A psychoanalyst is a bit like a watchmaker. While a watchmaker takes a watch apart to see what makes it tick (or try and find why it won't tick), an analyst unravels a mind to see why it functions as it does. Although I'm usually confident that the watchmaker can put the watch back together again, I always worry that the psychiatrist may not be able to put the mind back in good working order. So my feeling has always been, if the damn thing isn't broken, don't fix it.
"Fine" has convinced me that my policy is a wise one. Fine is a doctor. As the book opens, he has just graduated from Harvard medical school and his girlfriend, Stephanie, and best friend, John O'Day, have graduated from Harvard College. Fine is about to begin a residency in psychiatry, John is off to Dublin to become an actor, and Stephanie is ready to leave for Paris to learn her father's export-import business.
Shem gives us a brief recap of Fine's childhood. He was a chubby, unathletic but brilliant nerd in his high school days after he met Steph, a beauty even as a young girl, at a concert at Tanglewood. Their attachment continued through Steph's years in high school and Fine's college years at Yale. They began living together while at Harvard. John, an athlete from South Boston, joins them after a chance meeting at Harvard. For the last three years at Harvard they are all but inseparable. Now the troika is breaking up.
The second section of the book is set seven years later. Fine is a psychiatrist and psychoanalyst, and he and Stephanie are married. John O'Day, still acting, has temporarily dropped out of their lives. But, most important, Fine has finished his seven years of psychoanalysis and he has changed. No longer the brilliant but funny and warm-hearted person he once was, he now sees the world and the people in it as, presumably, an analyst sees them. No longer is he spontaneous. Of everything he sees, everything he hears, he asks "What does that really mean?" For Fine, the psychoanalyst, nothing can ever be simple. He analyzes the life out of everything. For example, Stephanie tells him, "This marriage is in trouble," and this exchange occurs.
" 'An interesting fantasy, Stephanie.'
" 'It's not a fantasy, it's reality.'
" . . . 'Your anger at me is your anger at your mother and your job. Get onto the couch, work it through.'
" 'After what analysis did to you? Are you kidding.'
" . . . 'Yes, and what did it do to me?'
" 'They analyzed out the Fine I loved! You used to be funny, lively, daring! Now you're so wooden -- every response is like there's a two-second tape delay, censoring. Why are analysts so weird?'
" 'Only the ignorant say we are weird -- ' "
Frankly, no. A lot of people think analysts are weird -- if not the analysts themselves, at least the work they do. And that, I think, is what Shem is saying in "Fine" -- that a lot of analysis is not only weird but dangerous, unless it is appropriately used by people who not only understand what they are doing but also have empathy with the patients they treat.
Shem, (a pseudonym) himself a psychiatrist, said earlier this year in an interview that "there has to be a balance between what the therapists and healers have learned over the centuries and what the therapist learns in his own life." He also says that psychiatry is "a kind of art in which the tool is who you are. The fuller you are as a person, the more breadth, depth, awareness, and experience you bring to the therapy, the more your patient will benefit. You bring to therapy a skill -- but it must be a skill based on the fullness of your self as a person."
"Fine" has a complicated plot. Fine carries on a practice in psychiatry; he is doing experimental work on grasshoppers and their ability to learn; psychiatrists in the Boston area, where Fine practices, are being murdered; John O'Day returns from Dublin and becomes reinvolved with Stephanie and Fine; Stephanie wants to launch a career as a stand-up comic; at times "Fine" reminds one of a Marx brothers comedy or a French farce with people running madly about.
But "Fine" is a serious book. Shem proved he could write humorously about the medical profession when he wrote "The House of God," a book about internship and residency training that is often hilarious but which is also essentially true. "Fine" is a less hilarious book, though it has many comic moments. Its prime purpose is to let us see, through one psychiatrist, just what psychoanalysts can and cannot do for patients.