“Voices are a soul’s signature,” says psychologist Dan Shapiro, who in his daily practice hears plenty of them. For all his expertise, he admits he’s still terrified that “someone will keep something from me, and when they tell me the truth, I’ll be useless.”
Treating other physicians has become one of Shapiro’s specialties. When the obstetrician Amelia Sorvino seeks his help—distraught that her own medical error could have injured a patient’s baby— Shapiro finds his talents as counselor and healer pushed to their limits. Session by session, he works to discover the sources of Amelia’s anguishfor his own sake as much as hers: he’s familiar with the burden of a doctor’s guilt, and he has seen how loss and trauma, if unchecked, can echo from generation to generation in a family. In this probing, intensely personal memoir, the words “Physician, heal thyself” assume a fresh and moving urgency.
|Publisher:||Knopf Doubleday Publishing Group|
|Product dimensions:||5.21(w) x 8.00(h) x 0.56(d)|
About the Author
Dan Shapiro is an assistant professor of clinical psychiatry at the University of Arizona, and the author of Mom's Marijuana. An expert on physician self-care and physician-patient relationships, he has been featured in the New York Times, the Chicago Tribune, Salon, and on ABCNews.com. He lives in Tucson. For more information, visit Dr. Shapiro's website at www.danshapiro.org.
Read an Excerpt
I sat behind Lauren Riley in seventh-grade English. Like me, Lauren was a camouflaged soul, invisible to peers. She was bright and always had some precocious book in her bag like Richard Bach's Jonathan Livingston Seagull or J. D. Salinger's Franny and Zooey. The protagonists were always smart and sensitive and misunderstood.
In the race toward puberty Lauren was behind most. She was a little heavy around the middle, as if the extra stores of toddlerhood had never burned off. Breasts, which had a magical power over me, were starting to make their first appearance among our most advanced female classmates, but Lauren remained flat. She had long, straight brown hair and split ends. Her clothing was always conservative and never quite fit. She usually dressed in dark colors and some of her dresses were homemade, the stitching obvious. Our lockers adjoined. The inside of her locker door was covered with newspaper articles about famous women pilots and politicians and a carefully written list of countries she wanted to travel to in alphabetical order1) Canada, 2) Denmark, all the way down to 10) USSRwith only Canada checked off at the top.
In seventh grade notebooks were our vanity plates. At the time, heavy blue canvas three-ring binders were the most common type. Using one of them, I could keep all of my subject notes in one place, making organization easy. Most students scrawled across the fronts of them. jesse and rachel, true love forever. Or the names of rock bands: blue oyster cult and acdc. Or sports teams: red sox, patriots, or celtics rule. Lauren carried separate notebooks for each class and had the names of famous women written on her binders. For science, she had madame curie written in neat cursive on the front of the notebook, and harriet tubman for history.
She redefined quiet. In English, if Ms. Pearlman asked an open question such as, "There are four points of extra credit toward your next test grade to anyone who can answer this very special question, a very challenging question," Lauren would sit as still as an oak and drop her head toward her desk.
"Who can tell me why Holden lied so often?" Ms. Pearlman asked us once. We'd been reading The Catcher in the Rye. I thought it was funny that he lied so much but I had no idea why. There was silence in the room as Ms. Pearlman slowly walked down our aisle. Paul Croteau and I figured it out once, that she paced a few miles every day up and down the aisles. Ms. Pearlman could wait for an answer. She was as patient as a stalker.
Ms. Pearlman arrived at Lauren's desk and smiled gently at her. "Lauren."
And Lauren said, without moving even a hair, "Maybe Holden lied to shield himself so that people would never really get to know him?," her soft voice disappearing into her desk. Ms. Pearlman smiled and repeated Lauren, as if she were translating for the rest of us, "That's right. Holden lied to shield himself," and then Lauren and Ms. Pearlman stared at one another, Lauren's eyes wide open like a scared rabbit, afraid of a follow-up question. Then Ms. Pearlman turned and continued up the aisle and Lauren exhaled softly into her hand.
