Autobiography of a Repaired Physician: Mental Health as Seen from Both Sides

By Prospero Shimshon Shimon

The Autobiography of a Repaired Physician : Mental Health as Seen from Both Sides
of the Desk is a trilogy. Book I deals with my life before, during and after the emergence of
an attack of bipolar disorder. The shattering consequences of the disorder and the personal
history that precede it are discussed in great clinical and personal detail. My chief concern is
that the reader comprehend how the past, present, and future come into play in understanding
the outcome in the treatment of this destructive and deadly disease.
Book II concerns the social stigma associated with having a history of the disorder and
the many pitfalls clinically, psychologically and socially that exist for an individual, such as
myself who is charged with the professional responsibility of caring for people suffering from
similar affl ictions.
Book III is about my adventures in the real world as I have seen it. It relates to the
madness of our world in which the ever present and infuriating search for power prestige and
possessions appear unfortunately to be the primary determinants of behavior in our society.
Many of my closest friends have tried to dissuade me from writing about this issue
because they feared I would be exposing myself to further social stigma. I feel strongly that
those who have suffered from the destructive effects of the spectrum of bipolar disorder must
know how treatment works and what pitfalls to avoid in treatment. As a physician it is my
duty to heal myself and with the help of some very talented colleagues. I have been able to do
just that. My struggle continues and in that sense more books will be written.
I would like to especially acknowledge the help of my wife Barbara, who has stuck with
me through thick and thin, and my children Miranda, Alexander and Victoria who love each
other and me.

• Language: English
• Publisher: Xlibris US
• Release date: Jan 29, 2011
• ISBN: 9781462807253

Prospero Shimshon Shimon

Dr. Simon grew up in Brooklyn New York. He graduated from New York University and then graduated from Tufts medical school in Boston. He interned in Medicine at Maimonides Hospital in Brooklyn then did his residency at the McLean Hospital in Belmont Massachusetts and the New England Medical Center. He is Board Certified Psychiatrist .He has three children from three wives and has had a difficult life in terms of own Mental Health. Thanks to the help of modern medicine he has overcome his difficulties and the struggle he went though in his life is documented in the three-volume trilogy he wrote. Each of the periods of his life is discussed both from a personal and professional point of view. The book is written to help elaborate and shed some light on the difficulties facing both the Psychiatrist and the patient in the treatment of mental disease.

Book preview

Chapter 1

Blood and Honor

My Uncle Beryl had been a corporal in General George Patton’s Third Army.

Patton was nicknamed by the press as ole blood and guts, but Beryl said, we knew him as his guts and our blood. I had misinterpreted the phrase on the Hitler youth knife he brought back Blut und Ehr as meaning blood and dirt. The real meaning was blood and honor. My American Army, the army that fought and won W.W.II on a vacant lot on 95th Street in Brooklyn, motto was blood and dirt. Maybe that’s why they lost and we won, thought I. The German Nazis saw war as honorable and bloody. We saw war as dirty and bloody. We were more centered in reality. Perhaps, in the end there will always be a victory of reality over fantasy in man’s desire to survive in a hostile universe. When the war was over, Beryl brought back many souvenirs and gave some of them to me. He took the rest with him when he got married. I kept the Hitler Youth Knife the souvenirs were extensive including:

1.    A huge Nazi-red decorative German flag with a black Swastika in a white circle right in the middle, which I kept, folded away in the hall closet of my grandparent’s apartment.

2.    A German carbine rifle was well oiled and ready to fire. It was a standard issue, a genuine Mauser. The bayonet came with a black scabbard. The bayonet had a deep blood gutter. The wooden stock spoke of a great deal of use, it was literally battle scarred.

3.    An officer’s dress military dagger complete with gold tassels and white imitation ivory hilt. A delicate Swastika was engraved on it. It came with its own brown leather covered steel scabbard.

4.    A German youth knife: very well sharpened with a heavy duty black plastic diamond hatched hilt and black metal scabbard with its own black belt with a Nazi eagle clutching a Swastika on it. On one side of the blade, it had stamped in small letters the words Solingen Wald. The other side was etched with words Blut und Ehr in script. I used it to play land with my friends. It was my favorite souvenir.

5.    A black German helmet that smelled of a combination of leather and old sweat. There was no Swastika on it. It had been taken from a real dead German. I imagined from the owner of the Mauser.

6.    An American helmet that was very rough to the touch like sand paper. It was the standard khaki brown color. There was no lining.

7.    Bernie’s army boots that I wore to the beach a lot as winter boots in the snow. They had wrap around buckled leathers over the boot and were very soldierly.

8.    Beryl’s dog tags, which I proudly wore around my neck.

9.    A captured and expensive German stamp album found in the basement of the headquarters of the SS Company in some Belgian town. It used to be the Belgian mayor’s house. That’s also where I found the girls, said Beryl. While conducting house-to-house searches after the Battle of the Bulge, he heard some movement in the cellar of a house in a Belgian town. There were female voices, and he and his buddies thought they might be collaborators. In reality the voices were those of a group of young women ranging in age from 18-21. They were delighted to speak to Beryl because they could not speak German, French or English. So the conversation went from a very gruff Rouse! to mir zynen yiddin, Jewish for we are Jewish. Beryl said Ich bin Yiddish, Jewish for I am Jewish There were loud squeals of joy and hugs and kisses.

10.    A Brown U.S. army shirt with a corporal’s patch on one side and a triangular patch with a black lightening bolt crossing a tank going over a brown hill in red, yellow and black on the other side saying Hell on Wheels Second Armored Division.

