Turn of Mind

The day after my fiftieth birthday, after a party James had thrown for me. Wondering if things were shredded for good this time.

It had been an evening of joy. People crowded in the living room, over-flowing into the kitchen, some sitting on the stairs. Drinking the excellent wine selected by James. My colleagues from the hospital. Dear Carl, and my assistant, Sarah, and, naturally, the orthopedics team: Mitch and John. Cardiovascular was there in force, as was Psych. And my family. Mark, fifteen, looking his most handsome, wrapping his arm around my shoulder, leaving it there as he guided me to the table laden with bottles and wonderful treats. Hugging me before pouring me a glass of wine.

Buddies. Fiona darting among the partyers, emerging occasionally to touch my arm. And James. Thrilling to know he was in the room. We sometimes met in the crowd. Each time he gave me a quick hard kiss on the lips. As if he meant it. Bliss.

But then, the downward plunge, the slide into hell. I was looking for James, he had disappeared. I searched the kitchen, the living room, dining room, even knocked on the bathroom door. No James.

Suddenly the room felt too crowded, too hot. I opened the front door and escaped to the stoop, to feel the cool May evening air. But then I heard sharp voices. Peter and Amanda. So intent on each other that they didn’t notice me.

You crossed the line, Peter was saying. He was speaking in a low tone but was clearly enraged.

But I did nothing . . . Amanda’s voice was cool and controlled.

Nothing? You never do nothing. Never. And now, a lie. On top of such cruelty. Like I said, you crossed the line.

The moon was bright enough to see their faces. From both, righteousness shone. A battle between two avenging angels.

It is time James knows, time he understands that his little family has some anomalies, some . . . unconventional antecedents. That he has a cuckoo’s egg in his nest. That he is in fact a cuckold. That he was not the only one who had wandered. He was holding Fiona’s hand. He had been joking about how she was a changeling, so different from himself. It was the perfect opportunity, one I have been waiting for. An opportunity to be seized. The truth must out.

And you were simply truth’s vehicle?

I didn’t say anything. I just looked. Just gave a look. That was all James needed. He was ninety percent there. How could he not be?

So you were lying when you said you did nothing.

Peter was having trouble modulating his voice and was breathing heavily. I had never experienced him like this. Usually so slow to anger, the sleeping giant.

I never lie. I didn’t say a word, after all. Not a word. So no. I never lie.

Except in extremis, that’s true.

What’s that supposed to mean?

It means that when it’s important enough to you, when it comes to protecting yourself against some intolerable consequence, you’re like the rest of us mortals.

Name one time I lied. Just one. Other than this supposed incident.

I have to go back fifty years. But it happened, and I have a long memory. Peter was calmer now, in control. He spoke deliberately. The philosophy test in 1966, he said.

Silence. Amanda didn’t move. I heard nothing but the cars streaming down Fullerton.

How did you know about that?

I was a research assistant for Professor Grendall. I was waiting outside his office. The door was half open. And you denied everything. That you’d cheated, plagiarized. You lied then.

Of course I did. It was necessary.

And then, after you left, Professor Grendall walked out, saw me, shook his head, and said, What a woman. What ruthlessness. She’ll go far.

And you said?

Be careful. That’s my future wife you’re talking about.

So when you approached me in the quad that year?

I’d already decided.

There was a silence. Amanda took a step back, put her hand on the iron railing surrounding the front garden, and wrapped her fingers around one of the iron spikes.

Well. You certainly know how to win an argument.

I wasn’t looking to win.

The Peter I knew began to appear again. The tension left his shoulders, and he put his hand to his head and stroked his hair—a gesture of appeasement often used when with Amanda.

No, you never are. I saw her fingers slowly unwind from the gate. She, too, touched her hand to her head, but as if it were aching.

So why did you do it? Peter asked. Make him aware of Fiona’s . . . ambiguous . . . paternity. About Jennifer’s single instance of straying, about what everyone else has known for nine years. As I said, you never would lie unless you were in extremis. What is going on?

Again, nothing but the sound of traffic.

Peter was speaking slower now, working it out.

The party. It’s something to do with the party. But what? We’re celebrating— that’s a happy thing. And honoring your best friend. You helped James organize it. And it’s gone splendidly. I’ve seldom seen Jennifer so delighted. She’s so difficult to please. But you pulled it off. You must have seen that. Jennifer and James so openly affectionate. Mark so proud of his mother, a kind of miracle at his age. Fiona taking brave forays out into the crowd before running back to Jennifer or James for safety. So what?

Amanda was rigid. She was not going to help him.

Peter stopped stroking his hair, his hand resting on the back of his head. He raised his other hand and extended it toward Amanda. Almost pointed but at the last second closed it into a loose fist.

That’s it, isn’t it. Too much happiness. You’re envious. A foul-weather friend.

That’s when I quietly turned and went back into the house, into the warmth and light. James was not to be found. I smiled and nodded until my face and neck muscles ached and the last guest had left. I put Fiona to bed and kissed Mark good night. Then lay sleepless in my own bed until morning.

The next day, James declined to go to the park with Fiona and me. He took Mark to the zoo. He rejected the idea of a family dinner, and he and Mark went to McDonald’s. For a month after that, he bit his words back into his throat every time I addressed him. He showed his back in bed. He turned his cheek when Fiona attempted her good-night kiss.

And then, after a month or so, the trouble passed. As it always did between James and me. You learn, you grieve, you forgive, or at least you accept. That’s why we’ve lasted. That’s how we’ve endured. The secret of a happy marriage: not honesty, not forgiveness, but acceptance that is a kind of respect for the other’s right to make mistakes. Or rather, the right to make choices. Choices you can’t be sorry for, because they were the right ones. So I never apologized. And so the matter died between us, but with it something else. Not enough to bring down the tree of our marriage, but a bough did fall that didn’t grow back.

Mark and Fiona felt it, of course. As children do, they acted out. Mark was sullen and rude to James. Me he treated with distance. But Fiona—it was hardest on her. She would sit on the couch between James and me as we watched a movie, placing her hand on each of our arms, as if she could be a conduit. Of what? Affection was still there. Delight in each other’s company, if slightly dampened. But respect— yes, that was the problem. There was now the taint of distain when James talked to me, a roughness in his embraces. In bed he was insistent and aggressive. Not necessarily a bad thing, for me. But Fiona took the change in our household very hard. She swung wildly between attempts at reconciliation and fits of rage. When she was good, she was very very good. But then the episodes. Too early to blame on adolescent hormones. Although as she got closer to puberty, they increased in intensity. She spent a lot of time with Amanda. When I couldn’t find her in the living room or her bedroom I would walk the three doors down to retrieve her. Amanda standing at the door, waving in a way that was both a beckoning and a farewell. Fiona, a recalcitrant and obstinate stranger. Then, after hours behind her closed door, the other Fiona would appear, offering to do the dishes, to help Mark with his math homework.

Those were strange, difficult years. I took on extra shifts, accepted new patients I didn’t have time for. Published articles. Began working at the free clinic. Busied my mind and body but emotionally descended into despair. It was Amanda, of course, who noticed and slowly patched me together again. The inflictor and healer of my pain, both.

I open the door, and there they are. My two children. The boy and the girl. Older, looking more careworn, especially the boy. I pull them both close, one arm around each, my cheek resting halfway on my daughter’s shoulder.

Why did you ring the bell? I ask. This is your home! You’re always welcome. You know that!

They both smile in unison. It looks almost choreographed. They seem relieved. Oh, we didn’t want to sneak up on you! says my son, my handsome, handsome boy. Even before his voice changed, the girls started calling.

Well, come in! I say. My friend and I just made some cookies. The blond woman has come up behind me. She smiles at the young man and woman.

We settle ourselves around the kitchen table. The blond woman offers coffee, tea, cookies. They both decline, although the boy accepts a glass of water. The blond woman takes a seat, too. There are undercurrents.

How have you been? the boy asks me.

Quite well, I say.

The boy looks at the blond woman. She shakes her head slightly.

Are you sure? You seem a little . . . excited. Overwrought, even.

This is from the girl, my daughter. The snake wrapped so tenderly around her delicate bones. Oddly enough, she takes after James. For all his height he is somehow insubstantial. Always ten pounds too thin. He doesn’t see it that way, of course. Always running, always swimming, always moving. On days he can’t go out because of excessive rain or snow or cold, he runs up and down the stairs for an hour at a stretch.

I consider her question. I weigh my options, my choices. And make up my mind.

This is a talk we had to have sooner or later, I say. I’ve been putting it off . But since you’re both here, now is as good as anytime.

The girl nods. The boy looks at me. The blond woman keeps her eyes on the table.

Your father doesn’t know. Not yet. So please don’t mention it to him.

We won’t, says the boy. You can count on that. He gives a wry smile when he says this.

It started a while ago. Months. I noticed I was forgetting things. Little things, like where I’d put my keys or my wallet or the box of pasta I’d taken out of the pantry. Then these gaps. One minute I’d be in my office, the next in the Jewel frozen foods section with no recollection of how I’d got there. Then words started to go. I was in the middle of surgery and I forgot the word clamp. I remembered it afterward, driving home. But at the time I had to say, Give me that shiny thing that pinches and holds. I saw my residents exchanging glances. Humiliating.

The boy and girl don’t look shocked. This is good. The hard part is yet to come.

I’ll even make a confession, I say. I don’t know your names. My own children. Your faces are clear—for that I’m grateful. Others blur beyond recognition. Rooms are sealed without doors, without any way in or out. And bathrooms have become extraordinarily elusive.

I’m Fiona, says the girl. And this is your son, Mark.

Thank you. Of course. Fiona and Mark. Well, to make a long story short, I went to the doctor—to Carl Tsien. You know Carl, of course. He asked me some questions, sent me to a specialist at U of C. They have a special clinic there. They call it, without a trace of irony, the Memory Unit.

They ran some tests. You may or may not know, but there is no conclusive way to diagnose Alzheimer’s. It’s mostly a process of elimination. They ran a number of blood labs. Made sure there were no low-lying infections. Eliminated hypothyroidism, depression. Mostly, they asked a lot of questions. And at the end of it all, they didn’t give me much room for hope.

Both my children nod calmly. They’re not crying. They’re not noticeably distressed. It’s the blond woman who reaches over and covers my hand with hers.

Perhaps I’m not being clear, I say. This is a death sentence. The death of the mind. I’ve already given notice at the hospital, announced my retirement. I have started keeping a journal so I have some continuity in my life. But I won’t be able to live on my own for very much longer. And I don’t want to be a burden on you.

The girl reaches out and takes my other hand. This is not comforting, this is awkward, having both my hands held captive by these nameless people. I disengage from both, place my hands safely in my lap.

That must be very scary for you, the girl says.

The boy gives me a half smile. You’re a tough old bird, he says. You’re going to wrestle this disease to the ground and break its arm before it takes you.

You don’t seem surprised.

No, says the girl.

You’ve noticed?

A little hard not to! says the boy.

Shh! says the girl. Actually, this kind of brings us to why we came here today, Mom.

Not only are we not surprised, says the boy, in fact it’s gotten so bad that it’s time to make a change. Sell the house. Move into a more . . . suitable . . . living situation.

What do you mean, sell the house? I ask. This is my home. This will always be my home. When I walked into it twenty-nine years ago— pregnant with you, by the way—I said, at last I found the place I can die in. Just because I mislay my keys every once in a while . . .

It’s not just the keys, Mom, says the boy. It’s the agitation. The aggression. The wandering. Your inability to use the bathroom, take care of basic sanitary needs. Refusing your medications. It’s too much for Magdalena.

Who is Magdalena?

Magdalena. Right here. See? You don’t even remember the woman who lives with you. Who takes care of you. Wonderful care. You don’t even remember that Dad is dead.

Your father is not dead! He’s just at work. He’ll be home—what time is it?—very shortly.

The boy turns to the girl. What’s the use? Let’s just do what we planned. We have all the documentation we need. It’s the right thing. You know it is. We’ve considered all the options—including you moving in here to help Magdalena. That idea was lunacy.

The girl nods slowly.

We could have a trained nurse. Start using the locks we installed on the doors. But that upset her so much, it did more harm than good. And she’s deteriorating so fast. It’s just not safe for her to be in anything but a closely controlled environment.

The girl does not answer. The blond woman abruptly gets up and leaves the room. Neither the girl nor boy seems to notice.

I don’t understand the boy’s words, so I concentrate on his expression. Is he friend or foe? I think friend, but I am not certain. I feel uneasy. There is a trace of hostility in his eyes, tenseness in his shoulders, that could be remnants of old injuries, old suspicions.

I am sitting at a table with two young people. They are getting up to leave. The girl had retreated somewhere, was no longer mentally present. Then she suddenly comes back.

Mom, I hope you’ll forgive us. There are tears in her eyes.

Fiona, she won’t even remember. This conversation was pointless. I told you that.

The girl is pulling on her sweater, wiping her eyes. And then there’s Magdalena. She’s been so important to us over the eight months. That is hard, too.

The boy shrugs. She’s an employee. It was a business relationship. A quid pro quo.

Ass, says the girl. Then a pause. I’m still glad we came, she says. Funny, I never knew how she felt when she realized what was happening to her. How she figured it out. That part was always a mystery.

Well, she’s never exactly been one for sharing feelings.

No, but I feel . . . honored somehow.

She has squatted down beside my chair.

Mom, I know you’ve checked out. I know you won’t remember this. And it’s all so very sad. But there have been moments of grace. This was one of them. I thank you for that. Whatever happens, know that I love you.

I’ve been listening to the rise and fall of her soft voice, paying attention to the cadence. Wondering who she is. This brightly colored bird in my kitchen. This beautiful girl with the face of an angel who is leaning over to brush her lips against my hair.

The boy is looking amused. You’ve always been sentimental, he says.

And you’ve always been an ass.

She gives him a little push as they walk toward the door. The end of an epoch, I hear the boy say as he closes it behind him.

The end, I echo, and the words hang in the now-empty house.

TWO

The woman with no neck is screaming again. A distant buzzer and then the muffled sound of soft-soled shoes on thick carpet hurrying past my door.

Other noises emerge from other rooms on the floor. The calls of incarcerated animals when one of their own is distressed. Some recognizable words like help and come here but mostly cries that swell and converge.

This has happened before, this descent from one circle of hell into the next. How many times? The days have morphed into decades in this place. When did I feel the warmth of the sun? When did a fly or mosquito last land on my arm? When was I last able to go to the bathroom at night without someone materializing at my side? Tugging my nightgown down around my hips. Gripping me so hard I look for the bruise after.

The screaming, although subdued, hasn’t stopped, so I get up. I can stop this. Prescribe something. One of the benzodiazepines. Or perhaps Nembutal. Something to relieve the anxiety, stop the noise, which is now coming from all different directions. I’ll order a round. Drinks are on me! Anything to prevent this place from descending into true bedlam. But arms are pulling at me, not gently. Heaving me to my feet before I am ready.

Where are you going. To the bathroom? Let me help. In the dim light I can barely make out the speaker’s face. Female, I think, but I find that increasingly difficult to tell. Unisex white scrubs. Hair short or tightly pulled back from the face. Impassive features.

No. Not the bathroom. To that poor woman. To help. Leave me alone. I can get out of bed myself.

No, it’s not safe. It’s the new meds. They make you unsteady. You could fall.

Let me fall then. If you’re going to treat me like a child, then treat me like an actual child. Let me pick myself up when I fall.

Jen, you could really hurt yourself. Then I would get into trouble. And you wouldn’t want that, would you?

It’s Dr. White. Not Jenny. Absolutely not Jen. And I wouldn’t care if you were fired. Another would just take your place. You’re interchangeable enough.

Dozens of people come and go, some lighter, some darker, some speaking better English than others, but all their faces blending into one another.

Okay, Dr. White. No problem.

She doesn’t let go of my arms. With a grip that could subdue a 250-pound man she pulls me to a standing position, puts one hand on the small of my back and the other at my elbow.

Now we can go together and see what’s happening, she says. I bet you could be of service to Laura! She sure needs it sometimes!

Still holding on to my arm, she walks me into the hall. People are milling aimlessly, as if after a fire drill.

Oh good, see, all over! Would you like to go back to bed now or have some hot milk in the dining room?

Coffee, I say. Black.

No problem! She turns to a girl, this one in an olive smock. Here. Take Jennifer to the kitchen for some hot milk. And make her take her meds. She refused at bedtime. You know what will happen tomorrow if we don’t get them into her.

Not milk. Coffee, I say, but no one is listening. That’s the way it is here. People will say anything, promise anything. You can ignore the words, even on the days when you can retain them, because you need to keep your eyes on their bodies. Their hands most of all. The hands don’t lie. You watch what they are holding. What they are reaching for. If you cannot see the hands, that is the time to be concerned. The time to begin screaming.

I study the face of the girl walking me to the dining room. My prosop-agnosia, my inability to distinguish one face from another, is getting worse. I cannot hold on to features, so when a person is in front of me, I study them. To try to do what every six-month-old child is capable of doing: separate the known from the unknown.

This one strikes no chords. Her face is pockmarked, and her head brachycephalic. She has an overbite and her right foot is slightly in-toed, probably due to an internal tibial torsion. Enough work there for many expensive medical specialists. But not for me. Because her hands are perfect. Large and capable. Not gentle. But this is not a place where gentleness thrives. Natural selection takes care of that, for both the caring and the cared for.

It’s a much-used word here, care. He needs long-term care. She is not qualified for home care. We are currently hiring more caregivers. Take care of her. Be careful with that. The other day, I found myself repeating the word over and over until it was meaningless. Care. Care. Care.

I asked one of the male attendants for a dictionary. The man without the beard yet who is not clean-shaven, the one whose face I remember because of the hemangioma on his left cheek.

He came back later with a piece of paper. Laura looked it up online for you, he said. He tried to hand it to me, but I shook my head. That was not a reading day, very few of them are anymore. He held up the paper and haltingly spoke, stumbling over the words. He is from the Philippines. He believes in the Holy Spirit, the Lord and Giver of Life. He makes the sign of the cross in front of the statue of the haloed woman on my dresser. He has asked me several times about my Saint Christopher medal and clearly approves of me wearing it.

Care: a burdened state of mind, as that arising from heavy responsibilities, he read. Watchful oversight. Assistance or treatment to those in need.

He paused and frowned, then laughed. That’s a lot of definition for such a short word! It sure makes my job sound hard!

It is hard, I said. You have the hardest job. I like this one. He has a face I approve of, in spite of—or perhaps because of—his birthmark. A face you can remember. A face that makes my anguish over my prosopagnosia dissipate a little.

No, no! Not with patients like you!

Stop flirting! I told him. But he got a smile out of me. Something this girl with the good hands is not going to do.

We reach the dining room, and she deposits me in a chair, leaves. Another will take her place. And another.

As with my patients at the free clinic I volunteer for every Wednesday: I focus on the symptoms, ignore the personalities. Just this morning I saw a case. If not for the puffiness around the hands and ankles, I would have simply diagnosed a mild case of depression. He was irritable. Unable to focus. His wife had been complaining, he said. But the inflammation made me suspicious, and I ordered tests for endomysial and anti-tissue transglutaminase antibodies.

