The Psychiatrist’s Assistant: A Brief Anecdotal Study in Hierarchies

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I sat on the psychiatrist’s couch only once, during the interview. Across sat a woman about my age -- a few months shy of thirty -- who was similarly petite, brunette, and bespectacled. Her demeanor was calm and expression neutral, though I have my guesses now as to the nature of her thoughts. The doctor herself was maybe 60, tall and fit and blonde. Though the job’s stated duties were in support of her home practice and instruction at the nearby medical university, she seemed particularly interested in the fact that I was a fiction writer, with an MFA and a few stories published. The fellowship that brought to me to her expensive city was not enough to live on, even augmented by a second grant, and I’d applied to this part-time position despite my lack of experience in taking appointments and transcription. As it happened, the doctor had her own creative pursuits on the side: a short story collection that was “being published” and a novel-in-progress. Part of my job, in addition to answering emails and performing research online -- she did not use computers -- would be to type her pages up and print them for her edits. In my understanding, the expectations did not extend to ghostwriting, so when the assistant -- my doppelgänger -- called with the offer to take her place, I agreed. I put quotations now around the phrase “being published” because, as I was to learn, she was paying to have printed by what was known, in literary circles and beyond, as a vanity press. I set this phrase apart now in quotations in order to capture one more way in which she asked to be understood, how difficult it proved to hold the line between transcription and translation. After that first encounter, I saw the psychiatrist when she came to sit on “my” couch, the one behind my desk where patients waited for their sessions. I listened rapt to her expert theories on the abuse of children by priests, less rapt to her creative struggle to dramatize them on the page. I saw her in the passenger seat of her own Prius as I ferried her down to the campus from her house on a hill, my heart hammering as it did when I drove even my used Focus through the traffic and fog of the city’s steep streets. Just as I feared the slightest scratch to her paint job, I seldom set foot in the pristine, expansive home beyond her office. Divorced, she had bought the house herself and lived alone but for a college-age child who visited. I tiptoed to the kitchen to leave the check I’d written for the house cleaners. Her second bathroom was upstairs, and there I spied the chaise upon which she must have written her morning pages as I slept and made my commute. When I received a parking ticket on her street, my breath caught: the cost would render a day’s wages a wash. Puzzled, she suggested I just explain I worked for her. Failing that, she would pay. One day -- she on the couch, I at my desk -- she learned that I was single and offered that men of my generation had many problems. She asked what I was doing to meet romantic prospects. She herself had tried everything from speaking to strangers at readings to placing personal ads, and now had a fiancé. It seemed they’d been engaged for some time with no date set, but about this fact she -- to use a medical term I’d picked up -- presented unconcern, in no rush to forsake her independence. I minded being single, and my throat closed as she probed. At the sliding-scale therapy I’d begun attending on the side, this was a topic much discussed with a therapist who was about my age, ring on her finger. [millions_email] During my orientation, I’d learned from my predecessor -- now a therapist herself -- how hard the doctor had fought to get where she was: a tenured position with the promise of working from home; the luxury of siphoning me off a share of her institutional funds. It was a fight, not hyperbolic, through a patriarchal wall that included bringing and winning a discrimination suit. She was a feminist of the second wave to my third, of the mind that all women’s work should be paid, and that you shouldn’t have to do yourself what you could pay someone else to do. A second assistant, who spoke English as a second language, saved me such tasks as attending to the laundry. In the hierarchy of women in the doctor’s employ, as a fellow intellectual I was near the top; as a friend, toward the bottom. It was just money that kept my ears open; money that kept me from my own desk. To her, I must have seemed to hold some key. Her trust in me was unfathomable, nearly hubristic. Part of my job, I saw, perhaps the most important part, was legitimizing her as a writer -- but just as well, she was legitimizing me as one that was “real.” I spent a few shifts on the couch behind my desk with the doctor’s first book of short stories and was surprised to find, given what I’d seen of her new one, that it wasn’t bad (even now, having shelved three years’ work on a novel, it’s difficult to comprehend how the same woman could be capable of such a polished work and such a -- as Anne Lamott would say -- shitty draft). The stories told a compelling family history; they were linked, which agents and editors visiting my graduate program told us had a better chance of selling. I’d set aside my own first collection, which had been shopped by my agent but failed to garner much interest, in favor of making headway on a novel: two-book deals being another market solution of the industry. But I remained unsurprised that the doctor’s book had landed where it had -- the “vanity” press. I was doubtful she had known the complex map of steps that began with agent queries, but her investment -- financial and emotional -- was such that I couldn’t bear to inquire. I wondered often whether I was falling down on the job. If I were not expected to tweak her sentences myself -- a temptation I’d had to resist -- couldn’t I have offered feedback of the type I’d given colleagues, and colleagues had given me, in and out of the classroom? The truth was, she had never asked for such help, and I had thought her endeavors a lost cause. The literary landscape since then has changed so much that I, who at the time wouldn’t have easily considered it, have happily published with a small press. I’ve forsaken the established route of starting at the “top” and knocking on the doors of gatekeepers. When I gave notice to the doctor -- fully aware I couldn’t without the excuse that I was moving -- she treated our separation with coldness. For a fee, and from the distance of my new, cheaper city, I reviewed the final proofs of her first book and received a finished copy. But we haven’t stayed in touch -- her emails wouldn’t even be written by her -- and for writing this, I must confess to whoever will listen that I feel both shame and relief. Image Credit: Wikimedia Commons.