Triblog

xii

“Sarah?” Steph’s voice sounded hollow on the phone. I’d come home at three, and lain on the couch for several hours, exhausted by a simple afternoon at the doctor’s. “Can I come over? We need to talk.”

“Why? What about your delivery?” I managed.

“Don’t worry about that, I’m off at five. Somebody else’s problem now. Petyr there?”

“Uh, yeah…no, he’ll be here in a little bit, last patient should be done now.” I wondered what she wanted him for, but the buzzing in my ears, the flashes in my eyes, the tingling in my fingers swamped any rational response.
“Good. See you soon.”

She swept in, still in her white coat with that stethoscope dangling around her neck, her face blank, unreadable. She sat down on the edge of the sofa, took my hand, squeezed it, and softly started, “Sarah, the CBC…”

“What?” I mumbled.

“That blood test I wanted you to get, a blood count. They have to double check the micro, the pathologist wants to look himself, but…Sarah, you might have leukemia.”

My mind went blank, the hum in my ears reverberating in my skull, almost in time with the throb between my eyes. “Wha…how…” was all I could could get out.

“Sarah, I’ve already talked with Dr. Viqueira in med onc at Dana-Farber. We made you an appointment with him tomorrow. He says he’ll probably suggest starting induction therapy this Friday.”

She must have noticed the glazed look in my eyes, reflecting my utter rejection of what she was saying. “I know, I’m sure, this is a shock, and there are ten thousand questions you’ll have. I’ll walk you through it, and make sure Petyr understands, but the one thing – the only thing – I want you to hear is this: you are in the best place in the world to treat this. And I’ll walk every step with you, help you understand, translate the medicalese. All you have to do is stay strong, be yourself, don’t despair. You’ll get through this.”

As she finished, Petyr walked in, shook a bit of rain off his overcoat, and looked with alarm at me on the couch, Stephanie by my side.

“What happened? Is everything all right?” he asked.

Steph patted my hand and stood up, saying, “Petyr. Hi. Let’s pull up those chairs from the dining room, sit here and talk with Sarah, OK?

For the next half hour, she reviewed with Petyr the profound anemia, low platelets, and crazed white cells they’d found on the CBC. Chemotherapy, survival rates: their talk drifted into that special medical language I only partially understood. Since it didn’t involve Ob, Peds, or high school Latin, at times they could have been speaking Aramaic. Words like thioguanine, cytarabine, adriamycin. Acronyms like DFS, IT. Chance of this, risk of that. I realized I was going to have to trust these two with my life, to know much better than I ever could, what this sudden shock meant, and how it could be thwarted. As they talked, I repeated over and over to myself like a mantra: “Not here, not now. I am here today, and I will see tomorrow.”

From some hidden cove deep inside, I finally gasped, “Will you please stop talking about me?” I looked pleadingly at Petyr. “Someone tell me, what’s going on? What’s going to happen?”

Steph’s eyes welled up as she said, “Petyr, I… can you…?”

His familiar formal tones, at other times almost comical, now served to reassure, to guide me towards understanding. My red blood cell count, shockingly low at 11 percent, explained my paleness, the profound exhaustion, the strange sensations. “Oxygen, the fundamental source of all our energy, can only travel on those red cells. Without them, it’s as if you are slowly suffocating. The white cells, the ones who’ve turned rogue, where the cancer is, are what keep you free of infection. But that’s not the immediate risk. Their mad drive to reproduce is crowding out the other immature blood cells in your bone marrow, where they all are made. That’s where we have to take the fight.” He leaned down, gently stroked my cheek, my neck, then went on. “First they will blast your body with powerful poisons – I’m sorry, that’s the only word for it – which break the DNA links in dividing cells.”

“In all dividing cells, Sarah,” Steph added. “Your gut, your…”

My hair, I thought.

“Yes, that’s what makes it hard. Once a week, for nine weeks, in a chair, through an IV, you’ll get those drugs, stop those bastards from taking over. It works, it works, it’s going to work.” His confidence was real, I knew. He was not going to lose me, not now, not because of this.

The next morning, Petyr called Wellesley, to cancel my work there through the end of the year. He spent the morning, time he should have been seeing his patients, finding emergency replacements to see my own small clientele. He was about to call the Institute, to cancel my classes there, when I hoarsely shouted “No!” I was not going to drop out now. “It’s not as if I’m going into the hospital. If the treatment’s on Friday, then Thursdays, won’t I be at my best, the day before?”

He knew me well enough not to argue.

Two days later, the cards started coming. From Jeanne, in England. From Marcia, Bev and Leslie. From Lizzie, now in Brazil with her husband, an oil engineer. And almost every other person in my date book. While I’d been sleeping away the exhaustion, he had been calling, then writing, seemingly everyone I knew for the last fifteen years. The only person I managed on my own was Mother.

“Hi, sweetie!” she brightly answered when I called that first night. “What did the doctor say?”
“Oh, mom!” was all I could come out with. Before I broke down, Petyr reached over, calmly took the phone, and proceeded to describe the diagnosis, the treatment plan, by the end probably convincing her I was well on the way to recovery. He also arranged for her return the next day.

She accompanied me that Friday to my first chemo treatment. In the waiting room, it seemed as if every other person wore a bandana on their head. Young children sat in chairs too large for them, their legs dangling, kicking languidly as they waited to be called. Older women, immobile with dark circles under sunken eyes sat next to downcast men with days’ old stubble. The air smelled of disinfectant, stirred by a slowly rotating ceiling fan. A poster of a kitten, eyes wide while she clung to a branch, urged us to “Hang in there!”

We each were called back in turn, some slowly shuffling, others pushed in wheelchairs. I whispered to my mother, “Is it me, or does this place feel sad to you?”

“Honey, you’re not them. You still have so much to do, so much to give, a life to live.” She took my hand, rubbed my arm, and said, “You’ve got to get the first punch in, knock this thing out.”

I looked at the slender bald boy of about 8 seated across from me. He dropped his chin, and through crinkled eyes, smiled back conspiratorially.  I had an inspiration. “Mom, on the way home, there’s something I want to pick up.”

“What do you need, honey?”

“You’re right, I have to get the first blow in, take this on my own terms, not let those damn drugs and white cells beat me.”

Back at home, my vein still burning from the chemo, the nausea building inside like a steam shovel carving out a quarry, I unwrapped the package from Gary Drug. Standing in front of the bathroom mirror, I fiercely lifted a chunk of hair off my shoulder, and began to shave my head.

xiii

The day after Thanksgiving, Petyr dropped me off at my fourth weekly treatment. For the first time, I met with Dr. Viqueira alone, no mother, friend, or solicitous lover to filter the conversation or deflect my deepest fears.

“You’re doing quite well, Dr. Stein,” he began. “Your hematocrit is returning to normal. your differential is much better balanced, we’re seeing more normal white cells, far fewer immature forms. How are you feeling? Any new bruising?”

I smiled, straightening the black bandana on my head. “If you mean, am I sleeping less than 12 hours a night, then, yes, I’m feeling better. And no, I’ve stopped seeing those little red spots popping up all over my skin.” He jotted a few notes in my chart, nodding, while I continued. “But I’ve been reading, in the library, trying to make sense of the future…”

“Dr. Stein, I appreciate your desire to know what will, what’s going to happen. I’ve learned though, that statistics are meaningless, when it comes to the individual.”

“Meaningless? When it says, ‘less than 25% four-year survival rate’, that sounds pretty real to me.”

“Right. I could list all the numbers…”
Before he could start, I ticked them off myself. “Median survival, 22 months. Median disease-free interval after initial therapy, 40 weeks. And the numbers are even scarier, should I need another course of treatment.”

“But surely you know, from your own experience conducting research, for any individual, there are only two possibilities: either a 0%, or 100%, chance of any particular outcome. Which applies to you, we can not predict. And so…”

“And so, I am choosing to believe, for me, it will always be 100%. Chance of a positive outcome, I mean. I can’t imagine living any other way.”

I measured my progress by how I felt Thursday nights, attending seminars at the Institute. The first trimester, consisting of “Freud II: 1917-1939”, and “Technique I: The Analytic Stance”, I completed the week of my first treatment. The next trimester featured “Psychopathology I: Neuroses and the so-called higher functioning patient” and “Dreams”.  I made sure to take a nap on Thursday mornings, and learned not to eat before each seminar. The others there studiously avoided any mention of my paisley-flecked bandanas and rapidly shrinking physique. While the clinic closed on Christmas and New Years, both Fridays that year, and my treatments moved to Thursday, the Institute was on its “end-of-year hiatus”. 

New Years’s Eve, Petyr and I celebrated the successful completion of my initial 9 weeks of treatment. Dr. Viqueira pronounced it a success, so I could switch to monthly maintenance visits for my chemo. The chance of a cure was now at 30%.

“Any resolutions?” Petyr asked.

“I’m going back to work, going to start up again at my practice. And Dr. Goldman asked if I would re-join the team for a new study.”
“Oh? What on?” he asked.

“Another C-L project, this time with radiation therapy and psychiatry. You’ve heard about conservative surgery, for women with breast cancer, using radiation instead of simply cutting everything out?”

“Lumpectomy, I think it’s called?”

“Right. Well, no one’s studied who is opting for that, why they do, and how they feel about it. They’re going to interview 100 women who had that, 3, 4, 5 years ago. I could review what’s already be known there, then devise and pilot a questionnaire to guide the interviewers, and finally work on training them.”

“That doesn’t sound too stressful.”

“No, and it would fill my time on Mondays and Wednesdays.”

Petyr walked over to the audio console, started flipping though the albums. “Anything you want to listen to, tonight? To ‘celebrate’?”

I closed my eyes. Jamie Taylor singing solo at the Menemsha Community Center filled my vision. “James Taylor,” I offered. “Fire and Rain.”

While he warbled, “I walked out this morning and I wrote down this song/I just can’t remember who to send it to/I’ve seen fire and I’ve seen rain/I’ve seen sunny days that I thought would never end/I’ve seen lonely times when I could not find a friend/But I always thought that I’d see you again”, memories of Michael Harrison, sunny days on Vineyard beaches, walks along the Charles, our whole history, surged like a grass fire though my core. I remembered I’d always meant to return to those days, to write him a “letter” explaining it all. As I wondered if I’d ever get there, Petyr interrupted my reverie.

“Next? Carole King, You’ve Got A Friend?”

Returning to the reality of my current life, I smile up at Petyr and said, “Yeah…no, not that, but Tapestry, for sure. The end of that second side.”

We snuggled as Carole started singing, “Tonight, the light, of love is in your eyes…” Petyr seemed hesitant, almost reluctant to hug, to hold me closer. I tried smiling, caressing; even soft purrs didn’t do the trick. Finally, I said, “Go ahead, I won’t break…” and he got the idea.

My soul had been in the lost-and-found, and he’d come along to claim it. We crescendo’d along with her, “…You make me feel, you make me feel…” and once again, I was complete.

While the needle ticked over and over in the final groove, I asked, “I wonder, what kept you going, those first few years when you lost your parents, your birth parents?”

“I’ve thought about that, now and then. Remember, I was so young, I can’t remember – did I lose hope, did I feel I had no future?” He pulled the covers up above our shoulders, protecting us from the winter’s chill snaking though the single pane windows. “Last year, at one of our talks during the Institute dinner break, you said something which has stuck with me. You’ve had the answer all along. Do you remember?”

I puzzled my way back through those conversations, about love, and its often unspoken sub-text, sex. About creating couples, families – the “iron tyranny of DNA”, he’d called it. I closed my eyes, and pulled from deep within, “Life itself is reason enough to be living.”

He nodded. “That’s the secret, that’s what pulls us forward, even though we know what happens in the end. Sarah,” he murmured, “Sarah, you are the strongest person I know.” I frowned, ready to object. “No, I mean it. Watching what you’ve been through, the past two months, your life upended, your body ravaged first by disease, then by treatment, I simply can’t imagine. I don’t know if I could ever be so… your spirit…” Petyr at a loss for words, always humbling.

“I don’t feel that way. I’m just trying to make it through each day, is all. Make it to bed, wake up, and do it all again.”

“Listen. One thing I’ve seen, courage…courage and bravery are in the eyes of the beholders, not the courageous. I’m learning about them, by sharing your life.”

All that spring, I slowly built my strength, taking walks through the narrow outdoor alleys and the sub-basement corridors connecting the medical center’s buildings. With each monthly treatment, I came to relish the roller coaster of the treatments. First the sledgehammer to my gut, to my endurance. Then, after a week or two, a rebound, higher than before each time. As I neared my thirty-third birthday, once again, I felt strong enough to pull out that little pink diary, and began at last to discover my story, to understand what had brought me here, so I would know where to go.

xiv

Dear Mike – I began to write – I think a lot about the old days now — those were really good days for me. You helped me so many times when I was down or confused; I could always count on you for the right advice. I never had any other friends who cared about me the way you did. I hope sharing our story will show my thanks for that…

And so I began to probe my past, tentatively at first, easing in, trying to re-capture the sights, the sounds, the feelings of the times, the people, the places, that formed me.

Whenever Petyr saw me writing out in longhand and he asked, “How’s it going?” I would reply with some variation on, “I worry if I spend too much time dwelling in the past, the future disappears.” Still, a little here, a little there, and within a year, I had a stack of paper two inches high, ready to be typed up, re-read, and put away in a box, that mental box safe from tears, regrets, and anger.