If I’m right, a life of deprivation to follow. No wheat. No dairy. No bread, the staff of life. Some self-dramatizing, self-pitying people would see being diagnosed with celiac as a death sentence of life’s pleasures. If only they had known what lay in store for them, what would they have done differently? Indulged more? Or restrained themselves sooner?

My milk arrives, along with a small cup of pills. I spit into the milk, hurl the pills so they scatter under tables, into corners.

Jen! someone says. You know that’s against the rules!

People start bending, going down on their hands and knees to retrieve the red, blue, and yellow pills. I resist the urge to kick the one closest to me in the backside and instead head back to my room. Yes. I will break every rule, transgress every line. And I prepare myself for battle as reinforcements begin arriving.

Something nags. Just out of reach. Something to be shuddered at. Something bloody but unbowed by my resistance. This dark shame. A pain too lonely to bear.

Visitors come and go. When they head toward the exit, I always follow, I quietly move in, ingratiate myself with the person or persons leaving. When they pass through the door, I will too. It’s that simple. No matter that I’ve always been stopped. One day it will work. No one will notice. No one will realize until mealtime. Then I will be long gone. I will eventually make it. Next time for certain.

There is a woman here who is always surrounded by people. Visitors, night and day. Beloved by all. She is one of the lucky ones. She doesn’t know where she is, she doesn’t always recognize her husband or children, she wears diapers, and she’s lost many of her words, but she is sweet and serene. She is descending with dignity.

The Vietnam vet, on the other hand, is alone. No visitors. He continually and loudly relives his glory days or his nightmares, depending on the day or even the hour. He either did or did not participate in a massacre, one of the famous ones. Some of the details ring truer than others. Heaving a goat carcass into a well. The way blood mists when slicing a vein. Like me, he understands that he is incarcerated for crimes past.

James has come home today from one of his trips. From Albany this time. A tedious case, he says. His schedule is as draining as my own.

Like me, he hasn’t slowed down with age. Still as urgent, as engaged as when we were in graduate school. And for me, always that thrill, that sense of discovery, no matter how brief his absence. Not a conventional sort of good looks. Too sharp, too angular for most tastes. And dark. Where Mark got his darkness, darkness within as well as without.

James starts to sit down, then changes his mind and strides across the room, straightens my Calder where it hangs. Then comes back. Finally settles in the chair, but is not relaxed. On the edge of his chair, his foot tapping. Always in motion. Putting people on edge, wondering what he will do next. An extraordinarily useful weapon in the courtroom and in life. In a world where people usually behave as expected, James is exploratory surgery: slice and probe, and you discover things. Sometimes a malignancy. But frequently something that delights. Today he is unusually quiet, however. He waits a few moments before speaking.

You look like crap, he says. But I imagine that’s just a shadow of how you feel.

You always call it like it is, I say. And because his features are fading into the early morning gloom, Can you turn on the light?

I prefer it this way, he says, and falls silent. He is fiddling with something in his hands. I lean forward. It is some sort of engraved medallion on a chain. It is somehow important. I hold out my hand, palm up, in the universal gesture of give me. But he ignores that.

You forgot about this, he says. He holds it up by one finger, the medallion swinging slightly back and forth. It could be a problem, he says.

I am trying to remember. There is a connection I must make. But it eludes me. I reach again for the medal, this time intending to take rather than ask. But James swiftly pulls back his hand, denying me. And suddenly he is gone. I feel a sharp sense of loss, the prick of tears on my eyelashes.

People come and go so quickly here.

Mark sits with me in the great room. He pleads. Please, Mom. You know I wouldn’t ask for it if it weren’t important.

I am trying to understand. People are watching us. A scene! The television is off, they are hungry for drama. And here it is, with Mark and me as the central characters. Yet I still don’t comprehend what he is saying.

Mom, it’s just until the end of the year. Until we get our bonuses.

His hair wants cutting. Is he married yet? There was a girl. What happened to her? He looks so terribly young, they’re all so terribly young. I’ve asked Fiona but she says no. Mom, can you understand me? Mark at ten. My tender boy. Fiona even younger, but watching over him. He has broken the Millers’ garage window with his baseball bat on a dare and it’s Fiona who knocks on their door and offers to cut their lawn for six weeks to pay for it.

You shouldn’t have done that, I tell him. You should have taken responsibility.

Mom? Stay with me here.

And you came home drunk last night. I caught Fiona mopping up the vomit on the living room rug. Fiona watches out for you.

Yes, always Fiona. You don’t know how sick that makes me.

What have you done that even your little sister won’t cover for you?

Mom, I swear, I promise, this time will be the last. Now he is getting angry. You have more than you need. You’ll be giving it to me and Fiona anyway, eventually. What’s a little in advance?

More people are stopping and staring. Even the Vietnam vet pulls up a chair. Entertainment! Mark’s voice continues to rise in impotent fury.

If you just told Fiona that you agreed, she would give me the money. Why won’t you do this for me? Just this one last time.

I was a reluctant mother. And Mark was difficult to love, I remember trying to cuddle him when he was three or four and crying about some playground injury, and I felt frustrated by the awkwardness of it all, the sharp elbows and bony knees. Yet he is my boy.

Mom? He has been watching me closely.

Yes.

You’ll do it?

Do what?

Give me the money?

Is that what you wanted? Why didn’t you say? Yes, of course. Let me just get my checkbook.

I get up to go to my room for my purse, but Mark stops me. Holds out a notebook and a pen.

Mom, you don’t have a checkbook anymore. That’s in Fiona’s hands. All you have to do is write a note here saying you’ll lend me the money. Just those words: I will lend Mark $50,000. No, you need a couple more zeros on there. That’s right. Now sign it. Great! Wonderful! You won’t regret it, I promise you. I’ll show you that I can make things right.

He’s halfway to the door before collecting himself, turning back, and kissing me on the cheek. I love you, Mom. I know I’m a son of a bitch sometimes, but I do. And it’s not just the money talking.

Show’s over, I tell the people who have gathered around. Go to your rooms. Shoo. They scatter like cockroaches.

Love, love is everywhere. People are pairing off, two by two, sometimes three. Couplings that last perhaps an hour, perhaps a day. Junior high for the geriatric set.

The woman with no neck is utterly promiscuous. She will be intimate with anyone. Here that means holding hands. Sitting in the lounge side by side. Perhaps a hand on a thigh.Very few words spoken.

Husbands and wives show up, are looked at blankly. Some of them cry, all are relieved. A burden lifted. But these lovers. To be eternally seeking, to be besotted, to retreat to and be stuck at the most ignoble stage of life. God preserve me from ever going through that again.

I was that foolish just twice. There was James. And then there was the other. It ended badly, of course. How could it not? His young, aggrieved face. His sense of entitlement.

He would be close to fifty now—how odd to think that. A decade older than I was then. I never cared to see how he fared after leaving. I assume he did well, things are easy for the beautiful ones.

But it wasn’t his beauty that attracted me. It was his feeling for the knife. I thrilled at that. His grip on the handle as if grasping the hand of a beloved. Still, to have that passion, that desire, but not the talent. I pitied him. And then pity turned into something else. I never used the word love. It couldn’t compare to what I felt for James. But it wasn’t like anything else either. And that counts for something.

When thinking over one’s life, it’s the extreme moments that stand out. The peaks and the valleys. He was one of the highest peaks. In some ways looming larger than James. If James was a central mountain in the landscape of my life, then this other was a pinnacle of a different sort. Higher, sharper. You couldn’t build upon its fragile precipices. But the view was spectacular.

There is colored tape on the rich carpet—somewhat spoiling the effect of luxury they work so hard to maintain here, but useful. This is a linear world. You go straight. You make right turns or left turns.

Following the blue line takes me to my bathroom. Red leads to the dining room. Yellow to the lounge. Brown is for the circumference walk, which takes you round and round the perimeter of the great room. Round and round. Round and round.

Past the bedrooms, past the dining room, the TV room, the activity room, past the double doors to the outside world with exit painted seductively in red letters. And on you go, in perpetual motion.

Something nags. Something that resides in a sterile, brightly lit place where there is no room for shadows. The place for blood and bone. Yet shadows exist. And secrets.

An extraordinarily clean place, this. They are constantly scrubbing, vacuuming, touching up the paint. Dusting. Fixing. It is pristine. And luxurious. A five-star hotel with guardrails. The Ritz for the mentally infirm. Plump cushy armchairs in the great room. An enormous flat-screen television in the TV lounge. Fresh flowers everywhere. The scent of money.

They keep us clean, too. Frequent showers with strong antiseptic soap. Harsh washcloths wielded expertly by rough hands. The indignity of a vigorous scrubbing of the belly, the buttocks.

Why bother exfoliating? Let the dead cells accumulate, let them encase me until, mummified, I am preserved as I am. No more deterioration. To stop this descent. What I wouldn’t pay. What I wouldn’t give.

I am sitting with a well-groomed woman with feathered gray hair. We’re in the dining room, at the long communal table. It has been freshly set for a dozen or so diners, but we are the only ones eating.

I have some sort of long pale strings of matter swimming in a thick red liquid. She has a piece of whitish meat. We both have a mound of white mush with a brown liquid poured on it. Through a sort of haze I recognize a fellow professional. Someone I could respect.

What is that? I point to something she has to the right of her food, something I don’t have.

That’s a knife.

I want one.

No, you don’t need one. See, your food is soft, easy to break into bite-size morsels. You don’t need to cut it.

But I like that one. Most of all.

That makes sense.

How long have you been here? I ask.

About six years.

What did you do?

What do you mean?

To get sent here. What did you do? Everyone here has committed a crime. Some worse than others.

No, I work here. My name is Laura. I’m the resident manager. She smiles. She is tall and broad-shouldered. Strong and sturdy. And what crime did you commit? she asks.

I don’t like to say.

That’s all right. You don’t need to tell me. It’s not important.

How long have you been here?

Six years. My name is Laura.

I like your necklace, I say. A word comes to me. Opal?

Yes. A present from my husband.

My husband is out of town, I say. Somehow I know this. In San Francisco, at a conference. He travels.

You must miss him, then.

Sometimes, I say. And then suddenly the words come more easily.

Sometimes I like rolling over in the bed, to find a place where the sheets are still cool. And he can take up a lot of psychic space.

But it seems that you have great affection for him. You talk about him a lot.

What is that you are holding?

A knife.

What is it for?

To cut.

I remember that. Can I have one?

No.

Why not?

It’s not safe.

For whom?

For yourself, mostly.

Just mostly?

There is a concern.

That I might hurt others?

Yes. There is that.

But I am a doctor, I say.

And you’ve taken a solemn oath.

I am gifted with a vision. A framed script hanging on a wall. I quote what I see written there. I swear by Apollo, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses . . . the image leaves me before I can finish.

Impressive words. Frightening, even.

Yes, I’ve always thought so, I say.

And of course, there’s the part everyone knows, about never doing harm, the gray-haired woman says.

I’ve always fulfilled that oath, I say. I believe I have.

Believe?

There is this thing that nags.

Oh?

Yes. It has to do with the thing you’re holding.

The knife.

Yes, the knife.

The woman leans forward. Are you remembering? No. Let me rephrase that. If you are remembering, keep it to yourself. Don’t tell me.

I don’t understand, I say.

No, not today. It is not your day to understand. But you might remember tomorrow. Or the day after. Memory is a funny thing. It might be a good thing not to try too hard. That’s all I’m saying.

And with that, she leaves, taking the lovely shiny sharp thing with her. Knife.

One living creature still trembles at my command. A small dog, a mutt that has somehow become attached to me. I’ve never been fond of dogs. The opposite, in fact. The children’s pleas counted for nothing.

At first I kicked the thing away. But it persevered, haunted me morning until night. The other residents attempt to entice it away at every turn, but it always returns to me after devouring a treat or being subjected to a trembling petting session.

I’m unclear who it belongs to. It wanders the halls at will and is a general favorite. But I am the one it pursues relentlessly. Despite the fact that it has a bed in the television lounge, bowls of food and water in the dining room, it sleeps with me. Shortly after I go to bed I feel a thump, of dog that I always hated. But gradually I have found comfort in it, have enjoyed being so adored.

Other residents are jealous. They try to steal Dog away. Several times I have awakened from deep sleep to find a dark shape bending over my bed, attempting to grab the whining wiggling body. I always let it go without comment, and the thing always returns to me. My familiar. Every crone needs one.

The only thing that helps is the walking. What the people here call wandering. They’ve set up a kind of a trail. A labyrinth for the mentally deficient.

On any given hour, there might be two or three of us traversing the loop. If someone tries to wander more randomly, they are stopped and firmly put back on the trail.

I remember the Chartres labyrinth, the children fascinated with it, following its mesmerizing lines to the center. Where pilgrims hoped to get closer to God. Where repentant sinners who suffered the stony path on their knees finally arrived, bloodied and weary, their penance fulfilled.

How I would love to experience once again that sense of freedom that follows punishment, that release that children feel once they have confessed and paid for their trivial crimes. But I—I have no choice but to keep wandering.

We have a visitor, Jen. Aren’t you glad we had a bath? Look how nice your hair looks!

It is a face I have seen before. That’s what I am reduced to now. No more names. Just characteristics, if they are idiosyncratic enough, and knowing whether a face is familiar or unfamiliar.

And those are not absolute categories. I can be looking at a face that I have decided is unfamiliar only to have its features shift and reveal a visage that is not only known but beloved.

I didn’t recognize my own mother this morning, disguised as she was. But then she revealed herself. She cried as she held my hand. I comforted her as best I could. I explained that, yes, it had been a difficult birth, but I would be home soon, the baby was doing well. But where is James? I asked. Mom, Dad can’t be here right now. Why are you calling me Mom and him Dad? More tears.

And then my mother was gone.

Now this one. A different sort altogether.

I am Detective Luton. We’ve spoken on a number of occasions.

Who performed your thyroidectomy? Was it Dr. Gregory?

My what? Oh—and her hand goes to the scar on her throat. I actually don’t remember his name. Why?

He always had a good hand with the needle. Your scar healed nicely.

So I’ve been told.

Has your dosage been titrated correctly?

Ma’am?

When was the last time your T3 and T4 levels were checked?

O, perhaps a year ago. But that’s not why I’m here.

It’s not my specialty, I know. But it’s something I would ask your endocrinologist. I find that eighty percent of the people with chronic thyroid conditions aren’t adequately monitoring their levels.

Okay, well I appreciate that. But I actually came here on another matter. I know you don’t remember, so I’ll just fill you in real quickly. I’m with the police. I’m in charge of an ongoing investigation into the death of Amanda O’Toole.

She pauses as if waiting for something.

Is that name familiar?

There’s someone on my street of that name. But I don’t know her well. We’ve only just moved into the neighborhood, and I have a new baby and a very busy practice. So I’m very sorry to hear it. But we were not more than acquaintances.

I’m glad. Because it was very upsetting to the friends and family of this woman. The sudden death, but also the way her body was treated after death.

Go on.

We believe, due to the violence with which her head hit the table, that it was not an accident. And then, sometime after death, the fingers of her right hand were cut off. No. Not cut. Surgically removed.

An interesting modus operandi. And why are you telling me this?

Because I want your brain. I need your brain.

I don’t quite understand.

We think you know something about this. But that you don’t know what you know.

How did you know that?

Just a hunch. You see a lot in my line of work.

Yes, I’ve been worried. My memory. It’s not what it used to be. Just this morning, I told James—my husband—that we were going to have to start eating more fish. You know, for the omega-three fatty acids. He wasn’t enthusiastic. It’s hard to get good fresh fish in Chicago.

Right. So you know what I’m talking about. So I’m wondering if you’ll humor me. Talk to me about your work, the memories you do have of Amanda O’Toole. Play some word games. I want to try and trigger a reaction from that very large brain of yours.

I’ll cancel my appointments for the morning.

The woman nods gravely. I appreciate that.

She takes out her phone. Do you mind if I record this? I have a bit of a memory problem myself. So, do this: Think about Amanda. Here’s a picture if it will jog your memory. No? Well then, don’t worry about what she looks like. What do you think of when I say the name Amanda?

I think of someone tall and straight and unyielding. Someone with dignity.

How would a dignified person meet death?

It’s a silly question. The only good death is a swift one. Dignity has nothing to do with it. Whether you suffer a heart attack or die due to a head trauma, it doesn’t matter. As long as there’s little or no suffering it’s a good death.

But you do hear of people who die with honor. Not just soldiers. You know what I mean.

It’s drugs. Drugs get most people through. Without drugs our own families wouldn’t wait for a more natural end. The drugs are as much for them as for us.

You’re a doctor, so you’re closer to death than most people. But then you don’t often deal with fatalities in your line of work, do you?

No, not many deaths due to hand trauma. I permit myself a smile.

But amputations?

Yes, a fair number.

What are the reasons you would amputate, say, a finger?

Infection, gangrene, frostbite, vascular compromise, bone infection. Cancer.

Is there ever any reason you would amputate all the fingers and leave the rest of the hand intact?

Yes. In cases of extreme frostbite or meningococcemia, there’s the possibility of gangrene, and you might well need to remove all digits.

And what, exactly, is gangrene?

A complication of necrosis, or cell death. In effect, a part of your body dies and starts to rot. Amputation is eventually required.

Have you ever had to perform an amputation due to gangrene?

Yes, occasionally. In this climate, you get some frostbite cases. It doesn’t usually get to the point where amputation is necessary—when it does, it’s unfortunately mostly among the poor and homeless.

But you wouldn’t see homeless people, would you? Not at your practice?

I do pro bono work at the Hope Community Health Center over on Chicago Avenue, and most of my work of this kind takes place there. And occasionally you get cases of what is called wet gangrene, which is due to infection. That’s more serious. If you don’t do an amputation in those cases, the gangrene can spread and eventually kill the patient.

So, in other words, you cut off body parts to keep the rot from spreading?

Yes, that’s one way of putting it. For the serious type of gangrene.

But there would be no reason to amputate after death.

No, of course not.

None?

None whatsoever.

Then why would someone do such a thing? In your opinion.

I’m not a psychiatrist. Certainly not privy to the deranged or criminal mind.

No, I realize that.

But it seems to me it might have symbolic value.

How would that work?

Well, if an amputation stops rot from spreading, then someone who was guilty of using their hands to do wrong—if their hands were, say, corrupted by unclean activities—that might be a way of sending a message. You know what Jesus says at the Last Supper: Behold, the hand of him that betrayeth me is with me on the table.

But why the fingers, not the hands?

That could be symbolic, too. A hand without fingers can’t easily grasp, can’t easily hold on to things. It could be a message for someone perceived as greedy, mercenary. Or someone who won’t let go emotionally. After all, without fingers, a hand is just a paddle of bone covered with soft tissue. Good for very little.

The woman nods. She stretches, gets up, and starts walking around the room.

I’ve noticed a certain number of religious things around the room, she says. And your ability to quote the Bible. Are you, in fact, a religious woman?

