6/20/04

The following is excerpted from the rough synopsis of a book which I will never write called (tentatively) Annie Cotter. The story line is a shameless derivation from Dr. Strangelove, My Fair Lady and Frankenstein, with some personal thoughts about cosmetic surgery and bioharmonic fluff. In the story, General Wesley Clark goes insane and finds the means to blackmail the nation into inaugurating, as President-and-Leader-of-the-Free-World, a bag lady named One-Eyed Annie. She has been run over by the bus of life as well as one from the Newark Transit Authority. Annie could best be called a fixer-upper. It is a story about how easily people and their institutions are turned into dysfunctional wrecks, and with what difficulty they are repaired.

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Chapter 7


At the insistence of the Surgeon General, Wesley Clark has agreed to observe a psychiatric interview with Annie Cotter. Annie herself has been cleaned up, although her appearance has changed for the worse because of this. Her face, beneath the removed street grime, is actually multicolored, changing from a blotchy, weathered russet color in the undamaged areas to a sickly purple where the caved-in portions of her jaw and cheek recede like the subsidence in a decomposed eggplant. It is difficult to tell where her right eye might have been. Although a very comfortable chair has been provided for her, she has chosen to sit on the floor. Efforts to remove her filthy bedroll from her arms have been met with violent resistance.

"Sock yer phlacker fuck sum snitch fackle bastard!" she exclaims.

Eisenhower is said to have brought to the Presidency one paramount skill from his military experience, the virtue of pragmatism. His advisors and their staffs were instructed never to place him in a political position which did not leave him six ways to move in case things didn't work out. On the battlefield, the live and volatile situation on the ground takes priority over theory, and revisions to the larger mandate are routinely necessary when reality does not present itself as expected. Any path to the goal which is inflexible is of no interest to military planning. So whereas General Clark has engineered his coup in scrupulous detail, he has not foreseen that his presidential draftee would be quite so completely unprepared to assume the burden of limitless power.

With hardly any hesitation, the maps and timetables in his brain revise themselves to accommodate hard facts and restore the viability of his objective. "Okay," he says. "I see what you mean."

He stares through the glass for a few minutes, sucking pensively on his unlighted pipe. "Any new Commander in Chief," he says finally. "is going to naturally require a period of orientation. President Cotter is no exception to that necessity. Getting a proper intelligence briefing into her is going to require a longer and perhaps more extensive I&E program than I anticipated. So, gentlemen, you have been granted a short reprieve. We'll postpone the inauguration for six months ... hell, take a year. But get this. I want her fixed. I want her repaired and fit for duty. You will reverse whatever godawful accidents have put this citizen into the deplorable condition we are witnessing. You will restore her, mind and body, and a year from today when the scepter passes to Annie Cotter she will be transformed to meet the challenge. I expect to look at her without gagging. When she opens her mouth I expect her to be able to quote from the Federalist Papers and name the heads of state of at least twelve countries. I'd suggest you get busy right away."

A team is assembled. Its members consist of the top people in their fields. The resources available are virtually unlimited, including physical facilities, expert assistants, military transportation. The smallest need expressed by any team member is to have the force of a presidential order. The organization is top down, there being no time for debate about the best approaches to Annie's reconstruction. All aspects of the task, physical (plastic & reconstructive, prosthetic, cosmetic, internal, nutritional), mental (psychiatric, psychological), cognitive (linguistic, educational, social) are to begin at once, simultaneously, with accommodation only for periods of unconsciousness following surgeries.

First in priority, due to extended healing times and the need for follow up procedures, is Annie's facial bone reconstruction. The chief surgeon in charge of this phase is Dr. Leonard Skittering of the Mayo Clinic. Like all surgeons he is something of a prima donna. "We'll get her in for a CT scan first thing in the morning," he tells the Surgeon General. "You'll get her in for a CT scan immediately," says the Surgeon General. "You'll have the bone prosthesis ready by morning."