Ms. Pearlman often tried to get Lauren to repeat whatever she'd said. When she asked us to explain why the man in "The Tell-Tale Heart" heard the pounding under the floor, four of us had provided answers like "Killing people makes your senses intense" or "The guy had, like, come back to life, man." Lauren said flatly, "He felt guilty." Ms. Pearlman prodded Lauren a few times to repeat herself until her voice was loud enough to be heard beyond her own desk, and then Ms. Pearlman stopped pacing. She smiled directly at Lauren, as if they had shared a private confidence. We all looked from one to the other, as if we were at a tennis match, before Ms. Pearlman went back to her pacing.
I teased Lauren every now and then. Her hair was so long that it occasionally covered my desk when she sat down, long brown strands fanning out across the surface like a peacock's tail. A few times I'd kneeled on my chair and put my head under her hair and asked David Roth to look at me.
"Check me out, I'm Lauren's twin brother." Lauren would spin quickly, a frown at first, and then a slight smile, and she'd gather her hair together and hold it to her chest. She never said anything, but I knew she wasn't angry.
One morning before English, I went to sit in my seat behind Lauren and found a note on my chair. It was folded in the "note" style, an elaborate origami square with triangular folds that made the note small and tight. Across it was my name written in neat cursive. I fought to open it and then stared at Lauren's careful handwriting. I need to tell you something...it read.
I said, "What's up?" but Lauren was turned away from me in her chair, her head down, and she didn't turn around. I waited. No response. I wrote a question mark below her writing on the note and tried to fold it back up in the right style but I couldn't get the final flap to fit. I gave up and dropped it back over her shoulder.
She opened it. While she wrote I considered the note and perked up. Recently I'd started to identify new feelings. One of them was for Lauren's best friend, a girl named Debbie. Notes were a common way to share romantic information because a friend could act as an ambassador and keep the evidence of everything said on both sides. The rules of adolescent diplomacy were elaborate and serious.
The note landed back on my desk. Folded perfectly as before. I struggled and then unwrapped it. You can't tell a soul. Standard procedure. I studied the letters. They were perfectly formed, the Y written in cursive looped perfectly. I scribbled "OK" and didn't even try to fold the note up properly. I dropped it again over her shoulder. Her head bowed and she scribbled more. Then she turned in her seat and looked back at me squarely and put the note on my desk, unfolded. Beneath my hastily scrawled "OK" was her response.
It's about me and my dad. I don't know what to do.
Not about Debbie. I sank. Lauren spun back around, leaving me staring into her fleshy neck. At the time, marital disputes were an epidemic. A lot of our friends' parents were divorcing. When Cathy Fox had suddenly vanished from math, Roland Cheyney had told me, "Her mother is taking her back to South Dakota where she's from. Man, like, it snows every day and it never gets above twenty degrees there." That night at dinner I'd studied my parents and cleared the dishes without being reminded. Maybe Lauren is going to have to live with her father?
There was some activity in the class and Ms. Pearlman quietly said, "Hush up, now," and then told all of us to turn to page 121 of our readers. Lauren reached under her desk and pulled up her Edgar Allan Poe reader. Then she folded her hands over her book, the ready student.
I wrote another ?? on the note and this time folded it to the best of my ability. When Ms. Pearlman looked down into her book and began to walk, her back to me for a moment, I slid the note around, onto Lauren's lap. She let it sit there. I pulled up my book, quickly found page 121, and waited. I felt eyes on me and looked at Ms. Pearlman, but she was opening her book and said, "The Raven." Looking to my left, I saw David Roth looking at me. He put his eyes toward Lauren, nodding slightly and then toward me, as if asking if we were "going out."
I gave him the finger, hiding it behind my other hand.
Ms. Pearlman told Michael Almonte to read. He was in the dreaded first spot in the front of the room in the corner. Michael was a bright kid who hated to read aloud but after a brief complaint, he complied and started with a slow pace, his voice carrying the slightest Italian accent.
