that’s how she got into whatever shit she got on. I met her through this bunch she was running with, Liza, Gyppo, Freddie Finn. She was already doing drugs, sir.”
An hour ago he’d been standing in front of seven hundred souls—students and faculty, including at least two Nobel laureates. What was he doing in the same room with this man? “You took drugs with her, did you not? Christ, she had gonorrhea when she died.”
“We were all of us messed up. Day after day we’d drop whatever cash we had on some shit, get baked, party, crash, then go scare up some more scratch. That’s how it was.”
Friedland opened the deep, right-hand lower drawer of his desk, the one small refuge of chaos in his office. Sorting through the dense clutter of useless gifts, eating utensils, business cards, mementos, and other odds and ends he barely remembered, he finally dug down to the old framed photograph at the bottom and pulled it out.
Gretchen stood in front of a massive live oak, squinting into the camera. She wore a woven straw cowboy hat and plum tank top and, though the photo stopped at her waist, he could easily picture the khaki cargo shorts, her sturdy, tan legs, the dark brown hiking boots with scarlet socks sprouting from the tops. In the background, beyond the oak, was a glimpse of the arid expanse of Topanga Canyon. He’d taken it the summer she graduated from high school.
He showed it to Lanny. “That’s what she looked like before she met you.” Lanny stared at the photo, his face freezing into an empty, dumb expression. “She had plenty of problems then, but drugs wasn’t one of them.” Lanny looked at him like a child, shrugged sadly.
He slammed the photo on the desk. “That’s the before. I don’t need to show you the fucking after. You were the fucking after.”
“Yeah, well, we were all, you know, pretty strung out. It’s a sickness, man.”
Friedland leaned back in his chair, closed his eyes. He’d treated addicts: as a resident he’d revived them in emergency rooms; in the psych wards he’d given them clonidine and buprenorphine; now he was occasionally called upon to assess a patient’s deficits from years of bathing his nervous system in chemicals designed to make him single-minded and stupid and ultimately unscrupulous, desperate, even deranged.
He looked Lanny over, studied him as a patient. Did he seem undernourished, a little jaundiced? There was a quaver, maybe emotion, maybe something else, in those last words, a shakiness in his hands, tiny drops of sweat on his upper lip.
“Do you still use, Lanny?”
“Nah, I kicked. A while back. I hardly ever touch anything anymore. Almost never.” There was another uncomfortable silence. “But you know, it’s tough right now. It’s a bad time.”
He hesitated, considering the bait. “What’s tough?”
“Well, I now feel I have known such tragic loss as you have.” Another silence. “It’s my son, Dr. Friedland. He went down the same path as me.”
“Yes sir. Not anymore.” His eyes flashed with something like irony, and he breathed out the same quiet, nervous giggle, but it carried no humor this time. When he spoke, his voice shook so much that it was hard to get the words out. “He just, um… he just passed. The day before…” He looked down at his fingers, which had begun moving on their own, like squid.
Lanny nodded. “Yeah, well, he was speedballing and, you know, his liver and stuff…”
“I’m terribly sorry.”
“Yeah.” A desperate anxiety filled his face. “Man, I could sure use a cigarette.”
Again Friedland studied the man in front of him, another of the many suffering souls he saw in this bizarre line of work he’d chosen. In most of the stories he told or wrote about his patients, their ailments were strange, exotic, sometimes even frighteningly debilitating, but—at least in his telling—they had some quirkiness and charm about them, and the patients generally showed some improvement, either in their symptoms, or at least in their accommodation to them. The theme was often the resilience and elasticity of the human brain and spirit (with the subtheme of Friedland as brilliant diagnostician and healer). Yet so many, the majority, of his cases did not make good stories—the ailments themselves were rather hum-drum—a paralyzing stroke or a meningitis causing weakness, muscle pain, confusion—and the patient was left diminished, without the expectation of much improvement.
Lannie took out a cigarette. “I won’t light it. I just need to hold it.” He gently rolled it between his thumb and forefinger as he turned his head nearly ninety degrees to stare out the window. “He was an athlete. Like me. I was good at everything, except maybe lacrosse or something. But Payton was all basketball. He was short, but for some crazy reason he loved hoops. Played all his life, even after his liver went south.” Again the laugh, sounding metallic and sick this time. “At the ripe old age of twenty-three, his liver tanks. I mean, it’s no record, but shit, that’s still pretty quick. He started young, he was that way with everything. He always went all out, balls to the wall, it’s how he was. His mom blames me, says it’s cause he hung around me and my associates that he got all sideways. I don’t know. She says she’ll kill me if I ever cross her path. That’s no figure of speech. She has a gun and she says she will use it on me and I believe her.”
Friedland, trying to listen with a sympathetic, professional ear, was distracted by thoughts of Gretchen. How could her life have intersected with the life of this man? Was her suicide a direct result of her bipolar illness, or did this manipulative predator drag her beyond hope or redemption? As soon as these questions occurred to him he realized how pointless they were, and he let them slip back where they’d come from. For a moment his mind floated.
“I think when you walked in you seemed like a guy I treated in the early days. Long time ago, before I ever met you. I couldn’t put my finger on it, but that’s who you must have reminded me of. A young man named Henry Rose.”
“Yeah, well I never knew anybody named that. It sure ain’t me.”
