After the crash, all I wanted was for someone to ask me what happened. All the police and firemen, the EMT crews, none of them asked. Even the reporters didn’t ask. They just wanted to know what it felt like, not what happened. Later, my friends and people I talked to, none of them asked either. I guess no one thought that I would know what had happened, why the plane had gone down.

When the plane starts going down that fast, at the terminal velocity where any object (no matter what it’s size) will fall at the same speed, everything gets really slow. The plane was shuddering and everyone was screaming or crying except for me. I was just staring out the window, watching the sun getting farther and farther away from my line of sight. And when it disappeared and the entire plane was shrouded in shadows because the lights had gone out, that was when the plane started to level out. And for a minute there everyone got really calm and they all exhaled one long simultaneous breath of relief. And then the collision alarm started going off. The flight attendants were crying. That’s when you know things are really bad and aren’t going to be getting any better. When the flight attendants start crying.

This woman next to me was squeezing my hand and I realized that the whole thing had gone numb and I couldn’t feel anything. I opened my mouth to say something to her, probably to tell her to let go, and that’s when we hit. The plane just lurched, snapped back like it was at the end of a giant bungee cord. Luggage flew out of the overhead bins and scattered everywhere. The whole plane started turning, very slowly, until it had turned in a full circle. And all I could think was that this is exactly how I hoped it would be.

But the cabin never broke up. It stayed in one long piece, a giant tube sliding through a cornfield. The cockpit separated and there was corn and corn stalks flying through the plane and I looked out the window and saw the cockpit sliding about thirty yards out from my seat, facing the wrong way. I could see the co-pilot in there and it looked like he was crying and praying. The woman next to me, the one that was squeezing my hand, she saw it too. She turned and looked at me and I just kind of nodded and shrugged because I didn’t know what else to do.

The plane started slowing down now, sliding slower. It was like being on a subway train. By this time everyone had stopped screaming and they were all gripping the armrests and staring down at their laps, probably praying like the co-pilot. The plane started to slowly lean to one side and everyone grasped what was happening and subconsciously leaned toward the other side in the hopes that the thing wouldn’t tip over. The wing dug into the ground and spun the plane around very hard. And then everything just stopped. Nobody moved for a long time even though there was screaming in the back of the plane. It was a muffled screaming, broken, like someone was drowning and kept slipping under the surface of the water.

Then, for no reason at all, the fasten seatbelt light dinged off and everyone automatically unbuckled their belts and stood up. This is Pavlov for the cell phone generation.

Someone in the back yelled out, “Is there a doctor here?”

And I stood up and said, “Yes. I’m a doctor.”

“Help these people.”

I looked to where he was pointing and realized what the broken screaming had been. The back three rows were buried under cornstalks, the passengers buried too. The corn had crashed under seats and slid down the aisle and pooled in the back, growing into a giant mound that was suffocating the people in the back rows. Before I got there a handful of men were already digging through the corn. There was an overwhelming stench of pesticide in the air and I realized that the aisle was covered with dead bugs. It was like some sort of Old Testament smiting that had been turned around by the hand of man.

By this time everyone was piling out the emergency exits, most of them just running away, out into the cornfield. It made it difficult to get to the back, between the people scrambling out and the piles of luggage, corn, and dead bugs blocking the aisle. I finally gave up and stumbled out of the exit with the others. A couple of minutes later, men emerged from the tail section carrying inert bodies between them. I walked over and said, “I don’t think I can do anything for them.” They all just looked at me. I pointed at the prone figures and shrugged. They turned around and looked and it was like they were seeing them for the first time.

There were six of them, four men and two women. All but one were misshapen, beaten to a pulp by an onslaught of corn hitting them at over 100 miles per hour. Blood was coming out of every orifice on their head, their eyes were swollen shut, teeth were missing, noses broken. The only one that wasn’t completely mangled, one of the women, had a large piece of corn sticking straight out of her mouth. I grabbed it and pulled it out only to discover another one buried deeper down her throat. She wasn’t breathing.

