Ben Oco regarded the pill bottle in his hand, lifting it to a pallid incandescent light. Tears rolling down his cheeks, breath laden with alcohol, he twisted off the cap and shook the bottle’s contents onto his palm. He wept as he tossed the eleven capsules into his mouth and gulped sloppily from his bottle of Bombay Sapphire. The room, which had been spinning for more than half an hour, began to droop. Ben swiped at his wet eyes, wondering whether his vision was marred by the tears, the pills, or the booze. He thought maybe all of the above. Before he could reach his bedroom, he stumbled and fell face-first onto the floor.
The paramedics found Ben in this position, prone on his grandmother’s Turkish rug. Fifteen minutes later, he was in the Emergency Room with a blood pressure of 74/40 and heart rate of 120. With evidence hinting at attempted suicide, the clinical team administered IV fluids and advanced life support. As the floor nurses began gastric lavage, an assiduous resident contacted Toxicology and Poison Control.
#
From the moment of Ben Oco’s conception, he had been the most obliging of children. His mother, Philomena Oco (née Bloucher), and father, Tiberius Duryodhan Oco, recalled a remarkably painless delivery following what had been an even more comfortable gestation. Little Ben did not kick once the entire nine months, nor did he beset his mother with even an afternoon of lumbar pain. At exactly the 40th week, on the 280th day, Philomena had the fleeting thought that it would be a convenient time to have her child.
And so, he emerged: sparing the obstetrician the nuisance of providing a slap to the bottom, Ben Oco wailed on cue—softly, of course, and in the most mellifluous tone ever to coat the halls of St. Elizabeth’s L&D floor.
Every person who met baby Ben agreed that he was the most pleasant child upon whom they had ever laid eyes. In kindergarten he shared his toys and stood statuesquely erect for each morning’s recital of the Pledge. What some viewed as fastidious patriotism, his parents understood to be their son’s cardinal trait: his willingness to please. Teachers, playmates, and even total strangers were enamored with Ben. He completed homework, made every social engagement to which he was extended an invitation, and played cards (sometimes for hours at a stretch) with his grandparents each week at their retirement home.
While Philomena marveled at Ben’s natural social grace, Tiberius grew worried for his son. Ben’s father, who had once studied Classics—with a significant emphasis on Greek tragedy—considered his boy’s perpetual drive to do what others wanted a poignant hamartia. What would happen if thieves asked Ben to rob a bank for them? What kind of moral backbone could his son have if his behavior was so impressionable?2
As time wore on, what Tiberius feared a fatal flaw proved to be Ben’s greatest boon. As Ben was beginning high school, he was confronted by a group of local hooligans who ordered him to shoplift from a posh grocery store. Ben happily entered the supermarket and returned thirty minutes later with two bulging bags, having cajoled the clerk into giving the boys several pastries that were—exactly at that moment—en route to a dumpster. Even more, he convinced the shop’s manager to offer the ruffians a job bagging, so that they could earn an honest and consistent income with which to furnish their rapacious pubescent appetites. The boys humbly accepted both the offer of baked goods and employment, never shoplifting again in their lives.3
Ben’s unique talents also led him to career opportunities. Due to his knack for discovering what others really wanted, and not simply what they professed, he facilitated all manner of negotiations, settlements, and contracts, often between multinational corporations and litigants in class-action suits. His ability to please any and all parties led to his recruitment by the United Nations; by the time he was 18, Ben had visited the DMZ at least two dozen times, and was well on his way to brokering peace on the Korean Peninsula.
Only once in his young adulthood did Ben’s sunny charisma falter, his exuberance replaced with dejection, vivacious optimism blighted by grief. One summer in late adolescence, while sermonizing in the West Bank, Ben learned that his grandparents had passed away. The nonagenarian card sharks, who had first met at a soda fountain in Mentor, Ohio and had been inseparable for the seven decades ever since, died on the same day, one after another—he collapsing from an infarcted coronary artery and she, in a classic case of Takotsubo Cardiomyopathy (a.k.a. “Broken Heart Syndrome”), from a sudden explosion of bereavement. Ben arrived in Cleveland in time to watch the final shovelfuls of dirt rain down on his former best friends, sobbing for the first time since his birth.