An integrated treatment plan is drawn up. While the surgical team is rectifying Annie's skull, the psychiatric team is to begin, with the assistance of medications, to bring her into the scope of human communication. Verbal therapies will be administered only by those practitioners who can find a rapport and build a trusting relationship with the patient, and this investigative process is to begin in those rare windows of lucidity between surgeries when the combination of pain medications and Annie's own dementia do not eclipse her environmental awareness totally. Nutritionists are working furiously in the background, analyzing her metabolic functions, dietary deficiencies, allergies, chronic abnormalities and obesity, implementing food intake regimens and medications. Specialists probe her internal organs and blood chemistry with ultrasound, laparoscopic probes, MRI exams and every imaginable test. Teams of technicians are employed around the clock to collate reams of physiological information into a comprehensive profile and treatment plan. Based on three-dimensional imaging technologies, a high priced ophthalmic prosthetologist from Dresden is retained to start work on an artificial right eye, not only to precisely match Annie's remaining eye, but to include tissue ingrowth grids designed to allow attachment to the ocular musculature (if any remains) and permit synchronous lateral eye movement. Prosthodontia and dental reconstruction are initiated. Fortunately many of Annie's teeth have been knocked out early on, so that tooth decay and gingivitis have not been a problem. The presence of intact bone means that implant specialists can plan on building a complete set of permanent teeth as soon as her skull and jawbone are ready. Dermatological experts begin a broad series of treatments. The weather has not been kind to Annie's skin. Dermabrasion and laser resurfacing are employed to efface natural wrinkles, while more aggressive procedures are planned for numerous old knife wounds and homemade tattoos. Occlusive dressings are applied right away in the hope of achieving some revision of her hypertrophic burn scars as well as current surgical incisions. Tissue expanders are also installed immediately, to grow the skin that will be needed for inevitable grafts.

Hovering in the wings are the psychological therapists and special education teams, waiting for Annie's body to provide enough support to Annie's mind for them to begin their task of bringing her into touch with humanity and perhaps human society with its community structures and history. Investigators are dispatched to rural Mississippi to locate family and neighbors. Treatments are scheduled beginning with basic cognitive incapacities and a meagre range of affective responses depleted by not having had a substantive conversation with anybody in 30 years. (By way of companionship, she has received radio programs through her jaw since the accident, plus occasional memos from Jesus which come to her at night in a soft Atlanta drawl.) Suppression of her Tourettes syndrome and restoration of rudimentary speech will be needed before any measurement of I.Q. can be made. Given some basic resocialization, hopefully an accelerated educational curriculum can be contemplated. An innovative educational science is devised, based on crash Berlitz seminars or the forced feeding of geese with pressurized egg noodles, to bring Annie up to speed on what the human race has been up to recently. Luckily there will be no need for more subtle academics than basic English grammar, geography and political science.

Waiting at the nether end of this daunting project, calculated to transform One-Eyed Annie from a human train wreck into the leader of the Free World, are the finishing touchers, the aesthetic practitioners trained in the removal of unsightly lipomas and the filling of naso-labial depressions with Gore-tex and bioharmonic fluff, the hair stylists and manicurists and haberdashers and etiquette counselors, including a group of actors who will be trained in the specific skill of being Annie's friends, in case, following the whole crushing process, she has not found the time or ability to acquire any.

*****

Heading the Psychology Team is Dr. Katherine Sloane. Dr. Sloane has been selected notwithstanding her political activism, which has tended to liberal extremes, for her astonishing record of clinical successes. Her early work with animals resulted in a series of radical (and largely ignored) papers on the myth of anthropocentrism as a source of error in the assessment of animal intelligence. Quantifying her experiments in the traditional way, the speed and success rate of teaching animals to perform certain standard tasks, her papers claim to establish that better success is obtained with empathetic approaches in which the experimenter freely projects human motivations and responses onto the animals, interacting with them as one might with the family dog or parakeet, as contrasted with a lesser success rate when such projections and assumptions are scrupulously purged from the experiments. Taking these and similar findings into the clinical environment, Dr. Sloane then proceeded to develop therapeutic techniques for human psychoneurotic disorders based on the subjective response of the therapist. She has advocated abandoning the futile project of constructing an objective picture of a situation existing in the ultimately inaccessible landscape of another person, and instead relying on a more Jungian paradigm in which the connection between selves is non-spatial and not fundamentally exclusive. The meeting of minds might well take place in the location of a receptive and demonstrative patient, but could as easily, and as truly, occur purely in the therapist's own unscientific empathetic fantasies. Notably, neither the diagnosis nor the treatment can be achieved in abstraction from actual engagements with the patients. Dr. Sloane's sessions tend to be turgid events, intensely interactive free-for-alls in which all the work of theory and practice combines in a single exhausting workout.

