The Eighth Girl: A Novel

Prologue

THE VOICES COME AND GO. LIKE FLU. WEATHER. WEEKEND SHAGS. I’M unsure how long they’ve been here, or if they intend to stay. I want to say they’re friendly.

Alive to their company I scale the scene, first noticing the cars. Then the backup, close to a mile, crawling under my feet—snaking the strip—my eyes crimping from their blaring white lights. Families escaping the city’s hum, men heading home to their wives. Girls in studied dresses switching heels for flats as they drive across town, ripe for a big night out. Everyone going somewhere, doing something, meeting someone.

Not me, I tell myself.

Not me.

There is no small corner of the world I wish to claim and delight in. No one who knows the stir in my gut. The burn. All my mistakes frozen in the tight lock of my face.

I inch forward enough to feel a surge of adrenaline, part of me always knowing it would end this way: me, the Voices, balancing on the ledge at Jumpers Bridge.

I grip the railings behind me to steady my shake, urging myself to remember how I got here—why is there a key in my left hand? I, after all, am right-handed. Still, nothing unfolds, my mind turning blank like a page erased of its words.

How long have I been here, strangling the bars? White-knuckling as if on the ride of my life—a roller coaster, a ghost train—my bare arms pimpled with cold like the skin of poultry. An ache in the base of my back.

Losing time is never good. It’s an expression of the insane. An indicator of how close I am to completely losing my mind. Concentrate, I order myself. Focus.

The Voices clear their throats. A rise of phlegm foaming in my mouth, now spat down at migrating cars, a cool lick of wind guiding its direction. Like all good enforcers, they seem to engulf me tonight, pointing fingers of blame, their message both hateful and threatening.

I STARE DOWN AT THE READY DARK—

Flash.

Dusk stealing me for a beat—

Flash.

AND NOT UNUSUALLY, AN IMAGE OF MY FATHER FLARES UP IN MY MIND.

He is sitting in the corner of my bedroom, his legs crossed in the high-backed wicker chair we bought from a car boot sale. When I open my eyes I notice he is wearing a black Crombie, a blue tie—the colors of bruises. His faint eyes and bristled chin payback from the night before. Floating from his left hand is a Hello Kitty balloon.

Flash.

Happy birthday, my sweet Xiǎo Wáwa, he whispers.

Thank you, Baba, I say, rubbing crusted sleep from my eyes. I’m too grown-up to be your little doll anymore. But I am sweet. Sweet as kittens.

Flash.

NOT WISHING HIM TO BE THE LAST PERSON I RELIVE BEFORE LETTING go, I picture Ella instead. The two of us are sitting in her backyard wearing denim cutoffs and cotton halters, jelly shoes rubbing the soft balls of my feet. The smell of jasmine in the afternoon air. I move a pitcher of beer around the shaded table to avoid the glare of sun. A bowl of salted nuts lassoing our thirst.

Suddenly, Ella surprises me with a silver box, a matching silk bow—which I pull, very gently, its twin loops coming apart. Inside: a stunning pair of gemstone earrings.

Green ones, she says, to match your eyes.

The memory calms me, and for a second I favor climbing back to safety. My helplessness eased. But then a single tear escapes, acting as a reminder of what she did.

Nerves turned on, I look down again.

How could she? Cunt.

Numb, forlorn, grief drenching my empty body, I loosen my hands. The Voices whispering softly in my ear: Jump, you fucking crybaby.

1

Daniel Rosenstein

I WALK TOWARD MY DESK AND GAZE OUT THE OPEN WINDOW AT THE amber evening, August light spilling through a veil of drooping wisteria. I check tomorrow’s diary: Thursday 8 A.M.—Alexa Wú.

Normally I wouldn’t start so early; certainly not before nine, but I have bent rules to accommodate her. A minor allowance because she’s looking for full-time work, has several job interviews lined up, and also works nights—did I have availability early morning, because she could do any day of the week if it was early? This she spoke to my answering machine, her voice trembling at the edge. I’d wondered about this. Imagining it may have been difficult for her to ask for something—the possibility that it might be refused.

