A Breath After Drowning Read online

  CONTENTS

  Cover

  Title Page

  Copyright

  Dedication

  Part I

  1

  2

  3

  4

  5

  6

  7

  8

  9

  10

  11

  12

  13

  14

  15

  16

  17

  18

  19

  20

  21

  22

  23

  24

  25

  26

  27

  28

  29

  30

  31

  Part II

  32

  33

  34

  35

  36

  37

  38

  39

  40

  41

  42

  43

  44

  45

  46

  47

  48

  49

  50

  51

  52

  53

  54

  55

  56

  57

  58

  59

  60

  Epilogue

  Acknowledgements

  About the Author

  Coming Soon from Titan Books

  Also Available from Titan Books

  A Breath After Drowning

  Print edition ISBN: 9781785656408

  Electronic edition ISBN: 9781785656415

  Published by Titan Books

  A division of Titan Publishing Group Ltd

  144 Southwark Street, London SE1 0UP

  First edition: April 2018

  2 4 6 8 10 9 7 5 3 1

  This is a work of fiction. Names, places and incidents are either products of the author’s imagination or used fictitiously. Any resemblance to actual persons, living or dead (except for satirical purposes), is entirely coincidental.

  © 2018 Alice Blanchard. All rights reserved.

  No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means without the prior written permission of the publisher, nor be otherwise circulated in any form of binding or cover other than that in which it is published and without a similar condition being imposed on the subsequent purchaser.

  A CIP catalogue record for this title is available from the British Library.

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  For Doug, forever

  PART I

  1

  KATE WOLFE’S 3 PM appointment stood in the doorway wearing a jaw-dropping miniskirt, a light blue tee, plaid knee socks, and chunky platform heels. Fifteen-year-old Nikki McCormack suffered from bipolar disorder. She believed that she was the center of the universe. She lived in a world of her own creation.

  “Hello, Nikki,” Kate said warmly. “Come on in.”

  The teenager took three small steps into the spacious office and looked around as if she didn’t recognize the place. It was all part of the ritual. Nikki scrutinized the charcoal carpet, the blue-gray walls with their framed degrees, Kate’s swivel chair, and her large oak desk, as if something might’ve changed in her absence. She’d been coming to therapy for seven months now, and the only thing that ever changed was the mood outside the windows—cloudy, sunny, whatever—but Nikki wanted the place to always be the same. Another quirk of her illness.

  “Hmm,” the girl said, index finger poised between glossy lips.

  “Hmm good? Or hmm bad?”

  “Just hmm.”

  Okay, it was going to be one of those days.

  The weather forecasters had been predicting snow. They argued over inches. It was deep into winter, February in Boston, but Nikki wasn’t dressed for the cold. She was dressed to impress. She wore a flimsy vinyl jacket over her skimpy outfit and a red silk scarf—no gloves, no layers, no leggings. Her pale, slender body was covered in gooseflesh, and her nipples showed through the flimsy tee, but Kate knew better than to suggest more seasonal attire. Nikki might storm out of the office as she had before, and that would be counterproductive to her therapy, so Kate ignored her maternal instinct and kept a steady focus on Nikki’s eyes—the azure depth of her sly intelligence. “Have a seat.”

  Nikki hesitated on the threshold, and Kate could read her emotions morphing across her face like the Times Square news ticker—the girl doubted she was welcome anywhere. She didn’t feel loved. She believed people were laughing at her. It saddened Kate to discover that such a smart, healthy, promising young person could have such low self-esteem. It was more than troubling.

  “I’ve been expecting you,” Kate said, coaxing her in like a kitten. “Have a seat, Nikki.”

  The girl entered the office with gawky teenage dignity, sat in the camel-colored leather chair and crossed her waifish legs. Her chunky shoes with their thick wedge heels looked ridiculous on her and were probably dangerous in the snow. Nikki wore enamel rings on every finger and a slender gold chain around her neck. She was heavily made up, with careful strokes of peach lipstick on her skeptical mouth and too much gummy mascara on her eyes. She came across as beguilingly bumbling, and yet there was something disturbingly passive-aggressive about her.

