But with Hector it was almost never like that. He looked at people as they told their story, he nodded in encouragement, made his little ‘mmm-hmm’ noises, twirled his moustache and sometimes he’d even say, ‘Wait, explain that again. I didn’t quite understand.’ Except on days when he was very tired, people really felt that Hector was listening to what they had to say and finding it interesting.
So people came back to see him, they made lots of appointments, gave his name to their friends, and mentioned him to their doctors, who sent other patients to him. And soon Hector spent long days listening to people and had a lot of tax to pay, even though he didn’t charge much for a consultation. (His mother was always telling him he should charge more, but he didn’t feel he should.)
He charged less for his consultations, for example, than Madame Irina, who was quite a well-known psychic. She would say to him, ‘Doctor, you should put up your fees.’
‘So I’ve been told,’ Hector would reply.
‘I’m saying it for your own good, Doctor, I can see what’s best for you.’
‘I’m sure you can. And how are you seeing these days?’
It should be explained that Madame Irina had come to consult Hector because she could no longer see into the future. Her heart had been broken when a man had left her, and ever since then she couldn’t see properly any more. As she was clever, she was able to find interesting things to tell her clients. But as she was not completely dishonest either, it troubled her not being able to see as before. And so Hector had given her pills for people who feel very sad, and gradually she was regaining her ability to see.
Hector didn’t know what to make of it.
He wasn’t just successful because he knew how to listen to people. He also knew all the tricks of his trade.
First of all, he knew how to answer a question with another question. For example, when people asked him, ‘Do you think I’m going to get better, Doctor?’ he would reply: ‘What does “getting better” mean to you?’ In this way Hector helped people to think about their own case and find their own ways of getting better.
He also knew all about medication. In psychiatry that’s quite simple since there are only four main types of medication that can be prescribed: pills to take when you’re sad – anti-depressants; pills to take when you’re scared – tranquillisers; pills to take when you have very strange thoughts and hear voices – anti-psychotics; and then pills to avoid highs that are too high or lows that are too low – mood stabilisers. Actually, it’s a bit more complicated than that because for each type of medication there are at least ten different brands of pill, all with funny-sounding names that have been made up specially, and the psychiatrist’s job is to find the most suitable one for his patient. Pills are a bit like sweets: not everybody likes the same ones.
And when medication wasn’t enough, or when people had no need for it, Hector had another way of helping them: psychotherapy. A complicated name for simply helping people by listening and talking to them. Not just talking to them any old how, but following a special method. As with pills, there are different types of psychotherapy, some of them invented by people who have been dead a long time. Hector had learnt a method of psychotherapy invented by people who were still alive, if rather old. According to this method, the psychiatrist talked to the patients as well as listening to them and this went down well, especially with those who had encountered psychiatrists who barely spoke to them, which they simply couldn’t get used to.
In Madame Irina’s case, Hector hadn’t used much psychotherapy because whenever he was about to ask her a question she would say, ‘I know what you’re going to ask me, Doctor.’
The worst of it was that she was often (but not always) right.
And so, using the tricks of his trade – medication, psychotherapy and his gift of being genuinely interested in people – Hector was quite a good psychiatrist. That’s to say, he was as successful as any good doctor, a cardiologist for example. He managed to cure some of his patients completely. Others he kept in good health provided they took their medication every day and came to talk to him from time to time. And finally there were some patients whom he merely managed to help live with their condition by making it as bearable as possible.
*
And yet Hector felt dissatisfied.
He felt dissatisfied because he could see perfectly well that he couldn’t make people happy.
HECTOR'S practice was in a city full of wide avenues lined with attractive old buildings. This city differed from most of the world’s big cities: the inhabitants had plenty to eat; if they were ill they could receive free medical treatment; children went to school, and most people had a job. They could also go to lots of different showings at the cinema that weren’t too expensive; there were museums, swimming pools and even special places to ride bicycles without being run over. People could also watch lots of different TV channels, read all sorts of newspapers, and journalists were free to write almost whatever they wanted. People had plenty of time off, even though this could be a problem for those who didn’t have enough money to go away on holiday.
Because, although everything worked better than in most of the world’s big cities, there were still some people who had only just enough money to live on, and some children who couldn’t stand school and behaved very badly, or didn’t even have parents to look after them any more. There were also grown-ups who were out of work and who were so unhappy that they tried to make themselves feel better by drinking anything and everything or by taking very bad pills. But those people didn’t live in the type of neighbourhood where Hector worked. Hector knew they existed because he had treated a lot of them when he worked at the hospital. And since then, he’d continued going to the hospital every Wednesday instead of going to his practice. And that’s where he saw people like Roger, for example, whom he asked, ‘Have you been taking your medication, Roger?’
‘Yes, yes, the Lord is my shepherd, He leadeth me.’
‘I’m sure he does, but have you been taking your medication?’
‘Yes, yes, the Lord is my shepherd, He leadeth me.’
You see, Roger believed that the Good Lord talked to him constantly, what they call hearing voices, and he would reply out loud. What’s wrong with that? you may ask. The problem was that when Roger didn’t take his medication, he would talk to himself in the street – sometimes in a very loud voice if he’d had a drink – and unkind people would laugh at him. As he was quite a big fellow this occasionally ended in trouble, and Roger would find himself back in the psychiatric hospital for a long time.
Roger had a lot of other problems: he’d never had a mother and father to look after him, he hadn’t done well at school, and since he’d begun talking to the Good Lord nobody wanted to employ him. And so Hector, together with a lady from social services, had filled in loads of forms so that Roger could stay in his tiny studio flat in a neighbourhood you wouldn’t necessarily have wanted to live in.
At Hector’s practice it was very different from the hospital: the people who came to see him there had done quite well at school, had been brought up by a mother and a father, and had a job. Or if they lost their job they quite easily found another. They generally dressed nicely and knew how to tell their story without making grammatical errors and the women were often quite pretty (which was sometimes a problem for Hector).
Some of them had real disorders or had suffered real misfortune, and in this case Hector generally succeeded in treating them using psychotherapy and medication. But a lot of them had no real disorders – or at least none that Hector had learnt to treat when he was a student – and hadn’t suffered any real misfortune either – like having unkind parents or losing somebody really close to them. And yet, these people weren’t happy.
Take Adeline, for example, quite