getting nervous, he started to make suggestions to Lilly. In church, maybe? Or at the market? Maybe at the beach with the kids?
âLet your wife answer the question,â Mattei said.
âI donât know where I was,â Lilly said. Her voice was flat.
âThatâs bullshit,â Mattei said privately to Zee after the session ended. âEverybody knows.â
5
T HE 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 hadnât cried yet; up until now all she had felt was shock. And guilt. She recognized Lillyâs 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 couldnât 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.
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M ATTEI 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 norâeaster. She didnât 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.
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âI WAS HAVING SEX.â L ILLY hadnât answered Matteiâs question until her sixth month of treatment with Zee. So it took a moment for Zee to understand the implications. âWhen I had my first panic attackâ¦I was having sex with Adam.â
It was before Lilly had told her the story of Adam. At first Zee thought that she meant her husband. But her husbandâs name was William, not Adam. Lilly watched for Zeeâs reaction. She expected to be judged. But Zee didnât flinch.
âTell me about Adam,â was all she said.
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I T WAS ABOUT THIS TIME that Zee stopped sharing all of Lillyâs stories with Mattei. Her case discussions, which had always been sodetailed, 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 Zeeâs way.
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B Y J UNE 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
Pierre V. Comtois, Charlie Krank, Nick Nacario