So where is she now?

One of Sam’s colleagues took her in for a few days while I’m down here. The boyfriend won’t have anything to do with her. And, no, Antonia has no idea what will become of the girl and her baby. She, Antonia, certainly can’t take this on right now.

She can almost hear her words landing on the soft ground of her sister’s heart. What, as young women, they used to call “the real me.” The Buddha in me bowing to the Buddha in you.

I’ll take her in, Izzy offers, pushing aside the covers and sitting up. It’s the most energized she has been since the conversation started. The llamas. The eighty-three orchids. The migrant artist revolution. The motel to house them. The farm to feed them. Now the pregnant teenager and the fatherless child she will soon give birth to.

Ay, Izzy, Antonia sighs, moved in spite of her exasperation. You have to start by taking care of yourself. The mantra of the First World. First, your own oxygen mask, then everyone else’s.

Izzy lets herself fall back on the bed. What for?

What do you mean “what for”?

All this goddamn self-care? “What’s it all about, Alfie?” her sister sings, a favorite song of their teen years.

“Is it just for the moment we live?” Antonia sings back, trying to brush off the question. Sometimes it’s not the right time to address the existential angle. One day at a time. One foot in front of the other—that’s the road she’s traveling and wants to encourage Izzy to travel.

How’s the migraine, by the way? Antonia changes the subject, something that never works with any of the sisters or ever worked with their mother. Dogs with a bone—all four. Just like Mami. The mango tree, the mangoes.

Forget it, Izzy says, rolling over, turning her back to Antonia. Leave me alone, she says, shrugging Antonia’s hand from her shoulder. If you’re not going to help me, at least help that poor kid.

Antonia feels a flash of anger. Everyone is always telling her what she should do! Starting with Sam, who claimed it was because Antonia didn’t know her own mind. Into the vacuum of her considerations he would step with his big, clunky certainties. She’s suddenly angry at him, too.

If he were alive, this would be the moment when they’d have one of their fights. That, too, is over. Which makes her all the angrier. Again, and once and for all, he has the last word.

Dr. Campbell has an appealing, androgynous look, with the toned forearms of someone who works out, a firm handshake, no makeup, no wiles or easy smiles. The only whimsy is a purple strand in her brown spiked hair, signaling something, Antonia is not sure what. Her students would know. Who will teach her these things anymore?

Dr. Campbell escorts the sisters into her office, lined with shelves stocked with what look to be textbooks, the flank of volumes punctuated here and there by a snow globe or paperweight. No family photos. Perhaps, as with PI Dot, that personal a touch would give too much away.

Dr. Campbell greets Izzy as Dr. Vega, a courtesy that will endear her to Izzy, who—as she likes to remind her sisters when they get uppity with what they know—did earn a doctorate in psychology. And not a half-assed MSW or one of those “honorary” doctorates like the ones they’ve given to Antonia for being a blabbermouth author, spilling everyone’s beans in the family and calling it fiction, but a real bona fide sheepskin that took her a decade to earn, with the help of Antonia’s edits and a hypnotist to boost her confidence. (So had it already started then, the paralyzed will, the lack of confidence, the tiny chemical worm in her brain?)

May I call you Felicia? Dr. Campbell asks Izzy, who makes a face. Call me Izzy, as in, dizzy Izzy, she says, glaring at her sisters. She’s heard their “secret” epithet for her.

Izzy? Dr. Campbell smiles tentatively. Please call me Kim.

It’s unsettling to entrust a beloved sister’s psyche to someone named Kim. Dr. Campbell, Antonia persists in calling her.

Dr. Campbell has a calm, focused manner. The old iron hand in a velvet glove. She must be in her early forties. She could be my daughter, Antonia muses, as she often used to with her students—first, thinking they could be her kids, then, by the time she retired, her grandkids. Dr. Campbell wants to hear from Izzy what she is experiencing. Let your sister explain, please, she admonishes whenever the other sisters interrupt to correct Izzy’s version of the story of the last couple of weeks. Back in childhood, when Mami was the referee, such preferential treatment would have brought on jealous accusations. You’re playing favorites! That’s not fair! But Antonia guesses Dr. Campbell’s approach is a therapeutic strategy, not favoritism.

