Saturday, March 29, 2008

"Positively Bud": Installment #2

Unless properly dissuaded, I intend to continue posting an excerpt from my story until it's finished.

"Positively Bud": Installment #2

The next morning Bud woke early, as usual, before dawn, to face a day like all the other days, when the terror of the bedroom finally drove him to the terror of the living room. After an eternity Martha's alarm went off. She reached over to hit it and Bud relaxed his desperate grip around her breasts.

"Good morning, honey," she said, yawning.

"Good morning, honey." It was easier for him to mimic speech than originate it.

Martha got up and began her morning pre-work ritual. Bud heard, in order, the coffeemaker, the shower, and the hair dryer while he lay on his back with the sheet up to his neck and stared at the acoustic ceiling, gray cottage cheese. He couldn't understand why these horrible feelings seemed to come from outside himself when in fact he generated them. Changing locations seemed as scary as staying still. Knowing his fear to be irrational did not change it in any material way: the bankruptcy of reason.

Martha came back to say good-bye and plant a perfunctory kiss on his forehead. "I'll call about that trial today," she promised.

"OK," Bud said and pulled the sheet tighter.


A young man hornrims sat behind a gunmetal gray desk and toyed with a pencil. His thin strawberry hair nearly matched the color of his scalp as he hunched over the extensive background history Martha had filled out. From time to time he would say "hmmm" and lower his glasses and look up for a moment, when his quizzical brown eyes wandered over Martha and Bud as if they were laboratory specimens. Sometimes his freckled nose wrinkled like a rabbit's, as if he could smell something about them even without the forms. After an interminable silence he set his glasses down and folded his hands.

"Mr. Rose, it seems you have tried all the conventional anti-depressant therapies, am I correct?"

Bud shifted in his seat, looked to Martha for support. "I guess so."

"More specifically, Mr. Rose, you have tried MAO inhibitors, tricyclics, SSRIs, and ECT without remission?"

Bud looked puzzled. "Yes he has," broke in Martha. "And he's also had psychotherapy, both individual and group."

"And what did that therapy consist of?"

Martha looked to Bud and gave him a nudge. "Talking," he said, "though I didn't much feel like talking."

"What did you talk about?"

"I don't really remember. One lady asked a lot about my childhood. Another guy kept telling me I had to change my thinking."

"I see." He leaned back in his chair and put his hands behind his head. "We have an experimental program for patients like yourself, Mr. Rose, but we cannot guarantee the outcome of the treatment. It would require at least a month away from home in a special institution. All costs would of course be borne by us. The program is designed for resistant depressives like yourself. Would you be willing to participate?"

Bud looked at Martha, who nodded, then turned to the interviewer and said, "Why not?"

"Good, good," the man said. "You seem a perfect fit for our protocol. You should know going in however that because the treatment is highly specialized no visits or outside contact will be allowed for at least a month, and we have the right to keep you under treatment for two months if necessary. Furthermore, not all of the treatment may be pleasant, as it is directed at changing your world and self-view quite dramatically. We aggressively attempt to reverse your negative thought processes by whatever means possible, and this challenge has produced psychosis in a few patients. Should that happen we will of course stop the treatment and release you on the proper medications. But all of our cautions are spelled out in the human research protocol here. Take a moment and read it over."

Martha took the brochure and began studying it, point by point. "The Institute for Positive Living is based upon a cognitive-behavioral approach to depression which utilizes both punishments and rewards to achieve optimal outcomes. The behavioral program for each participant is customized to fit their symptoms, age, and history. Although progress is slow the first several weeks, usually by the fourth week dramatic improvement can be expected. Seventy percent of the patients are discharged at that time."

Martha looked at Bud. He had only glanced at the brochure's cover and now held it loosely between his thumb and forefinger in pathological nonchalance.

"Bud, you need to know this doesn't sound like summer camp," she said. "It sounds intense and demanding and I can't be here to support you."


"So say something! Do you want to do this?"

Bud stared at her vacantly. "Why not?"

"Very good," the interviewer said. "We have an opening in two days. If you'll be so good as to sign these papers we can get you scheduled."

Bud signed the forms with painstaking slowness, then handed them back. The man took the papers and put them in a manila folder which he locked in a file drawer. He gave Bud a bunch of yellow triplicate sheets. Martha stuffed them in her purse.
"Very good, then. Here is a map to the institute. Please be there at 8AM sharp on Thursday morning. Do you have any questions?"

"Can he receive letters or packages?"

"I'm sorry, that's strictly forbidden. No outside influences are allowed. We cannot interfere with the study design, you see. Very unscientific. But you will be promptly notified before discharge, which will generally be between four to six weeks. Any other questions?"

Bud wagged his head in the negative. Martha put her finger under her chin and looked ceilingward but said nothing.

"Very well, then. We'll see you in two days. Pack what clothes you think you'll need as well as personal items like a toothbrush, soap, shampoo, etc. And, if I may so bold as to prognosticate, I think you will find the results positively amazing."

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