Sometime that summer, Petyr took us out to dinner, ordered a bottle of Champagne, insisting I take a sip. As I lifted my flute, I asked, “What are we celebrating?” 

He produced a large, white envelope, extracted a stapled sheaf of thick paper, numbers along the side of each page. “My divorce. The final act. Your pen, please?” I handed over my Rapidograph, and he began to initial each page, then finished on the final line with a grand flourish. Returning the pen, he rifled the stack, placed it back in the envelope, and announced, “Now, we’re free. Are you ready?”

“For what?”

“Do you think,” he began. “Do we think, it’s time we shared more? Found a place to live together? Over in Cambridge, they’re starting to build a new condominium complex. We can get in on the ground floor, so to speak, put our money down, reserve the best view, right across the river.” He reached over, took my hand, and smiled expectantly.

I nodded. “Three bedrooms, though.”

“Three bedrooms,” he said. “Why?”

“We each need an office.” It seemed obvious to me.

“What about the boys?”

“Well, you can put a bunk bed in yours, right?”

We went on like that, planning every detail. What furniture to buy, which kitchenware to keep, rugs, towels, the entire panoply of life together, the stability I envisioned in our future.

We moved in early January, 1983. Our first dinner guests were Steph and her fiancé. The small talk drifted for a while, then Steph asked, “Do you feel safe yet, Sarah? It’s been, what, over a year? You’ve been off the monthly treatments since September. There’s a glow in you I haven’t seen…”

Petyr took my hand, announcing, “She finally finished that project she’s been working on, writing a little book about her college days.”

Steph, surprised, asked, “A book? Why?”

“I tell Petyr, ‘It’s cheaper than therapy’!”

“But aren’t you in analysis already, what…?”

“I’m finding that telling the story to myself, first, late at night, to get the details right – then I can share it on the couch.”

Petyr laughed. “Dr. Kaplan doesn’t really have a couch, does she?”

I shook my head with a sad smile. He still had trouble with my sense of humor. “Euphemism, honey.”

“Hmm,” Stephanie speculated. “Sounds like you’re letting go of the past, the long-ago past.”

“Yeah, the long-ago helps me deal with the near-at-hand. When I think about dying…” 

Steph shook her head firmly. “You are not dying, you’ve got your whole…”

“No,” I countered, “no, when I think about dying, I don’t think about me” – here, I swept my left hand down my body, my right hand pointing to my head – “I don’t think about all this being gone. It’s my story, who I was, who was with me, who loved me, who I loved, where it all was going, all the beauty that I saw – that’s what worries me, that that will disappear.”

“But we’d still remember you, your story. As long as you’re in our hearts, you’ll still be here,” Petyr asserted.

I touched his hand. “Memories fade. Worse, they get transformed, gauzed over into dreamy highlights. And then one day you forget, move on, or you’re gone, too, and what happens to me? I have to share the beauty as I saw it, capture it in amber, for myself, then let it go.”

“Can I see it?” Steph wondered.

I laughed. “You’ve seen my handwriting. You’ll never be able to read it, not without a microscope. No, wait until I type it up, OK?”

xv

For my birthday, my thirty-fourth birthday, Petyr brought home a giant present. Ripping off the ribbon and sparkly paper revealed three white cardboard boxes with purple cursive lettering, ‘Lisa”. The image of a keyboard on one, a strange object with a long purple tail on another.

“What is this?” I demanded.

Petyr proudly said, “A computer. A home computer. You have heard of the Apple? This is their next iteration.”

“Oh, come on. I could never use a computer. All that code, the green flashing light on the screen – would drive me nuts, I don’t have time to learn all that.”

“No, no, no,” he asserted. “This is supposed to be easy, much easier. See, they call this the ‘mouse’…” He proceeded to unpack all the parts, snapping cords into sockets, switching it on to reveal a stylized smiling face superimposed on a little box.

He was right, it only took me a week or so to get the hang of it. As I started to transcribe my “book” into the machine, he came in with both hands behind his back.

While the machine whirred softly in the background, he produced a clear glass vase, followed by red and yellow roses. After placing the bouquet on the desk next to the keyboard, he got down on one knee, took my hand, and was about to speak.

“Yes,” I said. “Yes, of course.”

“You do know I just came in to ask you, please, could you type a little more quietly?”

His eyes twinkled as he stood up, pulling me with him, closer, firmer, while I nodded, saying softly, “You can’t fool me, you know.”

After the initial joy subsided, we started to plan.

Before we got too far, I said, “Let’s not make any final decisions, now. I want to wait, wait until I’m a year past my treatment, disease-free, two years since the diagnosis. If I’m well, in remission, no relapse, then, yes, yes, we can plan our marriage.”

Petyr nodded, repeating, “Yes. Yes. You’re right, of course.”

xvi

October, we sat in Dr. Viqueira’s office, waiting while he came back with the test results at my two year check.

He sat down at his desk, straightening his coat. He looked briefly at Petyr, down again at the papers in his hand, than up at me.

“Dr. Stein, I’m sorry…we’re going to have to do a biopsy, go in and see exactly what’s going on in the bone marrow.”

Petyr almost shouted, “No! What’s happening? Is it back?”

Dr. Viqueira blinked twice, pulled his lips into a thin line, and said, “Yes. From the CBC, looks like it, yes.”

That night, Steph came over. Petyr was distraught, and couldn’t manage a simple sandwich, much less the calls we needed to make, searching for a bone marrow donor in anticipation of the pending biopsy.

“ He said we should test all the family members, my mother, Charlie, Henry,…”

“Lisa?” Petyr wondered.

“Lisa, too.” I answered. “Steph, if you call mom and Lisa in LA, I can handle Henry and Charlie. They can get tested where they live, right? And you’ll make sure the typing, the HLA antigen results, gets to their doctors? It’s all so confusing.” I paused in wonder. “A bone-marrow transplant…” I bit my lip as a shudder of fear rippled from my chest down to my knees. “I know one of them will…”

“Don’t worry, we’ll find one. This is going to work out, Sarah, it will.”

In the end, it was Charlie. He and mom arrived by Halloween, ready for the trip in to Dana-Farber on November 1st.

“I read about this, sis. Sounds like a lot of fun, when they stab us there,” he said, point to his lower back.

I smiled, took his hand, and said, “I’m sorry, putting you through this.”

“You’re the brave one, Janie. Point me in the right direction, I’m ready to go.”

Next morning, I waddled into the cath lab, mom tugging at the strings of my hospital gown, making sure it stayed closed, did not reveal too much.

“Don’t worry about it, mother,” I laughed drily. “They’ll just open it up again once I’m in there.”

Fussing, she said, “Oh, sweetie. Putting that giant needle in your arm…”

“My chest,” I said. “Under the clavicle. Don’t worry, it’s routine, they do it every day here.”

After the local and the antiseptic painting of my collar bone, I drowsed under the Valium and Nisentil. I wasn’t worried, merely curious, when I heard the doctor say, a little too loudly, “Pressure there!” The nurse asked, “What?”

“Extravasation,” he said. “I’m pulling back! Keep the pressure on!”

xvii

My days are filled with mystery and wonder now, inside this bubble. After the bone marrow transplant, they said I’ll be inside here through February, 12 weeks in all, Charlie’s cells kept me alive, but wouldn’t ward off the normal micro-flora we all live with, unthinking, every day. I would not survive a week exposed to that.

After much cajoling and sterilization, Petyr and Steph convinced them to let me take the Lisa in. I’d finished my story in September, but decided, it couldn’t end there, abandoning Michael Harrison to his future in Los Angeles, so now I’m writing it the rest of the way, all the way, to what end I do not know.

After the hematoma from the botched CVP resolved, they’d tried again, were successful, and I started sharing cells with my oldest sibling. I’d thought The Boy In The Bubble was a Hollywood fable, but soon learned that, no, immunocompromised patients actually lived in this splendid isolation, able to see, but never touch, the world outside, their friends, their family.

The second day, Petyr came in the room carrying another vase of flowers. He set them on the table outside the bubble’s port, and announced, “I don’t care, Sarah. I  have set a date for us. I’ve got the hall, told the boys, made sure they’ll be there.”

“What? No, Petyr, I want to be whole, be well for you…”

“Nonsense. I’m not going to lose you. Not now, not this way. We’ll make it work.”

“When? How?”

“On a Sunday, May 27. Everyone will be there, you’ll see.”

Two days after my birthday, I thought. I can make it that far…

xviii

Sarah’s handed me her pen, and that composition book she carries everywhere.

“Mother, I can’t anymore. I just can’t. Will you take notes, make sure you write what I say, what happens, OK?”

Honey, you know I’m not a writer. Can’t someone else, Petyr…?

“No, it has to be you. You’ll know what to do, how to do it.” Sarah breaks down in another one of those coughing fits, then goes back to wheezing. She looks so tired, the circles under her eyes, her hair – her beautiful hair – so thin, so scraggly!

The doctor comes in, that busy one, who has to take care of all these people in the ICU. I don’t know how he does it. He really should get a haircut.

“Mrs. Stein,” he nods at me. “Sarah?” He lifts the sheets, listens to her back, her chest, breathing with her as he does.

“The pneumonia’s getting worse. The antibiotics aren’t enough,” he says. “It’s time for a ventilator, I think. You know what that means, Sarah?”

She nods. She must know, all the time she’s spent in hospital now. Then she shakes her head back-and-forth, back-and-forth. “No, no.” she struggles as she whispers. “Hooked up…to a machine…to breathe… for me. No…I’m done…with that.”

But Sarah, I say, your brother, Petyr, what about…

Again she shakes her head, “What’s the point…there’ll just be…another time…”. She falls back in bed. She looks exhausted.

The doctor asks, “Are you sure, Sarah? You know what this means, the chances of…”

“I know.” She pauses, another breath, a cough. “Today…today’s my birthday…It’s time…Time to let it go,” she says. “Let it go.”

xix

Petyr’s here this evening, he’s been here all day. Their wedding day. Or was. She made us cancel everything. I kept the flower order, brought them in, the white, the yellow seem so pure. I hope she notices.

He holds her hand, watching her breathe, each one a struggle now. She’s been sleeping all day, still here with us, but not, somehow. He looks at the clock, as it shudders a bit, that thing it does shifting past midnight to start another day. He stands up, leans over, kisses her cheek. She stirs, but doesn’t wake.

“I’m going for another coffee. You want anything, Miriam?”

No, I say, I’ll keep watch for now. Stretch a bit.

He leaves. Sarah moans, then so softly, so weakly I barely notice, she says, “Move…The light…”

What, honey? What is it, Janie? I lean forward, my ear nearly touching her cheek. Is there anyone else, someone you want me to call?

“He’s right here…I see him…it’s getting brighter…like a sunset … those rays…of light …and shadow…when it drops… below…a cloud…”

I grip her hand tightly. Shh, shh, I say. It’s going to be all right, Petyr’s coming back.

Her eyes still closed, she insists, “No, no,…he’s here…I can see him…getting closer.”

What do you see, sweetie, who is it?

“He’s reaching out…to me…for me…his arms…I feel a smile…his…

viii

Petyr’s final seminar, “Illness in the analyst and professional wills” almost put me to sleep. Barely into my 30’s, I didn’t see foresee any need to worry about this in my work. At dinner, I mentioned the upcoming wrap-up meeting of the NIMH working group on C-L psychiatry.

“This might well be my valedictory working on big group projects like this,” I started.

“Where is it, again?” Jeanne asked.

“Burlington,” I reminded her.

Walking by with his tray, Petyr overheard, stopped, and asked, “You are going to Vermont, Sarah?”

I nodded, then explained the work I’d been doing for the Harvard psychiatric residencies the past 18 months. “It should be beautiful there, early February, but I’m a little worried about the drive, if there’s snow.”

“Surely all your years here in Boston, you’ve learned to handle winter’s adverse conditions?”

“Of course. Ever since someone told me, ‘You can drive as fast as you want on snow or ice, as long as you don’t have to turn or slow down,’ I’ve discovered that, as long as you keep going, and don’t try to stop on a hill, you’ll make it.”

Petyr sat down, unfolded his napkin, and, nodding at Jeanne, turned to me, noting, “Burlington, you say? Perhaps you might want to stop at Killington on your way back, at my condominium. It would ease your drive home, and you might even take the opportunity to go skiing?”

I quickly thought, what is he asking? I felt attracted to him, but I’d assumed his on-going disentanglement from his wife prevented any opportunity to pursue that for the time being. “Will you be there?” I ventured.

He straightened up, blinked several times, and said, “Oh. Yes. We do have several concerns, don’t we? First, there are two bedrooms, you could use the boys’. Now, this being the last seminar I’ll lead this year, I don’t believe there is any reason we can not shift our relationship from student/teacher, to amicable friends.” He paused, glanced again at Jeanne, then, somewhat flustered, went on. “I have enjoyed our weekly talks here, and would look forward to continuing them outside the confines of the Institute. If you feel the same, of course…”

I glanced at Jeanne as well, who ever-so-slightly lifted one side of her mouth and raised her eyebrows. I began to wonder what it would take to break through his formal veneer, or if that were Petyr through to the core. Only one way to find out, I decided.