Ben felt sad, of course, but what needled him most was that he had not been there, had not been able to whisk his grandfather to the cardiac cath lab, nor squeeze his grandmother’s splotched and quivering hands. He was unable to bring them back—unable to help—and no amount of pleasing or cajoling would change what had already escaped the world of the living. Ben might have spent the rest of that month, if not the entire summer, pounding his fists plaintively on the freshly packed sod of Mt. Auburn cemetery if not for the urgent call from the United Nations. Ben was needed immediately as chief mediator during the armistice of the Angolan Civil War.
As Ben packed his bags and brushed up on his Portuguese, his parents watched his mood brighten, glimmers of enthusiasm and purpose breaking through the shutters of grey. Here was a situation he could solve—something he could make right. Still, Ben was never exactly the same after that summer, as those who worked with him would later attest. Despite a purported commitment to impartiality during the negotiations, Ben evinced an undeniable soft spot for the Front for the Liberation of the Enclave of Cabinda (FLEC), allegedly once dining privately with the separatist group’s leader, Henrique N’zita Tiago.
#
Even with such dazzling adventures, the most important thing to happen to Ben Oco was falling in love. Reed Sipson was a summer intern at the U.N. tasked with investigating reparations for descendants of the victims of the Thirty Years’ War. They struck up a friendship after quite literally bumping into each other in East River Park, where Ben had been absorbed in the terms of the Camp David Accords and Reed was musing, chin to chest, on how to secure recompense from a long-defunct Holy Roman Empire.4
Thus began an exciting courtship. Ben and Reed took frequent strolls along the river where they first met, made secret escapades into the World Health Organization HQ (where all the good snacks were kept), and freed a harbor seal from the New York Aquarium, driving it in an aqua-outfitted U-Haul truck to its home in the Puget Sound.
When the summer ended, Reed and Ben returned to their respective campuses to finish their senior years. For an entire ten months the couple communicated exclusively by post, Reed having a penchant for all things arcane (see her interest in seventeenth century religious wars) and Ben having such an exceedingly pleasing nature to never demand an email or video call. Despite their old-fashioned means of conversation, Ben and Reed’s relationship blossomed during this year apart. After graduation, they moved together into a one-bedroom apartment.
To Ben, their relationship was perfect. Reed was compassionate and beautiful, and her idiosyncrasies gave him something to which he could direct his powers of gratification. If Reed surmised that a proper gentleman ought to wear a hat, in the manner of every American president pre-JFK, Ben would don one and look not only tasteful, but downright sexy. Once Reed commented that Ben had put on a bit of mid-section blubber—completely understandably given the demands of his work. The next day he joined a 24-hour gym, and within one month presented her with a pack of rippling abdominals. As the couple progressed from dating to engagement to marriage, Ben Oco found himself challenged and rewarded.
As in the rest of his life, Ben’s unflagging desire to entertain the happiness of all around him verged on the extreme. To show his appreciation for Reed’s cooking, he always ate whatever she prepared for him, even demanding second and third helpings. Growing suspicious, Reed once swapped salt for sugar in a chocolate chip cookie recipe. Happily, Ben scarfed the whole batch, rubbing his still chiseled stomach and burping contentedly.5
While Reed was initially offended (did her husband really care about her or did he just say ‘yes’ to everything?) she grew to realize that behind Ben’s inherent goodwill was a simple aim: for those around him to be happy, and to share in what they desired. And this was not a bad thing. When it came to having children, Ben valued and respected her opinion, even though he desperately wanted to be a father, and unflaggingly supported Reed’s career as she ascended the rungs of the Institute for Reparative Studies (IRS).6
In this way, Ben never rolled over as much as he moved the line in the sand. He reframed apparent dichotomies. He let both parties come away with a bigger slice of the pie. People who knew him were fond of mixing such metaphors.