11.    A picture of my uncle Bernie (Beryl) with a big broad grin on his face surrounded by at least 20 nubile, young Jewish girls who he had liberated from a cellar in a small village somewhere in Belgium. They were lovely, grateful, young Polish Jewish ladies. The picture was just inside the heavy light blue canvas covered cardboard front cover of the stamp album. It was in black and white surrounded by the serrated edges that all the pictures taken in the 1940’s had.

12.    A 75-millimeter l casing. We used it for a doorstop until it got lost.

13.    A dud U.S. mortar l.

14.    A bunch of bullets, which were live for the Mauser. These were kept hidden from me.

The artifacts came from a war in which over 55 million people were slaughtered, it was the world into which I was born and spent my earliest years on the planet earth. My other Uncle Srully, Israel in English, was a sergeant in the Eighth Air Force stationed in England. He came back about the same time also with a smile and a uniform but no souvenirs. Srul had lost a lot of his hearing by standing around the props of big bombers and supply planes. He was a supply sergeant.

My heroes had come home. Srul was to die in 1975 of a Myocardial Infarction (MI). He never stopped smoking. By the time of his death, he had become deaf. He was about 60. He left two sons: Eddie, who was to become a chiropractor, and Steve, who was to become an art glass blower. His wife, my Aunt Lenore, died about 1984 in Florida of breast cancer. Her body was returned to New York, and she lies next to the remains of my father in our family plot in the Cypress Hills Cemetery between Brooklyn and Queens, just off of the Jackie Robinson Highway, formerly the Interborough Parkway.

Beryl eventually died in 2003 at about age 80. He put up a grand struggle with end stage renal disease and cardiomyopathy and had become devoutly religious. He had raised a happy, prosperous and large family. I wept over his grave. His son Freddie became an accountant. His son Paul became a kibutznik and architect in Israel. Paul invented a technique called drip irrigation, which became very important for the Israeli economy. His son Bobby became a conservative rabbi. Beryl’s wife Norma is still alive and well and lives in Florida in the winter and Woodmere, Long Island in the summer. As we were throwing shovels full of dirt on Beryl’s coffin, my brother’s black yarmulke blew off his head and into the grave. It was buried along with my Uncle Beryl.

The common caution given by ordinary every day laborers concerning the issue of personal involvement in one’s job has always been don’t shit where you eat. So what if you can’t help it? thought I. The believers in this cautionary admonition might reply: my friend, you’re truly screwed. My Uncle Bernie, he should rest in peace, used to talk about how the steel helmet, which he wore in Patton’s Third Army, was a pot that was good for anything. It was a toilet, a sink, a scrambled egg maker and a head protector in the foxhole, he’d say. During a war there are times when you can and have to shit where you eat, necessity becomes the mother of invention. Reality and its needs will always win out. This is true also of most psychiatric dilemmas as well.

My uncles were to me all that one needed for a quiet and happy life. I worshipped my uncles, and when they came home in 1945, I watched them play football on our block. I was five years old. They were handsome, young, dashing and full of smiles.

My father did not go into the military. I had other uncles and a father but my grandfather David, papa, my mother’s father. Beryl and Srully were the real men in my early life. Because of my birth, my father was able to beat the draft. Why them and not him? Thought I later on. Was he afraid? Would not I be afraid if one day I was confronted with death? My father had done well to stay away from the front lines of the Second World War.

Most of the games I played on the lot involved me and my friend Herman Wechter. The games were about war. He was the corporal and I was the sergeant. He was the person taking orders, and I was the person giving them. We dug trenches and foxholes. We carried wooden rifles made from wooden crate pieces we got from Balsam’s Appetizing Store across the street on the corner of 95th Street and Church Avenue in Brooklyn. We nailed them together and shouldered arms. Together we wiped out many a German infantry company single handedly. I was also was the enemy saying either Achtung! Achtung! Die American swine! Or if I was the Japs ahhhh! sooo vely cwever szeesz Amelicans." Herman was always my willing accomplice and sidekick. After the day’s battle, we created yellow rivers of urine, peeing into the trenches we had dug. We were fascinated by the flow of the water through the paths we had dug out. As more and more kids joined the outfit, we were able to create tidal waves in the trenches.

The war was a mystery and a joy to me. It meant singing from the Halls of Montezoo ooo ma! to the shaws of trip o lee and the’ kayys ons are rolling along and off we go into the wild blue yonder, anchors away my boy, anchors away were constantly repeated refrains. Listening to the 78 rpm recording of Red Army Choir singing the wondrous and lilting Meadowlands with its cavalry way far away in the distance, then the crescendo and finale with the whistling of the soldiers and the deep, powerful Russian voices of the Red Army Chorus, whose picture was on the album cover, I thought if the Germans were only allowed to hear this music, they would quit the war immediately.

It was an exotic time. The lights of Canarsie Bay at night were lanterns shining on a mystical, tropical island. Sailors and their dates clung to each other, their sinuous bodies wrapping around curvaceous, beautiful young women for love. The world was perched on the razor’s edge between intense love and violent death. Later in my life the work of Reginald Marsh, the great WPA artist, evoked my earliest years on the planet, swirling colorful nylon coated, long-legged flowery dressed, ladies and young uniformed men hot to trot. Coney Island, the rivers Hudson and East, the Atlantic Ocean, Atlas holding up the world, trolley cars, crowds, people in uniform, flowery, flowing dresses revealing maize pink and white briefs in a breeze, red lipstick, images of intense sensuality powerfully leap to my memory.