“Thanks for the offer. I’d like that. And, no, we don’t have to talk about analysis at all. Fun in the snow in old Vermont. We could be like Fred and Bing in Holiday Inn…”

I drove my trusty Saab to Lake Champlain Thursday afternoon. The twisty two-lane was thankfully free of any ice, Vermont having suffered through one of its periodic cold, dry Januarys. My headlights reflected off the naked skeletons of beech and maple, and the dark green needles of ever-present white pines. My thoughts raced past the upcoming conference, to the Saturday evening, night, and Sunday I’d be spending with Petyr. I concluded he needed to be led out of his self-imposed isolation. I conjured a fantasy of us sitting by a popping fire, sparks showering as pockets of caught the heat. We’d share drinks with a jovial group of tired skiers, lifting or glasses to their tales of prowess on the slopes.

I easily found the condo, its first-floor covered entry sporting vintage cross-country skis instead of a standard lintel. Petyr greeted me wearing a shiny blue nylon ski pants, perspiring slightly in his grey woolen sweater festooned with small skiers and reindeer in alternating rows.

“Oh, Sarah,” he began. “It was an invigorating day, despite the icy conditions. I always marvel that my muscles retain the memory of skiing, after weeks, or even months of time away. Come in, come in!” He took my satchel into the boys room, pointed out the features of his compact vacation retreat, then asked, “I haven’t yet eaten. I suppose you might be famished as well, after your drive over the hill?”

I told him my fantasy of hot chocolate – “I’m not much of a drinker” – while resting my legs next to a stone hearth, amidst other tired skiers. “I could pretend I’m one of them, maybe some of the ruddy-cheeked energy will rub off.”

We walked to an inviting pub, where the German food proved too heavy for my taste, the stone hearth crowded with raucous collegians, and the noise far too dense and confusing to allow any real conversation.

“Anywhere else we can go, might be more quiet?” I asked.

“Do you like board games, Sarah? We have a trove back at the condo, the boys and their…” He trailed off as he often did when thoughts of his family surfaced.

Quickly, I intervened. “I love Scrabble.”

“Oh we have that, of course. But are you sure you want to test your verbal prowess against me? I don’t like to lose.”

“You’re on, Dr. Cohen!”

Once back, I asked if he had any schnapps, for hot chocolate. I was delighted when he started to drink his straight, while I poured a thimble-full into some hot chocolate he eagerly created for me. I thought, “We’ll see how straight his thinking is when he gets a little drunk.”

He graciously offered to go first, placing “under” across the center star, saying with a hint of pride, “Twelve.”

I eyed my tray, filled with several e’s, an s, t, an o, j, and a q. Instantly, I slammed down “joust”, and snickered, “ Twenty-eight!”

The game remained close as we filled the squares ever-closer towards the edges, where my favorite spot, the bright red “TRIPLE WORD SCORE” beckoned. I’d been saving my “q”, and had also managed to get “z”, so I knew I had the game won as I started to line up my tiles in the lower corner, using “usurp” as the seed.

When he saw where I was headed, Petyr moaned, “Oh, no…what have you got there?”

“Don’t worry, it’s only three more letters. This “i” goes here,” I said as I laid it carefully one up from the triple word square. I gave him a sideways glance, then proceeded to spell “quiz”, for 96 points. “That should do it. Want to give it another try?”

He reluctantly shook his head, saying, “I see your competitive spirit is every bit as sharp as your insights. I fear you are too quick and well-read for me. I still do not believe that ‘jabiru’ is a word. Where did you learn that?”

“I told you, it’s a stork, has a big bill. You’ve never heard of it? I don’t know where I saw it, everything I read sticks with me, for some reason. Lots of useless information in there,” I said, tapping my temple. “It’s kind of a curse, really. Most people find it off-putting, when I start telling them stuff they don’t know.”

“I find it rather alluring,” he said as he gathered up the tiles and rack, placing them carefully in the box, which he returned to the bottom shelf of a converted television cabinet. “What do you say, tomorrow we go out to a Nordic trail?”

“I didn’t bring anything to wear, no ski clothes.”

“We can find something for you here. You’re about the same size as…”

ix

On my return home, I found a letter waiting for me from my mother. Starting with cheery news about her new neighbors in their apartment complex, she went on to describe her frustration with Henry, who insisted on working every day, even though his doctor told him he had to “slow down, until the blood pressure meds are doing a better job.”

“I don’t know how to get him to see he’s ruining his health. He still smokes, he forgets his pills, he won’t drop the steaks from his diet. I don’t know how to help him, Janie. Any advice?” she wrote. She ended with, “Oh, I’ve been going through all the boxes we took with us after the move, and found one full of of your stuff, from h.s. or college. Enclosed is a small sample. What should I do c it?”

Two yellowing sheets from one of my high school “math pads”, neatly folded in quarters, fell out. I’d forgotten about those poems I had written in the spring of 1966. I read them quickly, unable to immediately absorb their message, and stuffed them into my purse, along with the Kleenex and loose change.

Petyr called later that week. “Sarah, I need to see you, talk with you. I hope you’ll agree to have dinner with me, Saturday night.”

We met at one of those cloistered, wood paneled gourmet establishments near Back Bay. Men in suits with thinning hair accompanied women in designer frocks, somehow not wobbling on their impossibly thin four-inch heels. I’d worn my non-nonsense blue skirt with a jacket over a white buttoned shirt, and felt more than a little out-of-place, wishing I’d investigated the place after agreeing to meet him there.

During the wait between ordering and the arrival of our salads, he began, “Sarah, this is awkward, for several reasons. First, as you can imagine, I am not used to a formal night on the town with someone other than my wife. It may have been 15 years or more since…” He shook his head slightly, almost a shiver, then went on. “But more important, is what my invitation implies.”

At this point in my life, I no longer felt a need to ease tensions on a date, if that’s what this was. “Petyr…Petyr, I like being with you, talking with you, very much. I want to do more of it, but I can tell, you’re still worried about where you stand in your marriage, your wife, your sons.” He fiddled with his silverware, re-arranged his water glass, but said nothing. I plowed forward. “If you’re feeling hesitant about spending time with me, I can understand. I can wait.”

He took a deep breath, and said, “I have the same feeling, about you. It’s disconcerting, not having known it for almost two decades now, at least the newness of it. My worry is not whether it’s reciprocated – I can pick up the signs very well – but the impact it might have on my separation and intended divorce.”

I frowned and shook my head quizzically. “Oh?” was all that came out.

“Yes, there is no doubt my marriage is over. It only remains to call in the lawyers, unweave our financial entanglements, and decide on the future of our children. Up until last weekend, I had hoped that would work out favorably for me, as she is the one instigating the proceedings.”

“And you’re worried, I guess, that if you’re seen with another woman, seen with me on a steady basis, at your place or mine, that might be discovered, and used against you.” As I spoke , the phrase, “other woman” flashed across my inner vision. “And for my part, I couldn’t live with myself, knowing I might have have played a role in breaking up a family, your family.”

“Oh, no, no, no,” he interjected. “As I told you last fall, our separation began for other reasons entirely, before I ever arrived in Boston. Meeting you was such a happy occurrence, but it did not, most emphatically did not, end my marriage. That was over, I see now, several years ago. With you, I’ve found a reason to move forward with letting it go.”

I sensed we had a common goal. “I don’t want to sneak around to enjoy time with you, don’t want to feel like we might be surreptitiously observed.”

“And nor do I, nor do I. That’s what I’m trying to tell you.” He straightened up, and announced, “Next week, I’m going to ask if she intends to move forward with filing for divorce. If she does, and she gives ‘incompatibility’ or some such legal jargon as the reason, then my lawyer says it would be safe to enjoy the company of other women.”

There was that phrase again. I observed, “Until then, we can talk on the phone, and confine our meetings to public places, like this, separate cars, and all?”

“Yes, he says that’s best.”

“Sort of like teenagers, who aren’t allowed to date without a chaperone?”

He laughed. “I’m glad you see the humor in it, in addition to the frustration.” The server brought our entrees. Knife poised ready to carve his filet mignon, Petyr asked, with a growing twinkle in his eyes, “What I’m saying, Dr. Sarah Stein, is – forgive the sentimentality – ‘Will you be my Valentine?’ It is February 14th after all.”

I laughed out loud, startling the neatly coiffed couple closest to us. “I thought you’d never ask, Dr. Cohen!” I suddenly thought of the two pages of verse from 15 years earlier, and drew one out, gave it a brief glance, and handed it over to him. “Funny,” I said. “Mom sent this to me out of the blue a few days ago. Said there was a box full of stuff like this. I wonder if she was trying to tell me something…”

Dated 4-23-66, the one I pulled out read, with several words crossed out and replaced:

Just once I wish that you I could join my your world

Together, until there were was no longer need to talk

Seeing the stars and feeling new thoughts

No longer needing explanations or words

Smiling without questions

Crying and understanding why.

It seems it would be so nice to know

What is really there between the talk and silence

To know what is being felt

So that I could know how to act.

Yet despite the frustrations, I cannot change it now

We must remain separated

To join your world, I could no longer own mine

We are not allowed to learn too much

But do we really want security?

“Do you remember writing this, what you were trying to say?” he asked.

“I remember when I wrote it, what was going on in my life. But the actual writing, that’s buried in a mental fog. It does seem to fit us now, though, doesn’t it?”

Petyr wrinkled his forehead in thought. Looking over at me, he said, “It might be interesting to get the rest of that box from your mother, no? I would like to learn more about you, who you were, and suspect that might be a good place to start.”

x

Despite Petyr’s hesitance, we started spending more and more time together, that winter and early spring. By March, we began sharing our weekends. Falling into domesticity came easily to us.

One Saturday afternoon in bed, after we’d rolled apart, I lay on my side admiring his face. Stroking his eyelids, I murmured, “Kirghiz eyes.”

Startled out of his languid reverie, Petyr rolled to face me, asking, “Come again?”

“I said, ‘Kirghiz eyes.’ You know – Thomas Mann, The Magic Mountain.”

“Ah yes, Hans Castorp. His initial schoolboy homoerotic infatuation with Pribislav Hippe, reflected later in Madame Chauchat.” I worried he’d drop into his professorial mode, tell me the whole underlying leitmotif. Instead, he smiled and said, “Davos. My parents took me there, each winter. We’d ski, of course, then sit on the porch in the alpine sun the same as Hans and Settembrini, snug under a warm wool wrap. My father would recount that book, one of his favorites, to me on that deck. I’ve never read it, not wanting to spoil those memories.” He smiled again, then asked, “What do you know of it?”

“Your eyes, they have that Eurasian look…”

“Brought west by some Mongol marauder, no doubt…”

“I never read it, but Michael – I’m sorry to bring him up, you don’t remind me of him, but…he read that book for two different classes his freshman and sophomore years, never stopped talking about it. For several weekends one fall, every time I turned on the light, he’d call me ‘Settembrini’.”

“I’m flattered,” Petyr began. “Reassured, actually, that you see a bit of Michael when you look at me, in a metaphorical way.”

Quickly, I interposed, “I’m sorry, what? I didn’t mean to being him up, it’s just that…”

“He’s still in there,” he said, pointing to my temple. “As I said, I’m flattered. First loves, whether a father, mother, or a boyfriend, are so very important. They set a pattern, a template, against which the future can be judged. I trust I’m not found wanting?”

I paused to take measure of my feelings, discover what they meant. “With you, it’s deeper, broader.” I pursed my lips, wanting to make sure I got this right. “I feel…I feel, with you, it’s about creating something, someone new. Not about either of us as individuals, more like creating an ‘us’. Does that make any sense?”

“If it feels right, Sarah, it doesn’t have to make sense.” He sat up, pulled on his pants, and said, “Two becoming one, I didn’t know I was searching for that, but I see now you have brought that to me.”

Sunday morning we strolled to a deli, to pick up the New York Times, coffees, and a couple of bagels with schmear.

“How can you tolerate that cinnamon raisin with the strawberry cream cheese?” he teased. “And then cranberry sauce instead of lox – where on earth did you learn that?”

“Cincinnati is a very provincial town, you know. Be thankful I’m not putting chili beans on top,” I countered. “And downing it with beer.”

He laughed, then turned serious. “What we talked about last night? All I want now is to share my life. With one other person. Sharing and companionship…it’s like the sound of one hand clapping. If there’s no one to reflect or relate to…”

I finished his thought, “You don’t really exist at all.”

He smiled, wiped some cream cheese from my lips, then kissed me softly there.

The next day, Charlie called. “Sis, we’ve got to go home,” he began.

An ominous beat reverberated in my chest. “What?”

“It’s dad. Mom called. Sarah, dad…well, he must’ve had a heart attack.”

“Oh, my god, how is he?” I stammered.

“She said he was at dinner, just moaned and fell over. They didn’t make it in time…”

“Oh…” More softly, “oh…” was all I could manage.

Charlie drove up from Connecticut, bought our tickets, and shuttled me through Logan. By the time we arrived, Miriam had steeled herself to Dad’s death, insisting on making arrangements, a caterer for the keriah, friends to help us through sitting shiva. We said little, spending most of our time sorting through the boxes Mom brought out for each of us, the salvaged flotsam of our youth.

“You kids have to deal with these. I’m going to find a smaller place, one where your father isn’t around to haunt me every day.”

Charlie and I drove Dad’s car back to New England, hoping it would help us decompress. We talked of our days together, the old home in Clifton, summers in Martha’s Vineyard, visits with Arlene and their kids in Cambridge – anything to keep our minds off the diminution of our family, the knowledge that, as Charlie put it, “I’m the patriarch now.” All through Ohio and Pennsylvania, new leaves appeared, almost neon green as we sped by, the annual sign of rebirth and future’s promise. I couldn’t wait to return to Petyr, share my healing grief with him, and explore what that future might hold.

