"She didn't mean it, sweetie." Aunt Essie rubbed Marc's back. "She's just so sad, she doesn't know what she's saying."

Marc said nothing, and continued sniffling, face down against his pillow.

"Marc, honey, your mother was always…I remember when my brother first brought her home. He was crazy about her, but I always thought she was a little…" Aunt Essie made a gesture that did not clearly convey any specific personality trait, but didn't matter because Marc couldn't see it anyway.

Marc said nothing, and continued sniffling, face down against his pillow.

"What happened was just a terrible accident. Nobody's fault. Certainly not yours. And your mom knows that. She'll apologize to you for saying such an awful thing soon enough."

Marc said nothing, and continued sniffling, face down against his pillow.

"C'mon, sweetie. Let me get you cleaned up and we can go back downstairs. You can sit with your father and me."

Marc said nothing, and continued sniffling, face down against his pillow.

Aunt Essie switched to massaging behind his ears, like he was a cat. "We don't have to go downstairs. We can stay right here."

Marc said, "Okay," and continued sniffling, face down against the pillow.


"Give me something, Spector. They want to go other-than-honorable with you. That means no VA benefits. If there's some kind of explanation, we can bump it up to general discharge under honorable conditions, keep your medical coverage."

"I don't remember." Marc stared straight ahead, not meeting Khan's eyes. Khan was a good man. He knew that. If he said he was trying to help, he was.

"Drugs? Were you high? Looking for a hit? That's not great, but it at least explains things. We've counted substance abuse as medical before."

"No drugs," said Marc.

And that was consistent with his piss test, but hope sprang eternal in the U.S. military. "I don't know," Khan looked around the room as if an explanation was going to appear in one of the corners, "sleepwalking?"

"You think I sleepwalked, sleep-drove, sleep-hailed a cab, and sleep-picked a lock?"

"Okay, PTSD, then. There's no shame in it." They'd processed out two men already that week for psychiatric reasons. It happened. They were still entitled to benefits.

"I don't have PTSD."

Which is what they all said. "You were near that IED," Khan reminded him. "Saw that kid die. You ever have nightmares about that? Flashbacks?"

"It knocked me out. I didn't see the kid die. I was unconscious. Can't have PTSD from an event I didn't see."

"Forgot about that," said Khan. It was possible to have a head injury and PTSD, but the mental trauma had to come from something you were awake to perceive, like regaining consciousness surrounded by body parts. From what he knew about the blast, nothing like that had happened to Spector. "It knocked you out, though. Maybe a traumatic brain injury?"

"They cleared me. And that was a year and a half ago. I'm no expert, but…" Marc spread his hands as if to indicate the wide array of neurological disorders he did not have.

"Work with me, Marc. I'm trying to help you."

"No one can help me."


"Your cousin Becca is graduating from college. I just want you to know that you're invited. I know you probably won't come, but…" Elias Spector's voice trailed off. "I just wanted you to know that you're invited. That we want to see you there…you know, Case Western is near that Mexican restaurant you used to love. We could get lunch, just you and me. We could…"

Then a computer-generated voice told Marc he could press seven to delete the message, or nine to save it.

He pressed seven.


"My name is Steven Grant. Steven with a V. My mum died and I didn't know what else to do."

"Okay," said the nurse, "it sounds like you made a good choice coming here. I'm going to walk you through the intake process. It might seem like a lot, but we're going to take it one step at a time." She had a nice voice. It sounded soft, not the opposite of loud, but the opposite of hard.

Steven nodded.

The nurse handed him some scrubs and pointed to a bathroom. "I need you to change into these. Put your street clothes into this bag. Don't pull too hard on the pants' drawstring – it's made to break if you put pressure on it."

Steven did as he was told.

"Do you have anything else on? A piercing, jewelry, hearing aid?"

Steven's hand went to his Star of David necklace. "I want to keep it," he said.

"Let me see." The nurse squinted. "Yeah, that's fine for now. We might ask you to tie it with string instead of a chain, but we'll wait on that." She looked down at her clipboard. Probably a checklist. The nurse took the wallet out of his trousers. "We're going to make a list of everything in your wallet. That way you know no one has taken anything."

Steven didn't react, so she opened the billfold. She counted, "Twenty, forty, forty-five, forty-six dollars. And twenty, twenty-five…uh…European dollars."

"Pounds. British pounds."

"Of course. And you've got a library card. That's good. Do you like to read?"

"Yeah."

