“I must have read that somewhere,” she told me, “but I couldn’t find an attribution.” In fact, it was something I had said to her in session once, but I don’t mind that she doesn’t remember. Irvin Yalom, the psychiatrist, wrote that it was “far better that [a patient make progress but] forget what we talked about than the opposite possibility (a more popular choice for patients)—to remember precisely what was talked about but to remain unchanged.”
Rita’s third addition is a small print featuring two abstract gray-haired people, their bodies entwined and in motion, surrounded by cartoon-like exclamations: Ouch . . . my back! Slow down . . . my heart! In elegant calligraphy above the bodies, she wrote, OLD PEOPLE STILL FUCK.
It’s her best-selling piece to date.
55
It’s My Party and You’ll Cry if You Want To
The email arrives and my fingers freeze on the keyboard. The subject line reads It’s a party . . . wear black! The sender is Matt, Julie’s husband, and I decide to let the email sit there until I’m finished with patients for the day. I don’t want to open Julie’s funeral invitation just before going into session.
I think again about the hierarchy of pain. When I first started seeing Julie, I imagined that it would be hard going from hearing about her CT scans and tumors to listening to “So, I think the babysitter is stealing from me” and “Why do I always have to initiate sex?”
You think you have problems? I worried I’d say in my head.
But it turned out that being with Julie made me more compassionate. Other patients’ problems mattered too: their betrayal by the person who’d been trusted to watch their child; their feelings of shame and emptiness when rejected by their spouses. Underneath these details were the same essential questions Julie had been forced to face: How do I feel safe in a world of uncertainty? How do I connect? Seeing Julie called forth in me an even greater sense of responsibility to my other patients. Every hour counts for all of us, and I want to be fully present in the therapy hour I spend with each one.
After my last patient leaves, I slowly write my chart notes, procrastinating before finally opening the email. The invitation includes a note from Julie explaining that she wants people to come to a “cry-your-eyes-out goodbye party” and that she hopes her single friends might take advantage of the gathering “because if you meet at a funeral you’ll always remember how important love and life are, and to let the small stuff go.” It also contains a link to the obituary that Julie had crafted in my office.
I send my condolences to Matt, and a minute later, I get another email that he indicates Julie left for me. Because I’m dead, I’ll cut to the chase, it says. You said you’d come to my goodbye party. I’ll know if you’re not there. Remember to be my sister’s buffer for Aunt Aileen, the one who always . . . well, you know the story. You know all my stories.
There’s a P.S. from Matt: Please be there with us.
Of course I want to be there, and I’d considered the potential complications before I made my promise to Julie. Not every therapist would make the same choice. Some worry that this might be crossing a line—being overly invested, as it were. And while in some instances that might be true, it seems odd that in a profession dedicated to the human condition, therapists are expected to compartmentalize their humanity when it comes to their patients’ deaths. This doesn’t apply to other professionals in the person’s life: Julie’s attorney, chiropractor, oncologist. Nobody blinks if they attend the funeral. Therapists, though, are expected to keep their distance. But what if their being there would comfort their patients’ families? And what if it would comfort the therapists themselves?
Most of the time, therapists grieve their patients’ deaths in private. Who could I talk to about Julie’s death other than my colleagues in my consultation group or Wendell? And even then, none of them knew her the way I did or the way her family and friends (who get to grieve together) did. The therapist is left to grieve alone.
Even at the funeral, there are confidentiality issues to consider. Our duty to protect our patients’ confidentiality doesn’t end with death. A wife whose husband has committed suicide, for instance, may call up her husband’s therapist to get some answers, but therapists can’t breach that code. Those files, those interactions, are protected. Similarly, if I attend a patient’s funeral and somebody asks how I knew the deceased, I can’t say I was the therapist. These issues come up more in unexpected deaths—suicide, overdose, heart attack, car accident—than in situations like Julie’s. After all, as therapists, we discuss things with patients—and Julie and I had discussed her wish that I attend the funeral.
“You promised you’d stay with me to the end,” she’d said with a sideways grin about a month before she died. “You can’t abandon me at my own funeral, can you?”
In Julie’s last weeks, we talked about how she wanted to say goodbye to her family and friends. What do you want to leave with them? What do you want them to leave you with?
I wasn’t talking about transformative deathbed conversations—those are mostly fantasies. People may seek peace and clarity, understanding and healing, but deathbeds themselves are often a stew of drugs, fear, confusion, weakness. That’s why it’s especially important to be the people we want to be now, to become more open and expansive while we’re able. A lot will be left dangling if we wait too long. I remember a patient who, after years of indecisiveness, finally reached out to his biological father who had been seeking a relationship, only to be devastated to learn that he was lying unconscious, in a coma, and would die within a week.
We also place undue pressure on those last moments, allowing them to supersede whatever came before. I had a patient whose wife collapsed and died in midconversation, as he was being defensive about not doing his share of the laundry. “She died mad at me, thinking I was a schmuck,” he said. In fact, they’d had a strong marriage and loved each other deeply. But because this one argument became enshrined as the final words they exchanged, it took on a significance that it wouldn’t otherwise have had.
