The Psychiatrists of Phoenix Street

By Michael Segal

The heroes of my tales are all real people. Their names have been changed, but the stories are authentic. Some people came by themselves; some were brought to the psychiatrist, not to the writer. As far as Im concerned, I was looking for symptoms, diagnostics, and treatments, not for stories.

They have biographies that were revised here and there, to protect anonymity. The heroes are living among us. They are not easy to recognize. Any one of them can be your next door neighbor or the grandfather who is reading the newspaper in the park. In the summer, when the old man wears short sleeves, you can see the number that was tattooed on his forearm in Auschwitz.

Those who survived the Holocaust are becoming increasingly scarce.

The agitated and crabby man who drags his wife out of the supermarket was traumatized by the war. He cannot stand the crowds and the fuss.

Classic inpatients can no longer be identified at first glance anymore. Where can you find the good old psychotics?

• Language: English
• Publisher: Xlibris AU
• Release date: Dec 8, 2014
• ISBN: 9781499034073

Michael Segal

My name is Michael Segal. I was born in Bucharest, Romania, in 1957. I graduated from the Bucharest faculty of medicine (MD) in 1985, and one year later, I immigrated to Israel. I am married to Rodica and am the father of Ariel. My son is a student in economics at Haifa University. I finished my residence in psychiatry in 1995. Actually I am the head of a psychiatric ward in Sha'ar Menashe Mental Health Hospital, somewhere in the middle of the road between Haifa and Tel Aviv. In parallel, I am a lecturer at the Technion faculty of medicine in Haifa. I published papers in the field of clinical psychiatry. In 2011 I published my first book (and still now the only one) in Bucharest, in Romanian. The readers (not only friends) considered "Psihiatrii de pe strada Fenix" as a great success.

Book preview

BETWEEN BEETHOVEN, VAN GOGH, AND AMIR

THE AMBULANCE BRAKED sharply and parked in reverse, grating its wheels harshly on the fine gravel. The placard at the entrance advised briefly, ‘admissions—acute care department’. Amir was tied to the stretcher. He was brought in again against his will. Second time in six months. He had loaded his hunting rifle and pointed it aggressively at his father. Then he had suddenly started laughing hysterically. He had pointed the barrel at his own head and shouted, ‘Russian roulette! Russian roulette!’

‘I fooled you all! Did you really think I was going to do it?’ He threw the gun away and locked himself in the bathroom. It was the fourth time that morning.

His parents took advantage of the moment of silence to ask for help. They called the chief district psychiatrist and managed to convince him of the gravity of the situation and the imminent danger it represented. The doctor immediately sent an ambulance, with two ‘gorillas’. Amir suddenly found himself standing behind heavy, locked, welded doors, reinforced with thick bars. Still, he wanted to get up and hit them, hit them with his head. He struggled. Then, for minutes at a time, he stood inert, his eyes fixed upon the ceiling. He seemed to somehow speak to an invisible entity that only he could see, somewhere on the wall, towards the upper corner of the room. And again, all of a sudden, he would try to get up, screaming at the top of his lungs, ‘Let me go, stupid sons of bitches. Wait until I let myself free, I will get you all. You kidnapped me, I’ve been kidnapped! Help! Call the antiterrorist unit immediately! Let me go, I need to go to the bathroom! I can’t hold it in anymore!’

This was no longer a threat. The smell gave him away.

He was taken to the bathroom, washed, although he fought back, and dressed in hospital clothes. He was given a tranquilising injection, and within about half an hour, he was asleep.

I invited his mother to my office so that she could tell me everything she knew about Amir. I did not know him. He was admitted to a different department the last time he was hospitalised.

‘Everything was fine until two days ago,’ Yael started her story, half-troubled, half-intrigued. ‘He took his monthly shot in good faith. He took his medicines, except the sleeping pills. He said he didn’t need them, that he was fine without them, and that was true. Even though he is 25 now, I still go to his room at night to check if he is covered, if he turned off the lights, and if everything is in order. During the day, he works on the kibbutz banana plantations. On weekends, he gets together with his friends down at the local pub for a beer, nothing more. Especially now, with his medication, he doesn’t like to drink hard liquor. I’ve never seen him tipsy.’

‘LSD, marijuana?’ I enquired.