Most importantly, to his wife, Ben was not ingratiating, just gracious. As Reed liked to joke with her friends, a sycophantic husband was even worse than an alcoholic one. Ben—as everyone could attest—was neither.
#
In one area, however, Ben’s power to please failed him. As the years of marriage wore on, and honeymoon became homeostasis, Ben struggled with the fact that no matter what he did, he could never free Reed from the cloud that had followed her since adolescence. He could make her laugh till she gasped for air and he could make her smile for an entire afternoon, but the shadows always returned, and they laid upon her the weight of her entire lifetime.
Reed went days without eating. She cried everywhere, and at random. So common was it for her to stay in bed until the afternoon that she would have lost her position at the IRS if not for Ben’s frequent pleading with her boss. Still, there was nothing her husband could do, no task he could complete, to truly and fundamentally make her happy.
For years Ben searched for an underlying problem, a cause for such inexplicable effects. Did Reed suffer from a profound lack of fulfillment? Or was her psyche tormented by abuse long repressed?
Ben goaded her to try all forms of remedy. Yoga, St. John’s Wort, and “putting it into the right perspective” assuaged her sadness—but never cured it. Trips to Bali and stints of Japanese forest-bathing (shinrin-yoku) brought comfort, not bliss. Reed saw psychologists and psychiatrists, but also psychics and astrologers and even a Haitian Houngan.7 By the time she was 29, Reed had tried every drug on the market: tricyclics, MAOI’s, SSRI’s, and the atypicals. She had done CBT and ECT. And she had completed three stints at St. Luke’s—the nation’s best and most bucolic place for those who couldn’t be trusted with their own shoelaces or belts.
Of course, there were good days and good weeks—and even stretches of months during which Reed’s profound sadness evaporated. But invariably it would return, sluggish at first, and then condensing, absorbing her once more.
Ben Oco was wracked by the realization that for the first time in his life, when it was more important than ever, he was incapable of making a situation better. The country’s top scholar on mood disorders, whose consultation had been secured by Ben’s eminent charm and good will, assured him that there was nothing he could do about the situation. Some things were simply a question of “chemical imbalance.”
This fact Ben could not accept, and his attempts to fix his wife’s situation, to be the mediator between her illness and her health, became increasingly desperate. He traveled to Peru, hiking thirteen miles through the Andes to receive a rare crystal believed to wield the healing power of the Incas. In a moment of despair and anger at her husband’s inability to accept his own impotence, Reed threw the crystal into the garbage. Ben waded through the city’s putrid landfill only to find that his wife would not accept the sludge-covered gem.
He bought Reed stuffed teddy bears, wrote sappy sonnets, and made her sweet potato gnocchi with hand-pressed Tuscan truffle oil, but in the end, Ben’s wretched attempts at saving his wife from her own desolation hurt more than they helped. Reed started to believe that her husband endeavored in his silly way not because he wanted her to be happy, but to prove to himself, and the world, that he could make her so.
Thus, on May eleventh, three days after Ben turned thirty, Reed struck up an affair with her chiropractor. A man in possession of an incredibly lucrative practice and a most vapid mind, Dr.8Barcombe’s preferred topics of discussion included the horrible hypocrisy of continental breakfast, the value of Bitcoin (and cryptocurrency in general), his heart rate, and a cruise he once took with an ex-girlfriend to Cancun.
At first, it pained Reed to engage in such fatuous conversation. Yet as she returned home to find Ben’s excessively earnest presents (like an original signed copy of the Mayflower Compact) waiting on the kitchen counter, the obscenity of her husband’s overtures, the shamelessness of his attempts to cheer, eviscerated her even more than perfidy could. Lying in Dr. B’s bed, his meaty hands against her cheek, Reed stared at the chiropractor’s plasma TV—bought, she was told, at a devilish discount on Black Friday—and thought that maybe there was something more superior about modern entertainment and telecommunication. After all, writing letters really was so old-fashioned.
