Online Flip Book / Download   Back to our Information Page

As he pulled up the drive, Frank saw the skeleton of a Chevy Nova, grass to the windows, rusting in the side yard like some battle-wasted tank. Toy guns and action figures, their plastic faded, lay scattered over the brown lawn. The house, a white fifties prefab, sagged to one side, the chimney tilting. To its left stood a dilapidated barn. From the green spray-painted letters on its door announcing No Girls Allowed it seemed clear the building had some time ago been delivered from the intention of its creator into the hands of children.

He cut the engine and watched the cloud of dirt his tires had kicked up drift into a stand of oak trees shading the side of the house. They were the only trees in sight, empty prairie stretching miles in every direction. He rested his hands and chin over the top of the steering wheel, his head weighed down with the sinus ache of his hangover.

One of the reasons he’d taken his job at a county clinic two thousand miles from his friends and family was that the National Health Service Corps had promised to repay his medical school loans in return for three years’ work in an underserved area. Last night he’d come back to his apartment to find a letter in the mail: Congress was cutting the program’s funding, leaving him the full burden of his debt and a paltry salary to pay it with. He’d spent a year at the job already, and now they were hanging him out to dry. For the first time in his life there was uncertainty in his future. From college to medical school to residency to this job, everything had been applied for and planned. Now he wasn’t even sure he could afford to stay. He’d got drunk on a bottle of scotch his friend from back East had sent him for his birthday. The last thing he had wanted to do today was drive two and half hours here to Ewing Falls to evaluate some woman who’d been refusing to visit the clinic for a year and demanding her medication by phone.

Nearly hundred-degree weather had settled over the state for the last week and today was no exception. With each step across the drive, more dirt rose powder dry into the air. By the time he mounted the porch steps, sweat dampened his collar.

A first knock produced no response. He waited a minute before tapping again. The shades in the front room were pulled to the middle of the windows and all he could see was the wood floor and the floral print back of a sofa. He turned to look across the yard and saw a girl standing in the driveway. She seemed to have appeared from nowhere. By the height of her, she looked eight or nine, but her rigid mouth and narrowed eyes suggested someone older.

“Hey, there.” As soon as he spoke, the girl started walking quickly away, toward the trees.

“Hey,” Frank called to her back, “are your folks home?”

“She ain’t a bigger talker,” a voice behind him said. Frank turned back toward the door to see a middle-aged man dressed in a sweatshirt and work pants. Spidery angiomas, those star-shaped discolorations of the vessels seen in liver patients, blotched the skin of his rounded face. Hepatitis C, Frank thought, or the end of a serious drinking habit. The man took a drag on his cigarette, holding the filter between thumb and forefinger, the exhaled smoke floating over the porch, tingling Frank’s nostrils.

“You’re the one they sent up from the clinic,” he said flatly. He leaned forward, squinting. “Bit young to be a doctor, aren’t you?”

Frank got this all the time: old ladies asking when the doctor would be in—a useful icebreaker, but he wasn’t in the mood today.

“I’m here to see Mrs. Buckholdt,” he said. “I assume she’s home.”

The man looked out across the fields, the horizon molten in air heated thick as the fumes of gasoline. The expression on his face changed from scrutiny to the more absent look of recollection, as though he had suddenly lost interest in their conversation.

“Yeah,” he said, almost to himself. “She’s in there.”

Then he crossed the porch, past Frank, and wandered out into the yard.

*  *  *  *  *

“Mrs. Buckholdt?” Frank called out, blinded momentarily by the darkness of the front hall.

“Down in a minute,” she said, her voice coming from somewhere up beyond the stairwell.

Ahead in the kitchen, a cheetah chased a gazelle over the screen of a muted television. Frank could see the back of a boy’s head silhouetted against the screen’s lower half, the rest of him obscured by the counter. The house smelled of stale candy and the chemical salts of cheese-flavored snacks.

A bookcase stood on one side of the living room and a picture he couldn’t make out in the poor light hung on the wall opposite. Two large Oriental carpets covered the floor. He put his briefcase down on a torn leather armchair and took out Mrs. Buckholdt’s chart, which he would have read by now if he hadn’t been in such poor shape this morning.

After getting thoroughly drunk, he’d done the really smart thing of calling his ex-girlfriend, a woman in his program he’d dated toward the end of their residency. They had gone out for six months, which, at the age of thirty-two, was the longest Frank had ever been with a woman. If he hadn’t seen so many patients with romantic lives more desperate than his own, he might have considered himself abnormal. Anne had flown out from Boston a few times when he first got out here; he’d convinced himself that one day he would ask her to marry him.

