Her patients adored her. One was a ninety-year-old man who continued at each session to rail against his father. Another was an exquisite fashion model who was dissatisfied with her nose after half a dozen surgeries. Did it make sense to try again? She treated a stock broker who had amassed a fortune of one hundred and twenty million dollars, yet lived in fear of losing a dime of it. There were more referrals than she could handle. New York City was a meat grinder. Survival was difficult for young women in particular. She’d been able to help a number of them. It became a specialization. It was her own life that Dr. Anna Kovacs could not quite manage.

The issues were embarrassing; it would not be inaccurate to describe them as the stuff of soap opera. Dr. Kovacs was a single woman of thirty-five. She was in love with a married man who could not get himself to leave his wife. She had difficulty with what was known in the popular magazines as her body image. Striding up to her lover one night, naked, she had made the mistake of asking him what he thought of her figure. He’d hesitated for a moment, seemed to be struggling and finally said: “Nice pair.” And of course she had fallen apart over this, feeling he’d been dissatisfied, as she was, about the weight she had gained, and her bottom, which had begun to droop. Her Hungarian accent was another source of discomfort. Listening to her taped voice on a BBC interview, she realized that she hadn’t lost as much of it as she’d thought.

Once a week, she presented this bundle of conflicts to Dr. Flaghorn, an eighty-year-old psychiatrist who lived in Maine. She had been vacationing in Bangor when she experienced a panic attack over some impending eye surgery. A friend who lived locally had directed her to Flaghorn, who prescribed some medication and led her gently through the emergency. She continued to consult with him by phone, since obviously she couldn’t go running up from Manhattan when she needed help. There was some concern about the arrangement—not seeing him, hearing only his voice—but they had given it a try and it had worked out decently.

_____________

On a Friday in November, Anna saw the last of her patients, a housewife who was tormented by gay issues. By the end of the session, the woman had decided, at least for the moment, to give in to this inclination and spend a weekend in the Berkshires with her nutritionist. Before leaving Anna’s office, the patient had, for the first time, said goodbye with a hug.

Anna kicked off her shoes, lit a Gauloise, smoked it in luxury, and made her weekly call to Flaghorn. Her intention was to focus on several of her key conflicts—her tormented love life, the feeling that she was overweight and shaped like a dumpling. Irritatingly, she spent virtually the entire session berating herself for the impulsive purchase of a $2,000 pair of Christian Louboutin shoes. Though she could feel Flaghorn’s comforting presence throughout the hour, and picture the kindness of his eyes, he said little other than to ask if she had enjoyed wearing the shoes. But that was enough to calm her. He surprised her then by telling her he had decided to retire. She mustn’t be alarmed. He would continue to check in and see how she was doing. He had in mind an excellent referral.

Anna received the news with equanimity. She’d been aware of Flaghorn’s advancing age. It would be fun—if “fun” was the word—to see someone face to face.

_____________

No sooner had he hung up the phone than Flaghorn became aware once more of the woman in the apartment above, pacing the floor in what sounded like wooden clogs. Heavy ones. There was no point in calling her or knocking on her door. She was an old woman, older than Flaghorn. She couldn’t sleep at night. The one thing she seemed able to do was pace the floor. He wondered if he would have been quite so upset if he hadn’t decided to give up his practice. The plan—and they had gone ahead with it—was for Flaghorn and his wife to sell their home in Maine and to retire in Coral Gables, Florida. They’d gotten a decent price for the house, put a down payment on a condominium that was under construction in Florida, and taken temporary quarters in Bangor. In the meanwhile, Flaghorn had suffered a second heart attack and was advised not to travel until he had made a full recovery, which was far from assured. His wife’s health was frail as well. And they had not factored in the constant pacing of the woman above them in the two-family rental. There was a solution—an offer to the woman of carpeting, another temporary rental—but Flaghorn found that he was unable to focus on a correct way to proceed. His head was flooded with dark and confusing thoughts. His age weighed heavily on him. Years of training went out the window.