“Can’t you do anything?” one of the guys pleaded.

“Not really. Here,” I said and handed him one of my business cards, “if you need any counseling for this, give me a call.”

And then there was everything else. The police, the fire trucks, the EMTs. The airline investigators and the NTSB. The crying relatives and the television news crews. And no one asked me what happened. No one asked me if I knew why the plane had crashed. And all I wanted was for someone to ask me so that I could tell them.

“It was a suitcase. I saw a suitcase fall into the engine outside my window.”

But back before all that, I already had problems.

It was right after college that I realized that something was wrong. All that hard work, years of pushing myself, working my way through med school, and I never even thought of the future. I mean, I thought of the future but it was always this abstract kind of thinking. I never considered the future for what it would actually be. So I worked for years, stayed up all night to ace tests, stayed in on weekends to study. I don’t think I slept more than forty hours a week for eight years.

And what was my prize? What was my reward for all this hard work?

Stomach ulcers.

A receding hairline.

Depression.

A lifetime sentence in the ratrace. With a silk Perry Ellis tie as my ball and chain. My prison uniform.

That’s the thing they never tell you when you’re going through college. They always make you feel like you can conquer the world. That they’ve made you into this magnificent monument to knowledge, this repository of years of enlightenment. What they don’t tell you is that they’re just sculpting you, molding you into the perfect shape, another cog in the machine.

And you play along. You start buying all this stuff, the things they tell you to. What you tell yourself at the time, you say to yourself, “This just shows everyone how successful I am.”

The white leather Laholm corner sofa.

The Klinga series desk accessories for your home office.

“I’m just reaping the rewards,” you say to yourself.

The Morkedal bed with silk Calvin Klein sheets.

“I’ve earned all this,” you say. “This is what I deserve.”

And then you start buying storage space. You start replacing things. The only important things are you and your job.

I never thought about getting married. I guess it’s because I’ve never seen a marriage actually work (although I’ve seen thousands of them fail). One of my friends, Barry, he’s a marriage counselor. I always refer people to him. Every time I see a marriage falling apart, I don’t think, “That’s too bad.” I think, “There’s more money for Barry.” He’s probably got more job security than anyone else I know.

So I couldn’t get married. Marriage is something you always see happening to someone else and you say, “I’m glad that’s not me.” Marriage is cancer. And one day there’s just too much of it to save yourself and you end up moving out with a few shirts and a toothbrush. And everything you’ve earned, all the rewards you’ve reaped in your life, you just forget about them. And if you don’t get married you just put them in storage. You take all the things you were so proud to buy and you lock them up and never look at them again.

Later on, after I lost my job and became a terrorist and a murderer, I went back to the storage place and threw everything out. Maybe it would be picked up by one of my old patients.

Nevermind.

The important thing is to admit that you have a problem. After I lost my job and my credit rating was dropping, I had to admit the truth. Before that happened I knew the addresses of the credit card companies. I knew Ikea’s phone number by heart. I knew how much was in my bank account at all times. My watch cost more than my refrigerator.

And everything seems okay, you can quit shopping anytime. And then you’re a little behind on your payments, but that’s not a problem. And you have a few checks bounce, but that’s okay too. And you keep telling yourself, “Tomorrow I’ll change. I won’t buy anything tomorrow.” And then you see that Picarri dust ruffle you just have to have, the one with the gray stripe pattern. And then you might as well get a darker chair to coordinate with it. And then you realize you’re out of control. You realize your car’s going to be repossessed. One day you’re up to your wrists in receipts and you’re ready to sell blood to buy a new futon. A black metal futon rather than the pine one you have now. That can go into storage with the rest of your rewards.

And the way this goes, the worst thing about this, is that no one ever tells you that you have a problem. You don’t realize that you have a problem because no one thinks you do. It’s the same with sexual addiction. The biggest outlet for sex addicts is masturbation. You never reject yourself. And the things you buy never reject you. Even when you stuff them into a dark storage locker for years, when you come back they love you just as much as they always did.

