Good Patient

One 1 From the inside out, these are my layers: bad, good, bad, good, and now--new--again bad. They attach beneath my skin, nested one inside the other like Matruschka dolls, anchored with a pin through each skull at the top. They ring like a bell, scream and peal, complain, when layers and outsides clash. Beneath the layers, there is nothing: unbounded emptiness like the equation of the universe inverted so that one equals zero. I was born with just bad, in New York City in August, a twin, half dead, half orphaned. My mother told me the story once, in the hospital, how she'd gone into labor early on a Queens-bound F train, in the dead heat of the Summer of Love. When the first contraction came, a tightened belt beneath her skin, she dropped her purse and grabbed hard on my three-year-old brother's hand. He screamed, and people crowded in to help; she announced she wasn't moving, and I likely would have died somewhere between Prospect Park and Far Rockaway if an off-duty EMT hadn't been there to hustle her off. At Bellevue, the attending obstetrician cut a clean line up the front of her peasant blouse and told her he was going to do the same thing to her stomach: her baby--her babies --were in serious trouble. Both babies were in breech, the one closer to the cervix in extreme distress. The umbilical cord was caught. It was a matter of minutes before one or both of us was dead. "Well, you can imagine my shock," she had said to me. Her fingers trailed through the air like water. "Your father had left us without a word of where he was, I had your two brothers at home and no job and no money. Babies--zuh, plural? It was the first time I heard the word. I told him I didn't want you, naturally, in the heat of the moment I didn't want any of us. I told him just let me die, me and my babies, but by golly you were determined to be born." By golly, indeed; you might even say, My stars. I pushed my way right past my dead sister, bottom forward, dragging that umbilical cord like a piece of toilet paper stuck to a shoe. Broke my collarbone and tore a hundred-stitch hole in my mother, just to get into the world. "Hey--check this out. Do you suppose if a hemophiliac cut himself accidentally and didn't bother to stop the bleeding, it would be considered suicide?" Twenty-eight years later, another dying August New York day, and I'm attempting my own ass-backward introduction to the world once again. This time I'm already at the doctor's office, however; an imposing mahogany-and-leather suite filled with furniture that looks like it would be at home at the Harvard Club on 44th. Today is my first appointment with Rachel Lindholm, MD. She's a psychiatrist, and she is late. The source of my question is a pamphlet I'm reading on chronic depression in hemophiliacs. The audience is my husband, Robert, who's looking awfully uncomfortable for a guy who's pretty used to sitting on $5,000 couches. I repeat the question- "Get it? Bleeding? Hemophiliacs?"--and tickle his thigh with the pamphlet. It's a joke. Robert gives me a baffled, uncomprehending glare and doesn't even glance down at the pamphlet. Have it his way, I suppose, but for my dollar, why not enjoy yourself if you're going to have to wait? I go back to my reading and think that's one thing I can add to my short list of advantages psychiatrists hold over psychologists: better waiting-room literature. I should know. I'm a junior account manager for Pharmaceuticals at Boylan & Westwood, which is New York City's premier public relations company, if you're willing to believe our collaterals, and plenty of this stuff crosses my desk. I also should know because I've spent a goodly portion of my life doling out fifty-minute dollops of my mind to head doctors--PhDs and MSWs, even an EdD, one time. Dr. Lindholm is my fifth. She's my first psychiatrist, though. Shall I give it all awaWaterfield Duisberg, Kristin is the author of 'Good Patient' with ISBN 9780312326074 and ISBN 0312326076.