By the Time You Read This

33

DOROTHY BELL WAS BUNDLING up the newspapers for the recycling when an article caught her eye. She spread the paper out on the kitchen table and peered at it nearsightedly. According to the article, over two hundred mourners had attended Perry Dorn’s funeral. Perry Dorn, it said, a recent graduate of Northern University, had had many friends and the respect of his professors. The newspaper quoted several people who had known him.

“He was a very generous guy,” one said. “Whatever Perry had, he’d share it with you. Even when he was broke.”

“Always looking out for others,” said another.

“A very sharp intellect,” according to a professor of mathematics. “You had to work hard to keep up with Perry.”

The reason the Algonquin Lode was giving the funeral so much space, of course, was that Perry Dorn had shocked the community by blowing his brains out in a laundromat.

Long subject to depression, the paper said.

“But lately he seemed to be getting better,” said a fellow student. “He was looking forward to doing graduate work in Montreal. He was very excited about McGill.”

One of the subheads read “Romantic Reversals,” and under this a former roommate stated that Perry Dorn had had a tendency to become emotionally entangled with unattainable women. “The shame of it was, he could have had lots of girlfriends. There were lots of girls who would have gladly gone out with him, he was so smart and gentle. But he always went for the ones who weren’t interested. Then he’d get depressed and wouldn’t eat or sleep or even talk for days. It could get kinda spooky.”

Shelly Lanois, the young man’s sister, said only: “We’re all too devastated to comment.”

The name Perry Dorn didn’t mean anything to Dorothy Bell, but she might have recognized his face in the picture sooner had he not been wearing the graduation cap. It hid his prematurely thinning hair, but it did not hide the scrawny chicken neck, the outsized Adam’s apple, the deep-set, mournful eyes of the young man she had seen several times in the waiting area outside her husband’s office.

The moment she did recognize him, her heart began to pound. A young man on the verge of graduate school chooses instead to end his life—and in a spectacular manner. A young man who had many reasons to be happy and optimistic. A young man who had been a patient of her husband’s.

When Dorothy had first met Frederick—well over thirty years ago now—she had been deeply impressed by his intelligence. She had been no slouch herself, winning excellent marks in nursing school, but he had the kind of brilliance she had known she would never possess. He was dark and handsome—no beard, no specs—with a charming array of nervous tics. Even in his twenties he was a bit of a star at the London hospital where they worked.

When one day he asked her to go out to dinner with him, she had trouble forming the words to answer him. She turned around to look behind herself, to see if there were some other young doctors in the hallway who were in on the joke. But there was no one.

Neither of them had any money in those days. He took her to an American-style joint on the King’s Road with jukeboxes and bottles of Heinz ketchup in each booth. Hamburgers were an exotic treat in London in those days. Long after they were married, Bell told her that the place had turned out to be much more expensive than he had anticipated. He had had just enough to cover the meal, no tip.

“Never dared set foot in there again,” he liked to tell friends when he recounted the story. “Too embarrassed.”

From the first, Dorothy enjoyed his intelligence and his sense of humour. He liked her sensitivity, and the way she could transform a dreary duplex apartment into a real home. They were so contented that they saw no reason to disrupt the pleasantness of their life with children. That, at least, was the way Frederick had put it. Dorothy would have liked to try, but she sensed from things he said that he was not a man who would enjoy fatherhood.

She could still think back on those first few years with nostalgia. They amused themselves with weekend forays to obscure English villages and the odd walking tour.

Gradually—she couldn’t have said when it started exactly—the early happiness began to be marred by a certain instability in Frederick’s professional life. He had been overjoyed to be on the staff of the Kensington Clinic; it had a great reputation, and he was lucky to be there. But after only eighteen months he’d suddenly announced that they were moving to Swindon, where he was going to join the Swindon General Hospital. It was a pleasant enough place to work, and Dorothy enjoyed the other nurses there, but it had seemed a considerable step down. This was not a view she aired aloud.

It was while at Swindon that Frederick was investigated for over-prescribing. As he had explained it to her, all he had done was prescribe a tricyclic for a depressed patient, hardly an exotic line of treatment, but the patient had almost immediately swallowed a bottle of sleeping pills, also prescribed by Dr. Bell. The bereaved family claimed Bell had ignored obvious cries for help, that the boy should have been hospitalized. The hospital’s inquiry merely found him somewhat lax in follow-up, and gave him a reprimand. Even so, he had been outraged.

