Green Hills Literary Lantern

The Moral Anguish of Edwin Ross 



            I am a psychiatrist, actually a Freudian with a couch in my office, a dying breed. One of the most moving days of my life was when I visited Vienna and stopped at the house of the master, Berggasse 19, now a museum. To walk where the master had spent forty-seven years, had analyzed Anna O. and the Wolf Man and written The Interpretation of Dreams, brought a lump to my throat. I have modeled my office after his: the traditional couch, a leather armchair behind the head of the patient, on a credenza behind my desk a collection of primitive art: a woman with pointy breasts and the body of a winged lion, a bronze stern-faced cat on its haunches, gold earrings dangling from its pointed ears, a scribe in black marble seated cross-legged, intent on a tablet in his lap. When my patients ask the significance of these objects I say, “They’re from ancient Egypt and Greece. Think of them as a summary of the origins of civilization. They may cause you to consider your own origins, your own buried history. What you and I are doing together is like archeology, unearthing structures built long ago, understanding how they formed  and how they can be changed.”

            I never cease being surprised as the tale of a patient’s life unfolds, at how many suffer moral anguish. One man, a tall imposing fellow, is the coach of a college basketball team. The son of a Lutheran minister and a grade school teacher, the man has a strongly developed sense of moral values coupled with a neurotic need to be honest. His team has had a bad season and with the crucial game approaching, his own job in jeopardy, he finds that his star player is in academic trouble. The boy must pass a chemistry exam in order to stay on the team. The coach engages a tutor but the boy simply has no aptitude for chemistry. But the coach has access to the exam. The man is agonizing over whether to give the boy the exam or not. Though it is the role of the psychiatrist to enable the patient to find the solution to his problems on his own, I cannot refrain from giving the struggling man advice. I subtly suggest that he give the specific exam questions to the tutor who in turn will prep the boy. After all, no one is hurt by this: the school wins the big game, the coach retains his job and the boy in any event will never make a career of chemistry. The coach assimilates this, thinks it’s his idea, and this indeed allows the boy to pass the exam. But now the poor man, a where-did-it-all-go-wrong puzzlement about him, is in anguish because he has compromised his moral principles and is even considering making a confession to the authorities. I give him a brief lecture on ends and means, even quote George Washington’s motto, “The result justifies the deed.”

           However, it is not my purpose to recount the moral anguish of others but rather my own. A patient comes to me, a woman in her early thirties, a clarinetist, who has just gone through a traumatic divorce. Her husband, an attorney, had run off with an associate at the firm, leaving her with two young children. The woman, whom I shall call Emelia, now suffers from nightmares where long-muzzled animals tear her bras and panties from her chest of drawers and rip them to shreds with their teeth and claws. The woman’s hair is cut short and curves inward to frame her face, giving her a 1920s look; her eyes, large and uncertain, cloud over when she recounts her nightmares, about her the pained watchfulness of one who has been hurt. Her mouth is full, lips somewhat puffy; she is appealingly slender and moves with a natural grace. She comes three times a week, in the early afternoon when her children are at school, and never misses a session. Transference takes place in about six weeks. I can tell by her soft smile and the light in her eyes when she enters the office, her insistence on shaking hands when we part, her hand lingering on mine, and the intimacy in her voice.

           But transference is a two-way street and psychiatrists are warned—and sternly warned—to avoid emotional entanglement with a patient. A sure way to become a pariah in the psychiatric community is to marry one of your patients. I am not unhappily married (which may be the best one can say of any marriage) with three teenage sons. But as Emelia free associates on her life and fills her descriptions with literary and musical allusions, I find that I listen to her more attentively than to my other patients, that I look forward to her visits. One afternoon she mentions that that very evening she is performing in Schubert’s Octet at UCLA’s Schoenberg Hall, and what a profound piece of music it is.

