A Fortunate Age

by Joanna Rakoff

  “Crystal everything. Nana’s set of crystal. Service for eighteen. Water goblets. Wineglasses. Cordial glasses. Three decanters. A punch bowl and ladle and glasses—”

  “You mean the stuff we used at Passover? Those big glasses?”

  Clara nodded vigorously. “She got something like fifteen thousand dollars for them.”

  “Fifteen thousand!” This was more money than Emily could imagine receiving all at once. “For glasses?”

  “Yeah. They’re Baccarat.”

  Baccarat. Emily had often walked by that shop on Madison without slowing her pace—one of a zillion stupidly expensive shops for who knew who: tourists, the future wives of bankers, social strivers—without thinking its icy, boring goods had any significance for her, just as she’d gulped water from those huge, medieval goblets, with their rows of bulbous drops striping from base to rim, countless times, laughing overheartily at her pink-faced cousins’ repellent jokes, without considering the value of the heavy glass in her hand. But Clara had.

  But this was not the most pressing thing, the most dire thing, was it? Their parents were dismantling their house to pay for Clara’s care. When her mother said the well had run dry, Emily had not thought she’d meant it, not really.

  “Why?” she asked Clara, as though they were normal sisters and she, the younger, could ask Clara, the older, for explanations of the mystifying adults around them, instead of vice versa. She knew the answer to the question, of course. They’d sold the glasses to pay for Brattleboro.

  “Because she hates me,” said Clara, her face turning grotesque, witchlike, the point of her chin thrusting forward, her mouth curling into a grim scythe, the bright points of her eyes nearly eclipsed by the swelling folds of skin above and below them.

  “No, no, Clara, that’s not true and—”

  “No, it is true,” she insisted, in the singsongy tone of a wounded child. Emily had been right. The storm was rising. She braced herself. “I was supposed to inherit the crystal. And she couldn’t stand the thought of me having it. She thought I would wreck it and that you should have it, because you take care of things. But she knew she couldn’t give you everything.” Emily turned her face away sharply, as if she’d been hit. She had forgotten—How had she forgotten, or allowed herself to forget?—how much Clara, when it came down to it, seemed to hate her. She had, if she thought about it, spent her whole life trying to make up for whatever injury—her existence?—had caused this strange, groundless resentment, through the murk of which she still managed (why, why?) to love her sister.

  “Clara,” she said softly. “They need money. Things have been hard for them for a long time.” She couldn’t bring herself to say because of you, though she knew Sadie, and Lil, too, probably, would have told her that she should have, that Clara needed to understand the consequences of her behavior; but they didn’t understand that Clara couldn’t control her behavior.

  “What kind of person does that?” Clara was saying now, spittle rising to the corners of her lips. “What kind of person sells a family heirloom? It didn’t even really belong to her. It was from Dad’s family.” Though it was really all the same: her parents were second cousins.

  “I’m sure Dad was okay with it—”

  “No, you never let me be angry about anything, Emily,” she screamed, fumbling furiously for her packet of cigarettes, which, once secured, she clutched to her chest like a doll. “You always tell me to calm down. I don’t want to calm down. I’m sorry I can’t be fucking perfect like you.”

  And then, as suddenly as it had come, the storm broke. Tears popped into Clara’s eyes and her face went slack with sadness. “I’m so sorry, Em,” she said, leaning over and pulling Emily to her. “It’s not your fault. I’ve just made such a mess of my life.”

  “No, you haven’t,” said Emily, though this was so patently untrue that she loathed herself for saying it. “You haven’t.” She could go no further, could not embellish the lie, so she walked over to the stove and put the kettle on. They would have tea, no matter that their cocoa mugs still sat on the table, not even half empty.

  “I’m so selfish, I’m so selfish,” she moaned, and Emily felt her heart crack open inside her chest, leaving a dark wound, worse than anything inflicted by Curtis, worse because the things Clara said were true. Clara was selfish. She was manipulative. And cruel, even. And Emily, just maybe, had not loved her enough, because of it, even as she’d told herself—as did her parents—that the illness, not Clara, was to blame for her behaviors.