“Glad to hear you’re still out there saving the world,” she said, after he made a few comments he regretted now. She knew he’d come out here with the idea that he’d be given the freedom to practice the way he wanted to, which meant more time to talk with his patients. Wanting such a thing seemed almost renegade at this point in his profession, given the dominance of the biological psychiatry they’d been trained in, a regime Anne had never seriously questioned. 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.

“My mother wasn’t so liberal. Spending all that money to look at pictures, for a girl, no less—what a waste, hey? So I came home—three years, no degree.” She drew slowly on her cigarette. Her thoughts seemed to wander.

Though the shades were half pulled, the air in the front room was stifling. Frank could feel the back of his shirt dampening against the leather of the chair.

“I’m just wondering if maybe you could tell me a little about your symptoms.”

“My symptoms?” she said, leaning forward. “Yes, I can tell you about my symptoms. Some mornings I wake up shaking, and I’m afraid to get out of my bed. If I take some of the pills I can manage to get up and make my children breakfast. Some mornings the fear’s bad and I have to grit my teeth to get through it.”

She rubbed her half-smoked cigarette out into the tarnished silver ashtray on the coffee table.

“And I’m afraid of my son.”

“Why is that?”

Her already rigid body tightened a notch further. “Like I said, if I take the pills, it’s fine.”

Noticing her strained expression, Frank decided to back off. “You were saying you’d been to college. That’s unusual for most of the women I see.”

Mrs. Buckholdt leaned back in the couch and gave a small frown of acknowledgment, as if to say, yes, it was a pity more couldn’t go. As she relaxed, a remnant of what must have once been coquettishness surfaced in her face, and Frank glimpsed how she must have looked to the other high school kids, the ones who’d never dreamt of leaving.

“My parents were good Lutherans. We’d always gone to this big, very plain barn of a church over in Long Pine, whitewash walls, a simple cross. My mother—when she came to visit me at college—those Gothic stone halls we lived in, she didn’t like them, found them suspicious. There was something Catholic about gargoyles on the head of a drain; she didn’t like the smell of it. She’d been happy with my father out here, couldn’t imagine why a person would want to leave.”

She gazed past Frank, through the window that looked out over the side yard.

“I’d always pictured heaven as a rather ordinary place, where you met the dead and people were more or less comfortable. I think I imagined the whole world that way, as an ordinary place. But those paintings … they were so beautiful. I’d never seen anything so perfect in my life. Do you know Gericault? Do you know his pictures of Arcadia, those huge, lush landscapes of his?”

Frank shook his head.

“You should see them someday. They’re beautiful things to see.” She spoke in a slow, reflective manner.

“You came home, then,” he asked, “when you left college?”

“Yes, to my parents’ house.” She smiled. “Jack was just starting as an officer down at the bank. He’d spent a year at the state university, read a good deal. He didn’t want to stay here forever. Kept telling me that, because he knew it had been hard for me—coming back. He’d drive me out to the lake in his convertible. And he’d talk about a house in a town out in California. Always California. An orange tree in the backyard, how you could drive with the roof down all year round, a porch with a view of the ocean. I kept thinking of being close to a museum. I could enroll in classes again; it wouldn’t have taken many to finish. And near a city, I might do research. Jack—he’d nod at that. I was a college girl, you see, a catch.” She chuckled. “Twenty-five years ago, that ghost you saw out there—he was a handsome boy.” Her eyes came to rest on the floor by her feet. “Are you married, Dr. Briggs?”

There was a familiarity, almost a caring, to the way she asked the question, as though she were inquiring not for her own information but to give him the chance to tell her.

“No,” he said. “I’m not.”

“Is it something you hope to do?”

He imagined his professors judging him unprofessional for answering these questions. “Yes,” he said, “I’d like to.”

She nodded but made no reply.

“You married soon after you returned?” he asked.

“That’s right. Jason, my first son, he came early on. Of course, it made sense to save money for a while. Get a house here, just for a year or two, before the big move. I imagine you went to a Montessori, didn’t you? Or a country day school—maps on the walls.” She smiled at Frank, a wan, generous smile. “He was so bright, Doctor, from the very beginning. I wanted him to have all that. I really did.

