I ask him what he means.
"If I only wanted to get rid of the bags under my eyes, I'd either see a plastic surgeon or go to my family doctor-who recommended you, by the way, he says you're very good-and ask for something stronger than Ambien or the green moth pills. There must be stronger stuff, right?"
I say nothing to this.
"As I understand it, insomnia's always a symptom of something else."
I tell him that isn't always so, but in most cases it is. And, I add, if there is another problem, insomnia is rarely the only symptom.
"Oh, I have others," he says. "Tons. For instance, look at my shoes."
I look at his shoes. They are lace-up brogans. The left one is tied at the top, but the right has been tied at the bottom. I tell him that's very interesting.
"Yes," he says. "When I was in high school, it was the fashion of girls to tie their sneakers at the bottom if they were going steady. Or if there was a boy they liked and they wanted to go steady."
I ask him if he's going steady, thinking this may break the tension I see in his posture-the knuckles of his laced-together hands are white, as if he fears they might fly away unless he exerts a certain amount of pressure to keep them where they are-but he doesn't laugh. He doesn't even smile.
"I'm a little past the going-steady stage of life," he says, "but there is something I want."
He considers.
"I tried tying both of my shoes at the bottom. It didn't help. But one up and one down-that actually seems to do some good." He frees his right hand from the deathgrip his left has on it and holds it up with the thumb and forefinger almost touching. "About this much."
I ask him what he wants.
"For my mind to be right again. But trying to cure one's mind by tying one's shoelaces according to some high school code of communication...slightly adjusted to fit the current situation...that's crazy, wouldn't you say? And crazy people should seek help. If they have any sanity left at all-which I flatter myself I do-they know that. So here I am."
He slides his hands together again and looks at me with defiance and fright. Also, I think, with some relief. He's lain awake trying to imagine what it will be like to tell a psychiatrist that he fears for his sanity, and when he did it, I neither ran shrieking from the room nor called for the men in the white coats. Some patients imagine I have a posse of such white-coated men in the very next room, equipped with butterfly nets and straitjackets.
I ask him to give me some instances of his current mental wrongness, and he shrugs.
"The usual OCD shit. You've heard it all a hundred times before. It's the underlying cause I came here to deal with. What happened in August of last year. I thought maybe you could hypnotize me and make me forget it." He looks at me hopefully.
I tell him that, while nothing is impossible, hypnotism works better when it's employed as an aid to memory rather than as a block.
"Ah," he says. "I didn't know that. Shit." He looks up at the ceiling again. The muscles in the side of his face are working, and I think he has something more to say. "It could be dangerous, you know." He stops, but this is only a pause; the muscles along his jaw are still flexing and relaxing. "What's wrong with me could be very dangerous." Another pause. "To me." Another pause. "Possibly to others."
Every therapy session is a series of choices; branching roads with no signposts. Here I could ask him what it is-the dangerous thing-but I elect not to. Instead I ask him what sort of OCD shit he's talking about. Other than the one-up, one-down tying thing, which is a pretty damn good example. (I do not say this.)
"You know it all," he says, and gives me a sly look that makes me a bit uncomfortable. I don't show it; he isn't the first patient who has made me uncomfortable. Psychiatrists are spelunkers, really, and any spelunker will tell you that caves are full of bats and bugs. Not nice, but most are essentially harmless.
I ask him to humor me. And to remember that we are still just getting to know each other.
"Not going steady just yet, eh?"
No, I tell him, not quite yet.
"Well, we better be soon," he says, "because I'm at Condition Orange here, Dr. Bonsaint. Edging into Condition Red."
I ask him if he counts things.
"Of course I do," he says. "The number of clues in the New York Times crossword puzzles...and on Sundays I count twice, because those puzzles are bigger and double-checking seems in order. Necessary, in fact. My own footsteps. Number of telephone rings when I call someone. I eat at the Colonial Diner on most workdays, it's three blocks from the office, and on my way there I'll count black shoes. On my way back, I'll count brown ones. I tried red once, but that was ridiculous. Only women wear red shoes, and not many, at that. Not in the daytime. I only counted three pair, so I went back to the Colonial and started again, only the second time I counted brown shoes."