Her work, for all its undeniable brilliance, has not had much impact on clinical practice. Her professional peers have concluded that her skills, clearly superior in effecting solid cures and remissions of psychotic symptoms bordering on clinical miracles among her own patients, can not be distilled into a method, and are therefore essentially unteachable. No amount of textbook instruction or weekend training seminars will suffice to transfer to her colleagues a "technique" based on a fierce interest in other people or a treatment plan requiring hours of hard work. Standard textbook therapies, especially drug therapies, are much more attractive to busy practitioners with a full load of lucrative patients, bi-weekly golf dates and immediately gratifying diversions waiting at home in the jacuzzi.

"Heading up this group can't have been an easy decision for you," says Team Neurologist Dr. Otto Hoffmann over a fast cafeteria lunch. Dr. Hoffmann's specialty is reconfiguration of neural complexes resulting from psychogenic disturbances, and in determining when the physiological effects of psychological trauma can be reversed and when they can not. "Surely you have put a lucrative practice on the shelf to participate in this questionable project. Why did you agree to do it?"

"I keep a picture of a pig on my desk," says Dr. Sloane. "The explanation for this is the answer to your question, if your question is a real one. At any rate, I'll go ahead and tell you, and if I see that you are starting to fidget, I'll stop."

"Please continue," Dr. Hoffmann insists. "I would really like to know."

"The picture haunts and terrifies me, to the point, actually, of interfering with my enjoyment of life. On several occasions I've resolved to throw it away, or at least put it out of sight, but the thought of doing that is more frightening than leaving it where it is. It was taken, or acquired by an animal rights group, and was included in a section of their web site addressing the conditions of farm animals when they are brought to slaughterhouses to be made into meat products. "

"I'm not sure this is something I want to hear," says Otto.

"Oh it's nothing gory or disgusting," says Katherine. "At least not explicitly so. No, it's just a photograph of a young pig, alone in a holding pen at one of these abattoirs in the American midwest. The pen is part of a vast area of similar pens visible in the background, covered by a large shed roof. In the distance, some daylight finds its way in, but the ambient light is rather grey and ghostly. Wire mesh is everywhere, forming enclosures and gates and runways, so that the animals can be held or herded as necessary, moving by their own ambulatory power into the process which terminates their tenure as live creatures and resurrects their flesh as shrink wrapped ribs, link sausages and so forth. The sound from adjacent areas of their fellow creatures being slaughtered, suspended from hooks and butchered, must surely be audible in these pens, but can only be imagined from the photograph."

"I say that this particular pig is alone in the holding pen, but this is not strictly true. To the right of the photo, and cropped out of the print on my desk, is the corpse of a pig which has died in the pen, a common event, apparently, at every point in the transportation of these beasts from the "farms" where they are raised and fattened to the omega point at which their vital signs become moot. These bodies are winched out of the boxcars, trucks, pens, whatever, and rendered back into feed for the next generation of hogs. In this way the system is nearly without waste. The pig in my photo is a "downer" pig, too sick, according to the caption, to rise to his feet and join his brothers and sisters out the gate of the pen and into their holocaust. Ironically, he appears for the time being to be the only survivor. He sits on the filthy cement floor, bewildered, terrified and utterly, unimaginably alone."