           I think about going to that concert all the rest of the afternoon, consider inviting my wife Pat, then trump up an excuse about an evening meeting of the Southern California Psychoanalytic Institute and go alone. Emelia wears a tight ankle-length acqua-colored dress slit down from mid-thigh to reveal a shapely leg.  As she plays she moves her body and instrument in a sinuous motion. And for the first time, at least consciously, I consider Emelia as a sexual object. I fantasize that it would be nice to have sex with her while she played the clarinet and wonder how, practically, this could be done, imagine several possibilities. Throughout the piece my eyes never leave Emelia; I watch the music reflected in the movements of her body. Almost an hour after the start of the Octet I hear the dramatic strumming of the cello and Emelia, if anything, grows more sinuous yet. I have the impression that she herself is sexually excited by the music, as I am by her movements.

           At our next session I ask Emelia whether she was satisfied with her performance of the Octet. She says no, it had been less than perfect. Then she tells me how much she admires Schubert. “Imagine,” she says, “he wrote that piece at the age of twenty-seven, while dying of syphilis. But maybe faced with his own mortality Schubert rose to the level of genius as a way to cheat death.” I imagine the young Schubert bent over a table, a glacial winter in Vienna, coat collar up against the chill of his unheated room, scribbling the Octet by the light of a kerosene lamp, in a desperate race against the spirochete that is eating its way up his spinal column to his brain. “You have to admire his courage,” Emelia says. “It must be difficult to be anything but paralyzed knowing that soon you’ll be dead.”

           “But in the end we’ll all be dead,” I comment mildly. “A good reason not to be paralyzed.” To this Emelia gives a distracted nod then describes a nightmare she had the previous night. She was playing the clarinet in Mozart’s Clarinet Concerto, but no music, in fact no sound whatsoever came from her instrument. As she speaks my eyes are drawn to her slender body lying there on my couch. I remember her leg emerging from the acqua-colored dress, her movements as she played, and another possibility of sex with Emelia while she plays the clarinet occurs to me. We explore her dream and the fear it represents; I provide a Freudian analysis. Emelia sighs and says, “Is it really necessary to drag sex into all dream interpretations?” I do not respond to this; instead, in the guise of therapy I draw Emelia into conversation on music. “I think music is intrinsic,” she says. “Like language, it’s built into our nervous system. It’s language in non-verbal form.”

           “But that doesn’t explain why it can be so haunting,” I say. “A great melody can be quite simple yet stay with you forever. To me at least it’s not at all obvious why.”

           Emelia sits up on the couch, turns to me. “Composers talk of heaven,” she says. “Puccini claimed La Boheme was dictated to him by God. Brahms said when he composed his violin concerto he felt in tune with the Infinite. And Handel swore when he wrote The Messiah he saw all of paradise before him, even God himself.” She pauses a moment. “There’s magic to great music. I doubt if you can explain it.”

Being a Freudian, I say, “I suspect there’s a sexual element. That music evolved for courtship. Haven’t men always serenaded women to coax them into bed?”

           She looks at me with great seriousness; I focus on her lips: full, puffy—thousands of hours playing a clarinet would make anybody’s lips puffy. “The world is a messy place,” Emelia says. “We like order and simple patterns but find mostly confusion. An experience that’s perfectly organized, every anticipation satisfied, that doesn’t happen often. Great music orders the world for us and does it in a perfect and satisfying way.” She gives me a small self-deprecating smile, that of an intimate and not of a patient to her therapist. She is particularly lovely as she finishes, “Great music can make you feel larger, that something unique and precious has been revealed to you. It makes you realize that the world is more than it seems.”

           It’s pointless to tell Emelia that what I really like is Rogers and Hart and Cole Porter. I squint at her as if at some too bright object: I have realized something very different: I care deeply for Emelia, want Emelia. But while I think this an internal voice sternly warns that between contemplation and possession there is a vast gulf and it is impossible to know what lies on the other side.