I showed up at his apartment door, carrying my two suitcases while Charlie man-handled a cardboard box labeled simply, “Janie – H.S./Rdclff”.

Petyr appeared bemused. “Moving in, are we?”

“No, this is that box of childhood memorabilia I told you about. I haven’t opened it yet…”

“Sort of like a buried treasure,” Charlie blurted. “Good to meet you, I’m Sarah’s brother, Charlie?”

“Ah, yes, the father of her children, she sometimes calls you.”

Charlie looked askance at me, then said, “I have to get back to them. Arlene’s been alone ten days now, I can’t imagine…”

Petyr brought out a small box cutter and sliced through the tape, while saying, “Let’s see what we have here, all right?” He pushed the box towards me, “You do the honors?”

I pulled out first a yellow slicker hat, some play handouts, from which several tickets fluttered to the floor, stacks of folders with labels of a few high school and many college courses, fading photos, old yearbooks, yellowed newspaper pages from the Times, Enquirer, and Crimson. Amongst other odds and ends, I pulled out a thick, pink diary, its clasp locked shut. From the bottom, I extracted a peach-colored folder labeled “Love Rhymes”, containing all those onion skin papers, filled with Michael Harrison’s verses and stories.

While I went took the diary into the kitchen, Petyr lifted the crinkly onion skins, asking“May I…?”

“Oh, go ahead…what can it hurt?” I muttered.

In the kitchen, I managed to jimmy the lock, and, opening the diary, became lost in a different world and time, the spring of my junior year in high school. Time stopped while I floated through those memories.

By the time I returned, Petyr was half-way through the stack of poems. “These are..interesting,” he announced. “Appropriate, I guess, for a young man finding his first love. He was smitten with you, you know.”

I began to cry. He dropped the papers and came over, enfolding me in warmth while I shook with sobs. “Shh, shh,”, he said, stroking my hair over and over.

I calmed down. “I don’t know what it is,” I sniffed.

“Sarah, your father just died. It’s OK to cry, to keep crying. It doesn’t end after only a week, you know.”

“It’s not that. It’s this, all this,” I said, drawing back, sweeping my arm from the diary to the box now half-filled with reminders from another life . “I don’t know what to do with it. What am I supposed to do with it?”

“You’ve thought about this before, I’m sure?”

“Of course. All three of my therapists, they told me I need to put him away, behind me, in order to move forward.”

“And how did you feel when they told you that?”

“Angry. Angry and sad.”

Petyr gently grabbed both my shoulders. “Sarah, you should not, you do not need to, put him away. He will always be a part of you, informing and enhancing your future, if you let him. You need to put the anger and sadness somewhere they won’t overpower those lessons he gave you.”

“How? How do I do that?” I asked.

“The anger, the sadness, those are you, not him. You need to honor your memories, to let them go, learn from them.”

“OK, you’re so smart, you’re the analyst, how do I do that, if I haven’t been able to after ten years of trying?”

“If you wrote about it, if you had an inner conversation, you could find the box to hold these feelings in, and learn what he had – has – to teach you.”

“You really think that would work?” I asked with exasperation.

“Our lives are stories, in which we are the main character, no? It’s time to uncover yours, Sarah.”

xi

Petyr spent August in Vermont with his sons, while I continued to cobble together a career. Monday, Wednesday, and Friday, I worked in Wellesley at the state mental health clinic. Tuesday and Thursday mornings, I met with individual clients in my little office, slowly growing a reputation for taking on the most recalcitrant and rebellious teenage girls, brought in by mothers passed exasperation. Now desperate, they saw me as the last stop for their daughters before a life on the street loomed. I listened to and agreed with the girls, until our routine built into trust, and the trust could seed a return to a stable life,  even if not to their families.

Thursday afternoons and evenings in the summer were free, no classes at the Institute until the start of my second year in September. Occasionally, I’d accompany psychiatric residents and psychology interns on their rounds at the hospitals, talking with them afterwards about what we’d heard, what they’d learned, and where to look for help and information. I appended “Clinical Instructor, Harvard Medical School” to my business cards and stationary.

On his return, Petyr announced that he and his wife had signed a formal separation agreement, recognizing each of them as independent agents, allowing them free rein to openly date.

“So,” I teased, “I’m no longer alienating your affection?”.

Petyr smiled. “You seem less worried than I do about the risks we still might face. It’s true, according to my lawyer, she has no cause to complain, but if we were to move in together, he says a judge might consider the timing of that suspicious, wondering when our…affair might actually have begun. It may be a man’s world in politics, business and the university. But in divorce court, we do not get the benefit of the doubt.”

“Affair?” I challenged him. “Is that what this is? All I know is I’m no longer going to feel as if I’m, as if we’re sneaking around. I can’t hide anymore.” I took a deep breath, and risked, “I love you Petyr. You’ve got to l know that, and we need to start acting like that, as if it really means something.”

“What should it mean, beyond what we’re doing now?” he asked.

“I have to be absolutely sure this is not some rebound thing, that we’re together for our future.”

“Sarah, whatever happened in the past, for either of us, that’s where it is, and should stay. Yes, I want a future with you, for us, however, whatever, wherever. How can I make you see that?”

“Well, there is that little saying, ‘in sickness and in health’,” I blurted out.

“Oh, come on, you know that’s not possible, not until…”

“I know, I know.”

“What might convince you?”

A sudden thought raced through my mind. “Another symbol, Petyr – maybe I should bring you home to mother, announce our intentions?”

He laughed, then saw I was serious. “Well, taking off to go back there…can either of us afford that?”

That night, I called her. “How are you, Mom?”

“Oh, don’t worry about me, sweetie. I’ve got so much to keep me busy now, finding a new place, packing up again, meeting with the ladies at the temple. I’ve even started reading again, novels. Found a book club – I like that, making up for what I missed all those years. What about you? You must be very busy?”

Suddenly, I felt very tired, thinking about all I did, the stress of Petyr’s hesitance, dad’s death. “I’m exhausted Mom. I sleep 9, 10 hours a night, only have energy to go to work, then flop down after dinner, can’t even read or watch TV.”

“Oh, anything I can do? I could come see you, help out a bit.” She paused. “You think it might be lingering from his passing? Sadness can make you tired, I’ve heard.”

“I don’t know. But yes, could you? You can help me tidy up, there are friends, new friends, I’d like you to meet? Can you?”

She agreed to come in early October. After the call, Petyr seemed pleased I’d gone ahead and invited her to Boston. “But don’t you think it’s time, before she gets here, to look into that box she gave you? “

I remembered my promise to him, to try writing my story. Not knowing how to start, I re-opened the diary for inspiration. Reading those first glimmerings of curiosity about, as Petyr called him, “that boy”, I envisioned writing a letter to Mike, a missive explaining myself at that time, trying to decipher what it all meant. Not knowing exactly where he lived now – Oakland, or was it San Francisco? – proved a boon, as I didn’t imagine he’d ever actually be reading it. I simply needed a mental image of an audience to get started.

Even so, I found myself stumbling as I worked through those first few months in my diary, unable to write more than half a page at a time, before dropping my pen, feeling exhausted, a piercing pain between my eyes. I set it aside for a better time.

Mom arrived on the 7th, taking a cab from Logan out to my place in Somerville. I greeted her at the door with a prolonged hug, while Petyr stood awkwardly on one side, smiling, not knowing where to look. As we pulled apart, Mom noticed him and said, “Hello. I’m Miriam Stein – Janie – Sarah’s – mother.” She looked back at me questioningly.

I ushered her inside, taking her coat while Petyr picked up her suitcase, a valise with several decals plastered along the side – “France”, “GB”, “Israel”.

“Mom, this is Petyr. Dr. Petyr Cohen. He and I … he’s at the Institute, an analyst. I met him last year.”

“So glad to meet you, Dr. Cohen. How are you?” Mother’s eyes sparkled as she eyed him up and down.

“Mrs. Stein, Sarah has told me so much about you, your family.” His smile dropped as he went on, “I am so sorry, was so sorry, to hear of your husband’s passing. How are you doing?”

Mom smiled wanly, “Always a fraught question, coming from an analyst.” Petyr gave a polite chuckle while she went on. “Actually, I feel a bit relieved. Sad, of course, and devastated. In shock for a few months after. Now, I see it as his final gift to me, the gift of time, and perspective, about what is real, what is valuable, in life.”

“And that is…?” he asked.

“Time, Dr. Cohen. Time and love.”

We spent next day, Yom Kippur, with Petyr quizzing mom about my childhood, my brothers and sister, and finally, gently, about my father. She learned about his cultured upbringing in Switzerland, his parents’ disappearance in the Holocaust, and, finally, his sons and his pending divorce. After sunset, mom and I went into the kitchen, working on dinner, while Petyr left for his place, to catch up on the work he’d left idle on this Day of Atonement.

“Sweetie, he’s so charming, so precise. I notice he spent the night here…”

I knew this was not a comment, so I answered, “Mom, I’m…we’re in love.”

“Love?”

“I know, it never makes sense, does it? All I know is, it’s there, I feel it, I need it, and he does too.”

“Are you sure? He’s not just reacting to his wife leaving?”

“All I can go by is what he says, what he does. I can’t know what’s in his mind, can I? Not for sure, not with anyone, can we?”

“That’s true, that’s true. And you’ve always known your own mind, Janie, never let anyone tell you what to do. I trust you, that’s one reason why I’ve always been so proud of you.” She stepped back, collected herself a bit, and said, “One other thing, sweetie. How are you feeling?”

“About Petyr? I told you…”

“No. I mean, you look so pale. All we did was sit around today, and still, you’re sighing, rubbing your forehead, you seem so tired. Are you working too much? I know how you drive yourself.”

“I am tired. I thought it was a delayed reaction to Dad, or all the newness, Petyr, growing my practice…”

“Have you lost weight? I can’t tell, it’s been five months, you look thinner. Have you seen a…”

Exasperated, I knew she wouldn’t let this go. “OK, mom, OK. I promise I will see a doctor, get checked out. All right?”

Mother left several weeks later, before I finally saw my FP at HCHP in early November. Stepping into the small exam room, he seemed distracted. When he learned I was on the med school faculty, he unloaded with a brief diatribe against the increasing workload. I finally got his attention directed to my problem, and he quickly went through a history. Upon learning of my weight loss, and lack of a period for two months, he said, “Hmm…could you be pregnant?”

“I’ve been taking pills.”

“Well, we should check anyway. A urine test for that, some iron pills and a B12 shot. If you’re not pregnant, and you’re still feeling like this after the shot, let me know, we’ll look further.”

While waiting at the pharmacy to get my pills, I saw Stephanie Seacrist bustling by, her white coat flowing behind her as she sped toward Women’s. She stopped abruptly when she saw me, did a double take, and said, “Sarah, hi!” She frowned, then sat down next to me, resting her hand on mine. “I’ve gotta get to L&D. Delivery. But, listen, you look so pale. What’s going on, can I ask?”

I filled her in, and she blurted out, “B12 shot? No CBC? Really?” She pulled out a prescription pad, wrote quickly, ripped off the page and handed it to me. “Go to the lab, get this blood work. I’ll call you this afternoon with the results. OK? Please!” Then she jumped up, off to bring another life into this world, I presumed.

Bewildered, I looked down at her scribbles, hoping they would translate into some answers.

v

My repeated inquiries at the Boston Psychoanalytic Institute finally bore fruit. I met first with Dr. Jacobson, the executive director of the Institute, soon after my return from San Antonio.

“The Board has come around to your view of our field, Dr. Stein,” Dr. Jacobson announced. His stark Nordic features contrasted with his warm mid-south accent. “We’ve been looking for the right candidates to ‘break the barrier’, so to speak, and expand our analytic training programs outside of the stranglehold my medical colleagues have enforced since, well, since the time of Freud. Someone with your background, Harvard, your work in their psychiatric training programs, as well as your background in research…well, let’s just say both you and we can’t afford to have you fail, and what I hear from all your references is, that’s never an option for you.”

I smiled. Even though this is what I’d heard all my life, it had never reassured me. At least he was frank about telling me what the stakes were. “I honestly don’t know if I’m completely ready for total immersion, for being the guinea pig.”

“Glad to hear you say that. After talking it over with Dr. Rosenthal, our Dean of admissions, you could start out as a fellow. Spend a year in our Thursday evening seminars, keep on with your own therapist – is he an analyst? – and if things go well, if both you and we feel the case has been made, then you could transfer in to the the second year, hopefully finishing by  – let’s see, if you start in September, then it would be June of 1985 you’d graduate. How does that sound?”

Relieved, I answered, “Yes…no, my therapist calls himself an analyst, he’s very Freudian, but I don’t believe he’s had a formal certification.” I leaned forward, and went on, “I’m ready, this is what I want. Truthfully, I can’t wait to start.”

That September, I quickly got into the Thursday night rhythm at the Institute. 5:30- 7, Basic Concepts, then dinner in the atrium, followed by Introduction to Analytic Technique from 8-9:30. As I arranged my purse and notes before the start of the first seminar, I was startled by a tap on my shoulder.

“I thought that was you, sitting here in the corner, trying to hide!” Jeanne Heldman stood, one hand on a hip, head cocked to the side, a full grin creasing her face. “Janie Stein – what are you doing here?”