  But now Clara was better, wasn’t she? The volts—who knew how many—had altered her brain chemistry, allowing her to smile and laugh, to knock down walls and sand floors, to cook dinner and make new friends, to care about Nicaragua (albeit Nicaragua of twenty years prior) and the families of the victims of the World Trade Center attacks and the world in general, to say “I’m selfish” and understand that she should not be. All of the things Emily had proudly (why proudly? What had she done to facilitate such progress?) related to her mother.

  But she had been a fool—again—for Clara was clearly still ill and she had known it, hadn’t she? It was, Emily thought, as though Clara wore a veneer, a thin veneer, of health that was beginning, slowly, to crack.

  The next morning at work, Emily Googled “borderline personality disorder” and found, really, too much, some of which she remembered, dimly, from her undergrad years, and all of which both corresponded to her mother’s laments—“does not respond to medication”; “needs long-term treatment”—and described Clara almost too perfectly. “These individuals may suddenly change from the role of needy supplicant,” intoned the DSM-IV, “to righteous avenger of past mistreatment.”

  After lunch, she picked up the phone and, before she could think better of it, dialed the number of the Payne Whitney clinic, the website of which had come up repeatedly in her morning’s search. “Judith Lang,” she told the operator, who connected her without a word. “Dr. Lang, hello,” she said, as her voice was converted into ones and zeros by the hospital’s voice mail system. “This is Emily, Emily Kaplan. I hope you’re doing well. And I hope you won’t think this is too weird, but I’m calling because I have a, a bit of a problem that, um, lies within your area of expertise—” Inwardly, she cringed; why was she speaking like this? “And, I guess, I don’t really have anyone else to consult about it, so I was hoping you might have just a few minutes to talk to me. I’m so sorry to trouble you. You can reach me at work . . .”

  The following day, Emily found herself navigating the familiar corridors of the Payne Whitney pavilion, curiously filled with emotion. She had not thought she would return to this place without Curtis. Mrs. Lang—Dr. Lang—sat inside her sanctum on the second floor, conversing intently with one of her interchangeable residents—or interns, Emily couldn’t remember which was which—and waved Emily in without slowing her monologue. “We’ll just be a minute,” she called. “We’ve had a slight emergency this morning.” Emily smiled uncomfortably and walked over to the window, studying the small, tree-rimmed square below with great concentration so as not to appear overly interested in the discussion they’d foisted upon her, which had to do with a patient refusing medication. “Okay, that’s it. You’re all set with this?” she asked the resident.

  “Good to go,” he said, a phrase Emily disliked.

  “This is Emily Kaplan, by the way,” she told the man, swiveling back on her vast leather chair and reaching one arm in Emily’s direction. “A friend of Curtis’s. Her father runs the postpartum depression clinic at UNC.”

  “Interesting,” said the resident, with a stiff grin that made it clear that it wasn’t.

  “Okay, well, we need to grab some lunch,” Dr. Lang told him, waving a long hand at him and turning to Emily. “I’ll see you on rounds at three.” Tripping slightly over the doorjamb, the resident rushed out, and Mrs. Lang gave Emily a small, awkward hug. “Is everything okay?” she asked.

  “No,” Emily said, though she’d meant,
actually, to say yes. “Not really.”

  “Hmmm,” Dr. Lang murmured half an hour later, chewing thoughtfully on a bite of roast beef. “Your sister does sound like a classic borderline. The paranoia, the chain of broken relationships, the life lived in chaos, always making herself out to be the victim. Though I can see why they were thinking manic depression. She clearly has the periods of intense focus—”

  “Yes!”

  “—followed by periods of despair, but that’s pretty typical.” Electroconvulsive therapy, she said, was being used lately to treat severe depression or manic depression when drugs weren’t working. Dr. Lang herself occasionally prescribed it for patients. They were just starting to use it on “borderlines.” “The ECT, you understand, doesn’t do anything for the borderline personality disorder, most likely. It just treats your sister’s depression. And mania. It treats the symptoms, rather than curing the disease itself.” Emily nodded. “Did they do unilateral or bilateral?” Emily confessed that she didn’t know. “How many treatments did you say she had?” Emily didn’t know this either. “Hmmm. Well, how long was she at Brattleboro?”