           I try to listen to my other patients recount their lives. One man owns a magazine which is on the verge of bankruptcy. He loves the magazine, considers it an important forum for new ideas. A cigarette company wishes to take several pages of advertising. But he considers smoking a scourge and a killer. He cannot sleep as he anguishes over whether to take the cigarette advertising to keep the magazine afloat or not. But while the man rattles on about this I find myself thinking of Emelia. But this occurs not only in the office but at home, at dinner with my wife and children. She interposes herself, her face, her body, her voice, wherever I am and whatever I’m doing. When I recall my meetings with Emelia they’re transposed to a higher key, brightened, as if something extraordinary has happened. She enters my mind and butterflies flutter in my stomach. When she walks through the door into my office there is a champagne tang in the air, my heartbeat quickens and I think hers does as well. I now have difficulty looking at my wife, am short-tempered with her, as though she is at fault, in some way guilty. And when we have sex, God help me I think of Emelia.

           Subtly, I suggest to the magazine owner that in this imperfect world life is full of compromises and taking cigarette advertising for the greater good of keeping his magazine alive is all right. He seems relieved as though I have lifted a great burden from him.

           One afternoon, during our session, for no reason Emelia sits up and says, “You are opaque to me, Dr. Ross. Perhaps that is the way of psychoanalysis, but you are after all a man like another. Surely you too have suffered defeat and loss.” She stares at me with serious quizzical eyes and so, violating every rule of my profession and ignoring the internal warning voice, I recount to Emelia the great trauma of my life. My father was an asthmatic but he refused to let this dampen his passion for mountain climbing, waving away the warnings of his doctor and my mother’s concern. He hiked the Sierras, claiming that vigorous exercise was good for his lungs. On a cold April day, having dragged me along on what he called a training hike, my father died of asphyxiation on the summit of Mount Baldy, in the San Gabriel mountains outside of Los Angeles, ten-thousand feet above the smog-shrouded basin. I milled around in panic as my father, bottom sunk in the snow between two rocks, fought for air, then his breath came in pitiful little whistles, then disappeared altogether. I decided against artificial respiration, raced down the rocky slope, falling and running. By the time the paramedic helicopter arrived his body had stiffened in the cold. For a long time after the episode I repeated to myself, “My father is dead.” The thought kept sliding away and I felt a need to repeat it, yet each time I did it still seemed beyond belief, as if the order of the world had shifted. But the image of my dying father—lips blue, eyes focused on his only son in silent entreaty, then beyond him, at something cold and unimaginable—was cast in icy steel and would never leave me.

           “Your father did what he thought right,” Emelia says, voice clinical, our roles now reversed. “Without worrying about what anyone else thought. He died doing what was right for him. I think I would have liked your dad.”

           I check my watch: our fifty minutes are up. “I won’t charge you for this session,” I say. We smile at each other and it takes a mighty effort to resist taking Emelia in my arms. She does not say, “Thank you, Dr. Ross,” but rather, “Thanks, Ed.”


           In order to practice psychoanalysis you must yourself be psychoanalyzed. My analyst was a Doctor Morris Uhlenbeck, a shrewd practical man who later became a friend. Uhlenbeck, now in his eighties and retired, had as a young man met the master himself, in London where Freud had fled to escape the Nazis after Germany’s annexation of Austria. Uhlenbeck stared at the ravaged face of the founder of psychoanalysis—then suffering from the cancer of the jaw that within a year would kill him—listened to the man’s voice wash over him in unhurried waves, was overwhelmed by his dignity as though the man was speaking from a throne. When Uhlenbeck related this meeting to me he said he felt himself in the presence of God. When he left that encounter Uhlenbeck had no doubt where his own future lay. During my analysis I told Uhlenbeck that I had a persistent vision of myself as interchangeable with a thousand other men, that all I did was a repetition of what others were doing. From birth to death there was nothing to distinguish me from others. I plodded through my day, smiled or frowned when others smiled or frowned, ate, slept and fornicated like a billion others, and my anxieties were no different from theirs. Life was short and precarious, as my father found out on the mountain, and one day I too will be dead. I thought it would occur in autumn, my life a pile of dead leaves to be bagged in plastic and hauled away. I imagined my own grave, the single word EVERYMAN chiseled on the tombstone. It is against this feeling that I have always fought but which has never left me. Uhlenbeck observed that perhaps it was this that pushed me into psychiatry: to help people find what is unique in themselves, to help them out of the featureless mass that is EVERYMAN.