"When I was very small I had what might have been my first nightmare. That I remember it vividly to this day speaks of its psychological intensity, and in fact it is not uncommon among my patients and people in general to relate dreams and experiences expressing this deep seated fear of abandonment. In my own dream I simply woke up in my crib in a night meadow on the edge of a dark and forbidding forest in the middle of nowhere. My mother and father were gone and did not respond to my cries. The wind had a nasty edge to it, and the sounds that advanced from the forest were menacing and unearthly, not the kind of noises made by the creatures of my awareness, but a kind of mechanical rattle. I was, of course, terrified, and have remained so at some level to the present day. We all grow up and actually do, eventually, lose or depart from the parents who represent home and safety to us. We've all adapted to solitude, even ultimate, existential solitude. But these later experiences do not have the nuance of abandonment. This is why we are much more traumatized when we are rejected by parents or spouses than simply from living in the isolation that follows. The isolation is neither this nor that. The sun shines on the friendless and the lonely, and the joys and lessons of life are available to nearly all of us. But the betrayal, the violence of being ousted from our various homes, our childhoods or the surrogate homes of our adult lives, the desolation of eviction from the gardens of our origins, the severing of the primal connections from which we have whatever innocence we may claim to possess, this is surely a preview of damnation."

"Speaking of any animals whatsoever, regardless of where we find them, J.M. Coetzee writes: 'The question that truly occupies (them), as it occupies the rat and the cat and every other animal trapped in the hell of the laboratory or the zoo, is: Where is home, and how do I get there?' Indeed, that is a universal thought. It is the common basis of religion and empire, of love and cruelty. It is what all intelligence, given the chance to talk, has to say."

"And so this pig, I believe, embodies our worst nightmares and our deepest fears. We find him, an intelligent mammal, capable of the entire range of emotion from love to desolation, sitting on the cold cement, his pink legs curled under him like a baby's. He looks toward the photographer without hope or expectation from the horrifying dream that is his life. He does not have a friend in the place, or in any place whatsoever. He has never from the time of his weaning been anything more than sausage. He waits alone for somebody, some plant employee who has long ago put away the baggage of pity, to get around to killing him. To hold our eyes upon him knowing that we are ourselves the agents of his perdition is more than most of us can bear. For him, the deathly rattle in the forest is us."

"Well," Katherine smiles apologetically. "that makes a kind of long answer to your question, and perhaps more oblique than necessary. I have never really 'grown up' with respect to our capacity for heartlessness. We put the slaughterhouses of our world out of our minds. We throw the countless thousands of victims of war into blurry focus and toss off some kind of flip justification or hackneyed lament for them, for the outrage of that death and suffering. We dump human beings into hellhole prisons, deliver them into the hands of sadistic custodians, and give them not another thought. We walk past the homeless, the mindless, the broken and lost people on our own streets, we look through them, past them, away from them. Far from being of any help, we let one another die, without so much as a word of passing sympathy. We cover the bodies and bones with endless platitudes. "Grow up," we say to those who object. We have names for people who hug trees and animals, bleeding hearts who mollycoddle criminals, sympathize with the enemies of our soldiers, squander money on the unproductive poor. Like a small horde of marauding bandits, the fit, the affluent, the sane, the strong, the armed, we tear through the larger world of the gentle, the weak, the passive, the sick, the poor, the "downers" and make a joke of their right to exist. That is what has happened to Annie Cotter. She has been among the defeated from the beginning. She could be my new desk photo, a poster child for the scorned and ignored. It would be interesting to think that God - if anyone worthy of that title would lay claim to presiding over this horror of a world - would take Annie, mankind's crushed and demented creation, the product of our callous neglect, and place her back on top of the heap like a Queen. From my point of view this is the most arresting event imaginable. However it ends - and I won't, obviously, claim to be optimistic about it - how could I refuse to be witness to such a tale, or to accept a part - any part - in a revelation of retributive justice of this magnitude? Or on behalf of my corrupted race, to scramble to repair this mistake, this symbol of so many numberless mistakes? Our monster has been appointed to be our ruler. Consider the terrible beauty of it."

"I had a look at your patient today," says Otto. "If you ask me, the best you can hope for is to put some lipstick on your pig and hope for the best."

"You might be right," says Dr. Sloane. "but I think I'll fish around in there anyway, and see if we haven't left somebody behind inside Annie Cotter."

*****