  “So,” Kate began. “How are you?”

  The girl’s attention wandered everywhere. She studied the framed art prints on the walls, the overstuffed inbox on Kate’s desk, and finally Kate herself. “Yeah, okay. So I’ve been wondering… how do you deal with your patients and stuff?”

  “My patients?” Kate repeated.

  “I mean, because we’re so messed up? How do you cope? Day after day? How do you sit there and listen to us whine and complain and kvetch—how do you cope?”

  Kate smiled. She’d only recently begun her fledgling practice. Her framed degrees barely covered two feet of wall space behind her desk. She had a bachelor’s degree in psychiatry and neuroscience from Boston University, and a medical doctorate from Harvard. The birch bookcase held dozens of scientific journals containing articles co-authored by her. On her desktop was the psychiatrist’s bible, the DSM-V, the one resource she was constantly reaching for. “How do I cope with what exactly?”

  “With the stress? From having to deal with us crazies?”

  “Well, first of all, I don’t consider my patients ‘crazies.’ We all deal with stress in different ways. For instance, I like to go running and hiking and rock climbing and work it off that way.”

  “Seriously?” The girl rolled her eyes. “Because I can’t picture you running the Boston Marathon or anything, Doc.”

  “Did I say marathon? Oh no. Not me.” Kate laughed. “But exercise helps with the stress.” She was understating it just a bit. She loved to go running and hiking and climbing. These activities were her biggest release, next to sleeping with her boyfriend.

  “So how did you become a shrink?” Nikki asked, switching subjects.

  “It was a long process. I got my BA and did my doctorate, and then there was the internship, the residency and the fellowship. Finally, just this past year, I’ve started seeing private patients, like you.”

  “Oh.” Nikki smirked. “So I’m a guinea pig?”

  “I wouldn’t say that.”
r />   “No? What would you say?”

  Kate smiled, enjoying the way Nikki confronted the world—part adult skepticism, part naïve bravado. “Well, I consider you to be a bright, intuitive, sensitive human being, who just so happens to have bipolar disorder, which you need help managing.”

  Nikki jiggled her foot impatiently. “How old are you?”

  Okay, that was out of left field. “I’ll be thirty-two soon.”

  “How soon?”

  Kate’s relaxed smile contained a thorn of frustration in it, but she did her best to draw on the fathomless well of patience she’d accrued during her residency at McLean Hospital in Belmont, where she’d dealt with the craziest of crazies. Real hard cases. Human tragedy on an epic scale. Nikki would’ve been impressed. “Any day now,” she answered vaguely.

  “Wow. Thirty-two. And you aren’t married yet?”

  “No.”

  “Why not?”

  “My boyfriend asks me that all the time.”

  “He does?” Nikki laughed. “James is right. You should marry him.”

  James. Kate had mentioned him a few times, but she didn’t like hearing his name echoed back to her like this, as if Kate and James were characters from some TV sitcom.

  “You have a great laugh,” she said, redirecting the conversation. “And a terrific smile.”

  Nikki smirked. “You’re one of the privileged few, Doc. I don’t smile very often.”

  “I know. Why not?”

  She shrugged. “Maybe because life sucks?”

  “Sometimes it does suck. Sometimes it doesn’t.”

  “Wow. You’re honest. Most adults won’t say ‘suck.’”

  “Well, I want you to trust me, so I’m honest.”

  “I do. Pretty much.”

  “Good.”

  “So you’re going on vacation and leaving me all by my lonesome?” Nikki made a frowny-face. “Please don’t go, Doc. Not now. I know. Selfish me.”

  “Well,” Kate said hesitantly, and then smiled. “Everybody deserves a vacation now and then, don’t you think?”

  “Just kidding. LOL. Sarc.”

  But they both knew she wasn’t.