When sex addicts get really deep into it, they don’t even have sex anymore. They retreat into a fantasy world of sexual encounters, their imagination pleasing them more than any human ever could. But the important thing is that no one ever tells a sex addict that they have a problem. And no one ever told me I had a problem.

How it all starts is you want to buy things.

The billboards tell you how much happier you’ll be if you buy this car.

If you drink this beer.

If you wear these clothes.

And it always starts when you’re young. You’ve got to have the best clothes at school, you’ve got to fit in with the popular people. Because nothing is more sacred in this world than celebrity. Fame is the only worthwhile thing anymore. We used to want to grow up to be doctors, now we want to be spokesmen. Movie stars. Rock stars. Models.

And after you’ve slaved your life away and filled your apartment with everything you need to be a complete person, that’s when you start to realize that you’re not any better than you were before. And it’s a big let down. You really do want to have the perfect life.

2.5 kids and the fixed income mortgage payments.

The platinum credit rating and the perfect smile.

That’s when they’ve got you. You can’t even see what you need to make you happy. All you can do is buy more, replace the things that have let you down with more things that will leave you unfulfilled. And I had a really great practice. I had a strong list of clients. Most of them were sanitation workers. Psychiatrists kill to have sanitation workers. The thing about them is they bury everything. That’s one of the things that draws them to their work, the idea of burying everything forever. So when you get sanitation workers, they’re in for the long haul. You’re going to be digging for years to solve their problems. You’ve got a lot of steady work to do for years.

But you can’t just break out of it. You can’t even tell them how to break out of it. After Moses led the Hebrews out of Egypt, they had to wait in the desert for forty years. To free their minds, they waited for forty years. You see, even though they were free, they were still thinking like slaves. You need to sever all ties with anything you’ve ever learned, everything you’ve ever known, that’s the only way to actually start a new life.

And I couldn’t help my patients.

I couldn’t tell them what would make them happy because I was a slave too. What I needed to do was break from my life and wander the desert for forty years. Get out of the slave mentality so that I could see clearly.

People don’t like to hear that their psychiatrist is religious. They’d rather believe that you’re a staunch believer in science over creation. When you’re a psychiatrist, if you believe in God it means that there’s just so much less that you can do to help someone else. So for a long time I didn’t believe in God. I didn’t believe the Bible. I couldn’t. The very idea was detrimental to my business. Which is no surprise.

In the Old Testament, working on the sabbath was punishable by death. That’s the kind of thing that most religious people like to overlook. They like to make little compromises so that they can get along in society. Seriously, commerce has been the real death of Christianity. Science hasn’t hurt it. Faith is stronger than science. With faith you can look right past scientific evidence. Business is a bit tougher. Business says, “Play by our rules or you’ll never make it.”

And a lot of people forget that Christians were persecuted. Jesus was an outlaw. Sure, it was all about loving your neighbor, but it was also about rebellion. So now people have gotten comfortable with their use once and destroy little life and they don’t want to risk fucking that up. No one wants to get a weird look when they refuse to work because it’s the sabbath. It’s gotten so far from rebellion now, it’s more rebellious to not be a Christian. That takes guts these days.

And everyone’s got their own little rebellion. Maybe it’s piercing your nose or drinking espresso. Maybe it’s buying an SUV in the middle of an urban maze. It doesn’t matter, they all spell the same thing. Comfortable rebellion. Acceptable defections from conformity. Little individualistic gestures that eventually become the standard. And you can go out on the weekend with your tattooed friends and act like you’ve got everything figured out and you’re a unique person. But on Monday you’re going right back to you’re nine to five prison, swiping the barcode security badge that’s your real identity.

And maybe you realize that this just isn’t doing it for you anymore and you come to see me. And I can’t help you. I can’t tell you that what you really need to do is make the biggest mistake you can. You need to walk in front of traffic and pray for a collision. You need to burn your credit cards and push your car off a cliff. You need to rip out your teeth and smile a mouthful of blood at everyone else. You need to set yourself on fire. It’s only after you’ve completely erased your past and completely burned every bridge you have back to normality, that’s the only time you can really figure out what you want.

