(A novel by Susan Overturf Ingraham)
Chapter Twenty-Nine: El Paso, Texas, April 1964
[: Al Cullen must decide if he breaks his long-ago promise (one of many) to Kate.]
Al walked slowly from the parking lot to the front doors of Providence Hospital. He was weary, and he had been here only a week ago. It had been the longest week of his life, waiting to find out if Kate had improved and what the doctors had learned. He didn’t know much, just that the doctor had cut short Kate’s arranged two-week stay and had asked that Al return a week early to take Kate home.
Two weeks ago, Kate had come home from school and gone straight to bed. She had only indicated to Allison and Michael that she was exhausted and did not want to be disturbed. When Al got home at five-thirty, he checked on her. She seemed quiet, a little sad, but apparently all right, and he had left her there and prepared supper. Their family was dwindling: within the year, Sarah would be married, Michael on his way to medical school, and Allison finished with high school. Kate had always said that as soon as Allison graduated, she wanted out of Las Cruces. Al had always agreed to that, but it was not what he wanted: He was happy with his work, and his chances for promotion were excellent. But if he assured Kate they would move, she seemed calmer.
Al had turned in early that night, Kate never awakening when he got in bed beside her. The next morning, she had told him she was too exhausted to go to school, and Al had called the teacher substitute service. He had left for work while Kate had remained in bed, unwilling to read, watch TV, or get up. For the next five days, Al had found Kate in the same condition every time he came home: in bed, in the dark. On the fifth day, he had sat beside her on the bed and begged: “Kate, what can I do for you? Can I help you?” He had implored her with his eyes to take over her life again.
But Kate had remained prone. “I don’t know,” she had said. “I don’t want anything. I don’t want to do anything. I can’t go on, Al. I just can’t go on.”
“Yes, you can, Kate. There’s lots of life left for both of us. Our kids. And now our two grandchildren — and probably more to come. You want to see our kids graduate, don’t you? And get married? And then we can be together all the time. Come on, Kate. Snap out of it.”
Kate had turned her head to the pillow. “I can’t. I can’t. I can’t,” she had repeated to him. Al had held her hand and waited. She stopped crying. Silence had engulfed the room and minutes ticked by. Finally, in a quiet, low, pleading voice, she had begged him, “I need help, Al. I need help. Help me. I need help.”
Al had gone immediately to the phone and called their family doctor. Dr. Peters had told Al that it sounded as though Kate had spiralled into a severe depression. “You must get her to a hospital, Al,” he had said. “I’ll make arrangements for you to admit her to Providence in El Paso. It will be the best thing for her.”
Al had returned to the bedroom and told Kate that she had to find the will to get out of bed, get dressed, and walk to the car. He would do the rest, he said, but she had to do that much for him. She had obeyed his requests. Every movement had been an effort for her and she had cried often. Periodically she had stopped and had tried to get back in bed, but Al always talked her into making one more step. Once she was dressed, she sat on the edge of the bed while Al packed a suitcase for her. She was unable to be involved, but she did point to a few personal items — her hairbrush, her make-up — that she wanted him to include. Al had picked up the suitcase with his right hand and with his left hand, he had reached down and taken Kate’s. Together, they had walked out of the bedroom.
Kate’s eyes had remained glazed, and she had not said good-bye to her children. Al had walked with her to the car, opened the door, and assisted her in. She had been like a zombie — no emotion, no thought. For the ninety-minute drive, Kate had stared out the window, in a trance, unable to talk, to move, or apparently to think. Al had tried everything to cheer her up. He had talked about their early lives together and had reminisced about their teenage years. He had sung to her — every song he could remember the words to — but she had not responded. He had been exhausted and hoarse by the time they had reached the hospital. Al had admitted her within an hour of their arrival, and Kate had not responded to his farewell. He had driven home in a daze, heartsick with worry, afraid that Kate would never forgive him for taking her to the hospital.