My receptionist returned her call the following day, saying I had space on Tuesdays and Thursdays. That maybe she would like to come in then? She agreed; they fixed a day and time; I added Alexa to my roster of patients.

Other psychiatrists might steer away from bending their daily routine, but I have learned such gestures go a long way in the encouraging and building of relationships, am convinced that those who experience some adjustment will eventually learn to compromise.

OUTSIDE, PATIENTS ARE FIGHTING SIGNS OF FATIGUE. WITH TIGHT yawns they shuffle about, heads limp, shoulders down—their last attempt at exercise before one of the nurses will escort them back inside the ward before supper. Earlier they appeared disorganized and manic; eyes darting, movements awkward. Handicapped as much by the medication they take as the neurosis that makes the medication necessary.

Gathering on the solid timber bench, four patients decide to rest, but reluctant to engage with one another, they stare at the huge oak and surrounding island of grass. Hands cupped in their laps as if waiting for loose change.

In the distance a flock of lively blackbirds have landed, unruffled, on the copper power lines and at once appear like musical notes. Their song is enchanting until they migrate to the blushing apple trees, their chorus now moved to the shelter of leaves.

I open the top drawer of my desk and pull out a packet of M&M’s, allowing myself six candied yellow peanuts with what remains of my coffee. This I take black with three sugars—a long-standing ritual that commenced shortly after I was appointed Glendown’s consulting psychiatrist eight years ago. I rest my mug on the ceramic coaster; on it: a circular hand-painted picture of Aesop’s fable The Tortoise and the Hare—a gift from a former patient. A bipolar chef who, from the tender age of eleven, fantasized about setting objects alight. On her thirteenth birthday she set fire to her mother’s entire wardrobe: the smoldering Chanel kindled to a pile of ashen confetti. I like to stare at the coaster, replaying the hare’s boastful behavior and foolish confidence in my mind. Moral of the story: Never sleep on the job. Especially when your pyromaniac patient has access to a lighter.

Some clinicians claim the eroticization of gift-giving is meaningful because of its connection to the libido; that often the gift represents love and affection that is not always verbalized in the room. Even Freud, in his overzealous theories, believed a child’s first interest in feces develops because he considers it a gift given up upon the mother’s insistence and through which he manifests his love for her. Further insights led Freud to discover this unconscious link between defecation and treasure hunting, but in this I have to wonder. Maybe sometimes a cigar is just a cigar, a gift just a gift. A poop just a poop.

Evening drawing in, my thoughts turn to supper. A sudden rise of hunger spurs me into the tidying of clinical notes, Post-it reminders, mail, and my letter opener—also a gift, from Lucas, a recovering alcoholic who every evening had a strict one-hour OCD ritual that involved elaborate checking for serial killers in the cutlery drawer. Oh no, not the flat ones again, I would tease. And Lucas would smile, rolling his eyes, acknowledging his need for control and obsessive compulsions before tapping the sole of his oxford lace-ups eleven times.

When Clara passed away five years ago, Susannah, who rarely visits, suddenly appeared one afternoon with a corned-beef bagel, claiming she just happened to be in the area. As she looked around my office, a glint in her eye, she jokingly named it the Museum of Shrink Memorabilia.

Your patients are absolutely everywhere, Dad! She cried freely. "On the desk, on the walls, over there on the shelves. They’re even in the goddamn kitchenette! You know what? You should start paying them!"

I had belly-laughed at the time—my kind, funny daughter. Physically her mother’s child, with quick, grassy-green eyes and jet-black hair. Her broad shoulders, back then, weighted down with grief. I recall smiling—the joke causing my muscles to do something other than sag—as I grieved the loss of my wife. Her death making its own demands, my own emptiness impossible to ignore.

2

Alexa Wú

I THINK I MIGHT DIE OF EXCITEMENT. SERIOUSLY. REASON: ELLA Collette—best friend, bona fide babe, and, as of last night, matchmaker extraordinaire! Yep. Not only do I have a date, but I also have a date for the date. Next Saturday. Nine P.M. Hoxton.