So maybe you come to see me and I tell you to work more. Earn more money. Meet more people. Find a way to please everyone else. Make yourself happy by making others happy. Buy more things to make a good impression. Maybe I tell you that you have a repressed anger towards your boss and you need to find other ways to relieve tension. And what I should be telling you is that you need to quit your job and burn the building down. You need to throw your boss out a window to send a message to the world.

What I should be telling you is that it’s not your fault.

The world let you down.

You did everything right, you did everything you were supposed to do. You just fell for the lies. What I should be telling you is that you’re not alone. We’re all lost here. We’ve all been lied to. We’ve all fallen for the same bullshit and it really hurts. What I should be telling you is that you’re perfectly healthy, it’s the world that’s sick.

And maybe after a while, I do start saying this.

I mean, I never came right out and said any of this stuff but it started to become pretty obvious. When you’re a psychiatrist, all day long it’s like being the head of a movie studio. All day long people tell you their stories, the movie of their life. Most people, they have a grainy black and white life that only cost a few thousand dollars to film. You never get to meet any of the huge budget crowdpleasers. These people don’t need therapy, they enjoy themselves too much.

And all day long I was like a studio executive. Listening to storylines, plot twists I saw coming a mile away, and I offer advice. I tell them how to fix this or that. I tell them how to please the audience. Because that’s the only reason anyone comes to see me. No one comes to please themselves. Everyone’s there to find out how to please others. Because they want fame. They want celebrity. By now they realize they can’t get that worldwide fame that everyone dreams of. They want something smaller, something more simple. They want to be famous in their own little movie.

And when you’re like me, you don’t know what to tell them. You know the script says that you urge them to do well in business, buy more things, get the trophy wife and smiling children. That’s what the script tells you. But you’ve read that script before, you’re starring in your own version of it. And you know that it doesn’t work. So maybe you start hinting to them that they need to quit their job. They need to stop worrying about their bills and credit card debt.

And that’s not what they want to hear.

That’s not what you’re supposed to be saying.

You’re not sticking to the script.

So after that, people don’t want to come see you anymore. People don’t want to get psychological therapy from someone that’s telling them to ruin their life. And the worst part is that you can’t even ruin your own life, not in any direct way. You’re still chasing the lifestyle that’s being marketed to you. And it gets really hard when there’s no more money coming in and you don’t know where to turn anymore and your friends are suggesting that you seek counseling.

Maybe then you start travelling.

You just start flying around the country, visiting all the places you never thought you’d see. You try to spend all your time in the air. Because you think this might be your version of wandering in the desert until you’re not trapped anymore. And you think the more you travel, the better the odds. One way or another, things will change if you do that much flying. Planes can’t stay in the air forever. If you travel enough you’ll land in a different city every day and have a new chance every day. And in the back of your mind you know that if you travel enough, you get closer to the odds of a plane coming down unexpectedly.

But back before all that, I already had problems.

It was right after college that I realized that something was wrong. All that hard work, years of pushing myself, working my way through med school, and I never even thought of the future. I mean, I thought of the future but it was always this abstract kind of thinking. I never considered the future for what it would actually be. So I worked for years, stayed up all night to ace tests, stayed in on weekends to study. I don’t think I slept more than forty hours a week for eight years.

And what was my prize? What was my reward for all this hard work?

Stomach ulcers.

A receding hairline.

Depression.

A lifetime sentence in the ratrace. With a silk Perry Ellis tie as my ball and chain. My prison uniform.

That’s the thing they never tell you when you’re going through college. They always make you feel like you can conquer the world. That they’ve made you into this magnificent monument to knowledge, this repository of years of enlightenment. What they don’t tell you is that they’re just sculpting you, molding you into the perfect shape, another cog in the machine.

And you play along. You start buying all this stuff, the things they tell you to. What you tell yourself at the time, you say to yourself, “This just shows everyone how successful I am.”

The white leather Laholm corner sofa.

The Klinga series desk accessories for your home office.

