This story was originally typed in Word. As a result, the formatting might be a little broken here on my blog.

Sublime Plaza on 35th & Park was a curious office building. Everything about it was just a little bit off. Between the overhang that was a little too long on one side and the (somewhat tacky) mural of a bewildered Jean Piaget, Sublime Plaza didn’t look like a classic medical practice in any way. Despite being filled with doctors and psychiatrists, Sublime Plaza was almost dingy. The exterior was clean, but not perfectly so. Some weeds, here and there, would always be growing between the cracks of the sidewalk, waiting to be cut yet again. The most accurate definition of Sublime Plaza, according to the surrounding residents, would be “a curious building where curious professionals do their curious work.”

Dr. Conrad Vale, Psy.D. certainly fits this description. A man of short stature and great vanity, his slightly-graying hair was always freshly cut and well-kept. His closet consisted of numerous brown and black three-piece suits and nothing else. No navy blazers, no trench coats, no funny ties: Conrad had a reputation for wearing the exact same red checkered tie for everyday and every occasion. A golden Rolex GMT-Master adorns his right wrist, with numerous silver rings lining his fingers.

Just like his appearance, Dr. Vale’s office was meticulously clean and organized. Color-coded, systematized files line his under-desk filing cabinet drawers. On his desk, a Montblanc fountain pen (which Dr. Vale proudly claims was a gift from the Prime Minister of Germany) rests on top of the outstretched hands of a small, kneeling wooden figurine of Sigmund Freud; Conrad’s notebook is placed squarely in the middle of his desk, with equal margins on both sides from each end of the desk to the other. Behind his desk hung his many degrees: A Psy.D. from Columbia University, an M.D. from Cornell Weill Medicine, and a B.A. (with Distinction, of course) from New York University.¹ On the adjacent mahogany bookshelf sat multiple compilations of Annals of American Psychotherapy, a few copies of the Diagnostic and Statistical Manual of Mental Disorders, and rather curiously, a skull. In the center of the room was a modern-looking gray psychiatrist’s couch, with an equally modern chair positioned a few feet away at a 45° angle, facing the patient’s couch. Dr. Vale’s patients were of an equally peculiar character. Today, he was slated to see just three: Ruth, Joseph, and Jacob. Ruth was the first today, though.

Ruth could have been described most accurately as a woman who reminded Dr. Vale of his own mother: materialistic, ridden with debt², and attending her therapy sessions with a new designer handbag every single week. In Vale’s calculus, Ruth is the textbook example of a person exhibiting narcissistic personality disorder. He grew up with his mother’s incessant commentary on her own beauty and importance, and it’s safe to say Conrad has seen dozens of patients like Ruth in his office before. Strutting into the office, adorned with gold bangles, rings, and the newest fashion, refusing to accept her (to everyone else, very clear) problems, paying for the therapy on a near-maxed out credit card, and leaving once again. That’s just about how every meeting with Ruth would go, leaving Conrad to wonder why he just can’t help her the way he seems to have been able to help his other clients.

Near the end of their conversation today, Dr. Vale was prying at Ruth on her inability to see how she treats others (and her own bank account):

“Do we really have to talk about this again, Doctor? Every time I come here you give me your dissertation about how I need to consider ‘looking inward’ and ‘self-critique.’ What if I just love myself, hm? What if I love the way that I am?”

Dr. Vale sighed. This was now the 4th week in a row that she had tried to avoid his line of questioning. “Ruth, sometimes, you have to see the bigger picture. It isn’t just about you. Let’s work on trying to understand how best to keep your relationships together. Have you given anyone a gift these past few weeks? Like I told you?”

“Now, why would I listen to you?”

“You might find that it helps. Giving to others will make you feel good, too, you know.”

“I’m already running out of money! How could I afford that?”

“Are you kidding? Your Hermès purse over there seems to say otherwise.” Dr. Vale says snarkily before returning to a doctorly tone, “My apologies. That was unprofessional.”

“What did you just say to me?” Ruth exclaims, gathering her belongings in the aforementioned Birkin bag. “F*** off, Dr. Vale.”

Their time wasn’t even up yet, and Ruth had already stormed out of his office. 15 years ago, to the day, Dr. Vale had told his mother the same exact thing, in the same exact curt tone that he used today on Ruth. Up to her neck with debt and still failing to control herself, Vale’s mother was almost evicted for failure to pay her rent. For most of his life, Dr. Vale never received a single birthday or Christmas present. “How could I afford that?” was something he had heard one too many times before.

