Chemical Drug Use and Abuse

 “The Good Doctor” is much concerned with drug use and abuse. Life in this rural, economically depressed Nebraska prairie offers little opportunity or hope, and drugs become the means by which people dull disappointment and disillusionment. Jack Buckholdt promised his wife they would leave for a better life in California; Mrs. Buckholdt promised Jason he would escape poverty. When as a little boy he would cry over trouble at school, she would soothe him with a fantasy about taking him across the Atlantic so he could visit Italy and Greece. But by the time he was fourteen, Jason must have realized the only escape was through drugs. He became addicted to crystal methamphetamine. His erratic behavior, his sleeplessness, and his psychotic rubbing of his body, all indicate the effects the drug had on him. Moreover, his attacking his mother in a psychotic episode and running out of the house naked, never to return, suggests quite literally how drug addiction can maim those around the addict who love and want to care for him. The accident on the interstate is probably a direct outcome of Jason’s drug abuse, and metaphorically, it hints at the sense Jason may have had of there being no escape from this place. Moreover, the story shows how drugs can be abused by medical professionals who rely on them as an easy fix to mask psychological symptoms in welfare patients. Mrs. Buckholdt is a poor woman; it is easier to sedate her than it is to face the trauma and grief of her home life. Mrs. Buckholdt uses prescription antidepressants and tranquilizers to increase her ability to function in her family, to care for her remaining two children, but the drugs do not neutralize her anxiety, lift her disillusionment, or mitigate her fear of her surviving son. The story portrays drug abuse, illegal and dangerous teenage abuse, legal and equally dangerous professional use, all against a backdrop of chronic poverty and powerlessness.

 The tonic of the moment insulates or dulls, but  it cannot fix the landscape of problems which grind people into complete disillusionment and alienation.

 Post-Traumatic Stress Disorder

 “The Good Doctor” presents a woman who four years earlier was maimed by her son, who cut off the fingers on her right hand and who shortly thereafter was killed in an accident on the interstate. Mrs. Buckholdt experienced a life-threatening,  terrifying, and shocking event when Jason amputated her fingers; that event was closely followed by his death. When Dr. Briggs interviews her, he considers that Mrs. Buckholdt may suffer from post-traumatic stress disorder (PTSD). This interpretation makes sense because she was clearly  traumatized by the dismemberment and by the shock of her son’s death a few days later. Dr. Briggs theorizes that if this diagnosis is correct, Mrs. Buckholdt should be prescribed sertraline (Zoloft) to help neutralize her anxiety and irrational fear. Based on this one interview, however, Mrs. Buckholdt does not seem to follow the expected profile of someone who has PTSD. For one thing, she remembers the traumatic events but can discuss them as memory and not as though she is back there all over again experiencing the same pitch of emotion she went through in the moment. Her pain and loss have left her with irrational fear of her other son and with a fear that comes over her some days and prevents her from getting out of bed. Yet she does not evince drug dependency and, in fact, asserts that she can get along without the prescriptions if Dr. Briggs does not refill them. In the face of her pain, Dr. Briggs thinks about what he would recommend and how he would describe her condition in her chart, and yet Mrs. Buckholdt shows that she can manage without his help. She has developed toughness and resolve. She knows she must care for her surviving children, and she knows she can do it if she does not look back or dwell on the past. This may be denial, yet the reader will never know. She tells Dr. Briggs not to return and refuses the offer to come to the clinic once  a month.

 Alienation

 This story depicts the members of the Buckholdt family as individuals who do not relate to each other. Each person is shown alone: the daughter on the drive, the father wandering into the yard, the son locked into the kitchen watching a television with the sound off, and Mrs. Buckholdt herself, sitting on the couch and looking past the psychiatrist’s shoulder to the wall. Mrs. Buckholdt has hardened or shut down; in order to exist in the world of this household, she has repressed all emotion. The family lives out in the middle of nowhere, hours from the nearest small town, in a dilapidated house. The father drinks, the mother lies in bed some days afraid to get up, and the children are unresponsive and detached. It is as though each person is paralyzed emotionally, estranged, unable to express what is inside. The point seems to be that drug abuse and trauma can arrest people in their abilities to interact or be open to one another. The family is beyond the help of the psychological clinic, both geographically and psychologically.

Source:

Ira Mark Milne – Short Stories for Students – Presenting Analysis, Context & Criticism on Commonly Studied Short Stories, vol. 24, Adam Haslett, Published by Gale Group, 2006