The Ballad of Guan Ji Fu
Dr. Belson's last patient of the day had been referred to him by Dr. Furth, which was a portent of bad things; even worse, if he didn't wrap up the session by five o'clock and get out the door he'd be late for his daughter's soccer game, and he was late last week.
Dr. Furth was a family doctor across town and had only referred two patients to him over the years, but they were both extreme hypochondriacs and their sessions were brutal on him; after listening to both of them week after week for over a year he too came to believe that he was dying of cancer or had been stricken by a flesh-eating bacteria; his trachea was gradually narrowing, some slow-moving allergic reaction that would reach its peak while he slept and snuff him out; every morning and every evening for six months he stood before the bathroom mirror with his jaws wide, he probed with bulging eyeballs for spots on his tongue, his cheeks - and his eyeballs, were they jaundiced? He peered into his irises for darkness gathering in the brain, and every twitch of the heart or stab of pain in the back was doom and death come to collect him.
On his laptop, he reviewed the short, emailed referral from Dr. Furth: "Gary ____, possible Apotemnophilia, manifesting in acute and persistent desire to have healthy right leg amputated just above the knee." He closed his laptop and felt better; unlike hypochondria, which could bleed from one person to the next by sheer power of suggestion and a person's general level of apprehension about the world, Apotemnophilia was a different animal; latched somewhere deep in the brain, it influenced a person like a scheming, corrupting parasite, but that influence ended at the white bone wall of the cranium.
He got up and went to the door and as his hand reached the doorknob, his practiced, reassuring smile snapped onto his face like the sudden tick of a man with Tourette's. He stuck his head out:
Gary ____ was the only one in the waiting room and he came in and sat down, and Dr. Belson sat opposite him with his laptop on his thighs.
"How are you Gary?"
"Good. So, you were referred here by Dr. Furth, and he's your regular family doctor, correct?"
"Yeah. He said I have Apotemnophilia. I googled it last night; he's right, that's totally what I have." Dr. Belson fumed behind his smile: he wished Dr. Furth hadn't mentioned Apotemnophilia. With the availability of information online, Gary had walked in the door with assumptions and expectations, many of them likely wrong, or at best incomplete, which would make the job of cutting through to the root of the condition that much more complicated.
"Well, that's why he referred you to me. Dr. Furth is an excellent medical doctor, and he found absolutely nothing medically wrong with your leg, which is where I come in."
"He told me I had it; it's an actual disease, right?"
"Why don't we start with the leg," Dr. Belson said. "When do you first remember thinking or feeling that your leg - it's your right leg?"
"That your right leg somehow didn't belong on your body?" Gary slumped a little and spread his knees apart and stared at the ceiling, and he sunk a little into the cushion of the chair.
"Eight, ten years I suppose. Maybe more," Gary said. "Actually no, longer than that. I guess like this: I think it was always there, my whole life, but it was around 2002, when guys started coming back from Afghanistan with their legs blown off and stuff and it was on the news, that it finally made sense what it was, that my right leg just shouldn't be there."
"In many cases of Apotemnophilia," Dr. Belson said, "there's a sexual component to the desire to have a healthy limb amputated. Are there any sexual feelings involved with your desire to have your leg removed?"
"No, not at all," Gary said. "I know exactly why, the exact reason."
"And what is the reason?" Dr. Belson said.
"For a long time I didn't know," Gary said. "But a few years ago I saw this guy, a psychic, but not really, that's not the right thing; he does this hypnosis thing, where he reveals people's past lives, which I had always thought was bullshit, but not anymore. He made he remember it all, almost every detail."
"I'd love to hear it," Dr. Belson said.
"It took four or five sessions with this guy to bring it all together," Gary said. "It would come in bits and pieces, sometimes out of order, some things didn't seem to fit and then they did, so - this was a couple years ago - so I have it all straight now. And this may sound dumb or crazy, but you asked."
"It's not crazy at all," Dr. Belson said.
"Well," Gary said, "it was around four hundred years ago. I was a fisherman, in China. My name was Guan Ji Fu. Most of the men in the village were farmers, but there were a few of us who still fished the river, because our fathers did, and their fathers before them. I was thirty-five when it happened. I'd been making a living fishing for about ten years; my mother had died when I was small, and my father died when I was in my twenties, I'm not sure exactly how old I was - he fought in the battle of Lake Poyang when I was little and he never really got better, and got sick or infected or something - anyway, I'd been on my own for ten years and fishing and doing pretty well."