“Idiots,” he had cried. “Morons. What do they know? Depressed people kill themselves all the time. For all they know, that kid would have been dead months ago if it wasn’t for me. Suicide is what depressed people do. Hiding their intentions is also what depressed people do. They get good at it. If the charge is that I failed to read his mind, fine. I plead guilty.”

Of course, reading minds is exactly a psychiatrist’s job, Dorothy thought, even at the time. But Frederick was her husband and she stood by him, sharing his outrage. The young doctor had been so grateful that this early adversity strengthened their marriage.

Despite this episode, Frederick managed to find himself a better position soon after, this time in Lancashire, at the Manchester Centre for Mental Health. It suited him much better. They became active in the community, made many friends, gave enviable parties. Just when Dorothy had begun to think they were really set, really secure, the Centre informed them there would be another inquiry into Frederick’s practice. The hospital had become concerned by the number of suicides among the patients under his care.

But it was brief and largely exculpatory. No abnormalities were found in his prescribing. If anything, he made less use of drugs than his contemporaries.

“We over-prescribe, in my opinion,” he told the committee. “I believe the optimum treatment for depression to be a combination of psychotherapy and medication. Neither alone is enough, not for severe cases, but the risks of relying on medication are high, because the treatment proceeds at the speed of the drug rather than at the speed of the patient’s capacity to heal.”

In this, he was ahead of his time. By then he was known as one of the foremost authorities in England on the causes and treatment of depression. He took on a Herculean caseload, and specialized almost exclusively in depression. This, the review committee noted, was bound to result in a high number of suicides among his patients.

Still, Frederick had been offended by the whole debacle. “The insult, the ingratitude,” he said over and over again. “The incredible stupidity. They have to mount a committee of inquiry to discover the obvious: sad people kill themselves.”

Soon after, the couple had emigrated. Despite the hospital’s clearing of her husband, Dorothy had found her faith in his abilities shaken. She knew enough of hospital politics to know that the administration would be quite capable of keeping a lid on scandal. When, in the course of packing, she discovered a letter from the National Health Service announcing that it was beginning proceedings for yet another investigation—this one into the entire term of his practice from Swindon to Manchester—she had been thoroughly shocked.

The letter was dated just after the Manchester investigation, and yet Frederick had said nothing.

She could not bring herself to discuss it with him. She did not want him calling her idiot, moron, fool. But from the moment of their arrival in Toronto, Dorothy Bell had told herself that, without snooping, she would keep a closer eye on what happened with her husband’s caseload. Obviously, patient confidentiality precluded her knowing the names of most of his patients. Occasionally, though, she would overhear him on the phone. And a couple of times, when someone had died, he had said to her, “Patient of mine. Poor fella.”

She noticed that he clipped the obituaries.

Frederick never took to Toronto, and after a short stint at the Queen Street Mental Health Centre he had accepted a post with the Ontario Hospital at Algonquin Bay. He told his wife he was sick of city living, that he wanted to live in a smaller town, and she had no reason to disbelieve him.

That had been two years ago. But since then Dorothy had become aware of three suicides under her husband’s care: Leonard Keswick, a social services administrator; Catherine Cardinal, a teacher and photographer; and now this Perry Dorn. All three had been in the paper, one because he had been charged with a crime, one because she had been found dead next to a brand new building, and the last one because he had killed himself in such a public manner. It was hard to admit, but Dorothy knew it was likely there were more.

And this young man, this Perry Dorn. Why had Frederick not mentioned that he had been a patient? It had been all over the news and the local paper. An expression of shock or dismay might have been in order, but he had said nothing, not a word.

Dorothy put the article aside and finished tying up the last of the newspapers. It was time to do the grocery shopping, before the late afternoon rush. On her way out, she paused in front of Frederick’s closed office door. You couldn’t hear much through solid oak, but she could hear his voice, and quieter responses from a patient. He didn’t have a patient now; the next one wasn’t due for another half-hour. No, no, he was watching a recording of a session. He did that a lot.

She had asked him about it once: why did he go over his sessions so much?

“Self-improvement,” he said in his jaunty way. “You’re never too old to get better. When I replay sessions, I see subtle cues I missed, body language I didn’t notice at the time. And of course, it helps me remember things better.”

It’s gone way past self-training, she thought as she locked the front door behind her. Frederick now spent every spare minute watching his recordings, retiring to his office late at night when other people might be reading or watching television or getting ready for bed.

There was something unhealthy about it.