"So, I guess you’re wondering what I want to talk about. I mean, why else would I be here if I didn’t have—‘issues,’ you call them… right?”
    “That is the clinical term, Stanley, yes,” said Dr. Alexandra McCormick, smiling slyly. She looked about 40, on the slender side and tall—five-ten or eleven, I’d say, as her blue eyes met mine straight on when we shook hands in the doorway of her office at Broadway and West 90th, a bland, Reagan-era high-rise six floors above Food Emporium. Falling to fair Celtic shoulders her wavy hair seemed as black as her flowing sleeveless dress, her leather furniture and the frame on her Columbia University diploma—“Doctor of Psychology, Nineteen Hundred and Eighty-seven.” As we settled in—I took the couch, naturally—she crossed her legs, showcasing magenta flip-clops and matching polish on long, ivory toes. In months since I’ve often gazed at Alexandra’s feet, no perverse fixation but simply because at sensitive moments I avert my eyes from hers, downward, mostly, though occasionally toward her plain, black bookcase, with titles like The Disorganized Personality, The Divided Self and The Whining Male.
    “So anyway, to get things going, I thought since I’m a writer—allegedly—I’d jot down a few thoughts, you know, sort of a mental snapshot. Okay if I read it? It’s pretty short—just sort of an ice-breaker.”
    “Please.”
    Carefully, I set my City Diner coffee-to-go onto a wicker coaster shielding the ebony end table, then reached into the right back pocket of my jeans. Wedged in between the buttock and a cracked plastic MetroCard holder was a crudely folded piece of pale-yellow lined paper, torn with ragged haste from a spiral notebook. Unraveling the document as gracelessly as I might a gas station road map, I read aloud:
“I don’t sleep. Not strictly speaking, obviously, because if I didn’t sleep at all I’d be, in a word, dead. By which I mean in the literal, physiological sense, in the way Immanuel Kant is dead or Ronald Colman, as opposed to a looser interpretation—e.g. “Vaudeville is dead,” or Latin, or to be dead emotionally, spiritually, intellectually. In point of fact, I do sleep as many as three or four hours, perhaps five on a good night. But according to the National Institutes of Health that leaves me two hours in the red, 14 hours for the week and 730 hours—exactly one month—for the year. As a result, NIH estimates I’ve taken 11.4 years off my life, more or less, which may not be altogether bad, as those might well be 11.4 years of decline, decrepitude and the creeping onset of a kind of sour smell. Instead, that leaves a 13-month year in the relative prime of life for writing, painting and making love. Or in my case, fear, anxiety and self-loathing. Which is why I don’t sleep. That and the fact that I drink too much coffee. Of course, Balzac drank 40 cups a day and he wrote La Comedie Humaine. On the other hand, he died at 50. But at least he was awake for it.”

     “That’s as far as I got,” I said.
      “Interesting,” Alexandra replied, faintly bemused.
      “Like I said, just a snapshot. In the moment, kind of a State of the Union as of this morning, some random thoughts at the table, just, you know, with my coffee and CNN—ever since 9/11 I put it on when I get up, just in case…You’ll find that I fill in the silences, which is good, I guess, so we’re not just sitting here.”
       "Sometimes the silences are more revealing.”
        "Oooh, hmmm. Interesting. Well… Anyway. Why am I here? I guess I’m, I don’t know. Depressed. Not, like, Prozac, on-the-ledge depressed. More….what? Unhappy and barely functional, I guess. I’m sorry, this is kind of hard.”
         "You’re doing fine,” Alexandra said gently. “And you never have to apologize here.”
          "I know, I’m always doing that. Sorry. Ooop. There it is again…. Anyway, you come highly recommended.”
           "Always nice to hear.”
           "Yeah, when I called our Employee Crisis Line they said they’d had great reports—plus, you’re on our plan. Of course, I guess that means you’ve worked with other Time Inc. patients—I mean, clients—you call them clients, right? Geez, what if I bump into someone from work? Awk-ward. And it blows the whole confidentiality thing right out of the water.”
            “No worries,” she said. “I’m very careful about scheduling… You know, Freud never had that problem. When he saw people, they left his office through a back door. But he had one of those huge, Viennese apartments.”
            “On the Meshuggenahstrasse.” Rim-shot, Why can’t I resist a joke? “That was lame, I know. Sorry. I mean—Jesus Christ, I do apologize. My wife says it’s—I think ‘irritating and unappealing’ were her exact words. I get defensive about it, you know, but now I can really see what she means. I guess it’s true— you go to someone like you, someone objective and detached, and you start to see things.”
        “That’s the idea.”
        “Yeah,” I exhaled. “Well, where to begin? I guess it’s kind of a midlife thing. God, I’m such a cliché, I move to New York and bam! I’m seeing a shrink and saying it’s a ‘midlife thing.’ I’m one of those guys. I don’t know how to put it, really. It’s just sort of a core thing, a basic belief that my life has no value. Something along those lines. I mean, don’t get me wrong. I’d never do anything to myself—I know, that’s the big red flag for you guys, right? Well, I’ve never, ever thought of that. I love Rachel—my wife—too much.”
