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CHAPTER ONE

Jane O. came to my office for the first time in the spring of that year. She was thirty-eight years old. Her medical history contained nothing unusual. This was her first visit, she said, to a psychiatrist.

She spoke softly, as if concerned about being overheard. She did not remove her coat.

She didn't say why she had come, and she had left much of her paperwork blank.

But a silence can be useful. I have learned to let one bloom.

And so we sat for a while without speaking, in my small office on West Ninety- sixth Street, while the city thrummed around us.

Jane sat very still on the couch. She kept her arms crossed. Minutes passed.

There was a time when I would have found it awkward, to sit so long in silence with another human being, but I've grown used to it over the years, the way other doctors do to the nakedness of the body.

She wore a gray sweater and tortoiseshell glasses. She was pale, and she was slim. Very little makeup, or none. A simple gold bracelet encircled one wrist. No rings.

"I'm sorry," she said, finally. "It's just hard to explain."

I noticed then that the skin around her fingernails was red and peeling. In the silence, she began to peel it further. It was obvious that she was in some kind of distress, and I felt suddenly worried for her to a degree that I can't quite explain.

"Take your time," I said, which is the sort of empty thing I say when a patient seems more in need of kindness than of insight.

This was a period when very few patients were coming my way, and so I wondered how Jane had found me, who had given her my name.

Finally, she took a deep breath, then spoke: "Something strange happened to me," she said.

She shifted on the couch, crossed and uncrossed her legs.

"It didn't make sense," she said. "This thing."

There was no way to know what kind of experience she was describing, but when I asked her to tell me about it, she went quiet again.

A light rain had begun to drum on the scaffolding outside, the water suddenly amplifying the sound of tires spinning against the streets.

After what seemed like a long time, Jane cleared her throat, as if she was finally ready to say more. I had the feeling that there was something Jane wanted from me that she was not yet willing to ask.

But then, very suddenly, she stood up. I thought perhaps I'd let the silence grow too long.

"I think this was a mistake," she said.

"Wait," I said. "Let's start again," but she moved quickly. Already I could hear the swing and clang of the fire door, the echo of her clogs in the stairwell.

I marked the time in my notes— Jane had spent only fourteen minutes in my office.

The act of remembering, we know from neuroscientists, has a way of rewriting a memory, and this day, in particular, the day I met Jane for the first time, is one I have often revisited in my mind, perhaps altering it slightly with each remembering. And so I should say here that perhaps it was not raining on that day, as it is in my memory, or maybe the window was closed and not open. But the point I'm trying to make is that I met Jane on a day like that, that the city sounded the way the city has sounded on a thousand other afternoons when the spring is turning toward summer, when the air is warm but not yet stifling, and the windows are open— all the noisy possibility of New York.

Jane, though, seemed somehow separate from all that, and singular.

What I remember most about that first day is how lonely this woman seemed. I am not talking about ordinary loneliness. This was something else, a kind of loneliness of the soul.