"Interesting," Dr. Belson said.
"So, I didn't fish with a pole or with nets, and it's important to what happened that I explain a little about how I did my fishing. I used birds, called - well, they're called Cormorants now, so I'll just call them Cormorants - they're water birds with long necks, and I tied a leather strap around the lower part of their necks, and what I would do - my father taught me this, by the way, he'd fished this way all his life - I'd tie this leather around the lower part of their necks and it wouldn't hurt them at all, but when they dove under the water and scooped up a fish that was the right size, they wouldn't be able to swallow it because of the strap constricting their throat, and I'd trained them to bring me the fish and I'd reach right in and pull the fish out, and put it in a basket. And that's how I did it." Gary moved around in the chair and situated himself in various positions, as if the position of his body had to be correct before the next portion of the story could come out. Dr. Belson typed on his laptop: Patient moves a lot in chair, crosses/uncrosses legs, turns torso.
"I'd been doing this on my own for ten years, at least ten years, and everyone in the village knew me and they'd known my father, and they knew my birds. Shen and Kuo were their names."
"Kuo. Shen means 'Spirit,' and Kuo means 'Vast.' So together they were 'Vast Spirit,' see? Anyway, ten years doing this alone, and then one day he shows up. Tao Han. He was my age, we'd known each other for a while when we were little, his father fought in the battle of Lake Poyang too, with my father. So he shows up in the village one day, and he hasn't been there for years, and I see him one day when I'm walking back from the river and I have a basket of fish, and Shen is on one shoulder and Kuo on the other. And we hug and we talk, and he tells me that both his parents are dead too, and he's been living with his aunt for years in a village down the river, but he decided to come back. He didn't have any real skills, he didn't own any land to farm, so I thought to myself well, what should I do? I liked being alone. I liked fishing alone, just me and Shen and Kuo and the river, and I didn't really want to introduce another person into that scenario, you know? But I felt bad, so I asked him if he would like to help me fish, at least for a while, until he decided what he wanted to do. I would teach him to steer the boat, how to use the lantern for fishing at night, everything, and we would share the profits from the sale of the fish exactly even. The one thing I wouldn't teach him, though, was how to command Shen and Kuo. They were my birds and mine alone, and I made sure to tell him that. I did it in a nice way of course, I said the training of the birds took years, and they only trusted me, and it wouldn't make any sense for me to even try and show him anything, but one day if he wanted to invest in his own birds I'd teach him everything I knew. He agreed and everything seemed like it would be fine.
"And for about three months everything was fine. Great, really. Tao Han had a great instinct for the water, where to go, he didn't fight the current but worked with it, he put us in good spots, Shen and Kuo gradually got used to him being there. He built a hut on the river and I taught him the business of selling the fish, we split everything like I said, everything was great. Then one day, in the summer, I-- wait, I forgot something, it's important."
Dr. Belson was listening to everything Gary was saying, but he'd also been typing on his laptop. He'd written insulting variations of names for a hypothetical band fronted by Dr. Furth. So far he had the following:
Commander Kilpatrick and the
Commander Cosmos and the
Captain Thunder and the
General Johnson and the Ramblin'
Betty Bouffant and the
Jimmy Sapphire and his Ramblin'
Even though the name "Dr. Furth" didn't appear in any of the names, he imagined the exotic front men (and one woman) as Furth. He didn't know why a variation of the word 'retarded' appeared in each of the band names, why he'd written them, or why Dr. Furth was suddenly a kind of peripheral magnet for his angst, but reading back through them he felt bad, about the variations of 'retarded' anyway, and he put a line through Retarded, Retard, Retarded, Retards, Retarded, and Retards.
"'Ji Shu,' that was the command that I gave to Shen and Kuo; as soon as they heard that, from only my voice too, that's important, only from my voice, they'd leave the boat and get to hunting fish. But they would never leave the boat until they heard that command from me. So one day in the summer we went out, it was late evening, and Tao Han steered us to a great spot in a little eddy that had formed around an old fallen tree by the riverbank, the fish like old trees like that. Shen and Kuo are catching fish as fast as they can, there were so many, and Tao Han lit the lantern and put it on the end of the pole so we could keep going even as the sun went behind the mountains. So we finished, all the baskets were full, Shen and Kuo sat on the edge of the boat, one on each side of me. I was at the front of the boat, looking out forward because the moon had come up and it was shining on the water and it was really pretty. Tao Han always steered the boat from the back, and all of a sudden I feel this hand come around me and stuff a big wad of something, cotton or something, in my mouth - down my throat, really. And right at that moment, before anything else happened, I knew right then exactly what the fuck was happening."