"We've got a small library here, but we can bring in some books if you're looking for something specific. Two credit cards. Two debit cards. A US driver's license. A British non-driver ID. VA healthcare card…you're a veteran?"

When Steven didn't answer, she prompted, "Is that the insurance you'd like us to use?"

"NHS."

"I don't know that one."

"National Health Service."

"Oh, oh, you're talking about Britain. You're English, right?" she asked without really expecting an answer. She wondered why a British man would be an American veteran, but didn't linger on the question.

"Now, are you thinking about hurting or killing yourself?"

"I sometimes pick at my skin. I know I shouldn't. I got an infection one time."

"How about hurting someone else?" The nurse didn't think Steven-with-a-V looked like the violent type, but she'd learned to ask all the questions on the intake form.

"No."

"You said your mother recently passed away. Do you have any other family?"

Steven mumbled something that sounded very much like, "My mum's not dead," but shook his head and refused to repeat it.

"Father?"

He nodded. "We don't talk much."

"Any siblings?"

"No. Yes. No. I don't have a brother."

The nurse wrote that down verbatim, but didn't query further. "Married? Girlfriend? Boyfriend? Any children?"

Steven's right hand went to his left ring finger, as if feeling for a wedding band, but the finger was bare and he said, "No."

"Divorced? Widowed?"

"No." Steven was trembling, halfway between bursting into tears and a pressure cooker ready to pop. "I can't sleep!" he shouted. "And I can't stay awake. I'm tired. I'm very, very tired."

The nurse nodded gently. "We can help you with that. Sleep disturbances are very common with grief. And then you feel worse because you can't sleep, and then you can't sleep because you feel so bad. We can help you break that cycle."

"Grief?" asked Steven. "Why are you talking about grief?"

"Because-" The nurse paused. She had just picked up Steven's US driver's license to copy his information onto the intake forms. She stared at it, then looked over all of the cards she had pulled form his wallet. "Steven, why do these say Marc Spector?"

"Because that's my name." The British accent was gone. And the demeanor was subtly different, still vibrating, but with a distress that was more aggressive than the previous anxiety. "And I don't want to answer any more questions."


"Do you practice a religion?" asked Dr. Martins.

Marc pointed to his Star of David necklace.

"Would you consider yourself devout?"

Marc shrugged. "Was raised Conservative."

"What does that mean to you?" She tilted her head to the side when asking questions.

"No payot, but always though Reformed Jews were lazy."

"Were your parents devout?"

Marc raised an eyebrow. "They named me Marc. You know, that good Jewish name 'Marc'?"

"I could be wrong, but I was given to understand that many Jewish Americans had both Americanized given names and Jewish names they used only with family."

Marc nodded. He opened his mouth, shut it, opened it again, and then said, "Cain. My Jewish name."

Dr. Martins pursed her lips. "That's…that name seems like it could be a burden."

"It's short. Easy to spell, even in Hebrew."

"But for a baby…didn't Cain kill his brother?"

Marc Spector spent the next twenty-six hours in and out of restraints. The decision was made to transfer his case to Dr. Harrow.


"I'd like to talk with you about what happened in group." Dr. Harrow looked calm, patient as ever.

"I already apologized to her."

"And I appreciate that. But I still think we need to discuss it."

Marc crossed his arms.

"You reacted very strongly when Cynthia talked about having children."

"I get it. I shouldn't have said it. But she still shouldn't have kids."

"Have you ever gotten someone pregnant, Marc?"

"Yeah. Once. I was…I think twenty-three? She was the same age."

"And what happened?"

Marc raised an eyebrow as if Dr. Harrow were asking how babies were made.

"I mean, did she miscarry, have an abortion, or carry the pregnancy to term?"

"Miscarriage. She was planning on an abortion, but she miscarried first."

"How did you feel about that?"

"Wasn't my place to decide." Marc shook his head. "Up to her."

"I agree with that sentiment, but that doesn't mean you don't have an opinion."

"My opinion was I should be more careful, because the next girl might want to keep it."

"You didn't want to have a child."

"No. Too young."

"How about now? Is that something you want for your life?"

"No."

"Why not? You're not too young anymore."

"Fucked up people shouldn't have kids." Marc's voice was quiet, but his jaw jutted out so far it tensed the tendons in his neck and the muscles in his arms were so taut they were shaking.

"That's what you said to Cynthia in group." Dr. Harrow raised his hands in a placating manner, a silent acknowledgment that Marc did not need to apologize further. "You feel strongly about it. Why is that, Marc?" said Dr. Harrow softly. "What happens when fucked up people have kids?"