During her fours years at med school, followed by a psychiatric residency, we’d drifted apart. I’d last seen her in St. Louis sometime in the mid-‘70s, exchanging letters once or twice after. I leapt up, gave her a quick embrace, and said, “I haven’t seen you in…what…five years now? How was Philadelphia?”

She stood back, shook her head, and, as if in disbelief, said, “I got married!”

“Really? That’s …good, I hope?”

“Couldn’t be better. Found someone I actually want to have children with. He’s English, we’re going to London next year. I’ve already got a transfer arranged into the London Analytic Institute, they agreed to let me take the first two trimesters here, then…but wait, you’re not an MD, how…why did they…?
“Persistence. I guess. I wouldn’t let them go till they said, ‘Yes’.”

“That’s the Sarah Jane Stein I remember oh, so well,” she said with a bemused shake of her head. She went on, “After this, at the dinner break, we can catch up. I’ll tell you all about Roger…”

We spent the next eight Thursday evenings together, once again a little enclave of two, sharing doubts and dreams, renewing the subtle competition we’d used to encourage each other in college.

The second trimester featured Ethics, followed by Infant and Early Childhood Development. I’d raced through the syllabi the night before, and saw Petyr Cohen, MD, listed as the Ethics instructor. I called up Marcia, and asked, “What was the name of that guy you told me about, the one who had to hide during the war, ‘Peter-something’?”

“Petyr,” she said, with a light emphasis on the second syllable, “Petyr Cohen.”

“Right. I think he’s one of the instructors at the Institute.”

“Well, make sure you tell him I said, ‘Hello’.”

Dr. Cohen wore a rumpled dark brown herringbone sport coat with a blue tie, filled with small indecipherable red letters  in groups of three or four. While he explained how confidentiality serves as the basis of the therapeutic contract, I studied his face, his voice, his mannerisms. Exceedingly self-assured, he alternated between sitting at the head of the table, and walking around behind us as he spoke, sometimes pausing to lay a hand on one of us to emphasize a point, or ask a leading question, making sure to address each of us formally, as ‘Dr. —.” Proud as I was of the work that had led to my title, I still felt uncomfortable with it, as if I were wearing a coat several sizes too large. When it came my turn to be anointed, I noticed an unfamiliar tightening deep in my chest up through the back of my neck. I turned quickly, and found him standing several feet away.

“Dr. Stein, you are a psychologist. Unusual to see one of your profession here. I assume you follow the same standards of professional ethics and confidentiality as those of the Hippocratic persuasion?”

At a loss, all I could manage was a brief, formal smile and quick nod of my head. He smiled, said, “Right,” and moved on.

By the time we broke for dinner, with Jeanne in tow, I’d regained my composure, and found the courage to approach him. “Dr. Cohen, may we sit with you?”

He stood up, napkin in one hand, and, with the slightest of bows tempered by an equally slight impish smile, swept his hand broadly across the table. “Certainly, ladies. I’d be honored.”

I explained how we knew Marcia, gave him her regards, and asked, “You grew up in Switzerland?”

He ran his hand across the top of his head, softly ruffling his short-cropped hair, the slightest hint of grey at the temples. After an almost soundless chuckle, he said, “I was deposited in Switzerland by my parents when I was only 16 months old, in 1940, before their country – Hungary – sealed its fate by declaring war against the Soviet Union, July of 1941. My parents were prescient, I suppose, they knew what was coming, that Hitler would never let the Carpathian Mountains stand between him and an opportunity to expand his wretched Reich. And, of course, being Jewish, we never did find out what happened to them. Some camp in Poland perhaps? Who knows.”

“Oh, I’m so sorry…” I started.’

He brushed my concern away. “I was too young to even know them. I do have a picture or two, but to me, they have always been unfamiliar members of our star-crossed tribe. I mourn for them collectively, of course, but not as individuals. But thank you.” He quickly collected himself. “As I was saying, my real parents were an American doctor and his wife, a minor diplomat, both on the staff of the American embassy in Geneva, whom my birth parents knew from their previous assignment in Pest. By the time I was eight, I arrived with them in Philadelphia, a full-fledged citizen, with little memory of that tragic time.”

As he stopped to take a breath, and stab a morsel of lasagna on his plate, I asked, “But your name…?”

“Yes, that was from my birth parents. I asked my mother if she had a birth certificate. On it, the spelling is difficult to equate in English, of course, but she said the most common rendering would be with the ‘y’ instead of ‘e’. I am proud of it, every time I see or write my name, I can remember them, and how they sacrificed themselves for me.” 

He folded his napkin neatly after patting his mouth three times, then arranged his plate and utensils together in the middle of his tray. Looking deeply at me, he pronounced, “Well, Dr. Stein,” then, with a curt nod to Jeanne, “Dr, Heldman,” then back to me, “it’s been a pleasure talking with you. I hope we will share diner again next Thursday?”

“Please, call me Sarah,” I said, “I’d enjoy that very much.” As I rose, the jangle of keys falling from my purse startled us. He reached down, picked them up to hand to me, then halted as he noticed the small red toy jeep I’d attached to the crowded ring, nearly a decade ago, and forgotten as it faded into the background of my life.

Bemused, he asked with raised eyebrows, “Your car, Sarah?”

Frowning slightly, I tried to blink away the memories floating back. “My boyfriend gave that to me, when I was in college,” I found myself explaining.

“Oh?”

“He was a boy. Just a boy.”

vi

During December, Petyr Cohen walked us step-by-step through increasingly fraught scenarios of ethical dilemmas which commonly emerge during analysis. We easily dispensed with the risks of treating other family members of a patient, and receiving, or proffering gifts. Next, we covered non-sexual boundary violations.

After the seminar, Jeanne and I found our usual table along with Petyr. I asked him, “Can you give a real-life example of a violation, something I might actually encounter?”

He cleared his throat, sat up straighter, and pronounced, “Say your client has season tickets for the Bruins, box seats, front row. You are a big fan of Bobby Orr, and you wish to…”

“Wait a minute,” Jeanne interjected. “He retired a couple of years ago, didn’t he? I mean, I’m no hockey fan, but even I’ve heard of Bobby Orr.”

“Thank you, Dr. Heldman, I suppose you’re right. I’m not a fan either. I’ve never quite grasped the American obsession with team sports, especially the more violent ones like football and ice hockey. I believe it may have some connection with the deep strain of anti-intellectualism in our culture. The know-nothings who frequent these gladiatorial competitions – it’s as if their brains only have room for either sports, or useful thought. I was merely responding to Sarah’s request for a relevant example. Indulge me if you will?”

He paused, allowing me to interrupt. “I have that sports gene either. And you’re right, the amount of time and money we spend on all that play is inordinate, when it could be going to improve our society, to education, or…mental health.” Our dinner discussions had become the focus of my week, as I learned to banter with him and challenge his rigorous views. “But you said, ‘team sports’. Are there physical activities which do have a value, which can improve someone’s life, expand, not stifle our thinking?”

He turned directly towards me, and said, “I do love skiing. Growing up in Geneve, plying the piste was de rigueur. I have continued my love of the sport here in New England. Once my divorce is final, I hope the condominium we purchased in Killington will suffice in the settlement for me, while she is satisfied with the place in New York. As I was saying…”

I barged in, asking “What’s going on inside your mind, when you’re skiing? I knew someone, in college, who was obsessed with skiing. His senior, year in college he spent the winter in Aspen, then after his residency, another year in Salt Lake, skiing every day. He said those were the only times he felt free from…let’s see, how did he put it?…’the tyranny of thought’. He was one of the smartest people I’ve ever known, yet he seemed expanded, not diminished, by his time away from academics.” I reflected, “He had the same passion for swimming, another individual sport.”

Petyr’s eyes fell out of focus as he leaned back in his chair. “I agree, wholeheartedly, with that outlook. While I’m not obsessed, like your friend seems to have been, abandoning school, and then a medical practice, nonetheless, I relish the times I am able to test my prowess on the slopes.” Looking back at me, he narrowed his eyes and asked, “This is the same boy who gave you that Jeep on your key ring?”

I nodded briefly.

He smiled, and said dreamily, “I wish I’d had the courage of your boy friend. What was his name?”

“Mike. Michael Harrison.”

“Michael,” he said softly. “He had the right idea. Once in this country, my parents encouraged me to ski race. Ach! Every weekend! The gates, restricting where I could turn – all the beauty washed away from the sport. I complained, they never took me back, and we started going to Nantucket in the summer for vacations. Finally, when I returned to a conference in St. Moritz, meeting up again with old school chums, I remembered the beauty of the sport, the freedom of turning wherever one will, always seeking the least crowded line, following the sun across the hill. I came back, told my wife we would find a place in Vermont, somewhere the boys could escape the city…” He drifted off into his memories.

“Would it be a boundary violation, Dr. Cohen, if I asked you about your wife?”

“Certainly not. We’re all friends here, correct? Not analyst and analysand. What is it you’d like to know?”

“You have two children, right?”

“Yes, two boys, 9 and 7.”

“You must have loved each other, once. Why…how does that end, two people falling out of love? How can that be?”

He paused for thought, then said, “Love seems simple. And the younger we are, the earlier we are in a relationship, it is indeed simple. Think of your earliest loves , your mother, your father…”

I quickly said, “No words, we speak to them without words, saying a lot about very little – ‘I’m hungry’, ‘I’m wet’, ‘I’m tired’.”

“And yet, the love is unconditional, no? When love re-appears again, for the first time with someone outside the family, it pushes aside everything else in the world, all-defining, all encompassing, the same as when we were babes.”

Jeanne added, “Right. We learn how to grow with someone else. And sometimes, we grow in ways that run counter to being with that other person, is that where you’re going?”

Petyr nodded, “Correct. In my case – in our case – I discovered that my wife began to love our children, to the exclusion of all else. Not an unusual circumstance” – he glanced knowingly at me – “but one which a couple must work through in order to become fuller companions, to actually build a family. And that, I believe, was our failing.”

I challenged him.  “But wouldn’t you expect her to have that unconditional love for her children, for your children? Wouldn’t that be a strong foundation for a family?”

He sighed, for once speechless. Then, “We tried to work that through. Lots of talk between us. Lots of words…”

“But no feelings? No longer any feelings?” I asked, remembering my years with Howard.

“What is the saying, ‘It takes two to tango?’ For us, love died in tandem. I felt none for her, and none from her, for me at least. I tried to learn what I missed, what I did wrong. She insisted it was not me, it was her. But I believe it was us, together, as a pair, from whom love evaporated, as mysteriously as it seemed to come. It was not an argument, no specific behaviors she found lacking. Our foundation, the hidden core of any relationship, simply was no more.”

I wondered, “But couldn’t you have spent more time with all of them, tried seeing where that would lead? You might have created with her a different kind of love, larger, fuller, with a family.”

“Ah, Dr. Stein, you do indeed have the makings of an analyst, don’t you?”

vii

The following Thursday, Petyr led us through “Sexual Boundaries: How feelings of guilt, shame, and anxiety surround erotic feelings and erotic counter-transference.” 

“Sexual feelings between analyst and analysand often present pitfalls in the therapeutic process,” he began. “Analysts classically find it difficult to openly discuss their own feelings about the client, being unable to admit them to themselves, much less share with their colleagues, and especially with the patient.” As he spoke, he remained seated, hesitant to walk amongst us. His hooded eyes clung to his lecture notes while his hands rigidly held the paper. Afterwards, wrapping a shawl around his neck, he hurriedly grabbed his long wool coat and aimed for the door.

Once in the atrium, he turned to find me, saying, “I’m sorry, Sarah. I will not be able to share dinner with you this evening, you and Jeanne. I must get to the train station, I’m picking up the boys, who are traveling with their mother. They are spending the Christmas holidays with me, while she gets to use the Vermont condo.” He sighed with resignation, then brightened a bit in ironic amusement. “It’s funny. They spent Chanukah with their mother, who is …not Jewish, and yet, due to the peculiar custom of shutting schools for two weeks during a holiday many of us do not recognize, they will live with me during that difficult fortnight.” With a slight bow, he slapped his Kangol cap over his bristly hair, turned, and strode out into the night.

Jeanne and I gathered dinner from the carts, skeptically eyeing the attempt to mimic holiday fare: dried-out turkey breast, soggy peas, pale orange sweet potatoes ladled with runny faux-maple syrup.

“You’d think, given the history of psychoanalysis, and” – I glanced around the room – “the persuasion of the majority here, that we could dispense with this ritual?”

Jeanne laughed, crinkling her eyes into narrow slits. “Petyr’s not here, so you’re going to talk like him?”

I ignored the jab. “This sexual boundary stuff…Love seems simple. Isn’t that what we were saying last week? But you took years to find Roger, and I’ve…” I trailed off, vainly searching the plate for some latkes or gefilte fish.

Jeanne continued smiling. “Still looking for love in all the wrong places, Janie?”

“One thing I did learn is that true love – lasting love – comes from someone who cares about who you are, who you really are, not some imagined ideal, not what you mean or seem to them.”

“And you haven’t found that yet?”

“I don’t know,” I tried. “I want – I need – someone to whom I can give my heart, fully, but still retain my soul, for me. And be loved for being that person, who doesn’t swoon, who wants to create a couple, a family, a new creation, bigger, deeper, fuller, beyond either of us as individuals.”