He couldn’t take his eyes off you, Ella teases, batting her heavy lashes, mascara having left a tinge of slate above both cheeks.

Already dressed, I jump and land on my bed, straddling Ella’s flat body between my thighs, head pounding from last night’s vodka tonics.

Well, he couldn’t! she yells, triumphant, defending her ribs from my tickling hands.

Shhh, I say, tapping my head.

Well, he couldn’t, she whispers.

I blush as I always do when Ella gets like this. Am reminded of the time my Reason took it upon herself to fix me up with one of her former school friends, inviting him in a hurried, liquor-laced phone call to her house one Friday night. Both of us had been loose and giddy from cheap Russian wheat vodka. But this time it’s different. This time I actually like the guy. He’s funny. And smart. Handsome, but not too handsome. Tall, but not giant. And he has a body to die for. Swoon!

We met last night in Hoxton after Ella insisted that another night drinking wine at home and watching repeats of Girls was simply not an option.

Fancy meeting up? she’d called and asked, making it sound more like a demand than an inquiry. Some cute guy came into work handing out flyers for a new club—the Electra. We got to talking. I thought it might be fun. Sounds kinda different.

Different how? I asked.

You know, different.

So I went. And we met. The cute guy and me. Ella introducing us while he served sleek cocktails in chilled tall-stemmed glasses. His blue eyes holding hostage every girl seated at the bar. Ella noticed my dropped jaw as soon as I clapped eyes on him, then disappeared, squeezing my hand three times—a code we both use for reassurance. Help, I’d mouthed at her, palms dripping, stomach in knots, before catching his smile, which I nervously threw back. Then he leaned over and kissed me hello. I looked past his shoulder, aware the club was brimming with attractive bodies and girls performing lavish burlesque on a narrow mirrored stage. One girl with long red hair and legs for days feigned intimacy with a nickel pole at the far end. Her shoulders shimmering but her gaze somewhere else as she fingered a delicate gold necklace with a small key attached. I gawped for longer than seemed right, lost in her drops and swerves, her perfect body forcing me to want to run home and never eat again. But then cute guy’s gaze brought me right back, pinning me to the spot. Stirred, I felt my breath fill my entire chest.

Flash.

SNAPPING BACK FROM THE MEMORY, I SEE ELLA, DRENCHED IN MISCHIEF, cupping both hands beneath her chin to form a heart.

Alexa and Shaun, sittin’ in a tree; K-I-S-S-I-N-G, she sings, looking around me at one of my many clocks. Fuck!

What? I yell, startled. Mouth dry as a bone.

She pushes me off her—Fuck! Fuck! Shit!—jumps up and grabs her skinny jeans off my bedroom floor.

Why didn’t you wake me? she scolds.

I thought you took the week off work, I say, knowing I’m not being dense.

I did, but I’m babysitting the kid, remember? It’s half term. Mum’s got that temp job.

The kid, aka Grace, is Ella’s younger sister. Not particularly bratty for a thirteen-year-old, but she does have a tendency to nick stuff. A month ago it was a pair of hair straighteners, a week later steampunk comics and a manga Pop! Vinyl from Forbidden Planet. A large, goateed security guard caught her with them tucked under her sweater. He didn’t report her, just scared her a little, made her cry, and then called Mrs. Collette, which, if I’m honest, was probably worse than calling the police.

We can give you a lift if you’d like? I say, upsetting a pile of ironed clothes stacked on top of my oak dresser. Anna’s driving me to Glendown, so we can drop you on the way.

Ella relaxes.

Okay, she purrs, knowing she looks pretty when she pouts, that would be great. I can pick up Grace from her sleepover, then we’ll walk back home.

She throws herself, belly first, back on my bed. Her perfect elbows supporting her perfect chin. It’s the kind of chin that looks good in anything: mirrors, photos, cute scarves, turtlenecks. Anything. I walk toward her, pretending I’m a photographer while Ella poses, my fingers bluffing to click, click on a push-button, flash, flash.

Chin up, chin down, Ella tilts her head. Her tired eyes narrowing for effect until a final look involving her full lips sends me off balance.

I check my watch, aware I also need to get a move on.