#
When Reed informed her husband about her affair, Ben Oco was characteristically calm. He listened quietly as Reed described the seriousness of her relationship with Dr. B. It had evidently moved quickly; Reed and The Chiropractor were presently participating in couples tanning classes in anticipation of a trip to an all-inclusive resort in the Dominican Republic. They had already completed half of the melanoblastic sessions and had paid for the vacation in advance.9 The relationship was steadfast, Ben was told. There was no hope, even for a charmer like himself, of dismantling it.
Here Ben was confronted with a disheartening conclusion. First and foremost, he wanted to make Reed happy. Yet, Reed was supposedly happy with Dr. B. To please the woman he loved most in the world, a task at which he had been applying himself for the last seven years, he would have to leave her to the consummate charlatan. So be it, he thought. Ben had placated even less savory parties in the past.10
The syllogism of his mind dictated as such, so that very afternoon Ben Oco resolutely decided to help Reed Sipson move in with The Chiropractor. Before packing boxes of his wife’s things, Ben contacted a fleet of auction houses; the pair had accumulated a great many knick knacks in their years together, some of considerable historical and archaeological import. As Ben politely bartered with a purchasing officer from Sotheby’s about vintage colonial-era contracts, Reed sat blankly on the sofa.
What Reed could not see was how Ben Oco, selfless as always, kept his grief and suffering to himself. As much as Ben had wanted to be the perfect husband—the perfect person—smoothing over the wrinkles of unhappiness and the creases of angst, he found himself now, and for the first time ever, an undeniable failure. After Reed moved in with Dr. B, Ben took up drinking, a hobby which he had never previously enjoyed, and ate only old-fashioned donuts. He allowed his paunch to flourish. He developed a mild form of agoraphobia, finding it difficult to leave his home for more than a few minutes at a time, and spent most of his days ambling from room to room, stroking the dust from old pictures and watching cable news.
Soon, Ben quit his job, the last role in which he was seriously applying himself. Halfway through a deal he was steering between House Republicans and Democrats, Ben stopped responding to texts, emails, or calls. His abrupt departure from one of the most challenging cases in his career contributed, in many ways, to a government shutdown. Ben accepted immense guilt for the furlough of thousands of federal employees, and silently sank into even deeper despair.
#
Ben saw his ex-wife occasionally—at the supermarket as he scurried to purchase canned tuna and packets of dried milk—yet he was still surprised to find her one rainy morning, five months after they first parted ways, standing on his doorstep. She was chewing a piece of bright pink gum and gliding her thumb lazily on her smartphone. Reed informed Ben that she and Dr. B had just returned from their second Caribbean vacation. She had been dying to see him. It had been too long, she told Ben. She hoped he had been well.
She explained that she was stopping by to see if Ben had any of their old photos. If he did, she wanted very much to have them, if he could tolerate parting with such relics. Excitedly, Ben brought to the door a stack of pictures: the couple in Cambodia, climbing the Sleeping Giant in Kauai, posing with their rescued harbor seal. Reed smiled and thanked him.
Then, methodically, she pulled the backing from each frame, removing the pictures and matting. These she handed to Ben, who stood frozen. Reed looked up. Had he really expected her to keep the pictures? She merely wanted the frames—after all, they were vintage Gloucestershire oak. She tossed the empty wooden squares into the front seat of her car and waving, one final time, left forever.
That was when Ben Oco started upon the bottle of gin. Despite all the people he had pleased and all the deals he had done, at that moment, Ben found himself as lonely and as displeased as he ever would be. After an hour, he swung open the bathroom mirror and found Reed’s old prescription bottles, left behind in the frenzy of moving. As he took a yellow bottle from the shelf, Ben wondered whether Reed still ordered her medications from the same pharmacy, or whether she had finally been cured, had found relief from her vital disequilibrium.