“I’m just reaping the rewards,” you say to yourself.

The Morkedal bed with silk Calvin Klein sheets.

“I’ve earned all this,” you say. “This is what I deserve.”

And then you start buying storage space. You start replacing things. The only important things are you and your job.

I never thought about getting married. I guess it’s because I’ve never seen a marriage actually work (although I’ve seen thousands of them fail). One of my friends, Barry, he’s a marriage counselor. I always refer people to him. Every time I see a marriage falling apart, I don’t think, “That’s too bad.” I think, “There’s more money for Barry.” He’s probably got more job security than anyone else I know.

So I couldn’t get married. Marriage is something you always see happening to someone else and you say, “I’m glad that’s not me.” Marriage is cancer. And one day there’s just too much of it to save yourself and you end up moving out with a few shirts and a toothbrush. And everything you’ve earned, all the rewards you’ve reaped in your life, you just forget about them. And if you don’t get married you just put them in storage. You take all the things you were so proud to buy and you lock them up and never look at them again.

Later on, after I lost my job and became a terrorist and a murderer, I went back to the storage place and threw everything out. Maybe it would be picked up by one of my old patients.

Nevermind.

The important thing is to admit that you have a problem. After I lost my job and my credit rating was dropping, I had to admit the truth. Before that happened I knew the addresses of the credit card companies. I knew Ikea’s phone number by heart. I knew how much was in my bank account at all times. My watch cost more than my refrigerator.

And everything seems okay, you can quit shopping anytime. And then you’re a little behind on your payments, but that’s not a problem. And you have a few checks bounce, but that’s okay too. And you keep telling yourself, “Tomorrow I’ll change. I won’t buy anything tomorrow.” And then you see that Picarri dust ruffle you just have to have, the one with the gray stripe pattern. And then you might as well get a darker chair to coordinate with it. And then you realize you’re out of control. You realize your car’s going to be repossessed. One day you’re up to your wrists in receipts and you’re ready to sell blood to buy a new futon. A black metal futon rather than the pine one you have now. That can go into storage with the rest of your rewards.

And the way this goes, the worst thing about this, is that no one ever tells you that you have a problem. You don’t realize that you have a problem because no one thinks you do. It’s the same with sexual addiction. The biggest outlet for sex addicts is masturbation. You never reject yourself. And the things you buy never reject you. Even when you stuff them into a dark storage locker for years, when you come back they love you just as much as they always did.

When sex addicts get really deep into it, they don’t even have sex anymore. They retreat into a fantasy world of sexual encounters, their imagination pleasing them more than any human ever could. But the important thing is that no one ever tells a sex addict that they have a problem. And no one ever told me I had a problem.

And then one day it starts raining. And it’s not just any kind of rain. It’s that highly acidic rain that burns the shine off new statues. And sometimes you have patients that are paranoid about disease.

Cancer.

AIDS.

Rectal herpes.

And acid rain.

So you’ve got to explain to them that acid rain is actually a natural thing. That sulphur dioxide is the gas that triggers acid rain. Sulphur dioxide is vented by volcanoes and sea spray. Rotting vegetation. Decaying plankton. When the sulphur dioxide reaches the atmosphere it oxidizes into a sulphate ion. Then it joins with the hydrogen molecules and forms sulphuric acid that falls back to the earth. And you try to tell someone this, that the earth is killing itself.

There’s no need to be scared of the asthma.

Dry coughs.

Headaches.

Eye, nose and throat irritations.

This is all part of the natural order of things.

And then they’re saying that it eats away flags. That limestone and marble are turned to gypsum and crumble. That books are decaying from the acidic particles coming in through library vents. That toxic metals are burned down by the rain and absorbed into vegetables that we eat. That we’re going to have brain damage, nerve disorders, kidney failure, death.

And you’re still telling them that it’s the way things work. The earth is killing us naturally.

And you still know that power plants, coal burning, exhaust fumes, you know that’s what’s really causing this. That acid rain has been getting stronger since the industrial revolution. And you’re still telling them that it’s all okay. Nature kills us. Everything falls apart. We start decaying before we die. On a brighter note, we eat so many preservatives now it takes us six weeks longer to decompose.