Immediately overheard by Dr. Vale’s secretary after Ruth’s session was a fit of rage followed by a constant repetition of “I can’t fix her” that persisted for about 15 minutes, right until the next client came in. The Doctor wasn’t just in a bad mood– he was neurotically pacing about his office. He’d convinced himself that his insult to Ruth today was a violation of the Hippocratic Oath he took many years ago of “Do no harm.” Noticeably, he had taken off his twenty-four carat gilded Rolex and placed it in his desk drawer. Considering Ruth’s obsession with beauty and what he’d said a few minutes ago, Dr. Vale was disgusted with himself. “I’m just like my mother,” he thought, right before he heard the inevitable voice of his secretary buzzing in the next client.

“Dr. Vale will see you now, Joseph,” is something that he’s usually excited to hear his secretary say. Joe was a man of proudly Italian descent and a lover of the finer things in life, as long as it was made with .999 fine silver. An almost oversized, ostensibly pure silver Cuban chain-link necklace draped itself powerfully across Joe’s torso, with assorted rings, bracelets, and a silver Vacheron-Constantin watch lining his appendages. Time, and by extension horology, was something of vast importance to him. Approaching forty-five, Joe felt as if time was the only thing he didn’t have enough of. In fact, his own calendar wasn’t even dictated by himself ever since his promotion at Goldman-Morgan-Russo.³ He had earned himself a secretary, and with that, he had given up the last way he had control in life: his own schedule.

Offhandedly, during today’s therapy session, Dr. Vale noticed a certain air of discomfort emanating from Joe. His breath smelled like alcohol, although Conrad had never heard Joe talk about any issues with drinking. About halfway through their session, when Vale asked him about his new silver Aston-Martin sports car, Joseph paused for a moment. Despite being orientated towards Dr. Vale, Joe’s eyes were fixated on a point that appeared to be hundreds of feet behind him, perhaps a building or a car on the street. He paused for a while, for almost a minute of abject silence.

“Sometimes I wish I had the courage to just wrap that mother$%&*ing car around a tree,” Joseph blurts out, “It’s like a high-speed silver casket to me. I don’t even know why I bought it.”

Dr. Vale didn’t really know what to say. With all the precise procedures and standards of care he’d learned at Cornell, he had never really learned how to be empathetic. They don’t teach that in medical school, and if they did, Vale wouldn’t have paid attention anyways.

“Well, I’m sorry you feel that way,” Dr. Vale replies, after an awkward extended silence. “We could try an antidepressant if you’d like?”

“I’m fine. It’s nothing. I don’t know why I said that.”

And with that, Joe’s time was up for the day. Dr. Vale fidgeted with his special checkered tie, wiped a bead of sweat off of his forehead with his handkerchief, and prepared to apologize to Joe for not being able to talk to him further about what he’d just said. “I sound like I’m soulless,” Vale thought to himself. Even at the expense of a client, his schedule was dictated for him, too.

You wouldn’t have seen it on his face, but Conrad hated how much he related to Joseph. After the meeting, he took off all of his rings and threw them in the desk drawer, right next to his golden Rolex. Conrad didn’t even realize that his tie is half undone, like he normally would have. Holding his head on his desk feeling something that felt almost like shame, Conrad heard his secretary speaking to his third client: “Jacob, Dr. Vale isn’t ready for you yet. No, you can’t come in early. The Doctor needs a moment to prepare.” After a few minutes of trying to get it together (and failing), Conrad told his secretary to let him in.

Jacob was a scruffy young man. He was homeless for the time being, ever since he was released from a psychiatric facility last June. Jacob suffered from a somewhat mild form of schizophrenia, manifesting itself every so often in short outbursts of visual and aural hallucinations; because of this, he was unable to hold down a job. Jacob, however, seemed to be medication-resistant: Dr. Vale had tried every pill and tablet he could possibly prescribe. Risperidone, quetiapine, haloperidol, benzotropine – you name it! Because of his unusual resistance to treatment, the subject of their discussion was a nonmedical way to combat Jacob’s schizophrenia. To Vale, Jacob was just another one of those strange and mildly irritating patients that he had to take to keep up his relationship with the New York State Medicaid program.

As he always does, Dr. Vale started reviewing Jacob’s chart as he limped into his office. Peculiarly, while reading the results of his most recent urine test, Dr. Vale noticed that none of the biological markers for any of his attempted medications showed up on Jacob’s report. Blank. Zero. No detectable quantity. Dr. Vale pointedly asked, “Jacob, have you been taking anything I’ve been giving to you? I’m trying to help you, you know.”