I shake my head. I was raised Catholic, but now I just like the accessories. It’s hard to avoid some degree of biblical scholarship when you choose medieval history to specialize in for a graduate degree.

The woman stops in front of my statue.

I notice you brought this from your home. Who’s this? The mother of Jesus?

Oh no, that’s Saint Rita of Cascia. See the wound on her forehead? And the rose she’s carrying?

Who is she?

The patron saint of impossible causes.

I thought that was Saint Jude.

Yes, those two saints have very similar missions. But the feminist in me prefers Rita. She was not a passive vessel like so many of the virgin martyrs. She took action.

Yes, I can see how you would be attracted to that. Is that her medal you’re wearing around your neck?

This? No. This is Saint Christopher.

Why are you wearing this?

It’s a joke. Amanda’s idea.

What kind of joke?

Saint Christopher is not a real saint.

No?

A fraud. No, that’s not right. An implausible and unprovable legend. A fantasy of the devout. He was evicted from the host of accredited saints some time ago. But I loved him as a child. He was a protector against many things. One of them is a sudden, unholy death. The patron saint of travelers. You’ll still find people with statues of him on their car dashboards.

More accessories.

Yes.

So what does this have to do with Amanda?

She gave it to me. On my fiftieth birthday. I had just ended a tough decade.

Tough in what way?

On many fronts. So many losses. Of a very personal, rather self-involved narcissistic kind. Loss of looks. Loss of sexual drive. Loss of ambition.

That last one surprises me. You were at the top of your game when you retired.

Yes. But ambition is not success. It’s something else. It’s a striving, not an achieving. By age fifty I had gotten where I wanted to be. I didn’t know where else to go. In fact, there was nowhere I wanted to go. I didn’t want to be an administrator, join boards. I wasn’t ambitious in that way. I didn’t want to write textbooks or advice books. I didn’t want—didn’t need—more money.

And then?

Amanda helped, in her way. She told me to volunteer at the New Hope Community Medical Clinic, on Chicago Avenue, to give back to the world. Insisted on it. She had her reasons for knowing that I would comply. But the experience turned out to be extraordinarily gratifying on a number of levels. I had to become a generalist again. Think of the human body beyond the elbow. It was difficult.

And Saint Christopher? Sudden death?

Yes. If thou on any day Saint Christopher you see / Against sudden death you will protected be. In my case, death of the spirit. Against my fear, my despondency, that everything important had come to an end. The medal was Amanda’s way of saying don’t panic just because of the current darkness. That there was a way out. That by paying for past . . . transgressions . . . my mind would be at ease. That brighter things lay ahead. So she thought.

So the medal represented vanquishing spiritual trouble—nothing to do with friction between you and Amanda.

I wouldn’t say that. No. There was friction there.

She leans forward, asks, May I? and takes the medallion in her hand. Her face tightens. There’s something on the medal, she says. A stain. Do you mind if I look closer?

I shrug, reach behind, and pull the chain over my head, hand it over. She studies it.

It’s dirty, she says. Let me take it away and clean it. I’ll bring it back, don’t worry.

There is a pause. I say, Is there anything else? Because I have patients waiting. I’m surprised my nurse hasn’t interrupted us. She’s got instructions to keep me on schedule.

I beg your pardon. Yes, I’ve taken up too much of your time already. Do you mind if I stop by again?

Just make an appointment at the front desk. I hold office hours Mondays, Tuesdays, and Fridays. Wednesdays and Thursdays are my surgery days. I should see you in three weeks, to follow up on this consultation.

Yes. Thank you. You’ve been very helpful.

She leans down, pushes a button on her phone, and puts it in her briefcase.

Yes, she says. I am sure we’ll be talking again, quite soon.

Fiona is here. My girl. Her green eyes are slightly reddened. She has three moon earrings arcing up the outside of her right ear.

What is it? I ask. I’m still in bed. I can’t seem to find a clock to see the time.

What do you mean? she asks, but she is palpably upset. She sits down on the chair beside my bed, stands up, sits down again, takes my hand, and pats it. I pull it away, struggle to sit up.

You seem agitated, I say.

No. Well, yes. She stands up again, starts pacing. Isn’t it time for you to get up? It’s nearly nine o’clock.

I push myself up to a sitting position, throw off the bedclothes, lift my legs, and put my feet on the floor, steady myself. She pushes her chair back, stands to help me. I shake her hand off .

Are you okay? she asks.

New meds, I say. Or, actually, more of the old ones. They upped the dosage of both the Seroquel and Wellbutrin. They’ve also been slipping me Xanax when they think I’m not paying attention.

Yes, I know. They told me.

I look more closely at her face. The nose slightly reddened in addition to the eyes. Limp hair around her ears from tugging at it. Signs of distress. I know my girl.

Tell me, I say.

She searches my face for something, appears uncertain. Then makes a decision.

We closed on the sale today, she says. I just came from signing the papers.

You bought a house?

No, she says. Well, yes. But that’s not what happened today. Today I sold one.

I didn’t know you owned a house. I thought you had that apartment in Hyde Park. On Ellis.

I moved, about three months ago, she says. That apartment was so small. I bought a house right off campus. A brownstone, hardwood floors, exposed brick.

Her face becomes less haggard, as if reliving a fond memory, before clouding over again. No, it was the house in Lincoln Park, on Sheffield, that we sold, she says.

That’s where my house is. I love that neighborhood.

Yes, I know. I loved it too, Mom.

Her eyes begin to tear up. Mark, too. We were both born there. We’ve known nothing but that house. It was really, really hard. We took sleeping bags and spent last night over there. We stayed up all night talking and remembering. You know how long it’s been since Mark and I have spent that much time together without fighting? When I first called he wouldn’t pick up. But I kept trying and eventually he relented.

Wait a minute. You’re saying you sold my house?

Yes. Yes.

My house?

I’m so sorry.

But my things. My books. My art. The tapes of my surgeries.

Mom, we cleaned it all out months ago. You packed yourself. You decided what you would take with you and what would go.

But what about when it’s time to go home?

This is your home now.

This is a room, I say. I am furious.

I gesture around at the four walls. Point to the stainless-steel bathroom without a bathtub, only a shower. At the windows shuttered against the view of a parking lot.

Yes, but look. All your things are here. Your statue of Saint Rita. Your Renoir. Your Calder. And your most beloved of all, your Theotokos of the Three Hands.

There were others. Many others. Where are they?

Safely stored.

My furniture?

I took the little oak secretary desk, Mark the Stickley mission oak sofa and rocker. The rest, sold.

I swing my legs around, get up from the bed. My hands are clenched.

I’m having some trouble absorbing this, I say.

Yes. Mom, I’m sorry. I wasn’t going to tell you.

Then why did you?

Because I’m heartsick. Because you’ll forget. Because there’s no one else to tell.

Cry me a river, I say. I pull my nightgown over my head. Sit there in my underpants. Not caring.

Mom, please, don’t do this. Get dressed. She goes to the chest of drawers, starts pulling out clothes, hands me a bra, a dark blue T-shirt, a pair of jeans.

Don’t what? I drop the clothes, put my hands over my eyes, try to still the rising fury. No. Not at my girl. Hold steady.

Please don’t cry. We talked about this at length. You knew we had to do it. It was time. Please. I hate to see you cry. Look, I’m crying, too. She picks up the clothes, puts them on my lap. Here. Please. Get dressed. Please don’t cry.

I take my hands away from my face, show her my dry eyes. I’m not crying. One doesn’t cry over things like this. You get mad. You take action.

Fiona runs her fingers through her hair, rubs her eyes. I just don’t get you, Mom. You never crack. Not through any of this. Not through Dad’s death. Not even when Grandmother died.

That’s not true, I say.

Which wasn’t true? Dad or Grandmother?

What your father and I had was private. I grieved in my own way.

What about Grandmother? I was only nine, but I remember you coming home from Philadelphia. It was right before dinner. I was doing my homework at the kitchen table.

You know, I seem to recall this.

Yes. You came in, changed your clothes, sat down, and ate a huge meal. Roast chicken with mashed potatoes. Amanda had made it, and she and Peter came over and ate with us. Dad was off somewhere on one of his business trips. Mark was at football practice. And we sat and talked about nothing. Your recent surgeries.

Amanda’s wayward students. My math scores. And your mother had just died.

About which I could do nothing.

But it was your mother. Your mother! Wouldn’t you expect someone to grieve even a little bit?

Of course. Unless one were a monster.

But you didn’t.

You don’t know, I say. You just don’t know.

My voice is raised. A woman in lavender, a badge attached to her shirt, passes by the open door to my room, glances in, sees Fiona, hesitates, then passes on.

I was there, Mom. Unless you’re saying you got it all out on the two-hour flight between Philadelphia and O’Hare.

But I didn’t lose my mother that day.

I start getting dressed. It takes concentration. These are the pants. First one leg, then the other. This is the shirt. Three holes, the largest one for the head. Pull it down to the neck. There.

The day before then.

No. I had lost my mother years before.

I find my shoes. Slip-ons. I stand up, still holding on to the bed. I test the floor, find it steady, and stand up straight. Fully dressed. Where is my suitcase. The discharge nurse.

Here, fix your hair. She hands me a comb. You mean . . . ?

My mother was long gone by the time she died. Her mind had rotted out. She spent the last eight years of her life among strangers.

I walk around the bed, looking but not finding.

Oh. Yes, I see. Now I know what you’re talking about. Now I know.

No, I don’t think you do. I don’t think you could. Unless you’ve experienced it yourself.

Fiona gives a little half smile. And how do you experience it, Mom?

As termites eating away at my emotions. Nibbling at the edges at first, then going deeper until they destroy. Robbing me of my chance to say good-bye. You think, Tomorrow, or next week. You think you still have time.

But all the while the termites are doing their work, and before you know it, it’s no longer possible to feel the loss honestly or spontaneously. Most people start acting at that point. I’m not capable of that. Hence, no funeral. Hence, no tears.

I can’t imagine that.

Believe me, it happens.

Maybe to you. But not to me.

You think not. But you don’t know.

I do know. I do. I still feel. Everything. You have no idea.

Yes, well. Apparently not. What’s that expression? Other people’s troubles are easily borne. I’m sorry. I’m sorry for you and your pain. But I’ve had enough of this morbid talk. I want to go home. Let’s go.

I start looking again for my suitcase. I had put it here. Next to the bed.

No, Mom.

What do you mean, no? I’m ready—I packed last night.

Mom, you pack every night. And every morning the aides unpack you.

Why would they do that?

Because you live here now. Because this is your home. See? Look at your things. Look at your photographs! Here’s one of all of us on Mark’s high school graduation.

Yes, I miss the children. They left one day.

Mom, we went to college.

It was more interesting when they were around. I tried not to mind, but I did.

Well, you have plenty of people to keep you company here. I saw lots of them in the dining room, eating breakfast. Laughing and talking. It’s time for you to get over there yourself. Eat something. You’ll feel better.

Yes, but it’s time to go home. I’ll eat breakfast there.

Not quite yet. You don’t want to insult your hosts, do you?

What an utterly ridiculous question. You don’t keep guests against their will. What kind of host would do that? Let’s just go. They’ll understand. I’ll write a thank-you card later. Sometimes you just have to dispense with the niceties.

Mom, I’m sorry.

What are you sorry for? I’m ready.

Mom, I can’t. You can’t. This is where you live now.

No.

Mom, you’re breaking my heart.

I give up on the suitcase and make for the door.

If you won’t take me, I’ll get a cab.

Mom, I have to go now. And you have to stay.

She is openly crying, goes to the doorway of the room, waves her arm, flags down the woman who had passed through before. I need some help here.

Suddenly there are others in the room. Not anyone I know. Unfamiliar faces. They are pulling at me, preventing me from following Fiona out the door, telling me to be quiet. Why should I be quiet? Why should I take this pill? I close my mouth tight against it. Struggle to free my arms. One is being held behind my back, the other straight out. A prick, a sting on the inside of my elbow.

I fight, but feel the strength ebbing from my body. I close my eyes. The room is spinning. I am pushed onto a buoyant surface covered with something warm and soft.

She’ll be out for a while.

Good thing! Man, she’s strong. What caused this?

I don’t know. Her daughter visited. Usually that’s a good thing. Not like when that son comes around.

Why do we put up with it?

Friends in high places. She used to be some muckety-muck doctor.

I try holding on to their words, but they evaporate. The chattering of creatures not of my species. I lift my right arm, let it flop back down. Do it again. And again. It reassures. It hypnotizes. I do it until my arm is too heavy to lift anymore. Then, blessed sleep.

I open my eyes. James. A very angry James. How unusual. Usually he expresses dissatisfaction by refusing to eat the rare dinner I’ve cooked or by strolling in late to one of our children’s birthday parties. Once he threw my favorite pair of broken-in tennis shoes outside into the garden—the ones I used for my longest and most delicate surgeries. I found them later, covered with mud and infested with earwigs.

What is it? What happened? I ask now.

But he isn’t paying attention to me. It isn’t me he’s angry with.

Who let her in? he asks. He is speaking to the other woman in the room, one wearing green scrubs and a name tag. Ana.

We had no reason to know, she says.

I gave explicit instructions that no one could see my mother except those on the list I gave Laura.

Laura doesn’t screen everyone who comes to the ward.

Who does?

No one person does. Whoever is on duty. It’s very secure. They have to sign in. They have to show ID. And they can’t get out until we let them out. It’s a locked ward, as you know.

Who was on duty that day?

I don’t know. You’d have to ask Laura.

I will. You bet I will.

Mr. McLennan? A tall woman with gray hair waved back off her face has come into the room. She is wearing an auburn blazer that matches the carpet, and a knee-length black skirt. Sensible shoes. The way I used to dress when not in scrubs.

Laura, James says.

I understand you are upset by what you perceive as a breach of security.

Yes, he says. Very much.

She was a police officer pursuing an investigation. She showed her ID. She signed in and signed out. It was all properly done.

Did she read my mother her rights?

That I couldn’t tell you. I’m sorry.

James’s face reddens. We are about to witness something uncommon: James losing his temper. He almost always stays in control. Even in the courtroom, he prefers to keep his voice low. It makes for good theater. People have to lean close, strain to hear. I’ve never seen a jury so rapt as when James is lovingly murmuring all the reasons they should acquit.

But before things erupt, James notices I’m awake. Mom, he says, and bends down and gives me an awkward half hug. He is dressed oddly, for James. Not his casual clothes of jeans and a T-shirt. Not business attire either. No suit. Tan-colored cotton trousers and a white shirt. Black sneakers. But he is young and vibrant and handsome as ever.

Why are you calling me that? James, it’s me. Jennifer. How glad I am to see you!

James’s face softens. He sits down on the edge of the bed, takes my hand. And how have you been?

Well. Very well. Missing you. How tired you look. They work you too hard. How was New York?

New York was good, he says. I tripped the light fantastic. Went out on the town. Painted it red. He pats my hand.

Now you’re patronizing me, I say. I have a temper, too. Stop talking to me like I’m an imbecile. What happened? It was the Lewis case, wasn’t it? A tricky deposition? Did it not go well?

I’m sorry, Mom. You’re absolutely right. I was being patronizing. And you probably get enough of that here. He glances back at the gray-haired woman. I’ll come talk to you later, he says.

There is an ominous tone in his voice. There is something wrong with his face, too. Some trick of light. It is fading away, and the features are rearranging themselves, transmogrifying into someone who is not-James.

James? Why are you calling me that?

Mom, I know Fiona shines you on, and that’s okay, but it’s, well, it’s not my way. I am Mark. You are my mother. James is my father. James is dead.

Mr. McLennan, the gray-haired woman interrupts. She is still standing by my bed.

I said I’ll come to your office. When I’m done here.

James! I say. My anger is dissipating. Turning into something else, something unsettlingly like fear.

If I can make a recommendation, Mr. McLennan . . .

No. I can handle this on my own, thank you.

James!

Shhh, Mom, it’s okay.

Okay, the gray-haired woman says. She does not look pleased. If she becomes too agitated, push the red button there.

The door closes behind her.

James, what was that about?

Not James, Mom. Mark. Your son.

Mark is a teenager. He just got his driver’s license. He took the car out last week without asking, and now he’s grounded for a month.

Yes, that happened. But many years ago. Not-James smiles. And it wasn’t a month. Dad relented, as he always did. I think I had to stay inside for three days. You were furious.

He was always able to charm his way out of anything. Just like you.

Not-James sighs. Yes, just like me. Like son, like father.

James?

Never mind, he says. He reaches over and takes my hand, holds it against his cheek.

These hands, he says. You know, Dad used to say, All our lives are in your mother’s hands. Be careful of them. I didn’t understand what he meant. I’m still not quite sure, completely. But something about how you were the center. You were it.

He takes my hand from his cheek, clasps it between both of his.

He was very proud of you, you know. Whatever else may have happened. When I was small, and you were late coming home from the hospital, he used to take me into your office. He’d show me all your diplomas and awards. These are the credentials of a real woman, he’d say. It scared the hell out of me. Small wonder I haven’t married.

You’re nobody’s fool.

No. Whatever I am, I’m not that.

He is fading fast into the shadows. I cannot see his face anymore at all. But his hand is warm and substantial. I grasp it and hold on.

Do me a favor, he says.

What’s that?

Talk to me. Tell me about what life is like for you right now.

James, what kind of game is this?

Yes, call it a game. Just tell me about your life. A day in the life. What you did yesterday, today, what you’ll do tomorrow. Even the boring stuff.

A silly game.

Humor me. You know how it is. You think you know someone, you take things for granted, you lose touch. So just talk to me.

What is there to tell? You know it all.

Pretend I don’t. Pretend I’m a stranger. Let’s start with the basics. How old are you?

Forty-five. Forty-six? At my age you don’t count so carefully anymore.

Married, of course.

To you.

Right. And how are the children these days?

Well, I already told you about Mark.

The charming, intelligent, delightful one. Yes.

My daughter is another matter altogether. She was a gregarious, outgoing child. But she’s closed down now. They say girls do. And that you get them back, eventually. But right now we’re in the middle of the dark years.

It’s a mother-daughter thing.

I suspect so.

I can promise you that it does work out.

You have psychic powers?

Something like that.

Well, that would be something to look forward to.

You say that so mournfully. Yet you have a very rich, very full life.

The forties are a hard decade for women. I’d be the first to admit it. Lost hair, lost bone density, lost fertility. The last gasp of a dying creature. I’m looking forward to getting on the other side. A rebirth.

That sounds like something Amanda would say.

It does, doesn’t it? Well, we’re close. You pick things up.

You were a formidable pair. When I was small, I thought all women were like you and Amanda. God help anyone who didn’t treat me the way you thought I should be treated! Avenging angels.

She is one of a kind.

She was, indeed. He pauses. Did the detective ask about her?

What detective?

A woman here earlier this week. Did she ask about Amanda’s enemies? Whether there was anyone that wished her harm?

Oh, lots of people did, I would imagine. How could they not? She is difficult. Like you just said, an avenging angel. That is her genius— spotting the carcass before it has begun to rot. She out-vultures the vultures.