And you don’t know if you’re trying to convince them or yourself. And then one day it starts raining. And you start thinking that maybe they were right and you’re the one that’s crazy. And you look up at the rain and start wondering what else is up there. What else is coming out of the sky with that rain? How long do I have to be in contact with the rain before it causes irreparable damage? And the rain’s so high up, you’re amazed that anything could be up there. Planes fall out of the sky from that height.

Another thing they don’t tell you in college is that when you’re a doctor people don’t matter anymore. You never meet a person, you meet a symptom. I’ve never treated a John, I’ve treated a schizoaffective. I’ve never treated a Jane, I’ve treated a bipolar in a manic phase with psychotic features. You don’t get in this business to help people anymore. People don’t even want to be helped. They just want to know that it’s okay for them to feel so empty inside.

If you really want to make some money you go into child psychology and diagnose every kid as ADD. Ritalin manufacturers are like a Washington lobby group.

If you’ve fucked up too many times you end up at the mental hospital. Not much different from the inmates if you think about it.

But as long as you keep the patient happy, you’ll never go broke. Just tell them that they have a right to feel like they do, that’s all they want.

And every day more people are looking for that approval. That judgement. That excuse from the doctor.

The last thing you want to do is let them know what the mind is really like. That their whole personality is determined by some neurons firing. That who you are is fleeting and can be changed by a hard blow to the head. I mean, that’s rare. People don’t usually turn into someone else just because they get hit. But it’s been known to happen.

And you can’t ever let anyone know that. You can’t deflate their illusion of individuality, soul, uniqueness. It’s not the kind of thing that I like to think about either when you get right down to it.

There are actually more people in need of psychological help than ever before. It’s that whole millenium thing. Human minds are equipped to handle intense stress. You can handle something like a giant tiger chasing you through the jungle. But now our culture is built on stress. All the little gadgets that were supposed to make our life so much simpler have really just made everything faster. Life is stress now, prolonged and acute. And we’re not equipped to handle that. And that’s why people kept showing up on my couch.

And then one day you’re pushing them away. You’re telling them that they should give up on their dreams. You’re telling them that the world doesn’t need another bad actor. The world doesn’t need another unsuccessful writer. The world doesn’t need another useless musician. And you’re telling them that they don’t just feel like a number, they are a number. Even to you. You don’t know their name, you just now them as a bipolar disorder. A reward deficiency syndrome with accompanying alcoholism. A dysthymic disorder.

And one day you don’t have any patients left because word gets around. And nobody’s making any referrals to you. And you start thinking about dying. And you start traveling a lot. And you do a lot of research on religion because it’s something that people believe in. You can’t believe in anything anymore, how can they? Even psychiatry can’t be trusted.

The psychology bible, the Diagnostic and Statistical Manual of Mental Disorders, a new one comes out every year. Every year there are new labels for illnesses. Sometimes what used to be a symptom isn’t anymore. Sometimes the disorders have changed names. Sometimes what used to be a disorder isn’t anymore. Every year people are changed from healthy to insane and insane to healthy by this thing. How could I trust in that?

And then one day you see a piece of luggage fall into the jet engine outside your window. And it’s just so everything-you-wanted that you’re not sure what to do. And you’ve been on planes for weeks and you hear the same speech on every plane. There are emergency exits located here, here, and here. If you can not fulfill your obligation to open the emergency exit please ask to be reseated. No one ever asks to be reseated. We have to appear capable at all times. And the people aren’t even people by this point. You’ve seen so many people by now that there’s no such thing as an individual. All you see are barcodes when you look around. Tattoos. Nose rings. Comfortable rebellion.