He nodded at Lanny and smiled, though he had no idea why. Lanny stared back at him warily. “Henry’s memory did funny things. He’d get these intense recollections of past events, or just images, memories of people or occurrences or odd things, his uncle’s cigars, his skateboard, a little league game, his mother’s pancakes. These memories would invade his mind, suddenly, out of nowhere, and he couldn’t do anything about it. He couldn’t do his work. He’d gotten fired more than once.” He leaned back in his chair, and relaxed for the first time since he’d woken up that morning and begun reviewing his notes for the talk.
“Jeez, that’s crazy. Was he crazy, Dr. Friedland?”
Friedland shrugged. “Henry Rose. In those days we used to think there was a special meaning behind all those memories getting spit out of a brain like Henry’s. We were convinced that there was this hard-working, all-knowing little person inside, speaking in a special code that the big person, Henry, was too dumb to understand, but that a clever doctor could figure out if he listened very carefully. And that’s what I did. I listened, and I figured it out. Everybody was impressed, even Henry. I don’t remember what interpretation I came up with, because it was pretty much bullshit. Some part of his temporal lobe was wired funny and it would start firing and setting off random memories, and my job was to make up a good story. So that’s what I did. I like to think I do better now.”
Lanny had been listening with interest, but when Friedland paused, he stared mutely.
“So,” Friedland said, “I do have to get back to work here. Truly.”
Lanny stood up quickly. “Yeah, of course. Sorry to chew up your time.” His hand again clawed at his neck, and he looked out the window. “One thing, Dr. Friedland. I have Payt’s body. I mean the county has it, they wanted to confirm the cause of death, but it’s mine to take care of now.” He breathed a deep, miserable sigh and shook his head, overwhelmed with the burden of his son’s corpse. “I don’t even know what to do with it. I mean, he wasn’t much older than Gretchen, when she passed. Aside from his liver, he was in good shape. Wouldn’t it be of benefit to science?”
Friedland shrugged. “People usually arrange that kind of thing beforehand—if they want to donate their eyes or organs for transplants. Or for research or even anatomy instruction.”
“So is there some way you can use it?”
“Other people handle that sort of thing. You’d have to talk to them.”
“I’m talking to you. Can you arrange it?”
“I can make a call for you.”
“Would there be some kind of compensation?”
“I mean, it’s a bad time. I can use the money.” He took a step toward Friedland, made a kind of beseeching, helpless gesture with both open hands. “ I need the money.”
Friedland simply stared. He hadn’t seen it coming.
“He was mostly in good shape. His heart, his kidneys, his lungs. Only his liver was really fucked up.”
“Christ.” Friedland stood, moved quickly to the door, opened it.
Lanny shrugged, then sauntered out without looking at Friedland. But he stopped in the doorway and turned to face Friedland, his body uncomfortably close, his breath smelling like rotten lamb. “There’s nothing wrong with asking. I don’t have much of anything. Not like you. I just wanted to know.”
“Well, you have your answer.”
Lanny nodded, walked off. Friedland watched him move down the hallway—he looked bent, tired, older than his years. “Lanny!” he called out. Lanny stopped, turned, held him with a sullen gaze. Friedland walked over to him. “Get him… get Payton cremated or buried. Have them call me about the costs and I’ll take care of it. I’ll send you a check for an extra five hundred afterwards. Here’s my card.”
Lanny took the card and stared at it, as if he hadn’t understood what he’d just heard. Then he nodded. “Okay. Yeah, I’ll do that, Dr. Friedland. Thanks.”
Friedland went back into his office and shut the door. He sat, picked up the photo. The glass was cracked. Melanie had gotten it framed, and he’d kept it on the shelf on the wall next to his desk for years—the three years before Gretchen’s death and another two afterwards. Then, on the day he’d finished his first book, he’d taken it down and stuck it in the drawer, telling himself he was stepping into the next, happier phase of his life. Which, amazingly, is exactly what happened, as if the simple, symbolic act had carried shamanic power.
The phone rang. “Hey Doctor F, it’s me.” Lanny’s voice sounded shaky, his breathing irregular, as if he’d just been crying. “You don’t have to pay for any burial. I’ll take care of it.’’
“Lanny, I’m happy to do it.”
“Nah, I got it.”
Friedland felt a physical pain, quick and sharp, at the center of his stomach. “It’s not… I mean it’s easy for me to—”
“Yeah I know, but I got it. Okay, well, okay then.” He hung up.
A little dazed, Friedland slumped back in his chair, stared at the photo. He had always seen boiling energy and a kind of wild mischief in Gretchen’s eyes. Now her gaze seemed full of reproach. Had he failed her as a father? Had he simply bequeathed to her some snippet of genes that blossomed into the bipolar nightmare of her late teens?
During the question period after his talk, a short-haired, serious young woman—a grad student who had attended his seminar the previous year—was the first to raise her hand. “It sounds like your method brings you very close to your patients. Would you say that you love them?”
For a brief moment he’d felt a kind of panic, as if he’d stepped into a trap set by a lawyer: somehow either answer seemed incriminating. He’d managed a hedgy, mildly charming response about how fond he was of many of the vulnerable, sometimes desperate people he treated and studied, but that his role established a line he could not cross and still serve them well. Now, alone, he admitted the real answer to himself: a simple no. Sure, he cared, but he didn’t love them, any more than he loved his students or, for that matter, his colleagues. He had loved his daughter. He still loved his wife, though he no longer knew why.
And now it occurred to him that he was what he’d told Lanny he was: a man who observed the injured souls who hobbled into his office, then came up with stories that made some sense and maybe helped in their treatment. That was his work. He had no helpful stories about his own life, about himself or those he had loved.
He started to put the photo back in the drawer, but changed his mind. Better to have it out where he could see it, and remember.