Near the end, Julie fell asleep more often during our sessions, and if before it seemed like time stopped whenever she came to see me, now it felt like a dress rehearsal for her death; she was “trying on” what it would feel like in the stillness without the terror she had of being alone.
“Almost is always the hardest, isn’t it?” she said one afternoon. “Almost getting something. Almost having a baby. Almost getting a clean scan. Almost not having cancer anymore.” I thought about how many people avoid trying for things they really want in life because it’s more painful to get close to the goal but not achieve it than not to have taken the chance in the first place.
During those luxuriously quiet sessions, Julie said that she wanted to die at home, and for our last few sessions, that’s where I saw her. She had surrounded her bed with photos of everyone she loved, and she played Scrabble and watched The Bachelor reruns and listened to her favorite music and received visitors.
Finally, though, even enjoying those pleasures became difficult. Julie told her family, “I want to live, but I don’t want to live like this,” and they understood this to mean that she would stop eating. She was no longer able to eat most foods anyway. When she decided the life she had left wasn’t enough of a life to sustain, her body naturally followed suit, and she was gone within days.
We didn’t have a profound “grand finale,” as Julie had been calling our final session. Her last words to me were about steak. “God, what I would give for a steak!” she said, her voice weak and barely audible. “They better have steak wherever I’m going.” And then she fell asleep. It was an ending not unlike our sessions, where even though “our time is up,” the conversation lingers. In the best goodbyes, there’s always the feeling that there’s something more to say.
I’m astounded—though I shouldn’t be—by the turnout at Julie’s funeral party. There are hundreds of people here from all parts of her life: her childhood friends, her summer-ca
mp friends, her marathon-training friends, her book-club friends, her college friends, her graduate-school friends, her work friends and colleagues (from both the university and Trader Joe’s), her parents, both sets of grandparents, Matt’s parents, both of their siblings. I know who they are because people from all of these groups get up and talk about Julie, telling stories of who she was and what she meant to them.
When it’s Matt’s turn, everyone goes silent, and sitting in the back row, I look down at my iced tea and the napkin in my hand. IT’S MY PARTY AND YOU’LL CRY IF YOU WANT TO! it says. Earlier I’d noticed a big banner that read I STILL CHOOSE NEITHER.
Matt takes some time to settle himself before he speaks. When he does, he shares an anecdote about how Julie had written a book for him to have after she was gone, and she titled it, The Shortest Longest Romance: An Epic Love and Loss Story. He loses it here, then slowly composes himself and keeps going.
He explains that in the book, he was surprised to find that near the end of the story—their story—Julie had included a chapter on how she hoped Matt would always have love in his life. She encouraged him to be honest and kind to what she called his “grief girlfriends”—the rebound girlfriends, the women he’ll date as he heals. Don’t mislead them, she wrote. Maybe you can get something from each other. She followed this with a charming and hilarious dating profile that Matt could use to find his grief girlfriends, and then she got more serious. She wrote the most achingly beautiful love letter in the form of another dating profile that Matt could use to find the person he’d end up with for good. She talked about his quirks, his devotion, their steamy sex life, the incredible family she inherited (and that, presumably, this new woman would inherit), and what an amazing father he’d be. She knew this, she wrote, because they got to be parents together—though in utero and for only a matter of months.
The people in the crowd are simultaneously crying and laughing by the time Matt finishes reading. Everyone should have at least one epic love story in their lives, Julie concluded. Ours was that for me. If we’re lucky, we might get two. I wish you another epic love story.
We all think it ends there, but then Matt says that he feels it’s only fair that Julie have love wherever she is too. So in that spirit, he says, he’s written her a dating profile for heaven.
There are a few chuckles, although they’re hesitant at first. Is this too morbid? But no, it’s exactly what Julie would have wanted, I think. It’s out-there and uncomfortable and funny and sad, and soon everyone is laugh-sobbing with abandon. She hates mushrooms, Matt has written to her heavenly beau, don’t serve her anything with mushrooms. And If there’s a Trader Joe’s, and she says that she wants to work there, be supportive. You’ll also get great discounts.
He goes on to talk about how Julie rebelled against death in many ways, but primarily by what Matt liked to call “doing kindnesses” for others, leaving the world a better place than she found it. He doesn’t enumerate them, but I know what they are—and the recipients of her kindnesses all speak about them anyway.
I’m glad I came, glad that I got to fulfill my promise to Julie and also see a side of her that I can never know about any of my patients—what their lives look like outside of the therapy office. One on one, therapists get depth but not breadth, words without illustrations. Despite being the ultimate insider in terms of Julie’s thoughts and feelings, I’m an outsider here among all these people I don’t know but who knew Julie. We’re told, as therapists, that if we do attend a patient’s funeral, we should stay off to the side, avoid interacting. I do this, but just as I’m about to leave, a friendly couple starts talking to me. They say that Julie is responsible for their marriage—she set them up on a blind date five years ago. I smile at their story, then try to excuse myself, but before I can, the woman in the couple asks, “And how did you know Julie?”
“She was a friend,” I say reflexively, mindful of confidentiality, but the moment I say it, I realize it also feels true.