And then you see a piece of luggage fall into the jet engine outside the window and you don’t have to worry about anyone else anymore. You don’t have to worry about yourself anymore. You don’t waste any time worrying about your Applad kitchen with the pale blue lacquer finish. And you’re not worrying about your brand new Lexus that still has the new car smell. And you forget about your DKNY shirts in your alligator skin luggage. And for once in your life you enjoy a moment for what it is. An actual event. Not just the precursor to the future. The future isn’t something big and exciting that’s just over the next horizon. The future is now. This is the future from a few minutes ago. And everyone forgets how close the future is.

In the fifties we thought that there would be colonies on the moon and robots helping us with our housework by now. We’d have flying cars and amazing mass transportation. We’d all wear the same clothes all the time. Everything would be figured out by now. And now most of us aren’t looking towards the future. We’re looking at the past. We want to go back to a time when there weren’t great inventions like the cell phone and the all purpose lawsuit. And the future’s not something to look forward to anymore. It’s something to fear.

And then you see the sun disappear behind the bulk of the plane, you’re pointed downward at an angle that makes light disappear. You’re falling like acid rain, full of dangerous chemicals, destined to destroy whatever’s below you. And you just smile and want to tell everyone how happy you are. You want to let everyone know that this is the greatest moment in your life. You want everyone to realize that this is the most alive they’ll ever be. And then the plane starts to straighten out and it doesn’t even matter because you’ve already reached the point of no return. You’re alive now, nothing can stop that.

And when you’re sitting in a cornfield watching everyone cry and scramble around looking for their luggage, that’s when you look down and find a copy of the Bible. And this is just too perfect to be a coincidence. This is just so much larger than life it couldn’t have been unplanned. And you open up the book and start looking through it randomly. And the coincidences are just too big to ignore.

You randomly flip and land in Exodus.

There’s just got to be a message here.

You randomly flip and you’re in Revelations.

And this is just from God’s lips to your ear.

And you keep finding words like freedom.

Let my people go.

Escape.

Destruction.

Death, famine, and pestilence.

But especially vengeance.

What you do as a psychiatrist is use cause and effect. You find the effect and guess the cause. We don’t want you to know it’s guesswork. We have all the answers. We assume things about you. Like if you admit that you’ve ever had a drink, you’re an alcoholic. If you say you’re not an alcoholic then you haven’t come to terms with it. If you’re married, your spouse is a co-dependent. That’s why they’ve never brought up your drinking problem. If you dislike your father, you were abused. It doesn’t matter if it’s right or wrong. Right is just an opinion of perspective. So we look at the effects and guess the cause.

You’re up all night, can’t concentrate, and you have no energy? Clinical depression.

Shortness of breath, lightheadedness, confusion, sense of impending doom? Anxiety.

It’s like being a detective. All the clues are presented to you and then you decide what happened. And sometimes it’s like being a corrupt detective because no matter what the evidence says people have to take your word for it. And sometimes you don’t want to be right. Phobias always got to me.

Claustrophobia, when you can’t stand closed spaces.

Acrophobia, the fear of heights. Most people think that’s vertigo but it’s not.

Aquaphobia, the fear of water.

Ophidiphobia, fear of snakes.

Astraphobia, fear of lightning. That’s a rare one.

Phobias are irrational fears. That’s what all the books say. But I never saw that. Maybe it’s just your body telling you that you shouldn’t be out on a ledge 50 floors up, or locked in a little room, or sitting in the middle of a bunch of snakes. I could never see why there was anything wrong with that. But you keep these things to yourself. You tell people they have a phobia and they need to do this and this to work on it, you give them their own little twelve step program. You tell them that they can overcome it. I never wanted to tell them that. I never wanted them to drop a natural defense they had because other people didn’t have it.

I guess the day that I met with Billy was the first day I really lost faith in my job. Billy had a phobia. He was afraid of flying. In Billy’s movie he missed his father’s funeral because he had a massive panic attack at the airport. That means Billy missed out on being the star that day. Billy wants to be able to fly. He doesn’t even want to be comfortable flying, he just doesn’t want to have a panic attack when trying to fly. So we play cause and effect. I dig into his past. He’s never had any problem flying before. Then, just like that, he couldn’t fly anymore.