The subway had shiny straw seats. When it pulled into Brighton Beach Station, there was the promise of great steaming, hot delicious knishes at the bottom of the stairs filled with potatoes, kasha and even meat. The sandy streets beckoned us to the beach. The damp sandy smell of the subway stop at Brighton Beach was a signal for joy.

A warm, slow cooking gefilte fish smell-taste combined with the flicker of many candles harkening back to the original light of creation, suffused my grandmother’s apartment on Friday nights. My mother was still beautiful and young. My grandfather was strong and working hard in his shop. My grandmother wept bitter tears as she read letters concerning the murders of her family in Europe and the Yarzheit lamps, the memorial glasses laden with wax, filled the kitchen with eerie shadows cast by the iridescent orange-yellow light of Friday nights. It was erev Shabbos, the evening before the Sabbath. Soon the light from the flames of the wicks became so intense that the red golden flickering and the dancing shadows of our murdered European brethren created a shadow box show on all the walls.

In grandma and grandpa’s house, there was an especially horrendous story about my grandfather’s sister Brana, who, while trying to escape the SS Einsatzgruppen carrying her three-month-old baby, was stopped on the road. Nazi soldiers laughed as they threw her baby in the air and shot it for target practice. Then they raped her. Then they shot and killed her. She was grateful to be shot noted the eyewitness, who sent the letter in Yiddish to my grandfather. The story breaks my heart to this day. Many times the Nazis would kill children in front of their mothers and not kill their mothers so that they lived with the pain of the memory. My early reality was filled with such imagery and they became for me a kind of screen upon which the rest of my life was to be played.

Where people live and who lives next to whom is very important when you grow up. I lived on the second floor of a five family house on East 95th Street in Brooklyn. In the house next door lived my grandparents on my mother’s side and four other families. The houses were attached so that the wall of our dinette area touched the wall of theirs. Below me were Mrs. Glantz and her beautiful daughter Myra. Above me were the Sirota’s—Dunya, Gedalia and their son David. Loud, colorful stirring sounds of patriotic Russian music filled the night, often the day. The Sirotas had been good communists. David, 16, and was said to be a brilliant genius. In front of them were the Levines and their son Arnold, who was about 15 at the time. He used gobs of Brylcreem on his hair, and his head therefore shone brightly in the sun as he sat on the green bench on the red stoop downstairs. Arnold, unlike David, was not thought to be a brilliant genius. He was a yenta, Jewish meaning busy body. He was like his mother, Mrs. Levine, a bigger yenta. The thought of what yentas would repeat was to become the bane of my existence later in life. What rumormongers and purveyors of third party wishful thinking purporting to be tellers of the truth has become a great societal problem as well. One of the Lord’s primary admonitions to man in the form of the commandment Thou shalt not bear false witness against thy neighbor is considered by the Lord to be a major infraction of the rules of existence and worthy of divine sanctions. Yentas can ruin humanity. False information can result in major disasters.

Down the hallway from me in the front lived Miriam and Mordicai Goldberg with their daughter Eloise. She was my main babysitter. She had red, beautiful, apple cheeks, big brown eyes and a round face. She had a bright cheerful disposition and hundreds of comic books, which she avidly read to me when she babysat. Downstairs, in the back under us lived the Haverbacks. In front, just to the left of the stoop, were the Glantz’s. Haverbach’s wife was sick; she was the Glantz’s daughter Marlene. She died at a young age leaving Mr.Haverbach a young widower. Across the yard from us was Mrs. Matlick. She engaged in the old world custom of dropping garbage into the yard from her window. She did not like us kids when we played loudly in the yard shouting, Matlick’s dumping again! for all to hear. She preferred anonymity.

Across the way lived Helene Katz and her sister. Helene and I played house a lot in the alcove of the cellar of her building. There was always a big argument as to who would be the kids and who would be the father. Helene was always the mother because she was the only girl. She had a sister, Laura, who was about 19 and who my father used to secretly watch get undressed through the Venetian blinds of his bedroom at night.

I felt that there was some deep dark secret that the Goldbergs knew about how my parents had somehow done wrong by me. Forty years later Miriam Goldberg sat alone wearing adult diapers in a nursing home in Far Rockaway, Queens. She had developed Alzheimer’s disease. I had not heard from Eloise Goldberg for about 20 years. Her beautiful then 18-year-old daughter slept over at my house in Chestnut Hill, Brookline, Mass. while waiting for a place to live near Brandies University, where she was to attend college. Eloise called and said that she wanted me to see her mother because she felt that they weren’t doing the right thing in the nursing home. I agreed to see Miriam.

Simeon Locke MD, a neurology professor, who had studied central nervous system (CNS) degenerative diseases like Alzheimer’s, used to say, the brain peels away like an onion. He played tape recordings of patients over time going from polysyllabic to monosyllabic words finally to ga ga and goo goo. Along with the verbal and conceptual regression, there was the inevitable behavioral regression. In the end stages of Alzheimer’s, an adult body lives with an infant’s brain. The patient has to be totally cared for and can be dangerous and embarrassing.

The room smelled of feces, and it was dimly lit. Miriam was tied to the bed with a Posey support-restraint canvas belt so that she could not wander or fall. I stood in the gloom and could make out a face that could have been the Miriam I knew in my infancy and early childhood, but it was dull animal-like, expressionless. The humanity was missing. She wore very large diapers. There was a table surface across the bed with what looked like a bowl of wallpaper paste in front of her. I slowly approached the bed and gently said Hello Miriam. She looked up. Her face suddenly lit up and a human smile sparked brightly. She came to life. Prospero! What are you doing here? Where were you on V.E. (Victory in Europe) and V.J. (Victory over Japan) days.

