Transfer of Care

For two weeks, you are a photograph.

There's a man with a long lens on the corner of Seventy-Fourth and Lexington three mornings out of five. There's a woman from a cable show who calls the front desk so often that Sylvia starts answering, "Steinhauer and Associates, no comment," before the woman can say hello. There's an anonymous account that posts the picture of you at the door with a circle drawn around your hand on the handle, as if the handle were evidence of something.

The practice issues a statement: We do not confirm or deny whether any individual is or has been a client. Steinhauer reads it aloud at the Monday meeting, then looks at you over his glasses.

"Which is true," he says, "and also the only thing any of us will say."

Femke Hasselby, the postdoc, catches you in the kitchen afterward. She's twenty-eight, Swedish, all elbows and nerves, the best diagnostician in the building if she'd ever believe it.

"Is it terrible?" she whispers. "The cameras?"

"It's boring," you say. "That's the terrible part."

It's a lie, a little. It's not boring to walk home and see a stranger lift a camera when you turn your key. It's not boring to wonder which of your clients has seen the photo, and what they think it means about the hour they spend with you.

You keep working. You see your Tuesday panic disorder and your Wednesday grief and your Thursday woman who can't stop checking the stove. You eat yogurt standing up. You pay the minimum on your student loans, which are the size of a small house, and the full amount on Ridgecrest, which is the size of a slightly larger one.

On Sunday you take the bus to Montclair.

Your mother is in the sunroom, in the blue cardigan you bought her, doing a puzzle of a lighthouse with pieces that don't belong to it. She looks up when you sit down and her whole face brightens.

"Theresia," she says. "You came."

Theresia is her sister. Theresia died in 2009.

"I came," you say, and take her hand, and help her find the edge pieces.

On the bus home you look out at the Turnpike and think, with no warning at all, about a man saying Nobody's said that. In eleven years. You push the thought away. It comes back. It has been coming back for fourteen days, at red lights and in the shower and at two in the morning, and you are a professional, and you know exactly what intrusive thoughts are, and knowing doesn't help even a little.

On Thursday, October 8, Yaw Okonedo calls you at the office.

"Transfer of care is complete," he says. "I have your note. Thank you; it was clean. He's signed the releases the board needs, and he's coming twice a week."

"Twice?"

"His choice." A pause. You can hear him deciding how to say the next part. "I won't tell you anything about his treatment, Ava, and you won't ask."

"I wouldn't."

"I know. That's why I'm comfortable telling you this one thing, which is not about his treatment." Another pause. "He asked me whether it would be appropriate for him to contact you. Personally."

Your hand goes still on the desk.

"I told him what's true," Okonedo says. "That you were never his treating clinician. That you ended a single intake and referred him to me, which was the correct and rather brave thing to do. That he is in care with me now. And that whatever happens between two adults outside of anyone's clinical relationship isn't mine to permit or forbid." He lets that sit. "I'm telling you so you aren't ambushed. That's all."

"Thank you, Yaw."

"Mm." The same noise Hilde makes. All the good ones make it. "Be careful with yourself."

You hang up and sit very still in your office with the door closed, looking at the chair he wouldn't sit in.

That evening you call Hilde, because you promised yourself you'd call Hilde about anything, and because you are a coward who wants permission.

She doesn't give it.

"He's in care," she says. "Good. He asked his own clinician before reaching out. Also good; that tells you something about him." You hear her settle into a chair. "Now tell me what you want."

"I don't know."

"You do. You've known since four forty on September twenty-fourth." Her voice gentles. "I won't tell you what to do, Ava. I'll tell you what I'd want you to watch for. Don't let him make you his doctor. Don't make him your rescue from a lonely year. And if anything ever begins, go slowly enough to be sure it's yours."

"Nothing's going to begin."

"Then you have nothing to worry about," she says, and you can hear her smiling.

At home the radiator clanks like someone's trapped in it. You make tea you don't drink. You answer two emails, delete three, and lie on the couch with your feet up on the armrest looking at the water stain on the ceiling that looks like Ohio.

At 11:40 p.m., your phone lights up on your chest.

Unknown number.

You almost don't open it. Reporters have your work number; one of them found your cell last week. You thumb the screen ready to delete.

This is Joachim Vantreight. You declined me as a client on September 24th. I've been seeing Dr. Okonedo since.

You sit up so fast the tea sloshes.

Another message arrives while you're still staring at the first.

I'm writing as a man, not a patient. Tell me if this crosses a line you still care about.

The radiator goes quiet. The whole building goes quiet. Somewhere out on Eighty-Second Street a cab leans on its horn, and you sit on your couch with your heart going like you've just run up four flights of stairs, which you haven't, and you read his words again, and then a third time.

Then the three dots appear under them.

He's still typing.