a reprise of the heavy mood, now more sustained, settled on me. Psychiatry training programs are reputed to be less brutal than some other residency programs—and I had found it so—butthe work has its own peculiar challenges. At times, psychiatrists feel the absence of the neat solutions surgeons or pathologists enjoy, and it can be wearying to always have to find the mental preparation, the emotional focus, that is necessary for sitting with patients. The only thing, when I thought it all through, that enlivened the long hours I spent on call or in the office was the trust those patients had in me, their helplessness, their hope that I could help them get better.
In any case, unlike when I had first begun work in the hospital, I no longer spent much time thinking about patients, usually not until the next appointment, and often, when I was on rounds, I needed the chart to recall even the basics of a particular case. That I thought of M. away from the medical campus was, in that sense, an exception; he was, like V., the rare patient whose problems were not relegated to the back of my mind when I stepped out onto the street. M. was thirty-two, recently divorced, and delusional. On bad weeks, the medication seemed to hardly help at all.
A hint of winter was in the air as I began to cross Broadway and was held for a moment in the yellow eyes of the cars hunched in serried ranks at the red light. It was just past five o’clock and night was falling fast. The buildings of the medical complex stood shoulder to shoulder against the charcoal-colored sky and, all around me, people wore padded jackets and knitted hats. I entered the subway at 168th Street and caught a packed southbound 1 train. So absorbed was I in rehearsing that afternoon’s consultation with M. that, when the train reached 116th Street, I simply watched the doors open, stay open, and close. The car moved on past my stop, and momentarily I tried to figure out what had happened. I hadn’t been asleep. My staying on, I finally decided, was intentional, if not conscious. This was confirmed at the next stop, when again I failed to exit and instead sat there, with the feeling that I was watching myself, waiting to see what would happen next. Everyone in the car seemed to be wearing black or dark gray. One woman, unusually tall, more than six feet,wore a black jacket over a long, black, pleated skirt and knee-length black boots, and the play of depth in these layers of her clothing brought to my memory the virtuoso black-on-black passages in certain paintings by Velázquez. Her pale, pinched face was overwhelmed, nearly, by the black of the clothes. No one on the train spoke and no one, it seemed, knew anyone else. It was as though we were all listening closely to the rattle of the train on the tracks. The lights were dim. I knew then that I was no longer heading directly home.
At Ninety-sixth Street, I switched to the 2 express, which happened to arrive on the platform just at that moment. This carriage was brightly lit. The man sitting across from me wore a pumpkin-colored jacket, and next to him was a woman in a sky blue ski jacket and striped gloves. A few people in this train talked to each other, neither demonstrative nor loud in their manner, but enough to highlight in my mind how somber the other train had been. The brightness, perhaps, gave people permission to open up. To my right sat a man whose full attention was on Octavia Butler’s
Kindred
, and to his right, a russet-haired man leaned forward in his seat and read
The Wall Street Journal
. His natural expression was delirious, which gave him the aspect of a gargoyle, but when he straightened up, he had a handsome profile. At Forty-second Street, a man in a pin-striped suit entered holding a volume with the title
You’ve GOT to Read This Book!
The book was open in his hand, but as he came in and stood by the seats, he kept his eyes fixed on a spot on the floor. He did so for a long time. He kept the
In any case, unlike when I had first begun work in the hospital, I no longer spent much time thinking about patients, usually not until the next appointment, and often, when I was on rounds, I needed the chart to recall even the basics of a particular case. That I thought of M. away from the medical campus was, in that sense, an exception; he was, like V., the rare patient whose problems were not relegated to the back of my mind when I stepped out onto the street. M. was thirty-two, recently divorced, and delusional. On bad weeks, the medication seemed to hardly help at all.
A hint of winter was in the air as I began to cross Broadway and was held for a moment in the yellow eyes of the cars hunched in serried ranks at the red light. It was just past five o’clock and night was falling fast. The buildings of the medical complex stood shoulder to shoulder against the charcoal-colored sky and, all around me, people wore padded jackets and knitted hats. I entered the subway at 168th Street and caught a packed southbound 1 train. So absorbed was I in rehearsing that afternoon’s consultation with M. that, when the train reached 116th Street, I simply watched the doors open, stay open, and close. The car moved on past my stop, and momentarily I tried to figure out what had happened. I hadn’t been asleep. My staying on, I finally decided, was intentional, if not conscious. This was confirmed at the next stop, when again I failed to exit and instead sat there, with the feeling that I was watching myself, waiting to see what would happen next. Everyone in the car seemed to be wearing black or dark gray. One woman, unusually tall, more than six feet,wore a black jacket over a long, black, pleated skirt and knee-length black boots, and the play of depth in these layers of her clothing brought to my memory the virtuoso black-on-black passages in certain paintings by Velázquez. Her pale, pinched face was overwhelmed, nearly, by the black of the clothes. No one on the train spoke and no one, it seemed, knew anyone else. It was as though we were all listening closely to the rattle of the train on the tracks. The lights were dim. I knew then that I was no longer heading directly home.
At Ninety-sixth Street, I switched to the 2 express, which happened to arrive on the platform just at that moment. This carriage was brightly lit. The man sitting across from me wore a pumpkin-colored jacket, and next to him was a woman in a sky blue ski jacket and striped gloves. A few people in this train talked to each other, neither demonstrative nor loud in their manner, but enough to highlight in my mind how somber the other train had been. The brightness, perhaps, gave people permission to open up. To my right sat a man whose full attention was on Octavia Butler’s
Kindred
, and to his right, a russet-haired man leaned forward in his seat and read
The Wall Street Journal
. His natural expression was delirious, which gave him the aspect of a gargoyle, but when he straightened up, he had a handsome profile. At Forty-second Street, a man in a pin-striped suit entered holding a volume with the title
You’ve GOT to Read This Book!
The book was open in his hand, but as he came in and stood by the seats, he kept his eyes fixed on a spot on the floor. He did so for a long time. He kept the
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