The further I dug the more phobias I found. The root was so obvious it was staring us both in the face. We were too afraid to say it out loud though. So I took Billy through the exercises.

Trust the industry.

Accept your feelings.

Breathe.

Relax.

Take supportive actions.

Handle your worries.

Use visualizations for rehearsals.

Our own little seven step program just for Billy.

And Billy left and Billy was happy. He got what he came for. He could handle things now. And maybe I should have said something. Maybe I should have said, “You’re not afraid of flying, you’re afraid of this world. And you should be.”

Because it wasn’t flying. He wasn’t scared of flying at all.

He was scared of everything. Airplanes, antibiotics, cell phones, computers, cars, ATM machines, and surveillance cameras. Boardrooms, shopping malls, coffee shops, subway tunnels, and traffic lights. He wasn’t afraid of flying. He was afraid of technology. He was afraid of progress. And there’s nothing you can do to cure that. Progress will not halt. Technology won’t give up.

And everyday I’d get more patients like Billy. They were all riddled with anxieties and depression. Everyone had trouble sleeping and avoided elevators. Everyone felt empty inside. Everyone watched television religiously. And there would always be that one big thing that they needed fixed right away, that one problem that was interrupting their movie and causing them problems. That’s what I was there for. I was there to make everything well enough that they could go on. That’s what got to me. That’s when I started hating what I did. That’s when I started wondering why phobias were bad. Because now people were afraid of everything. And maybe there wasn’t anything wrong with that. Maybe that was proof of something. Maybe everything was getting out of control.

And maybe psychiatry was just a safety valve now, maybe it wasn’t going to last much longer. Maybe when everyone had intense phobias about the world around them, maybe then we’d realize that the phobias were telling us we were making a mistake.

And everyday I’d be seeing more people like this.

More people saying, “I just don’t feel like a person anymore,” and “There’s no privacy”.

And after a long time you start agreeing with them. You start confessing that you don’t feel like a person either. Because what the bible, the DSM, tells you to say, well it just doesn’t make sense anymore. Because maybe these people aren’t crazy. That’s the hard thing to think about. You can treat someone that has a problem. How do you treat someone that is just telling the truth?

That we are consumer byproducts.

That we don’t exist as independent people anymore.

That our privacy is openly sold to the highest bidder.

That our life is worth so much an hour.

When that’s the truth…are you crazy to be upset by it?

What you’re supposed to do when you’re depressed is make a plan. You make an outline, or even several outlines. You write down what you want to accomplish now, what you want to accomplish in the near future, and in the far future. This is supposed to be therapeutic. You take baby steps.

On the list of things you want to accomplish now you write simple tasks that you can easily complete to instill confidence in yourself.

Mow the lawn.

Get out of bed.

Go to the grocery store.

Easy things.

On the near future list you write the harder goals.

Find a job.

Begin dating again.

Make amends with your loved ones.

This list is the list of goals you’ll attempt after you’ve restored your self-confidence and you have energy again. When you’ve escaped that hellish gun-in-your-mouth phase that saps all your energy. These are your goals. You can’t beat depression without goals.

The last list is the list of your whole life. The things that would make you happy, things you want to do before you die.

Go back to college.

Get married.

Move to the suburbs.

Become a Congressman.

Retire early.

This is the list that we don’t intend for you to accomplish. This is the list of things that you tell yourself you can do. No one ever accomplishes anything on this list. Everyone gets trapped in their second list, the near future list. They don’t even realize it. They start living by a new list.

Wake up.

Get out of bed.

Shower.

Shave.

Fight traffic until you get to work.

Please the boss.

Work hard.

Avoid eye contact.

Punch out and head home.

Lounge in the living room watching television.

Regret your mistakes.

Feel empty.

Dream of a better life, a life of fame and fortune.

Pin all your hopes on the lottery.

Promise yourself that you’ll find a better job tomorrow because you can feel it crushing your soul.

Go to sleep lonely, realizing you haven’t really communicated with anyone all day.

Repeat the next day.

And repeat the next day.

And repeat.

Until you die.