  “About three months. But I don’t think they started them right away.”

  “Criminal.” Popping the last bit of sandwich into her mouth, Dr. Lang vigorously wiped crumbs from her lap, glanced crisply at her watch, and stood up, towering over Emily, who sat before the remains of her salad, unsure if she should follow. She decided to stand. “It’s just criminal. Releasing a patient like that. Midway through treatment. If that.” She began walking toward the elevator. Emily followed, two steps to every one of the doctor’s. “I’ll call Jay Fleming, get her records. Can you make me a list of the other hospitals she’s been at?”

  “Ye—”

  “And does she have a doctor in Chapel Hill? Or someone at Duke?”

  “Yes. I think so. I can find out.”

  “Email it to me today.”

  “Okay—”

  “Generally patients with problems as severe as your sister’s do ECT every two weeks for about a year. Not once or twice, then never again. And they’re monitored closely for years afterward.” She pressed, with great precision, on the elevator’s up button. “So we’ll need to get her started again. Do you want to bring her in tomorrow?”

  Emily shook her head and grimaced. “No, no, I don’t think she’d come. She thinks she’s well now and if I suggest she see a psychiatrist she’d . . . freak out.” Dr. Lang gave her a stern look.

  “Well,” she said, her tone, Emily thought, slightly colder, “would you want me to come meet her in a casual way? We could all have lunch at that nice Thai place? Or I could stop by your apartment?” Emily considered. How would she explain a lunch date with someone their mom’s age? She could say Dr. Lang was a former professor, in town for a conference. “Or, would you rather I sent a resident? Someone closer to your own age?” She grinned. “They don’t let anyone over forty into Williamsburg, do they?”

  “That might be better,” said Emily, laughing. Dr. Lang had never joked with her before. “He—or she—could come for Sunday brunch, if that’s good. We always have a big crowd. Clara won’t even notice one extra person.”

  That Sunday, a sandy-haired young man rapped on her door, clad in neat garments that might have appeared in the dictionary under the term “casual attire”: faded jeans of no particular style or brand, flannel shirt of nondescript color, bulky wool sweater striated with cables and loops, one creamy strand of wool unraveling at the joint between collar and shoulder seam, all of which appeared to have been pressed, down to the loose thread. “I’m Dr. Gitter,” he said, glancing nervously around. “Josh Gitter.” He may or may not have been the resident she’d met earlier in the week on her visit to Dr. Lang’s office, for he was pale, blinking, bespectacled, mildly Jewish, moderately preppy, like the rest of Dr. Lang’s minions.

  “Come in,” said Emily, leading him into the apartment. “It’s a little smoky in here. I hope that’s okay.” The doctor smiled a quick, tight smile—as if to say that it wasn’t okay, but he was happy to suffer for the sake of the common good—sizing up the various bearded and tattooed persons before him, taking pulls off their cigarettes and swills of Clara’s dark, thick coffee.

  “Hey,” shouted the anarchist publisher. His son was racing madly around the room, chasing a stray cat that had climbed in through the window, lured by the platters of lox. “Hey,” the others shouted, waving ringed fingers holding half-eaten bagels. “Welcome!” Clara called. Dr. Gitter raised his hand, said “Thanks,” and smiled at Emily. “Have some coffee,” she said quickly, leading him to Clara’s latest recovery project: a gold velvet chair with a tufted, buttoned back.

  And there he remained, silent and unmoving but for the occasional bite of bagel—garlic, without butter or cream cheese—for an hour, while Clara’s throng rose and fell, in waves of chatter and laughter, around him. At one, he rose from the chair—a quick, Dr. Lang–style movement—and gestured toward the door with his head. Emily followed him into the vestibule. “Can we talk outside?” he asked, in a quiet voice that wasn’t exactly a whisper.

  “Sure.” The gravity of his tone caused her, stupidly, to giggle. “I’ll walk you to the subway.” She grabbed her coat and keys and slipped out the door.

  “Listen,” he said the minute they hit the street, “your sister isn’t doing well. She’s in a sort of manic state and I suspect she’s going to crash. But it’s definitely going to get worse first.”