For a week, he had worked long hours, trying not to think about Kate. He had wanted to call every night, but the doctor had advised against it. When the doctor had unexpectedly called him and said that Kate was better, Al had been pleased, but he still did not understand what had happened and in what condition he would now find Kate. It was a surprise to him that she was ready to return home a week earlier than expected; he hoped that meant that she had not been so very sick after all.
To curb his nervousness, Al decided to walk up the stairs to the fourth floor — the psychiatric ward. He found Dr. Riley’s office, informed the receptionist that he was there, and sat down to wait. Within ten minutes, Dr. Riley came in the office, greeted his secretary, and then went into his own office, closing the door behind him. Moments later the receptionist led Al to the door and let him in.
The doctor’s office was extravagant — a big room with two large ficus trees, a huge oak desk and leather-back office chair, a Freudian couch, and two comfortable easy chairs for guests. The desk was uncluttered, apparently like the doctor’s mind, and only displayed a desk lamp, a 5x7 photograph of his wife and two daughters, and a two-pen gold-enameled desk set. The room had a sterile feel to it despite the plants and the large, comfortable chairs. A large window overlooked the parking lot below and faced south towards Juarez. One could see the river and a border crossing from the doctor’s window; the contrast between the wealth displayed in the room and the poverty of Mexico beyond the window was paradoxical. Al felt immediately uncomfortable and sincerely wished that the meeting was over, but he was anxious to know about Kate.
“Good morning, Dr. Cullen,” Dr. Riley said. “I appreciate your coming back early. I know it’s a bit of a drive for you. But your wife is much better, and quite desirous of returning home, so I felt that she should go as soon as she could. Please, take a seat,” he said, as he pointed to the two chairs opposite his desk.
Al chose the chair on the left. Although the chairs were identical, this one seemed to suit him more. He didn’t know why. “I’m glad to hear that, doctor. Are you sure she’s better? Will she be able to cope if I take her home?”
Dr. Riley leaned back in his chair and put the ends of his fingertips together as though he were holding a ball. “Yes, she seems to be. However, I will tell you, Dr. Cullen, that your wife is the one pushing to go home. I believe she should remain for further treatment. You must be aware that treatment is ineffective if the patient doesn’t want to be treated.”
“What, exactly, happened, doctor?” Al was afraid to hear Dr. Riley’s answer, but he felt compelled to know the truth.
“Your wife was suffering from a severe depression when you brought her to us, Dr. Cullen. Did you know that?”
“Yes. Well, at least, I assumed that she was depressed. She had refused to get out of bed for five days. She finally asked me to help her.”
Dr. Riley nodded his head. “That’s a good sign, Dr. Cullen. When patients ask for help, it usually means that they can recover. I spent two days evaluating your wife’s condition. She would not speak much, and she refused food that was offered to her because she believed it was poisoned. I felt immediately that drastic measures would be necessary to get her to respond to her environment again. Are you familiar with Electroconvulsive Shock Therapy, Dr. Cullen?”
Al cringed. Yes, he had heard of shock therapy, but he didn’t know much about it. He had seen photographs in his college psychology textbooks of people receiving shock therapy. That was the extent of his knowledge. “Yes. Yes,” he said, not prepared to admit to Dr. Riley that he really didn’t know much at all. “I know what it’s about. Why? Is that what you did to Kate? Did you give her shock therapy?”
“Electroconvulsive Shock Therapy has proven to be very affective, Dr. Cullen, in patients with schizophrenia.”
“Are you saying that Kate has schizophrenia?”
Dr. Riley’s tone became officious. “No, she doesn’t,” he said. “She came here with a severe mental depression. She also shows symptoms of paranoid personality disorder. She suspects most people of attempting to exploit or harm her. She seems unforgiving of others, carries grudges against people, and is reluctant to confide in others because she doesn’t trust them. This makes therapy difficult. Her depression seems to be the result of her continued hyper-vigilance over many years. Her breakdown is a result of being unable to control her environment and having no more hope. In short, she is exhausted from her hyper-vigilance. How long do you think your wife has been ill, Dr. Cullen?”
