Living a small life gave me leave to notice small things-like certain off-color spots in the St. Augustine grass which I correctly diagnosed as an early sign of chinch-bug infestation. Instead of saving the world, I saved the eighteen holes at Fort Pelham and felt surprisingly good about it.

Small disconnected facts, if you take note of them, have a way of becoming connected.

The great American philosopher, Charles Sanders Peirce, said that the most amazing thing about the universe is that apparently disconnected events are in fact not, that one can connect them. Amazing!

Here are a few disconnected facts, as untidy as these pesky English sparrows buzzing around the martin house.

Ellen.

Is she sick?

There is this: Change in personality: from a thrifty albeit lusty, abstemious albeit merry, Presbyterian girl to a hard-drinking, free-style duplicate-bridge fanatic.

Her sexual behavior.

Her gift for bridge: Van Dorn says that after three rounds of play she can calculate the probabilities of distribution of cards in individual hands as accurately as a computer.

Her relationship with Van Dorn.

The Azazel convention.

Bob Comeaux and John Van Dorn. Lucy says they are "up to something." The only evidence so far: Both are overly friendly toward me. Both want something. What? Bob wants me to work with him at Fedville. Why? Van Dorn wanted me to go to Fresno with Ellen. Why?

Three new patients (short case histories follow) who couldn't be more different, yet there is a certain eerie similarity, certain signs and symptoms in common, such as Change of personality. From the familiar anxieties, terrors, panics, phobias I used to treat to a curious flatness of tone. Their old symptoms are in a sense "cured," but are they better? Worse?

Change in sexuality: Sexual feelings more openly, yet more casually, expressed. Less monogamous? More promiscuous? Or simply more honest, part and parcel of the sexual revolution? Plus certain clues to changes in sexual behavior in women: less missionary positioning, front to front, and more front to rear, six to nine, Donna backing into me. Also a hint of estrus-like behavior in Mickey LaFaye, who speaks of her "times," not meaning her menses. Check menses in future histories.

Language behavior: Change from ordinary talk in more or less complete sentences-"I feel awful today," "I am plain and simply terrified," "The truth is, Doc, I can't stand that woman"-to two-or three-word fragments-"Feel good," "Come by me," "Over here," "Donna like Doc"-reminiscent of the early fragmentary telepathic sentences of a three-year-old, or perhaps the two-word chimp utterances described by primatologists-"Tickle Washoe," "More bananas."

Context loss: They respond to any learned stimulus like any other creature but not like an encultured creature, that is, any human in any culture. Example: Ask them out of the blue, Where is Schenectady? and if they know, they'll tell you-without asking you why you want to know.

Idiot-savant response: They're not idiots but they're savants in the narrow sense of being able to recall any information they have ever received-unlike you and me, whose memory is subject to all manner of lapses, repressions, errors, but, rather, like a computer ordered to scan its memory banks. An ocular sign: eyes rolling up behind closed lids as if they were "seeing" a map when asked, Where is St. Louis?

Is this a syndrome? If so, what is its etiology? Exogenous? Bacterial? Viral? Chemical?

In a word, what's going on here?

Can't say. My series of patients is far too short. Three patients. I need fifty. I need blood chemistry, seven different kinds of brain scans, especially CORTscans.

Here comes a patient. Enrique Busch. I spy him a block away and hurry to get inside. Wouldn't do for a shrink to be caught sitting on the porch zinging paper P-51s at a martin hotel. Ellen taught me that when she was my receptionist-nurse. Act like a respectable physician. Wish I had her back.

Inside, just time enough to call Lucy Lipscomb. Nothing doing. I leave a message at the hospital that I'll see her around noon after I see more patients.

Here is Enrique.

CASE HISTORY # 1.

Enrique Busch is an old, chronically enraged ex-Salvadoran. Although he was not a member of one of the fourteen families who owned that unfortunate little country, he married into one and had the good fortune to get out with most of his money and his family and remove to Feliciana, where he bought up thousands of acres of cutover pineland, which he converted to Kentucky bluegrass country with horse farms, handsome barns, hunter-jumper courses, and even a polo field.

His presenting complaint two years ago: insomnia. His real complaint: rage. Every night he lay stiff with rage. He spent the day abusing people. I have never seen such an angry man. There is nothing like an angry Hispanic. It was killing him, this rage, with hypertension, sleeplessness, pills, and booze. He hated Communists, Salvadoran liberals, Salvadoran moderates, Salvadoran Indians, nuns, priests, fundamentalists, Cubans, Mexicans (!), blacks. He hated Americans, even though he had gone to Texas A&M, chosen this country, and done well here. Why did he hate the U.S.? Because we were suckers, weren't tough enough, were appeasing Communists, and sooner or later would find ourselves face to face with Soviet troops across the Rio Grande. And so on.