Once upon a midnight dreary, while I pondered, weak and weary, Over many a quaint and curious volume of forgotten lore...
I'd met Lauren's dad once when he came to pick her up because Lauren's mother was sick. She was sick quite a bit. Mr. Riley was a short, slight man with a lot of hair. He wore black glasses that were too big for his face and had a chain on his belt that disappeared into his pocket. His pants were always baggy, as if he'd lost fifty pounds but had never bought new clothing.
The note landed back on my desk, again folded fastidiously. I used my pencil to pry it open. Ms. Pearlman asked Wallace Crenshaw, sitting next to Michael, to read next. Wallace barked out each word as if doing the play-by-play at a baseball game. Whenever he tripped over a word he started the entire sentence over.
I looked at Ms. Pearlman. She mouthed the words, as if she could magically help Wally read the lines accurately. I looked down into the note.
My father touches me.
Suddenly my mouth was dry and my whole body went stiff. Wallace Crenshaw's staccato rendition of "The Raven" screamed in my ears.
"'Tis some visitor," I muttered, "tapping at my chamber door; Only this, and nothing more."
And there it was. It descended on me like a curtain. A divide between childhood and adulthood, Lauren perched on one side, her plump childlike body holding out her hand to me, and I still on the other. My face felt hot.
I wrote, Tell your mom? and handed it around her into her lap.
She wrote for a few moments and I listened to Wallace pound out Poe's poem. Lauren's note landed back on my lap. No way. Would kill her. Ms. Pearlman called on someone else and I sat listening, my pencil hovering over the note. A fantasy brewed of me waiting with three friends for Lauren's father outside of Connecticut General, where he worked as an actuary. All of us wearing masks and carrying baseball bats. It would be dark. "Working late, Mr. Riley?" I'd ask him. Then we'd surround him and he'd ask who we were and what we wanted. I'd beat the bat in my hands a few times, like in the union movie, just to show we were serious, and his eyes would open wide. Maybe he'd pull out his wallet and offer it. "We don't want your fucking money," one of us would say. Then I'd say, "If you touch your daughter again, we'll kill you." My voice would be deep and powerful, like Paul Robeson's or Darth Vader's. I felt a rush of adrenaline and my head felt clearer.
She needed to be rescued. Call the cops, I wrote. I handed it over and Lauren read it and shook her head while she carefully wrote a response. What was wrong with calling the cops?
I looked up and Leo Gerome was reading.
And the silken sad uncertain rustling of each purple curtain Thrilled mefilled me with fantastic terrors never felt before.....
Lauren handed the note back. I opened it.
Won't work. Don't want foster care. They could take me and my little brother away. If the police didn't believe me, I'd be stuck with my father, and he'd know I'd told on him, then what?
I didn't have a response. I sat in the chair feeling restless. There had to be an answer. A good answer. There's always a solution. Isn't there? Lauren spun in her chair, grabbed the note, folded it up, and the exchange was over.
That evening, at home, I got down the yellow pages and looked up the number of an anonymous help line in Hartford. Then I called Lauren; her family's number was in the book. An adult male voice answered the phone and said, "Who is this again?" after I had already told him. When Lauren came on I asked how she was.
"Fine," she said, curtly. I heard his voice in the background asking who the hell it was. I realized it was probably the first time Lauren had been called by a boy.
I said, "I got the number of a hotline, for people in...you know...the same situation. Uh, it's..." and I read off the number quickly, but I could tell she wasn't writing it down. Then she said, matter-of-factly, "I have to go." And she clicked off.
I stood for a moment listening to the dial tone. It hadn't gone at all as I'd expected. On the bus, on the way home, I'd imagined us talking for an hour, and me eventually giving her the number. Of course, in my fantasy she didn't really need it anymore, because I'd been so helpful and, somehow, telling me had solved everything. I fantasized about her telling all of our friends, and especially Debbie, what a decent guy I was, how mature.
