4
WHEN LILLY’S HUSBAND HAD first brought her to Mattei, Lilly had been heavily dosed on Klonopin. Her anxiety had become so debilitating that the internist her husband had been taking her to had first prescribed Xanax and then, when that failed, increasing doses of the branded clonazepam. Lilly could barely speak. She couldn’t drive. The pupils of her eyes looked like tiny pinpoints. But she was no longer anxious. She was zombie calm.
It turned out that Lilly hadn’t driven for the better part of a year, which had been inconvenient at best with a husband and two young children to care for. Instead of taking the kids to the yacht club to swim, Lilly had started walking them down to Gashouse Beach, which she said she preferred. But the kids missed their friends and the swimming lessons they had signed up for, and Lilly had such a bad feeling about the ocean—a terror that it would take her children, that the surf would send a rogue wave or that some remnants of red tide would seep through their skin to infect them—that she didn’t even let them wade in the water at the beach. Instead they were allowed only to sit on the rocky shore, playing in what little sand they could find, building castles, and slathered with so much 45 SPF that the blowing sand began to coat their pale bodies, making them look like sugar cookies.
By August, Lilly’s husband had taken pity on her and hired a nanny. That was when the real trouble started.
Lilly willingly surrendered her SUV to the nanny, happy to be free of it, preferring to walk around town. She had Peapod deliver groceries. And then she paced.
At first she confined her pacing to the house. She went up and down stairs. She circled from the foyer to the kitchen, through the sunporch to the dining room and library. She climbed all three flights of stairs, avoiding the basement but pacing the rough, unfinished floor of the attic, feet tapping a rhythmic heel-toe, heel-toe. She slept little, pacing the house at night until the nanny complained that she thought the old place might be haunted, because she could hear someone walking above her ceiling.
The next day, when the nanny took the children to their lessons, Lilly’s feet took her outside, through the labyrinth of Marblehead streets, past the fading window boxes where the vinca and blue scaevola struggled against the August drought. On the day when the drought finally broke, she ducked into the Spirit of ’76 Bookstore to get out of the rain, but the place was too quiet for her and she imagined that everyone could hear the squishing sound her sneakers made as she walked on the carpet, so she went back outside. But it was pouring, thundering and very windy. She stood under the awning and watched as a black plastic garbage can caught wind and rolled down the two-lane street, hitting a standing group of planters like a bowling ball, leaving a seven-ten split. She stayed under the awning until she noticed people looking at her, and then she crossed the street and entered the Rip Tide, someplace she’d never been to in her life.
It was three-thirty. The construction workers who weren’t already finished for the day were finally called off the job because of the rain, and the bar was filling up. Lilly walked to the far end and took one of the high stools, one she could wind her feet around to still their movement.
“What can I get you?” the bartender asked.
Lilly didn’t drink. She had no idea.
“Do you have any kind of food?” she asked the man. She was aware that she was the only woman in the place. She could feel all eyes on her.
“They have great steak tips,” a man two stools down offered.
“Lunch is over. The kitchen doesn’t open until five,” the bartender said.
“Oh, come on, the lady looks like she could use a good steak.”
She knew they were looking at her, but she had no idea how she must appear. Wet-T-shirt contest was the first thing she thought, but she was too skinny for wet tees to matter much. Her collarbones felt sharp and jutting.
The bartender muttered and went to the back to cook. “You owe me one,” he said, not to Lilly but to the man who’d procured the steak tips for her.
The man dragged his bar stool over to hers.
His name was Adam, he told her. He lived above one of the shops on Pleasant Street, just a few houses down on the left. He did finish carpentry for a local contractor, the same one her husband had recently hired to do some work on their house.
Lilly ate the steak tips. She ate the salad that came with them, too. She even ate the garnish, something pickled and sour, though she couldn’t name what it was.
SHE HAD GONE TO HIS house, she later told Zee, because he’d offered her a dry T-shirt and a ride home.
They’d done it that first afternoon, she said, not in the bedroom but right there on the green couch in the corner, the wind whipping the aluminum sign against the side of the building, hailstones the size of golf balls crashing hard against the windows, denting the cars in the bank parking lot across the street.
“I felt safe for 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.”
5
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 altogether or that the dosage Mattei had prescribed was insufficient. Lilly was in the middle of one of the most clearly manic periods Zee had ever witnessed.