A nice way to talk about your best friend.

She’d be the first to admit it. She senses weakness and goes in for the kill.

Whereas when you saw weakness you chose to heal.

I wouldn’t say that’s why I chose surgery. Not exactly.

Did you and she ever fight?

Once or twice. Almost breached our friendship. We would declare a truce almost immediately. The alternative was too horrifying to contemplate.

What would that horror have been, if a breach had occurred?

For me, loneliness. For her I can’t guess.

It sounds like an alliance rather than a friendship. Like the treaties between heads of state, each with powerful armies.

Yes, it was a bit like that. Too bad she doesn’t have children. We could have arranged marriages between our two houses.

Created a dynasty.

Exactly.

I have some other questions, but you look tired.

Perhaps. I had a long day of surgeries. One particularly difficult one. Not technically difficult. But it was a child with meningococcemia. We had to take off both his hands at the wrist.

I never did understand how you could do what you did.

The father was distraught. He kept asking, But what about the kitten? He loves the kitten. It turns out he wasn’t worried about eating, writing, or playing the piano, but about the child losing the soft feel of fur against a certain part of the body. Trying to reassure him that other areas of the epidermis were equally sensitive to the feel of fur didn’t do any good. We had to medicate him almost as much as his son.

Sometimes that’s how you grieve. In the small ways. Sometimes those are the only ways open to you.

I wouldn’t know.

Oh?

My losses have been minimal. Containable. Small enough that they don’t need to be broken down any further to be processed. Except when I lost my parents, of course. My dear father. My exasperating mother. There I managed to compartmentalize, to shut off the particular horrors that way.

You’re lucky, then.

I forgot your name.

Mark.

You look familiar.

Lots of people tell me that. I have that kind of face.

I think I am tired.

I’ll go now, then.

Yes. Shut my door behind you, please.

The good-looking stranger nods, leans down to kiss me on the cheek, and leaves. Just a stranger. Then why do I miss him so much?

Wait! Get back here! I call. I command.

But no one comes.

When I have a clear day, when the walls of my world expand so that I can see a little ahead and a little behind me, I plot. I am not good at it. When watching the heist movies that James loves, I am impressed by the trickery the writers think up. My plots are simple: Walk to the door. Wait until no one is looking. Open the door. Leave. Go home. Bar the front entrance against all comers.

Today I look at the photo I picked out. Labeled clearly: Amanda, May 5, 2003. My handwriting?

In the photo, Amanda is dressed simply but severely in a black blazer and pants. Her thick white hair is pulled back in a businesslike bun. She has just come from a meeting, something official. The expression on her face is a mixture of triumph and bemusement. The memory tickles, then slowly returns.

I had heard a story about her, told to me by one of my colleagues at the hospital whose son attended a school in Amanda’s district. One of many such stories that had been whispered over the years in the neighborhood.

But this one was different, more extreme. It concerned an eighth-grade history teacher. A plausible rogue. Stocky and shorter even than some of the students, he nevertheless charmed. A thick mop of ragged black hair and dark eyes to match. Refined features and a low, thrilling voice with which he told delightful stories about authority subverted, injustices corrected, wrongs revenged. Even Fiona, as world-weary as she was at thirteen, had been enthralled when she was in his class.

Parents watched him carefully, especially around girls, but there was never a hint of impropriety. He always left his door open when with a student, never contacted one outside of school by phone or by e-mail. Never touched a student, not even a casual hand on the arm.

Why had Amanda disliked him so much? Perhaps only because he took the easy way out as a teacher, choosing popularity over her more rigorous and less appreciated pedagogical methods. And then, acting on an anonymous tip, the police raided his classroom, found pornography on the computer. A terrific scandal ensued, but the fact that it was a school computer, left mostly unattended in an unlocked room, made the police hesitate to prosecute. He still quit. My guess was that he couldn’t bear his students looking at him as anything but a hero. But soon after he left, the rumors began. That he had been set up, that it had all been engineered. That someone powerful wanted him out. No one actually said Amanda’s name.

I asked her about it. I remember that day, the day of the photograph. She’d stopped by to say hello, was waiting in my vestibule to be asked in. I kept her waiting.

Did you have anything to do with Mr. Steven’s ouster? I asked.

To my surprise, she looked uncomfortable. Extraordinary, really. There was a pause before she answered.

Do you believe I would do such a thing? she asked, finally.

That’s not an answer.

There was another pause.

I don’t think I’ll give you one, she said. After all, whoever actually put the pornography on that computer would face federal charges. I think I’ll take the fifth.

She started to smile, but then stopped. What are you doing? she asked.

Getting the camera.

Why?

To capture the expression on your face.

Again, why?

It’s an unusual one. One I’ve never seen before. There. Done.

I’m not sure I’m pleased about this.

I’m not sure I care, I said. And now, if you don’t mind, I’ve got some paperwork to do.

And I closed the door on her face—not something I had ever dared to do before. As I recall, we left it at that. We never referred to it again, as was our way. But I thought the interchange significant enough to print the photo and put it in my album. Amanda, accused. I might have added, Jennifer, marginally victorious. For once.

Dubuffet. Gorky. Rauschenberg. Our eclectic tastes in art amused the people around us. But James and I were always in absolute agreement. We’d see a print or lithograph and would know without even looking at each other that it must be ours.

It was an obsession that grew with our means, became an addiction. And sometimes there was the pain of withdrawal. There was that Chagall we saw in a Paris gallery: L’événement. Love and death, love and religion. Our favorite themes. We talked about it for years, I even dreamed about it, became the bride in the chicken’s belly, was seduced by the tunes played by the levitating fiddler, drifted in a glorious world of deep blues and warm reds. So far above us, yet like spoiled children, we longed for it.

They tried, of course, to conceive, Peter and Amanda. My guess is that no egg was tough enough to implant itself into her impenetrable womb. For she was hard through and through. A tough old bird, I overheard a neighbor say at a party. A prize bitch, was the response. But not always. No. There was how she treated Fiona. She took her role as Fiona’s godmother seriously. Even though it started as a joke.

Fiona was never baptized, we had no intention of ever doing such a thing, heathens that we were. Yet the day after I brought Fiona home, and Amanda and Peter came over with a bottle of champagne, I announced that I wanted Amanda to be Fiona’s godmother.

A fairy godmother? Peter had teased.

I dipped my fingers into my champagne glass and sprinkled some of the bubbles onto Fiona’s tiny wrinkled red forehead. She awoke and let out a piteous wail.

Amanda was taken aback by these developments.

And what if my christening gift turns out to be a curse? She did an imitation. On your sixteenth birthday, you will prick your finger . . .

We all laughed. No, give her a real blessing, James urged.

Well then, Amanda said, and cleared her throat. Became solemn, to all of our surprise. Serious she was frequently; solemn, never.

Fiona Sarah White McLennan. You will inherit the many strengths of both your mothers, she said. Both your birth mother—she raised her glass to me—and your godmother. Here she toasted herself, took a sip. And you will have the love and support of both of us no matter what happens. Nothing except death can or will separate us from you. Never forget that.

For good measure, Amanda threw another sprinkle of champagne on Fiona.

And now comes one of those moments. A shift in perception, a wave of dizziness, and an awareness. It comes to me. What Fiona was going through. Amanda already gone. Me slipping away. Every day a little death. Fiona at three days old being told she could never separate, that she would always remember. A curse indeed.

A red-haired woman sits opposite me. She knows me, she says. Her face is familiar. But no name. She tells me but it evaporates.

How are you? she asks.

Well, I don’t tell many people this, I say, but my memory is shot.

Really? That’s terrible.

Yes, it is, I say.

So I’m curious, the woman says. What do you remember about me?

I look at her. I feel I should know her. But there is something wrong.

I’m Magdalena, she says. I changed my hair color. Just felt like it. But it’s still me. She tugged at her hair. Now do you remember?

I try. I stare at her face. She has brown eyes. A young woman. Or youngish. Past child-bearing age, but not like me yet. A melancholy face. I shake my head.

Good, she says.

That surprises me. Pleasantly. Most people are distressed or get angry. Aggrieved.

I need an ear, the woman says. I want to say something, and then I want it to vanish. A kind of confession. But I don’t want it in anyone’s brain, even if they are sworn to secrecy. And I don’t want a traditional confession, to do penance for it, because I’ve already finished with that. No one has suffered more for this than I have. And I don’t even have to ask you not to tell it. That’s the beauty of it all.

I have no objections. It is a sleepy heavy day. The kids are at school. I don’t have any surgeries scheduled. I nod to continue.

She takes a deep breath. I sold drugs. To kids. I took my grandchildren to the playground at the middle school. I sold lots of stuff. Pot, of course. But also Ecstasy, speed, even acid.

She stops and looks at me. No shock, she says. That’s a good beginning.

She continues: Then, one day, one of my grandkids got into my stash. Swallowed some LSD. She was just three years old. Three! I didn’t know what to do. I couldn’t take her to the hospital. So I didn’t. I just sat with her in a dark room and held her hand while she screamed. Screamed and screamed. Hours of it.

The red-haired woman covers her eyes with her hands. I am patient. I will hear this out.

She was calmer when my daughter came to pick her up, but not enough. My daughter was already suspicious. She knew I had been a user. She knew I had friends, still. And so that was the end. She didn’t turn me in. It was close, but she didn’t. She said I needed to get help, get off the stuff, and if I did she wouldn’t report me. But she also wouldn’t speak to me again. So I did it. Went to rehab.

But despite that, lost my family anyway.

I don’t say anything. At the clinic, strung-out teenagers are a dime a dozen. And occasionally we get children. Mostly children who had gotten into their parents’ bottom drawers. Behind the socks or underwear. Occasionally one that had been given the stuff on purpose. I treated everyone, let the staff deal with the legal and moral issues, which didn’t concern me.

But why tell me this? I ask.

I’ve needed someone to pass this on to. Someone who wouldn’t be shocked and wouldn’t wince at the stink of me. You’ve got a practical and resilient kind of morality. You forgive trespasses.

No, I say. I wouldn’t call it forgiveness.

No? What is forgiveness but the ability to accept what someone has done and not hold it against them?

But to forgive, something has to touch you personally. This hasn’t touched me. That’s why I stopped believing in God. Who could worship someone that narcissistic, who takes everything anyone does as a personal affront?

You don’t really believe that. I know you don’t. She gestures toward the statue of Saint Rita. You have faith. I’ve seen it.

What is your name?

Magdalena. And do you remember what else I’ve told you?

I pretend to think, although I already know the answer. No, I say finally. I wait for the exclamations, the reminder, the subtext of blame. But it doesn’t come. Instead, relief. No, something more. Release.

Thank you, she says, and takes her leave.

A man is in my room. Hyperactive. Hopped up on something. Eyes dilated, jittery, moving around too fast. Fingering my things, picking them up, and putting them back down again. My comb. The photo of the man and woman and boy and girl. He grimaces at the latter and puts it down again.

He is wearing black trousers, a pressed white and blue shirt, a tie. He does not look completely comfortable.

We were apparently in the middle of a conversation, but I have lost the thread.

And so I told her, it’s time for a truce. No more squabbling. After all, we used to be so close. And she agreed. But with reservations, I could tell. Always so cautious. Always playing it safe.

What are you talking about? I ask. I see, with alarm, that he is tracing his finger around the edge of my Renoir, his fingers coming perilously close to the young woman’s red hat.

Oh, never mind. Just babbling. Trying to keep the conversation going. So. You do your part. You tell me something. He’s now opening and shutting the top drawer of my bureau, sliding it in and out, in and out.

Like what? His movements are making me dizzy. Now he is on the move again, flitting from one object to another, examining everything with great interest.

He seems especially fascinated by my paintings. He moves from the Renoir to the Calder, from the left side of the room to the right, and then to the center, where my Theotokos of the Three Hands glows from its place above the door frame.

There is some connection here, something that tickles about this man and this particular piece. History.

Tell me what you did today. He sits down briefly on the chair next to my bed, then quickly stands up again, continues pacing.

I can more easily tell you about what happened fifty years ago, I say. I struggle out of my bed, holding on to the rails for support. Wrapping my gown around me in some semblance of modesty, I sit myself in the chair he has vacated.

So tell me. Something I don’t know.

And who are you again?

Mark. Your son. Your favorite son.

My favorite?

That was just a joke. Not a lot of competition for that honor.

You do remind me of someone I know.

Glad to hear it.

A boy living in the graduate dorm at Northwestern. Dark like you. Restless like you.

The man stops. I have his attention. Tell me more about him, he says.

Not much to tell, really. A bit of a ladies’ man. More than a little of a pest. Always knocking on my door, trying to entice me to put down my books and come out to play.

Which I am sure you would not do. This was when you were in medical school?

No. Before that. When I still wanted to be a medieval historian. I smiled at my words, so implausible.

What changed your mind? The man has settled down, is leaning against the door frame, his fingers drumming against his chest.

My thesis. The conflict in the medieval medical community between applying traditional folkloric remedies and following the precepts found in Avicenna’s Canon of Medicine.

Whew. Glad I asked.

I had a double undergraduate degree in history and biology. My thesis was a way of combining both my passions. But I fell in love with the Canon. I spent more and more time at the medical school, interviewing professors and students, observing. The dissections especially captivated me. I wanted a scalpel so badly. One of the students noticed. He allowed me to shadow him, took me down into the lab after hours, showed me the procedures he was learning, put the knife in my hand, and guided my first incisions.

Dr. Tsien?

Yes. Carl.

Is that how you met? I never knew.

My first mentor.

I’ve always wanted to know, was there anything between you? Anything romantic, I mean?

No, never. He just recognized a fellow addict. He was the first person I told that I was quitting the PhD program to apply for medical school. My biggest supporter when I chose orthopedic surgery. The medical establishment was not exactly friendly to the idea of a woman in that role.

And what about that guy, that party animal in your dorm? The man is smiling wryly.

Oh. Yes. Him. Another unexpected detour. My life was full of surprises around then. By that I mean I surprised myself. So many about-faces. So many disruptions of well-laid plans.

You and Dad didn’t talk much about your early years. I got the impression that both of you spent them in a bit of a daze. Him in law school, you beginning medical school. And by all accounts completely besotted with each other. Dr. Tsien spoke about it sometimes, with a bit of envy, I always thought.

Yes. It was that.

You don’t seem inclined to talk about it. Neither was Dad.

I’d rather not.

Because . . . ?

Because some things shouldn’t be scrutinized too closely. Some mysteries are only rendered, not solved. We found each other. And never regretted it the way others do their own youthful couplings.

The young man is picking up his soft leather satchel, leaning over me, brushing my cheek with his lips.

Bye, Mom. I’ll see you next week. Probably Tuesday, if work allows.

Yes, definitely a familiar face, one resonating on numerous levels. Later, after dinner, I finally get a name to attach to the face. James! I say, startling the Vietnam vet so that he spills his water into his bread pudding.

It is somewhat later that I realize my icon is missing. I keep my own counsel, for now.

They are telling me something, pointing to their heads. Pointing to my head. Tugging at my hair. I push their hands away.

The hairdresser. The hairdresser is here. It is your turn.

What is a hairdresser, I say.

Just come on, you’ll look and feel so much better!

I allow myself to be pulled to my feet, guided step-by-step down the hall, passing stuffed armchairs positioned strategically in little groups, as if conversing with one another. Tables laden with fresh flowers. What kind of place is this.

We enter a large room with shiny tile floors. Along one wall, tall cupboards containing plastic bins filled with yarns, colored paper, markers. A long counter along the opposite wall with a sink in the middle. Tables and chairs have been pushed to one side, and a clear plastic tarp has been laid out on the floor, a single molded plastic chair on the middle of it. A woman dressed in white, standing by.

Would you like to wash your hair before your cut? she asks, then answers herself. Yes, I see that would be a good idea.

I am turned around, and propelled gently but firmly over to the sink, and bent over. My hair and neck are ignominiously scrubbed, rinsed, then scrubbed and rinsed again. Led back and pushed into the chair, where the woman tugs a comb through my hair.

And what shall we do today? Another woman’s voice breaks in. Short, I think. Very short. We’re having some problems with grooming.

The woman in white agrees cheerfully. Very well! Short it is!

I try to protest. I’ve always been complimented on my hair, its thickness, color. James calls me “Red” when he’s feeling especially affectionate.

No, I say, but no one responds. I feel the pressure and coldness of steel against my scalp, hear the clip clip clip of the shears. Shorn like a sheep.

Other people are gathering around, looking. She looks like a man, one woman says loudly and is shushed. I wonder about that. Man. Woman. Man. Woman. The words have no meaning. Which one am I really?

I look down at my body. It is thin and spare. Androgynous. Sunken chest, chicken legs, I can see the femoral condyles and patellas through the material of my slacks. My malleoli without socks translucent and delicate, ready to snap if I put too much weight on them.

You look beautiful, says the woman doing the cutting. Like Joan of Arc. She holds up a hand mirror. See. Much better.

I don’t recognize the face. Gaunt, with too-prominent cheekbones and eyes a little too large, too otherworldly. The pupils dilated. As if used to seeing strange visions. And then, a secret satisfied smile. As if welcoming them.

Something is worrying at my ankles. A small furry thing. Dog. This is Dog. What is that joke. About the dyslexic atheist insomniac. I have turned into that joke.

I have managed not to swallow my pills this morning, so I am alert. Alive. Before depositing them under my mattress, I examine them. Two hundred milligrams of Wellbutrin. One hundred fifty milligrams of Seroquel. Hydrochlorothiazide, a diuretic. And one I do not recognize, oblong and pale beige. I make a point of crushing that one between my fingers and letting the dust fall onto the rug.

I do three laps around the great room, deliberately ignoring the brown line. I step over it, around it, never on it. Step on a crack. Around and around. I count the doors. One. Two. Three. Four. Only twenty in total, and four are unoccupied.

On my third pass I pause at the heavy metal doors at the far end of the long hallway. I can feel hot air wafting in through the crack, see the relentless sunshine beating onto the cement walkway outside through the small, thick windows. I remember those Chicago summers, heavy, oppressive, and stultifying, keeping you a prisoner in your house and your office as much as the bitter winters did.

James and I talked about escaping when we retired. Fantasized about a Mediterranean climate. Moderate temperatures, somewhere near the sea. Northern California. San Francisco. Or farther down the coast, Santa Cruz, San Luis Obispo. Lotus land. Or perhaps even the Mediterranean itself. James and I spent a month on the island of Mallorca after Fiona left for college. To forestall the empty nest blues that never came.

After that, there was idle talk of an eighteenth-century finca with a large garden. Growing our own tomatoes, peppers, beans. Living off the land. Solar panels on the roof, our own well. Out of sight. Our own desert island. Who were we fooling? We were going off the grid in any case, each in our own way.

A hand touches my elbow.

Hey, young lady! A man’s voice. He has a pleasant enough smile, but his face is marred by an eggplant-colored hemangioma in his right upper quadrant. Inoperable.

I am finishing up my lunch when someone pulls out the chair next to mine, sits down heavily. A face I recognize, but I am in a stubborn frame of mind today. I will not ask. I will not. This woman seems to understand that.