I couldn't do much for him beyond helping him recognize his anger and to suggest less booze and barbiturates, and outlets for his energy less destructive than death squads. Take up a sport. Beat up something besides people. Beat up a golf ball. Shoot something besides people. He took my suggestion. The upshot: Too old for polo, he took up hunting and golf, joined the ROBs (Retired Old Bastards), a genial group of senior golfers at the country club. The golf, eighteen holes a day, tournaments at other clubs, helped. He competed ferociously and successfully, his blood pressure went down, he slept better, but in the end he blew it and either withdrew or got kicked out. Why? Because he never caught on to the trick of Louisiana civility, the knack of banter and horsing around, easing up, joshing and joking-in a word, the American social contract, in virtue of which ideology is mitigated by manners and humor if not friendship. He could not help himself. On the links he could hack up the fairway, hook and slice and curse with the best of them, but afterward in the clubhouse he could not suppress his Central American rage. One doesn't do this. His fellow ROBs didn't like Communists or liberals or blacks any more than he did. But one doesn't launch tirades over bourbon in the locker room. One vents dislikes by jokes. But Enrique could never see the connection between anger and jokes (unlike Freud and the ROBs). He never caught on to the subtle but inviolable American freemasonry of civility. And so he got kicked out.

So here he is two years later. And how is he? Why, he's as easygoing and fun-loving as Lee Trevino. Not only is he back in the ROBs, he's just won the Sunbelt Seniors at Point Clear. Blood pressure: 120/80.

He even tells me a joke, not a very good joke. Here is the joke: There was this old Southern planter who had bad heart trouble. So his doctor tells him, Colonel, you got to have a heart transplant. He says, Okay, Doc, go right ahead. But what the planter doesn't know is that the only heart the doctor can find is the heart of a young black who's been killed in a razor fight. So when the old planter wakes up, the doctor comes in and tells him, Colonel, I got bad news and good news. The bad news is that I had to give you a nigger's heart. Good God, says the old planter, that's terrible; maybe you better tell me the good news. So the doctor says, the good news is your deek is ten centimeters long.

"You get it, Doc?" says Enrique, laughing.

"Yes, I get it, Enrique," I say. "But it should be ten inches, I think, not ten centimeters."

"You right, Doc! Ten inches!" says Enrique, slapping his leg, laughing all the harder, not caring that he's screwed up the joke.

So what has happened to Enrique? I don't know.

Why is he here?

He needs something. And in fact I can help him. It's about his daughter Carmela, a nice girl, a thoroughly American, Southern U.S. girl. It seems she has enrolled at the University of Mississippi as a freshman. She loves it. Her heart is set on being pledged by the Gammas, a sorority. All her friends are Gammas. If she does not make Gamma, her life will be ruined. There would be little doubt she would make it, but it seems there is a little hitch, says Enrique, and it is because her complexion is quite brunette like mine, and you know how it is in Mississippi, even though she is pure Castilian-German. Now here it is, the end of rush week, and she has not been pledged.

Enrique in fact looks like an Indian.

"That's too bad, Enrique," I say, still wondering why he's here.

"Here's the thing, Doc. I understand that the Gamma rush captain is a young kinswoman of yours, the granddaughter in fact of the distinguished lady from the Mississippi Delta who was the foundress of this very chapter of Gammas. Now here it is at the end of rush week-" He looks down at his diamond-studded Rolex watch as if minutes counted.

I look at him in astonishment. How does he know such things? I had forgotten myself, if I ever knew, that Jo Ann had gone to Ole Miss, let alone that she was rush captain of Gamma.

"Come inside, Enrique." I remember all too well what it is to have an unhappy daughter.

It takes ten minutes. I call Aunt Birdie in Vicksburg and Jo Ann at Oxford. Two or three words about Carmela being a darling girl, member of an ancient aristocratic Castilian and Prussian family, indeed one of the first fourteen families of El Salvador, a prime prospect whom they can't afford to lose to the Chi O's, and so on.

I hang up. "She'll get her invitation this afternoon," I tell Enrique.

"Oh, my dear friend! Jesus!" cries Enrique, leaping to his feet. There are actually tears in his eyes. I'm afraid he's going to embrace me, so I shake hands quickly. He shakes with both of his. "You name it, Doctor! Anything!"

"My pleasure, Enrique." It is. Such matters can be serious. I can't stand to see a child, any child who sets her heart on it, get blackballed by the sisters, who can in fact be as mean to one another as yard dogs.