The person Flaghorn called, Miss Nettigan, was a social worker he had been introduced to at the hospital. A woman in her early forties, she was slim as a whisker; her countenance was grave. Yet he was drawn to her. Not sexually, God knows, although that particular flame hadn’t entirely been snuffed out. For all the slenderness of her frame—she was a marathon runner, incidentally—there was a core of strength about her, as if she were a sapling that would remain upright in a hurricane. He had sat next to her in the hospital cafeteria and gotten to know her a bit. Her reputation in the small city had preceded her. It was said she worked miracles with victims of trauma. Flaghorn did not feel that he fit into that category. Yet he decided, in what was becoming his grief, to call Miss Nettigan.

The home in which Miss Nettigan saw her patients was not much bigger than a doll’s house. Unsurprisingly, it was immaculate. Flaghorn had to use the bathroom and was barely able to squeeze himself upstairs on the narrow staircase. The study in which she worked was crowded in with books, limiting the living space even more. Flaghorn glanced at a few of the titles. Novels, scholarly works. He was aware of each of the books, had wanted to buy them, but had not gotten around to it. In this setting, away from the cafeteria’s glare, there seemed to be a light in Miss Nettigan’s eyes. He had never met anyone quite so composed. Flaghorn had always been leery of the spiritual, but he felt, sitting opposite this woman, that he might have been in a cathedral. Perhaps it was time for him to change course. Hadn’t his great god Freud kept the door open just a crack to The Next World? In a great rush, he spoke to her of his fears . . . loss, abandonment, death, of course, and blindness. Miss Nettigan came across as someone who had made her way through a world of fear (a valley?) and come back (been returned?) safely. She gave him a mantra: Don’t be afraid. My God, was she insulting him, a man of science, or what passed for it? The banality of it. And yet he clung to the three words. He was comforted. He thought about hugging her. Fearing she would break in his arms, he simply thanked her and shook her hand.

_____________

Who would ever guess that Miss Nettigan, outwardly a model of composure, was a bundle of nerves? She had agreed to marry an academic much younger than she was. The wedding was a month off, and she was far from confident that she had made the right decision. A film company had shot a low-budget film in the area that summer. The director had gone seriously over budget and experienced several panic attacks. He had been referred to Miss Nettigan, who had been able to calm him and to see him through the shooting, which would continue on to Vancouver. The film director was so delighted with the therapy that he asked Miss Nettigan if she would like to join his company as an executive producer. Never mind that she lacked experience. He had been exposed to her “touch” and was confident that she would be a valuable addition to his group. The compensation, though it wasn’t much of an issue to Miss Nettigan, was impressive.

Suddenly she had a decision to make. She loved the movies, the splashiness of the film world, which was in such direct contrast to the sobriety of the work she did. But the change would mean giving up her practice and abandoning her patients, at least one of whom was suicidal. There would have to be a move to the West Coast, a full continent away from the town in which she was born. And, of course, there was the impending wedding. She could not imagine that her fiancé would countenance a move to the Coast. Nor was she sure she would want him to come with her. She had an agonizing decision to make and did not feel she could make it on her own.

One name came to mind. Selfowitz. A strange man, but by all accounts a brilliant one. Each year, he drove up from Boston, rented a huge cabin in the Maine woods, and invited his patients, of all things, to spend a week with him—hunting, fishing, performing theatricals, and playing games in the forest. To cap it off, he was an Orthodox Jew. She had been introduced to him at a community barbecue, not that an introduction was necessary; she had read several of his books. His reputation was one of treating only major figures—film stars, ballplayers, titans of industry. No doubt his fees were astronomical. Still, she might be able to afford a consultation.

_____________

Considering his reputation as psychiatrist to the stars, the office of Selfowitz was surprisingly modest. A bit gloomy, actually. The furniture was frayed, the lighting weak, almost funereal. She wondered if he hadn’t chosen the décor for effect. If so, what effect was he trying to convey? Austerity? Serious thought? She had no idea. But no sooner had she entered his office than she felt faint and had to lie down. He took her pulse and said it was a bit “patchy,” which was not encouraging. But his smile was. He assured her that she would be all right, then asked about her medication. It was fairly standard. But she had had four steaming cups of black coffee in the hours previous. Nerves, apprehension. Could she measure up to his important patients? Clearly the caffeine was the villain. She’d had enough of it to put anyone out of sorts.

When she’d recovered to the point that she could tell her story, she presented it in a measured and quietly confident style. Miss Nettigan had more or less rehearsed it on the train down from Bangor. He took some notes; now and then he would remove his skullcap, then slap it back on, as if he were carrying on a war between science, his brand of science, and religious belief. He let her go on for fifteen minutes or so, then held up a hand and stopped her. It was as if a passenger had reached over and grabbed the wheel of a car she had been driving. This was disturbing, but only momentarily.