“I’d kept my books from college, and there were the ones Jack had, and some I bought. So while the school taught him George Washington every year, I read to him. I wasn’t a fanatic, I didn’t throw the television out, we didn’t ground him. I read him books after supper and when he got older he read them himself. And I showed him things. I played him records, drove him to Chicago once, took him to the museum. He liked the paintings all right, but you should have seen the look on his face when he saw the height of those buildings and all the people in the streets—delighted, that’s what he was, delighted. I couldn’t stand the idea of him hanging around here, waiting for some dead-end job. Of course that made me a snob, wanting more for him. Those teachers down at the high school, they didn’t like me. Too much trouble.

“Round about when he was fourteen, this place, it started doing its work on him somehow. I could see it happening. The little tough guy stance, afraid of anything that wouldn’t make him popular. His father had started drinking by then. Everything was going to hell around here, prices dropping through the floor, all these farms that couldn’t make a dime. Jack spent his days taking people’s homes and property their families had owned for decades. So it didn’t worry me at first, I figured the man deserved a drink or two when he came home. That was before the bank went under. And as for symptoms, yes, to tell you the truth, I was depressed. I was. Things hadn’t gone like we’d planned. I kept thinking about the girls I’d roomed with, visiting Europe, standing in front of those pictures. I shouldn’t have done that—let myself look back that way. It’s the sort of thing kids notice, the way you’re not really there in the room with them.”

She paused. It appeared to Frank as though she were deciding whether or not to go on. Their eyes met briefly, but he said nothing.

“There was a kid,” she said, eventually. “Jimmy Green. His parents had lost their house; the family was living with relatives out on Valentine. He and Jason started spending their time together. He rode an old motorcycle and they’d be out in that barn with it for hours, doing I don’t know what, fixing it, I guess. Since he was eight, I’d driven Jason over to Tilden for violin lessons. He’d gotten some grief for it at school, kids calling him names. He’d cried about it some when he was younger, but he loved that music. Used to sit in that wicker chair right over there by the door, his little legs bouncing, twenty minutes before we even got in the car, his eyes begging me to hurry. You know he stood in this room one evening after practice and played five minutes of Mozart for his younger brother and sister? Mozart. Can you believe that? In this living room.” She shook her head, amazed.

“About a year after he started hanging around the Green boy, I was sitting in the drive waiting for him to come out—he’d spent all day in that barn, we were late. Before he left the porch, he took his instrument out of the case.”

Her jaw tightened, her lips barely moving.

“We’d bought the violin together. Years ago, on a trip to Saint Louis. His father had given him the money and he’d stood on his toes to hand it to the salesman. That day I was waiting in the car to take him to his lesson, he walked up and smashed his violin on the hood. Said he was tired, didn’t feel like going that afternoon. That’s what he said: tired. Just like that. Walked back into the barn.”

In her voice, there was only the blankness of reporting. Not a trace of sorrow.

“You’re a doctor in these parts,” she said. “You must know all about methamphetamine.”

Frank nodded. He’d seen some of it in the clinic, and heard more. It had become the drug of choice for kids out here, cheaper than coke and without the hippie connotations of pot. In the end, it wasn’t the drug itself that got people but the lack of sleep it caused. After three or four days of no rest the body collapsed or slipped into psychosis.

“I told his father he had to do something, had to go to the Greens, or down to the school, find out who they were getting it from. But Jack—he didn’t have it in him. The bank had been shut three years, he was scared of everything by then.

“I suppose I should have put Jason in the car and driven him out of here, gone with him somewhere. I didn’t, though. I just took it from him whenever I could. I searched his room every day for those little envelopes of crystals. I checked the pockets of his trousers, begged him to stop. You know, once I even told him I’d buy him marijuana instead. His own mother. When the police finally caught the two of them buying it in the parking lot down by the market, I was glad. I thought it would shake him up. He spent three months up at Atkinson, at the juvenile center.” She caught Frank’s look. “You think that was a mistake.”

“It’s a rough place, but it was out of your hands.”

“Well, you’re right. It didn’t help. He was worse when he got back, angrier, more confused. And he still did it. I don’t think he even stopped while he was in there—how that can be, how they can run a jail where children can get drugs, I just don’t know how that can be … and of course he was so young, just sixteen, boys at that age—” She broke off. “All those hormones in him … I suppose the drug—” She stopped again, covering her mouth with her hand.