  “Is James going with you? On your vacation?”

  This session was veering dangerously off-course, and the girl’s questions were becoming a distraction from her therapy. Kate tried to right the ship, but she wasn’t on her game today. They still had a lot of packing to do. “Why all the questions?” she asked. “What is it about me going on vacation that concerns you?”

  Nikki scratched her chin with a painted nail and stared at something beyond Kate’s shoulder. “What are those? Nuts?” She pointed at the bookcase. “Are you trying to tell me something, Doc? Like maybe I’m nuts?”

  Kate was startled to see a jar of Planters Roasted Peanuts on top of her bookcase. Ira must have left them there. Dr. Ira Lippencott was Kate’s mentor, a brilliant Harvard-educated psychiatrist with an offbeat sense of humor and a maverick approach to psychotherapy. “No,” she said calmly. “That’s a coincidence.”

  “Are you sure? Because, you know, theoretically, I am nuts.”

  Kate couldn’t help smiling. “I assure you it’s completely unintentional.”

  “Ah ha! Nothing’s unintentional.” Nikki pointed an accusing finger at her and grinned. “You told me that once, remember?”

  “Ah ha.” Kate tried to appear wise but couldn’t help wondering if Ira had left those peanuts in her office on purpose, as a sort of test. And Kate had failed to even notice them. How long had they been sitting there, gathering dust? He was probably wondering what the hell was wrong with his favorite former resident that she didn’t even notice the “nuts” on her bookshelf.

  “What’s that?” Nikki asked, pointing at Kate’s desk. “Is that new?”

  “Oh. It’s a paperweight. A trilobite.”

  “Wow. And a big one.” Nikki McCormack had an interest in paleontology. She knew perfectly well what a trilobite was. “Coltraenia oufatensis. Of the order Phacopida.” She shifted around in her seat and yanked her creeping miniskirt back down. “Hey, I just thought of something. What if I end up like that?”

  “Like what?”

  “Like a trilobite? Maybe a thousand years from now? Or maybe just my skull, holding down paperwork so it doesn’t blow away? I could end up like that, right?”

  “I doubt that very much.”

  “Why do you doubt it? Why couldn’t I end up a fossil on somebody’s desk?”

  “Is that what you’re worried about? Being studied like a fossil?”

  Nikki’s lips drew together in a long flat line.

  Kate picked up the trilobite. “Is that what you think, Nikki? That I’m studying you? That you mean nothing more to me than this trilobite?”

  Nikki’s troubled eyes glazed over, and she looked away.

  “Because nothing could be further from the truth. You’re very real to me, and very much alive, and it’s my biggest hope that someday soon, you’ll learn to love yourself as much as others love you.”

  Tears squeezed out of Nikki’s beautiful eyes and spilled down her cheeks. Eight months ago, Kate had diagnosed her during her crucial four-week stay at Tillmann-Stafford Hospital’s Child Psychiatric Unit, and she’d come to the conclusion that the girl suffered from bipolar disease and depression, which made it impossible to predict if she would be alive a few decades from now. Would she live to see thirty-two? Kate certainly hoped so, but the statistics were sobering. Her role was to improve those odds.

  “Nikki,” she said softly. “We’ve discussed this before, but I’d like to brush on it again. Since I’ll be on vacation next week, Dr. Lippencott would be happy to see you for therapy while I’m gone. Can we set up an appointment?”

  “No.”

  “Are you sure?”

  “Trust,” the girl said in a shaky voice.

  “Trust?”

  “I don’t trust people. I’m supposed to trust them, right? Well, I don’t.” She grabbed a tissue from the floral-patterned box placed strategically on the blond-wood table next to her chair and blew her nose.

  “That’s okay. It takes time to trust people. But you can trust Dr. Lippencott. Should I set up an appointment for next Tuesday? Same time?”

  Doubt misted her face. “Just because you say I should trust him doesn’t mean I can or I will.”

