The first time you hear a patient's unconscious, I mean really hear it in all of its immediacy and intimacy, there's a shock—no matter how much Freud you've read, how much analysis you've had, how prepared you think you are. My first patient was an eleven-year-old boy. We met two or three times a week at his school, a middle school for bright children from poor, mostly black and brown families. There we were in one of our sessions, which were held in the principal's office, the closest thing the overcrowded school had to a private space. I was listening to him explain how, in different countries, there are different gestures for “fuck you.” He was pretty clearly enjoying the opportunity to use the forbidden word and make the forbidden gesture in my presence. In the United States it's the middle finger, he told me; then showed me. In China, it's the index and pinkie fingers. He paused for a moment over this gesture, which had triggered an association: Spider-Man. My patient then began to spin one of those vivid, violent daydreams that took up most of our sessions for the year and a half we worked together: Spider-Man is in China, he tries to shoot his web, but the people think he's gesturing “fuck you” at them. So they cut off his fingers. He tries to shoot the web from his mouth, so they cut off his mouth. He tries to shoot it from his butt—by now the patient was laughing hard—they cut off his butt. Defeated, Spider-Man returns home to find his mother. He gets into bed with her. She gets pregnant and has a baby. When Spider-Man realizes what's happened, somebody—it's not clear who—cuts out his eyes. Spider-Man dies.