        “That’s the only reason?” Alexandra was not bemused.
        “Oh, well, I mean, what else is there?”
        “You tell me.”
         “True—I guess that is a problem. She’s the only thing I love in life. I know, I know, I should love myself. Actually, I’d settle for a kind of benign indifference. But I’m crazy about Rachel—she’s an actress and she’s gorgeous and brilliant, with these huge, black soulful eyes and she sings like an angel. Of course, I get a lot of cracks, like, ‘What’s she doing with you?’ Anyway, the midlife thing—I mean, it’s not classic stuff. I don’t lust after other women, younger or otherwise. I don’t want to go out and get an earring or a tattoo or a Porsche—I get motion sickness anyway. My whole life. Especially in stop-and-go traffic, like on the 104 Bus or when I was a kid, coming back from the Shore on the Garden State Parkway Sunday night. I practically grew up on Dramamine—you know, I can still taste it, that bitter, chalky—God, I’m babbling like James Woods.
         “Babble is good,” Alexandra said, before switching gears: “So, have you ever been significantly depressed before this?”
        “Well…I had a little—a little problem when I was like, 17.”
         “Would you like to talk about it?”
         “Yeah, well, thing is—can we maybe sort of work up to it? See, I don’t remember a lot from then. It’s all kind of blocked….Maybe we can talk about what’s happening now?”
    “It’s your 45 minutes,” she said, kindly.
And I was pissing it away. Beyond the fact that I was a self-proclaimed middle-aged wreck, my new therapist knew nothing about me. So I launched into a cursory autobiographical sketch—adoring parents, long deceased; much older brother and sister, grew up essentially as an only child; married in 20s, childless by choice; ex-Ph.D. candidate now writer for a monstrously successful magazine, though no one I know admits to reading it. Lived my first four decades in Metuchen, NJ, 45 minutes outside New York City, a Capraesque town where the main street is actually called Main Street. A little over a year ago we’d moved to an 850-square-foot, 1925-vintage one-bedroom on the Upper West Side, with high ceilings an eat-in kitchen and inlaid molding we painted salmon pink and apple green. It was a reward for years of scrimping. We’d always dreamed of living in a pre-war Manhattan apartment—that is, one built before Pearl Harbor, sturdy and soundproofed. It was a stark contrast to the decidedly post-war garden apartment where we’d spent a dozen years, during which thirteen different tenants lived above us, all of whose urine streams we heard with unfiltered clarity. Our new home was on the ninth floor of a massive limestone fortress extending almost the length of West 94th Street, between Broadway and West End Avenue. Recently the co-op board named our building The Stanton, after women’s suffrage icon Elizabeth Cady Stanton, who in 1902 died in a brownstone previously on the site. They might well have dubbed us The Hiroshima, for in that same house was born, in 1904, the physicist J. Robert Oppenheimer, father of the atomic bomb. One could also make a case for The Ego: Norman Mailer lived in the present structure circa 1960, when, during a drunken party, he stabbed and wounded his first wife.
       This somewhat turbulent history seemed appropriate to my emotional state when I made my first appointment with Alexandra McCormick. It started just below the diaphragm—“butterflies” is the going term but that somehow seems too bucolic. This was more a clenched fist, knuckles pressing, twisting, like the hammy hands of a baker kneading bread. I’d take deep breaths and feel a throbbing, audible and insistent, from my throat up into the ears. At worst, lines of sweat slid down my chest to the waist and from my scalp down the neck and back. I’d carried anxiety and depression through much of my youth, but save for that egregious spike at 17, it was a mainly muted presence. Perhaps it was genetic. But I trace it to an elementary school open house when I first realized my parents, then far into their 40s, seemed older than everyone else’s. All things being equal, that meant they would die before everyone else’s. Long nights I lay awake, door open a crack to let in a reassuring shaft of hallway light and in summer the soothing roar of a Vornado exhaust fan in our bathroom window. I’d lie there under posters of Willie Mays and the Presidents and a golden-framed print of Leonardo’s Last Supper and I’d do the math: When I’m 18, they’ll be 59; when I’m 30, they’ll be 71…”
       When I was 30, as it happened, they were both gone. Now I was in my early 40s, just 15 years away from my father’s age, when his sudden death struck like an asteroid. And after years of relative quiet my high anxiety had returned, along with a dense fog of dread rolling through me, clearing now and then, but only for a time. More than my own mortality, I lived in constant terror that something would happen to Rachel and then I’d have to kill myself. Not rashly—I don’t have the guts and just my luck the Catholics are right and I’d be punished by spending Eternity without her, floating around some netherworld with a lot of Muslims and Sylvia Plath. My plan was more passive-aggressive: Going to the worst area of some notoriously unsafe country or city, lying in the street and just waiting….”