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WHEN I WAS AN INTERN AT A Veterans Administration Hospital twenty-four years ago, my first psychotherapy patient was a chronic schizophrenic male who I saw three times weekly for a year. He was my contemporary, from an upper middle class assimilated Jewish family, a graduate of an Ivy League School, who had become psychotically ill while in basic training. He had been residing at this hospital for several years. An attractive, crew-cut man, muscularly built, with piercing blue eyes that were at the same time glazed and blank, he wore cigarettes in his ears.
During the next months, he became engaged as did I, the cigarettes came out of his ears, his eyes became alive and his communications though indirect became more comprehensible. One particularly gray day, pretending to read the "Times" and not looking at me, he was smiling broadly and commented "The sky seems very blue today." He had been coming regularly to sessions and it was obvious that he was very happy. At another meeting, he told me that he was thinking of getting a puppy. I understood that he wanted to care for the child part of him that he had neglected and that had been abandoned by his cold, distant mother and unavailable achievement-oriented father. He began to go out on passes and to speak more directly about his adolescent and college years where he had felt so alone and alienated. There was a mutual excitement and appreciation of the connection we had made.
I periodically tried to remind us both that I would be leaving in a year. Still, I was not fully prepared for his reaction when I finally said I would be leaving at the end of the month. He said nothing, but his eyes went blank and he simply left the room. I went to his ward: The cigarettes were back in his ears and he looked through me as though I weren't there. I returned a few more times but he acted as though I did not exist. I dreamed that I was following him down corridors never being able to catch up with him. I had fantasie