Al looked surprised. “Ill?” he asked. “I don’t know that she is ill. Kate’s a smart, wise, and witty human being. We’ve had a long and fruitful marriage. She’s never just gone to bed and refused to get up before.” I’m not going to admit to you that things haven’t always been easy with Kate, he thought.
“Yes, I’m sure that’s true, Dr. Cullen. But I’m not talking about the most recent incident. Your wife displays symptoms which indicate that she’s been dealing with this illness for a long, long time. Has your marriage been a good one?”
Al resented the doctor’s question. This is a private issue, he thought. He said nothing.
“I know this is difficult, Dr. Cullen,” the psychiatrist continued, “but your wife’s future health is at stake here. I believe she’s had a long-standing condition probably since her teenage years. Did you see these symptoms in her then?”
In a flashback, Al remembered Kate’s jealousy, her unreasonable fears, her continual expectations of promises fulfilled. We’ve had rough times, he thought, but there had been good reasons — the Great Depression, her impossible father, the secret marriage. It was understandable that Kate sometimes was moody, afraid, quiet, argumentative, untrusting. Al was not ready to reveal any of this to a stranger. He maintained his optimism. “Yes, sir, Kate has had a lot of unhappy times in her life. But I’ve been good to her and we’ve had a good marriage. Kate knows that I’ll care for her. She had a controlling, dominating father who made life miserable for her for years. But she’s been a good mother, a loyal wife, and a successful teacher.”
Dr. Cullen moved in his chair and leaned his elbows on his desk. He picked up a rubber band and flipped it between his fingers continuously as he talked. “I’m sure she’s been a good person, Dr. Cullen. Patients with depression and paranoia are not bad people. But their problems often lie in their past. Tell me about your wife’s father. What was he like?”
This was a topic that Al was willing to discuss. He almost blurted out his words. “Oh,” he almost shouted, “Lars Jacobsen was a mean-spirited, angry, bigoted, dishonest, lying, unfaithful man! He controlled his wife and his children. He didn’t want Kate to marry me. He forced Kate to leave home in the middle of her college education, and he insisted that Kate and I stop seeing each other. I never had a conversation with the man where I felt comfortable. He tended to play practical jokes on people, and they were often rooted in a meanness that I can’t describe.”
Dr. Riley tossed the rubber band on his desk, leaned back in his chair, and put his arms behind his head. “And your wife, Kate — what did she think of her father?”
“What did she think?” Al repeated the question. “I’m not sure. She seemed torn between loving him and hating him. She was embarrassed by him. She was determined not to be controlled by him. There have been times when she would not speak to him.”
Dr. Riley sat forward in his chair again. “Is he still alive?”
“No, he died nine years ago.”
“What about your wife’s mother?”
“Oh, Kate’s mother is a nice woman, although I think she allowed her husband to get away with too much. She seems to love her children and she’s still very active socially.”
“Was there violence in Kate’s home, Dr. Cullen?”
Al had always wanted to know the answer to that question. “I don’t know. Kate sometimes told me that there were things I didn’t know and it was better that I didn’t. But she never said much. I know that Lars Jacobsen sometimes hit his wife — Kate told me that much.”
“Well, Dr. Cullen, many of your wife’s issues probably stem from her childhood. With a father like the man you describe, she probably got some very specific messages about life and about men. There’s a possiblility that her father hurt her in more ways than one, and in ways that even she is not willing to admit to you. She has some issues, but she’s not saying much.“ Dr. Riley shifted in his chair and looked directly at Al. “Dr. Cullen, I know this isn’t easy, but are you willing to tell me what your marriage has really been like?”