I remembered immediately exactly what I was doing on V.E. Day. I was in Lenore’s basement annoying her and Srully as they were trying to neck on a divan. On V.J. Day, I was out with the crowd on the block cheering and sitting on many shoulders looking up at the effigy of General Tojo hung between Sonny’s Candy Store and Balsam’s Appetizing Store on the corner of 95th Street and Church Avenue in Brooklyn. I told Miriam where I was, and she said she already knew and smiled. We had a great block party, she said. I thought you were lost, sometimes you are so bad. I smiled back. We started to talk about the neighbors. We discussed the Levine’s and the Sirota’s and the latest gossip on the block circa 1945. I asked her how Mordecai was and she appropriately saddened, he’s gone.

A tear left the corner of her right eye and ran down her face. Her husband had died long ago. She still missed him and for several years doctors had thought that her memory loss and decreased functional capacity was due primarily to depression.

She and Mordecai Goldberg had been married for over 45 years. How’s Eloise? I said. She’s fine, replied Marion. Her face started to freeze into the same expressionless mask I saw when I first entered the room. She reached under the sheets and appeared to be searching for something. She pulled up a piece of feces. She placed it on her tray and started to play with it. She was in diapers now. I was in diapers when she first came into my life. Now she was in diapers and so it goes in the words of the immortal Kurt Vonnegut.

Ontogeny recapitulates phylogeny, Professor Willy used to say in the main lecture hall in Havermeyer Hall at New York University Heights. He had a very nasal way of saying it as he gazed onto the banked seated classroom through his thick, Coke bottle, glasses as his mustache scrunched up against his nose on tah genie rekapit! U lates Phi lodge a knee! He wore a Prussian, blue three-piece suit and was bald. He looked and sounded like W.C. Fields in the Bank Dick. The words meant that the development of a mammalian animal’s evolutionary structure throughout the ages leads up to the current organism. The phylogenetic anatomical expression occurs as the organism matures embryonically. In humans, we go from sponges to fish, to tadpoles, to mammals right in the womb. When we are finally born, we leave our aquatic realm.

Many years later I was to say to medical students: "The psychological development of humans recapitulates itself throughout the ages of man, and we move up and down individually and socially as the situation demands. Phylogenetic behavioral components are recapitulated from blind mouths to mutual humans. We go back and forth as biology and reality demand. The process plays out at all levels.

For example, it was my karma to ontogenetically play out my tennis serves exactly, clumsily and poorly the way I first started it at the beginning of each season. It was my dharma to not force it and to let it evolve so as to achieve the fine and excellent way I had improved it over the last 30 years. If I did not allow this to happen, I would have a lousy serve and a lousy season.

Chapter 2

Kindergibber and the Vitchvatcherbars

When I was just a kid, for as long as I had remembered, I thought that the inclination to do good or evil was a voluntary activity.

Little appeared to happen spontaneously. Things were always my fault and my fault only, one way or another. I believed that everything that happened to me was because of me. I later was to learn that the Jews, as a group, had over the ages, viewed this as a gift from G-d. Taking responsibility for all our actions is a microcosm of the ongoing struggle against the seeming randomness and violence of nature.

The act of creation of the universe is G-d’s own free will exerting itself over chaos. Being created in G-d’s own image meant having free will just like G-d. It was his, hers or its gift to us, his own chosen people when he created us in his own image. Our Tikun or universal G-d given task as a religious group, was to overcome the chaotic demands of our own instinctual drives and be as much like G-d as we could by obeying as many of his 615 commandments as spelled out in the Torah as we could or minimally the first ten, if we could. We had to overcome our instinctual and immediately reassuring tendencies to seek out pagan gods, replacing them with the one G-d by accepting the abstract law handed down by G-d to Moses then from Moses to us at Mount Sinai. The reason we did not get it directly from G-d was that we were too scared to go directly to him. G-d was too dangerous to be near. It was a matter of survival. There were to be no more orgies in front of golden calves.

Free will is a gift, a divine insanity. I had never heard the term until I was sent to Yeshiva when I was five years old. When it was explained to me, it was easy for me to understand. I felt that I had possessed free will for as long as I had been alive before that time. Neither being good nor being bad seemed to come naturally: they always seemed to me to be acts of will. I was therefore always over conscientious. Goodness and badness were invariably my own fault. All of my report cards for as long as I can remember said, under the heading in the back: Teacher’s comments—could do better.

Many years after my childhood in my early 60’s, I was carefully tested for character pathology by the world’s leading expert, and he found was that I suffered from being over conscientious. It took me a very long time to understand that there is, in addition to free will, an unconscious. When the unconscious takes over, free will takes a back seat and goes to sleep. Conversely, when you are asleep, your unconscious takes over; free will can not and does not exist. If being good and not committing a sin means consciously acting against instinctual tendencies and sublimating them or repressing them, acts committed in an unconscious state or altered states of consciousness are not the subject of free will or sin.