"What was happening?"
Have you ever been betrayed, Dr. Belson?" Dr. Belson sat silently for longer than he thought he should, and finally stammered out: "Of course."
"I mean betrayed, really betrayed," Gary said. "By someone you trusted, invested time and effort and emotion in. And in one instant you realize it was all just to get what they wanted. Some people can be so patient, you know?"
"I do have an idea what that kind of betrayal is like," Dr. Belson said.
"So all that time I'd spent showing him how to fish, how the boat works, how Shen and Kuo work together, how everything works, he'd been patient and took it all in, and it was all so he could get me out of the way and take the birds and the profits for himself. That's why the first thing he did was stuff that cotton in my mouth. He needed Shen and Kuo and he knew god damn well they wouldn't leave the boat until I commanded them, and he knew that if I thought he was trying to take them I'd yell 'Ji Shu' and they'd take off and he may get me, but he'd never get them. So he pushed this stuff down my throat and kind of got on top of me - I was between him and the birds - and he tried to hold me down and get to them." Gary looked at his lap and shifted in the chair again, he blinked and pulled at his cheeks with long fingers as his chin trembled.
"They were like my kids, you know?" he said, and he sat up straight with his knees together and stuffed his hands under his thighs.
"I didn't have any children, so they were it, and I just couldn't let him take them. I stretched out my right leg across the boat, and in my mind, I imagined that my leg was made of stone. He couldn't move it. I wasn't going to budge. He gets up off me and I couldn't hardly think, I couldn't really breathe 'cause I was choking on this cotton, he'd stuffed it so far down my throat. And the next thing I feel is fire on my leg. Except it wasn't fire, it was steel; Tao Han had come down on my thigh with a sword. He kept hacking at it but I didn't move it. If he wanted my birds he was going to have to chop my leg off to get them, and he kept going and going, then he hit bone and then he just stomped on it and it snapped." Gary was crying now, he pulled his hands from under his legs and wiped his face with them and Dr. Belson grabbed a box of tissues on the table between them and held them out, but Gary waved them away.
"And that was pretty much it," he said, shifting again in his chair and facing Dr. Belson with the side of his body.
"I knew he'd get them; he'd gotten them, it was over, I was gone, I'd lost, but you know, I did what I meant to do, I never moved my leg, I tried to protect them until the very end, and he had to chop my leg off to get to them. The last thing I remember was the blood in the bottom of the boat, Shen and Kuo were gone, and that was it. I was dead." Gary shifted again in his chair.
"You don't believe me, do you?" he said.
"I believe that you've had a very profound, very real emotional experience, I believe that completely. I'm not very well-versed on the whole past-lives thing, but that doesn't matter. First of all I want to thank you for sharing that with me. I could tell that wasn't an easy thing to do." Dr. Belson looked at the clock on the wall behind Gary: 4:58. Enough time to wrap up, set up another appointment and get out the door. If traffic cooperated, he'd be at the middle school soccer field by 5:30.
"What I'd like to do is set up another appointment with you for next week, and we can talk through why - because of what you felt happened to you in this former life - why you feel the desire to have this healthy leg you have now, why you feel that it needs to be removed. All right?"
Gary's face became suddenly still and serious.
"My leg will be gone by next week," he said.
"What do you mean?" Dr. Belson said.
"I have the disease, right? Apotemnophilia? You can either get me in touch with a surgeon who'll amputate my leg because I have a disease, or I'll just have to do it myself."
"I think that would be a terrible thing to try to do to yourself, Gary."
"They did it during the Civil War all the time, no anesthetic," Gary said. "I read all about it. First I'd have to get all my equipment and such - it's amazing what they have at hardware stores - then clean and disinfect everything, my leg and all. Then I'd apply a tourniquet to the upper part of the thigh which would effectively cut off the blood flow to the femoral artery. Bet you didn't think I knew what the femoral artery was, did you?" Dr. Belson leaned back in his chair and thought: I should call St. Anne's, I should have him involuntarily admitted right now; he's clearly disturbed and clearly serious about doing harm to himself.