“I haven’t been taking it, Doc.” Jacob said as he shifted in his chair, darting his eyes across the room. “That shit turns me into a caged animal! A caged bird, man! That’s not me! A bird! Why would I even get some shitty job when I’d just be like you all day! Stuck in here! Stuck in this stupid beige box! Stuck!”

Conrad’s red checkered tie shifted a little further down on his neck. He still didn’t realize that it had come so undone over the course of the day; usually, Conrad wouldn’t even tie it so sloppily to begin with.

“Jacob, I understand that you might feel that way. But you can’t function in New York like this! Don’t you want to get off the streets? Don’t you fear dying under an overpass somewhere because you don’t have a place to stay?”

“No, Doctor, I feel free.”

“What?” Conrad says, as he bites off a hangnail,

“Free?”

“Yes, free.”

“Well, then why are you here?”

“Because it keeps me out of that damned institution. I’m happy with how I am. I don’t care if it’s not ‘normal.’”

Silence loudly fell upon the room like an explosion. Conrad really couldn’t process this revelation. His methods were sacred–he was the top psychotherapist in the entire city. But his most treatment-resistant client was also his happiest. “What am I even doing here?” Conrad thought to himself. Had the incredible Conrad Vale finally found the one patient he couldn’t help?⁴ Do the degrees and awards behind his desk even matter when he can’t fix such a sick patient? As these thoughts raced through his head, Conrad was silently picturing his former medical faculty at Columbia–New York Presbyterian Hospital laughing down at him. Conrad’s eyes darted from Jacob to his copy of the Diagnostic and Statistical Manual of Mental Disorders and back. Disorder. Dis-order. A lack of order.

With that, Jacob was out of time for his session that day. In many ways, Conrad felt like he was personally out of time, too. After Jacob quietly walked out, and Conrad’s secretary clocked out for the day, Conrad was left alone in his office. His once-revered red checkered tie was now fully loose, gliding off his neck with every movement he made. He muttered to himself, over and over, “a silent, peaceful death.”

Conrad, or “Dr. Conrad Vale, Psy.D., M.D.” as he (usually) signed his letters, uncapped his prized Montblanc fountain pen and began to write a note:

To the staff of Vale Medical, I can’t do it anymore. What is life if not to be lived? What does it mean to be free? I fear Death’s mistress because I have too much available to me here in my practice. I don’t want to fear Death any longer ~ and when She takes me, I want it to be quiet. A silent, peaceful death. I don’t know the answers to these questions yet. But I have to find out, and that can’t happen in New York. It can’t happen in Seattle, Boston, Toronto or San Francisco ~ any of these soul-sucking cities, for that matter. I’m done with this slow walk towards a loud and shocking heart attack that I’ve been on for the past 20 years of being a physician. You’ll all receive your severance checks in the mail in a few weeks. Conrad

With that, Conrad silently capped his pen, placed it back in the loving arms of wooden Sigmund Freud, and carefully set the note on his secretary’s desk. Alongside the note, he left his iconic red checkered tie. For the last time, Conrad locked the door and stepped out onto 35th Street.

An old, somewhat Gothic-looking lead birdcage was just barely visible from the open window of an apartment across from Sublime Plaza. There was no bird inside; the door was left ajar. A few pigeons (‘sky rats,’ as Conrad called them) pecked at a crouton on the street next to him. Sat upon the iconic green globe of the 35th & Park Subway Station was a small white dove, staring intently at Conrad as he raised his head towards the station for the final time. Underneath the dove was a poster of a poem that Conrad had seen thousands of times on his commute to work, a poem of Anne Brontë’s:

The rest had been torn off earlier that morning. As Conrad reminisced on what was no longer Vale Medical as of thirty seconds ago, Sublime Plaza’s towering presence suddenly didn’t feel so overwhelming. Singing the rest of the now-disheveled poem from memory, he stood in the shadow of the skyscraper behind him: “In vain–in vain! Thou canst not rise,” Conrad exclaimed, as he again looked for the little white dove. But it had already flown away. As he began to step down into the subway station to catch the next (6) train, Conrad noticed a small piece of paper falling from the top of the entrance. It was the remainder of the Brontë poem previously posted on the subway globe:

Conrad picked the little piece of paper up and stood dazed in the entrance to the subway. After some deep breaths, he slowly turned around to look at the building he had called his second home for the better part of the last twenty years. “Oh, thou wert made to wander free,” Conrad thought, realizing that he’ll never return to this curious building on 35th & Park ever again. Standing in the entrance of the 35th Street Station, with his briefcase in one hand and the torn-off page of The Captive Dove in the other, Conrad was free at last.