The Long View.

midtown mental health clinic

octor's Notes

patient: B. Clinton treated since: January 27th, 2001 insurance: Federal/OK

September 12th, 2001

Patient calls private number and demands an appointment. Doctor reminds him that his scheduled session isn't for another week, and that we just had a session on September 10th. He replies that he is depressed by the events and that he needs someone to work it out with. Doctor replies that the next several days are actually pretty full, and whatever time doctor has will be spent volunteering downtown as a grief counselor. Patient becomes irate. What about my grief? he asks. You don't think I hurt, too? You don't think this kills me? I mean, me, especially? Doctor cautions patient against appearing in public or on television with that attitude. What attitude? patient asks. All I'm saying, patient continues, is that I'm a victim of this thing too. Maybe, in a way, I'm the biggest victim. Doctor agrees to see patient as soon as possible.

September 14th, 2001

Patient's attitude seems to have stabilized. He now sees that the thousands of people in the World Trade Center towers, the hundreds of firefighters, rescue workers, and police, and their families and friends, are the true victims of September 11th, and that while he no doubt feels their pain (a phrase I have forbidden in our sessions as unnecessarily projective and delusional) he is in no way a victim of the events, is in no way directly touched by them, and is in no way hurting the hardest.

Patient seems to understand with the aid of low levels of oral psychopharmaceuticals that he is on the periphery of these events' aftermath. So far, he seems okay with it.

September 25th, 2001

Patient arrives for his usual scheduled session only one hour late, as we've agreed.

(Patient had been chronically late by several hours, until we finally agreed upon the one-hour rule: Patient can arrive late, if he feels it necessary, but only by an hour. This was a difficult and protracted discussion, with the patient demanding presidential prerogatives, but agreement was eventually reached. For further issues that required careful negotiation between doctor and patient, please see Note for March 17th, 2001: Explaining to Patient Why He Cannot Sit In On Other Patients' Sessions and Offer Advice.)

Patient seems to have decided that his role at this time is, essentially, passive. He has agreed to help with the fundraising efforts-when the request came, though, he admitted to doctor that he misunderstood who the funds were intended for-and has tried to keep himself busy with service to the city. We agree that this counts as progress.

Patient gets more comfortable talking about his role as healer. He mentions fundraising, consoling families, attending gatherings of victims, helping with Red Cross efforts. Doctor compliments patient, reminding him that he has an important part to play in the healing of the city even if he wasn't a direct victim. Doctor reinforces the basic thrust of patient's therapeutic work: that delusional egomania hurts the patient's effectiveness. Patient agrees. I can't believe I ever thought I was a victim in this thing, he says with a laugh. I mean, nothing could be further from the truth! I'm not a victim. I'm a healer. I'm a leader. In fact, I'm the chief healer in this city today. I've been leading this city through this terrible crisis since Day One. I'm a hero.

Clearly, patient has a long way to go.

October 18th, 2001

In the wake of George W. Bush's soaring popularity, patient has become depressed and listless. Under the advice of doctor, the patient has refused all direct interviews with the news media.

In an interview the previous week, patient had declared to journalists that when he was president, he ordered a cruise-missile attack on Osama bin Laden and almost got him. Patient went on to describe the various anti-terror measures he implemented, declaring himself, in many ways, the first Director of Homeland Security. When subsequent press reports contradicted the patient's claims, under the strong advice of doctor, patient disconnected his phone, pulled out his cable, and spent ten days sitting quietly, watching the leaves turn.

November 26th, 2001

Following patient's speech at Georgetown, in which he traced culpability for September 11th to the Crusades of the 11th, 12th, and 13th centuries, patient arrives, confused. I thought that's what you wanted from me, he says. A wider historical perspective. Not one based entirely on me. Doctor agrees and tells patient that he considers the Georgetown speech to be a great milestone in patient's therapy. Patient has finally begun to see the world in its larger scope, and the sweep of history as something other than a collection of events that, when aligned, point directly to a Bill Clinton presidency.

So why am I getting nailed for it? the patient asks.

Patient has a point. Doctor reminds him that therapeutic progress is slow and often painful, and that the outside world rarely recognizes the great strides a patient makes.

So I am a victim, the patient declares. I knew it! I am a victim of September 11th. I am! I am!

Patient dashes out before the session is over, and before doctor can collect the $20 co-pay.