Eric Erickson discovered that the modes of expression in human societies were phase specific and time specific in terms of development. If you did not get through a given phase of development at the right time in the right way, it was likely that you would suffer on the road to maturity. He wrote a book called Childhood and Society. He showed that we humans are all locked into developmental modes, which are phase specific. For example, the earliest mode occurs in the oral phase during infancy. It is characterized by a total dependency on the mother. The relationship between the infant and the nurturing mother is called an anaclitic relationship. A sick patient reclined and incapacitated in a bed totally dependent on nursing care, is in an anaclitic relationship. In normal growth and development, it’s a relationship of total dependency. All expression is via the mouth to the breast. The infant sucks on the breast and areola area, and the mother gives the infant milk. All is well. Deprive the infant of the breast, and oral rage often ensues until the infant is satisfied. There are many forms of interaction and gradations of the suck and feed dependency relationship. Various thematic aspects of infant breast abuse exist, such as biting versus intense sucking. Ultimately, the infant learns to delay the need to suck and waits for the mother and the infant becomes acculturated into the mother’s time schedule. Timing is how society now has a say in the mother-child relationship and maturation proceeds apace. It’s likely that there is a time in utero when the fetus interacts with the mother in the womb as an individual entity. It may someday be discussed as the chorionic-placental phase or umbilical mode of existence, which may resemble the world of divers wearing scuba gear in warm waters. There then develops an anal phase, later a urethral phase as the organism struggles for increasing levels of control and self-assertion. Then the genital phase leading to modes that are ever more complex and modal, phase specific activities and expressions. All this development leads to autonomy as a human being leading to the ability to become a mature adult.

Taking a kid by the hand and leading him or her into the autonomous independent real world in western society is usually accomplished by a loving and giving parent of the same sex with the active participation of the parent of the opposite sex. My father wasn’t available to provide such a rite de passage. I had to find my own way. There was a dearth of ritual in my immediate family, my home, other than my mother lighting Sabbath candles every Friday evening. My father had no rituals. My grandfather had rituals. He davened, prayed, every morning by putting on tephillin. Tephillin were leather straps rapped around his arm containing a leathern box which he placed in the left ante cubital fossa at the level of his heart and on his forehead, which contained the Shema, the sacred prayer of all Jews which they should say as they are about to die—the words from the Torah: Hear O’ Israel the lord our G-d the Lord is one.

My grandfather was daily attesting to his belief in G-d with his heart and mind. My father taught me no such rituals. Nobody had time to teach me to grow up and become a human being. My mother sensed this lack of acculturation and that is why she so fiercely demanded that I get it elsewhere by sending me to Yeshiva. I wanted it from my father not from a strange man. The people in the Yeshiva assumed I was there already having absorbed religious rituals into my everyday existence. I had not done so.

Erickson’s phases imply modes of expression and general affective states associated with them. They also coincide with Freud’s maturational schema of migration of the libido and provide ample background for movement up and down the libidinal expressive spectrum with regressions and fixations all along the pathway. The expression of anger in a childhood could be accomplished by a loss of a previously learned autonomous behavior, such as bowel control. The whole process isn’t conscious and not within the control of the child. Free will isn’t involved.

Why was I the way I was? A black and white photograph of my immediate family taken right after the Second World War sits on my desk. I was five years old then. My uncles had returned and were still in uniform. They are at the top. They were young and thin and wore their khakis without ties. The uncles on my father’s side; Morris, Sammy and Harry had been spared the draft because they all had taken high blood pressure pills given to them by my Uncle Morris, who was a pharmacist. It was a Jewish tradition, in general, to avoid a draft if possible, whether it was the czar’s army or the American army. I did not think much my father’s way out with his artificially induced high blood pressure. However, on my mother’s side, things were different. Two of her brothers were old enough to serve, namely Beryl and Israel (Srully); Stanley (Shutzy) was too young at the time. They served because they felt they had to as matter of duty. In the picture they exhibit that far away look of combat in their eyes as though they were only interested in something having nothing to do with what was happening. It was the thousand yard stare of soldiers after combat. They look still frightened even though they were safe at home. They had seen worldwide death and devastation up close and personal. Their terror was exaggerated, no doubt, as the flashbulb went off, a form of posttraumatic stress syndrome. Painful traumatic events lurked in their unconscious and were shortly triggered into terrifying consciousness by the explosion of the photographer’s flashbulb. I stood with a blank stare at the front of the grouping. My mother stood behind me, ramrod straight, at attention her hands on my shoulders, like epaulets, each finger tipped with bright red glossy nail polish showing up as black in the black and white picture. Her original boyfriend and true love, Sidney, my middle namesake, had been killed six years earlier during the British commando raid on Dieppe. He was an American Jew who had volunteered to fight alongside the British before the US entered the war. My mother was beautiful in a 40’s way, full breasted and slim with red lipstick and hair dark and rich, wearing her floral patterned dress. My father Irving, wearing a flowery necktie and light double-breasted suit with a mustache, stands alone away from my mother, distant, not smiling. My grandfather David was a Layvee, a descendant of the Levites, caretakers of the temple of old. My father’s father Julius was an Israelite just an ordinary descendant of the ordinary citizens of old, one of 600 thousand who stood before Mount Sinai to receive the word of G-d. According to legend all Jews can trace themselves to one of three groups: Priests (Kohanim), Levites (Layvees), and Israelites (Yisroels). The descent is through the father, so mine was that of an ordinary citizen. My mother had married beneath her station. Papa, my favorite grandfather, my mother’s father, sits with Jean, the shop stewardess and the floor manager. She is in a flowery dress with her arm draped around my grandfather and around his shoulders with him grasping her hand with a big smile on his face. His brother, Hymie, stands at the far end, next to his daughter, my second cousin, Roberta, who looks like the twin of my daughter Miranda only 35 years before she was born. Hymie has no smile. The women of my grandfather’s shop sit around the table—Tessie, Trudy, Bessie, Becky, Ruby, Sophie, Irene and Eva—all looking into the camera with no real smile but with a look of contentment. The war was over, and they all had jobs.

