BEDLAM’S DOOR

Nonfiction

King of the Puerto Ricans

BEDLAM’S DOOR:
True Tales of Madness and Hope
By Mark Rubinstein, M.D.
296 pp. Thunder Lake Press

Reviewed by David E. Hoekenga, M.D.

This collection of stories from Doctor Rubinstein’s practice of psychiatry is truly far stranger than fiction. For example, the one entitled the ‘Man of Means’ tells of a very well dressed man in a soiled and threadbare suit hanging out outside the Regency Hotel. He carried a gold-plated cigarette case and matching gold-plated lighter. An elegant briefcase was filled with a few million dollars in Monopoly money. Rubinstein diagnosed this man as “paranoid with delusions of grandeur.” One of the admirable parts of this book is that the author includes an afterword with a follow-up on each client. Several psychiatrists in New York had seen Man of Means, but none could track down his past. Rubinstein wrote, “I feel in love with psychiatry because each patient—though sharing human commonalities—had a unique personal story.”

Another case was the lead story in the book: “The King of the Puerto Ricans.”  Brought in by the police for running down Delancey Street flipping trashcans and shouting, “I’m the King of the Puerto Ricans.” It turned out that Nathan was Hungarian and had lived through Auschwitz when his entire family had been sent to the gas chambers because he was a carpenter and built beautiful cabinets for the Nazis. When he came to America in 1947, he worked as a carpenter his past presumably buried and forgotten. Then, working as a carpenter, he fell of a roof, broke a bone in his back and couldn’t work. He became depressed and had nightmares. Then he became afraid the SS was coming for him. He started raging. With medication he got better.

“The dreams,” I (Rubinstein) said tentatively. “You never had them before you hurt your back?”  

“No. Never before. I was living a normal life—like it never happened. That’s all I wanted in this life, to live and be left alone.” He sighed. I just wanted to make a new life with Sarah, here in America.” 

“And...?” 

“I had to forget. I used these hands, and I worked and worked, and never stopped.” 

“Do you think you forgot your past?” 

He shook his head. “It’s all back now, like it was yesterday.”

“It was never gone,” I said. 

He gazed into my eyes. “It’s—it’s such a terrible thing, the past. It hangs around my neck like a stone.” 

“Your past life?” 

“Yes. And the anger I feel.” 

I nodded. 

“This bitterness…it eats at me. It’s...it’s...I cannot describe it.”  He peered out the window and then turned to me. “If I could tear open my chest, and if you lick my heart, it would poison you.” 

Later Rubinstein said, “It’s what held you together... from Auschwitz until now. The wood, the hammer and the nails.”

In the afterword Rubinstein wrote, Nathan’s story illustrates many things: survivor’s guilt, the horror of post-traumatic stress disorder, the strange tenacity of memory, and above all, the enduring power of past experiences on a person’s functioning—even on an entire way of life.

The author includes a lot of useful information about particular psychiatric terms such as phantom limb pain, the difference between an obsession and a compulsion, bipolar disorders, and post-traumatic stress disorder. He takes the time needed with each patient to tease out the real problem before reaching a conclusion.

Read this book to learn patience and to marvel at the unbelievably bizarre workings of the human mind.