Lilly’s feet were moving again. She never slept. She spent huge sums of money. Her food bills alone for the elaborate guilt feasts she was cooking for her family were running about $750 a week—for two adults and two children, both of whom were picky eaters. Lilly no longer remembered why she’d ever needed a nanny in the first place. She could easily handle two young children. And her trysts with Adam were getting more and more daring. With no nanny on board, Lilly had taken to sneaking Adam into her house in the late afternoons, claiming that the place needed some repair work, first on the playroom shutters and later on a crooked piece of crown molding in the living room that had bothered her for years.
Lilly and Adam had sex on every horizontal surface in the house. Hearing their cries of passion one afternoon and thinking that someone was hurting the children, a neighbor called the police. As the cruiser pulled up in front of the house, Adam went out the back door of the basement, hurrying across the yard by Black Joe’s Pond and down Gingerbread Hill, pulling on his work clothes as he ran. The police were waiting for him at the bottom of the hill, where his red truck was almost always parked these days. He knew them all, had gone to high school with a couple of them.
“Everyone knows what you’re up to,” one of the cops told him. “Why don’t you try to keep a lower profile?”
There were some stifled smiles, maybe even a pat on the back from the cop he knew.
“They don’t exactly disapprove,” Adam had said to Lilly when she freaked out about the cops. “One of us? Messing with some rich guy’s wife?”
It was the first time Lilly had felt uneasy about what she was doing and the first time she felt bad for her husband. Sweet William, who had never done anything to deserve this. For the first time during her long affair with Adam, Lilly felt shame. And the minute the shame cloud descended, things began to fall apart.
At Zee’s direction Mattei wrote a script and added a sedative to take the edge off and a light sleeping pill to keep Lilly’s feet from wandering. When Lilly complained of weight gain from the lithium, they switched her to an antiseizure medication.
It was difficult to say when Mattei started to become suspicious. “Tell me what’s going on,” she asked Zee directly. “I don’t mean with the symptoms, I mean in her life.”
“She’s been having an affair,” Zee confessed, feeling her face redden.
“And you didn’t tell me this because…?”
“Doctor-patient confidentiality.” Zee knew that this was a hot button with Mattei, who claimed to have enormous respect for doctor-patient confidentiality.
“What’s the real reason?” Mattei said.
“That is the real reason,” Zee insisted.
“Is the affair still going on?”
“Yes,” Zee said.
“What else is she doing?”
“What do you mean, what else?”
“Is she drinking, is she doing drugs? What other kinds of risky behavior is our so-called Mrs. Perfect indulging in?”
There was some triumph in Mattei’s voice as she asked. She’d begun calling Lilly “Mrs. Perfect” ever since William’s initial goddess-like description of her. No one was that perfect, Mattei had told him with Lilly right there. P
erfect was a huge burden for any woman.
“Just the affair.” Zee was aware that her stomach was churning. She wished she hadn’t said anything. Her face felt hot and red. She wanted to throw up. In all the cases she’d treated so far, nothing like this had ever happened to her. It was as if she had just confessed to the infidelity herself.
“Maybe you should take back this case,” she said.
Mattei seemed to think about it for a while before making her decision. “No,” she said. “I don’t have time to take on another patient. And you’re not getting out of this that easily.”
Zee sat quietly as she waited for Mattei to mull over their plan of action. She thought about getting up and walking out of the office and never looking back. It had become her fantasy lately. Not yet five years into her practice, and she was already having burned-out escape fantasies. Not a good sign.
“We’re upping her meds,” Mattei said, reaching for her pad. She slid a prescription across the desk.
As the new dosage of antiseizure medication started to work, Lilly seemed to come back to mid-range. During the next several sessions and into the early fall, she drove herself to Boston and spoke in her sessions with Zee the way a more normal patient might have. She talked about going back to college, or at least taking a class or two. She talked about the competitive process of getting her son into their private school of choice.
She had stopped seeing Adam, she told Zee. It had been very difficult for her. The medicine hadn’t changed the fact that she thought she was in love with him. She said she believed that Adam was the great love of her life, her soul mate. But she was trying hard to do the right thing. For her children. And for the man who used to be referred to simply as “my husband” and who had now taken on the permanent moniker of “Sweet William.”
The Map of True Places Page 4
