Tales from the Couch

Seeing the patient from psychiatry’s perspective

A Shot in the Dark

A family's lfe ruined in an instant

It was 5:00 PM on a cold winter evening. I’d testified at a Workers’ Compensation hearing and was walking toward my car with an attorney. We were the only two people on a lonely, narrow street. The stores were shuttered. The neighborhood was in a devastated section of Bridgeport, Connecticut.

Suddenly, coming from across the street and down the block, we heard the cracks of two shots from a small-caliber pistol.

People rushed from their apartments toward a store—the source of the shots. The once-deserted street was now filled with people milling about. The police and an ambulance arrived. We learned that two men in the store had been shot—one fatally.

A year later, I was scheduled to examine a Workers’ Compensation claimant who could no longer work. Reading the records sent a chill through me. While working at a dry goods store, Ari had been shot during a holdup attempt.

Entering my office, Ari looked like a tough customer. About 6 feet tall, he was built like a bulldozer. He was unshaven, disheveled, and looked depressed.

He described having been working with his father-in-law in their dry goods store in Bridgeport. It was on the very street I’d been on the day of the shooting. At 5:00, two men entered the store with pistols drawn. They threatened and demanded the money in the register. Ari’s father-in-law handed over the cash. One gunman, for no reason, shot the older man in the chest. He died instantly. He then fired at Ari, hitting him in the groin. The gunmen fled.

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It was the shooting I’d heard that frigid evening.

Ari was taken to the hospital and underwent surgery. However, he was left impotent and infertile by the injury.

This rugged 29-year-old former Israeli paratrooper, married less than a year, became profoundly depressed. He was plagued by recurrent dreams of his wife’s father being shot to death before his eyes. He had intrusive thoughts and recollections of the robbery and shooting. He shook violently whenever he heard sirens—from police cars, ambulances, or fire engines. He could no longer enter the store where the shootings occurred. The very streets of the city signaled danger, and he became increasingly homebound by anxiety.

Ari and his wife had been planning to have a baby, but that dream died on that fateful day. Ari had developed the classic signs and symptoms of Post-traumatic Stress Disorder along with profound depression—complicated by survivor’s guilt for having committed the “sin” of living while his father-in-law died.

Ari’s psychiatric disorder was caused by this horrific work-related incident, and he was entitled to Workers’ Compensation benefits because of his physical and psychiatric state.

I decided against telling Ari I was half a block away on that fateful night, but I’ll never forget hearing the shots that changed his life forever.

 

Mark Rubinstein

Author of Mad Dog House and Love Gone Mad

 

Mark Rubinstein, M.D., is a former professor of psychiatry at Cornell. His most recent book is the novel Mad Dog House.

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