Here we go again, Al thought. How much can I say? How much will Kate know I said? Al assessed Dr. Riley before him. He wasn’t sure that he liked him, but Al also thought: I’ve tried to help Kate all my life on my own. I could use some help. He took a deep breath and let out a long sigh. He smiled, cocked his head, and decided to be more honest. “It’s been good and it’s been bad, doctor. I love my wife. I always have. But she’s possessive, demanding, controlling, jealous, and sometimes totally unreasonable. We argue a lot.”
Dr. Riley displayed no emotion. “What do you argue about?”
Al sighed and looked out the window, over the doctor’s shoulder. “Usually about me, of course. Kate is highly critical. If I’m late from work, she assumes I’m having an affair. I can deny it a million times but she never believes me. I’ve told her that she’s a smart, wonderful person, but she doesn’t believe it.” Al’s shoulders seemed to sink a little lower with each comment he made. It feels good to tell someone about this, he thought.
Dr. Riley’s words were comforting. “This is all understandable, Dr. Cullen, given your wife’s history. I remind you again that I believe your wife suffers from paranoia. She fears everyone and trusts no one. Did you see this behaviour in her early?”
Oh, my, Al thought, yes. Yes, these problems have been here for years. How could he forget the first time she had slapped his face because she believed that he had flirted with another girl at the post-graduation party?* Al nodded his head and said, “Yes, doctor, I did see her behaviour early. But when I was a young lad, you know, I was flattered by her jealousy. I figured it meant she loved me. Her jealousy has been a part of our entire relationship. It’s just who she is.”
“Has she ever left you, or tried to leave you?”
Al rolled his eyes and nodded his head. “Many, many times. And sometimes she’s taken the children.”
“How far does she get?”
“Not very far. Sometimes just to the car parked in the garage.”
“What makes her come back?”
“I guess I just wear her down. I’m not very sure.” Al had been staring at the floor through most of this exchange, but now he looked at Dr. Riley.
“I understand, Dr. Cullen. It’s not easy to talk about these things. What you‘re telling me, however, is no surprise, based on what I’ve learned about your wife this week. Her depression was so severe when she first came that I felt electroshock treatment was the only answer. It is why I had you sign the release last week which allowed me to choose the most suitable treatment I deemed necessary. I am highly regarded within my own profession for the use of this treatment; I have had years of experience and used this treatment with hundreds of patients. Patients with depression began to be treated with electroshock more than twenty years ago. Ninety percent of even severe cases which are resistant to all other treatments improve after three to four weeks of therapy. It’s become the therapy of choice for depression, although some new techniques are beginning to be considered. Improvement is usually quite rapid. It also provokes retrograde amnesia which means that there is no memory of events immediately before the shock treatment. Therefore, patients do not have negative feelings towards the therapy.”
“Then you are telling me that you gave my wife shock therapy?” Al asked, even though the answer seemed obvious.
“Yes, of course, I am,” Dr. Cullen replied calmly.
Al was surprised. He knew that he had signed that release form, but he had assumed that they would most likely give Kate medications. He thought they would also talk to her and help her to see all the things he had tried to tell her for years but she never seemed to believe. “How many times did you give this treatment to her?” he asked.
“She had four — one a day — on the third, fourth, fifth and sixth days she was here. I spent the first two days evaluating her but she was nearly 100% unresponsive. She remained despondent, extremely anxious, and unwilling to talk. After the first treatment, she began to come out of the depression. By the fourth treatment, she was willing to talk with me, but her main purpose by then was to agitate for her immediate release. This is why I asked you to return. I would have liked to have kept her here another week, but she was unwilling. I was afraid that her progress would be severely hampered by insisting that she remain. It does not mean, Dr. Cullen, that your wife is cured. Long-term therapy would be an excellent idea. Are you willing to bring her back for either bi-weekly or monthly appointments? I know you have a bit of a drive from Las Cruces, and it would be a burden to ask that you bring her more frequently.”
