Book Review : Hanky-Panky in a Psychiatric Hospital

The World as It Is by Norma Klein (E. P. Dutton: $18.95; 322 pages)

Dr. Stern is arrogantly overbearing, Dr. Grieff is crude, Dr. Szell is crass, Dr. Wishnick wears provocative transparent blouses, and Dr. Welch, the third-year resident, considers the nursing staff his personal harem. Since “The World as It Is” is far too solemn to qualify as satire, those suggestive names might be only a Freudian accident, reinforcing the author’s bleak view of the psychiatrist fraternity. Although the fictional Lionel Nash Institute for Mental Health, where this nefarious quintet practices, is world-renowned, anyone suffering from an emotional disorder would be better off sleeping in doorways and taking his chances on the kindness of strangers.

The novel opens as Stern and Grieff are conniving to conceal the fact that one patient has just died from an overdose of Thorazine while another remains in a coma. The drugs were ordered by Stern, who was apparently too stoned to read the caution on the package. Fearful that an investigation will uncover his cocaine and marijuana habits, he and his mentor, Grieff, agree to shift the blame to an innocent nurse known to be an addict. While the aptly named Dr. Menchel protests that “This man was murdered, under our auspices,” his colleagues shout him down and close ranks.

Vastly relieved, Stern pursues his cold-blooded plans to marry a Philadelphia heiress. After the wedding, he hopes to continue his passionate sexual relationship with his current mistress, Roxanne, an arrangement that just might be possible if he and and his bride keep separate apartments in New York and Philadelphia. Roxanne, however, has just landed in Lionel Nash Institute after a suicide attempt triggered by the New York Times announcement of Stern’s impending nuptials.

An Occupational Hazard

This isn’t the first time, and Dr. Stern is worried. Dead patients may be an occupational hazard; dead mistresses are a professional embarrassment.

Enter Alix Zimmer, who has just become a voluntary patient at Lionel Nash after a hallucinatory episode at her brother-in-law’s wedding. A capable attorney who has seen her mother, father, sister and lover all die within the decade, Alix assumes that a short stay at Nash will soon restore her energy and spirits.

Urged on by her handsome, effete husband Luke, who encourages her to think he might be willing to consider parenthood once she’s feeling herself again, Alix signs in as calmly as if she were going to the hairdresser. Not so Noah Epstein, a sweetly unstable biology teacher, who has wound up at Nash after cracking up at a party honoring his younger brother, a writer of immensely profitable books on sexuality, an area in which Noah has always felt woefully deficient.

Perseverance Pays Off

Though Alix quickly realizes that the therapy offered at Nash is only exacerbating her problems, she discovers that even a voluntary patient at a New York mental hospital is not free to leave unless two doctors agree and a spouse requests the release. (There’s something useful to be learned from every book, if one can only persevere.)

When Luke proves reluctant to cooperate, Alix manages to escape, a feat that proves surprisingly easy, perhaps because the staff at Nash is so preoccupied in covering up murders, getting high and browbeating the patients that security is virtually non-existent.

Though Alix has befriended Noah and attempted to galvanize him into taking similar action, he’s unable to summon the necessary vitality; continuing to languish there under the malevolent influence of Stern, Grieff, et al.

The evil Dr. Stern gets away with murder, losing his mistress but keeping his aristocratic bride and his lucrative practice. Dr. Grieff suffers a stroke, but we are led to believe he’ll recover. Alix divorces Luke, adopts a child and joins a less demanding law firm. Poor Noah Epstein, who might have been a great scientist if only he had the right doctors, winds up selling haberdashery in Saks, but as his loyal wife says: “It’s who you are that counts, not what you do.”

Considering the state of the healing art as practiced at the Nash Institute, he’s a lucky man to have escaped with his life.