Papa was a good boss. His shop manufactured Stanley Lingerie: women’s panties and bloomers—all sizes, including 4X and even 5x that also could be used as a parachute in case of emergency. My grandmother, Dora, his wife, her face blank, sits with a swirl of her hair covering the sebaceous cyst on her goulyah, forehead, plump, in black touching nobody with a smile. Papa is smiling

My father had abandoned me at an early age. How very, very different a relationship is my relationship to my own my son Avi, who sat on my shoulders and was the subject of intense adoration by me when he was the same age. Sometimes I think I had to be my own father. Perhaps that is why I went into the field of psychiatry later in life. I was wondering what I had done wrong throughout most of my early childhood that my dad should have left me so utterly alone. Boys need fathers who take them by the hand. Boys cannot be fatherless. I had to search for surrogates in schools and extended families of all kinds. Fatherlessness is a very painful thing for a young boy to experience. It leads to a lot of limit testing behavior, a lot of need to find boundaries. Sometimes I think of G-d, the father, as talking to the children of Israel, who were feral and knew no boundaries. He frightened them at first then asked for their love later.

Rabbi Kindigibber was a short, squat, heavyset man with a very thick neck. He had a ruddy face accentuated by an even redder and cratered huge rosaceous nose. He often gave off a whiff of herring and onions and wore the uniform of the Hassidim: yellow stained Tsitsis, a four cornered fringed garment, which had to be worn by all Jewish males as commanded by G-d, a yellow stained white shirt, no tie, a black vest which could only go halfway down his protruding belly, white socks, black heavy shoes and knickers. Saliva unavoidably dripped from his thick red lips and his gray-white wispy beard seemed to hide a multitude of personal afflictions, of which, we were, thank G-d, spared. I was forced to wear my own mini version of the uniform.

I sat in the first row, catching all the spray with the say. I didn’t deliberately sit there, but the other kids forced me to sit there because of my own, not so fragrant emanations, a sort of counter-smell to the rabbi. I had regressed in that place and frequently became incontinent resulting in my hiding soiled shorts in various corners of the Yeshiva. I was embarrassed. My unconscious had taken over, and I didn’t understand what was happening to me. I didn’t like attending that school. I hated it. My mother forced me to go.

It was the famous Vitchvatcherbar Yeshiva. It was 1946. I was six years old. Vitchvatch was a small town in the Ukraine, a shtetl that had managed to survive the pogroms, the communists, the Nazis and Stalin. As late as 1995 one of my medical students, a recent émigré, told me she came from there. Many great sages had emigrated from Vitchvatch, especially the famous Vitchvatcherbar Rebbe, whose picture was proudly displayed on every wall in the school, and who was the founder and leader of the entire Vitchvatcherbar community in Brooklyn. He arrived in the USA in 1920, about a year after the birth of my mother and six years after my grandfather, who helped pay for the rebbe’s passage. My grandfather, although not a true Vitchvatcherbar, having come from Kiblitch believed in the teachings and sanctity of the Vitchvatcherbar Rebbe and donated much money to the movement anonymously because humility in charity was the sign of true charity.

Loyalty to shtetl, a small Jewish village, was very important to the Jews who settled in this country. The loyalty to shtetl was so great that grandfather David was buried in the Kiblithcer section of the cemetery not with my grandmother. She is buried right next to my father along with my Aunt Lenore. My father is therefore to spend all eternity with two unpleasant women. Maybe this is his punishment for not being fatherly to me when I was a child

My mother insisted that I attend Yeshiva. I hated it with a great passion. I wanted to be a plain ordinary American citizen. All the neighbors saw how crushed I was to be forced to go. She would not relent. I had to go no matter how much I hated it.

Rabbi Kindigibber’s favorite topic was Berashet (Genesis). He said in de begginink dere vas nutink andt out of nutink, Hashem (G-d) created de heafvens andt de irth andt de voild vas tohu vawe vovu, (the Babylonian term for chaos, the period before creation) an emptiness a voit mitout shepe of fowrm.

The concept of a void without shape or form intrigued me, even at that age. And then he would say  . . . ant de nefesh (spirit) uff Hashem mooft overe dee face uff dee deeps. My first question to Rebbe Kindigibber was; if everything was tohubohu (chaos), how come it says there was a face? on the deep whose name was Tahom, the Babylonian goddess of fertility, over which the spirit of the Lord moved? Kindergibber looked at me at first, quizzically then with disdain, his pale blue eyes whitened by the florescent bulb above. Der aare soitin kvesht yuns dat cunnot be enseret unt shut nutt be esket unt dis ees von uff dem.

I later learned that another forbidden question was who made G-d? Wat iss yur namme? he asked. I told him, and he noted it in his big black book. One particular aspect of the creation story seemed directed at me. He would look at me intensely when relating it, ant Gut createtd menn ant breathted into hiss nustrils a soul ant gafe him a Yaytzer tov, zee inclinayshun to du goot ve Yazer harah zee inclination to du efil, but, his face would lighten up with great expectation of redemption, zer is alzo vreee vill! He would stare directly at me as though he knew something about me very, very special and very, very bad. It was as though there was no redemption for me. I looked at the bible and noted that there was no mention exactly of what Kindergibber was talking about and concluded he made up that part of the story. I remember wondering even at the age of six, how could free will fit in with these two basic inclinations. Either you were good or you were bad. Why would G-d make it in such a way that we should have such conflicting inclinations and free will as well? I was sure I was bad and lacked the free will to escape it.