“I was here, in the living room. It was a Sunday. Jack had taken the kids over to visit his sister. Jason had been so erratic those last few days, we were trying to keep the younger ones away from him. He’d been out till dawn that morning and the morning before and then up there in his room all day, but not sleeping, I could tell he wasn’t sleeping. I was waiting for him to come down to eat something. I kept thinking, just one more conversation, we’d talk and somehow …

“I was right here on the couch. I heard his door open, and then I heard him crying. It was like years ago when he was a boy and he’d had an upset at school and I’d sit with him out there on the porch with his head in my lap as the sun went down and I’d tell him how one day we’d take a trip on a boat all the way across the Atlantic and he’d see Athens and Rome and all the places where the stories I’d read him took place, and he’d fall asleep listening to me. When I heard him cry that day I thought maybe it was all over—that he had come back to me somehow. He hadn’t cried in so long. I went up the stairs.

“My son. He was naked. He’d been rubbing himself. For hours, it must have been. He’d rubbed himself raw. He was bleeding down there. And he was crying, his tears catching in the little beard that had started growing on his cheeks, the soft little brown hairs he hadn’t learned to shave yet. When I got to the top of the stairs he looked at me like I’d severed a rope he’d been clinging to for dear life, just like that, like I’d sent him down somewhere to die. What could I do?

“I got a towel. From the bathroom. A white towel. I got gauze and ointment, and I sat him down on his bed and I cleaned him and put Band-Aids on him and I tried not to weep.”

Mrs. Buckholdt sat on the edge of the sofa, shoulders hunched forward. Her words had drained her, her face gone pale now. She stared blankly at the floor.

“I was his mother,” she said quietly, almost listlessly. “What was I supposed to do?”

For a moment, there was silence in the room.

“The kitchen,” she said. “I was in the kitchen. Later. Making him soup. He’d always liked soup. Maybe he’d taken the drug again. I don’t know. I felt him behind me. Suddenly he grabbed my wrist, forced it down onto the cutting board, and he chopped my fingers off, the fingers I’d touched him with, chopped them off with a meat cleaver. Then he walked out naked into the backyard.”

*  *  *  *  *

The two of them sat there together a long time, the sun hanging low on the rim of the western sky, casting its giant columns of light down over the land, level over the yard, level through the unshaded panes of the windows, pouring over Mrs. Buckholdt’s back, casting shadow over the coffee table and the tarnished ashtray and the rounded, dark center of the densely patterned wool carpet.

In the time she had spoken, it seemed to Frank as if Mrs. Buckholdt’s body had sunk down into itself, leaving her smaller and more frail, her earlier, imposing demeanor exhausted. He experienced a familiar comfort being in the presence of another person’s unknowable pain. More than any landscape, this place felt like home.

“How did your son die?” he asked.

“The two of them, he and Jimmy, they’d borrowed some friend’s truck. It was only a few days later—he never had come back to the house. They were out on the interstate, headed west. They crashed into the wall of an overpass. Jimmy made it with some burns. He still lives out there on Valentine. I see him now and again.”

By dint of habit, the trained portion of Frank’s mind composed a note for Mrs. Buckholdt’s chart: Patient actively relives a traumatic event with intrusive recall; there are depressive features, hypervigilance, and generalized anxiety. Diagnosis: posttraumatic stress disorder. Treatment: a course of sertraline, one hundred milligrams daily, recommendation for psychotherapy, eventual titration off clonazepam.

He wondered how his colleagues felt when they said these words to themselves or wrote them on a piece of paper. Did the power to describe the people they listened to save them from what they heard? Did it absolve them of their duty to care?

As the silence between them stretched out, Frank remembered the first patient he’d seen as a resident, a woman whose husband had died in a plane crash. Each hour they spent together she filled with news of her two children, her son’s play at school, a job her daughter had taken at a hotel, right down to what they had chosen to wear that morning, and she said it all gazing out the window, as though she were describing events in the history of a foreign country.

He could remember lying in bed on the nights after he’d seen her, alone in his apartment, her plight weighing on him like a congregant’s soul on the spirit of a minister or a character’s fate on the mind and body of a writer. Often, lying there, he would remember an earlier night, lying in his bed as a child, soon after his family had moved to a new town. Their house was still full of boxes, and their parents had been arguing. From the other bedroom, he heard his older brother talking to their mother in a scared tone: he hated his new school, the unfamiliar kids, the way they pushed him around, and he wanted so very badly not to go back in the morning. The fear in his voice troubled the air like an alarm. Their mother’s voice was lower, her reassurances muffled by the distance of the hall. Frank had wept himself to sleep, pained to tears that he could do nothing to prevent his brother’s suffering.