Ella, calmed now, picks up last month’s Vogue. So what’s his name, this new Glendown shrink?

Dr. Rosenstein. But he said to call him Daniel.

"I bet he did. And I bet he said you’d have to pay through the nose for the pleasure, thank you very much. I guess they do that, don’t they—shrinks—get you to trust them, act all friendly, lure you in before rawrrrr—pouncing in!"

Ella’s imitation of a wildcat isn’t half-bad. On hands and knees she dismisses her Vogue and claws her fingers, opens her mouth wide, and prowls along my bed like a tiger in the savannah. She roars again.

You’re crazy! I laugh.

Thrilled with the compliment, Ella crosses her eyes and shows me her jazz hands.

Anyway, enough of the shrink, she says, swapping my pajama shirt for her cotton tank top, you’re clearly besotted with this Shaun guy, which probably means I’m about to lose my best friend until you get bored of him. When are you meeting up?

Saturday. I shrug.

"Saturday," she mimics, coy and kittenish, then points at my forehead.

What?

Your bangs are all wonky, she says, her hot breath blowing the fine strands of my hair.

Not convinced, I stride toward my Venetian mirror, but when faced with my reflection, yep, soon realize what she means.

I was going for electro-pop, I say, feeling defensive and licking my three longest fingers, using them to press down on my bangs.

Yeah? Well, it’s definitely more geek than Gaga.

Rude!

Just saying.

Sweeping my long brown hair to one side, I tuck the wayward strands behind both ears. Unfortunately, my right ear is unable to hold back my hair as effectively as the left because a chunk of it is missing. I am the opposite of Mr. Spock. Were I to be invited aboard the USS Enterprise I would have to decline. Fact. I pinch my cheeks for a flash of color and turn, noticing that Ella, now fully dressed, has borrowed my mint cashmere sweater, which I have to confess looks a zillion times more chic on her than it ever has on me. I may sound a tad envious, but that’s only because I am.

ALEXAAAA! Hurry up. I haven’t got all day. You’ve got five minutes, young lady!

That’s my stepmother, Anna, at the bottom of the stairs screaming her pretty little lungs out, clearly vexed. Ella and I roll our eyes.

Anna pretty much raised me after my mother killed herself—pause for a feeling—there. If my young life’s taught me one thing so far, it’s not to skip over difficult feelings. For many years I did my best to avoid them, fearful they’d destroy me. Comfort eating, drinking, masturbating, or sometimes even cutting—the backs of my legs, often with a blunt kitchen knife. The messy butchering ordered my pain inward and took preference over letting others witness my rage, a result of my mother’s sad life and lonely death. I was too vain to cut my arms and hadn’t wanted to give people the opportunity to judge me, at best, or at worst, pity me, assuming I was self-loathing, which, if I’m completely honest, I was at times.

When one of your parents kills themselves you grow up believing you were never quite good enough. But you also realize there is always a way out, however many people you might hurt in the process. Selfish, I know.

When I was nineteen years old, Anna suggested I go to therapy. I’ll pay, she said, so she did and I went and it helped. For four years I talked the hind leg off a dog. I became fluent in the language of shrinkese: exploring feelings, repeating behaviors, and patterns of self-destruction. I understood why cutting felt safer than rage; masturbating less scary than intimacy; why eating kept the Body protected and that talking was curative. Back then, Anna had me down as some kind of teenage cliché—mad, moody, and depressed, and for this she blamed my father, claiming no responsibility for her part. I eventually became a bone in Anna’s contention. An inconvenience and constant reminder of the man, my father, who eventually up and left. But I haven’t forgotten what she did, or rather, what she didn’t do. I’ve stored a tiny mental note in my brain should I ever need to remind myself, the resentment felt just one among many.

Better go, I say, collecting my denim rucksack and sunglasses.

Ella smiles and leans into me. Your dress is on back to front. Who got you dressed, Dolly?

Checking my collar, I notice the label that ought to be at the back is right here beneath my chin. I laugh, embarrassed, circling my red dress back to its rightful place before straightening it with a gentle tug at the waist.

Whoops. I smile.

