Further to my earlier note deploring the general acceptance of the narrator's and the parents' acceptance of the medical view of the son, and suggesting that VN himself should be distinguished from the narrator, I should like to add a few remarks.
It's true that VN does write to his publisher ("The New Yorker") at one point about their having published some years earlier his story about "the Jewish couple and their sick boy". And, as I mentioned, he says in his critique of "Crime and Punishment" that Raskolnikov should first of all be "medically examined". But that is in the context of his dislike and distrust of Dostoevski: his whole point is that Raskolnikov is a "filthy murderer", morally responsible, and that Dostoevski's implicit equation of his evil crime with the relatively minor "impairment to human dignity" of the prostitute Sonia's profession is contemptible, making the book absurd. VN is disgusted that D is making R's "filthy" crime almost "normal": hence his saying he should be "medically examined", just to emphasize how crazy and despicable R's rationalisations of his crime are. I suspect that, if pushed, VN would agree that this is not a medical matter at all.
After all, VN is renowned for his magnificent opposition to psychoanalysis.
It seems to me that he would hate the reader of "Signs and Symbols" to settle for
<< the doctor's words... What he really wanted to do was to tear a hole in his world and escape >>
or for
<< The system of his delusions had been the subject of an elaborate paper in a scientific monthly, but long before that she and her husband had puzzled it out for themselves. "Referential mania," Herman Brink had called it. In these very rare cases the patient imagines that everything happening around him is a veiled reference to his personality and existence. He excludes real people from the conspiracy-because he considers himself to be so much more intelligent than other men. Phenomenal nature shadows him wherever he goes. Clouds in the staring sky transmit to one another, by means of slow signs, incredibly detailed information regarding him. His inmost thoughts are discussed at nightfall, in manual alphabet, by darkly gesticulating trees. Pebbles or stains or sun flecks form patterns representing in some awful way messages which he must intercept. Everything is a cipher and of everything he is the theme. Some of the spies are detached observers, such are glass surfaces and still pools; others, such as coats in store windows, are prejudiced witnesses, lynchers at heart; others again (running water, storms) are hysterical to the point of insanity, have a distorted opinion of him and grotesquely misinterpret his actions. He must be always on his guard and devote every minute and module of life to the decoding of the undulation of things. The very air he exhales is indexed and filed away. If only the interest he provokes were limited to his immediate surroundings-but alas it is not! With distance the torrents of wild scandal increase in volume and volubility. The silhouettes of his blood corpuscles, magnified a million times, flit over vast plains; and still farther, great mountains of unbearable solidity and height sum up in terms of granite and groaning firs the ultimate truth of his being. >>
The particular young man now becomes merely one of "these very rare cases", where "the patient" imagines etc. etc. The mother and the narrator, bewitched by the doctor's account, or even by what the mother and father have "puzzled out" for themselves, have replaced the actual, individual son by these generalisations. It is they who now purport to "sum up" the "ultimate truth of his being", so that he is predictably, totally, a hopeless "case".
But VN is all for the particular, unique individual; he hates generalisation.
The parents in the story at first "stubbornly regarded" "those little phobias of his" "as the eccentricities of a prodigiously gifted child". But then they seem to have succumbed, as parents tend despairingly to do, to the totalising, closed, dehumanising language of the doctors.
VN's challenge to us, as readers, is to be "good readers" and "re-readers". That means, surely, not to fall, ourselves, for this dehumanising language, this closed, pseudo-scientific psychiatric system.
If we are able to resist this, then we can see that it is only from such a dehumanised, despairing position that it does not occur to us that the third telephone call may be from the boy himself. How ridiculous that the only way such an intelligent reader as Alexander Dolinin can envisage a happy end, a way out, is by having the son kill himself and then effect a posthumous reconciliation with his parents!
But if the (living) father can decide "To the devil with doctors!", why not the (living) son?
Obviously, there is no such thing as "what really happened" in the story. I'm just talking about the range of possibilities that people appear open (and closed) to.
Anthony Stadlen