But my interest in Enrique lies elsewhere. It is the change in him. Imagine a Central American who's lost interest in politics! Who knows all about Ole Miss sororities!

On the way out I ask him casually where San Cristobal is-San Cristobal, the town in Chiapas, Mexico, where his family first settled. If I'd asked him two years ago, asked him anything about Mexico, he'd have got going on the Mexicans, whom he dislikes, but now he merely closes his eyes.

"Oh, I'd say it's about three hundred miles northwest of Santa Anna." Santa Anna is the place where he lived on his finca in El Salvador. He doesn't even ask me why I wanted to know. He'll tell me anything, give me anything.

I ask him if he will come in next week for a couple of tests-I tell him I want to see if he's as healthy as he looks. What I really want is a CORTscan.

"My pleasure, Doc," says Enrique, trying out his interlocking grip on an imaginary club, swinging as easily as Sam Snead.

CASE HISTORY #2.

Here is Ella Murdoch Smith.

Her problem used to be failure and fright. "I can't cope," she once told me quietly. "It's too much. What happens when people can't cope? Is there a place to go, some government program for people who just can't cope any longer?" she asked ironically but seriously. I told her I didn't know of any such program. "But this is ridiculous," she said. "Have you ever heard of a card game where you're dealt a hand, a losing hand, and you're stuck with it, can't turn it in, can't fold and draw a new card, and you're stuck with it the rest of your life?" I admitted I had never heard of such a game. "You're right," she said. "There is no such game. I want to fold this hand." I took her threat of suicide, of folding her hand for good, seriously.

Her husband had left her with two small children. She had to go to work. An educated woman, she had no particular skills and had a hard time holding down a job, taking care of the children, running the house. She became frightened.

I looked at her. That was three years ago. What was remarkable about her was that here she was, a handsome, formidable woman with heavy breasts, youngish but with hair gone prematurely iron-gray and done up in two heavy braids-and shaking like a leaf. She had been frightened for months.

Frightened of what? Failure? Not according to her. One might have thought she had enough ordinary troubles to frighten anybody. But she had her own theory. She read books on psychology. She misread Freud. Her theory was that she had a strong sexual drive, that it was not being satisfied, and that in consequence she became anxious. So anxious she couldn't cope.

As the older Freud would have told you, it's not that simple.

I think I helped her. I only saw her a few weeks. There was not enough time or money for a proper analysis. But we made some progress.

The young Freud might have partly agreed with her-of course, it was the other way around, she was agreeing with Freud. Suppressed or unfulfilled sexual needs translate into anxiety, etc. Now I don't know how it was with the middle-class Viennese Hausfrauen Freud saw as patients. Maybe he was right about them. But he was not right about Ella. As a matter of fact, she satisfied her needs and drives, as she called them, had an affair with one of her bosses, a chicken farmer-and became more frightened than ever. She actually wrung her hands and cried, her face going red as a child's between her heavy iron-gray braids.

I began to notice something about her. The only times she was not frightened were when she carried off some little performance, a gesture which seemed to her to be "right," that is, sufficiently graceful, clever, savvy, warranted, that it pleased her and me. I never cease to be amazed at the number of patients who are at a loss or feel crazy because they don't know what to do from one minute to the next, don't think they do things right-I don't mean right in the moral sense, but right in the way that people on TV or in books or movies always do things right. Even when such actor-people do wrong, go nuts, they do it in a proper, rounded-off way, like Jane Fonda having a breakdown on TV. "I can't even have a successful nervous breakdown!" cried Ella, wringing her hands. She thought she had to go nuts in a poetic way, like Ophelia singing sad songs and jumping in the creek with flowers in her hair. How do I know what to do, Doctor? Why can't you tell me? What I want to tell them is, this is not the Age of Enlightenment but the Age of Not Knowing What to Do.

One day she carried off a charming little gesture and I noticed that it pleased her very much. She showed up with copies of Feliciana Farewell, the yearbook of our high school-yes, she had discovered that we had attended the same high school here and the same university in North Carolina. She opened the two books to show me her picture and mine-yes, we had both been editor of the yearbook. She gave me the yearbooks. It pleased her. She stopped trembling.

We talked about failure. What is failure? Failure is what people do ninety-nine percent of the time. Even in the movies: ninety-nine outtakes for one print. But in the movies they don't show the failures. What you see are the takes that work. So it looks as if every action, even going crazy, is carried off in a proper, rounded-off way. It looks as if real failure is unspeakable. TV has screwed up millions of people with their little rounded-off stories. Because that is not the way life is. Life is fits and starts, mostly fits. Life doesn't have to stop with failure. Not only do you not have to jump in the creek, you can even take pleasure in the general recklessness of life, as I do, a doctor without patients sailing paper P-51s at a martin house. I am a failed but not unhappy doctor.