Ella and Anna are the only people besides my previous shrink who know about my other personalities. During my third year of therapy I decided to come clean and confessed to the other people living inside me, and that was when I was given a diagnosis of DID.

Dissociative identity disorder, previously known as multiple personality disorder, is caused by many factors, including trauma in early childhood. This leads to depersonalization (detachment from one’s mind, self, or body) or derealization (experiences of the world as unreal) and dissociative amnesia (inability to remember events, periods of time, or life history, and in rare cases complete loss of identity).

I was fearful to begin with, thinking that if I told anyone about my condition that I’d be committed or that said shrink might attempt to control, remove, or even destroy my personalities. This was not an option. After all, I was the one who created them, which meant I got to decide who went and who stayed. Not him.

Anna has less of a grasp on my condition because she chooses to live in denial and think of my personalities more like moods. The very idea of others living inside me freaks her out, so I guess it’s just easier for her this way. Less mad.

Those who have never seen a switch of personalities in someone often expect some big dramatic physical transformation. Something like a vampire or werewolf sprouting fangs, hair, and claws. But in reality it’s much more subtle. The Body doesn’t change per se, just the body language. Or sometimes it’s our voice or the way we dress. Occasionally, I’m told, it can be the gaze that is actually far more unnerving than anything else.

Unlike Anna, Ella can handle it—them—us. The Flock. And even though she finds it rather amusing at times, she is incredibly attuned to us all. She can usually tell when one of us has taken the Light and seized control of the Body. Take last week: Ella and I were waiting for the Tube when Dolly, not realizing we’d left home, woke up and caught sight of a moving train and completely freaked. Ella immediately noticed the switch—a childlike look of confusion, the simple in-turn of feet and wringing of hands—then put her arm around us for comfort.

It’s okay, Dolly, Ella whispered, don’t panic. It’s just a train.

Most people wouldn’t know what to do with so many personalities set loose in one body. That’s one of the reasons we’re so close, Ella and I. Even though we’re very different—opposites, even—she’s not once made us feel mad or bad or unlovable.

I look affectionately at my Reason and follow her swishing black bob down the stairs.

"What time do you have to be there, at Daniel’s?" she asks.

Eight, I reply.

Remember. Just be yourself. Okay?

Okay.

She turns back and smiles. You got this.

Outside, Anna greets Ella and me with a tight jaw. She crosses her tanned, slender arms and with a pinched mouth—glossed with peach—makes a disapproving sound. I attempt a smile, hoping it might smooth things over, but she simply looks away. Clearly miffed at having missed her Zumba class, she makes a point of slamming the door of her Volvo SUV—such a drama queen—and mutters something under her breath about thighs and bums.

You look nice, I chime brightly, lying.

Anna checks her rearview mirror, fingers a lone blond curl, and keys the ignition.

Yeah, thanks for the lift, Ella adds.

I clear my throat.

Sorry you missed your class, I say sheepishly, applying three strokes of cherry ChapStick.

But Anna’s glance, mean and sharp, silences us. Refusing to indulge our docile chitchat.

You girls, she finally snaps, gripping the leather-covered steering wheel, why do you have to drink yourselves sick? There’s no need for it, getting drunk like that. It’s not—

"Ladylike? I finish for her. Christ, Anna."

Silence.

You’re right, Mrs. Wú, Ella allows, kneeing me in the back of my seat, "we’re no ladies. You’re such a bad influence, Alexa!"

I eject my seat belt, and a trio of pings fills the car, alerting us that I’m no longer safe. I twist around, giving Ella the middle finger.

Alexa! Anna barks. Quit fooling around.

Sniggering, Ella winks so I slap her leg, hard, making a you wait face before turning back to face the road. Click.

The three of us are quiet. Just the sound of rushing wind from the open car windows. The SUV’s husky engine and Anna’s The Best of Bluegrass all adding ambience to our stale urban road trip. Head still pounding, I lower my sunglasses to cover my eyes, the light immediately dimmed. I step inside the Body and turn to Runner. Thanks for the hangover, I say, voice dripping with sarcasm.

Whatevs, she snickers.

