Adam Haslett: You Are Not a Stranger Here

They’d argued about it plenty, always ending with her calling Frank a romantic clinging to an old myth about the value of talk. But no words of hers could change the fact that Frank had instincts about what it meant to spend time with the people he cared for, and they involved more than picking a drug. He knew his patients sought someone to acknowledge what they were experiencing, and he knew he was good at it, better than most of his colleagues.

At medical school, they all joked about the numbing: from four months spent dissecting the body of a dead man, cutting into his face and eyes, to seven hours clamping open a woman’s chest, only to watch her expire on the table—whatever the particulars, it didn’t take most people long. And then in residency, schizophrenics trembling in psychosis, addicts, manics, beaten children. Frank joked too. But he always felt odd doing it, as if it were a show to prove he was adapting like his peers. The fact was he still felt like a sponge, absorbing the pain of the people he listened to.

Privately, he considered it the act of a certain kind of faith.

Never having been a religious person, empathy had taken up the place in him belief might have in others.

Trying to ignore his headache, he skipped over the internist’s report in Mrs. Buckholdt’s chart and went straight to the psych note: forty-four-year-old woman with no history of major mental illness in the family; first presented with depression following death of her eldest son, four years ago; two younger children, boy and a girl. When he scanned the margin indicating course of treatment, he saw how shoddily her case had been managed. A brief course of antidepressants, probably never finished, and since then nothing but benzos—sedatives—written as needed. No therapy. George Pitford, the shrink Frank had replaced, wasn’t about to drive five hours round-trip for a meds consult, so he’d just kept calling in her refills. A cryptic line he’d scrawled at the bottom of the page read, Injury may be a factor.

“My apologies for not greeting you at the door,” Mrs.

Buckholdt said, entering the living room, hands tucked in her pockets. She was an attractive woman, slender, taller than her husband, in better physical health, though she certainly looked older than forty-four. She wore tailored black pants, a bit faded, a white rayon shirt, a silver necklace. He’d been expecting a disorganized person, some kind of shut-in.

The woman before him seemed almost out of place here, in this house out in the middle of nowhere.

She closed the door to the kitchen, turned a key in the latch to lock it, then crossed the room to join him.

“I’m sorry you had to come all this way,” she said. “In this awful heat. Would you like a drink? Water perhaps, or a lemonade?”

“I’m fine for now,” he said, “thank you.”

She took a seat on the couch and he lowered himself into the leather armchair.

“The reason I’m here is the director thought it would be a good idea for me to check in with you in person. He said you’d had some trouble getting down to the clinic for your last few appointments.”

Her gaze rested somewhere over his shoulder. “I take it you’re childless,” she said.

Frank had patients who asked questions about his life, but they usually didn’t come so fast.

“It might be best if we talked about how you’ve been doing lately. The clonazepam, it’s an antianxiety drug. Have you been experiencing much anxiety lately?”

She lowered her glance momentarily to look Frank in the eye. She had a handsome, slightly gaunt face, powerful green eyes, a strong, almost male jawline; her black hair was brushed back off her high forehead. Frank didn’t often see female patients with such a self-possessed demeanor.

The women who came to him at the clinic usually had the blunt affect of beating victims or the long-untreated ill.

“You’re here to write a prescription. Am I right?”

Frank was about to respond when Mrs. Buckholdt raised her left arm from her side to tuck a strand of hair behind her ear.

As she did so, she lifted her other arm from her pocket to rest on her lap. All four digits were missing from her right hand, the skin grown smooth over the rounded ends of the knuckle bones. Frank couldn’t help but stare at the fleshy little knobs. Some kind of farm accident, he guessed, the injury Pitford had mentioned. Catching himself, he focused resolutely on her face. Whatever he’d been planning to say had vanished from his mind.

“Maybe I’ll have a glass of water after all,” he said.

“Yes, do. Just help yourself. The key’s in the door.”

“HEY THERE,” HE said to the boy in front of the television as he looked in the kitchen cupboard for a glass.

Apparently this one wasn’t a big talker either. He was slightly older than his sister, twelve perhaps. He stared at Frank with an odd expression, as if he were trying to decide if this man in front of him existed or was merely a passing mirage.

“What are you watching there?”

On the screen, a jackal or wolf fed on the gashed belly of a deer.

“You want some water?”

The boy shook his head.

THOUGH HE FELT odd doing it, Frank turned the key again in the door, locking it behind him as he reentered the living room. Mrs. Buckholdt hadn’t moved from the couch. She sat rigid, her eyes following him as he crossed to his chair.

“I see you first visited the doctor about four years ago. That was just after your son died. The notes here say it was mostly depression you were coping with at that point. Is that right?”

“I wonder, Dr. Briggs. Where is it that you grew up?”

“Mrs. Buckholdt, I think that in the time we have it’s important for me to get a handle on your situation so we can try to help you.”

“Of course. I apologize. I just like having a sense of who I’m talking with. You’re from the East I take it.”

“Massachusetts.”

“Whereabouts?”

“Outside Boston.”

“I take it you grew up in a rich town.”

“Mrs. Buckholdt—”

“I won’t go on forever,” she said. “But tell me, it’s a rich town, isn’t it? Tidy lawns. A country club. Kids going to college. Am I right?”

“A relatively affluent suburb, yes,” he said, taken in by the gravity of her tone, chiding himself at once for being drawn out on a personal matter.

“Now, is the depression something you’re still having an active problem with?” he asked firmly.

Her eyes wandered again over his shoulder, the same look of recollection he’d seen on her husband’s face appearing now in hers. He realized she must be looking at the picture on the wall behind him. He turned to get a glimpse. It was a print of a late medieval painting, the image of a bustling town square during some kind of revel, all manner of people—vulgar, refined, youthful, decrepit—praying, eating, wandering through the square, the scene painted in browns and reds.

“It’s a Brueghel,” she said.

“Right,” Frank replied, recognizing the name vaguely.

“ The Fight Between Carnival and Lent, fifteen fifty-nine,” she said. She examined Frank’s expression, as if for signs of incredulity. “It may surprise you that I studied at one of your Eastern universities for a few years. My father liked to think of himself as a progressive man. Very liberal, always took his daughters seriously. He found pleasure in the fact I took up a thing as impractical as art history; used to drop it in conversation with friends at the Rotary and then chuckle in his way at their bemusement. He died while I was out there, just after I’d started my final year.”

With her one good hand, she picked up a box of cigarettes, removed one, and lit it. Almost demurely, she blew the smoke down toward the floor.