Then I began to worry. Maybe I shouldn't have given her so much advice? Maybe I should tell my parents? But that would probably make things worse; they'd call the cops, or the school principal, or reporters. Lack of assertiveness was never one of their shortcomings. I hung up and went down to my room, turned on a comedy show, and tried to forget it.
Lauren and I never spoke about it again. I didn't have the courage to ask her what had happened. Or even how she was. I stopped teasing her. I think I stopped talking to her altogether. When I saw her in the halls she usually had her head down, her notebooks pulled to her chest. When I saw her at her locker I waited for her to leave and then went to my locker.
Two years later, when we were in ninth grade, Lauren suddenly disappeared. She just didn't show up for school one day. There were rumors about her being pregnant, or a secret pothead, or that she was involuntarily put into a hospital up in Boston.
I never saw her again.
It's been twenty-two years since I last spoke with Lauren. I'm a clinical psychologist now. I can't say what impact she had on my choice of career, only that she's never far from my mind when I'm doing therapy. I'm still terrified of the feeling that someone will keep something hidden from me for a long time, and when they do tell me the truth, I'll be useless. When they finally beg me to throw something into the frothy water to save them I'll scurry along the banks, frantic, unable to find anything that will help.
What People are Saying About This
"Explores wth startling depth and immediacy the question of who shall heal the fallen physician." –Elle
"A terrific read: deeply touching, keenly analytical and warmly amusing. No reader will come away unaffected. And no reader will fail to gain new understanding of the intricate web of skills and attitudesmind and heartthat constitute a good doctor." Milwaukee Journal Sentinel
"Masterful storytelling. . . . Amelia's secret keeps the pages turning. . . . A fly-on-the-wall peek into a doctor-patient relationship. . . . a well-written, suspenseful story." Austin Chronicle
"Like Oliver Sacks, Shapiro presents this medical case and its professional analysis from a unique perspective that the public seldom shares. His book is highly recommended for its naked revelations of the medical and psychiatric professions and its truths about the human condition, our frailties, and our vulnerabilities." Library Journal
“There are a few gifted doctors and therapists–the neurologist Oliver Sacks comes to mind–who manage to bring the narrative skills of a novelist to their discussions of the disorders that plague the human body and spirit. Dan Shapiro . . . appears to be one of them.” –Milwaukee Journal Sentinel
“Shapiro clearly shines as a gifted physician and an expressive author. His writing ambles competently from page to page, dishing insights in carefully measured, melodic prose. The underlying message is one of human frailty, compassion and a better understanding that we all are somehow responsible for one another.” –Rocky Mountain News
“By plying his own hard-won wisdom at having been both terrified patient and uncertain healer, he succeeds not only in ‘delivering’ Dr. Amelia but also a compassionate and stirring look at the inner lives of medical professionals.” –St. Louis Times Dispatch
“Dan Shapiro . . . is a psychologist who specializes in treating troubled physicians. The message is important: Doctors are not omnipotent. As human beings, they sometimes make mistakes and need healing of their own.” –Atlanta Journal Constitution
“In a choice reminiscent of Kay Redfield Jamison in An Unquiet Mind, Shapiro writes about his own responses to Dr. Amelia's revelation. . . . Each season, book after book rolls toward the public pregnant with ruin. Here is a rare story about healing that seems earned.” –The Plain Dealer
“Honest and perceptive. . . . A very sensitive and engrossing medical memoir.” –Publishers Weekly
“[Shapiro] preserves an important message: Doctors are human beings who falter sometimes and must find solace before they resume their lives.” –Arizona Republic
“A fascinating view of the interactions between a psychologist and his patient during the therapeutic process. . . . A revealing narrative of self-discovery.” –Kirkus Reviews
Typical psychiatrist/patient interaction & session story, yet it was uplifting in that I having been employed in on various labor and delivery units, I sympathized with the physician and her troubles. I was also able to see some of my personlity in her persona.