Rebecca slid into the upholstered chair beside Iris, who handed her the x-ray and other test results that had come that morning. The phone rang and Iris’ mother-hen voice comforted and made an appointment for a patient with a problem. Rebecca looked up to watch her. Iris was one of the constants in her life. Tall, unrepentantly bulky, Iris carried her extra fifty or so pounds with such authority under richly tailored suits and dresses that her size became an advantage. Her short blonde hair defied gravity, swept up and away from her neck in shiny controlled waves. Rebecca had been lucky to find her at that point in Iris’ life when her children were grown and her divorce pending. Rebecca had been enchanted by the verve and energy manifest in the amplitude of the hips, the direction of the hair.
Apart from her parents, Iris had been the one Rebecca had leaned on the most during David’s final months. Iris was the one who had done double duty in the office, arranging for other doctors to cover for Rebecca while she ran back and forth from the hospital. That last time in the office, when it became clear that all hope had run out, Iris had taken her in her arms and let her cry, gently explaining that she would have to leave her tears there because David needed her strong.
Iris was wearing a mauve suit today, matching the decor. “You start at one with Mr. Bellini,” she said handing Rebecca a file. “Oh, and Mrs. Kochinsky called for an appointment tomorrow.”
“Is she still seeing Dr. Romanov?”
“She said she prefers you. She not only wants the one o’clock tomorrow — she wants her old slot back, every Wednesday.”
Rebecca allowed herself a momentary smile. Dr. Romanov had covered for her during her absence. Apparently he had done fine with stomach ailments and skin rashes, but had no knack for psychotherapy. She had hoped Mrs. Kochinsky would return for her weekly sessions. Though Rebecca practiced general medicine, she had realized over the ten years of treating patients that a handful of them needed to talk out their problems more than they needed sedatives or painkillers. A certain rapport with her patients was required but the decision to conduct psychotherapy always grew out of Rebecca’s concern for their physical well-being. Mrs. Kochinsky refused all medication but had eagerly arrived for therapy each week like clockwork since coming to Canada from Argentina one and a half years earlier.
Rebecca stood up to retrieve Mrs. Kochinksy’s file from the wall unit, leaned over to sniff the vase of daffodils Iris had arranged on the counter near her desk. Their fluted yellow centres emanated a sweet vapour filled with hope and mute possibility. Incomprehensible spring. She felt it creeping into her shrunken heart in those sudden moments when the fading fragrance of new paint wafted through the air.
She took the file and stepped into her office. A new print of Monet’s Lilies hung on the wall. She had removed all of David’s sketches and watercolours from the old office and put them into her basement. Maybe one day she would be able to look at them.
She sat down in her new grey leather chair and opened Mrs. Kochinsky’s file. “Severe anxiety and insomnia. Very agitated. Rx: mild sedative. Patient refuses meds. Worries that somehow they can be tampered with. Consistent with persecutory thinking. Recommended psychiatrist, but patient reluctant.”
Rebecca recalled the charming Polish accent tempered with Spanish. “Life in Argentina became dangerous in nineteen-seventies,” Mrs. Kochinsky had told her. “After Peron died in ’74, one dictatorship after another. The military. You understand. Always the military. They did what they want, they got rid of anyone they don’t like. It was dangerous sometimes in streets. And you, people like you, they have special hate for psychiatrists” — she pronounced the silent p. “They pull some from hospitals, some from homes. All disappeared. Gone. They didn’t trust them. Who knows why? What they don’t understand, they destroy.” Rebecca had taken in the stylish hair, the tasteful suit, and wasn’t prepared for what came next. “Who would think they’d take me? What did I do?”
Especially difficult for Rebecca to deal with was the dream. Though described to Rebecca often, it was like a jigsaw that fluctuated with each unexpected fragment of memory, a space filled in here, another there. At first Rebecca hoped that once completed, the puzzle would lose its terror. On the contrary, the more Mrs. Kochinsky remembered, the closer she came to concluding the picture. Rebecca realized that the sum of such parts would add up to a whole that few people could bear.
Whatever details dropped out of her memory, the dream always began the same way: waking up, startled in bed. The door exploding with shouts. ¡Abra la puerta! ¡Abra la puerta! Her face on the floor of the car, the guard’s foot on her back. Mrs. Kochinsky intoned the events like a well-worn article of faith, a shadow religion that held her captive on the darkest of altars. Rebecca listened as the older woman repeated the dream in pieces that she could endure on this side of memory.
The odd thing was, when David died in September, Mrs. Kochinsky was the only patient Rebecca told, the only one she felt could understand. The older woman observed Rebecca with empathy for a while, commenting on the shadows beneath her eyes. Rebecca felt close to her then. It was a bond between them that grew like a dark flower.
Rebecca read over some of her notes from January, Mrs. Kochinsky’s last visit: “Presented in somewhat agitated state. Well-dressed. Excited, unable to calm herself. Thought content disordered. Elevated BP. 160 over 100. Still upset over sister who has entered nursing home. Sister stopped speaking. Mrs. K. feels abandoned though visits almost every day. Furious with brother-inlaw for quick decision to send sister away. Mrs. K. restless during session. Sleep disrupted, loss of appetite. Recommended Rx: moderate dose chlorpromazine. Still refuses meds.”
Rebecca flipped through notes on Mrs. Kochinsky’s previous visits. Last July her patient had missed an appointment. This had never happened before. Iris interrupted Rebecca’s examination of another patient so she could take the phone. Mrs. Kochinsky muttered, between wails, that her only living relative, her younger sister Chana, had suddenly gone mad. Mrs. Kochinsky had moved to Toronto to be with Chana who had now retreated into herself, unwilling or unable to live in the world. Mrs. Kochinsky was not going to come for her appointment then or ever again, she had outlived the rest of her family. What is there left to live for? Chana was all she had, and now even she was gone. I’m only alive because I’m not dead.
Rebecca had abandoned a waiting-room full of patients and driven the few blocks to Mrs. Kochinsky’s duplex to find her anything but elegantly dressed. Her patient lay in bed, wrapped in a cotton housecoat.
“Mrs. Kochinsky....”
Her eyes opened but would not focus. Rebecca checked her wrists. No blood. Then her eye caught the empty pill bottle on the nightstand. “Mrs. Kochinsky! What have you done!”
She swept up the bottle: Chana Feldberg. Take one tablet at bedtime when needed for sleep. Valium. 15 mg. 30 tablets.
Rebecca had waited in the busy emerg while Mrs. Kochinsky’s stomach was pumped. She knew the ER nurses would be curt and perfunctory with a suicide attempt, preferring to expend their energy on patients who actually wanted to survive. They’d been waiting for a psychiatric assessment for two hours when Mrs. Kochinsky suddenly sat up in the bed, grey-brown hair fly-away, and announced she wanted to go home. Nothing Rebecca said would deter her from getting dressed. Rebecca, perturbed by the possibility that a psychiatrist might hold her for lengthy observation, accompanied her patient through the crowded ER where nobody took any notice of them.
At Mrs. Kochinsky’s, Rebecca called social services to arrange for a visiting nurse. She sat on the edge of Mrs. Kochinsky’s bed and looked into eyes that were vacant with pain. She took gentle hold of the limp hands. “You mustn’t let them have this victory,” she said, and a lot of other things she couldn’t remember. Mrs. Kochinsky wept long tears as Rebecca spoke, listening more, it seemed, to the steady rhythm of her words than the words themselves. There was a primitiveness in Mrs. Kochinsky’s need for the sound of someone’s steadfast heart, like the need of a newborn for the beat of its mother’s pulse. Rebecca was willing to be that heart, that pulse, as long as it kept