A colleague complained to me a few days ago about his office. He was troubled by plumbing that was making some gurgling noises and by the sounds of construction from outside the window. I cheered him up by telling him about the time I had The Worst Office in the World. I thought I would describe that place here, in case there are others out there who find some fault with their own offices and need cheering up too. I do this as a public service.
I want to say, first of all, that I am not someone who needs to have a stylish office. The psychiatrists’ offices I see in the movies, with wood paneling and a secretary in an adjoining room, are foreign to me. Having a secretary would make me uncomfortable, sort of like being driven to the office by a chauffeur. My current office is plain, and dusty a little. I still have not put up the curtains I planned on putting up when I first moved in about forty years ago. I still have the second-hand desk I bought back then. I have had other offices, including bare rooms in a prison and in a state hospital. I have interviewed patients in a nursing station. For a while, briefly, when I was on maneuvers in the army, I saw patients in a tent. So, when I say I had The Worst Office in the World, I am not speaking lightly.
A few years before I was assigned The Worst Office in the World, I was a medical student at New York University. I remember a particular conversation with one of my psychiatry professors, because he turned out to be wrong. “Psychoanalysis is the wave of the past,” he said to me in 1958.
A few years later, when I was a psychiatry resident at Albert Einstein College of Medicine, the psychoanalytic wave was still crashing all about me. The death instinct that Freud had postulated was floating out to sea, but the Oedipal complex (the cause of all neurosis, according to Freud) was still very much in evidence, along with the oral and anal stages, and the fast-approaching scrotal stage. There was a lot of talk of clitoral vs. vaginal orgasms. The current wisdom of the time explained autism as a disturbance of breast feeding!
I think when I began my residency, I asked the wrong questions. Or maybe I laughed at the wrong times. Or smirked. In any case, in a matter of just a few weeks, I picked up the reputation of being “anti-analytic,” which was one step up from being a pedophile.
Around this time, I was assigned a supervisor. After knocking on the door to his office, I entered.
“A guy like you should be in psychoanalysis,” he said, before I had a chance to close the door behind me.
I walked over to his desk and sat down in the chair in front of it. “Have we met?” I asked politely.
“No. But I can tell.” he said.
I judged from his expression that he was not saying that I was so bright and sensitive that my skills would be augmented by the process of being analyzed. He had noticed something wrong. An experienced psychoanalyst can tell you have all sorts of problems before you even open your mouth. I wondered what it might be. It was not the way I dressed, I thought, although I had heard some complaints about that too.
Of course, I understood that he had been told something bad about me. I thought about asking him, but decided not to. He did not volunteer his reasons for thinking I should undergo psychoanalytic treatment four or five days a week, for four or five years—the usual practice at that time. This small encounter was the sign of things to come.
Still, I was busy dealing with patients and learning about patients, so I did not spend much time dwelling on anything else. I had been married recently, so that took some time too. Then, in the middle of my residency, I got drafted, which took a lot of time. Two years. (See my novel, “Maneuvers.”)
When I came back, things had not changed much. No one was outwardly hostile, but I could tell.
One day I received a notice of a meeting, the most recent of a number of such meetings which seemed to take place every other day and which were notable because of how long they went on without anyone saying anything. I never attended these meetings, and I used to throw out those announcements. Then, just as I was about to throw out this one, I took a closer look. It read something like this: “Dear Dr. Neuman, there will be a meeting at such and such place at such and such time on such and such date. The subject matter will be the such and such topics with the addendum by so and so about such and such. Please do not attend.”
For a moment or two I wondered why my absence on this occasion was so important that they bothered to request it formally—especially since I never attended these meetings in the first place. But I decided not to enquire about it.
On another similar occasion, during a time when I was visiting homes doing research on communication in young children, I returned to the hospital for a supervisory session. My supervisor—a different supervisor-- waited until I was seated, then he said:
“Eleanor said she doesn’t want you using the phone in the child psychiatry rooms.”
I looked at him. Eleanor was one of the senior people in the department of child psychiatry, of which I was nominally a part.
“She doesn’t want me using the phones.” I repeated after him.
He was silent for a moment or two. “That’s right,” he said, finally.
I thought about this. “I never use the phones in child psychiatry,” I said.
He stared at me some more.
“Listen,” I said, “I’m a child fellow. It seems to me I should be able to use the phones if I want. Which I don’t,” I added. When he said nothing in reply, I went on: “Do you think I should ask Eleanor why I can’t use the phones?”
He studied me soberly. Then he stared out the window. Then he turned back to me. Finally, after some long moments of deep thought, he shrugged.
So, I did not bother to find out what I was suspected of doing with the telephones.
Things came to a head when I was assigned The Worst Office in the World.
When I went looking for it, I walked by it twice before I saw the number on the door. It was an ordinary door, suitable for a closet. My first thought after opening the door was that it was a closet, until I looked closer. It was not big enough to hold a rack of clothes. There was a sink on one wall near the entrance, a non-functioning sink, I noticed, trying to turn a faucet which did not turn, although there was still a steady drip from its spout and a resultant brownish stain on what must have been a porcelain surface at some time in the past. It was a broom closet, I realized.
It is hard to describe the first impression I had of this closet/office, but it was not favorable.
By turning sideways, I could squeeze by the edge of the sink and the opposing wall. The closet extended another four or five feet without widening at any point. At every point it was possible to lean against one wall and touch the opposite wall with my fingers. That made it wide enough for a folding chair. It was deep enough to hold two folding chairs facing each other, not quite touching. And two such chairs were sitting there. I could not make out very much more initially because the room was dark, even when I pulled the string on a bare bulb light that hung from the ceiling. I seem to remember that there was some sort of tiny window at the other end. There was, in any case, a dim light coming from that area of the room. There was nothing else.
I thought this office might strike my patients as uncomfortable. And so it proved to be.
“It’s like a portal to some mysterious place,” one patient told me in a hushed voice, looking in but not willing to cross the threshold. “Does it connect to another space and time? I think I smell sulfur,” he added. There was a faint smell. But I thought it was ammonia, a residue from its previous existence as a broom closet.
I had another patient who liked me. (We called this “positive transference” in those days.) So I inveigled her into sitting in the office with me with the door slightly open. (It was always slightly open, since the door jamb had warped slightly.) “It has a certain atmosphere,” she said, trying to look on the bright side. “An ambience ,” she said, savoring the word.
There was only one other patient whom I saw in this office; and it served a positive function for him. He had come to treatment complaining, in part, of a fear of being buried alive. The closet/office provided an opportunity for exposure therapy. We could sit there and pretend we were dead.
I did not meet anyone who was ever inclined to dispute my opinion that this was the Worst Office in the World; but there was some doubt expressed about whether this was the worst conceivable office. Or, putting it differently, was it possible that at some time in the future, somewhere, there could be an office that was even worse? I disproved this thesis by performing a thought experiment, what Albert Einstein had called a gedankenexperiment.
Starting with my closet/office, I wondered if any change could be made that would worsen it.
There was still the question of why my superiors would choose to assign me to an office which was not usable. They could have said simply that they had run out of office space, and I was last on the list. So, I could borrow other people’s offices or interview patients walking down the hallways—which is what I did, of course. What motivated them? I never asked, so I don’t know. I do not often think about by superiors back then; but when I do I take some satisfaction in knowing that they are probably all dead by now.(c) Fredric Neuman 2013 FollowDr. Neuman's blog at fredricneumanmd.com/blog