Detective Luton, she says. Just here for a short visit.

I am not going to make it easy for her. So I take my napkin off my lap, fold it, and place it across my empty plate. Push my chair back to rise.

No, wait. I won’t be here very long. Just sit with me for a moment. A young man in scrubs approaches, offers her the coffeepot, and she nods. He puts a cup in front of her and pours. She raises it to her lips and gulps it, neat, as if it were water.

I was on my way somewhere. My annual pilgrimage. And suddenly found myself driving here. One of those urges. I used to have more of them. I used to be more spontaneous. Here she smiles. One of the hazards of growing older.

I nod. I don’t understand, but my impatience is ebbing. This is someone in pain. A state I can recognize.

So how are you doing today? the woman asks.

We seem to have taken a step backward, I say. From words that mattered to socially appropriate but meaningless questions.

Instead of appearing upset by my rudeness, the woman looks pleased.

In good form, I see. Glad to see that.

So why are you here? I ask.

As I said, I was on a pilgrimage. I guess you could say this is part of it.

In what way?

I was on my way to the cemetery.

Anyone I knew?

No, not at all. You and I aren’t connected in that way. Our relationship is a . . . professional one. She motions for more coffee. Well, mostly.

Are you my doctor?

No, no. A member of the police. An investigator.

She stares at her hands, pressed tightly against her coffee cup. Seconds tick by. I find I am now curious rather than annoyed or impatient. So I wait.

She finally speaks, slowly.

My life partner had Alzheimer’s. Early onset. She was a lot younger than you—only forty-five.

I am having trouble following her now. But I sense the emotion and nod.

People think it’s just forgetting your keys, she says. Or the words for things. But there are the personality changes. The mood swings. The hostility and even violence. Even from the gentlest person in the world. You lose the person you love. And you are left with the shell.

She stops and pauses. Do you know what I’m talking about?

I nod. My mother.

The woman nods back. And you are expected to go on loving them even when they are no longer there. You are supposed to be loyal. It’s not that other people expect it. It’s that you expect it of yourself. And you long for it to be over soon.

She reaches over and takes hold of my wrist, gently raises my arm into the air a little. It is a sorry spectacle, no muscle tone, as thin and desiccated as a chicken’s leg. We both gaze at it for a moment, then, just as gently, she lowers it down into my lap again.

It broke my heart, she says. And, somehow, you’re breaking it again. Another pause.

Then, as suddenly as she had arrived, she is gone.

A dark night. Figures emerging and diverging from shadows, moving just out of my range of vision. A very dark night and I need to get up, to move, but I am restrained, my arms and legs tied down tightly to the bed.

I retreat into myself. I use all my will to get myself away from here to somewhere else. A dial spins in my head and I hold my breath and wait for what might happen. The pleasures and risks of a time traveler.

And so I find myself walking in the door to my house, greeted by the shrieks of a young infant in pain. I know immediately when and where I am. I am a mother for the second time. I am forty-one, she is one month old. She has been crying for half her life. Every day from 3 pm until midnight. Colic. The unexplainable screaming of a young child. The Chinese call it one hundred days of crying, and I have eighty-five days left.

A particularly bad case, the pediatrician says. The noise assaults me every night after a long day of surgeries. When I come home, the nanny, Ana, hands me the child and literally runs from the room. James and Mark are already hiding behind closed doors.

I am marking my calendar, as I did before my first child was born. We’ve tried all the latest drugs and theories of modern medicine. I have cut out dairy and wheat from my diet, filled her bottle with catnip and ginger teas, dissolved Hyland’s colic tablets in milk pumped from my breasts. But nothing has worked, nothing eases her and our pain.

To save my family, every night I put the baby in the car seat and drive. I stop for gas, for a cup of coffee, and when I enter the convenience store or the café with my wailing bundle, all conversation ceases, and I am hustled to the front of the line.

Tonight is typical. I pack a thermos of coffee, put the baby in the car, and head out. I prefer the expressways, the long thin ribbons of concrete that stretch out in all directions except east, turning Chicago into a great spider.

I take the Fullerton ramp onto the Kennedy heading north, past Diversey, past Irving Park, past the Edens split and north to O’Hare. All the while the baby screeches, taking no noticeable breaths.

The noise. The noise. Sometimes we park at O’Hare and walk among the crowds there, moving in our own little bubble, everyone on their way to parts unknown, rushing a little faster now because of us.

But this night we continue north of O’Hare, proceed northwest through Arlington Heights and Rolling Meadows and farther until we hit country. The numbing ugly flatness of the Illinois landscape that I’ve never quite adjusted to.

The baby has not stopped her wailing. It is only 9:30 pm. Two and a half hours to go. All moisture has long ago been expelled from her tear ducts, and she’s now into the dry heaves, her little motor revved to high. It will not stop until the clock strikes midnight. When the world turns right side up again.

Then, up ahead, flashing lights, a crowd of people. An accident. It looks serious. I stop, put the baby into a pouch that I buckle around my neck and waist, and go to investigate.

People scatter as I approach, Fiona’s cry as painful as any siren. Above her and the expressway noise, I shout, I am a doctor! How can I help? A motorcyclist is down, a compound fracture of his leg, the bone protruding, his face as white as the bone, his eyes closed against the pain.

I stoop down, the weight of the baby making me sway a little off balance. Everyone moves away from us, even the paramedics retreat. I examine the young man, who by now is barely conscious. An open femoral shaft fracture, he will need antibiotics, an irrigation and debridement, and an intramedullary rod.

I probe his other limbs: arms and other leg, all is well, but he is growing paler. His breath is coming quicker, he is clearly distressed, he is going into shock, and so I turn to the paramedics and say, Get him to the nearest trauma center, but first administer ten milligrams of IV morphine sulfate to help control the pain.

All the while the baby continues to wail, and everyone is moving farther and farther away from us except the prone motorcyclist who manages to sort of gesture with his hands.

One of the EMS technicians seems to understand this and shouts something to me that I cannot catch because at that moment the baby emits a particularly loud burst of misery. The technician opens his mouth again, shuts it, cups his hands around his lips, and forces out words.

You’ve been very helpful, he begins. He takes one step toward me, hesitates, and then retreats two. But now could you do us all a favor? Absolutely! I shout back. What do you need? He hesitates a moment. We’re very appreciative! he yells, and takes a deep breath. But would you please please just leave?

I turn to go but cannot move and suddenly I am back in the softness of my bed, the straps hard around my legs and arms. A small warm body is still next to me, but it is silent and furry and odorous. Dog. The silence is welcome. But I wonder. How long do I have? How long before things come full circle and I descend to that state of inarticulate rage and suffering, the state Fiona started her life in? Not long. Not long now. I open my mouth and begin.

I like tactile things. A carved wooden candlestick, from a beautiful grain, I guess mahogany. A string of prayer beads with the Turkish evil eye hanging off as a pendant. A porcelain teacup patterned in royal blue curlicues.

And there is a scarf. A plain cream-colored woolen scarf. But long. Long enough to reach from the head of my bed to the foot. Perfect for wrapping around my head and lower face to protect against the Chicago winter.

I remember winters. Once we lost heat for a week and the water in the toilet bowl froze. We had to move out. James insisted on the Ambassador East. It was a frivolous choice, as the children were still young and the luxury was wasted on us. We all slept in one bed, the baby crawling among us, her breath tickling our cheeks. That golden time! James let Mark shave, smeared menthol shaving cream all over his six-year-old face, carefully pulled the razor across his fuzzy cheeks. I painted the baby’s toenails a bright magenta. We ate at the Pump Room every night, the kitchen made macaroni and cheese for the kids, and James and I ate lobster risotto and veal chops, and eggs Benedict in the mornings. The tangy half-cooked yolks, the creamy hollandaise, the asparagus that delicately scented our urine for days. Ana would show up as breakfast was ending so James and I could go to work. I’d put on layers of clothing and that woolen Irish scarf, and head off to the hospital.

All this evoked by a simple article of winter clothing. Something I won’t need again. For winter doesn’t exist here. No seasons at all. No heat. No cold. They’ve even banished darkness. They said, Let there be light, and there is, perpetually. A temperate climate for intemperate people.

There is a young man interested in me. A teacher crush. How we used to laugh when it happened, we women. For the men, it is no laughing matter, however. They are tempted. They fall. It is a serious thing. But for us, amusement only.

Yet this one. The way he watches me. And he is beautiful. Does that matter? Yes. He comes to my office after lectures on various pretexts. Once he pretended not to understand the basics of tendon transfer surgery. Another time he asked me about skin grafting, that most basic procedure.

Once he posed a riddle and I answered it, not realizing he was joking. What do you say when someone tells you, Doctor, it hurts when I do this? I absentmindedly replied,Tell them not to do it. He laughed and I looked at him for the first time.

It makes you feel young. It makes you feel old. You feel powerful. You are vulnerable.

It was none of those things. I felt no guilt. I felt no shame. And not because of James’s own behavior. I simply wanted to take it as far as it could go, to run it into the ground. This was a new experience.

For the most part you leave doors open. Bridges unburned. You don’t accept hopeless cases. You make sure to have an exit strategy. There was none in this case.

Hello, old friend.

A balding man, Asian American, with a strong Bronx accent, is standing by my chair. He is smiling familiarly at me. That is, he is smiling as if he expects to be familiar to me. He is not.

Do I know you?

I say this coldly. No more pretense. No more smiles for strangers.

Carl. Carl Tsien. We were colleagues. At Quicken St. Matthews Medical Center. I was Internal Medicine, you were Orthopedics.

That sounds plausible, I say.

Ah, you’re being cautious. Not committing yourself. He smiles as if he has just said something witty.

So, you say we were colleagues? I ask.

Yes.

Why were?

I am testing him, not just for knowledge but for truthfulness. Trustworthiness. He hesitates for a moment, then speaks.

You retired.

A nice euphemism.

Yes. To his credit, he looks a little chagrined. Well, that’s what you called it at the time. So you’re aware of your disease?

On good days like this, yes, I am completely aware of how far I’ve sunk.

Is my face at all familiar?

No. And I can’t tell you how boring it is to get asked that all the time.

Then you won’t hear it from me again, old friend.

Glad to hear that, stranger. So, why are you here?

He again looks uncomfortable. Shifts a little in his chair.

As an . . . emissary. From Mark. And as I look enquiringly at him, Your son, he says.

I have no son.

I know you’re angry with him. But let me make a case on his behalf.

You don’t understand. I have no recollection of any son. And I’m not inclined to play along. I used to, you know. Nod and pretend. No more.

He is silent.

Well, let’s talk hypothetically. Say you did have a son. And say that he had gotten himself into a bad situation. Made some mistakes. And imposed on you—or tried to.

Imposed in what way?

Borrowed money, repeatedly. Asked for more. Hassled your friends, as well. Even stolen, for example, your icon. He got a substantial sum for that.

I’d say, To hell with him.

Yes, but suppose he’s cleaned up his act. And wants to reconcile.

I’d want to know why.

Well, you’re his mother. Isn’t that enough?

Since I don’t know him, I don’t know why it would matter one way or another to him.

It’s just the idea of it. And the fact that he can’t get through to you. Either you’re furious at him, or you don’t remember him. Either way, he’s lost his mother.

How old is he?

Maybe twenty-nine, thirty.

In other words, old enough to survive without a mother.

That’s the person who doesn’t know she has a son talking.

In other words, a rational person. I’ve noticed that people with children do irrational things. Anything to protect their young.

As you have.

How is that?

It means that you yourself have protected your young on occasion. Even beyond what a rational person would do.

And how would you know that?

Jennifer, we’ve known each other for nearly forty years. Longer than most marriages survive. There’s little I don’t know about you. What you’ve done. Or what you’re capable of doing.

Sounds tedious. Like most marriages. Once you know everything there is to know about someone, it’s usually time to move on.

Well, there is affection.

Perhaps.

And that irrational thing that’s even stronger. Love. People do strange things in the name of love.

What exactly are we talking about here? We seem to have strayed from the subject.

Back to the subject, then. Will you forgive Mark, your hypothetical son? Under the circumstances I just described?

I give it some thought, try to conjure up an emotion beyond bemusement at being asked to forgive and forget when I’ve already forgotten.

No, I say, finally. You can ask me again when I know who we’re talking about.

But that may not happen. As you yourself said, today is a good day.

No, it may not happen.

At the very least, can you not do anything that will harm him in any way?

That implies I have power over him.

You do. More than you know at this moment.

As I’m unlikely to remember this conversation either, what’s the point?

Sometimes things stick. Promise?

Hypothetically I promise not to harm this person I don’t remember. Do no harm. If you’re really a doctor, you took that oath, too. So this is an easy promise to make.

A vision. My young mother, sporting a Peter Pan–like haircut. She who always wore her dark hair long, pulled back in a ponytail during the day, loose and flowing and beautiful at night, even throughout her long decline.

She has her hands cupped around something precious. She is not wearing her wedding ring. Perhaps she is not even old enough to be married yet, although she met and married my father when she was eighteen. He was twenty-seven, and both sets of parents complained but were powerless to stop them.

But this image is so much more vivid than anything in my present life. The colors vibrant, my mother’s rich chestnut hair, her milky clear complexion, the white softness of the skin on her arms, shoulders. I feel so calm looking at her. Hopeful. As if she held my future in her girlish hands and that the smile on her face was an assurance that my story would have a happy ending after all.

Never felt guilt. Never felt shame. Until I was brought to this place. Trussed like a chicken. Denied the right to move my bowels in private. Purgatory I heard one of the other residents call it. But no. That implies that heaven is within reach once you have paid for your sins. I suspect this is a station on the one-way road to hell.

I was fifteen, spotted with acne and smitten with Randy Busch. I was a young mother with an ever-present child at my side—Mark clung tenaciously to me until he was ten—and then I was an older pregnant woman being tested to ensure I wasn’t carrying a mutant. I was a reluctant host, during that pregnancy. I pushed Fiona out and went to sleep. I had to be nudged to take her to my breast. I simply endured those first six months, the colic, the sleepless nights, those months so critical to bonding.

I went back to surgeries within two weeks. A cold vessel indeed. But somehow attachment grew. Fiona hated our nanny, Ana, so beloved by Mark, by us all. It was only me she cried for, when I left and when I returned. And so reluctantly I took her on.

Someone came in this morning and brought photographs. Lovely full-color photographs. I sit in the great room and study them.

One woman sidles over, then screams. Others come over. Others recoil. My lovely lovely pictures. One shows the excising of a tumor in the olecranon fossa. Another, a hand reattachment. I feel the twinge of muscle memory. Contrary to what people might think, the knife is not cold, the blood on latex gloves is not warm. The gloves separate you from the heat of the human body.

From the moment I opened up the arm of a cadaver and saw the tendons, the nerves, the ligaments, and the carpal bones of the wrist, I was in love. Not for me the heart, the lungs, or the esophagus—let others play in those sandboxes. I want the hands, the fingers, the parts that connect us to the things of this world.

The straps are too tight around my legs. I can move my arms an inch perhaps. My head from side to side. There is an IV in my arm. A bitter metallic taste in my mouth.

Someone is sitting at my bedside. It is dark. Through the blinds a dull gleam illuminates the lower part of her face. She has the mouth of a ghoul, thin-lipped and grotesquely long. If she opened it she could swallow the world. What is this. She is taking my hand. No. She is raising it. No. Help me. She will bite into a vein, she will suck out what remains of my life.

Stop. Please stop. They will come if you don’t stop, the ghoul says.

She is placing something in my hand, closing my fingers around it.

What is this. A holy relic. Did they give this to you. Why am I being so honored.

It is a plastic bag containing a small metal disk, engraved. I can feel the protrusions. On a long chain. The bag is cold against my palm. I shake my head. I continue shaking it. The movement feels good.

Do you know your name?

I strain against what binds me. I do not answer.

Dr. White. Jennifer. Do you know where you are?

I do, but it is in pictures. No words. I am on a porch, sitting on the top step. A brisk morning in late October. The trees are golden. There is a line of pumpkins on the porch gazing at the world with horrified expressions. A daddy pumpkin, a mommy pumpkin, and a baby pumpkin. All agape at some terrible vision. That was my idea.

I am sixteen. There is a young man coming. I am ready. My dress is short, cut square, boldly colored with blue and red geometric shapes. My boots reach just below my knees. The step is rough against my bare thighs. These boots are made for walking. Any moment now, he will be here. I am quivering with excitement.

Dr. White?

The young man will come. I am beloved.

Dr. White, this is important. That medallion. It tested positive for type AB blood. Amanda O’Toole’s blood type.

We will be charging you with first-degree murder. You will go through a mental competency examination, plead not guilty for reason of insanity, and that will be it. But I’m not happy. Because I don’t understand. And I like understanding.

Amanda.

That’s right, Amanda. Why did she die?

Amanda, she knew.

Knew what?

She never dyed her hair. Never wore a scrap of makeup. But vain, regardless.

Vain about what?

A seducer. Not for sex. Secrets. She knew everything. I never figured out how. A dangerous woman.

Yes, I can see that. I can indeed. Would you like some water? Here let me pour you some—and here is a straw so you can drink. That’s right. Don’t strain, I’ll hold it.

I am . . .

Yes?

Frightened.

Yes.

What will happen next?

You will be examined. Declared mentally incompetent to stand trial. The judge will dismiss the case on the condition that you are committed to a state facility. Where you will likely end your days.

What are the alternatives?

Her face is becoming clearer. Not a ghoul at all. A plain, doglike face. A face you can count on.

Untie me?

I believe I will. I believe you are calm enough. Here—and I feel the pressure around my arms, then legs, slacken. I pull myself up to a sitting position in the bed, drink some more water. Feel the blood start flowing back into me.

Yes. My illness is getting worse.

And it will get worse still.

The woman is silent for a moment. Then, I want to know why Amanda died, she says.

I believe I could. Kill. There is that in me.

Yes. There is that in many people. I have a recurring dream that I have killed my sister. I am overcome by shame. And afraid. Not of the punishment. Of having people know what I really am. I think that’s why I became a cop. As if the trappings of good would keep me safe from that nightmare.

I pause and try to clear the thickness from my throat. It is hard to talk.

The knife in my hand always felt right. The first incision, to get inside the body, that playground beneath the flesh. But those guidelines. To know what is acceptable. Stay within parameters.

The woman stands up, stretches, sits down again.

Jennifer. I want you to help me.

How?

You know something. I want you to try. She takes the plastic bag away from me, holds it up. Do you recognize this? A Saint Christopher’s medal. With your initials engraved on the back. Can you think of any reason Amanda’s blood would be on that medal?

No.

Did you wear the medal?

Sometimes. As a reminder. A talisman.

And do you have any ideas about who killed Amanda?

I have ideas.

The woman leaned forward.

Are you protecting anyone? Jennifer, look at me.

No. No. It’s better this way.

The woman opens her mouth to talk, then looks hard at my face. What she sees there convinces her of something. She lays her hand on mine before she leaves.