Kindergibber was very suspicious of me and was convinced that I was the one who was stinking up the class by crapping in my shorts and hiding them behind the radiator. I was, in fact, one of the culprits. I neither was sure that he didn’t know, and if he did, he couldn’t prove it nor did nor could anybody else know. Maybe he did know. Maybe they all knew and just weren’t saying anything, especially Kindigibber who was becoming increasingly impatient. If Picasso had a blue period, this was my brown period. I lost many a pair of jockey shorts. I did not soil myself deliberately. In fact, to the best of my recollection I didn’t even feel it when I actually defecated.

When it did happen, I didn’t know what to do with it. The total lack of ability on my part to control it, as well as the damage it caused me in terms of social relationships, was very great. You my therapist may well be dubious about the issue of my not knowing when it actually happened, but I can honestly say that I didn’t know when it would happen nor did I know or understand or have the remotest understanding as to why I had so extensively and severely regressed. I use the term regression advisedly. Looking back my loss of bowel control meant that I had returned to a previous state of incontinence.

The regression began the minute I entered the Vitchvatcherbar Yeshiva, and it lasted until the fourth grade. Why then? And why in such a public venue as the Vitchvatcherbar Yeshiva, a hallowed place to my parents, especially my mother? It was her irrevocable decision to send me there. It was her iron implacable will, her choice to teach me respect and above all to give me a good religious background. There was no negotiation, no way out.

To this very day there is a strong association in my deepest psyche between the Hebrew language, the Jewish religion in general, foul feculent odors, helplessness and despair. I have been able to overcome this by diligently attending the beautiful Sabbath services given at Temple Rodeph Shalom on 83rd Street between Central Park West and Columbus Avenue in Manhattan, where I also study the Torah and other ancient books.

One very trenchant memory is that of waiting for my father to take me home very close to the first day of school. He failed to show up. I’m not sure how I got home. I felt that I had no father or at least one I could depend on. I was always being let down by that man and left to my own devices. I felt total social isolation and abandonment. At home, there was not much of a way to reach for the outside world for help. The radio was my only solace. In that plastic black and white box laid acceptance and closeness to a world I knew existed but not in my real world. The Shadow, Gangbusters, Sam Spade, Archie and Jughead, Superman, The Comic Weekly Man, Jack Armstrong and his All American Boys, The Jack Benny Show, Dagwood and Blondie Bumstead, The Lone Ranger and The FBI with its resounding L. A. V. A. L. A. V. A. Even the soaps, like Helen Trent and Our Gal Sunday," were all that I had to keep me somewhat sane in what I felt was a cruel and rejecting family, whose resources, both material and emotional, were very limited.

I was, implausible as it may sound, able to find some friends in Yeshiva. There were some fellow sufferers in the class. They were Moishe Staull and Solomon Nussbaum. I was sure they suffered from the same loathsome infirmity I had. They seemed to stink just as much as I did. Poor Kindergibber was frequently puzzled when he couldn’t be sure of which one of us had created the latest olfactory delight. Solomon Nussbaum had a small, mouse-like face. He was an imp. He would dart around Puck-like creating a ruckus and disappearing from the ensuing melee and general fracas. His family was very frim, religious, so he had it over me. His father picked him up on time when school was over mine didn’t. One day in the schoolyard, he hatched a plot to take the bubble gum machine from the candy store on the corner and bring it back to school. He reasoned we’re the only one’s that really use it so we should have it nearby. Moishe Staull was in on it and agreed that it was a good idea. The three of us dragged the machine from the store for about a block, carried it up the four marble steps of the Yeshiva and placed it in the main lobby, between the gold inlaid names of the original donors and the list of famous Vitchvatcherbars who had graduated from the Vitchvatcherbar Yeshiva right under the largest portrait of the rebbe himself. It seemed to be not only practical, but also a fitting thing to do. Nussbaum had said we were the only one’s using it, so it should be here. I was proud. Now at last I would get some positive recognition. We weren’t really interested in taking the money but making it easier for all of us to get to the bubble gum so that everybody could have his fair share. The glow of the accomplishment quickly vanished. The two other stinkers left the scene. In fact, I noticed, by the sudden silence that the lobby was empty. I stood there with a big smile on my face. It took a while to realize I was alone.

Suddenly I looked up, and there were the candy storeowner in a white apron and the headmaster Rabbi Holzbaum standing over me, looking like Saddam Hussein twins with skull caps. Next, there was nothing but pain, particularly in my left external ear with which Holzbaum grabbed me and hauled me off to his office. The other bubble gum thieves weren’t caught. I kept saying it was for the good of the school. He kept saying your father will hear about this. He wasn’t interested in the other two referring to me as the ringleader. My father was notified, and the strap was duly administered while my mother, after giving me the knipe, a very deep pinch from long fingernails strengthened with nail polish, yelled from the kitchen, Irving teach him respect, teach him respect!