Jeanne turned serious. “I’ve watched you,  Ja…Sarah, this last month, here with Dr. Cohen. You don’t have that look of swooning – I’ve seen that in you before, you know – you seem fully yourself with him…”

“I know, I know. This love I’m talking about grows, grows slowly, doesn’t explode like it did when our bodies were bursting with fresh new ideas about the world. But Petyr – I don’t know. He’s still in…transition, still with one foot in New York, wondering why he can’t stay with his family, the other, here in Boston, looking for something new.”

“It doesn’t feel like time yet, you mean?”

I gently laid my knife and fork across the still-full plate, and slowly pushed it towards the center of the table.

After New Year’s, we returned to discuss “Erotic Countertransference and Self-Disclosure.” Two weeks with his sons had refreshed Petyr Cohen. He filled the room with knowing laughs as he described the advantages of using erotic feelings in the analytic process, while warning us of the pitfalls.

“You do not want to be the Doctor who wakes up one morning to see his – or her – name and professional reputation besmirched in headlines in the Boston Globe. We must be even more careful, in these changing times, when the slightest raised eyebrow, wink, or half-smile could not only be misinterpreted, but even used against us as evidence of nefarious intentions and action.” He paused for emphasis, then said, “In this modern era, the dictum goes far beyond, ‘Keep your hands to yourself’.”

As we sat down to dinner, I asked Petyr, “How are your sons?”

He breathed in deeply, smiled, and spread his arms wide. “They are both growing, so much, so fast. Stuart, the older, has begun to read the books I’ve been sending, a new one every month. The latest is a history of the Lewis and Clark expedition. He told me he wished he had the chance to go off, explore, and discover someplace untouched by man. Peter, he’s all involved with his new roller skates, the fancy kind with urethane wheels, what to they call them?”

“Inline?” Jeanne prompted.

‘ “Inline. Yes, that’s it. Perfect for rolling along through the park while his mother jogs beside him…” He caught himself short, frowned, and grew pensive.

I put in, “That’s Petyr, Junior?”

“No, with an ‘e’, not my ‘y’. Too much of a burden to pass that on.”

“Last time, Jeanne and I talked about your seminar, and got into a discussion of love again. Made me want to ask you, why do people pair up? What is the driver of love?”

He seemed to relax with the opportunity to delve into a favorite topic of his. “Of course, in all creatures, the iron tyranny of DNA, of sexual reproduction, demands a mate. It may be the most powerful force on the planet, the insistence of those four nucleic acids to replicate their double helical structure.”

“Oh?” I countered skeptically.

“Yes. Think of how much the surface of our sphere, our Gaia, has been changed by evolution, how the very oxygen in our atmosphere was created by plants, how long-dead creatures have returned from their buried depths, to be burned, filling our air with their nitrogen and carbon oxides.”

I scoffed, “I think you’re getting far afield from what I asked!”

“No, listen. Even though intellectually, scientifically, we can see that human reproduction is a primary basis for people pairing up, the magic, the beauty, the miracle of it all is that we feel this urge not as a pure primal desire, but has something hallowed and fulfilling, as love. Forming couples, forming families, is at our very core, what makes us alive, what keeps us alive.” He placed his napkin down for emphasis.

I heard an echo in my head, and shared it with Petyr and Jeanne. “Life, life itself, is reason enough to be living, I like that, I like that very much.”

CHAPTER NINE

Life Itself Is Reason Enough To Be Living

March, 1979

The morning after dinner with Julia, I called the Ob clinic at Harvard Community Health Plan, intending to ask for a pregnancy test and initial appointment.

“When was your last period?” asked an impersonal voice on the other end.

I double-checked my date book, although I had it memorized already – January 17th, ten days before Howard had invaded my apartment and violated my tranquility. “The 17th. January,” I heard myself say in hollow tones.

“You were regular? Hadn’t missed any?”

I thought, this might be what the orals were going to feel like? “Mum-hum,” I agreed.

“Any bleeding, spotting, cramps?”

“No.”

“Morning sickness, breast tenderness?”

“A little, I guess.”

“OK, we can set you up for an appointment on March 15th, Thursday. With the nurse. She’ll do a history, send off some labs, a pregnancy test and the other prenatals.”

A flicker of dread flashed through me – the Ides of March. I shivered almost imperceptibly, and asked, “Can I get one before that, a pregnancy test? Today, tomorrow?”

“We can do that, honey, but it won’t be ready for a couple of days, not till after the weekend. And besides, this early, it might not be positive yet, even if you are. No need to come in, unless…”

“No, nothing’s wrong, I just thought…isn’t there a blood test, or something?”

“Yes, but the doctors, they say we’re not supposed to offer it unless a women’s bleeding, or high risk. Any medical problems, like diabetes? How old are you, again?”

“I’m …I’ll be 30 in May. No, I don’t have any problems like that.”

“Why don’t you wait until you come in. It’s not like you’re going to do anything different before then, are you?”

I didn’t have the strength, after days at the clinic, evenings in the library, and nights of fitful sleep, to say anything other than, “OK, Thursday, March 15. Got it.”

At our first meeting in March, Julia and I started preparing for my upcoming orals.

“I’ll be the First Reader, of course, and the department chief will be the committee chair. Don’t worry about him, he’s there to make sure the rest of us treat you fairly.” Dr. Klein smiled. “Fairly – that means we ask you tough questions, but don’t try to score points off of you. We’re not there to show how smart we are, but to make sure you understand your own work. When you do get the doctorate, no one should doubt your ability to review someone else’s study. Our reputations are on the line here, as much as yours. We’re not going to play ‘Gotcha’, Sarah. Stay poised, be yourself, and everything will go smoothly.”

I spent the next two weeks re-reading all my sources, along with those evenings in the library scouring the guides to periodical literature, looking for anything new which had come out that might be even tangentially related to adolescent mothers and their newborns. Totally immersed, I was able to forget for hours, even days, at a time, that my body was changing. Sometimes, when I woke up, the thought of coffee didn’t sit well, and my breasts did seem a little boggy, but most of the time, I could ignore whatever might be happening in my uterus.

At my prenatal appointment, the nurse led me to the scale, and announced, “58 kilograms, 162 centimeters.” What is that in real money? I wondered. I’d never paid much attention to my weight, so I had no clue if I had gained any or not.

She started the interview with that horrid question, “When was your last period?” I knew after all my time in Ob clinics, following my research subjects, why that was so important, but I still wished I didn’t have to remember. We went briskly through my medical history, finishing with, “Do you have any questions, Sarah?”

I hesitated. That morning, I’d notice the faintest pink swirl in the toilet. “I’ve heard sometimes you can spot at 2, or 3 months?”

“Why, did you…?”

I nodded my head, and she went on. “We could have you examined, take a look, get the pap smear and culture out of the way. Maybe it would reassure you?”

“Um…I don’t know – a doctor does the exam?”

“Oh, you’ll like her, she’s one of our senior residents. Gentle, knows her stuff.”

A female gynecologist, Dr. Stephanie Seacrist, walked in, stethoscope slung casually over the shoulders of her starched white coat. With her blond hair pulled back tightly into a no-nonsense bun, and large-framed glasses enhancing her smiling eyes, I immediately relaxed.

Explaining everything I should expect, before she did it, she quickly finished the exam by feeling for my uterus and ovaries with her left hand, while pushing up from inside with two fingers of her right. Then, she took my hand, guided it down to my pubic bone, and said, “Here, feel that? Your uterus?” I nodded as she withdrew her hand, looking briefly at her fingers as she turned the glove inside out.

After she helped me sit up, she asked “Is it OK to talk now, or do you want to get dressed first?”

“Go ahead, it’s OK.”

“I do see a spot or two of blood in there, but there are no lesions, and your cervix is long and closed. So it’s probably nothing. Sometimes as the placenta grows into new parts of the endometrium, that lining can shed a tiny bit.” She dropped her smile as she looked straight at me. “Your uterus seems a little small, for your dates, though. Feels seven weeks-size, and you’re close to eight.”

“What’s that mean?”

“Oh, probably nothing, we never know for sure when conception happens…”

“Even if you know the date when…”

“Yes, you see, sperm can linger in the uterus, or the egg in the tubes, and we don’t know when ovulation happened, how long it takes for the egg to travel down.”

I looked away, frowning, and started to say, “I…”

She quickly went on. “We’ve got a new test now, called ultrasound. It’s not x-rays, no radiation, uses sound waves. At this stage, we should be able to see a baby in there, if it’s at least 7 weeks along. We call it ‘real-time’, because the computer turns the reflected sound waves into a black and white moving image of what’s inside. We could might even see a heartbeat. Sound good?”

I nodded, getting more and more anxious. “When?”

“This is not an emergency, so next Monday is probably the earliest we can squeeze you in, OK?”

I dropped my head, hoping my hair would hide the wetness welling in my eyes.

“Sarah, is everything OK?” Real concern flowed through Dr. Seacrist’s quiet question. “I saw the notes, from the nurse, the baby’s father’s not involved?”

I shook my head, felt the tears now flowing past my nose. I sniffed, saying nothing.

She took my hand. “You don’t have to go through this alone, you know.” She reached into her lab coat pocket and handed me a card after scribbling on it. “Here. You can call me, anytime. That’s my home number. We’re going to get through this, you and me.” Then, in a more business-like tone, she said, “My team’s on call this weekend. If anything – anything at all – happens, call the L&D number on there, ask for me, we’ll make sure everything is OK. All right?” 

Biting the inside of my lower lip, I nodded. I wanted to say, thank you, but couldn’t get it past the lump in my throat. She patted my hand once, twice, then said, “Well, I’ll let you get dressed now. Remember, anything. Anytime.”

ii

“Anytime” came sooner than I’d imagined. Friday evening as I rode home, I started feeling some cramps. By the time I got to the bathroom, a little blood with a small clot plopped out. I called the health plan consulting nurse, hoping she’d tell me to “lie down and check with us in the morning.” Instead, she said, “You can stay home if you like, but there’s no way to know for sure what is happening or what might be going on without an exam.”

“If I stay here, how would I know if I have to come in?”

“If the cramps or bleeding get worse, then you really should,” was the answer.

“Is there anything I can do to stop this?”

“I’m sorry, that’s a question you’d have to ask the doctor.”

After hanging up, I pulled out a book I’d bought that week to support my anticipated journey. On impulse I’d purchased Spiritual Midwifery, hoping to gain an alternate perspective to the medicalized obstetrics I’d encountered throughout my career. It offered stories of women living on “The Farm”, a post-hippie commune in Tennessee. Attempting independence and self-sufficiency, the author, Ina May Gaskin, had taught herself and others about pregnancy and childbirth. They became midwives to their community’s burgeoning population. Starting with mostly joyful stories of births, Ina May then detailed what happens during pregnancy, how to keep yourself safe, what can go wrong, and what to do if it does. I flipped to the short section on “miscarriage”, and learned that “…two out of every ten women will have some spotting in the early months, but only one of them will have a miscarriage.”

Somewhat reassured, I was able to fall asleep, but was awakened by a gooey wet feeling between my legs. Just a smear this time, on the insides of both thighs, but enough to send me searching for Stephanie Seacrist’s business card.

“Sarah, you should come in. Now. I’ll see you here, take a look, we’ll talk.”

I headed back to Women’s Hospital, the cramps increasing all the way. By the time I limped through the ER doors, I knew more blood was coming out. Stephenie was there to catch me as I staggered towards a gurney, helping me lie down while she said to the nurse at her side, “Set her up in the gyn room, with a sterile speculum and some ring forceps, please.” Looking at me through eyes enlarged by her glasses, she asked, “Cramping?”

I moaned affirmatively.

“It’s OK, you’ll be all right…”

“The baby?”

“Let me look, then we can talk, all right?” She gave my hand a squeeze, then helped lift me onto the exam table. After the nurse had removed my pajama bottoms, Stephanie said, “Sarah, you’ll have to put your heels into the stirrups now. I’m going to drop the foot of the bed, then tilt you back a bit.”

She talked me through putting in the speculum, adjusted the light above her shoulder, and asked, “Can you get me some four-by-fours?” The nurse ripped open a package of gauze wipes, and then I heard the “click” of an instrument, while Dr. Seacrist said, “Just cleaning things off here…” and then, a “Plop” as something fell into the stainless steel bucket below the table. 

“What was that?” I asked fearfully.

“Oh, some blood, a clot…OK, I see it now,” she said, as I felt a sudden, short cramp which reverberated several times, then passed. “Nurse?” Dr. Seacrist asked as I heard her metal stool swivel while a jar cap was unscrewed, then screwed back on. “OK, Sarah. The bleeding’s all stopped now. Let me take this out…” And then I was lying with my legs  straight again, looking pleadingly at Stephanie Seacrist.

“I’m sorry. I’m so sorry, Sarah.” She took my hand in both of hers, and said, “There was nothing we, nothing you could do.”

My chest tightened, first with a deep sadness, then a sudden resolve, awareness that, whatever had happened in my womb, my life, my future would go on. “Was it…” I managed, gripping her hands firmly.

“There’s not much there, just the placenta and some unformed tissue. What we call a ‘blighted ovum’.”

“Blighted…” I tried.

“Yes, a lot of conceptions, things don’t go right from the start. The baby never really forms, probably a misfire, the chromosomes coming together improperly. Would you like to see?”

The practical, clinical side of me took over, and nodded. She handed me a small plastic jar, two inches or so in diameter, in which a thumb-sized clump of white feathery material rested beside a small translucent bag, bulging with fluid, whitish flecks floating inside. I turned it round and round, looking up through the bottom, hoping I could sense a soul. My gaze lingered a minute more, then I handed it back to her, asking, “What happens next?”