"FUCKED up PEOPLE shouldn't have KIDS!" Marc slammed his cup down so hard it cracked, which was impressive because it was made of hard plastic, not glass. The patient looked down at the cup which was now leaking what little water hadn't been splashed out. He wrinkled his nose at the mess and looked up at Dr. Harrow with the faintly disgusted look of a restaurant patron about to remind the server he had asked for dressing on the side. "Can we do something about the temperature in here? You wear those sweaters and we just have these." He picked at his cotton scrubs. "It's awfully chilly."

"Steven," said Dr. Harrow.

"Yes?"

"I was talking to Marc. I'd like to finish my conversation with him."

"Who's that? It's my session, innit?"

Dr. Harrow gave a thin smile. "Of course. My mistake." He flipped a few pages back in his notebook. "Let's see. We were talking about…assertiveness."


"Is your religion very important to you?" asked Dr. Harrow.

"Huh?" Marc Spector was slowly eating a slice of lunchmeat by tearing it to shreds.

"Your necklace." Harrow touched the spot on his own neck where Marc's Star of David rested.

"Oh." Marc acknowledged, but did not answer, the question.

"There are lots of ways that people identify as Jewish. What does it mean to you?"

"Nothing, really. Just a way to make Mormons uncomfortable."

"Why Mormons?"

"Because they knock on your door. And they believe some weird shit about Jews."

Dr. Harrow made a note to look up Mormon beliefs about Judaism, for his own curiosity if nothing else. "Was religion important to your family, when you were growing up?" And that was the real question, just another way to approach the issue of childhood.

"No," said Marc, shaking his head. "We didn't do that stuff."


"How do I get out of here?" Marc sat stiffly, as though the chair were balanced precariously.

"If you want to leave against medical advice, there are only very limited circumstances in which we can stop you. You'd have the right to a hearing before a judge, but honestly," Dr. Harrow tipped his head to the side, "I don't think we'd go that route."

"You're saying I could just walk of here today."

"I'm not recommending it. But if that's what you decided, I would do a final assessment to determine if you were a threat to yourself or others, and as long as you're not, you could go on home."

"Even if I'm still crazy?"

"The law is very specific about who we can hold against their will. Just being 'crazy'," Dr. Harrow emphasized the word with air quotes, "doesn't cut it."

"I don't want to be here."

"Hardly anyone does. But you haven't left. You could have, all this time you could have, and you haven't left. Why is that?"

Marc shrugged.

"Do you think that maybe, just maybe, it's because you have some hope? You think it's possible that things will get better if you keep trying?"

Marc's expression turned hostile. "You think I haven't tried before?" he hissed. "You think I just gave up and that's how I ended up like this?"

"Remember what I said about dialectics – two opposing ideas that are both true? It's true that you tried your hardest before, and it's true that continuing to try now can help you get better."

"That sounds irrational. And you're supposed to be the one fixing all the irrational-" Marc waved a hand at his head.

"What if before you were putting all your effort into treading water and I'm here to teach you how to swim to shore?"

"Treading water," echoed Marc, sounding empty and distant.

Dr. Harrow realized that his water-based metaphor that he had used with dozens of prior patients, was probably a poor choice, but he hoped that Marc could take it at face value. "You've been working night and day to avoid terrible thoughts, memories, emotions. Just trying to survive. And that's what you had to do, because you didn't have the skills to handle those things. But now you're older, stronger, safer, and if you put that same effort toward accepting the truth, toward accepting yourself, you won't have to hide anymore."

"Hide. I don't hide. I'm not hiding. It's not…it's a foxhole."

"Okay, it's a foxhole. And it's deep. And there's a ladder that can get you out, but the ladder is burning hot." Dr. Harrow tipped his head forward. "There's a way out of this hell you're in, Marc, but it's going to hurt. Not physically. Mentally. It's going to hurt to face those things you've been trying to avoid. But it's the only way out of that hole you've worked so hard to dig for yourself."

"I didn't dig it," spat Marc. "She did."

Dr. Harrow didn't have to ask who 'she' was, even if Marc hadn't been particularly forthcoming about the nature of his trauma, Harrow was a psychologist – he knew mommy issues. "You did what you had to do to survive an intolerable situation." He sighed. "We have people here with PTSD. They're jumpy, always looking for danger. There was a time when that was healthy, maybe even saved their lives. But they don't need it now. Now it's a problem. What you did worked when you did it. But is it working now?"

"I work in a gift shop," said Steven.

