This story by Adam Haslett explores the frustrations of a young government psychiatrist as he makes a house call to evaluate a remote patient. The woman, living with guilt, depression and fear after the death of her methamphetamine-addicted eldest son, wants to renew her prescriptions. The doctor strongly believes she is also in need of therapy, but faces two problems in providing it: distance (a five-hour round-trip to see her), and the woman’s refusal to participate. Themes include social change, rural poverty and lack of opportunity, shattered dreams, disillusionment, substance abuse, guilt, PTSD, alienation, biological psychiatry vs. clinical psychology.
The story’s abrupt ending leaves readers wondering about the woman’s reason for refusing therapy. Does she feel strong enough to face her demons alone (she appears remarkably composed, and says she can survive without the meds if necessary), or is she is taking the easy way out because she is uncomfortable talking about her problems. Either way, failure is likely to have devastating consequences for her family.
Original Text / PDF (6,350 words)