#
Thus, I met Ben Oco, tachycardic and hypotensive, in the Emergency Room. He had a large hematoma on his forehead, from where he had fallen face-first, and lips powdered with the black of activated charcoal. I had been paged by the ER physician, as in all cases of attempted suicide, but found there was little I could do. Psychiatric evaluations require some modicum of communication, but Ben Oco lay obtunded and unresponsive. His hold on life, once vigorous and proud and gracious, was weakening by the minute.
The medical team followed the standard overdose protocol with exceeding readiness and care. Ben was subjected, minutes after admission, to rapid sequence intubation. As his body began to seize and convulse, he was given benzodiazepines. To manage his precipitously low blood pressure, Ben’s bed was tilted downward, and his circulatory system was infused with fluids. His stomach—once a powerful digester immune to bouts of reflux—was pumped of its former contents and plied with toxin-absorbing solutions.
Still, his condition worsened. The team feared that the drugs had already reached his bloodstream and that Ben’s life would soon come to a close. Inwardly, I feared something even worse: that Ben might live, but with permanent brain injury, an end more doleful than death itself.11
As the minutes wore on, Ben’s chest rose ever more slowly. We watched, helplessly, as his liver function enzymes skyrocketed, and his blood became unprecedentedly replete with urea and creatinine. His liver and kidneys, the twin powerhouses of toxin elimination, were shutting down. I barked at a supercilious medical student, scribbling furiously in a spiral notebook. Calculations of glomerular filtration could wait. So too could the EMR and the billing codes. Here, before our very eyes, was a man departing the world of the living, dying despite the most advanced biomedical technology humankind had to offer. It was a rare moment to behold, a moment deserving of respect.
And then, without even a shudder, Ben’s electrocardiogram flat-lined. His heart had stopped.
As the team stood stoically silent, a third-year resident, Kalverina Machechnikova, flew into the room, panting and grasping at a pink sheet of paper. A member of the shift that first admitted Ben, Kalverina had held on to the pill bottle used in his suicide. She had looked up its prescription ID number and found that it was part of a Phase III, double-blind trial. A novel neurotransmitter inhibitor almost ready for market.
Wanting to learn how to counter the drug’s toxicity, she called its manufacturer. To her immense surprise, she learned that the individual for whom the prescription had been written, one Reed Sipson, was assigned to the placebo arm of the trial. That is, the pills which Reed had been taking for six months prior to her divorce, and which her ex-husband had swallowed in one gigantic gulp, had consisted of nothing more than sugar and cellulose.
Kalverina held up the fax from the FDA’s clinical trial manager, waving it around her head. The evidence was on the paper. The man lying at the center of the hospital room had not ingested anything more dangerous than a mildly sweetened iced tea.
Immediately, the EKG machine started to sound. Ben’s heart erupted in a flutter of staccato beats. The monitors revealed his blood pressure creeping back to normal, his liver and kidney function accelerating at a heady pace. Slowly at first, his body began to wriggle and then, within minutes, he opened his eyes and looked around the room. The physicians, nurses, and technicians, who moments before were bowing heads and crossing chests, stood with their mouths irreverently agape. Within half an hour, drips removed, gown strewn mercilessly aside, Ben Oco stood up and walked out of the hospital.
Since then, I have tried, to no avail, to contact Ben—who, according to my interviews with family and former-friends, now lives a mostly secluded and unremarkable life. (I was so struck by Ben’s case that I took a year off from my clinical and teaching duties to compile the narrative herein represented). Hunting down Ben’s life story, I was impressed by how all who were close to him, and particularly those who were not, remarked on his incredible powers to solve and placate. From what I have been told, however, the man is now much less impressionable, and rarely if ever willing to please. After quitting his international mediation practice, Ben Oco earns a modest living as a claims adjuster for a motorcycle insurance agency. In this capacity, he is reviled by victims of vehicular collisions, however, in stark contrast to his former self, seems to care little about his clients or his reputation. Neighbors regard him as a cantankerous yet immaculate gardener.
Every few months, I search his name in our medical record database, hoping, selfishly, that he has been admitted again. Despite treatment for benign nasal polyps two months ago, he remains, to the best of my knowledge, in good health.12
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