Dr. Harrow counted to five so he was clear-headed as he decided whether he wanted to push forward because it was in the client's best interest, or because he himself was getting impatient. Client's best interest, he decided. "No," he said, "I was talking to Marc."

"Maybe there's a problem with the schedule?" Steven shrugged, bland.

"Marc and I were having a difficult conversation. Avoiding frightening topics was adaptive when you were young and small, but now it's holding you back."

"I don't know what you mean about frightening topics. I'm here for a sleep disorder. If you want to meet with this Marc now though, I could just reschedule." Steven pointed to the door and made as if to get up from his chair.

"I think you can hear me, Marc."

Steven looked around, painfully confused. "Is there a problem with your intercom?"

"What you're doing right now, Marc, this is treading water. When you avoid stressful topics, you feel relieved, and that's like a hit of a drug. Avoiding is a drug and you're an addict."

"I don't use drugs," said Steven. "I'm a vegan!"

"I'm not going to give you more reinforcement for avoiding. I'm going to wait until you feel ready to come back, Marc."

"I don't know who you're talking to!" cried Steven.

Harrow set down his clipboard and picked up a thin stack of papers. "Hm," he said, reading a report.

"Stop ignoring me!"

Harrow highlighted a key line.

"This is really, really rude. Just unbelievably rude."

Harrow pushed his glasses up on his nose and continued to read. And continued to read. And continued. And continued, as Steven fidgeted and harumphed. And continued until Steven deflated, squared his shoulders, and swallowed his British accent.

"It's me," said Marc. His voice sad and it wasn't loud, but it was his own.


Dr. Harrow picked up a note card and read off of it. "Marc, what month comes after Adar?"

"Nisan."

"What is a masechta?"

"It's a part of the Talmud. Like a chapter."

"Who was Maimonides?"

"A Jewish scholar. From the Middle Ages, I think. Spanish, fled to Egypt. Wrote Guide to the Perplexed." Marc scowled. "What's with all the questions? We playing Jew's Clues?"

Dr. Harrow peered at Marc over his glasses. "You told me you weren't religious, weren't raised religious."

"So?"

"Marc, very, very few people would know the answers to all of those questions. In fact, I got the question about Maimonides from a national poll that found only half of Jews even knew he was Jewish. You knew his origins and the name of the book he wrote."

"What are you getting at?"

"I think religion is important to you, or at least it was."

"Well, you're wrong."


Dr. Harrow stood and walked around his desk, pulling up a chair so he was seated only a few feet from Marc. He held a manila folder in his left hand. As soon as he began to open it, Marc stiffened and leaned back. "Okay, deep breath," said Harrow. "My goal for this session is that you stay present. If we look in the folder, that's a bonus."

"What's inside?"

"Marc, would it surprise you to know that this is the third time I've tried to show you these documents?"

"I've never seen that before."

Harrow raised an eyebrow. "You're not seeing them now," he fluttered the closed folder. "How do you know you haven't seen them before?"

"I…I got a glimpse of the corner."

"Of course." Harrow knew how to pick his battles. "Do you want me to tell you what it is?"

Marc pressed his feet into the ground, his fingernails into his palms. In better times, he might have forced himself to sound casual, but at the moment he was simply doing his best not to switch into Steven. "Sure, doc," game spilling out through gritted teeth.

"It's your medical records. From before you were in the military."

"Checking to make sure I have all my shots?" Swallowing air.

"You do. At least medically, you were well-cared for as a baby."

Marc lunged forward and grabbed the folder, too quick for Harrow to make any attempt at securing it. He took the whole thing and shoved it into the shredder under Harrow's desk, which processed about a third before jamming. He was sweating profusely, his movements jerky and uneven. He kicked the shredder, which retaliated by falling over.

"I have other copies, Marc."

"Why you gotta do this to me? Why can't you just leave it alone? Why do you have to show me these things? I don't want to look at it. I can't. I can't and I can't and I'm not going to."

Harrow leaned forward so he could see under the desk. When the shredder fell, it had spilled the unprocessed papers out from the folder. There weren't any photographs – even x-rays wouldn't have been saved from that far back. So unless Marc had unusually good vision, there was no way he could read the text clinic notes. But he clearly knew what they said: Nothing damning. Nothing that would've held up in court. But records of injuries that strongly suggested abuse: fractures of the posterior ribs, cauliflowered ear, bruising to the spleen and liver, a cluster of long lacerations along the back, some deep enough to require stitches. Each with a benign explanation that was, in isolation, believable.