After a short drive over to Grace’s sleepover, we pull into a gravel driveway. I spot a stray cat the color of marmalade licking its ass on the front lawn.

See you later! Thanks again, Mrs. Wú, Ella calls, slamming the car door.

As she approaches the block of flats, I notice the ground floor’s net curtains twitch and part—Grace appearing in between them like some kid sandwich, an eager smile to her softly freckled cheeks. On seeing her big sister—adored and envied in equal measure—Grace dashes to open the front door, the curtains flapping in her wake. She strokes her new champagne bob, an attempt to mimic Ella, and waves. Anna and I wave back, the ginger cat now on her back and enjoying the warm reach of sun on her pink belly, oblivious to the crouching tomcat staring down from the garage wall. Ears pricked and alert.

WE SWERVE INTO GLENDOWN’S VISITORS’ PARKING LOT. ANNA KILLS the engine and sighs.

Resting her lean forearm on the ledge of her open window, she looks me square in the eye. Look, she says, you knew you had therapy this morning. It’s not my responsibility to get you here and your friend back home. If you’re going to make these commitments, Alexa, you need to get yourself organized.

I didn’t realize—

You never do. It’s like you’re in a goddamn dream world.

I was just—

Anna’s French-manicured nail pokes a hole in my sentence and cuts me off. Just what? Expecting me to chauffeur you around?

Hardly, I answer back. The truth is that it’s actually Ella who drives me everywhere, only last night she’d fancied a drink or five.

Maybe I need to remind you how hard I work, the sacrifices I’ve made.

I retreat, noting the alley-cat look in her eyes, pupils growing, irises shrinking.

I know, I’m sorry, I say, defeated, opening the glove compartment and choosing a hard candy from a dented tin. I offer her one but she refuses.

Silence.

Anna’s face settles.

Shall I wait for you? she asks, a softer tone to her voice now I’ve apologized.

No, it’s okay. I’m going to meet Ella and Grace in the West End afterward, I say, the candy rattling against my teeth, cherry sweetening our unease.

Anna checks her rearview mirror and adjusts the collar of her silk blouse.

All right, then, she says, delighting me with a somewhat tight-lipped kiss on the cheek. I close the door, peer in, and wave. But already she is gone, is staring ahead and driving off.

3

Daniel Rosenstein

TWO PATIENTS LEAN AGAINST GLENDOWN’S IMPERIAL OAK—A BULK OF A tree—deciding on a game of I Spy. The usual conundrum of finding something other than an obvious tree, flower, or patient immediately stunting their game. Charlotte, a resident for three years, gives up after her second attempt and walks away, leaving Emma stranded, more interested, it seems, by the imaginings in her head.

They’ll be here soon. Not long now, she declares, eyes wide and remote while tilting her gaze to the sky. Isn’t that right, Dr. Rosenstein?

I smile. Not wanting to contradict or interrupt Emma’s imagined world, yet knowing it’s the happy invaders to whom she’s referring. The ones she believes to be her real family.

The morning warm and cloudless, I wander across the lawn. The fresh air feels good in my lungs. A trace of honeysuckle paving the way across the graveled path toward Glendown—a residential hospital for what were once termed lunatics or the criminally insane. But lunatic asylums are antiquated in the leafy suburbs of North West London and are best left to the imaginations of all things gothic. The patients are neither insane nor lunatics. Rather, they are long-standing sufferers of trauma.

Taking a turn at the knee-high borders of flowering shrubs, I run my hands along the thick dwarf hedges of lavender, inhaling the scent it leaves on my fingers. Fresh cuttings have been planted in the herb garden, rosemary and chives. A project set up last year to encourage residents’ outdoor activity, though I can see it would benefit from some attention, the large-leafed ivy slowly spreading across the soil.

My thoughts turn to today’s patients. The attention they will need. The care. Their rising disquiet spreading like wildfire, requiring that I hold and contain, name and affirm. Be the good psychiatrist they assume me to be. I have wondered, sometimes, what might happen if I were to disappoint them, if my ethical code were to slip. My clinical standards abandoned, their good shrink turned bad, or vigilante.