‘No, I don’t think so. He confessed that he had once tried a hash joint that his friends passed to one another during a trip to India after finishing his military service. He didn’t feel anything special, except an unpleasant dizziness and nausea that lingered on for a few days. Nothing more.’

‘Is he reliable? Can you trust what he says?’

‘Absolutely. I’ve never caught him telling a lie. He’s so honest that he’s almost stupid, he takes after his mother,’ Yael says, sketching a smile. ‘As I was telling you, he seemed fine until the other day. Then out of nowhere …’

‘Out of nowhere …,’ I encouraged her and then I waited.

‘He complained of stomach aches. Cramps. They came and passed.’

‘Did he eat something new, something different, is he allergic to anything at all?’

‘No, I don’t know him to be allergic to anything. He only eats what I cook for him. He doesn’t cook for himself, he doesn’t even use the microwave. When he works, he loses himself in his work.’

‘It’s true I only caught a glimpse of him. However … he looked pale and a little grey in the face. Is he suffering from anything?’

‘No, nothing, he is healthy as a horse. He served in an elite unit. He runs five to ten kilometres daily. His physical condition is excellent. It wasn’t easy to get him to the hospital. Four orderlies struggled with him.’

‘After the stomach aches, what else happened?’ I enquired.

‘Things deteriorated rapidly. At night I heard him walking around his room, talking, laughing. I thought he was on the phone, but when I looked around the living room, I saw his phone plugged in to be charged.’

‘Maybe he used the landline.’

‘No, he doesn’t have a phone in his room. He talked and argued with himself or with imaginary characters. The next day, at breakfast, he seemed even more changed. He was agitated, edgy. He had moments when he was completely cut off from the world. By the way, he moved his lips, he seemed to be hearing voices and answering them. I tried to find out more from him. He looked at me with a strange glare in his eyes. He got up suddenly, without touching any food, not even the toast. He locked himself in the shed behind the house. During the past few years, he built a kind of workshop. Ever since he was little, he enjoyed working on things, repairing them: bicycles, radios, anything. I heard him, however, playing with the pellet rifle. He opened the shed door and started shooting at sparrows. He didn’t hit any. Ever since he started taking the antipsychotic treatment, his hands have been kind of shaky. He let out an ugly curse. He is not one to curse. Anyway, he always controlled himself when I was around. He continued talking nonsense. Meaningless words. Rambling pieces of sentences.’

‘Tell me, does this story resemble in any way what happened six months ago, before his first admission?’

‘It does in some way. Last time he was even more violent. He also locked himself in the shed then. He used to work all the time. He would fix things, solder, and only come inside to eat. I remember him complaining about stomach aches also, and about queasiness. I think he even threw up. I managed to convince him to do some blood tests at our local clinic. The results indicated some anaemia. Then he was admitted to the psychiatric ward in the hospital, section 10, the department of first admissions. He was given a few IVs, and in about two days, he was a different person. He talked normally, he knew who we all were, he was content.’

‘Strange, it generally takes more than that for a patient to recover from a psychotic episode.’

I checked the summary of his first admission. Yael was right. The boy had spectacularly recovered after only two days. The ‘old-school’ medication had paradoxically produced results almost immediately.

I decided that this time I would hold back with the antipsychotics. I hydrated him intravenously. I only gave him only tranquilising medications and only when urgently needed. This is how it was done in a closed ward. He was administrated a sleeping-inducing injection. He wasn’t violent. He complained about stomach aches and spent most of his time in the bathroom.

The next day he was much more lucid. He wasn’t very coherent, but he could answer short questions. With the experience gathered from similar cases, the nurses in the ward were convinced he ‘definitely took something’. He asked his roommate if he also saw the blond girl on the ceiling, dressed all in white. The roommate waved his hand in disgust. He could only communicate with God. Around midday, Amir was awake enough for me to talk to him. He swore to God he hadn’t taken anything: neither drugs nor alcohol.

I felt like I was missing something in this whole story. But what was it? The next morning, he was absolutely peaceful, even smiling. He kept apologising to everyone about his bad behaviour and for causing trouble.

‘I kind of rambled, didn’t I?’

‘Sort of. Do you remember what you said?’

‘Nothing at all, as if was in a trance. I remember I had an awful stomach ache and I felt weak. When I looked in the mirror this morning, I got scared: I was weak, pale, and I had dark circles around my eyes.’

‘Tell me about how you spent your time during the days before you were admitted to the hospital.’