I am sitting in the great room. Although there are clusters of other residents in the vicinity, I am alone. I want to be left alone. I have much to think about. Much to plan.

The door to the outside world buzzes, and a woman enters. Tall, brown hair cut smartly to her jawbone, carrying a suitcase made of buttery leather. She comes straight over to me, holds out her hand to be shaken. Jennifer, she says.

Do I know you? I ask.

I’m your attorney, she says.

Is this about our wills? I ask. James and I just redid them. They’re in the safe-deposit box.

No, she says. This is not about your will. Can we move over here? Good. Let me help you. Much better.

Dog trots over, settles himself at my feet.

How cute. Look how he loves you. She makes herself comfortable in her seat, sets her briefcase on her lap, and opens it up. This is not a happy visit, I’m afraid. It’s about your being a so-called person of interest to the police in an investigation. I have some bad news. The DA’s office has decided to charge you. In one sense, this is just a formality. You will be examined, be found mentally incompetent.

None of this makes sense, but her face is serious, so I make mine serious too.

The bad news is you won’t be able to stay here after that. You’ll be committed to a state hospital. I’m trying to get you into Eglin Mental Health Center here in the city. But the DA is pushing for the Retesch facility downstate, which is substantially more restrictive.

She stops, looks at me. I don’t believe much of this is getting in.

She sighs, then continues: I’d hoped you’d be in good enough shape today. To understand. Legally, your son has power of attorney. But I prefer to get my clients to sign, as well. Here. Here’s a pen.

She puts something in my hand, guides it to a piece of paper, and touches its surface.

You’re petitioning for acquittal for reasons of mental incompetence. The DA is not going to fight it. As I said, the only point of contention is where you’ll be sent. I’m sorry.

Her face is mobile, expressive. Makeup expertly applied. I always wondered how to do that. I never bother myself—it rubs off, streaks my surgical mask, my glasses during surgery.

The woman is now telling me something else that I can’t follow. She sighs, pats Dog absentmindedly. I’m sorry, she says again.

She gives the appearance of waiting, perhaps for a response from me. That she considers her words bad news there is no doubt. But I have no intention of letting them touch me.

We sit like that for several minutes. Then she slowly puts papers back in her briefcase and snaps it shut. It’s been a pleasure working for you, she says, and then she is gone. I try to remember what I have been told. I am a person of interest. Of course I am. I am.

I am cunning. I get rid of Dog. I do this by kicking him in front of one of the aides. Then I pick him up and make as if to throw him against the wall. Shouts ensue. Dog is taken from me, forcibly. Taken off the ward at night, forbidden to come into my room. I miss him. But he would ruin my plans.

Mom?

I turn to see my handsome son, aged considerably but still recognizable. Someone visited this morning, a stranger to me, left abruptly when I didn’t recognize her. When I wouldn’t play along. A brash, unreasonable woman.

How were your exams? I ask.

My what? O, yes, they were good. They went well.

I’m not your professor. You don’t have to be afraid I’ll flunk you.

I’m a little . . . nervous . . . when I visit. I never know how you’ll greet me.

You’re my son.

Mark.

Yes.

Do you remember my last visit?

You’ve never come to see me here. No one has.

Mom, that’s not true. Fiona comes several times a week. I come at least once. But last time you told me you never wanted to see me again.

I would never say that. Never. No matter what you’d done. What have you done?

Never mind that now. I’m glad it’s forgotten. You weren’t exactly . . . sympathetic. But all is well now.

Tell me.

No. Let’s move on. Glad to see you’re in good form today. I wanted to ask if you remembered something.

Remember what?

Something that happened when I was around seventeen. Certainly older than sixteen, because I was driving. I’d borrowed your car to take my girlfriend out to the movies. Remember Deborah? You never liked her. You never really liked any of the girls I dated, but Deborah, my girlfriend throughout high school, you really hated. Anyway, you had a bunch of boxes filled with stuff. Deborah began rooting around in them. Just curious, or maybe it was a malicious kind of curious, because when she found it she was positively gleeful. A plastic flowered pouch filled with what Deborah said was very expensive makeup.

Makeup? Among my things? Seems unlikely, I say.

Well, I don’t know the names of all of it, but I did recognize mascara, lipstick, a powder compact.Various brushes. Deborah said it was all well used. She showed me a tube of magenta lipstick, half worn down. I nearly swerved off the road. I’d never seen you wear any makeup. Not a scrap. And yet here was this tube of magenta lipstick.

Magenta is for people with no taste. I would have been, what, fifty at that time? This is sounding increasingly implausible, I say.

Yes, I thought so. It totally disconcerted me. Like finding Dad prancing around in one of your dresses. I realized you had secrets. That there was this side of you that none of us knew about. Where you wore mascara and magenta lipstick and needed to please in that way—a desire we’d never have attributed to you.

Oh. Yes.

Now you’re remembering.

Yes, I say, and am silent. There was only one time I tried to please in that particular way.

Well?

How old were you?

Like I said, probably seventeen.

Yes. That was around the time I shifted offices—they built the new facilities on Racine and I cleaned out my filing cabinets, my desk, threw everything in boxes and into my car. Probably all sorts of odd things in there from previous lives.

Is that all you’re going to say?

Yes, I think so. Just history. Prehistory, as far as you are concerned. Nothing to be said about that. Now I’ve come up with something. My turn. I’m also going back to around that time. When you were seventeen. Same girlfriend. Deborah. The peddler’s daughter.

Yes, that was your charming name for her. Because her father owned a gourmet cookware distributorship. And I know exactly what you are going to say.

No, I don’t think so.

You caught us. In flagrante delicto.

Well, it would have been hard not to! Right in the middle of the living room, clothes everywhere, the noise! But that wasn’t what was important. What interested me was that when you heard my footsteps, you turned around, almost as if expecting me. You had a look of intense satisfaction on your face that quickly changed to disappointment, before the more expected embarrassment.

Your point being?

You’d hoped for a different witness. My guess is your father.

Now why would I want that?

I don’t know. Something happened between you around that time. Something after you’d interned for him when you turned sixteen, just before your senior year. You were so close until then. Then, trouble. You came home from work together one night that summer not speaking. And it lasted for years.

I’d rather not talk about it.

Even now?

Even now.

If it had something to do with a woman, you don’t have to worry about telling me. I knew it all. It didn’t change anything between your father and me.

Well, maybe you weren’t the only one affected.

What’s that supposed to mean? Who could it matter to but me?

There were two other members of our family. Two other people who were betrayed.

No, honestly. Why would it matter to you? He was still your father. There was no betrayal there.

No, not there.

Stop being so mysterious.

Oh, come on, Mom. Even you had to admit that the peddler’s daughter was pretty hot. Did you think Dad wouldn’t notice? And once he noticed, what he would try to do?

So he made a pass at your girlfriend. He made passes at everyone.

Forget it.

Or is the problem that he succeeded?

I said, forget it. I should have known better than to try to have a conversation with you. I’m actually sorry you won’t remember this one. Because I want it to stick.

How angry you are. You seemed to come here in a conciliatory frame of mind. And now you’re burning bridges?

They’ll be rebuilt. And reburned. The never-ending cycle.

Just be careful.

Why? Because you might just remember this time?

Yes. At some level, I believe you do remember these things.

He gets up and dusts something off his pants. His face changes, grows crafty. His voice is now quieter and more measured.

I think you do remember. Fiona does, too. Like what happened to Amanda.

I don’t answer.

You do know, right now, don’t you? That she is dead?

I nod.

He lowers his voice, comes even closer. Almost touching.

And do you know more than that? What do you remember?

Get out, I say.

Tell me, he says. He is so close I can feel the warmth of his body.

I said, get out.

No. Not until you tell me.

I reach for the red button above my bed. He sees what I am fumbling for and his hand shoots out, grabs my wrist.

No, he says. You’re going to deal with this.

I struggle to free myself, but his grip is strong. I give a sudden twist to my hand, free it, and slam the button. He gives a little shout of anger and grabs my wrist again, holds it against his hip. It hurts.

You know you’re guilty, right? You know there’s no way out. A confession won’t do any good at this point. It won’t do anyone any good.

We hear running outside the room. He releases my wrist, stands back.

Out, I say.

Good-bye then, he says. And he’s gone.

My door is closed, but I am not alone. Although it is dim, I can see a shape flitting around the room. Dancing, even. As my eyes grow accustomed to the light, I can see that it’s a young girl, thin, with spiky auburn hair, bending and shimmying, barely avoiding the furniture. Her arms are raised above her head, and her fingers are wiggling. She is clearly in high spirits. Manic, I would even say. But not a healthy state. Someone agitated beyond her ability to control it.

Hello? I ask.

She stops twirling and is suddenly at my bedside. She takes one of my hands but remains standing despite the chair next to her.

Mom! Oh Mom, you’re awake! She stops and looks at my face. Mom, it’s Fiona. Your . . . oh, never mind. I stopped by to say hi. Her words come out staccato—even now she can barely control her limbs, she is in such a state, waving and gesturing as she speaks. I’m sorry I haven’t been here this week—it’s been midterms. But now I have some time off. And I’m going to take a little break. Only a week, then classes start again. But I’m flying out this afternoon. Five days in paradise! Don’t worry, I’ll be in touch. I know you don’t talk on the phone anymore, but I’ll check in with Laura twice a day. And Dr. Tsien has agreed to keep an eye on you while I’m gone.

She is trying to keep a somber face as she tells me this, but the edges of her lips keep tugging up. Still, I would diagnose her state as one of fevered, rather than healthy, excitement.

I believe I should call in a consult, I say. I’m concerned. But your condition is not in my area of expertise.

The young woman gives off a little shriek of laughter. Borderline hysterical.

Oh, Mom, she says. Always the clinician.

Then she takes a breath, runs her hands down the sides of her body, smoothes out her dress. She sits down next to me.

I’m sorry, she says. It’s a combination of excitement and relief. Some time off to enjoy the fruits of my labors, which as you know I very rarely take. But it hit me yesterday:Why not? And so I booked a trip to the Bahamas. You and Dad took us to New Providence a couple of times, remember? I’m not going back there. I’ve been doing a little too much revisiting of the past. And the future is so grim. You. Mark on the verge of going under. I don’t want to think about these things. So it’s five days of now. Which is something you should understand.

I’m having trouble holding on to her words. Her face is slipping away.

Yes, just go back to sleep. It’s late. I didn’t mean to wake you, just wanted to say good-bye. And it’s only a few days. I’ll be back next Wednesday and will come by Thursday. They have my contact info here.

She gets up to go, still electric with energy.

Bye, Mom. I’ll see you again before you even realize I’m gone. She gives a little snort of laughter as she says it, and then the door bangs and my room is empty.

I need to get to the hospital. I was paged. Where are my clothes. My shoes. I just have time to splash some water on my face, I’ll grab a cup of coffee at the Tip Top diner on Fullerton. Now. My purse and car keys.

Jennifer? Why are you up? It’s three o’clock in the morning. My goodness, you’re dressed oddly. Where are you going?

No time to chat. There’s a trauma coming in.

A young woman, in light green scrubs speaks soothingly. No need to hurry. We’ve got everything under control. The emergency has been taken care of. I’m not convinced. Her name tag reads simply erica. No letters after it, no credentials. A bit slovenly, rubbing sleep from her eyes. Asleep on the job? It hardly seems possible. Still some of the urgency is dissipating. I am beginning to wonder why I am standing here, with a red skirt over my nightgown and a wool scarf around my head and neck.

I heard a noise, I say.

Did you? The only thing I heard was you thumping around.

No, it was outside. A car door slamming.

There isn’t any downstairs here, sweetie. Just the one level.

Dr. White.

Excuse me?

It’s Dr. White.

I’m sorry. I don’t mean anything by it. You’re really a sweet lady, that’s why!

It was Mark, I think. He keeps coming by. Asking for money. I don’t know why he’d come over now, in the middle of the night. Only to leave again without saying anything. I tried to wake up James, but he sleeps so soundly. When I went to the window, all I saw was a figure heading down the street, walking quickly.

Dr. White, you were having a dream.

No. I heard the door slam. The footsteps. The figure.

I know. Now time to go back to sleep.

I can’t. I’m up now.

Dr. White, there’s nowhere to go.

I need to walk. If I can’t walk, I will scream. You will regret it.

Okay, okay. No need for that. Just behave yourself. Don’t get me in trouble.

No, I just need to walk. See? Just walk.

And I begin to make my nightly rounds, to walk until my ankles can’t support me any longer.

I sit in the great room, tears streaming down my face. Dog is trying to lick them off, but I push him away. This is what I remember: my son Mark on the table, his chest open. Flatlining. Everyone has left the OR, the lights have been turned off. I can barely see, but I know it’s him. A coronary artery bypass grafting gone awry, a simple procedure, but one I am not qualified to perform. This was not a dream. I have not been asleep. That I have done something terribly, terribly wrong is beyond a doubt. The gallery is full of people, no one I recognize. All sitting in judgment. All in possession of knowledge beyond my reach.

My pills sit untouched on the bedside table. I will not take them. Not today. I want to see clearly. I have a plan. I awoke with it fully formed in my mind. It grows stronger as the day progresses.

At breakfast we are reminded that the Girl Scouts are coming today and we will stuff cambric squares with lavender to make sachets. Your clothes will smell so nice! the gray-haired woman says encouragingly. I am remembering today. I recall Girl Scouts, their fresh faces and forced smiles. How they enunciate. They are at the cruelest age. They do not call Fiona. They do not invite her to their parties. They do not know how much I hate them for this. How I want revenge.

A little later, the painters arrive. Not just a touch-up. All the walls in the great room are being redone, painted the inevitable green. The door opens and closes as they bring in equipment, buckets of paint, tarps. They set up a barrier of tape, wet paint signs hanging from it.

This does not prevent incidents. A new arrival to the floor plunges his cupped hands into a bucket of paint, begins drinking it like water. Attendants run toward him, emitting cries of dismay. There are calls for the doctor, and the man is grabbed by the arms and hustled toward the front desk. I see my chance.

I go to my room. I put on my most comfortable shoes. Is it summer or winter? Hot or cold? I don’t know, so I struggle into an extra shirt just in case. If it is winter it will be hard, but I will make it. I will go home. My mother and father are worried. They always worry.

I wasn’t allowed to have a driver’s license. I had to learn secretly during college. Even though I was still living at home, my boyfriend taught me in the parking lot of St. Pat’s, and took me to the testing facility. When my mother went through my purse looking for contraceptives, she found the license. A greater betrayal, in their eyes, a worse sin against them, such an unexpected rebellion. Honor thy father and mother. I did, I do. I must get back to them. I hurry back to the scene, where the painters are all standing around in confusion. None of them speaks English. They are waiting for something, someone. I edge toward the door, hidden among the workers. There is a banging on the door. An attendant runs over, punches the code, and the door swings open wide, admitting a man dressed in white like the others, except clean, not spattered with paint.

I catch the door with my foot just before it closes. I take one look back. The man in the clean clothes is talking to a tall gray-haired woman, gesturing with his hands. Old people are crowding around them, attendants trying to entice them away. I open the door wider, feel the rush of hot air. I won’t have to worry about frostbite, at least. One more step, and I am through. I let the door fall behind with a click.

THREE

The sun is blinding. How long since you were so bombarded with un-filtered light? Overpowering heat, the air thick and foul-smelling from the fumes of softened asphalt under your feet. It gives as you step, makes a dark, sucking sound with each move. Like walking on a tarry moon.

You tread carefully over the sticky black surface. Sweat trickles down your neck, your bra is already soaked. You pause to take off your sweater but then are confronted with the problem of what to do with it. You hang it carefully on the antenna of a small blue car parked nearby and keep walking. There is some urgency to move, some sense that there are conspiracies afoot, that lightning will strike multiple times if you stand in one spot.

You are in a lot filled with cars of all makes, models, and colors. Which one is yours. Have you been here before. Where is James, he has the keys. And your purse? You must have left it at the hospital. Your phone. It should be embedded in your flesh so critical is it to your ability to function.

Fiona once threw your pager down the toilet and flushed. Mark, not nearly as competent, merely buried it in the back garden, and you heard it chirp at dinner. You didn’t punish either of them, understood that they were merely playing out their Darwinian destinies. Who will inherent the earth? Not any scion of your flesh.

You are nearly at the street. Placards everywhere, violators will be towed. A gate, a gatekeeper adjusting a waist-high sign, lot full. He nods to you.

The sidewalks are crowded with people, mostly the young, dressed in as little as possible. Girls in short summer dresses with spaghetti straps holding insubstantial fabrics against small breasts. Young men in oversize shorts that reach below the knee, falling from their slight hips. Sidewalk cafés, umbrellaed tables encroaching upon the sidewalks, forcing people out into the street. Cars honking. Planters that trail flowers too bright and perfect to be real. Yet you see a woman pick off a blossom and put it in her hair. Waiters hefting trays over their heads. Colorful red and pink and blue cocktails in large v-shaped glasses. People sipping from small white cups. Enormous salads.

Everything as it should be. Everything in its place. Where is your place. Where do you belong.

You realize that you are impeding the flow of traffic. People are politely navigating around you, but you are inconveniencing them. One man bumps your elbow as he passes and stops briefly to apologize. You nod and say, not at all, and begin moving again.

Summer in the city. How exciting when your mother and father allowed you to begin coming here by yourself, away from the row houses of Germantown, the concrete schoolyards and industrial storefronts, the glazier shops and printing presses. Away from the grime-colored house with the trains running through the backyard. Your mother and her gypsy charm. Black Irish, full of magic.

In your teens you turned yourself to stone to withstand her. You vowed to never rely on trickery to bind others to you. Not a difficult vow to keep, as you had no such tricks at your disposal. Your charm nonexistent. Your beauty minimal.

Whatever power you had to attract was of a colder variety. Touching nerve-terminals / to thermal icicles. Who told you that? No matter. As it turned out there were some who appreciated it. Enough of them, yes.

You have been walking for miles. Hours and hours. South, judging from the sun, which is setting to your right. This endless street of endless festivities. You cannot see beyond it, an eternal pleasure fair. And nowhere to sit.

You realize you are hungry. It is long past dinnertime, your mother will be worried. You are suddenly tired of the gaiety, and you would settle for the quiet kitchen, the dried-out pot roast and soft brown potatoes, the boiled carrots. You realize you are beyond hunger, indeed famished. But why are you hesitating? You are surrounded by bounty!

With some trepidation you approach the nearest restaurant. Italian, its name unpronounceable, written in fancy neon script over a flowery bower. Outside, perhaps a dozen tables covered with white tablecloths, full of diners.

The din is tremendous. You can’t see inside the restaurant, it is dark and the entrance is overflowing with people laughing and talking, at least a dozen men and women holding glasses filled with red and white wine lounging against the railings of the outdoor seating area, toasting one another. You try to get closer to see inside.

Just one, ma’am? This is a man in jeans and a white shirt. Is he talking to you? You look around, but no one else is there.

My husband is parking the car, you say. This must be true. You do not eat alone in restaurants.

The wait is at least fifty minutes. Would you like me to put you on the list? Unless you’d like a seat at the bar.

