Triblog

!!!!!*****WORKING DRAFT*****!!!!!

“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. Someone 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’re still checking it, the pathologist wants to look himself, but…Sarah, I think 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 med onc, and if what I think is there, we’re going to get you to Dana-Farber to start 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. I’ll walk every step with you, help you understand, fight for everything you need. All you have to do is stay strong, be yourself, don’t despair. We’ll get through this.”

Just then 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, and 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 realised 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 will live 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 times almost comical, now served to reassure, to guide me towards understanding. My red blood count, the 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, slowly starving. 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 hugged my head, 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 breaks the DNA links in dividing cells.”

“In all dividing cells, Sarah,” Steph added.

“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 spent seeing his own patients, finding emergency replacements for 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. It’s only one day a week, Thursdays, won’t I be at my best the day before each treatment?”

He knew me well enough not to argue.

Two days later, the cards started coming. From Jeanne, in England. From Howard, inIsrael. 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 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 sad-looking 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, put this thing on the defensive.”

I looked at the slender bald boy of about 8 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 by those damn drugs’ and white cells’ rules.”

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, fiercely grabbed a chunk of hair from off my shoulder, and began to shave my head.

********

!!!!!*****WORKING DRAFT*****!!!!!

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 who were long past exasperation, and were now desperate, seeing me as the last stop for their daughters before a life on the street loomed. Mostly, I listened and agreed with the girls, until the routine built into trust, and the trust could seed a return to a stable life, if not to their families.

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

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

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

Petyr smiled. “You seem less worried than I do about the risks we still might face. It’s true, she has no cause to sue you, according to my lawyer, 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 still in business and education. 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, hiding our affections.” 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, wherever, whatever. 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 my mother. “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 8, 9 hours a night, only have energy to go to work, then flop down after dinner, can’t even read, watch TV.”

“Oh, anything I can do? Maybe I should 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.”

“Maybe, I don’t know. But yes, could you come? 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, just before Yom Kippur. After the call, Petyr seemed pleased I’d gone ahead and invited her to Boston. I remembered my promise to him, to dig into that box from home, and 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 where he lived now – Tacoma was the only clue I had – 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 just inside, smiling, not knowing where to look. As we pulled apart, Mom noticed him and said, “Hello. I’m F 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 sparkled as she eyed him up and down.

“Mrs. Stein, Sarah has told me so much about you, your family.” His smiled 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, 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. We did nothing today, just sat around, and still, you’re sighing so much, 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 maybe a delayed reaction to Dad, or maybe all the newness, Petyr, growing my practice…”

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

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

The earliest appointment I could get with my my family doctor at HCHP was not until 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…do you think you might be pregnant?”

“I’ve been taking pills.”

“Well, we should check anyway. A urine test for that, maybe 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 towards 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 quickly 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.

********

!!!!!*****WORKING DRAFT*****!!!!!

On my return, I found a letter from Cincinnati waiting. Starting with cheery news about her new neighbors in their apartment complex, she went on to describe her frustration with George, 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, I think. Enclosed is a small sample. What should I do c it?”

Two yellowing slips from one of my high school “math pads”, neatly folded in quarters, fell out. In blue ink, I apparently had written two poems 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 next 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 gowns, somehow not wobbling on their impossibly thin four-inch heels. I’d worn my non-nonsense blue skirt and jacket over a white buttoned shirt, and felt more than a little out-of-place, wishing I’d investigated the place a bit before 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 was no longer accustomed to easing tension 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” suddenly 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 quickly 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. You have just given me 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 some 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. Before he began 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. I don’t know, but I think she was trying to tell me something…”

Date 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 lost in some buried fog, I think. 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.”

********

!!!!!*****WORKING DRAFT*****!!!!!

Petyr’s final seminar, “Illness in the analyst and professional wills” almost put me to sleep. Just 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 me? I knew I felt a little attracted to him, but I’d assumed his continuing disentanglement with 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 Januaries. My headlights alternately reflected off the naked skeletons of beech and maple, and the dark green needles of the 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 fantasized us sitting amongst a  jovial group of tired skiers, sharing drinks around a fire which pooped as pockets of resin caught the heat and showered sparks against the stone hearth.

I easily found the condo, its first-floor, covered entry with vintage cross-country skis instead of a standard lintel. Petyr greeted me, still in his shiny blue nylon overall bibs, 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 the memory my muscles retain, 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 collegiates, and the noise far too dense and confusing to allow any real conversation.

