Joy

Photo by Christian Castro

A new patient is coming this morning, referred only by "word of mouth," she says on the phone when Dr. Stephen Margolis returns her call. But when Edith Adler walks in the door, at once he knows he's seen her before. An attractive, neatly groomed woman in her sixties, around his own age, in a taupe wool skirt, a white silk blouse that almost matches her long silver-white hair. In her walk, in the alertness in her eyes, she cultivates a youthful look—silk scarf in many colors, calf-high boots—as if she were in her twenties. She's trying to look not girlish but capable, clear-eyed. She reaches out her hand. He takes it.

"Haven't we met? Don't we know each other?" he says, narrowing his eyes—and, wary, prepares to recommend she see another therapist. It's textbook—not a good idea to offer therapy to someone you know, even if not well. If the doctor isn't a blank slate on which the patient can write, transference is made more difficult. But the textbook also knows this: from the very first exchange of glances, the patient begins to create the doctor that the patient wants or needs. From the beginning, even before the beginning, there is no blank slate.

"We spent an evening together," she says, "a couple of years ago. At the Graubarts' for a dinner. You, your wife, me, my friend Beryl."

"That's right. Yes. Beryl. I remember."

"We were very close. Beryl and I. For years and years. For almost half a century."

Does she mean they were lovers? He remembers hearing from Joe Graubart that Beryl Stern died a couple of years ago. Already she, Beryl, has entered Margolis's sunny office in a Cambridge attached house not far from Harvard Yard, with bay window and window seat, its Freudian couch lain on by patients in analysis with him. Margolis has only two analytic patients, patients he sees three or four times a week. The rest of his patients he sees once a week. She's only a virtual visitor, this Beryl, brought here by Edith Adler, but he's certain Beryl would become a frequent guest—would, if he didn't suggest, as now he does, that Edith Adler see someone else.

She considers. "I know the drill, Doctor." She sighs, as if she's bored by his conventionality. "It's different in my case. Like Beryl, you see, I'm dying."

At once he believes her, and he admires the comfortable way she's using her own death as tactic. Matter-of-factly he asks, "And that makes a difference?"

"Yes, yes." She sounds impatient, irritable. "I understand. We're all dying. But I am to have the privilege of foreseeing my end—bowing out, I'm told, in a few months. It's a cancer, different from Beryl's. Let's not speak about that. I intend to let the disease run its course without self-pity and without major intervention. Even my oncologist says it's too widespread for an operation to be of value. And given the side effects of chemo—no, I'll take what I need to cope with pain. And so, you see, I'm not interested in untangling my neurotic conflicts, Doctor. Too late for that!"

She laughs. "I'm sure you know 'Pirke Avot,' 'Ethics of the Fathers.' It prescribes that you repent when?—one day before you die."

"It's a joke," he says.

"Of course—a Talmudic joke: we don't know when we're going to die, so it's today you should repent. In my case, I do know—well, I know approximately. And I'm not repenting, Doctor. I simply need you to be clever enough, objective enough, to help me gather together the pieces of my life. Not that I can bring the awareness with me to another world." She smiles. "It's in this world I want to feel, however briefly—" She gropes for...