1.Jane O. came to my office for the first time in the spring of that year. She was thirty-eight years old. Her medical history contained nothing unusual. This was her first visit, she said, to a psychiatrist.
She spoke softly, as if concerned about being overheard. She did not remove her coat.
She didn’t say why she had come, and she had left much of her paperwork blank.
But a silence can be useful. I have learned to let one bloom.
And so we sat for a while without speaking, in my small office on West Ninety-sixth Street, while the city thrummed around us.
Jane sat very still on the couch. She kept her arms crossed. Minutes passed.
There was a time when I would have found it awkward, to sit so long in silence with another human being, but I’ve grown used to it over the years, the way other doctors do to the nakedness of the body.
She wore a gray sweater and tortoiseshell glasses. She was pale, and she was slim. Very little makeup, or none. A simple gold bracelet encircled one wrist. No rings.
“I’m sorry,” she said, finally. “It’s just hard to explain.”
I noticed then that the skin around her fingernails was red and peeling. In the silence, she began to peel it further. It was obvious that she was in some kind of distress, and I felt suddenly worried for her to a degree that I can’t quite explain.
“Take your time,” I said, which is the sort of empty thing I say when a patient seems more in need of kindness than of insight.
This was a period when very few patients were coming my way, and so I wondered how Jane had found me, who had given her my name.
Finally, she took a deep breath, then spoke: “Something strange happened to me,” she said.
She shifted on the couch, crossed and uncrossed her legs.
“It didn’t make sense,” she said. “This thing.”
There was no way to know what kind of experience she was describing, but when I asked her to tell me about it, she went quiet again.
A light rain had begun to drum on the scaffolding outside, the water suddenly amplifying the sound of tires spinning against the streets.
After what seemed like a long time, Jane cleared her throat, as if she was finally ready to say more. I had the feeling that there was something Jane wanted from me that she was not yet willing to ask.
But then, very suddenly, she stood up. I thought perhaps I’d let the silence grow too long.
“I think this was a mistake,” she said.
“Wait,” I said. “Let’s start again,” but she moved quickly. Already I could hear the swing and clang of the fire door, the echo of her clogs in the stairwell.
I marked the time in my notes—Jane had spent only fourteen minutes in my office.
The act of remembering, we know from neuroscientists, has a way of rewriting a memory, and this day, in particular, the day I met Jane for the first time, is one I have often revisited in my mind, perhaps altering it slightly with each remembering. And so I should say here that perhaps it was not raining on that day, as it is in my memory, or maybe the window was closed and not open. But the point I’m trying to make is that I met Jane on a day
like that, that the city sounded the way the city has sounded on a thousand other afternoons when the spring is turning toward summer, when the air is warm but not yet stifling, and the windows are open—all the noisy possibility of New York.
Jane, though, seemed somehow separate from all that, and singular.
What I remember most about that first day is how lonely this woman seemed. I am not talking about ordinary loneliness. This was something else, a kind of loneliness of the soul.
I have tried to consult my notes whenever I can, in the hope that what follows here is as accurate an account of these unusual events as is possible. I shall refer to this patient as Jane O. in these pages, in order to protect her privacy, but her full name does appear in my notes.
When I think of Jane as she seemed on that first day, an odd image comes to me: a pine tree growing alone on a great, wide plain.
As I would later tell the detective, I didn’t think I would see Jane O. again.
2.Three days later, I got a call from the emergency room at New York–Presbyterian Brooklyn Methodist. A woman had been brought to the hospital by ambulance after a maintenance worker found her early that morning—unconscious on a field in Prospect Park.
The woman had no wallet with her, and no identification. No keys. No phone.
Upon waking, the patient could not recall how she had come to be in the park, or, initially, where she lived. She was severely dehydrated, but she was otherwise uninjured.
By the time she arrived at the emergency room, her confusion had begun to clear. Her name, she said, was Jane.
And—to my great surprise—she gave my name, Dr. Henry Byrd, as her doctor.
Photographs taken on that day, after she was found in the park, as part of the hospital’s initial examination, show a woman with sunburned cheeks and chapped lips and with tiny bits of leaves clinging to the curls of her hair. But most striking—to me, at least—is the expression on her face: a look of being caught off guard.
When I first saw those pictures, months later, it was hard to reconcile the woman in the photographs with the woman I had by then come to know. In my presence, Jane always radiated a sense of neatness and control, an obsession, almost, with exactitude. I guess I should not have been surprised that I could not detect her usual precision in those hospital pictures—and yet, even now, that is my feeling: surprise.
By the time I arrived at the hospital that first morning, Jane had pulled her hair back and washed her face. She was quiet in a green hospital gown. A paper cup of orange juice was resting between her hands. The only obvious evidence of where she had spent the previous night was the dark dirt beneath her fingernails.
“I’m so sorry to bother you,” she said when she saw me. Her face looked grim with worry.
“Don’t be,” I said. “This is what I do.”
But the situation was actually somewhat unusual for me and was made possible only by the babysitter who sometimes watches my daughter on Saturday afternoons. I wanted to reassure Jane, though. I wanted to put her at ease, and to make her feel that this visit involved no inconvenience to me at all. This kind of deception is not uncommon in the practice of psychiatry, as in life.
Jane didn’t mention our earlier brief appointment, but the memory of it—and her abrupt departure—hung in the air between us.
Although she had now regained her lucidity, she still could not explain how she had come to be lying facedown in the park that morning.
“The last thing I remember,” she said, “is filling my teakettle with water.”
This was her habit, she said, to make a cup of tea right after dropping her infant son at his daycare, which was four blocks from her apartment.
But that was Friday morning. Now it was Saturday afternoon.
Jane could not account for the roughly twenty-five hours that had passed between the moment she finished filling the teakettle and the one when she was discovered in the park.
______
It was not at all clear to me what we were dealing with here. As I spoke with Jane in her hospital bed that morning, the police were searching her apartment for signs of forced entry. It was an obvious and troubling possibility: that Jane had been the victim of some kind of abduction. But that alone would not explain her blackout.
Certain drugs could have done it, of course: alcohol, obviously, or Rohypnol, the infamous date rape drug, or any number of other hypnotics, none of which is understood in any kind of depth. Even general anesthesia continues to mystify, and in fact, its main effects may be only amnesia and paralysis.
Jane reported that she had not ingested any such substances that morning, as far as she knew, and that she had been alone in her apartment in those last remembered minutes.
When I asked her if anything like this had ever happened to her before, she shook her head.
She took a small sip of orange juice. I noticed, again, the way she picked the skin around her fingernails.
I then asked her the question I’d been wondering about since the start: Did this have anything to do with why she had come to see me the week before?
I could tell that the subject made her uncomfortable.
“No,” she said, quietly. “That was about something else.”
I’ve learned to second-guess statements like that. One thing can always mean another, and a doctor learns early the law of what is known as Occam’s Razor: The simplest explanation is the likeliest to be true. On that day in the hospital, it seemed to me that the two events—Jane’s short visit to my office and this unusual amnesiac episode—were linked, somehow, perhaps two consequences of the same source of internal distress.
An MRI had shown no signs of stroke or brain injury. A series of blood tests had been sent to a lab.
Even then, though, I sensed that this might be something else. There are a great many psychiatric conditions that can disorder the mind without leaving any trace in the brain or the blood.
Copyright © 2025 by Karen Thompson Walker. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