He seems to be waiting for an answer, so you nod. It seems expedient. He beckons and you follow him through the path he clears in the crowd. He leads you to a high stool, places a menu in front of you, and a menu in front of the empty bar stool to your right.

I’ll show your husband here when he arrives, he says. You nod yet again. Gestures seem to take you a long way. You are relieved, as words seem evasive, unreliable. It seems like months since you have had congress with anyone. You have been a wraith weaving through the streets of revelers, unseen and unheard.

You open the menu, but cannot make sense of it. Penne all’Arrabbiata, Linguine alle Vongole, Farfalle con Salmone. But the words are evocative, make your mouth water. How long has it been since you’ve eaten? Days and days.

People sit elbow to elbow, some with plates of food in front of them, others with glasses of different shapes and sizes filled with colorful liquids. Some are watching a television mounted on the wall, surrounded by shelves and shelves of bottles that reach to the ceiling.

On the screen, beautiful girls in evening gowns are pointing to appliances—refrigerators, microwave ovens. It is a pretty, even spellbinding sight: the girls in their bright dresses flashing across the screen, the light flickering over the bottles.

The noise is high but not unpleasant. You feel as though you are in the belly of a live organism. The camaraderie of productive bacteria, the kind that sustain life.

The bartender approaches. He is a heavyset man with thick black glasses. Young, but he will need to monitor his cardiovascular health, his ruddy complexion is not due to sun or overexercise. A stained white apron tied around his ample waist.

And how-a can-a I-a help-a you, my-a beauteous one-a? he asks in a mock accent that you assume is meant to be Italian. You point to one of the menu items, the one with the shortest name.

Ah, the Pasta Pomidoro. A specialty of the house-a! And to drink? You are thirsty but cannot think of the right word. Something in a liquid state. You point to the bottle he is carrying. You test out your voice.

That, you say, and are grateful that it comes out only slightly rusty.

Jack Daniel’s? He drops his accent and gives a spontaneous-sounding laugh. This day has been full of surprises! Straight? You nod. He laughs again. Very well, a straight whiskey it is. I don’t suppose you want to follow that up with a beer chaser?

You try to judge from his expression what the right answer is. You nod again. What’ll it be? he asks. We got Coors, Miller Lite, Sierra Nevada on tap.

Yes, you say. Something changes in his face. He gives you a look that worries you. Watchful. You have seen that look before. You never could fool anyone. You always got caught. That is what keeps you on the straight and narrow. Not a conscience. No. But the knowledge that you are no good at cheating, that no bad deed goes unpunished.

He shrugs and turns away, busies himself at some machinery with complicated handles, and then places a tall frosted glass filled with something frothy and yellow in front of you. What is this. Where am I. You suddenly have a revelation. You are Jennifer White. You live at 544 Walnut

Lane, in Germantown, in Philadelphia, with your beloved mother and father. You are eighteen years old and have just started classes at the University of Pennsylvania. A biology major. Your life stretches out in front of you, a clear path, no encumbrances to speak of. There is a cold beer in front of you. Your first in a restaurant! You have never ordered a beer on your own before. You have every reason to be lighthearted. Suddenly you are.

You notice another glass at your elbow. This one is smaller, not cold. Filled with a rich amber-colored liquid. You pick it up and swallow. It burns going down, but it is not distasteful. You drink again, and it is gone.

Another? asks the man. You are startled. You did not realize he was still there, still watching. You nod. You test out your voice again.

Certainly, you say.

He gives a short laugh and again you catch that look. He places another small glass on the counter, pours, pushes it in your direction. You leave it there, turn your attention to the tall cold glass, and take a sip. This goes down easier. Beer, yes.

Your father always pours a small amount into a teacup for you whenever he opens one for himself. This one quenches your thirst in a way the other one didn’t. You drink deeply. You are starting to feel good—you hadn’t noticed how on edge you had been. That edge is dissipating. Slow, pleasurable warmth. A heaviness of limbs. Colors are brighter, the noise subdued. You have traveled into a private space within the organism, a private pocket of comfort. You love it here. You will come back every night. You will bring your mother and father and let them work their considerable magic on these delightful people, your comrades.

The bartender puts a napkin and some silverware in front of you. You pick up the knife. There is something about this. Something that is familiar yet strange. You have a sense of anticipation. You press the sharp edge of the knife against the wooden counter, press and pull it toward you. A white line appears in the wood, straight and true.

If you could press harder, split open this dark matter, what would come out? What would be revealed? O the excitement of exploration! You pick up your beer again and drink some more. Good. You had not realized how tight your shoulders were, the tension in your neck.

Waiting for someone?

The voice is from a girl to your left. She is about your age, you estimate. Perhaps a little older. Twenty. Twenty-two perhaps. Very pretty. Her hair cut so that it hangs longer on one side of her face than the other, and fringed unevenly at the edges. It is not unattractive. She has a nice smile. Her eyes are ringed with blue, mascaraed to bring out their size and brilliance.

Am I? You consider this. You want to answer, but you do not yet trust that the words will match your intent. You try.

No, you say. I’m alone.

You are heartened that she is not disconcerted. You try again. I was hungry, you say. This looked nice.

Oh, it’s a great little place. We love it. She gestures to a young man on the other side of her. He watches the television. And Ron takes good care of everyone. She smiles at the man behind the counter. He leans forward to you and speaks confidentially.

If this young lady gives you any trouble, just let me know. I’ll take care of her, he says. The pretty girl laughs.

A plate of noodles covered with thick red sauce appears in front of you. It smells fabulous. You are ravenous. You pick up the fork and begin eating.

So, let me guess. You’re a professor. This is the young man to the girl’s left. He has forsaken the television, the beautiful girls, and now seems to be addressing you.

Excuse me? You wipe your mouth. The food is as good as it looks. The noodles al dente, the sauce rich and aromatic with spices. So much better than what you could do. James is the real cook, the children’s faces fall when they come into the kitchen and find you there.

The girl interrupts. Oh, it’s just a game we play in bars. Guessing who people are, what they do. He thinks you look like a college professor. I can see that. But I need to think about it before I guess. There’s a lot at stake! Winner has to buy everyone a round of drinks. She puts her hand to her forehead, acts as if she is thinking hard. Definitely someone professional, she says. You weren’t just a housewife.

The young man hits her playfully on the arm.

Okay, okay, I shouldn’t say that. It’s just that you look like you’ve been out in the world more.

The young man hits her again.

Oh, did I say something else stupid?

No, you say. The words come out smoothly. You are saying what you mean to say. Relief. The path between your brain and your tongue is open.

And, yes, I am most definitely not a housewife, you tell her.

You realize your voice sounds contemptuous. James always warns you about this. You wrap another length of pasta around your fork. You take another bite. You have not been this hungry in a long time. There were only five women in my program, you explain.

What type of program was that? No, let me guess. The young man is enthusiastic. I’m good at this. You’ll see. My guess is . . . English literature. Medieval poetry.

The girl rolls her eyes. How sexist can you be? A woman, she must be an English major, must be poetry.

Well, what would you guess, Einstein?

The man behind the bar breaks in. Given the way she throws back her drink, I’d say something a little tougher. Engineering. You built bridges, right?

No, no. You are laughing. It has been so long since you have enjoyed yourself so much. These fresh young faces, their ease, no trepidation around you. You realize, suddenly, that you have been frightening people. That thing you see in their eyes, it is fear. But what have they to fear from you?

What’s your guess, Annette? The young woman pretends to think hard. I’m going to go out on a limb here and say lawyer, she says. I bet you defend the poor and defenseless of the world against unfair prosecution.

No, no, you say. Never a lawyer. Words have never been my forte. That’s my husband.

See? I was close!

Well, I wouldn’t exactly call him a friend of the underprivileged, you say. The thought makes you smile.

Then what would you call him? asks the girl.

The last resort of the rich and powerful. And he’s very good at what he does. He always gets them off. He’s worth every one of the considerable pennies he charges.

Something closes down in the girl’s face. And you? she asks.

You realize that you have erred. That you have forgotten the hypersensitivity of the young. Fiona and Mark were inured to it early. The cynical joking about it around the dinner table. During Mark’s teenage years, he insisted on opening up every meal with a particularly egregious lawyer joke. He was hoping to get to James, but that wasn’t the way. He’d bring his own to the table.

How can you tell the difference between a dead skunk and a dead attorney on the road? Then, after a pause, he’d triumphantly bring out the punch line: The vultures aren’t gagging over the skunk.

The girl is still waiting for your answer.

I’m a doctor, you tell her. An orthopedic surgeon.

That’s bones, right? the young man asks.

Yes. It’s more than just the bones. It’s everything to do with injuries, degenerative diseases, birth defects. I specialize in hands.

Annette does hands, too.

The girl laughs. He means I read palms. I took a Learning Annex class in psychic skills. Most of us were there as postmodern cynics. But I learned some things.

Chiromancy, you say. You’d be surprised how many believers there are. There’s been a considerable amount of research into palm creases and fingerprint whorl variations published in medical journals.

Really? The girl leans forward. She turns slightly and it’s her turn to hit the young man. See? I told you! She turns back to you. Like what?

For a long time scientists have been interested in exploring whether phenotypic markers can diagnose genetic disorders.

Can you say that in English?

Certainly. Doctors have always been interested in whether they can use the lines in your hands and the length of your fingers and even your fingerprints as a way of diagnosing illness.

Like what kind of illnesses?

Mostly genetic. For example, there turns out to be a strong correlation between a single palmar crease and aberrant fingerprints and Cri Du Chat syndrome.

Cri Du Chat? Cry of the cat? the young man asks.

Yes, because babies born with this defect mew like cats. They are usually severely mentally impaired. Then there’s Jacobsen Syndrome. Also diagnosable by the hands.Very similar to Down.

Are there any happy diagnoses you can make with the palm? Annette likes telling people they have long lives and will come into riches some day.

Unfortunately, most of the deviations from the normal in hand characteristics point to problems, often severe ones. But one researcher claims to have found a strong correlation between different ratios of finger lengths and exceptional musical ability. You pause. Of course, that’s just statistically speaking. Look. You hold out your right hand. See how my index finger is just as long as my middle finger? That’s statistically abnormal. Yet I don’t have any genetic defect that I know of.

Let me see your hand, the girl says, somewhat abruptly. You hesitate, then let her take it. She leans over your palm, frowning.

How’s my life line? you ask.

Oh, no one believes that one anymore. Good thing, too. According to your life line, you had a very short life. You’re dead, technically. But otherwise, you are intellectual rather than materialistic. You have the power to manipulate, but you choose not to exercise it. And your life has not been especially fortunate.

You’re using past tense, you say. Is that because I’m technically dead?

I’m sorry?

You didn’t say, your life will not be especially fortunate, but that it has not been.

The girl blushes. I’m sorry. I didn’t mean to imply that your life is over. You don’t act old.

You are puzzled. Why should I? you ask.

You’re right, I’m stereotyping. Blame it on the beer.

But how old do you think I am? you ask.

Oh, I’m terrible at this. Don’t ask me.

I would guess we’re about the same age. Or that I’m slightly younger.

The girl smiles. I deserved that. You know, I took that Internet test, the one that is supposed to tell you your real age, and I scored sixteen. All my friends scored older—thirty, thirty-two. Jim here is an old soul. His real age is thirty-five, according to the test. In actual years, he’s only twenty-four, of course.

I’m eighteen, you say.

Good for you! Forever young!

Not forever, you say. Although it certainly seems that way sometimes.

If I were really thirty-five, I’d want to slit my wrists, says the young man.

The girl rolls her eyes. Here he goes again, she says.

Why on earth? you ask.

I mean, if I were thirty-five and were in the position I am now. Stupid job. Not getting on with anything. Not having written my novel. Things like that.

Are you working on a novel? you ask. It seems like this is information that a lot of people divulge in bars, on examining tables.

No. That’s the point. Here I am, still in my twenties, so I have an excuse. But at thirty-five you don’t have any more. Excuses, I mean.

You’d be surprised, you say. Mark will have plenty of excuses when he’s that age. Just wait and see.

Who is Mark?

You are confused. Who is he?

Just someone I know, you say. I think he might be my nephew.

You think? The girl starts to laugh and then looks at your face and stops.

An image rises up in front of you. A distraught face. Slight shoulders shaking. Someone in deep distress. Her face is familiar.

Fiona, you say slowly. Fiona is someone else I know, someone I admire very much, who seems to have gotten herself into some trouble. Mark, on the other hand. You pause to think. Mark has always been in trouble.

The girl looks confused. Fiona?

Fiona is someone who always knows exactly what she wants and how to get it, you say slowly. But sometimes that is not the best thing. No.

I find I don’t really like those kind of people very much, the girl says.

No. You would like Fiona.

The girl nods politely. She has lost interest in talking about people she doesn’t know. She whispers something to the young man next to her and he smiles in return. He has turned his attention back to the television. It’s now the national news, all bad. Catastrophes natural and manmade. Money lost by millions, upticks in flooding, natural disasters, murders committed and unsolved.

You have finished the food on your plate, and both glasses, the tall and the short one, are empty. The heavyset man is at the other end of the counter, talking to another man in a suit.

Do you know where the bathroom is? you ask. The girl points. There. Near the door where you came in.

You get off the stool, stumbling slightly. You feel your way across the crowded room, using the backs of chairs and sometimes people’s shoulders, as guides. You are unsteady and feel intense pressure on your bladder.

The door marked toilet is locked, so you wait, shifting from one foot to the other like a small child. You hear the toilet flush, water being run in the sink, and the click of the door as it finally opens. A woman emerges.

You stumble past her and barely make it to the toilet to relieve yourself. Even so, there is a wet patch on your pant leg. You take a paper towel and rinse it out, making it more prominent than before. At least it’s not as bad as blood. You think of all the times you locked yourself in public bathrooms like this, scrubbing at pants to rid them of bloodstains from tampon overflows. For a doctor you’ve had remarkably little insight into your own body. You secreted tampons everywhere: in your purse, in the glove compartment of the car, in your desk drawer, and yet you were continually caught short. Your body was always betraying you.

It got worse as you got older. There were days in your forties and early fifties when you hesitated to schedule surgeries because of brief, intense episodes of hemorrhaging that could happen any time. Your body defeated you in ways it had never in the past. You wore double tampons and pads underneath that. You’d go into the surgery wearing adult diapers, waddling slightly when you walked. But once the gushing started, there was no stopping it. You learned to live with the humiliation. Blood in the OR. You kept extra clothes in the office, in the car. Two years of that. You thought you might mourn the loss of fertility, but the trauma of perimenopause made you welcome it.

You look in the mirror as you wash your hands. What you see there startles you. The very short crinkly white hair. Your face covered with red blotches, liver spots on your forehead, and the slack skin over the jawbone. Too much sun.

You never did listen to the dermatologists, felt their cautions were old lady-ish. Now you are an old lady. Your life should be discussed in the past tense. You are suddenly tired. It’s time to go home. You exit the bathroom only to stop, disoriented.

Where are you? A crowded restaurant. Overwhelming smells of heavy garlicky sauces. The noise makes your head ache. Bodies press up against you, propel you back into the open door of the bathroom. As if from far away, you catch sight of a door marked exit. You start to make your way toward it.

Voices are shouting behind you. Hey! Lady! A man holding menus nods, opens the door for you. Stop her! The man sings a cheery Good evening! Evening? you ask, and then you are outside, a warm breeze caressing your face.

When did day turn to night? The heat into deliciousness? The streetlights are on, all the shops and restaurants are lit and welcoming, and bright lights shine amid the leaves of the trees, which are in full bloom. People everywhere, holding hands, linking arms, the warmth of human bodies in harmony. It is a party. It is a fairyland. You plunge deep into the festive night.

You have not lived until you have seen fish striving for the moon. By the dozens they burst out of the water, their silvery bodies flashing as they rise. The perfect shiny arc as they peak. The downward trajectory is lyrical: perfect dives back into the blue gray depths.

The air is balmy and tropical, but the lake water frigid. How it numbs your feet and ankles. Still, there are others who would not be dissuaded. You see heads just above the water, arms reaching up and slicing through the water, a long line of heads attached to shoulders and arms. Bursts of water from the feet, those tiny motors.

The park is nearly as bright as day—the automatic streetlights haven’t switched on. Celebratory howls emanate from the zoo. All the benches are occupied, the pavements crowded. And dogs everywhere, running, rolling, chasing balls and Frisbees, frolicking in the shallow waves. The fish continue to jump and splash.

Ma’am? A young man is running up behind you. He is holding something in his hand.

You forgot your shoes! He is out of breath. He stops and holds out a pair of new-looking white sneakers. He has the look of someone who expects gratitude, so you try to infuse your voice with warmth.

Why, thank you, you say. He is still extending the shoes, so you take them, but the minute he turns his back, you drop them on the grass. Who needs shoes on a night like this? Encumbrances. They just separate your flesh from this goodly sphere, the earth.

To your right you see a young couple vacate a bench. You sit down, not because you’re tired but because you want to watch the parade.

And what a parade! Musicians: drummers and horn players and trombonists. You have to strain to hear them because the crickets are so loud. Then come the entertainers, the tumblers and acrobats and men on unicycles and women on stilts, all dressed in the most outlandish costumes.

Some are naked. You have to laugh at the men’s fully extended penises, aroused by the night air and the proximity of so much beauty. You are almost aroused yourself.

You think of your young man. He is late. He is always late. You are always waiting. Your father says that a woman who waits must contain all and lack nothing. You think he was quoting, but you were never able to discover what. He is full of surprises, your father. Barely an eighth-grade education, yet he would correct your college English papers.

But your young man, your beautiful young man. He wears green to match his eyes. He is not stupid, but he is not smart enough to hide his vanity. You discovered foundation makeup in his locker, yet not for a moment did you think he was cheating. Not that he wasn’t capable of that. But he was so full of guile as to be guileless.

But you? Hook you up to a polygraph and you would flunk every question. Did you love him? Yes. No. You would have been tagged a liar for either answer. Sometimes. Maybe. Only when hooked to a machine calibrated to detect ambivalence would you pass.

After the entertainers, the animals. But such animals! Not any that God created. Fabulous creatures with the heads of lions with large child faces mounted on them. A herd of cats, goose-stepping in the moonlight.

You are reminded of the wonderful and terrible books of your childhood. There was one where a boy was given the power to read into the hearts and souls of creatures by feeling the shape of their hands. Thus the hands of kings and courtiers often felt like the appendages of cloven beasts, and the hands of honest workers were soft like those of the highest royalty.

The idea that you couldn’t tell the nature of the creatures around you, human or otherwise, without such a gift was terrifying. In bed you would hold your own hand to determine what you were. Human or beast?

Across the path from your bench is a low stone wall separating the grass of the park from the sand of a narrow beach. There is writing on it. A sacred script. Thick strokes in black paint outlined in red. Punctuated by a face that grins. It is sending a message. But what is it?

The parade is over. People are leaving for other festivities. The dogs have vanished, the children lifted onto shoulders and taken to bed. Silence descends. You close your eyes to revel in it.