“I don’t know,” Al hesitated. “Have you talked to Kate about this? Has she agreed?”
The doctor shook his head. “No, actually, she hasn’t. In fact, she has been very difficult at accepting any idea of further treatment. I was hoping that you might be able to convince her.”
“I doubt it, doctor. Kate is very much her own person. She has a fear of hospitals, particularly of psychiatric wards. When Kate was a child, she had an aunt who was committed to an institution and never returned. Kate has repeatedly asked me to promise that I would never commit her. I’m worried how she is even going to react to me today, since I’m the one who brought her here a week ago.”
“You don’t have to worry about that, Dr. Cullen. First, she won’t remember the shock therapy treatments. Second, she’s aware that she was severely depressed, but she’s also aware that she’s better now. You’ll find her quite tractable, I believe.”
“I doubt it, Dr. Riley,” Al added dryly. “I would never have used that word to define Kate.” Al smiled a little at this thought and Dr. Riley enjoyed the moment as well. Al, however, had another thought to add: “Doctor, do you think Kate’s hysterectomy two years ago might have anything to do with her current problems?”
“Why would you think that it would?”
“Well, she had fibroid tumours and she bled excessively. They did several D&C’s but they were only temporary solutions. She didn’t want to have surgery, but she finally agreed. Afterwards, she got very sick from an infection, and I almost lost her. In addition to being severely ill, she became despondent and wouldn’t eat the hospital food. I became convinced that, if she stayed in that hospital, she would die. So I brought her home. I had to spoon-feed her for several weeks. She was so weak she couldn’t get out of bed. She had hives from an allergy to one of the medications they gave her. She fought hard to survive, Dr. Riley, but I’ve always thought that she’s been more difficult since that time. Do you think there could be a connection?”
“I doubt it,” Dr. Riley said. “Women can be upset by losing their uterus, but your wife is in her 40’s and she knows she‘s past child-bearing age.”
“Yes, I know that,” Al said with a slight hint of exasperation. “But I think this had more to do with her general well-being, her feeling about who she was.” Al looked at Dr. Riley for guidance, but his comments seemed to fall on deaf ears.
“I can’t imagine how that could connect,” Dr. Riley said as he arose from his chair and laughed lightly, although Al didn’t see anything that the doctor should be laughing about. “I will say, however, that I strongly suspect the root of your wife’s problems lies in her childhood, her father, and perhaps even back another generation. If I could work with her in psychotherapy, I might get to the bottom of it. But I think you’ll find her much improved from last week. I’ll take you to her now.”
He strode across the room, leading Al, and opened the door to the reception area. Together they headed down the hallway towards the general ward. Al felt nervous and irritable. He certainly wanted to see Kate, but he was also scared to see her. He was not sure how he should react to her or how she would react to him.
As Dr. Riley opened the door into the ward, Al heard Kate’s voice. She was sitting on the first bed in the ward, already fully dressed, looking as though she was ready to go home. She was talking to a nurse, and he could see immediately that this was not the same woman he had left behind a week ago. As they approached, Kate turned towards them.
“Hello, Mrs. Cullen,” Dr. Riley greeted Kate. “How are you feeling this morning? Good, I hope. Al’s here.”
Al stepped forward and reached for and held Kate’s hand. “Hi, Kate. How are you doing?”
“I’m fine, Al!” She seemed excited. “Are you here to take me home?” she asked. “I’m ready to go.”
“Not quite yet, Mrs. Cullen,” Dr. Riley said. “But soon. I still think you should stay another week, and your husband agrees with me, don’t you, Al?”
You jerk! Al thought. How dare you put that on me! “I don’t know, Dr. Riley. I think it’s important that Kate decide. What do you think, Kate?”
“I’m ready to go home. Now. Today!”
“Okay, then,” Al said. “That’s what we’ll do. How long will it take to process the papers, Dr. Riley?”