  “No. But what I mean is… I trust him. And you trust me.”

  “One plus one doesn’t always equal two.”

  “That’s true, but—”

  “Wait. I almost forgot.” The girl lifted her scruffy backpack off the floor, settled it on her lap and rummaged through it. “I got you a few things,” she said excitedly.

  A red flag went up. “I can’t accept gifts from my patients, Nikki. We already discussed this…”

  “They aren’t gifts per se.” She took out a handful of weathered items and lined them up on the edge of Kate’s desk: a barnacled pair of 1950s eyeglasses; a translucent tortoiseshell comb; and a corroded compass. “You can find the most amazing things at the beach. People throw all this stuff away, and it ends up on some garbage barge in the middle of the ocean, and they dump it overboard, and then it washes ashore. Some of it’s very old,” she said breathlessly. “And look, I saved the best for last.” She reached into a hidden compartment of her backpack and took out a circular piece of metal, which she placed in Kate’s hand. “It’s made out of lead. Guess what it is, Dr. Wolfe. Go on. Guess.”

  Kate studied the object in her palm. “A button without the button holes?”

  “It’s a skirt weight from the twenties. Insane, right? Women used to sew them into the hems of their dresses to keep the wind from blowing them up. Pretty cool, huh?”

  Kate smiled. “Very interesting.”

  “They were so modest back then,” Nikki said wistfully.

  Kate’s fingers curled around the skirt weight. “It was a different time.”

  “They were all veddy prop-ah ladies a
nd gentlemen,” Nikki said in a mock-British accent, tugging on the hem of her miniskirt.

  Kate tried to hand the gifts back to her, but Nikki shook her head. “You keep them. I’ll take them back at our next session. That way you’ll have to come back.” Her smile was forced. “Where are you guys going for your vacation?”

  Kate decided not to press the issue. “Don’t worry about it. I’ll be back in two weeks.”

  “Two weeks,” Nikki whispered, touching her flushed cheeks. “What if I… need something? I mean, what if something comes up?”

  “You can always call Dr. Lippencott, or else you can call me,” Kate said. “You have all my numbers, right? Call me any time, Nikki. I mean it. Day or night.” She plucked a business card out of the wooden cardholder on her desk and wrote down her personal contact information again. “Everything’s going to be okay. That’s what I want you to understand.”

  “Thanks.” Nikki took the business card and held it in her lap.

  “Promise me you’ll call if you need anything. I’m serious. Okay?”

  “Okay,” she said softly.

  Kate gave her an encouraging smile. “You know, my sister and I used to play this game when we were little, where I’d measure her height on the kitchen wall. Always in the same spot, once a week, to see if she’d grown any taller. Savannah was on the short side, and she was an impatient little girl… she couldn’t wait to get bigger. And so, just to please her, I’d cheat a little by adding a sliver of height to the chart. She’d get so excited, thinking she’d grown taller during the week. That was our little game.” Kate leaned forward. “But I can’t do that here, Nikki. I can’t add a sliver of height to your chart. I can’t fudge the truth. I’m going to be absolutely honest. No cheating. Okay? We’ve got a long way to go, but I promise, we’ll get there together. You aren’t alone.”

  Nikki nodded rigidly. “And you’ll be back in two weeks?”

  Kate smiled. “Two short weeks.”

  2

  KATE’S BOYFRIEND COULDN’T WAIT for his steaming hot pizza to cool down before he took a bite. “Ow. Ow.” Dr. James Hill waved his hand in front of his mouth and gulped down some beer.

  James was a psychiatrist in the Adult Locked Unit at the same hospital where Kate worked. His patients were often the toughest to deal with: psychotics and schizophrenics who’d fallen through the cracks; often homeless, often hopeless. James dealt with the pressure by cracking a cynical smile at the broken mental health system that didn’t help these people. He shared his stories with Kate and laughed at some of his patients’ misadventures. Dark humor was a coping mechanism, and even psychiatrists needed to cope.