  “Are you saying she’s manic-depressive?” she asked. “We were told that was a misdiagnosis. That she’s actually—”

  Dr. Gitter waved his hand impatiently. “Borderline. I know. Brattleboro sent her records. From what I can see, that’s pretty accurate. What I mean is: I suspect there’s a psychotic break around the corner. She’s flying. Which could mean she’s abusing her meds. You need to take them and mete them out to her.”

  Emily knew she could not do this—and, really, did she need to? She saw Clara take her pill each evening. “She’s an adult. I can’t really—”

  Again he waved his hands, cutting her off. “You can.” He pursed his lips, which were wide and dark, and shook his head. “She has a serious history of abuse.” He sucked his lips for a moment, then whistled. “I can’t believe they gave her Klonopin. You know, right, that it’s like the thing now. K-pin. King Pin. All the kids do it. It’s cheaper than coke. Cheaper than crack.”

  “No, I had no idea, so you think—”

  “Yes—”

  “But it seems to be working,” said Emily, aware that she was flailing, that she, somewhere in the back of her mind, did have an inkling that Klonopin was one of those drugs—Ritalin, Vicodin, OxyContin—that was always showing up in the paper, found in the bloodstream of some Choate suicide, or in the glossies (“Confessions of a K-head”) or whatever, and that, yes, okay, maybe she’d suspected Clara’s newfound focus verged on the manic, on the potentially—but just potentially—chemically induced.

  “Maybe.” The doctor shrugged. He wasn’t wearing a coat, she noticed, despite the cold wind that surged up around them, blowing dried leaves in a little circle at their feet. They were still outside the door to the building that fronted Emily’s little back-house. “But it could just as easily be the Prozac and Tegretol. Now, that I get—” And on he went, talking, Emily thought, largely to himself, about various drug protocols and combinations, and the difficulties of medicating borderlines, who are famous for overdoing or ignoring their drugs, until Emily could stand it no longer.

  “I don’t think she’s on Prozac—”

  “I saw her file,” he said, almost angrily, as though Emily were responsible for all this—but then, she supposed, she was. “They have her on Prozac and Tegretol, which is pretty standard. The Klonopin is just as needed, for anxiety.”

  “Okay, okay,” said Emily, raising her hands in a gesture of surrender. “I’m sorry,” she added, uncertain what she was apologizing for.

  “
It’s okay,” said the doctor, shoving his hands deeply into the pockets of his jeans. He was cold. She should walk him to the subway, send him back to wherever he came from—uptown, most likely—but he kept talking. “This is serious stuff. The bottom line is: she needs to be hospitalized, long-term. For starters, let’s get her to the clinic tomorrow morning. We’ll start up the ECT again—she definitely needs to finish the first course of treatment—”

  “No,” she said. “Wait. This is too much. I mean, I mean . . .” Her voice drifted off and he looked at her patiently as he’d no doubt been taught to do in medical school. She wasn’t sure where to begin. “I mean, presuming I can actually get her there—she thinks she’s all better, you know—I, we, don’t have any money. We can’t pay for a minute at Payne Whitney. She doesn’t even have insurance.”

  He shook his head, a gesture of impatience. “Dr. Lang will figure it out. Don’t even think about that.”

  Emily thought this doubtful, but was tired of quibbling. “Okay, but I have to talk to my parents—”

  “Your parents,” he said, “released her to your care. You’re in charge.”

  “Yes, that’s true,” she said, but her own patience was tapping out. Who was this guy to tell her what to do? He’d spent an hour with Clara and thought he knew exactly how to cure her.

  “Well, then,” she said, slowly, icily, “I need to think before I commit my sister to a mental institution.”

  The anger on his face mirrored hers. “Oh, come on. Don’t be melodramatic. You’re not committing her. Your sister is ill. She’s not going to get better with intermittent therapy. She needs a consistent course of treatment. She needs to start up the ECT again and start working with one doctor, over a long period of time. Months. A year. Or more. She needs analysis and behavior modification and closely monitored meds.” He ticked these last three off on the fingers of his left hand—fingers that had gone red from the cold.

  Emily was so furious she couldn’t speak. Her mouth, against her will, hung open. “Why don’t I walk you to the subway,” she said finally, swallowing to bring some moisture back to her mouth.