I took her hints of suicide-"I don't have to play this hand," etc.-seriously. We spoke of failure and she got better. I can't claim a cure, but she got better. She showed some initiative, stopped wringing her hands, moved to Nags Head on the Outer Banks of North Carolina, got a job teaching school, put her children in the excellent public school system of North Carolina, and even began writing poetry. She sent me a postcard showing the beach and the dunes of Kitty Hawk. It read: "Did you ever walk on a beach in December in a gale. The winter beach is lovely." Later she sent me a poem she wrote called "Spindrift," about the spindrift of the waves being like the spindrift of the heart, etc.

Now, admittedly there is still some cause for alarm here: Ella setting too much store by walking on a winter beach and writing a poem about spindrift. There are at least a thousand women poets in America, mostly in California and New England, who walk on beaches and write poems about spindrift, spindrift of the waves, spindrift of the heart. Beware of women poets who write about spindrift. There is a certain peril in this enterprise. She could easily shoot herself down. The winter beach and the spindrift, relied on too much, could let you down. But at least I understood her and she me. We transmit on the same wavelength. She was functioning, living, not trembling, taking herself less seriously, had come to terms with failure. Her children were doing well in school, were happy, had not yet fallen prey to the miseries of adulthood.

Cure? No. What's a cure in this day and age? Maybe a cure is knowing there is no cure. But I helped her and she me. She gave me a gift which I liked. I still have her two volumes of Feliciana Farewell on my shelf.

So here she is two years later.

She had called earlier, saying she needed my testimony in an industrial liability case, that it meant big bucks.

Big bucks? That didn't sound like Ella.

I am waiting on the porch when she shows up. She arrives in a Nissan pickup with gun racks in the rear window. She's wearing an elbow cast. The driver stays in the truck, a fellow in a yellow hardhat. I ask her if he's going to wait for her.

She laughs. "Don't worry about Mel. Let's go inside."

I follow her in. The change in her is startling. Her hair is cut short, dyed pinkish-blond, as crimped and stiff as steel wool. She's wearing long shorts, the kind that pull up over the stomach, and she's got a stomach, but the bottoms are rolled up high on her thigh. Her clear plastic shoes have openwork over the toes. Jellies, I think they're called. About two dollars a pair from K-Mart. She looks like a Westwego bingo player.

It seems she has returned to Louisiana, gotten a job with Mitsy, the local nuclear utility at Grand Mer.

Now I've got nothing against Westwego types-they can be, often are, canny, shrewd, generous women, good folks. But there's something about the way she plays the part-yes, that's it, she's playing it and not too well, somewhat absentmindedly.

But I'm fond of her. When she makes as if to give me a hug, I give her a hug. She's bigger.

"How you doing, Doc?"

"I'm fine. I'm glad to see you."

"I hear you been having trouble."

"Yes. But I'm all right now. Do you have trouble?"

"Old Doc. You always been my bud."

"Thanks, Ella." It's time she let go, but she hugs me tight, a jolly, nonsexual hug, like a good old Westwego girl.

"Dear old Doc. Tell me something."

"All right."

"You getting much, Doc?"

"What? Oh." Well, so much for the spindrift of the heart. "What happened to your arm, Ella?" I ask, holding her off to take a look.

"You're not going to believe this, Doc."

Maybe I won't, but it's a relief to get her into a chair, aggrieved and telling me her troubles.

I am wondering about Mel out in the truck.

She goes into a long rigmarole about getting abused by her superior at Mitsy, a person named Fat Alice, who beat her up and broke her arm-and then getting fired. She wants to sue Mitsy for a million dollars and wants me to testify about her mental health.

"The real boss, who is also her boss, says he knows you," she concludes.

"Who is that?"

"Mr. Beck. Albert J. Beck."

"Bubba Beck? Yes, we went to high school together. Don't you remember him? He was all-state quarterback."

"Will you call him?"

"Yes. What is it you really want, Ella?"

"I want my old job back and I want him to tell Fat Alice to leave me alone."

"All right."

"Tell him also that thanks to Fat Alice I was also exposed to radioactive sodium and have been rendered sterile."

"All right."

I reach Bubba at home. Although I haven't spoken to him for twenty years he doesn't seem surprised.

"How you doing, Ace?" asks Bubba.

"I'm fine. I have a patient here with a problem. You might be able to help."