“Will you think about me?” Julie used to ask me before she went in for her various surgeries, and I always told her I would. The assurance soothed her, helped her stay centered in the midst of her anxiety about going under the knife.
Later, though, when it became clear that Julie would die, that question took on another meaning: Will a part of me remain alive in you?
Julie had recently told Matt that she felt horrible for dying on him, and the next day he sent her a note with a lyric from the musical The Secret Garden. In it, the ghost of a beloved wife asks her grieving husband if he could forgive her, if he could hold her in his heart and “‘find some new way to love me/Now that we’re apart.’” Matt had written, Yes. He added that he didn’t believe that people disappeared but that something in us was eternal and survived.
Walking to my car that day, I hear Julie’s question: Will you think about me?
All these years later, I still do.
I remember her most in the silences.
56
Happiness Is Sometimes
“Honestly, don’t hold back. Do you think I’m an asshole?” John asks as he sets down the bag with our lunches. He’s brought his dog Rosie to session today—her “danny” was ill and Margo’s out of town—and she’s on John’s lap, sniffing the takeout containers. Now John’s eyes are on me, as are Rosie’s beady ones, as if they’re both awaiting my response.
I’m caught off guard by his question. If I say yes, I might hurt John, and the last thing I want to do is hurt him. If I say no, I might be condoning some of his more asshole-like behaviors instead of creating awareness around them. The second-to-last thing I want to do is to be John’s yes-man. I could turn the question around on him: Do you think you’re an asshole? But I’m more interested in something else: Why is he asking—and why now?
John flicks off his slip-on sneakers, but instead of arranging himself cross-legged on the couch, he leans forward, elbows on knees. Rosie jumps down, positions herself on the floor, and looks up at John. He hands her a treat. “Here you go, my little princess,” he croons.
“You’re not going to believe this,” he says, looking back at me, “but I made a, uh, unfortunate comment to Margo a few nights ago. She said that her therapist recommended a couples therapist for us, and I said that I wanted to get a referral from you because I don’t necessarily trust her idiot therapist’s suggestion. I knew the second it came out of my mouth that I should have filtered, but it was too late, and Margo just tore into me. ‘My idiot therapist?’ she said. ‘Mine?’ She said that if my therapist can’t see what an asshole I am, then I’m going to the idiot therapist. I apologized for calling her therapist an idiot and she apologized for calling me an asshole, and then we both started laughing, and I can’t remember the last time we laughed like that together. We couldn’t stop, and the girls heard us and they came in and looked at us like we were a couple of crazy people. ‘What’s so funny?’ they kept asking but we couldn’t explain it. I don’t think we even knew what was so funny.
“Then the girls started laughing and we were all laughing about the fact that we couldn’t stop laughing. Ruby got on the floor and started rolling around, and then so did Gracie, and then Margo and I looked at each other and we got on the floor and all four of us were rolling around on our bedroom floor and laughing. And then Rosie runs over to see what all the commotion’s about, and when she sees us rolling around the floor, she freezes, right there in the doorway. She just stands there shaking her head, like, You humans are too much. And then she runs away. And then we laughed at Rosie, and as I was rolling around on the floor with my wife and my kids and the dog is barking at us from the other room, I watched the scene, almost from above, like I was observing it and living it at the same time, and I thought, I love my fucking family.”
He basks in the thought for a second before continuing.
“I felt the happiest I’ve been in a long time,” he says. “And you know what? Margo and I actually had a really nice night together after that
. So much of the tension that’s normally between us was gone.” John smiles at the memory. “But then,” John continues, “I don’t know what happened. I’ve been sleeping much better, but that night I was up for hours thinking about what Margo said about my being an asshole. I couldn’t get it out of my head. Because I know you don’t think I’m an asshole. I mean, you obviously like me. So then I thought, Wait, what if Margo’s right? What if I’m an asshole but you can’t see it? Then you really are an idiot therapist. So which is it—am I an asshole, or are you an idiot?”
What a trap, I think. Either I say he’s an asshole or I claim I’m an idiot. I think of Julie and the phrase that her friends wrote in her high-school yearbook: I choose neither.
“Maybe there’s a third possibility,” I suggest.
“I want the truth,” he says adamantly. A mentor once remarked that often in therapy, change happens “gradually, then suddenly,” and that might be true for John too. I imagine that as John tossed and turned in bed, unable to sleep, the house of cards he’d built for himself about how everyone else was an idiot came crashing down, and now he’s left with the wreckage: I’m an asshole. I’m not better than everyone else—special. My mom was wrong.
But that’s not the truth either. It’s simply the collapse of the narcissistic defense in the form of an overcorrection. John started out with the belief that “I’m good and you’re bad,” and now it’s being turned upside down—“You’re good and I’m bad.” Neither is right.
“The truth as I see it,” I say honestly, “is not that I’m an idiot or you’re an asshole but that sometimes in order to protect yourself, you act like one.”
I watch John for his reaction. He takes a breath and seems like he’s about to say something flip but then decides not to. He’s quiet for a minute, gazing at Rosie, who has fallen asleep.
Maybe You Should Talk to Someone_A Therapist, HER Therapist, and Our Lives Revealed Page 41