The final and most painful strategy was the administration of a high retention enema. The enema was the most terrifying and painful experience of all. The big bright red rubber bag hung over my head like a rubbery sign from G-d reminding me that I was about to receive water judgment. I thought to myself better to have this than judgment by fire. The bag hung by shower hooks above me. Then there was the big black enema insertion tube. My father filled the bag with warm sudsy water and then came the slow filling of what I thought was my stomach. He kept it there until the pain became so unbearable that I screamed. I actually wanted and longed for death rather then this horrendous degrading experience. It was in the toilet that my parents chose to correct the lack of respect problem and to reteach me the doody in the toilet lesson. High colonics became de rigueur. It wasn’t only meaningless, painful and embarrassing, it didn’t help. In fact, I became so terrified I grew to hate all toilets. I developed less and less respect no matter how many times my father would make me kiss the strap.

It was then that I began my first severe head banging episodes. Banging my head against a pillow at night became my only comfort and greatly helped me to fall asleep. I imagined man-eating demons were coming after me, and the only way to scare them off was to bang my head and then my feet as well in the bed. Since my mother was becoming increasingly deaf, she presented no problem, and my father was not interested nor was he home much. Several years later I was frightened out of my wits and ran out into the middle of the street when Mr.Haverbach, Mrs. Glantz’s widower son-in-law who lived in the back room just under my bedroom, and who had thought all those years that the banging was due to my father’s sexual involvement with my mother, struck back.

Mr.Haverbach had noted one summer evening that there was much banging. He couldn’t sleep. He had seen my parents going to a movie. He began to bang furiously back at the ceiling with a broom handle, and when I heard the noise, it was as if all the evil demons of hell were coming after me, and I bolted out in to the street in my pajamas screaming for help.

Soon I became a truant. I would take my green metal tube top rectangular bottomed lunch box with a thermos full of tepid grape juice, with the over-ripe fruit, the sandwich of either pieces of greasy chicken with mayonnaise or salami with mustard, and go to the roof of my building and stay there until it was time to go home. My ruse worked, at first, especially in the spring, but I couldn’t resist throwing pebbles down on unsuspecting elderly passers or shpritzing them with seltzer that I purloined from the Sirota’s seltzer box on their fire escape. I was, of course, caught. I couldn’t figure out why because, how could they know it was I? The treatment was the strap, the enema, the knipe and worst of all the demand that I get right back to school or I would be sent to the dreaded reform school, which was up the river somewhere. I had been sure that I could remain undetected on the roof. I had nobody to talk to.

My old friends, Herman, Arthur, Michael and even Joseph were in P.S. 219. I was in hell. I even hid myself in my mother’s bedroom closet amongst the hatboxes and the fur coats. It was cozy at first, but I was caught by early afternoon after I surfaced for air. I remember putting on my mother’s soft elbow high black gloves and broad brimmed black hat with a mask made of variegated kerchiefs and played Zorro, leading an imaginary sidekick named Poncho to newer and greater adventures to break the loneliness and cut into the despair. Sometimes the same outfit allowed me to become the Lone Ranger, and I could talk to Tonto who always spoke back to me in a deep Native American referring to me as keemosabbie. There was isolation, and there was depression.

There were days when I actually attended school. Kindergibber’s second favorite theme was G-d’s discussion with Abraham and the whole Abraham story. In our textbook was a picture of an elderly man with a white beard wearing a turban humbly gazing into the night under the stars being told by G-d that your seed shall be as numerous as the stars in the heavens and as the grains of sand upon the earth, and you shall be the father of nations. We never had regular notebooks like I noticed other kids had, but carried Makberesis designed for Hebrew notes with another turbaned individual named Rashi, a medieval Jewish scholar’s dour image engraved on it also wearing a turban. He was another ancient individual with whom I felt no kinship.

Eet vas den, said Kindegibber, zat Abram beekem Abraham zee fater uf nayshuns. Kindigibber loved that idea and viewed it as a direct continuation of G-d’s original charge to Adam and Eve to be vrootvul unt moolteeply. He would also relate this to Noah, who he thought was only relatively righteous, and G-d therefore chose him. Noah vas rightshiss in hiss generayshuns, said Kindegibber. As with respect to the command to be fruitful and multiply, he would often refer to Noah’s sons Shem, Ham and Japheth, especially Ham, who he said was not like his father or his brothers and wasted his seed in a tent with his father Noah who was asleep at the time. As a result, Hashem, G-d, banished poor Ham to live in Africa.

To me, at the time, the entire discussion seemed to be related to agriculture and desert farming. All this talk about seeds and fruit had no real meaning for me. I raised my hand when he asked the class what we thought it all meant, and I said G-d told Abraham that he will eventually have enough to eat in the desert if he would not waste seed like Ham, who wasted it his in his father’s tent. Kindergibber, who saw himself as a reserved and rational man, reflected for a moment, looked at me and his thick lips parted in an enigmatic half smile, half frown and proceeded to tell the story of Onan.

Onan, he said, committed a great avairah or sin. He fas vakinkg alung-dee rode ven he met a shiksa (a gentile female) unt den he vaistid hiss seet onto de rode, said Kindergibber. Onan was then summarily struck dead by G-d. Kindigibber glared at me. I could feel his heavy schmaltz herring breath on my face so what du yu tink of dat Ephraim (my Hebrew name)? I could think of no rational explanation. I said I never met a shiksa. The only girl in this class was Luba Cohen, and she’s over there. Ask her why Shiksa’s like seed to be wasted? G-d just didn’t want anybody to waste their seed because children were starving in Europe, even then. Whenever I couldn’t stomach my mother’s under cooked liver, steak or beets for borscht, all of which reminded me of blood, I stood the risk of being accused of wasting food and was subjected to a knipe with the admonition that children were starving in Europe. She had to eat almost raw liver as prescribed by the doctor because she was anemic, stemming from her