I check my watch before drifting over to count the nine sash windows punched out of Glendown’s walls while Nurse Veal peers down at me. Her thick arms crossed over her tight white tunic. She neither smiles nor waves, her stare as cold as a witch’s tits.

From nowhere, a fat bumblebee rests and hovers, its sound much louder than you could possibly imagine for something of its size. Perfectly still, the bumblebee sails toward me, disoriented and drunk on pollen and fine weather. I wait—the bumblebee edging nearer—then swat it with the flat of my hand. When I glance up at the window, Nurse Veal is gone.

GLENDOWN’S THICK AIR HITS ME AS I ENTER ITS IMPOSING BLACK Georgian door. The earlier fresh lavender breeze snatched from my lungs and replaced with the familiar, foreboding dank scent. Walking along the squeaky corridors, my rubber-soled shoes suck on the oatmeal-colored floor—linoleum surfaced for easy cleaning of vomit, shit, or tantrum-thrown food. The canteen filled with the smell of itself. Above me, unreachably high windows have been opened: the hope that the pungent smell of cottage pie will eventually escape.

Nurse Veal has transported herself to the office box. A perfect six-by-six-foot tuck shop where every morning at seven A.M. she doles out daily meds in tiny white paper cups like Smarties. She spots me, wipes her brow, then looks away. I check my hand for any sign of the flattened bee and continue walking toward my office. Distant cries from Ward C tailing off like a fading siren.

SHE IS ALREADY THERE WHEN I ARRIVE.

On seeing me, she stands. With quick fingers she straightens her bangs, then places both of her feet together: black round-toed shoes. Scuffed and unflattering. Feeling discomfort at her standing at attention like this—a little soldier, a child of the Red Revolution—I prevent myself from speaking: at ease.

She is pretty and shy, with a pale, almost translucent complexion. She dodges my gaze, instead focusing on my collar like an orphan longing to be hugged. Her eyes, I observe, are jade green and flecked with gold, wide and unsure. Her shoulders hunched. Hands nervous and wringing.

Hello. Alexa? I inquire, glancing up at the silver waiting room clock.

Yes. Hello.

You’re a little early, I reply, but come in.

Boundaries, I remind myself. Keeping firm boundaries is essential for building trust. For some clinicians, the odd five minutes are neither here nor there, but experience tells me a firm framework keeps the patient safe—and the psychiatrist too. I open the door and wait for her to follow, but as I turn, she has stopped.

Captured in the heavy doorframe, she appears small for being, I assume, in her midtwenties. Her face a heart perched above a short red dress that looks like one a child no older than ten might wear. We stand in silence for a moment while she glances over her shoulder—checking for what, I am not quite sure.

She stares again at my collar.

A slight cough.

Would you like to come in? I ask.

Yes, sorry, she says, tugging at the hem of her dress.

It is standard practice for the patient to lead, to initiate dialogue by opening up and discussing what is currently on his or her mind, but with new patients I tend to sidle over into the driver’s seat. Getting a hold of the therapeutic reins. It can be as simple as an introduction or a question regarding their reason for seeking treatment. Occasionally, there will be tears before either question, and that’s usually when I sit back, allowing the patient’s feelings to breathe. There are no hard-and-fast rules, but I believe it helps to have some sense of the person before your next move. Today I wait.

Alexa finds my eyes, readjusts her dress, and stretches. Her posture now suddenly alert, upright and focused.

I want to resume my therapy, she begins.

You stopped?

He retired.

Oh.

I was in twice weekly for just over four years. We did some good work, I think. But then Joseph—Dr. Applebaum—retired. Moved out of London to spend more time with his family. He had grandchildren. He was old.

I imagine that was difficult, saying goodbye.

It was. It—

I sense her unease, aware of her sentence breaking off. The slight drop of her chin.

"It was—?" I encourage.

It was difficult. Painful. I missed him terribly.

I shift in my seat, leaning to one side. I must look like a therapy cliché: legs crossed, wry smile, head tilted in deep thought. A box of tissues resting between us.

She twirls a strand of her long brown hair, smiles, then hands me