He suggested—told her—it wasn’t the career change that had put her in a shitstorm. (And that was the word he’d used.) Take the job if it appealed to her. She would get used to California. Have little difficulty making new friends. The sheer adventure of it would be a tonic. Her patients would get along. There were skilled mental health people in the area. Should the new career not work out, she would always have her own profession to fall back on.

But the young man she was planning to marry was another story. An economics major, he had twice been caught plagiarizing and been thrown out of the university. He had come on to several of her girlfriends. Passing through customs in Aruba, he had, without notifying her, slipped a package of amphetamines into Miss Nettigan’s suitcase. Only recently had he revealed that he had been married twice before. Did she want to be tied to a man who had—putting the best face on it—such grave character flaws?

Miss Nettigan wasn’t used to being instructed. Yet she felt slapped awake. The style was so dramatically at variance with hers. It was as if Selfowitz had compressed twenty sessions into one. The effect was rough and cleansing. The road was clear. California here I come. She took a few minutes to steady herself. Then she thanked him with a firm handshake, just as he was putting the yarmulke back on his head.

_____________

Selfowitz saw two more patients that day—a one-time National League MVP who was undecided about whether to retire and the head of a bottling company in the middle of a bitter divorce. (Was there any other kind?)

Though he enjoyed the work, he was relieved that the week was at an end. Almost eagerly, he made out two checks for the adopted twins’ tuition—one for Stanford, the other for Brown. He couldn’t have been more pleased by their performance at school. Both were straight-A students. The girl was a soccer star; the boy had distinguished himself in science. His younger, biological daughter had not fared as well. More physically attractive than the others—the word “knockout” applied—she had shown promise as a poet. He had adored her from the moment she was born, and with good reason, until she turned seventeen and went careering off in a dark direction.

She had been ordered to leave two boarding schools, had several DUI’s, and had gotten hold of his ATM card, draining ten thousand dollars from his checking account. Selfowitz was a widower. The year she spent living with him after his wife’s death had been a disaster. Standing beneath the awning of his building, he had watched her suddenly jump on the back of a motorbike and drive off with a doorman who had just arrived from Chechnya. That was the last he’d seen of her. Somehow she had ended up alone in Cabo San Lucas, hungry, or so she claimed, and of course penniless. She knew of a job opportunity as a chef’s assistant in Santa Monica. She needed him to send her several thousand dollars for the airfare and to help her “get started.” And he would do it, of course. Hating himself all the while.

He knew the rules. He’d virtually taught the rules. Break the bond. Cut the cord. He wasn’t doing her any favors. Was being a bad parent, actually. But you had to see her. Know how frail she was. Be there when she had a panic attack. See her put an invisible gun to her temple. Dramatically. Convincingly. Tough love, indeed. What if he made a mistake? Turned his back on her? What then?

Selfowitz, who had trained hundreds of young therapists in Boston, needed someone to talk to. The previous year, he had attended a convocation of mental health practitioners at the Sheraton in Washington, D.C. A handsome-looking therapist had caught his eye at a cocktail party. She was fair-haired, generously built, a woman in her thirties, he would guess. She seemed composed, entirely content to be off by herself, and to be amused, and certainly not critical of the swirl of social activity around her. He made it his business to introduce himself and was, of course, pleased that she had read his book on biofeedback, the “seminal” work on the subject. (The description was hers.) She practiced in Manhattan; though she saw a wide variety of patients, her focus, more and more, was on family affairs.

She had a lovely quality, ever so slightly flirtatious. Her accent was intriguing. Eastern European, he imagined. He’d considered calling her, meeting her for a drink, but had never followed through on the impulse. He had another purpose now. He could have reached out to a dozen others, the cream of the profession. But he felt he needed to speak to someone who was totally out of his orbit. The woman certainly qualified.

Alone in his office, he looked for her card. Where on earth had he put it? Momentarily panicked, he searched around and recalled he’d tucked it away in his address book.

He found it easily enough:

Depression, Anxiety, Family and Parenting
Dr. Anna Kovacs
PsyD, MA, LMHC