           When I think of Emelia—and thoughts of her are never far from the surface of my mind—she is all anticipation and promise. And this anticipation makes me feel younger than my forty-eight years, and the world around me seem younger, as though time itself has reversed. I repeat Emelia’s name as if it were a charm, a mantra that would pull me out of the undifferentiated sludge of EVERYMAN.

           When Emelia comes to our next session her clothes are different, her arms bare, skirt short and about her a faint far off scent of jasmine. She sits on the couch and I—feeling tension as when as a boy I shoplifted something in a store—rather than taking my accustomed position on the leather armchair behind her, sit beside her. We look at each other a long moment without speaking. I take her in my arms, the warning voice obliterated,  and in a cloudburst release we tear at each other’s clothes and make love on the couch.

           We lie together afterward, still not speaking, and I stroke the leg that had excited me so when she played the Schubert Octet. “Was that part of therapy?” Emelia asks with a wry smile.

           “Quite the opposite,” I reply soberly. “It will be difficult being your analyst after this.”

           “We can manage,” Emelia says. “Aren’t my fifty minutes up?”

           “I cleared my afternoon calendar and gave my secretary the day off,” I say and hold her close and after a while we make love again, more deliberately, like old partners. When we leave together the day seems extraordinarily clear, the air carrying a rare texture, a promise of springs and summers yet to come.


           Life at home has now taken on a monochromatic tedium and I have grown testy, see disorder everywhere: the boys’ rooms, the bathroom floor, dust on the furniture, streaked windows. Then my sons: at their age they should have an immense curiosity about life, but they seem as incurious as slugs. I now view Pat critically. All that she says now strikes me as foolish and trivial. I criticize whatever she does. Am I, I ask myself, subconsciously trying to alienate her, to make our possible breakup more palatable to her? “Why are you treating me badly, Edward?” she asks, eyes questioning and hurt.

           “I’m sorry,” I say, and am indeed sorry. “I have a difficult case I’m struggling with.” Which, when you think about it, is not a lie.

           Then one evening after an encounter with Emelia, my wife says, “I notice, Edward, that your tie has been reknotted.”

           “What?” I say, feigning bewilderment.

           “When you left this morning the end of your tie just touched your belt. I noticed that when I—lovingly I might say—adjusted the knot. It now hangs, if you look, at least two inches below the belt.”

           “Is this the voice of jealous paranoia I hear?” I ask.

           “It’s the voice of someone trying to understand what is happening to our marriage,” Pat says.

           It does not end there. The following evening Pat says, when we are in bed, “There was a stain on your underwear, a characteristic seminal fluid stain, like that which appears on your pajama bottoms after we’ve had sex.” She stops and waits. My heart gives a mighty pulse of guilt. When I do not respond immediately, she says, “Are you having sex with another woman, Edward? Perhaps even with one of your patients, though I’m sure that totally violates the ethics of your profession.”

           The thought that women can ferret out clues of infidelity in ways that men cannot crosses my mind. Probably estrogen related. Ovaries: another pair of eyes—they see things in ways men never can. “I don’t know where that stain came from,” I say. “My prostate has been acting up. Maybe that’s it. But this jealousy, Pat, is tiresome.”

           “Listen, Edward,” she says, her voice clear and icy, “if you are having an affair with another woman, sooner or later I will know it. And I’ll not live with you under those circumstances and neither will your children. So you had best carefully examine your life and decide what you want to do. But there is one thing I can assure you. If we separate it will be very expensive for you. Your bank account will not be the same, ever.”