“Anywhere else we can go, might be less 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 the thought 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 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 just 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 just 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.”

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

********

!!!!!*****WORKING DRAFT*****!!!!!

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 quickly 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, I think, that 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 gather 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, I think, 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 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, I think, to pass that on.”

“Last time, Jeanne and I talked about your seminar, and got into a discussion of love again. Made me think, 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 atmosphere was created by plants, how long-dead creatures have returned to further fill 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.”

********

!!!!!*****WORKING DRAFT*****!!!!!

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 really 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 don’t think 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, challenge and be challenged by 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 with, “What do you think about, when you’re skiing? I knew someone, in college, who was obsessed with skiing. As a senior, he spent the year in Aspen, then after his residency, another year in Salt Lake, just so he could ski 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, we think it is everything in the world for us, all-defining, all encompassing. And it is, just as when we were babes.”

Jeanne added, “Right. We have to grow, not just our selves, but with someone else. And sometimes, we grow in ways that run counter to being with someone, 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, was simply 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?”

********

!!!!!*****WORKING DRAFT*****!!!!!

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. I was thinking, after talking it over with Dr. Rosenthal, our Dean of admissions, that 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 just 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, neck 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, the last time I’d written her a few years 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’er going to London next year. I’ve already got a transfer arranged into the London school, 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, dinner break, we’ll 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, picking up the hidden 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 served 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 questions, 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. Thinking he’d touched me there, 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, “Not really, Dr. Stein. You may have heard I was deposited in Switzerland by my parents when I was only 16 months old, in 1940, before my 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.”

********

!!!!!*****WORKING DRAFT*****!!!!!

Dr. Klein was right, my thesis defense proved anti-climatic. During my zealous preparation, not only had I memorized the entire dissertation, the key points of all 63 references of the references and also new papers more recently published. 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 compartment 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 just as effective a psychoanalyst as an M.D.

Dr. Goldman, as the Director of Medical Education for all the psychiatric residencies associated with Harvard Medical school, was far to 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. NIMH scheduled an initial conference for San Antonio in March, and sent out the responses they’d received to all 120 programs they’d invited to respond.

“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, 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 expertise 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 100 feet away.

When I brought all the forms back 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?”

One evening, in the unnatural warmth of south Texas, walking along the Guadalupe River, wondering why the Paseo reminded me of the Seine, with stately [BOATS?] slowly gliding under arched bridges, I had a sudden realization about my life. Working in a vast institution, where there was always another person above the one to whom I might report; hiding out in the cocooning safety of academic castles like Harvard and BU; searching for research topics, then gathering data and reporting it – it all 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. You don’t need to hide here anymore. 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 just 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.

********

!!!!!*****WORKING DRAFT*****!!!!!

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 didn’t think I could put my life on hold while I dwelt on my conflicted feelings.
Once again, 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 think we’re kindred spirits, you know what I mean?”

“Uh, sure. I’d love to get together, just chat. You’d probably have to find another doctor, but there’re plenty of us to go around. Maybe 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 just go somewhere along Francis, near Brigham Circle?”

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

Thursday 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 why they took me?”

“They took you because you’re good. That you’re a women, that’s just a bonus for hospital.”

“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. W&B in charge, Lauren, Heidi and I doing all the work.

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

“The med-ed guy?”

“Yeah, 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.

“I don’t think, for me at least, it’s 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 by just doing what I do. 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…”

It took over an hour to tell her the whole sordid Howard story, pregnancy, miscarriage. By the end, I felt better than I had since it all started, three months earlier. Crying with a friend I’d know 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 good bye until July. “Oh! Something I forget. I meant to tell you. Are you still looking at the Boston Institute, looking into psychoanalysis?”

“They’re hesitant, about taking on a psychologist, but yes, I’m hanging around there.”

“Their loss if they don’t. What I forgot, this prof, my favorite attending, Petyr Cohen, he’s starting there this month. I think you’d like him. He’s very smart, knows so much, not just about medicine, psychiatry – he’s already an analyst – but his story, what happened to him during the war. You really ought to met him.”

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

“No, no. At least I don’t think I am. 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?”

“Oh, maybe forty, I think. Very interesting story. He grew up in Switzerland. His parents were Jewish, Greek Jews I think, 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 diplomats, and sent him to an international school, so he speaks perfect Brit-tinged midwestern. Anyway, he’s a charmer, like I said. Ask him anything, then sit back and be entertained.”

********