With a half smile, she answered, “Well, in the old days – meaning when I was an intern – we would have done a D&C, scrap off the inside of your uterus, make sure everything is out and the bleeding’s stopped. But now, as long as you don’t bleed any more – and I don’t think you will – we’ll watch you here in the ER, and you can go home in a few hours.”

I wondered, Why don’t I feel sadder? Out loud, I said, “Thanks. Thank you.” Brusquely, I added, “Can I get dressed now?”

“Of course. The nurse will get you a pad. I’ll come back in a few minutes, OK?” I nodded, trying not to look as she took the jar from my hand, and carried it out with her.

On her return, she sat down heavily on the round, backless stool, and swiveled to look straight at me. “How are you feeling?”

Firmly, I said, “No cramps, all gone. Thanks.” Almost impishly, I continued, “I guess now, I’ll have all my energy available for my orals. So that’s a good thing?”

“Sarah, I sense you’re like me, you’ve always been on top of everything in your life, your direction…but there are some things we can’t, we shouldn’t control.” She paused, “Given you’re a psychologist, a scientist, I shouldn’t need to tell you this, but, listen: Deep inside your heart and mind, I know, you’ve lost someone very close and dear to you. You know, better than most, I suspect, that grieving is healthy, something you have to do. Don’t let the name ‘blighted’, or the size fool you. This pregnancy, this baby was – is – very real to you, someone you’ll never get back, who you’ll always carry with you inside. When it comes – and it will come – when the sadness comes knocking, please, please let it in.”

iii

In the first three weeks after my miscarriage, I threw myself into a job search and continued preparations for my orals. I knew I was suppressing my feelings about losing the pregnancy, but I couldn’t put my life on hold while I dwelt on that.
One evening, I dug Stephanie Seacrist’s card out of my desk drawer.

“Dr. Seacrist, it’s Sarah Stein.”

“Oh, Sarah, how are you? I didn’t see you at your two-week check.”

“Things have been so busy, I never even made that appointment. Everything’s fine, no cramps, no bleeding.”

“Well that’s great. What’s on your mind, then?”

A little awkwardly, I asked, “I know this might not be right, maybe it violates professional ethics, but…can I see you? Outside of the clinic I mean. Not about the miscarriage, more as a…I feel we’re kindred spirits.”

“Uh, sure. I’d love to get together, and chat. In the evening sometime, after work? The best time for me is always the clinic day, before I go on call. Say, this Friday?”

“Great. You know, our offices are so close, we can go somewhere along Francis, near Brigham Circle?”

“Sure, about seven, all right? Oh, and Sarah…you can call me Steph, OK?”

Friday evening, we talked for hours, and discovered the usual strange convergences in our lives. She’d grown up in Columbus, but headed west to Stanford, then UCLA for medical school before deciding the east coast was the place for her.

She allowed, “I’ll never know why Harvard took me, it wasn’t like I was the top of my class.”

“How many women in the residency, Steph?” I asked.

“I’m the only one, my year. And there was only one other, when I got here three years ago.” A bit sheepishly, she wondered, “Why, you think that’s the reason they took me?”

“They took you because you’re good, Stephanie”

“What about you? How are you treated?”

“There have been women in clinical psych for a while now,” I began. “But I still find that, every time I’m looking for work, for a position somewhere, it’s always a man I have to convince.” I told her about the Child Development Unit, with Drs. Wernick and Brazelton in charge, Lauren, Heidi and I doing all the work.

“And now, I’m meeting with David Goldman…”

“The med-ed guy?”

“Yes, he’s trying to integrate the Psychiatry department into the hospital consultation system, and needs someone to direct the research they’re doing on how well it works, this consultation liaison program.”

“Consultation liaison? I’ve never heard of that.”

“Say a lady shows up in labor, full term, but she won’t cooperate? You quickly discover that she’s, as we say in my business, ‘crazy’, schizophrenic, maybe. And hasn’t been taking her meds. You’ve got no clue what to do, but you have to get her to settle down even if only a little, so she doesn’t destroy herself in labor or having the baby. And then what about taking care of the baby after? So you call the psychiatric consultant…”

“Like a cardiologist, if she had heart disease? What’s so special about that, we ask for consults all the time.”

“Right, but for some reason, shrinks have been shunted aside over the years. It’s like they’re not speaking the same language as the other MDs anymore. Anyway, he wants to study ways to help that communication happen better, faster, and more effectively. He thinks he needs a psychologist for that.” I smiled in anticipation. “I’m jazzed about it, hope I get it.”

“Sounds intriguing. Good luck!” She turned serious. “Did you think about what I said, the night of your miscarriage? About grieving?”

“You’re right, of course. I know all about the five stages of grief, that’s really become psych 101 by now.”

“Knowing about it and doing it are two different things, Sarah,” she countered.

“For me at least, it’s not an orderly, step-wise process. I was angry at first, at the very first with…him, then I denied the spotting was important, then I bargained with the nurse, and you. And of course, I was very depressed the night it happened.”

“Acceptance?” she ventured.

“I’m not sure I’ll ever get there, at least I don’t see it yet. I do know I handle things like this not so much as feelings, but by thinking them through, and getting on with my life. Which for now means, getting ready for that oral exam.”

The next day, Marcia called from New York, where she was finishing up her psych residency at Albert Einstein. “Sarah! Good news!”

“Did you get it?” She’d been looking for work back in Boston, and had narrowed the search down to the HMO where I’d been getting my care, HCHP.

“Yep. I start July 1st. I’m coming up this weekend, to fill out forms, talk to the admin people, that sort of stuff. You want to get together tomorrow?”

“Perfect. I’ve got a few things to unload on you.”

“Like what?”

“For starters, my orals are next week…”

That weekend at dinner, it took over an hour to tell her the whole sordid Howard story, my pregnancy and miscarriage. By the end, I felt better than I had since it all started, three months earlier. Crying with a friend I’d known for over ten years was literally what the Doctor, Stephanie Seacrist, had ordered.

As we gathered our coats and purses, Marcia pulled up short before I could reach out for another hug, this time to say goodbye until July. “Oh! Almost forgot! I meant to ask, you still looking at the Boston Institute, looking into psychoanalysis?”

“They’re hesitant, about taking on a psychologist. I’m close to wearing them down, though.”

“Their loss if they don’t. I meant to tell you, this prof, my favorite attending, Petyr Cohen, he’s starting there this month. I bet you’d like him. He’s very smart, so cosmopolitan. He’s already an analyst. You ought to meet him, hear how he survived the war.”

I looked at her suspiciously. “Are you trying to set me up?”

“No, no. He’s married, two kids. OK, separated, but still in the  middle of all that. Ugly.” She shivered. “It’s why he’s moving, leaving so he doesn’t have to be in the same city as his wife. Anyway, if you cross paths, tell him I told you about him.”

Intrigued, I pressed her. “During the war? How old is he?”

“Around forty. Very interesting story. He grew up in Switzerland. His parents were Jewish, Greek Jews, but they lived in Hungary. Somehow, when he was very little, they got him out, to stay with another family, hoping he’d be safe, while they waited out the war. The family in Geneva were American, a doctor and his wife. They sent him to an international school, so he speaks perfect Brit-tinged midwestern. Anyway, like I said, he’s a charmer. Ask him anything, then sit back and be entertained.”

iv

Dr. Klein was right, my orals proved anti-climatic. From the first question, it was obvious I knew more about adolescent mothers’ relationships with their infants than anyone else in the room. The conversation quickly devolved to a relaxed exploration of my comportment and ability to remain poised while the committee grilled me with mock seriousness.

The psychology Board exam demanded even less. Billed as a rigorous test of my general knowledge in all clinical psych fields, others had remarked on how 4 hours, 15 minutes was not nearly enough time to finish all the questions, much less review answers. All my life, though, standardized tests had come embarrassingly easy. With only four choices per question, and what seemed like a lifetime of immersion in the field behind me, I breezed through in a little over three hours, checked each answer twice more, and still finished before the proctor called “Time!” A month later, I learned my score of 787 had been the highest in the state that year.

As I methodically added to my supervised clinical hours during a post-doc year at Beth Israel, I divided time between the Consultation Liaison program there, and seeing clients in a state-run clinic in Wellesley. I approached the Boston Institute, hoping I could convince them a Ph.D. could be as effective a psychoanalyst as an M.D. Juggling all these balls at once left little time to wallow in the past or worry about the future.

Dr. Goldman, as the Director of Medical Education for all the psychiatric residencies associated with Harvard Medical school, was far too busy to respond when the National Institute of Mental Health sent out a request in June of 1979 for information about the measures and methods used to evaluate the effectiveness of C-L education in the programs. So naturally, as the newest member of the staff, I got the job. I dutifully canvassed all the program directors, and discovered no one had any systematic way of instructing the residents, much less evaluating them.

“This is worse than embarrassing, Sarah,” Dr. Goldman told me when I shared the news with him. “We’re Harvard, for crying out loud! See if you can put together something I can use to move the program directors on this. Go to that conference in San Antonio, learn all you can, and we’ll fix it. We’re supposed to be national leaders, not followers…” 

Pursuing what I regarded as busy work, I daydreamed as I wrote the proposals. Here I was, ready to finally practice independently, and now part of a national effort to advance how psychiatrists are taught. I imagined I’d return from the conference, recognized for my skill in educating residents to work effectively with obstetrician-gynecologists, going on to become an expert in teen-age pregnancy. As my dreams became more baroque, by age 50 I’d become an advisor to the government, testifying before Congress, with a teen-ager – a chaste teen-ager – of my own.

The conference proved to be much less exciting that my fantasy. For two days, medical education directors and their staff analysts droned on while displaying endless variations of evaluation forms on transparencies, nearly unreadable when projected on a screen 100 feet away.

On my return to Dr. Goldman, I told him, “I’ll try to pull something together from all this, and help you get the programs to develop a standardized training module, with follow-up evaluation, but…”
“There’s always a ‘but’ with you, isn’t there, Sarah,” he joked.

“In this case, it will be my final ‘but’,” I replied.

“Oh?”

I told him about one evening, in the unnatural warmth of south Texas. While walking along the Guadalupe River, wondering why it reminded me of the Seine with cruise boatsslowly gliding under arched bridges, I had a sudden realization about my life. I’d been hiding out in the cocooning safety of academic castles like Harvard and B.U., searching for research topics, then gathering data and reporting it. All that felt stifling now that I had my doctorate in hand. At my core, I knew that improving the world through policies, papers, and politics was not what had drawn me into psychology. I needed to leave that world. I needed to help people one at a time, on a personal level.

After explaining all that, I told him I would stay through the follow-up conference, set for February, 1981, in Burlington, Vermont – “New England, somewhere I understand, where it actually snows in winter” – and then set up my own clinical practice.

He beamed when he heard that. “You are so ready, Sarah. It’s time, it’s surely time, for you to fly on your own. Anything I can do to help, let me know.”

I rented a small office in Brookline, ordered a telephone, and began calling insurance companies, to make sure I was on all their lists, the HMOs, the PPOs, the entire alphabet soup that was taking over mental health care as it had medicine. I sent announcements to every psychiatrist, pediatrician, family doctor, and psychologist in Suffolk County. With my job in Wellesley, and the C-L work at Beth Israel, I had one day a week free to see clients. I was on my way.

x

Sept. 28, 1978

Janie –

I really did get the letter you wrote last May, but I’ve been on an extended vacation since Christmas, which is about to end this weekend…After residency, I worked in LA for Kaiser from July thru the end of the year. April and I stayed in Venice at the beach all summer, dodging roller skates, impersonating burned-out hippies, and enjoying our last months of LA madness. Venice is a unique place – every single type of person in the world is represented there, mingling down where the cosmos meets the sand – Ocean Front Boardwalk. Heterogeneity rules in Venice, the melting pot by the sea. A great contrast to where I am now.

April left LA about a year ago to study midwifery at the U. of Utah in Salt Lake City for 2 years. I moved into a rent-free shack, comforted only by a water bed and stereo, in the backyard of a close friend’s house in Manhattan Beach. It’s really senseless to try & live in LA unless you’re by the ocean. All summer, I went to work, saved my money, & rode my bike every morning on the beach-side path, in preparation for my grand, open-ended vacation starting Dec. 31st.

We bought an 80-year old house in the oldest part of SLC, on a hill overlooking the 20 x 10 mile plain housing most of Salt Lake, ringed by mountains, crowned by the Wasatch rising 7,000’ on the eastern edge. It’s an awesome sight, and I see it all from my front porch. Convenient though it is to the city, I came to ski every day. Little Cottonwood Canyon, home to Alta and Snowbird, is like Boston to a marathoner, Broadway to a theatre-lover, Hawaii to a surfer, the Himalayas to a mountain climber. [Here he goes on an extended rhapsody about winter, powder snow, and skiing. A small sample follows]

…Skiing is like an Apache dance with gravity. I have to implicitly trust my body, that it knows much better how to ski than my conscious mind does. After all, it’s the nerves and muscles that do all the work; why not let them run the show, rather than some ephemeral evolutionary anomaly like consciousness, created by an overactive and at times unnecessary cerebral cortex? My most enjoyable moments skiing seem to come why my mind is just part of the audience.

