A Breath After Drowning
Alice Blanchard
For Doug, forever
PART I
1
KATE WOLFE’S 3 PM appointment stood in the doorway wearing a jaw-dropping miniskirt, a light blue tee, plaid knee socks, and chunky platform heels. Fifteen-year-old Nikki McCormack suffered from bipolar disorder. She believed that she was the center of the universe. She lived in a world of her own creation.
“Hello, Nikki,” Kate said warmly. “Come on in.”
The teenager took three small steps into the spacious office and looked around as if she didn’t recognize the place. It was all part of the ritual. Nikki scrutinized the charcoal carpet, the blue-gray walls with their framed degrees, Kate’s swivel chair, and her large oak desk, as if something might’ve changed in her absence. She’d been coming to therapy for seven months now, and the only thing that ever changed was the mood outside the windows—cloudy, sunny, whatever—but Nikki wanted the place to always be the same. Another quirk of her illness.
“Hmm,” the girl said, index finger poised between glossy lips.
“Hmm good? Or hmm bad?”
“Just hmm.”
Okay, it was going to be one of those days.
The weather forecasters had been predicting snow. They argued over inches. It was deep into winter, February in Boston, but Nikki wasn’t dressed for the cold. She was dressed to impress. She wore a flimsy vinyl jacket over her skimpy outfit and a red silk scarf—no gloves, no layers, no leggings. Her pale, slender body was covered in gooseflesh, and her nipples showed through the flimsy tee, but Kate knew better than to suggest more seasonal attire. Nikki might storm out of the office as she had before, and that would be counterproductive to her therapy, so Kate ignored her maternal instinct and kept a steady focus on Nikki’s eyes—the azure depth of her sly intelligence. “Have a seat.”
Nikki hesitated on the threshold, and Kate could read her emotions morphing across her face like the Times Square news ticker—the girl doubted she was welcome anywhere. She didn’t feel loved. She believed people were laughing at her. It saddened Kate to discover that such a smart, healthy, promising young person could have such low self-esteem. It was more than troubling.
“I’ve been expecting you,” Kate said, coaxing her in like a kitten. “Have a seat, Nikki.”
The girl entered the office with gawky teenage dignity, sat in the camel-colored leather chair and crossed her waifish legs. Her chunky shoes with their thick wedge heels looked ridiculous on her and were probably dangerous in the snow. Nikki wore enamel rings on every finger and a slender gold chain around her neck. She was heavily made up, with careful strokes of peach lipstick on her skeptical mouth and too much gummy mascara on her eyes. She came across as beguilingly bumbling, and yet there was something disturbingly passive-aggressive about her.
“So,” Kate began. “How are you?”
The girl’s attention wandered everywhere. She studied the framed art prints on the walls, the overstuffed inbox on Kate’s desk, and finally Kate herself. “Yeah, okay. So I’ve been wondering… how do you deal with your patients and stuff?”
“My patients?” Kate repeated.
“I mean, because we’re so messed up? How do you cope? Day after day? How do you sit there and listen to us whine and complain and kvetch—how do you cope?”
Kate smiled. She’d only recently begun her fledgling practice. Her framed degrees barely covered two feet of wall space behind her desk. She had a bachelor’s degree in psychiatry and neuroscience from Boston University, and a medical doctorate from Harvard. The birch bookcase held dozens of scientific journals containing articles co-authored by her. On her desktop was the psychiatrist’s bible, the DSM-V, the one resource she was constantly reaching for. “How do I cope with what exactly?”
“With the stress? From having to deal with us crazies?”
“Well, first of all, I don’t consider my patients ‘crazies.’ We all deal with stress in different ways. For instance, I like to go running and hiking and rock climbing and work it off that way.”
“Seriously?” The girl rolled her eyes. “Because I can’t picture you running the Boston Marathon or anything, Doc.”
“Did I say marathon? Oh no. Not me.” Kate laughed. “But exercise helps with the stress.” She was understating it just a bit. She loved to go running and hiking and climbing. These activities were her biggest release, next to sleeping with her boyfriend.
“So how did you become a shrink?” Nikki asked, switching subjects.
“It was a long process. I got my BA and did my doctorate, and then there was the internship, the residency and the fellowship. Finally, just this past year, I’ve started seeing private patients, like you.”
“Oh.” Nikki smirked. “So I’m a guinea pig?”
“I wouldn’t say that.”
“No? What would you say?”
Kate smiled, enjoying the way Nikki confronted the world—part adult skepticism, part na?ve bravado. “Well, I consider you to be a bright, intuitive, sensitive human being, who just so happens to have bipolar disorder, which you need help managing.”
Nikki jiggled her foot impatiently. “How old are you?”
Okay, that was out of left field. “I’ll be thirty-two soon.”
“How soon?”
Kate’s relaxed smile contained a thorn of frustration in it, but she did her best to draw on the fathomless well of patience she’d accrued during her residency at McLean Hospital in Belmont, where she’d dealt with the craziest of crazies. Real hard cases. Human tragedy on an epic scale. Nikki would’ve been impressed. “Any day now,” she answered vaguely.
“Wow. Thirty-two. And you aren’t married yet?”
“No.”
“Why not?”
“My boyfriend asks me that all the time.”
“He does?” Nikki laughed. “James is right. You should marry him.”
James. Kate had mentioned him a few times, but she didn’t like hearing his name echoed back to her like this, as if Kate and James were characters from some TV sitcom.
“You have a great laugh,” she said, redirecting the conversation. “And a terrific smile.”
Nikki smirked. “You’re one of the privileged few, Doc. I don’t smile very often.”
“I know. Why not?”
She shrugged. “Maybe because life sucks?”
“Sometimes it does suck. Sometimes it doesn’t.”
“Wow. You’re honest. Most adults won’t say ‘suck.’”
“Well, I want you to trust me, so I’m honest.”
“I do. Pretty much.”
“Good.”
“So you’re going on vacation and leaving me all by my lonesome?” Nikki made a frowny-face. “Please don’t go, Doc. Not now. I know. Selfish me.”
“Well,” Kate said hesitantly, and then smiled. “Everybody deserves a vacation now and then, don’t you think?”
“Just kidding. LOL. Sarc.”
But they both knew she wasn’t.
“Is James going with you? On your vacation?”
This session was veering dangerously off-course, and the girl’s questions were becoming a distraction from her therapy. Kate tried to right the ship, but she wasn’t on her game today. They still had a lot of packing to do. “Why all the questions?” she asked. “What is it about me going on vacation that concerns you?”
Nikki scratched her chin with a painted nail and stared at something beyond Kate’s shoulder. “What are those? Nuts?” She pointed at the bookcase. “Are you trying to tell me something, Doc? Like maybe I’m nuts?”
Kate was startled to see a jar of Planters Roasted Peanuts on top of her bookcase. Ira must have left them there. Dr. Ira Lippencott was Kate’s mentor, a brilliant Harvard-educated psychiatrist with an offbeat sense of humor and a maverick approach to psychotherapy. “No,” she said calmly. “That’s a coincidence.”
“Are you sure? Because, you know, theoretically, I am nuts.”
Kate couldn’t help smiling. “I assure you it’s completely unintentional.”