You saw his obituary, of course. "Accidental death" can cover such a multitude of sins, can't it? In the news story, Johnny's death was reported as the result of a fall, and of course he did fall-at a spot we all knew well, one he had asked me about only last Christmas-but it was no accident. There was a good deal of sedative in his bloodstream. Not nearly enough to kill him, but according to the coroner it could have been enough to disorient him, especially if he was looking over the railing. Hence, "accidental death."
But I know it was suicide.
There was no note at home or on his body, but that might have been Johnny's idea of a kindness. And you, as a doctor yourself, will know that psychiatrists have an extremely high rate of suicide. It's as if the patients' woes are a kind of acid, eating away at the psychic defenses of their therapists. In the majority of cases, those defenses are thick enough to remain intact. In Johnny's? I think not...thanks to one unusual patient. And he wasn't sleeping much during the last two or three months of his life; such terrible dark circles under his eyes! Also, he was canceling appointments right amp; left. Going on long drives. He would not say where, but I think I may know.
That brings me to the enclosure, which I hope you will look at when you finish this letter. I know you are busy, but-if it will help!-think of me as the love-struck girl I was, with my hair tied back in a ponytail that was always coming loose, forever tagging along!
Although Johnny was on his own, he had formed a loose affiliation with two other "shrinks" in the last four years of his life. His current case files (not many, due to his cutting back) went to one of these Drs. following his death. Those files were in his office. But when I was cleaning out his study at home, I came upon the little manuscript I have enclosed. They are case notes for a patient he calls "N.," but I have seen his more formal case notes on a few occasions (not to snoop, but only because a folder happened to be open on his desk), and I know this is not like those. For one thing, they weren't done in his office, because there is no heading, as on the other case notes I have seen, and there is no red CONFIDENTIAL stamp at the bottom. Also, you will notice a faint vertical line on the pages. His home printer does this.
But there was something else, which you will see when you unwrap the box. He has printed two words on the cover in thick black strokes: BURN THIS. I almost did, without looking inside. I thought, God help me, it might be his private stash of drugs or print-outs of some weird strain of Internet p**n ography. In the end, daughter of Pandora that I am, my curiosity got the best of me. I wish it hadn't.
Charlie, I have an idea my brother may have been planning a book, something popular in the style of Oliver Sacks. Judging by this piece of manuscript, it was obsessive-compulsive behavior he was initially focused on, and when I add in his suicide (if it was suicide!), I wonder if his interest didn't spring from that old adage "Physician, Heal Thyself!"
In any case, I found the account of N., and my brother's increasingly fragmentary notes, disturbing. How disturbing? Enough so I'm forwarding the manuscript-which I have not copied, by the way, this is the only one-to a friend he hadn't seen in ten years and I haven't seen in fourteen. Originally I thought, "Perhaps this could be published. It could serve as a kind of living memorial to my brother."
But I no longer think that. The thing is, the manuscript seems alive, and not in a good way. I know the places that are mentioned, you see (I'll bet you know some of them, too-the field N. speaks of, as Johnny notes, must have been close to where we went to school as children), and since reading the pages, I feel a strong desire to see if I can find it. Not in spite of the manuscript's disturbing nature but because of it-and if that isn't obsessional, what is?!?
I don't think finding it would be a good idea.
But Johnny's death haunts me, and not just because he was my brother. So does the enclosed manuscript. Would you read it? Read it and tell me what you think? Thank you, Charlie. I hope this isn't too much of an intrusion. And...if you should decide to honor Johnny's request and burn it, you would never hear a murmur of protest from me.
Fondly,
From Johnny Bonsaint's "little sis,"
Sheila Bonsaint LeClaire
964 Lisbon Street
Lewiston, Maine 04240
PS-Oy, such a crush I had on you!
2. The Case Notes
June 1, 2007
N. is 48 years old, a partner in a large Portland accounting firm, divorced, the father of two daughters. One is doing postgraduate work in California, the other is a junior at a college here in Maine. He describes his current relationship with his ex-wife as "distant but amicable."
He says, "I know I look older than 48. It's because I haven't been sleeping. I've tried Ambien and the other one, the green moth one, but they only make me feel groggy."
When I ask how long he's been suffering from insomnia, he needs no time to think it over.
"Ten months."
I ask him if it's the insomnia that brought him to me. He smiles up at the ceiling. Most patients choose the chair, at least on their first visit-one woman told me that lying on the couch would make her feel like "a joke neurotic in a New Yorker cartoon"-but N. has gone directly to the couch. He lies there with his hands laced tightly together on his chest.
"I think we both know better than that, Dr. Bonsaint," he says.