           I consider Pat’s ultimatum and ask myself what now? I have offered advice on the resolution of the problems of others. But then nothing is easier than advising on the life of another. I visit Morris Uhlenbeck, as a friend, and explain my quandary. The old analyst sits unmoving as a boulder, his gentle mournful face and bald head splotched with pre-cancers. He wears a brown suit, wide old-fashioned lapels, that now looks two sizes too large. His office has not changed. Draperies still cover the two windows; those on one window are partly open and a shaft of dusty sunlight brightens the leaves of a dracaena plant in a corner. Uhlenbeck sighs. “My dear Edward,” he says, “you have made a grave error. But first let me ask you, would you leave your wife and sons for this woman?”

           I have already struggled with this and concluded that I’m not at all sure. He shakes his head, a tired old man who has heard far more desperate stories in this room. “You had best make up your mind,” he says, “but I suspect the answer is no. If that is the case, I would advise you to cease seeing this woman as a patient or anything else, difficult as this may be. Just drop her. You will have withdrawal symptoms to be sure, but that cannot be helped.” He stops and stares into the distance; there is a silence and I think he has lost his train of thought when suddenly he leans forward, eyes narrowed, and there is the flash of an earlier, sterner Uhlenbeck. “Your error has other sides to it of which, as a professional psychiatrist, I’m sure you are aware. We live in a litigating society. Your patient, now mistress, can sue you for malpractice, for having taken advantage of her vulnerability in the analyst-patient relationship. In a word, she can destroy your career and you.”

           I stare at Uhlenbeck: this obvious thought had never occurred to me. I discard it immediately as impossible. “She would never do that,” I reply.

           Uhlenbeck shrugs this off. “Do not be naive, Edward,” he says, then goes on. “In any case, you do not strike me as a man ready for a radical change in his life with all that would mean emotionally and financially. Forget this woman. It’s in her best interest and certainly yours. And make the break diplomatically. You can also pray she does not reconcile with her husband the lawyer who, with righteous indignation, might urge her to sue.”

           Uhlenbeck sinks back into his chair, gazes at me in a way that he has never done before, the look of a father deeply disappointed in his errant son. Then his gaze again drifts toward something far off, about him now a Zen-like calm, a man on the edge of eternity.

           When I leave Uhlenbeck’s office, into the bright smog-diffused southern California light, I see the future: limited visitation rights to my sons, they slowly becoming strangers, me impoverished by alimony payments, and in the end would my life, after passion declined, be any better than my life with Pat? And yet, and yet . . . I want Emelia.


           As I come to Emelia on the couch, all conflict gone, obliterated in an hormonal avalanche, she pushes me away. “This is all very nice, very enjoyable,” she says, “but it has no long term outcome. To tell the truth, Ed, when I leave you I feel dirtied. I don’t sleep around, I’m not a whore, but that’s what I feel like. To be blunt, I don’t want to be the mistress of a married man. If you’re willing to leave your wife and family, and soon, then we can continue. Otherwise, there’s no future in this. If we can’t make our relationship permanent, then parting, though it will be painful, is for the best.”

           I’m amazed at the clarity and tidiness of her message, as if she were a character in a play. If she is undergoing a hormonal avalanche it certainly is not evident. She must have thought about this and prepared, even rehearsed, her speech. I sober up, a man who has just experienced the rise and downfall of hope. “I understand how you feel,” I manage. “This is not easy for me either. Leaving my family is a huge step and something I really have to think about. Then we don’t truly know each other . . .” I trail off, not sure where to go from there, not at all sure what I want except to fuck Emelia right there on my couch, a possibility that is now all but gone.

           Emelia stands up. “You know me far better than I know you. You have listened to my secrets and heard my dreams. That’s a lot . . . You have my phone number. When you’ve made up your mind, give me a call.” And she is gone and I’m left staring at the empty couch.