"Then with my left hand I would pull the skin just below the tourniquet as tight as I could, and with my right I'd cut with the scalpel, and I'd follow all the way around. I'd cut down through the skin and the muscle, circumnavigating the thigh. See, one of the reasons this would work is because the leg is healthy; no pre-existing injury to the leg; no shredding of the flesh from a mini-ball, no piercing wound from a bayonet, no sickness or gangrene, so the risk of fever and infection is greatly reduced. I have books on all this, and some Youtube videos bookmarked. Then I'd use a canvas retractor to pull the skin and muscle upward to expose the bone. I'd make it myself, the retractor. Then a hacksaw. And you can't just go charging down into the bone, you know; you have to start slow and gentle, to establish a groove, then you can really start cutting. The problem is the shaking and the leg moving around, because it can mess up the angle of the cut. Like sawing a two-by-four. Have you ever done that? Then you cut through, and the leg is off. Then there's the tying off of the femoral artery and a few other minor but important arteries and veins - I have an anatomy book I'm reading for that - then disinfect, wrap the stump in gauze, change the dressing regularly and all that." Dr. Belson sat and looked at the clock: 5:07.
"That sounds like a very well informed plan. But it would kill you. You know it would kill you, right?" he said.
"Do you want me to die?" Gary said.
"Of course not, which is why I need you to tell me that this is all hypothetical, all part of this fantasy you have. I need you to tell me that, Gary." Gary shifted, settled, shifted again, settled. He smiled.
"It's all hypothetical, of course. You're right. I'd never try that. I don't even like the sight of blood, really."
"Good," Dr. Belson said. He pulled up his calendar on his laptop.
"I have an open appointment next Wednesday at three o'clock. Will that work for you?"
"Can we make it four? I work until three-thirty," Gary said.
"All right, four o'clock next Wednesday," Dr. Belson said, and he marked the appointment in his calendar and took a business card from a stack on the table. He took a pen from his pocket and flipped the card over to write the appointment information for Gary, but as he wrote, no ink came out. He kept writing anyway, and at the end there existed only the inkless lines from the tip of the pen as it pressed the words into the card, and they looked to him suddenly like the faint waterless gullies of a far world, viewed from a cold, unreal height: Gary ____, Wed 8/29, 4pm. He handed it to Gary.
"Sorry, my pen," Dr. Belson said. "Can you read that?"
"I'll remember," Gary said.
They both stood up and shook hands.
"See you next Wednesday," Dr. Belson said, and he watched Gary exit the main glass door to his office and walk to the elevator at the end of the hall and get in and disappear. He closed the door to his appointment room and looked at the clock again: 5:16. He'd never make it. Maybe he'd get there before the start of the second half, but maybe not. Even if he did, his daughter would be angry with him and his wife would be furious.
He locked up and turned the lights off and went down the back stairwell. A part of him wanted Gary to cut his own leg off, or at least to try. He imagined Gary's face wincing in a kind of pained ecstasy as he first pulled the scalpel across his skin. The ecstasy of getting what he wanted. And if it went disastrously wrong, what then? 'I'm as shocked as anyone, officer. He didn't mention anything to me about this plan to cut his leg off, and I can assure you that if he had, I would have had him involuntarily committed to the psychiatric wing of St. Anne's, absolutely. I wish he had said something; I could have gotten him the help he needed, and he might still be with us.'
Unlike the hypochondriacs, whose unyielding health paranoia had infected him, he felt no sudden need to chop off one of his own arms or legs. The whole thing did, however, bring to his mind a story from one of his college textbooks on the history of the treatment of mental illness in Europe. There was a doctor in Germany or Austria, he couldn't remember, in the 1880's, who ran an asylum there; the doctor's young son had died from tuberculosis, and he personally carved out the boy's heart and kept it in a jar of formaldehyde in his office. He held meetings with other doctors with the heart placed between them on his desk; he carried it with him as he made his rounds, he talked to the patients and held the jar to his chest with both hands.
Dr. Belson got in his car and made his way across town. He hoped he would at least make it for the second half. He hadn't seen his daughter play a full game in almost a month. She was very good, and there were already aspirations of college scholarships even though she was only in the eighth grade. He would sit next to his wife and cheer loudly and he wondered if that might help to make up for his lateness, and he wondered too why the world could be such a beautiful villain.