Death Is Psychologist’s Way of Life : Therapist Works With AIDS Patients and Their Families

Judy Pollatsek spends her life dealing with other people’s pain. She is a new kind of therapist, a psychologist whose practice is devoted exclusively to “D and D” as she calls it: death and dying.

Since 1979 she has worked for the St. Francis Center, a nationally known non-sectarian organization in that counsels the dying and the grieving. Until recently, Pollatsek’s patients were mostly cancer victims and their families. Now many of her patients have acquired immune deficiency syndrome, or AIDS. Since 1983, 20 of her patients have died.

For as long as they are physically able, Pollatsek’s patients come to her comfortably homey office at the center, in a yellow frame house on a quiet side street near Sibley Hospital. When they are bedridden or hospitalized, Pollatsek visits them.

During therapy sessions she sits in a flowered overstuffed chair, her legs tucked under one hip. A well-thumbed leather personal organizer rests next to a large glass ashtray full of cigarette butts on her wooden desk. Patients sit opposite her on a low-slung sofa, a Kleenex box within easy reach.

Pollatsek resembles Liza Minnelli with her throaty voice, diminutive frame, earthy irreverence and cap of close-cropped black hair. She has a mobile, expressive face, not the impassive countenance of a traditional psychiatrist, and laughs easily.

She is a married, 50-year-old, grandmother who counsels dying homosexuals her son’s age and is sometimes affectionately called the “Death Lady.” Here is her account:

What I learned from doing therapy with the dying and grieving is that what you cannot do is take away somebody’s coping mechanism, however aberrant. If someone is depressed, you don’t try and talk them out of it, which is what most other people do. What works is acknowledging their depression and saying, “I’d be depressed, too,” or giving somebody a hug.

I don’t find it depressing, generally, because it’s such a rare opportunity to be with people when they are at their most real. The interactions I have with people who are dying are at such a gut level that it’s almost a gift. But the inexorable downhill course makes me sad, always makes me feel as if I failed.

All therapy is about loss. I was always in therapy. It was what we did in our family--everybody went to therapy. My mother’s solution to everything was: See a therapist.

Father, Mother and Stepfather

My real father was a manufacturer, but I really had two fathers. I was born in Pittsburgh, but my parents divorced when I was 3. My mother ran away with my stepfather, is what I gather, and my father said, “She’s staying,” so I lived with him for three years while she was in New York. No one ever explained it to me. She just disappeared.

When I was 6, he decided I needed my mother, so I was sent to New York. It was real confusing to me, the divided loyalty part, the going back and forth part. I had a real sense of being abandoned by both parents. For years, I’m told, when my mother went out for the evening, I would check her closet to see if she had taken all her clothes.

My mother married my stepfather when I was 8. I was really bitter about it. I liked him a lot. He was more fun than my father, but I loved my father, and I had these secret fantasies that my parents would get back together.

My stepfather was a musician. He played double bass with the NBC Orchestra and Toscanini. My mother was a pianist. I went to hear Toscanini every Sunday and there were labor-union benefits where Josh White or Paul Robeson would sing.

We lived on the Grand Concourse and later in the deepest Bronx, the most ethnic part. I was an only child and my stepfather taught me how to do really important things. He would meet me every day after school. One day we would go to second-hand book stores, another day we would go to the park and talk to the old men who played chess and boccie ball. Some days we would hit all the delicatessens on a different block and stand outside and smell, and we would rate the delicatessen by the smell. A “10” delicatessen had a barrel full of chocolate Malomars with nuts in them and herring in a barrel and tomatoes in a barrel.

The Move to Los Angeles

In 1946, when I was 10, my mother’s parents moved to Los Angeles and everybody followed. By that time my grandparents were very wealthy. They bought a big house in Beverly Hills, a mansion really, right off the Sunset Strip.

Sometime in the early ‘50s, my stepfather was an unfriendly witness before the House Un-American Activities Committee. I remember that was a time when we were ducking subpoenas and hiding out a lot of people in our house who were also ducking subpoenas. Eventually he was called to testify. He was blacklisted for years; all of our friends were. I don’t know if he was a (Communist) Party member, but he was certainly very left wing.

I have talked to children of other people who had the same experience, but their parents warned them not to speak about this to their friends. I never had that. We knew it was the right thing to do, that (Sen. Joseph) McCarthy was an idiot.

L.A. was magic for a kid growing up, in a bad way probably. It may just have been my own peculiar kind of childhood. It wasn’t quite a California childhood because I wasn’t in with all those bronzed people. I had really weird friends and I never felt as though I quite fit in.

Every night for at least two years I used to go to a bar called the Keyboard Club in Beverly Hills where Bobby Short was a young unknown. We would leave there and go to another bar, and when we would walk in, the band would play “Little Girl Blue” and the bartender knew I drank scotch. When I graduated from high school in 1954, I didn’t go to college, which really upset my family. At the time I was single-handedly putting out a magazine called Architectural Products that my uncle owned. I was 17 and it felt very glamorous.

Then I had a blind date with the man who became my first husband. He was much older, 25, a lawyer who lived in San Francisco. I’d had a year of getting involved with brilliant, destructive, manipulative geniuses, and I was tired of that. I was in therapy and the psychiatrist convinced me that what I really wanted to do was settle down with a nice Jewish boy. So I convinced Jack that he should marry me. I remember sending him “Peanuts” cartoons in which Lucy is saying to Schroeder, “Marry me.”

I knew I wasn’t happy, but it was what I was supposed to be doing. We bought a house in the upper Haight and were the ‘50s equivalent of yuppies. I was a young mommy with two babies and I was active in the San Franciscans for a Better Library and the co-op nursery school. It never occurred to me that I shouldn’t be doing all that until 1964 when I was driving home from Christmas shopping.