           I can’t sleep, treat my children like inmates of a penal colony, am sullen with my wife. I know the right answer is to forget Emelia but like some lovesick adolescent I can’t get her out of my mind. I call Emelia and invite her to lunch, not really sure why except that I want to see her. We sit opposite each other at Ettore’s, an Italian restaurant near my office. After we order, she says, “What is it that you want to tell me?”

           I stare at her, confused, not sure what I want to say. Maybe that I love her—though it’s not clear what that would accomplish—but her eyes are cold, of one who has been disappointed and disillusioned and more than once, and I can’t bring myself to speak of love. “I’m still thinking,” I say stupidly.

           Emelia looks at me with the same icy stare Pat gave me when she pronounced her ultimatum. “You’re a weak man,” Emelia says. “Removed from your office and that couch, I see you as a very ordinary human being. Not sure what you want, except sex. Unable to make up your mind and accept the responsibilities that go with sex.”

           I look reality in the eye, gesture futilely, and feel the decision make itself. “I’m sorry but I can’t leave my wife and children,” I say.

           Contempt stares at me. “Why did you invite me to lunch?” Emelia says. “To tell me what I already know? Or is it because you want to lure me onto that multi-purpose couch of yours one more time?” She gathers her purse, places her jacket on her shoulders. “I’m not an object,” she says. “You of all people should know that.” She shoves back her chair, comes to her feet. Frustration in my soul, I watch the movement of her body, admire her legs, as she leaves the restaurant and my life. The master had it right: unpleasure provides a profound education.

           My next patient that day is a gynecologist, a man with a modest practice, a dim shadowy hysteria about him. He is a compulsive gambler and can’t break the habit so he is seeing me. But he has run up a huge gambling debt. The bookmaker to whom he owes the money is getting nasty and has threatened physical violence unless payment is received. The gynecologist can make a great deal of money and quickly by performing abortions. However he profoundly believes in the sanctity of life and abhors the idea of destroying life by abortion. But he needs, and desperately needs, the money. And this dilemma, which squirts forth from him as from a whale’s spout, he agitatedly dumps on me: should he solve his problem by performing abortions even though this compromises his principles? The man clearly expects me, solemnly and wisely, to provide an answer. People, you know, even other doctors, have an exaggerated sense of what a psychiatrist can do. But then one often has exaggerated ideas about what one doesn’t understand.

           I do not give the gynecologist advice nor do I from then on give anyone advice. Let them all look into their heart and find their own solutions. I cease being a sage and stick to analyzing dreams, curing phobias, fetishes, obsessions, hysteria. I must confess that I sometimes have doubts about my profession, feel like a man throwing stones at the wind. How worthwhile really is it to examine your life? I’m no longer sure that knowing yourself makes you a better person.

           I now treat my wife with the dignity she deserves and am tolerant with the boys. Pat senses that much has changed, does not inquire into the past but accepts the tranquility of the present. When I think of Emelia there are no longer butterflies and I see her for what she was, a distraught woman seeking help. I did her a gross disservice by leaping from psychiatrist to lover. In the end, all she obtained from those thrice weekly sessions was one more disillusionment. I wonder whether her nightmares persist and feel guilty of both betrayal of a patient and violation of the Hippocratic oath I took so solemnly as a young medical school graduate. And I fervently pray, as Uhlenbeck said, that it does not occur to Emelia, in  a vengeful moment, to find herself an attorney and haul me into court.

           In my analysis of Emelia I fell victim to a pitfall of psychiatry: returning the love a patient felt for me. And yet there are moments when my times with Emelia and my fantasies of her as she played the clarinet return to me with renewed brilliance and a twilight nostalgia. I am careful now with my female patients, careful of reverse transference and where it can lead. I have come to better understand the master, there in Berggasse 19, and why he was relentlessly monogamous.



William Eisner’s first novel, The Sévigné Letters, was published to critical acclaim, was adapted for the stage and played at the Lobero Theater in Santa Barbara. A collection of Eisner’s short fiction, entitled Done in By Innocent Things, was published by GreyCore Press in 2003 to excellent reviews. His short stories have been widely published.