‘Well, I worked. Since it’s not the banana harvest season, I spent most of my time in the office.’

‘Office?’

‘Well, it’s just a matter of speech, it’s what I call the shed where I spend my time repairing all sorts of electrical devices. I have a solder, and I make little balls or pellets from scrap metal and I sometimes go with my hunting rifle to shoot at little birds.’

‘Do you have any other hobbies as well?’

‘Music. I listen to rap and trance while I work.’

‘Do you smoke when you work?’

‘No, I don’t, I quit about half a year ago, a little before my first admission.’

‘Before? Not after?’

‘No, it was definitely before!’

‘And what do you do when you feel like smoking?’

‘I chew on things; I keep them in my mouth so that I can get past the urge to smoke.’

I asked him what he chewed. Amir’s answer got me thinking. I asked him to go back to the ward and said we would talk again a little later. I went to the hospital library, read up on the relevant literature, and went back to the ward. In the waiting room, I found Yael, with a smile on her face, happy about her son’s spectacular recovery.

I decided to talk to both of them at the same time.

Yael and Amir sat down and waited anxiously.

‘I might have caught the culprit!’

‘The culprit?!’ they both asked at once.

‘I mean I might have found the smoking gun in act 2! To be more precise, I found a fair explanation for Amir’s condition. I ruled out the main suspect—schizophrenia. That’s a totally different situation that doesn’t just disappear in a couple of days.’

‘Oh, that’s such great news!’ Amir said. ‘A weight has been lifted off my shoulders.’

‘Not so fast. The weight has probably descended into your stomach.’

‘What do you mean? I feel faint! Do you think there’s something wrong with my stomach?’

‘Be patient and you will understand. Your health is up to you. As I was saying, I ruled out schizophrenia. Without caution and without treatment. However, I discovered a more dangerous suspect, which torments you and can slowly kill you. Speaking of food, just before the end of our meeting, you told me you had quit smoking and that you would fool the need to light a cigarette by always chewing on something.’

‘True! I chew on little lead pellets. Like one does with chewing gum. After a while, I spit them in a water tank so that they cool down. Those that I don’t use, I roll and make pellets out of them and I use them to shoot at little birds. I chew on pellets when I work, when I listen to music. I even like the smell of burnt material when I weld the alloys.’

‘Tell me, do you happen to swallow some of these?’

‘Only by mistake. It happened to me a few days ago. But I eliminated it yesterday. I heard the noise when I went to the bathroom,’ Amir said, smiling, a bit baffled.

‘As I was saying, I believe that I discovered the culprit. While you were welding alloys, chewing and swallowing pellets, it is very likely that you developed lead poisoning. In medical parlance, we call it saturnism. This explains the stomach aches, diarrhoea, the ashen pallor, the delirium, the psychosis. You got better because you are out of the shed and implicitly out of the toxic area. You also eliminated the pellet. For extra safety, I sent a blood sample over at the toxicology department. What is certain is that in the future you must stop playing with lead. It attacks your nervous system, to say the least. To be honest, this whole story introduces you to gallery of famous intoxicated personalities. There are all sorts of speculations related to the death of Beethoven. They say that, after screening his hair, a large quantity of lead was found. At the end of the eighteenth century, people used to illegally add lead to cheap wines to make them sweeter and more refined. And since rumour has it that during his last years, the Titan from Bonn was a real heavy drinker …

‘It’s possible that even Van Gogh’s insanity was related to lead poisoning. There was also a suspicion that he had schizophrenia and epilepsy … what is certain is that in those times paints were mixed with a high quantity of lead. And this brings us and Van Gogh to Arles, the city where he spent a few years as a painter and later as a patient of the local hospice.’

‘The agony of geniuses.’ Amir sighed, winking at me.

‘I hope that, for your sake, the resemblance to these famous characters ends here, unless you compose or paint.’

‘Not yet … who knows … I will definitely remember this! I don’t want to end up like Beethoven or Van Gogh!’ Amir continued, half-joking, half-serious. Encouraged by the outcome, I decided to release him, and before we parted ways, I offered him some chewing gum … mint flavoured. A few days later, I received the toxicology screen results. The lead levels in his blood were significantly above normal.

The schizophrenia stamp was replaced with a lead seal—fortunately, a temporary one.

THE COBBLER

‘WOULD YOU PLEASE see my dad? I feel like he has been depressed lately.’