He thought now how it had always been for him, ever since he was a boy sitting on the edge of a chair in the living room listening to his parents’ friends—a divorced woman whose hands shook slightly in her lap as she told him with great excitement about the vacation she was to take, or the man whose son Frank saw teased relentlessly at school, talking of how happy his boy was—the unsaid visible in their gestures, filing the air around them, pressing on Frank. And later in college, at a party, drink in hand, standing by a bookcase, chatting with a slightly heavy girl hanging back from the crowd, tracked into every shift of her eyes, every tense little smile, as if the nerves in her body were the nerves in his, her every attempt to disguise her awkwardness raising its pitch in him.

Sitting in front of this oddly compelling woman, he realized more clearly than ever before this was why he’d become a doctor: to organize his involuntary proximity to human pain. He could use his excuse of debt to leave his position at the clinic; he could even leave his profession, move away, anywhere, but still there would be this opening in him.

Mrs. Buckholdt rose from the couch and stood by the window. As she raised the shade, more of the waning sun flooded the room. Her shoulders tensed at the sound of a knock on the other side of the kitchen door. Frank watched her take a breath.

“What is it, darling?” she called out.

“Can I come in?” a quiet voice asked.

She crossed to unlock the door. The boy edged his way into the room. Biting her lower lip, holding herself rigid, Mrs. Buckholdt managed to run her hand through her son’s hair.

“What is it, dear?”

“When are we leaving?”

“In a few minutes,” she said. “Go ahead and get ready.”

The boy stared for a moment at Frank, his expression as mysterious as before. He turned back into the kitchen and they listened to his steps as he climbed the back stairs.

“Mrs. Buckholdt,” Frank began, knowing that by saying what he was about to say he was committing himself to remaining here, to finding some way to scrape by. People like this woman needed him, needed a person to listen. “In situations like yours, it can help a great deal if you have someone to talk with. I couldn’t see you every week, but I could do it once a month, and if you were able perhaps to get down to my office, we might meet once every two weeks. We could sign you up for free care. The drugs can only do so much.”

She had remained standing by the door, her arms crossed over her chest. “That’s generous of you,” she said, taking a step into the center of the room.

After a moment’s pause, she looked again at the picture on the wall. “That print there,” she said, “it was his favorite. He picked it out at the museum in Chicago. He loved all the different characters, the bits of activity.”

Frank turned to look. In the left foreground, a tavern overflowed with townspeople, drinkers spilling into the street, following in the wake of a large-bellied mandolin player wearing a floppy hat. In front of him, the obese leader of the carnival sat, as if on horseback, astride a massive wine barrel pushed forward by the revelers, his lance a spit of meat. Opposite him and his train, somberly dressed people stood praying in some rough formation behind a gaunt, pale man propped up in a chair—Lent holding out before him a baker’s pole. He faced the leader of the carnival band, the two posed in mock battle. Behind these contending forces, the square bustled. Fishwives gutting their fish on a wooden block, boys playing at a stick and tethered ball, dancers dancing, merchants selling, children peering from windows, a woman on a ladder scrubbing the walls of a house. There were cripples missing limbs, almsmen begging by the well. A man and woman made love. Another couple, dressed in Puritan costume, their backs to the viewer, were led by a fool through the middle of it all.

“Certainly no Arcadia,” she said. “Nothing lush about it, not the kind of painting I fell in love with. I’ve looked at it a lot since he’s been gone. My professors taught me Brueghel was a moralizer, his paintings full of parables. But that’s not what I see anymore. I just see how much there is, how much life.”

She looked at Frank. “The woman over in Tilden, she teaches Michael the violin now, and she won’t let me pay her. He’s not as good as his brother was, but he’s good.”

She bowed her head. “You seem like a kind man, and you’re kind to offer what you did. But I don’t want you to come back here. And I don’t want to come to your office. A few days a week I use those pills to get by, but there are days when I manage without them. Those are the better days. When I don’t look back, when I’m not afraid—better for my kids too. If you feel like you can’t write me a prescription, I understand. I’ll survive without it.”

The boy could be heard at the top of the front stairs. Frank rose from his chair and took a step toward Mrs. Buckholdt. She turned to watch her son enter the room, carrying his violin case. Quietly, he took a seat in the wicker chair by the door.

“Go and get your father,” she said. “Tell him it’s time to leave.” He ran along the hall, into the kitchen, and out the back door.

Frank’s stomach tightened, the panic beginning before his mind could form the thought: he didn’t want to lose her, he didn’t want the telling to end.

Mrs. Buckholdt took her handbag from the front table.

“It really is recommended in almost all cases such as this that a patient undergo some kind of therapy, and given the extremity—”

“Dr. Briggs,” she interrupted, opening the front door to the view out over the yard and beyond to the empty road, “didn’t you hear what I said?”