The audience! Yes, that was my trepidation on this day at the summit of Alta. I knew, although I couldn’t see them yet, that once over the lip into the chute, I would be the single object of attention for all those coming off the Germania and Sugarloaf lifts. People standing around, idly wondering which run to take, casually adjusting buckles, gloves, and goggles, would look up and be forced to follow my every move. As my predecessor finished his run, invisible below me, I actually heard applause and whistles. In a way, I hoped it wasn’t for him, for that would mean people were warming up to the show, and I was the next one down.

At these times in skiing, it is important to clear one’s mind, to say one’s mantra, whatever it is. Some ski freaks will shout at this point, screeching like a psychedelic cowboy or crazed Swiss yodeler. I prefer to simply repeat the obvious truth that, at this point, there is only one way to go, and that is DOWN.

Storming into the head of the chute, my mind empty at last, I fight a few turns through the spray left by the previous three skiers, and then lock onto a virgin track right in the middle, heading straight down. I am dimly aware the, yes, I actually can ski this stuff, and then the exhilaration starts to build as I focus on the incredible feel of the snow beneath, no, around my feet. Not dry and fluffy Utah powder, but fresh and buoyant nonetheless; my Haute Routes sink in ankle deep, the tips riding free on the surface. Knees locked, feet together, arms pumping, hips rising and falling, I imagine that I am skiing through something incredibly dense and yet quite fluid, like mercury. My body working perfectly, my mind is totally free to feel the luscious endless depth beneath me. I am totally alone, the entire mountain deserted, completely mine.

Too soon, too soon, the Sugarloaf-to-Germania traverse appears below, signaling the end of my run. Usually, I don’t feel a burning need to look at my tracks, but in this case I know I have to. Leaning forward on my poles, I look back up. To me, the line seems perfect, completely symmetrical. If you’re gonna put on a show, I say to myself, you might as well do it right. I rest a minute, trying to freeze the feel of the snow and the sight of my tracks into my memory forever. A transcendent moment, putting me utterly at peace…

In May, I went job-hunting – Denver, Seattle, the Bay Area. The outcome: this Monday I will start working in Oakland. I’m going to spend the next nine months there while April finishes her school here. I’ll probably be able to spend 4 to 10 days a month in Salt Lake, so we should be able to keep things going. We have to, ‘cause we got married August 25th, outside, at the end of Little Cottonwood Canyon, past Alta.

I know, it might seem a little weird, a midwife and obstetrician getting married. Both professions derive from the same sources, and of course serve the same ends, but their means and attitudes are quite divergent. Those differences, however, are subordinated in our family to a more over-riding concern. At least half the time, one or the other of us may be called out at any moment to attend a birth.

It’s not the commonness of birth which characterizes us, it is the acceptance of disruption. A large part of our work is fundamentally unscheduled. Most unscheduled events are frowned upon: tornados, auto accidents, wars. We seem to schedule our celebrations: birthdays, graduation, marriage, Christmas, the 4th of July. But birth remains unscheduled, yet inherently joyful. We relish this ceaseless disruption of our lives…

Mike

xi

“Sarah?”

Howard’s familiar baritone came through clear, static-free, as if he were calling from the room next door.

“Howard? Where are you?” I wasn’t sure I wanted to know, but after all our time together, politeness came naturally. “I haven’t heard from you in…years. How are you?”

“Actually, I’m here, in Boston. Somerville. Thought I’d take a holiday for a bit, see the old school, friends, you know?”

“So, I’m on your list? After the way we left it?”

He chuckled. “You’re the first, Sarah Jane.” He left that dangling, as if afraid to go on.

“Well, I suppose I should appreciate that, should see you.” My life was full, this January, a frenzied struggle to polish my dissertation for submission to my thesis committee and a reputable journal. On this snowy Saturday, I decided I deserved a distraction. I gave him my address, asking him to wait two hours while I finished up my work.

By the time he showed up, I already had on my puffy coat, muffler and gloves in hand, ready to whisk him out the door to dinner. I didn’t want him in my apartment, afraid of how that might feel. “It’s such a mess in there, I wasn’t expecting anyone…”

By the end of dinner, he’d caught me up on his last year or two. He was engaged, to a Palestinian girl in the process of converting to Judaism. He was managing the finances of his kibbutz, which had become a powerhouse in the growing Israeli wine industry.

“We’re specializing in that new grape, Shiraz,” he said. “A real money-maker over here, for some reason. American Jews are enthralled with buying anything we make. Gives them a feeling they’re helping to defend the homeland.”

“I hope it’s better than that sweet stuff my parents always had,” I said with a smile.

“How is your family, anyway?”

“Mom’s still the same as always. You’d think she had a son who was a doctor, the way she talked about me the last time she was here. When she found out I have to take a board exam to start practice next summer, the first thing she asked was, ‘What’s the highest score you can get, Janie?’ But my dad – he seems to be slowing down. He’s put on a little weight, won’t stop eating all those steaks, despite what his doctor says. Even wheezes now when he goes upstairs. They had to move to a one-story place for him.”

The evening went on like that, catching-up, superficial pleasantries, a quick return to the easy camaraderie we’d always had. By the time we got back to my place, I felt safe enough to invite him in. He reached into the back seat for a box, embossed with the logo of his winery, clusters of gapes on a background of rolling fields, Sea of Galilee in the distance.

“I know you don’t care for wine, but please, just for me, try this? It might change your mind.”

Once inside, I found two dusty goblets, rinsed them off, and set them on the kitchen table. “Here. For old times’ sake?”

He lifted two bottles from the box of four, saying, “You’ll like this. I’ll leave the rest, you can give it as a present if you don’t want any more.”

Howard went overboard that evening, soaking up one bottle and half the other, while I found myself surprisingly sleepy after two glasses. At first voluble, full of himself, by the time he was half way through that second bottle his eyes drooped, his words slurred, and he kept blinking at me, saying, “Sarah…we had…you, me…such good time together. We should have…you.”

I knew I couldn’t let him drive home like that. I gathered up the glasses, rinsed them out, then found a clean sheet and spare pillow, draping them over the living room couch.

“Howard.” It sounded like he was snoring. “Lehrman!” I shouted. He started, weakly lifting his head and staring up, eyes at half-mast.

“Umpf?” was all he could muster.

“Come on, get up, over to the couch. You can leave in the morning.”

Acting as his rudder, I managed his shuffling walk to the sofa, where he plopped akimbo, one leg still dangling to the floor. I slipped off his shoes, not bothering to move his leg. I didn’t really want to touch him any more.

That night, I had one of those flying dreams, where I start jumping up, and up, feeling almost weightless, bounding with high arcs that seem to last forever. Each time I rose further, until the wind started to buffet me, stronger and stronger. Now falling, my legs and arms splayed out, uncontrolled, until…

I awoke, finding Howard on top of me in mid-climax. Screeching, I pushed him away, howling, “What the hell are you doing! Get out of here! Get the fuck out of here!”

“I’m sorry, sorry…” he mumbled.

“Sorry’s not the word for it – you’re pathetic! Don’t ever, don’t ever come back, or call me, never, you hear.” I scrambled up, raced into the living room, grabbed his shoes and coat, throwing them out into the hall. He stumbled after them, and I slammed the door behind him, bolting it twice and throwing the chain for good measure.

Shaking, I raced to the bathroom, washing, scrubbing, pulling out the Massengill pack, squeezing it over and over inside. My breathing came in spasmodic bursts, which led into sobs, Shaking, I covered the toilet seat with a towel and sat down, trying to think. “What just happened?” was all that came through my mind. I closed my eyes, and tried to remember, had I done anything, said anything, that led him to believe…? I felt embarrassed, ashamed, like it was my fault. 

“That’s not fair! It’s not fair!” I shouted. Not fair, that whatever power I had built, all my self-esteem, could be ravaged, tarnished in an instant. By someone I had trusted.

I imagined calling my sister, telling her. I heard her say, “Well, your ex-boyfriend, you let him in, two bottles of wine, what did you think was going to happen?” 

xii

Sunday, I alternated between anger and depression, fuming first at Howard, then myself. I feared calling anyone, afraid of their reaction, or maybe my own, the imagined words of my sister echoing in my thoughts all day. Finally, after dinner, I called Lauren, and spilled the story.

“I’m so sorry, Sarah, that happened to you. You’re right, it’s not fair. Not fair, to you, not fair to us, to women. What are you thinking? What do you want to do?”

“I don’t know, I don’t know. I can’t see straight, I just want to smash his face. Or hide my own, I don’t know.” I started crying. “Besides,” I said through sniffles, “What can I do? Just wait, I guess, see what happens…”

“I’ve heard if you take two birth control pills, the old kind, the strong ones, now, and then again in the morning, that sometimes works.”

The thought went through my chest like an electric shock. “What do you mean, like an early abortion?” I shivered, thinking of facing another man, a doctor, to explain and ask for a prescription. “I couldn’t do that, not now.”

“Why not?”, she pressed.

“Seeing a doctor, I can’t handle that right now…”

Lauren suggested calmly, “Wait a minute. Didn’t you tell me about Esther, that  grad student who did a circle thing with you and your friends, the mirror thing? You said she helped out at the Women’s Health Collective, right?”

Lauren’s thought pulled me away from my enraged emotions, re-triggering the analytic part of me. “Yes. Yes. The ones who did that book, Our Bodies… “

“Right, her. She might know what to do.”

After I hung up, I dug out my copy of that thick paperback, found their phone number, and called first thing in the morning.

“Yes, there is a good chance doing that would prevent implantation. Not 100%, but better than 50-50.” Esther explained after I’d re-introduced myself and we caught up a bit. “It is a prescription, unless you know someone who would share a pill pack with you.” She paused, and I heard distant voices in the background. “Oh, yeah…they’re starting to try an IUD to see if that works. Put in a Copper-T, that’s supposed to prevent implantation, which doesn’t happen right away, you know. But you’d have to be sure, you don’t want to make a bad situation worse. And they don’t know for sure about any side effects on the baby if it doesn’t work. Nobody’s been willing to study it yet.”

Her hesitance convinced me. Deep inside, I knew this wasn’t right. “I don’t have to decide now, about anything. Who knows, the odds are I’m not even pregnant, right? And I can always do something later, can’t I?”

All February, the deadline for my thesis submission overpowered the fear and anger I’d felt that first weekend. By the end of the month, I had finished it to Julia’s satisfaction. We sent it off the the American Journal of Orthopsychiatry for peer review, and scheduled my oral defense with the committee in mid-April. She took me out for a celebratory dinner..

“Have you decided on what you’ll be doing, once you graduate?” she asked.

I glanced down at my salad, covered with thin strips of salmon, and felt a little queasy as I replied, “I’ve put in for a fellowship at Beth Israel, with the medical school…”

“Back to Harvard, eh?” she commented with a twinkle.

I nodded. “The Department of Psychiatry is starting up a program in consultation liaison. They need a research director.”

“Interesting. What’s that entail?”

‘I’m not sure yet. I’ll be meeting with Dr, Silverman…”

“The medical education director? Wow, must be a big deal.” she enthused

“I guess so,” I said with a sigh. “It’s something, to keep me busy. I hope I’ll like it. I can’t really start practice until after I pass my boards.”

“Oh, don’t worry about that, you’ll do fine, Sarah.”

I said nothing, still wondering why I didn’t feel like eating.

Dr. Klein noticed my discomfort. “What’s up? You don’t seem very excited about being done, with the thesis and all, and finally stepping out into the real world.”

All those years, those meetings with her, her guidance, support and honesty, helped me to confess, “I’m late. Julia. I think I’m…”

She put her fork down, reached across the table and gently took my hand in both of hers. “What is it, what happened?”

I managed to get through the whole story without crying. “I’m numb to it now, that night with Howard. Now, I’m wondering about the future, my future.”

“Have you been talking with your analyst about it?”

“My new one? I’ve only seen him twice since then, it’s been all about what happened, not what I’m going to do. Besides, I don’t know if I want to talk that over with a man, especially one I’ve only known for a few months. Can he really understand? I know he’s supposed to have professional detachment, but I don’t feel safe, yet, to talk about a pregnancy with him. It’s not just my feelings. It’s about…my life.”

“Your life?”

“You know the phrase, ‘biological clock’? It’s not only time ticking away,  whether a woman can get pregnant. It’s also about when in her life a women can be pregnant, can have a baby. Raise it, love it, give her, or him, all the attention they deserve. If I have it now, what will it do to my work, I don’t even have the assurance of a stable job, to say nothing of a man, a husband to help me out.”

She nodded a bit ruefully.

“You don’t have to keep it, you know.”

I closed my eyes and swallowed hard. Even though I hadn’t been thinking about this, I instantly knew the answer. It started pouring out. “Intellectually – and politically – I believe in it. ‘My body, my self.’ But the last six years, I’ve watched mothers and their newborns, bonding, loving, so many times. All those girls I saw, the teen-agers, they seemed so happy, so ready to be a mother. And yet, they had so little – still in school, most of them, no job, no money, even those with a boyfriend, he didn’t live with them. I’ve got so much more, my degree, my experience if only because I’m nearly twice as old as they are. And then there’s…love is the only thing I can call it. I don’t even know for sure I’m pregnant, but already I love my baby, I never want anything to harm her. I’d do anything for her.”

“Anything? Raise it alone, juggle your time at work, give her to someone else eight hours every day?”

“All I know is, I have to make it work. It’s the only way I can be me. It’s what I’m supposed to do.”