“Within the hour,” Dr. Riley said. “But are you certain you want to do this, Mrs. Cullen? You know what I think. I believe you need more treatment.”
“I’m certain, Dr. Riley.” There was no hesitation in Kate’s voice.
“Very well. Very well. I will sign you out, but I will indicate that this is against my advice. Will you come back for some more sessions?”
Kate showed surprise and looked at Al. “Did you know about this?” she asked.
“He suggested that to me, yes, Kate. But I made no commitment. It’s up to you. If you want me to bring you back for sessions, I’ll do that. I’ll do whatever you want.”
“We can talk about this on our way home,” Kate said, and she made it clear in her tone that she would not discuss the topic further until later. Dr. Riley left to start the paperwork, and Kate began to pack her small bag.
Forty-five minutes later, they were walking to the car and heading for Luby’s cafeteria for a late lunch. Shortly after eating, they left El Paso.
“It was a strange week,” Kate said, her first words since they had begun the drive. “I know I’m better now but you always promised me that you would never leave me in a place like that. Why did you do that?”
“Because you were ill, Kate. You wouldn’t get out of bed. You wouldn’t speak to anyone. You wouldn’t go to work. You wouldn’t do anything. You asked me to help you.”
“Strange, I don’t remember that.” Kate leaned her head against the car window and closed her eyes. “I don’t remember that,” she repeated again. “What did I do? What happened?”
“You came home from work one day and you went to bed and you wouldn’t get up. You stayed there for five days.”
“Five days,” Kate repeated. “I just don’t remember that.” It became almost a lament.
“Kate, I love you. You begged me for help. I called Dr. Peters and he told me to take you to El Paso. He said Dr. Riley would help you, and I believed him. I didn’t know what else to do. And you are better. Don’t you think you’re better?”
“I guess, Al. The first day or two is a blank. The only thing that’s really clear to me is the last couple of days when I had my sessions with Dr. Riley. As my mind seemed to clear, I just kept telling Dr. Riley I wanted to go home.”
There was a moment of silence and then Al said, “I’m glad you’re better, Kate. Do you think you should go back to see Dr. Riley for a little while?
“No, I don’t think so, Al. I’m fine. I can take care of myself. I just had a bad time for a little while. But I’m fine now and I don’t want to go back there.”
Al sighed. His heart was heavy. He had hoped that he might be able to convince Kate to return for therapy, but in his heart he knew that she would never agree. “All right, Kate. Whatever you say.”
The rest of the ride home was quiet. They talked about his week — what he had done, where he had gone, whom he had been with. They talked about the children and their week — Sarah and her boyfriend were talking about marriage, Michael had received an “A” on a microbiology test, and the school had phoned to say that Allison would be inducted into the National Honor Society. Al told Kate that some of her colleagues from work had called and expressed their concern for her. He asssured Kate that he had told no one where she was.
As Kate and Al pulled up to their home in Las Cruces, Al thought: What next? Will the shock therapy permanently change Kate? He shook his head and answered his own question: Doubtful. And, anyway, I can’t hope for too much. We’ve had rough times. Could they really be over? He thought it unlikely but he couldn’t help but hope.
Meanwhile, Kate struggled to remember what had happened. She only knew that she felt better — she felt lighter, more confident, less afraid, calmer. She grabbed her purse, a pillow and a blanket, and walked ahead of Al into the house. It feels so good to be home again, she thought. She went straight to the bedroom, reached under the mattress, and felt for her diary. It was still there. Good, she thought, things are as they should be. Life will go on. And my letter is still safe in the safe deposit box.
- Continue to Chapter 30.
- Refer to Family Tree to keep relationship of characters in mind.
- Return to Family Legacies Table of Contents.
Disclaimer: While it is true that my characters were inspired by my own genealogical study, I could not and did not know my ancestors with the same intimacy that I have created in my characters. Therefore, let it be said that these characters are fictional and created from my own imagination. Similarity to persons living or dead is unintentional and coincidental.