"I want you to burn every copy. It's my records. It's my right. I'm going to find them all and I'm going to burn them." Marc was practically vibrating as his twitching became more intense. He gripped his hair with his fists. "I can't do this. I can't. I can't be in the same room as that. I won't do it. No. No. No way. Get rid of it. Get rid of it right now." He sealed his lips tightly to keep a sob from escaping. "Right now."

"Okay," said Harrow gently. He walked the long way around the desk and used his cane to pull the spilled papers toward himself. He bent down to pick them up, clearly conscious that he was exposing himself to some degree of risk, baring his neck to Marc Spector. He rummaged through his desk before pulling out a cheap plastic cigarette lighter. "Come on," he gestured to Marc.

"What- where?"

"These windows don't open, and the smoke alarms are very sensitive."

"…You're gonna let me burn it?"

"Here? No. In the courtyard? Yes."

"You still have a copy."

"I do. And I'd appreciate you not burning my computer. But if you want to burn this one, be my guest."

Marc followed Harrow down the hall, every muscle in his body telling him to run, to grab the papers, to wrestle Harrow for the lighter. He'd been out to the courtyard many times before, almost every day. He knew where it was. It was a miserable little spot, clearly carved out so staff could smoke outdoors, or because some regulatory body or another demanded the patients get some modicum of fresh air. It was completely paved. Someone had taken the time to bring in a few flowerpots, but not apparently the time required to plant flowers in them.

Harrow waved off an orderly. "It's okay. We're finishing the session outdoors," he said as he tapped his badge against the electronic lock.

"I can't stand it. I can't stand it. I can't stand it. I'm gonna fall apart. I'm gonna tear in two."

"Here," said Harrow. He handed Marc the lighter. "Do you want to do one page at time or all at once?"

Marc weighed the satisfaction of burning one page at a time with the risk that he would see what was on those pages. He squatted down. "Gimme the file."

It took a few tries to get it to catch fire. It seemed unfair that there would even be wind in the fenced-in block, but there was enough to put out his first few attempts. But it worked, eventually. The folder and its contents were a pile of ashes and staples. Marc rocked backward and sat down on the ground. He looked exhausted, breathing as though he had just run a marathon. He looked at the ashes, the back to Dr. Harrow, then back to the ashes again. "Sorry," muttered.

"Do you remember my goal for our session today?"

"You wanted to show me that stupid file. For the thirtieth time or something."

"I wanted you to stay you while facing something distressing. And you did."

"If only all my problems could be solved with fire." Marc wiped away sweat that was threatening to drip into his eyes.

"You said, 'I can't stand it'. But you could stand it. You did stand it."

"I shredded it and burned it." Marc dropped the lighter, apparently realizing he was still holding it.

Harrow took note of where the lighter landed, and made a mental note to retrieve it later. "You didn't dissociate. You didn't attack me. You didn't hurt yourself."

"I didn't read the file."

"Rome wasn't built in a day. And besides, you got to experience something amazing: the terror goes away whether you flee or not."

Marc poked at the pile of ashes, his agitation and fear exhausted. "You already read the file, didn't you?"

"Yes."

"She wasn't always like that. It wasn't until I…you already know that part." Marc ran his fingers through the ashes, rubbing them all over his hands as if her were washing them.

"Not until after your brother's death."

"She just…we all changed."


As was typical, Marc sat stiffly and silently in his chair, like a child's poseable doll.

Dr. Harrow waited.

"Zephaniah."

"Hm?"

"My Jewish name. The one they gave me. Means G-d is hidden. You won't have heard of him. Really minor prophet. He just tells the king to repent, the king doesn't repent, Israel gets invaded again. Same story over and over."

"God is hidden," said Dr. Harrow.

"Yeah. He's really good at hiding. So good he might as well not exist at all." Marc's lips stuck out, a telltale sign he was grinding his teeth.

"You feel that God hasn't been there for you."

"He's not there for anybody. Ever heard of the Holocaust?"

"Losing your faith can be a very difficult experience."

Marc laughed ruefully. "That's the sick joke. I didn't lose my faith. I still believe in G-d. I just think he's a dick."

Dr. Harrow mentally crossed his fingers as he decided to take a gamble. "You told Dr. Martins that your name was Cain."

"That's the name I gave myself. After, you know…"

"After your mother told you that you were to blame for a horrible tragedy."

"Cain, he, he didn't mean to…he made his offering in good faith, and G-d rejected it. Doesn't say why."

"Do you feel that God rejected you?"

"He's a jealous god," whispered Marc. "I strayed. Why would he ever want me back?" He wept.