According to Izzy, her sisters totally overreacted. She was headed to Tilly’s house, but then one thing led to another, including losing her cell so she couldn’t very well call and inform them she had changed her plans. Right? Absolutely, Dr. Campbell nods, as if this is indeed reasonable. She is no fool, though, nudging gently. What about some llamas I heard you picked up? And did you say you had put some money down on a motel?

To hear Izzy’s version, she acted with total moral and emotional probity. And she believes it, too. But then Antonia’s never known Izzy to lie in order to deceive or mislead. It’s more that she lies to make things more like they ought to be.

What’s wrong with that? Izzy has challenged Antonia. How’s it any different from you and your fiction? Izzy holds no one’s cow sacrosanct.

The process continues and is so circuitous, Antonia wonders if Dr. Campbell will ever get to the point, make a diagnosis, and get Izzy into treatment. Or is “Kim” getting snowed by Izzy, the consummate con artist, charming, smart? The wild and wooly sister, everyone’s favorite in the sitcom version of their lives.

How about we try this, just to be sure? Dr. Campbell finally suggests in the velvety voice of hidden steel. To assuage her sisters’ concerns but also to follow up on Izzy’s own complaints of migraines and seizures, problems that could result in mini strokes, memory loss, or worse, wouldn’t it be a good idea to have Izzy check herself in for a thorough evaluation?

Dr. Campbell has just uttered the hot-button phrase, memory loss. Dementia has to be Izzy’s biggest dragon, given their mother’s demise from Alzheimer’s.

Any number of physiological factors could be contributing to Izzy’s symptoms, Dr. Campbell elaborates. That’s why she is recommending a minimum of two weeks of testing and evaluation. Consider it a kind of a spa for your soul, Dr. Campbell adds with a lusty laugh. Wouldn’t we all love to have that kind of time-out for our souls? Dr. Campbell turns to Izzy’s sisters, who all nod like obedient dashboard dogs with springs in their necks.

Izzy seems to be considering the doctor’s proposal. She herself has been thinking about having some tests done, she confesses. Did Kim know that their mother had Alzheimer’s? And does the doctor know about the study done by researchers at Columbia Presbyterian that found that Dominicans have a genetic propensity because of all their intermarriages? That’s what you get for only marrying your white cousins. Or pretend white cousins. We all have black behind the ears, Izzy quotes the Dominican saying. There follows a long tangent into the slave trade, their dark-skinned tíos and tías claiming suntans, Izzy and Antonia’s tight, verging-on-kinky hair.

Dr. Campbell listens patiently. All the more reason this testing might actually be valuable to the whole family.

Izzy states her terms: she wants her evaluation to include an MRI and a CT scan, to establish a base line of her brain’s agility. Absolutely, absolutely, Dr. Campbell couldn’t agree more—the effusive phrasing that will also appeal to Izzy.

Antonia is holding her breath. Is it going to happen: Izzy will agree to get consistent, residential professional help? Antonia exchanges a glance with her sisters. On their faces those lifted eyebrows of incredulous cautious hope, part and parcel of their genetic package.

But wait! Izzy jabs a thumb in her sisters’ direction. What about their “diagnosis”—Izzy air quotes—that I’m bipolar? There! She’s acknowledged the elephant in the room. The sisters flash Dr. Campbell an SOS. But she ignores them. The woman probably understands she needs to befriend that elephant. Izzy relishes having elephants in the room. It’s her preferred domestic pet, the sisters like teasing her.

Well, if the evaluation were to come up with that as a diagnosis, and I’m not saying it will, Dr. Campbell adds as Izzy’s face has tensed with suspicion, even so, we would find a way to treat it.

I know what you’re all up to! Izzy says in a beeping-metal-detector voice. She has uncovered their plot. You pump me full of meds, so that I’m “functional.” I’d rather die than be a zombie!

But you have been on medications before. Dr. Campbell checks her notes.