You wake up with a start. There is a hand on your arm, moving down it. You are startled to see it is still night, but a night so bright that you could read by it. The hand belongs to a stranger, a youngish man, not clean, wearing a fisherman’s hat and an army coat. Seeing that you are awake, he withdraws his hand.

I was just wondering, do you have any money I could borrow, he says.

Normally you would just say no. You give your time and money to the clinic. But things are different tonight. Your sense of well-being. The beauty that surrounds you. You wonder what you would feel if you took his hand.

You look for your purse. But there is nothing. You check your pockets in case you brought only your wallet or stuck your driver’s license and a credit card in a pocket. Nothing. The man watches as you go through your contortions.

Probably you shouldn’t have been sleeping here, he says. Probably someone got here before me, someone not so nice.

He pulls a pack of cigarettes out of the breast pocket of his coat and offers you one. When you refuse, he lights one himself and settles back on the bench.

When I saw you there, I thought, Now what’s a nice lady like that doing in Lincoln Park in the middle of the night? he says. It was a real strange sight. But where are your shoes?

You look down. Your feet are bare and dirty. There is some dried blood on the side of your ankle. You reach down and pluck out a piece of glass. The hem of your pants is muddied.

Someone’s been paddling, says the man. I can’t say I blame you. It’s certainly the night for it.

You notice that it’s no longer quite as quiet. Although the crickets have subsided, and the hum of traffic from afar has dwindled, there are other noises. You notice that the two of you aren’t alone. The field surrounding you is dotted with dark shapes, people rolling up carts, unfurling blankets. A man and woman struggle with a mass of material that turns into a small tent. An encampment is forming.

The man continues to talk as he smokes.

You’re new. You must prefer the shelters. A lot of the women do. You can stay cleaner there. But I don’t care too much for the rules. In bed by nine PM. No liquor. No smoking. No getting up before six AM.

You must be a night person, you say. I always was, too. I’m a wanderer.

Wanderer. Wandering. Wanderlust. You like the sound of the words as you speak them.

You said it. Give me the park at night anytime. Hey, where’s your stuff ? I can help you settle in.

I don’t know, you say. Home, I guess.

You have a home?

Of course. On Sheffield.

That’s a pretty nice street! Where on Sheffield?

Twenty-one Fifty-three Sheffield. Right down the block from St. Vincent’s.

I know that area. So you have a house there. So why are you out here, middle of the night, no shoes?

I guess I wanted some fresh air, you say. But now that he asks, you’re not sure. The man’s face has filled your mind, driving all other things out. His nose, his mouth. The grime in the considerable laugh lines around his eyes. A slight bruise on his cheekbone. The tufts of hair that stick out from under his cap. Not an unlikable face. A capable face, but capable of what?

What about your family?

They’re all dead, you say. My mother. My father. Everyone died.

Hey, that’s rough. Real rough. Mine all died too. I have a sister somewhere, but she doesn’t talk to me anymore.

He takes a deep drag on his cigarette, finishes it off, throws the butt on the ground, and grinds it in with his boot.

Hey, do you think we could go to your house? I sure would love to sleep in a bed for once. A bed with no rules.

We have a guest room, you say.

Well, that’s just perfect. I would love to be your guest. Just love it. He stands up, dusts off his trousers, and waits.

You get up too. Your feet are sore. A slight stinging on your ankle. Can you walk? You can. But you’re suddenly very tired.

Do you know how to get there? you ask.

I sure do. My old stomping grounds. And Antoine’s, too. Let me get Antoine. He’d sure appreciate a guest room himself.

I only have one guest room. But it’s a double bed.

Well, I could do worse than share a bed with old Andy. Let me find him. You just stay here. He runs off, glancing back at you every other step as if to make sure you don’t go away.

You do as he says. You are grateful that someone has taken charge. You never let James do that. You must be getting older. Old. The desire to abdicate responsibility. To let others act, decide, lead. Is this what aging is all about?

Suddenly the man is back. With him, another man, slightly built. Cleaner than the first, but a less open face.

You finally ask the taller one, Are you my husband?

Excuse me?

How long have we been married?

The small man laughs. If she really does have a house on Sheffield, you could have a real sweet deal.

Yeah, but what if she does have family after all?

You heard her. They’re dead.

Yeah, but she’s fucking nuts. We don’t really know what’s what.

James? you say.

The small man speaks up. Yes?

No, you say. Not you. James.

The other man hesitates. Yes?

James, I’m ready to go home.

Okay, my dear. The man looks at the small man and shrugs. What have I got to lose? he asks. Okay, he says to you, let’s go. Sheffield and Fullerton, here we come.

Seemingly hours later, you finally reach your house, unlatch the gate. The men stand aside, waiting for you to take the lead. A sign has been planted in the front garden. sold. Everything is dark. No curtains in the windows.

You walk up to the front door and turn the knob. Locked. You ring the doorbell. You ring it again. You pound on the door. James! You call. An arm grabs you from behind. Quiet. Do you want to wake the neighbors? You have forgotten. Right. The neighbors. You reach above the door and feel around the edge of the door frame. Nothing.

Doesn’t she have a key?

Apparently not. The taller man retreats down the stairs and tries one of the ground-floor windows. It doesn’t give. He tries the other. In the meantime you yourself have retreated to the front garden. You are turning over rocks. You know the spare key is here. You put it there yourself.

The ground is cold against your bare feet. You step on something that crunches. A snail. Then another. You always hated them. Marauders. Thieves. Robbers of beautiful things. Fiona loved them, however. She would paint them brilliant colors using Amanda’s fingernail polish, and set them loose. Living jewels among your petunias and impatiens.

You step on a sharp stone and let out a cry.

Shhh! says one of the men.

What’s that? the other one says. Short bursts of sound, a woop woop woop from down the street. Red and blue lights flash.

Fuck, says the short man, and he’s off like a flash, the other man after him. You go in the opposite direction, into the alley. Down three houses, one, two, three. Through the back gate and into the back garden. To the large white rock under the drain pipeline. The key is under it, just where it should be.

Peter would tease Amanda. Keys everywhere! he’d say. Scatter keys through the neighborhood! To every woman and every child! Amanda would just shrug. Better than being locked out in subzero weather, she said. Better than breaking a leg or having a stroke and no one able to come over and check on you.

You let yourself in. The house is silent, waiting. It smells stale, of mildew, a slight memory of gas. You flip the light switch but nothing happens. Still, it is Amanda’s kitchen. No flowers, no fruit, but her photographs, her furniture. She is not here. You know that somehow.

You wander down the hall. You know this house like your very own. Since you were pregnant with Mark. Amanda was the first person in the neighborhood to come to your door. Carrying not cookies, not a casserole, but a potted cactus. Ugly, with a small yellow star-shaped flower on the crest of one of its spiny arms.

I know you by reputation, although you don’t know me, she said. You treated one of my students who had an unfortunate accident with a firecracker. You repaired three of his fingers, and he still has use of two of them. Everyone says you are a genius. I admire genius.

Not a genius, you said. Just good at what I do.

You accepted the cactus. And promptly threw it in the garbage when Amanda left. You hate plants, and cacti most of all. You would have preferred cookies. But a few days later when you saw Amanda in the street, you stopped to say hello.

You remember it as clearly as if you were there now.

When are you due? she asked.

May 15. Just nine more weeks, you said.

You must be ready by now. How do you feel? Excited, I’d imagine.

No. My husband is. He’s the one that wants children.

You waited to see what effect your words would have on this woman. She was tall, with impressive posture. Her back was straight, her gold hair curved in a shiny helmet that just reached her shoulders—you knew it was her real color. There were faint streaks of white—not gray—at her temples. Her tailored clothes were crisply ironed. You were conscious of your baggy cotton pants, your extralarge T-shirt billowing over your round belly, your worn sneakers.

Amanda laughed. You’re what, thirty-five?

Thirty-five. It was time.

She smiled a little wryly. We’re still trying.

You didn’t even try to hide your surprise.

I don’t give up easily. She reached out and patted your stomach—a gesture that too many people felt free to make. You found that you didn’t mind. It wasn’t presumptuous, but something else: There was yearning in it and a bit of awe. This made you speak more gently than you otherwise would.

Sometimes it’s time to move on, you told her.

Not yet, she said. We haven’t given up yet.

What about adopting? you asked, then wished you could take back your words. Of course she must have considered it. How facile. And you actually found yourself blushing. But she didn’t seem to mind or notice.

No. I need more control than that, she said.

That’s an odd way of thinking about it, you said. You were becoming interested in this woman.

Nevertheless, control is what I want, said Amanda.

But if you could get a newborn, wouldn’t that be control enough? you asked. You were genuinely curious about what she would say. You shifted a little on your feet. The baby was moving, thrusting its limbs so that your stomach got distended into strange, angular shapes.

After all, you continued, you’d have the child right away. You can even be in the delivery room in some cases, so the first person the infant sees is you.

Still not enough, Amanda said.

Enough what? you asked.

Control. That would take care of the nurture part. But what about the nature? That would be an unknown.

But you’re a teacher, you protested. Surely you see how different children from the same households, raised the same way with the same food and the same experiences, can turn out differently?

Yes, Amanda said. You need to know that you’re the source of whatever comes out. Otherwise you leave open the door for other emotions, other attitudes toward your child to creep in.

Emotions like what?

Contempt. Disdain. Or just plain dislike.

Let me get this straight. You can love a child who displays, let’s say, unattractive traits or behaviors if you know he or she came from your genetic makeup. But if you don’t know . . .

. . . then who knows what you might feel toward them? Amanda finished your question.

Like a body rejecting a donated kidney, you said slowly.

Exactly. And because you don’t know until you transplant it, why take the risk?

Because people need kidneys. And you say you need a child.

I do, she said. And the way she said it convinced you of her resolve.

But it didn’t add up. You protested, But you’ve left half the chromosomes out of the equation. What about the genetic makeup of the father? That’s certainly out of your control.

I can deal with Peter’s genes, with any peculiarities that arise from them, she said. You wondered about that. You didn’t believe at that point that you would ever consider James as something you’d have to deal with. You changed your mind later, of course.

The woman stopped. My turn to ask some questions, she said. Why did you resist having children? Is it your career?

No. I suppose it comes down to control as well, you said. I like making my own choices. I always have. But with a child you have no choice. When it is hungry, you must feed it. When it has soiled itself, you must clean and change it.

But as a doctor, aren’t you constantly responding to patients’ needs? When something happens during a surgery, you have no choice. You have to fix it. When an emergency arises, you have to respond.

That’s different, you said.

How?

You spoke slowly, trying to work it out.

It requires the best of you, you said. Something unique. Not just anyone can perform a transfer of an intercostal nerve into the musculocutaneous nerve to restore biceps function. Or an open carpal tunnel release, for that matter. Even other specialists mess those up. Yet a child can love anyone. Children do love the most horrible, depraved people. They attach to warm bodies. Familiar faces. Sources of food. To be valued for such base requirements doesn’t interest me.

You’ll change your mind when you have the baby. I’ve seen it happen time and time again.

So people say. My anticipation is that I will hand it over to James and let him deal with it.

You interest me. Not many people would think this way, much less say so.

I usually say what I think.

Yes. I see that. And I suspect you don’t have much patience for people who don’t.

You’re right. Not much.

Then suddenly your memory skips ahead to the birth, which was three weeks early. There were some problems with Mark’s lungs. He came out furry, covered with lanugo. A small, red wheezing creature. He was your patient before he was your child, which helped the transition.

Naturally you breast-fed him, because of the antibodies. Did your duty in that regard, despite the inconvenience and pain. You didn’t like being sucked dry multiple times a day, and the thought of it distressed you more than you expected.

You weaned him at three months and resumed your professional life once you no longer leaked milk at the slightest provocation. You hired Ana at that point—Ana who did all the things a good mother would do. You were not a good mother. And yet Mark clung to you. And, six years later, Fiona did the same. By then Amanda had stopped trying to conceive, even she admitted it was pointless.

When was the last time you saw Amanda? You cannot recall. You accept that she is gone. They are all leaving, every one of them. James. Peter. Even the children. A diaspora. But you are somehow drawing strength from that. With each loss, you are stronger, you are more yourself. Like a rosebush being pruned of extraneous branches so the blossoms will be larger and healthier next season. Sheared of this excess, what will you not be capable of ?

You have a vision: Amanda, here, on the floor, her heart violated, her eyes still open. You always thought the practice of closing the eyes of the deceased a silly one. It’s for the living, of course, who would like the dead to behave, to have death approximate sleep. But there is no repose for Amanda. She’s on her back, her hands clenched as if about to engage in battle. Her legs akimbo. Are you making this up? Because there are others in the room, shadows are flickering. Words are being spoken. Must you do this? Yes, I must. Quickly then.

Your mind is full of other fantastic images, some in lurid color, some in black-and-white. It is like watching a compilation of movie clips filmed by a lunatic. A heap of harvested hands on the white sands of a turquoise sea. Your parents’ house in Philadelphia, engulfed in flames. I am very far gone indeed. Here. So it was here. You can see the remains of the yellow chalk mark mixed with dust. What Amanda could never have abided.

Your filthy bare feet leave footprints. Shoes. You need shoes. Amanda was taller and heavier than you, but you wore the same shoe size. Eleven. Wearing boxes without topses.

You take the stairs to her room and find a severe blue dress with a belt and a pair of black flats. You try to wash your face, but the water has been turned off, so you spit upon a towel and scrub at the worst of the dirt. Then you lie down on Amanda’s bed.

But before you sleep, Peter visits. He stands by the window, blocking the moonlight. What did you do? he asks. Why did you do it? He has been digging in the garden. His knees are black with wet earth. He is holding one of Fiona’s most brightly colored snails in his palm. In the sweat of thy face shalt thou eat bread, till thou return unto the ground; for out of it wast thou taken. You are sweating. Enough, you say. But he is gone, replaced by Amanda. She sits on the edge of the bed. She takes your hand. Hers is whole, unblemished. You are relieved: It was all a dream, then. All a dream. And finally you are able to sleep.

You are awakened by a crack of thunder, the sound of drumming against the window, on the roof. Outside the window you see gray and wet, but it is still warm. You see that you are already dressed, shoes even. You must have been on call.

Those days as an intern, learning to jump up from the soundest slumber, ready to slice. No transition from oblivion to hyperawareness. You are aware of an empty stomach, but when you go downstairs the refrigerator is dark and empty, and a sour smell emanates from it. In the pantry some dry cereal, stale. Rat droppings on the shelves, holes chewed in the bags of pasta, the cracker box.

You catch sight of the clock still ticking above the sink. Eight forty-five. The clinic opened at 8 am. You are late. You stuff some cereal in your mouth, run to the front door. You do not have your car keys, you must take a cab. You walk swiftly down the street toward Fullerton, where the cabs stream past day and night.

You are already soaked from the warm rain. The first two cabs are occupied, but then you are in luck: The third one stops. To the New Hope Clinic, you say. Address? he asks, but you can’t remember. He punches the name into a small machine mounted on his dashboard. Chicago Avenue, he says. Okeydoke.

He is dark, handsome. A Palestinian flag is draped over the front seat. His cell phone rings and he spits out a string of guttural sounds, hangs up. You brush off the water as best you can and try to relax. Chicago the gray lady. You don’t mind.

Sometimes you want the outside world to match your interior reality, you said to James once, trying to explain why you loved thunderstorms. Another boom overhead and a streak of lightning on the right. Awesome, says the taxi driver, and catching your eye in the rearview mirror, he smiles.

The taxi pulls up in front of a low gray building. Seven seventy-five, the man says. You reach for your purse. You begin searching around the backseat, you pat your pockets, you are frantic. The man looks more concerned than alarmed. You work here? he asks. Or a patient? You are a doctor, you explain, and the man nods like he expected as much. Perhaps you can borrow it, he suggests. I will wait.

You run through the rain to the front door. The waiting room is full of people, many more people than there are chairs. Jean is at the front desk, checking in a woman with a crying infant. When she sees you she looks startled. Dr. White! she says. What a nice surprise! Aren’t I on the schedule? you ask. Then, without waiting for an answer, you say, No matter. Clearly you need me. I’ll be ready in ten minutes.

You walk into the back area and are surprised at all the strange faces. A medium-size dark-skinned man stops you. I’m sorry, he says, staff only here. His name tag says dr. aziz. It’s okay, you tell him. I’m Dr. Jennifer White. Apparently there was a schedule mix-up, but it looks like you could use the help.

Dr. White? he asks, but you are already at the back sink, washing up. You go to the wardrobe, take a white coat, button it over your dress. What do you have for me? you ask. The other doctor hesitates, then shrugs. Room three, a rash, could be shingles, could be poison oak, he says. The chart is on the door.

You give a quick knock for courtesy, then enter the room. The woman is perhaps thirty, African American, a fine strong frame. But she is holding on to her left side and her face is in pain. Let me see, you say, and she reluctantly lets go. You pull back the blue hospital gown to see an angry rash with raised red bumps and blisters that have erupted on the skin in a band that reaches across her belly and around her back.

Does this hurt? you ask.

Yes. It started out as a kind of tingling. But now it hurts. Badly.

You look. Some of them have become pus-filled, others are still in the early stages of formation. You motion for her to turn over. Nothing on the other side, just this broad swath down the right side of her body, her hip, thigh, and buttocks.

What is it?

Herpes zoster. Known more commonly as shingles, you say. I’m going to prescribe one of the antivirals. Acyclovir. It should decrease the duration of skin rash and pain. I hope we’ve caught it early enough. Also apply cold compresses to the rash three times a day. Above all, do not scratch or you risk infection.

How did I get this? You called it herpes. Did I get it from my boyfriend?

No, not at all. Shingles is caused by the same virus that causes chickenpox. You know, what you had as a child.

You are looking for your prescription pad. It’s not in your pocket. You excuse yourself and go out into the hallway.

Excuse me?

Yes, Doctor?

I have misplaced my prescription pad. Can you get me one? You turn and nearly bump into another woman wearing a white coat. She does not have a name tag on. She looks frazzled. She examines your face with curiosity. Are you Dr. White? she asks.

You nod, yes.

I recognize your photo. I didn’t realize you were still involved in the clinic. I thought you’d retired. Dr. Tsien still talks about how much you are missed at the hospital. She frowns, opens her mouth, closes it again.

You don’t follow all of this. I come here every Wednesday, you say.

But today’s Thursday.

You pause, think. I must have had a conflict this week, you say.

Everyone has been very grateful for your help. That a doctor of your caliber would work here pro bono has always meant a lot to us. Not to mention the other contributions you’ve made, of course. She still has a bemused look on her face, as if trying to remember something.

You turn to go. You face a bewildering mass of doors. Where were you? You pick a door at random and go in. An older man is sitting in his underwear. He looks surprised. Is something wrong, Doctor? You tell me, you say. What brought you here today?

The man looks uncomfortable. As I told the other doctor, I’m having trouble going to the bathroom.

Does it hurt? Or do you have urgency but no voiding?

The second one. I think. I try to piss and nothing comes out. It hurts.

Any erectile dysfunction?