Accident Changed Her Life

I got hit by a truck broadside and the car skidded 15 feet on my arm and then burst into flames. I was rescued by two gas station attendants, and I was in the hospital for a long time.

The accident was real important in a number of ways. When I was struck and the car turned over and started skidding, it seemed like hours. Everything was in real slow motion. As the car was turning over, I remember thinking, “This is really interesting. I’m going to die. There’s no way I can survive this.” I consciously thought, “If I live, I can stop doing this.” In that instant I wasn’t afraid to die.

I went into the hospital as Jack Pollatsek’s wife, Jessica and Joshua’s mommy, a ‘50s housewife. I whined. I was a kid. The nurses and doctors were authority figures and I was a good girl. There was a point at which I began to take control. I left the hospital a completely different person. It was the beginning of who I am now, whoever that is.

About six months later, Jack and I split up.

I lived with Jim, my second husband, for seven years before we got married. We met in Berkeley, where he was teaching economics. I was in therapy again and my therapist said to me, “What do you want to be when you grow up?” I was 35 and I had been writing and doing free-lance editing and I said, “I don’t know,” and he said, “You would make an incredible therapist.” He was a very well-known Berkeley psychiatrist and he said, “I would like to train you.”

Getting Proper Training

So I essentially became his apprentice. I was in supervision and I saw patients and we did a group together. About this time I went to Antioch, which had a West Coast branch, and I got a bachelor’s degree in nine months. Antioch had this system where you get credit for equivalencies, so I spent nine months documenting that my life had been the equivalent of a college education.

When I was in graduate school in psychology, I started working with cancer patients. This was pre-AIDS.

I loved doing therapy then. I still do. I love puzzles and mysteries and archeology. People are like puzzles, and you have to listen until you put together all the pieces, or find the missing one. It’s always there.

We moved to Washington in 1979, six weeks after we got married. Jim had been offered a job at (the Department of Health and Human Services) for $29,000, which seemed like a fortune. I was ready to be a grown-up at this point. I thought Washington was a city of grown-ups, which turned out to be somewhat erroneous. I was really miserable and I almost left.

Washington struck me as being humorless and a place where I realized I was going to have to clean up my act. The people Jim worked with were these churchgoing people from Springfield (Va.). It was weird. I didn’t know people like this. I was dressing all wrong, wearing denim jumpers and Birkenstocks in Georgetown, where we lived.

I couldn’t find a job, so I decided I would become a volunteer in my own field and I applied to all these death-and-dying agencies. I chose St. Francis because there was much more opportunity here than anywhere else.

When we first started seeing AIDS patients, Bill Wendt (the Episcopal priest who founded the center) would say to me, “Why don’t you take it? You’re from San Francisco.” So that’s how I got all the gays. I’m real comfortable in the gay community. Maybe it’s because I took the trouble to learn about the life style, maybe it’s because I’m not shocked by anything anybody tells me, or because my general attitude is one of acceptance about a lot of things. I like gay men better than straight men generally, because they’re more real, they’re nicer, they’re not as afraid of their emotions. But I’m not a fag hag. I didn’t marry one and I don’t date them.

Getting to Know Patients

One of the things I look for in a patient is somebody who speaks the same language. It’s more what I avoid than what I look for. I avoid people I just don’t like, or who bore me or if I find their process trivial or annoying. Then I get them to work with someone else who will care about them.

I begin to mourn from the minute I see someone. These are not people I generally have had a relationship with, but I know what the outcome will be from the day we meet. With AIDS, the boundaries change. I usually don’t socialize with patients. I try to be religious about that. That isn’t true with AIDS because sometimes you take somebody out to lunch because they desperately need it. You go to their homes because they can’t come to you. The lines really get very blurred.

You meet someone at the beginning of an illness and they say, “I will never get to the point where I need a wheelchair or I’m bed-bound. I’m an independent person. I’ll kill myself first.” They rarely do. Then you see all the mini-givings-up. People are really happy that they can still get around with a cane or a wheelchair or they can still make it to the bathroom.

How people cope with that incredible, encroaching loss of dignity is amazing to me and very sad to me. As death approaches, AIDS patients talk about hope. They say “if I can get into this (National Institutes of Health) protocol,” or “if I can just make it through the summer, or to that concert, or to the beach, or to my mother’s grave.” Or they stop talking about any of those things and just keep on trucking until the very end when they talk about wanting to die. There’s some point that almost everyone says, “I don’t want this anymore.”

The true knowledge that you’re going to die is like staring into the sun. You can only do it for a few seconds and then you look away. In the meantime, you’re living. Therapy with anybody who’s ill has less to do with the cosmic issues of life and death and what is the meaning of life than it does with diarrhea, what drugs you’re on, how well you slept last night, if you vomited, should you get out of the house, should you stop working, so and so is pulling away from me, this person has been really wonderful, a lot of mother stuff, what happens with a lover.

I make a deliberate effort, not entirely successful, to keep my home and work separate. My husband does not want to hear about my work. It’s not AIDS, it’s death he doesn’t want to talk about. So I have a drink and return phone calls and there’s an hour between the time I get home and the time he does so I can decelerate.

Social Functions Are Rare

I’m really awful socially now. I’m too tired, I’m too spent, so I don’t go to social functions. I’ll go to AIDS functions, those things engage me, but dinner parties, no. That’s very bad. I don’t like saying no, but I can’t psych myself up for them. My worst fear is I’ve become so self-absorbed that no one else interests me.

I’m not afraid of AIDS. I have thought of having myself tested (for the AIDS antibodies) a few times, if for no other reason than I could say, “See, I don’t have it.” But I’ve never gotten around to it. I get little things from my mother, like “I hope you’re being careful.”