Jane was staring out the window now, which overlooked one of the hospital's air shafts. City code requires that every interior room like this one have a window, even if the only view it offers is of a nearby brick wall. But windows like these always give me the sensation of being trapped in a well.
"Anyway," Jane said softly, "isn't everyone a little traumatized?"
When I asked her what she meant by that, she dismissed my question, alluding with one hand in the air to the general state of the world.
I noticed that Jane had a habit of diverting my attention away from the specific, the private, the self. It seemed that it was easier for Jane to speak in generalities.
At the end of my formal evaluation, I asked Jane something I had been curious about since her first brief visit to my office.
"May I ask," I said, "how you got my name?"
I was still relatively new to private practice, and my transition to it had been quite unexpected. I assumed that an old colleague had given Jane my name—either out of generosity or pity for me. I had left my previous job under difficult circumstances and for reasons that lie outside the scope of this narrative.
"Oh," said Jane, as if this question embarrassed her. "Well, you won't remember," she said. "But I actually met with you once before."
I was surprised, though perhaps I should not have been—I'd seen hundreds of patients by then, maybe thousands, particularly in the early part of my training.
"It was a long time ago," she said. "1998."
Twenty years had passed since then, and my life at that time came flooding back to me. It was my first year as a psychiatry resident. I was new to New York. My wife was not yet my wife, and neither of us had been touched by any real suffering—all of that lay ahead. Also rushing back now, that feeling of possibility that I have come to associate so strongly, in retrospect, with youth. So much about the future—the whole shape of my life—was then unknown. In the two decades since that time, I had become everything I now was, for better or worse, like plaster hardening in a mold.
"I'm sorry," I said, "I'm not very good with faces"—which is more or less true.
It struck me as odd that a patient I had seen only once would seek to reestablish care with me two decades later. After all, there are a great many psychiatrists in New York City.
"What was it that was troubling you back then?" I asked.
"It doesn't matter," she said.
I suddenly became aware of a commotion behind me. Until now, we had been alone in this hospital room, but it was designed for two patients. A second woman was now being wheeled through the door.
I have quite a bit of experience conducting psychiatric evaluations with little or no privacy, but I sensed it would be difficult for Jane, who was watching her new roommate with alarm. I pulled the curtain between the beds. The sound startled Jane, the clack of the rings on the bar.
After that, she spoke even more softly.
Toward the end of our conversation, a group of visitors arrived to see the other patient in Jane's room. Their voices called my attention to Jane's aloneness, their noisiness throwing into relief her intense quiet.
Among the voices floating up from the other side of the curtain came the squeals of a small child, speaking Spanish. She reminded me of my daughter, which I mention only to explain that a distracting tenderness came into me at this moment, which led me, perhaps, to ask Jane the wrong question.
"Has anyone contacted your parents?" I asked.
"No," she said. She had already mentioned that they lived on the West Coast.
"Do you have any other family living nearby?" I asked, already guessing the answer.
One of my other interests, an early specialty, is loneliness: how it affects a person physically—the body, the brain. I had already sensed a certain isolation in Jane's body language.
"Or is there anyone else we can call?" I asked. "A friend, maybe?"
I felt a little rude as I spoke that word: friend. The one thing more excruciating than loneliness is having attention called to it in a social situation.
"No, thank you," she said.
On the other side of the curtain, the child began to cry. Her little shoes were just visible beneath the curtain, those purple Velcro straps, those little yellow socks. The force of my next thought surprised me: I hoped that whatever had brought that girl's mother to the hospital was a malady of the body and not of the mind.