I could feel obvious concern in the girl’s voice on the phone. A few days later, she and her father were at my door. The daughter looked worried, a little agitated. She tried to speak for the old man. The assumed patient was small, thin, neatly dressed, and quietly waited for Maya to end her description. He seemed accustomed to her precipitated and sometimes even exaggerated reactions.

‘Since my mother got sick, about half a year ago, and we had to admit her to an asylum, my father doesn’t seem like himself anymore. I am so afraid he will collapse too. I don’t have enough strength for both of them. My brother doesn’t help me at all. All the weight is on my shoulders. But you know what, I will be quiet and let Meir tell the story himself.’

Meir looked really happy that he finally got the chance to explain himself.

‘What can I say, my daughter pushed me to come urgently. I, in my opinion, feel pretty well. It’s true, it’s hard to be alone all of a sudden. It is not easy taking two buses to get to her hospice. And it’s even harder seeing her like that, not able to speak and move. She is in a wheelchair now. The nurses feed her. We’ve been together for over fifty years. I met her on a ship to Romania, we were young, and she was beautiful. She is from Romania. I believe you are too, Doctor, by your accent.’

I nodded gently.

‘Yes, me too. And you as well?’

‘No, I’m from Poland. I am 83 now.’

‘This means, by my judgment, that you met your wife after the Second World War. Are you a survivor of the Holocaust?’

Meir looked at me. He tried to observe me, wondering if I really was interested in the subject and in him, or if it was just professional curiosity. When he understood that I was really interested, he asked politely, ‘How much time can you spare me? You might regret it, it’s a long story!’

‘As much as you need! You are my last patient today. We can stay here the whole night.’

I thought it was going to take about an hour. Two and a half hours later, he was far from getting to the end of one of the most fascinating stories of surviving the Holocaust. The old man spoke loud and clear. He remembered every place, every detail. Considering his respectable age, he was a real phenomenon.

‘It was either God or my genes that gave me my good memory. Two or three years ago, after my first recording at Yad Vashem, the world centre for Holocaust research, documentation, education, and commemoration, I was invited to return to Jerusalem for another recording of about six hours. It seemed they weren’t used to such databases either. You know … the remaining survivors, most of them, either can’t or won’t remember. I feel like I owe it to them. Someone has to tell these stories. I am the member of my family who survived, maybe the only one in my town.’

‘Where is that exactly?’

‘I was born in Oświęcim, you know where that is?’

‘The name of Auschwitz in Polish, if I remember it well.’

‘That’s right! This is where I was born. The irony! I was in the ninth grade when the Germans started building the camp. They took us out of classes, 15-16-year-old boys, to dig the foundations for the surrounding fence. We were the ones who put up the barbed wire networks. We worked for months. Every day.’

‘When you finished, did they make you a prisoner?’

‘No, not immediately. I hold a record that is hard to envy: as thin and small as you see me, I was in eighteen camps: Bergen-Belsen, Buchenwald, Mauthausen, Dachau, Monovitz.’

Meir continued naming them chronologically, one after the other, with an amazing accuracy.

‘Eventually, after all this tour de force, the circle closed in Auschwitz. I arrived there in the spring of ’44, little before the massive transportation of Hungarian Jews. Even though I weighed less than 40 kilos, I was lucky. I got through the selection, I was able to work. The crematorium could wait. My buddy, Marek, with whom I had gone from camp to camp and who I had found in Auschwitz, whispered to me:

Be careful, when they make the call, to stand as straight as you can and blow air in your cheeks! They are looking for craftsmen. If they take you to bench mining, you are through! Tell them you are a cobbler!

A cobbler? How am I supposed to say I am a cobbler? I never was one, I have no idea how to fix shoes. They will catch me right away.

Wait a minute! When you were a child, didn’t your mother used to send you to the cobbler to repair your boots?

Yes, she did. She used to send me to Motke, the cobbler at the street corner. I would wait for him to fix them on the spot.

Well, then you don’t remember how he worked, how he changed the sole, and put the spikes in?

Sort of. Anyway, seeing it done by someone else is a whole different business than doing it yourself. You know what?! … Fine, I’ll listen to you. I’ll try … in the end, what do I have to lose? Let’s see how this turns out.

‘We both remembered that cynical slogan on the gate from the camp’s entrance: Arbeit macht frei, meaning Work sets you free.

‘The next day, at the