the first time in years,” Lilly told Zee.
Zee thought Lilly’s description sounded anything but safe, yet she knew it was an important statement. “What about it made you feel safe?”
“The couch, for one thing. It was this deep-cushioned thing, kind of a dark green velvet. Like a forest or something.”
“Forest green?”
“Yes, and the light from the window.”
“You said it was stormy.”
“It was. Maybe it wasn’t the light—it was the sound of the hail against the window. It was also what was outside. The car sounds and the shops. The bookstore and a ballet school. You could hear the music from the school, and I was picturing the little girls doing their barre exercises.”
“Even in the storm, you could hear so well?” Zee asked.
“Yes,” Lilly said. “I could hear the music. It was as if real life was happening right outside the window—all around us, really—and we were part of it somehow. I’ve never felt that way before. Safe and warm,” she said.
He had given her a ride home in his red truck. She made him drop her off down the hill from where she lived, near Grace Oliver Beach, by the little house that had once been a penny-candy store. “Can I see you again?” he asked, taking her hand. He was so sweet that he made her want to cry. She told him no. He told her he thought he loved her.
They made love every afternoon all summer, sometimes at his place, sometimes in the truck if they could find a secluded spot to park. She was always home by five. Lilly thought it was important that Zee know this.
“I’m always home in time to cook dinner,” she explained.
What Lilly actually cooked were huge guilt feasts. The more she fooled around, the better she cooked. She pureed vegetables, adding odd flavorings like strawberry and peanut butter, anything the kids would actually eat. She went organic at the farmers’ market. She even dug up the backyard at midnight to put in a vegetable garden. She never finished it, which caused a huge issue with their landscape designer. The Guatemalan yard workers seemed to have less of a problem with it. They just mowed around the pit as if they believed that it really would become something beautiful one day, and they never filled it in as their boss had suggested. One of them even found a packet of seeds in the shed and planted a few rows of what looked at first like carrots but later revealed itself to be yarrow.
As the days grew shorter, Lilly sank into a depression that rivaled those of the great poets. She stopped walking. She fired her nanny. Dishes piled up in the sink. One of the children got lice, and she didn’t even know it until the school nurse sent home a note and a bottle of Pronto shampoo.
How did that make you feel? Zee never even had to ask the standard shrink question. She already knew the answer. Lilly felt all the most destructive emotions out there—fear, judgment, inadequacy—as if there were some secret to parenting that she’d never been taught.
“Look,” Mattei had told Lilly’s husband when he’d dragged her in to see the famous doctor in what amounted to his last hope for his wife. “Most places they give you a pill, they send you on your way. I’m not going to do that.” Zee could see the look of relief in his eyes as Mattei explained the process. First they would wean Lilly off all her meds, and then they would be able to see just what they were dealing with. In the meantime Lilly would be given a complete physical and all the standard tests, checking thyroid and estrogen levels, and even a dexamethasone-suppression test to rule out Cushing’s, though both Mattei and Zee were already pretty sure what the diagnosis would turn out to be.
“We already had a physical,” the husband said, confused by some of the terms Mattei was using but clear on this one. He gestured to the folder he had presented her with earlier.
“I want you to have it at Mass General,” Mattei said.
They agreed. Then Mattei asked Lilly one more question, one she asked all of her patients.
“Where were you when you had your first panic attack?”
There was a long silence. The husband, who usually answered every question for his wife, looked baffled.
Everyone waited for Lilly to speak. Finally, after the silence was so awkward that the husband was getting nervous, he started to make suggestions to Lilly. In church, maybe? Or at the market? Maybe at the beach with the kids?
“Let your wife answer the question,” Mattei said.
“I don’t know where I was,” Lilly said. Her voice was flat.
“That’s bullshit,” Mattei said privately to Zee after the session ended. “Everybody knows.”
The parking lot across from the Old North Church in Marblehead was already full, so one of the funeral directors waved Zee down a side street where there were more spaces. When she turned the corner, she caught a flash of ocean so bright her eyes throbbed with it.
The pallbearers were unloading the coffin as she climbed the steep granite steps. She hurried ahead, into the wide expanse of church, taking a seat in the back row. An old woman moved aside to make room for her, dragging her cane across the wooden bench with a scraping sound.
There were photos of Lilly everywhere.
Zee had to swallow hard to keep from crying. She hadn’t cried yet; up until now all she had felt was shock. And guilt. She recognized Lilly’s children from photos. They sat in the front pew, the little girl unaware and chatting; the boy, who was reputedly so spirited, sat apart from his father and sister, staring straight ahead at the plain white wall. Zee couldn’t take her eyes off the boy. His stoicism stole her heart. She almost expected him to salute the coffin like the famous photos of John-John Kennedy, though she knew it would not happen.
Mattei had prescribed lithium to Lilly at their third session. She diagnosed Lilly with bipolar 2 disorder, probably with a chromosomal element, she said, and definitely with panic. Mattei treated Lilly alongside Zee for the first two months, until she was certain the medication was working. So often during manic periods, patients were tempted to discontinue their medication. It was very important to monitor both the meds and the dosage. When Mattei was certain that the drugs were properly dosed and were being taken, she turned the case over to Zee.
It had taken Lilly several months to start talking. But when she finally did, it was like opening the floodgates at Salem Harbor after a nor’easter. She didn’t stop. Her childhood had been ideal, she said when Zee asked. There was no abuse of any kind and no history of alcoholism. Her mother and father had a wonderful relationship. And Lilly loved her husband. Maybe not more than life itself, the way he said he loved her, but she did love him. She spent the next three sessions talking about how and why this was true.
“I was having sex.” Lilly hadn’t answered Mattei’s question until her sixth month of treatment with Zee. So it took a moment for Zee to understand the implications. “When I had my first panic attack . . . I was having sex with Adam.”
It was before Lilly had told her the story of Adam. At first Zee thought that she meant her husband. But her husband’s name was William, not Adam. Lilly watched for Zee’s reaction. She expected to be judged. But Zee didn’t flinch.
“Tell me about Adam,” was all she said.
It was about this time that Zee stopped sharing all of Lilly’s stories with Mattei. Her case discussions, which had always been so detailed, began to have their sharper edges rounded over, so that they would more easily merge into the general. There were more discussions about the symptoms, the phases and progression of disease, than about the details of each case. For her part, Mattei thought this was a good step, that Zee was gaining confidence as a therapist. Sensing that she could handle the caseload, Mattei began to send more patients Zee’s way.
By June it was apparent either that Lilly had stopped taking her medication