On and off, Izzy says. And they were zero help.

That could be part of the problem, Dr. Campbell nods. You have to give them time. But hey, bottom line is this can only work if we work together. Our approach is based on participatory care. We want our patients to discover a new life worth living and learn to make better choices. She seems to be reading off some brochure. The sudden shift to the first-person plural. The professionalese phrasing. Stay authentic, Antonia coaches the doctor internally. We are almost there.

It’s the only way it can work, the doctor goes on. Many, many patients have been helped at Liberty House. Medications are key but Izzy is right. The meds have to be adjusted, carefully monitored. Often, it’s a simple chemical imbalance in the system, as you well know, the doctor adds, a nod to Izzy, the professional colleague. As if the two women are conferring on their mutual patient, another Izzy, who sometimes goes rogue, loses self-control, needs their collaborative help.

Izzy has fallen silent, her dark-side-of-the-moon mood, which Antonia knows well from her own sojourns there. Slowly, Izzy raises her head in a canine tilt, sniffing the air, picking up a scent that won’t allow her to proceed. She levels her gaze first at Dr. Campbell, then over at her sisters, sitting in a righteous trinity to her right. Antonia finds herself wishing that she had made a different seating choice. She had thought of it when they walked in the room, as she always does when visiting a therapist’s office, convinced that the therapist has pegged each choice—couch or rocker or straight-backed chair or meditation cushion on the floor—with a corresponding disorder.

Mona and Tilly hold steady, returning their sister’s piercing look with the long-suffering, loving expressions they perfected in childhood to respond to their mother’s rages. But Antonia has never been able to withstand Izzy’s probing interrogations; her sister’s eyes bore through her many selves to that tender, unrehearsed self that hasn’t yet practiced and performed itself. Antonia looks back, and she, in turn, pierces through her sister’s many self-presentations—the charming, cunning, impassioned, flirtatious Izzys—past all the maneuvers that have allowed her to outsmart her therapists and evade treatment. But what Antonia sees unsettles her. She feels a cold liquid entering her veins, as when she has been put under at the hospital for some procedure or other. She winces in anticipatory pain.

Izzy is beyond their reach.

I hear your words, she had said some weeks back to Antonia on the phone. I hear them, but they don’t come through to me. What a horrible thought! Like that Dickinson poem Antonia often taught, the plank in reason breaking, the speaker dropping down and down, hitting a world at every plunge, never landing. And Finished knowing—then—

The poem stopped mid-sentence. Below it only the white blank of the page. This was Antonia’s dragon, why she had avoided too much contact with Izzy after Sam’s death: words, words, words, failing her.

I don’t know, Izzy says, her head like a periscope turning and looking around. I don’t know. I think I’ll give it a pass.

Tilly is the first to burst into tears. Please, please, Izzy, I’m begging you. I’ll never ask for anything ever from you, I promise! Tilly has fallen on her knees, sobbing so hard that soon she is gasping for breath, bringing on her smoker’s cough, a hacking, horrible sound, as if she is coughing up her very soul. The sight of her in such agony fells Mona, who drops to her knees, pulling Antonia down with her. What a sight before the cool-mannered psychiatrist with her diploma from Harvard on the wall. No wonder her patient exhibits extreme behaviors. The sisters are all nuts. But wait, maybe Dr. Campbell was present the day Dr. Vega lectured her medical school class on cultural sensitivity. This might be a Latina way of caring.

See what I have to put up with? Izzy jokes, flashing the doctor a collegial smirk.

But Dr. Campbell seems to have shifted allegiances. She will not settle for a glib response. I’d say your sisters really love you, she speaks with a wistfulness to her voice, as if this is a love she has yearned for and never known herself.

I guess then . . . Izzy takes a deep breath and lets out a surrendering sigh. I guess Love wins the day. The sisters lurch forward to hug her, cheerleaders whose down-on-their-luck team has finally won a game.

There is a flurry of phone calls: to the physician in charge of admission at Liberty House, the psychiatrist who will lead the team evaluating Izzy, the pharmacist for a prescription Izzy is to start immediately, a small dose, to settle her down. It is decided. Today being Friday, the weekend upon them, on Monday Izzy will report to this office and she and Dr. Campbell will walk across the green to the house that looks like an antebellum mansion to begin her soul spa.

Izzy stands, ramrod straight, clicks her heels together, and gives them all a salute. Antonia’s heart sinks. Oh boy, oh boy, she thinks. This is not going to work.

10

Cuckoos in Kyoto

Emotions ran high, as they always did when the sisters gathered together. But despite its intensity, it had been a hopeful weekend, considering. Monday, at 10 a.m., by her own consent, Izzy would be admitted at Liberty House, a name she accompanied with air quotes.

Her sisters kept congratulating each other. They had pulled it off. “Monday, Monday,” they sang out of earshot of Izzy. Of course, this treatment wouldn’t be a magic bullet. Izzy had an illness that would need to be managed all her life. I told you guys, Mona said one too many times.

Izzy moped, packing and repacking her bags. What to take with her to the loony bin, she joked.

Remember, her sisters kept reminding her. You’re not going to Siberia or a lockdown prison. You’re free to go out if you need to.

Izzy responded with that look again, the one that had unsettled Antonia at the psychiatrist’s office. She had something up her sleeve—Antonia was sure of it. Promise me, she confronted her sister straight on, that you’re not going to . . . Should she name the unnamable? Put ideas in her sister’s head? Instead she said, Promise me you won’t break my heart. Izzy? Do you hear me?

I hear your words, but they don’t come through to me, Izzy had said. Her voice, but without Izzy behind it.

Kaspar had taken off to Boston to see the Botticelli exhibit at the Isabella Stewart Gardner museum. Enjoy your madonnas! the sisterhood toodle-ooed, ushering him out, glad not to have him around to temper their temperaments. When Tilly, with Mona in tow to keep her company, stepped out for a smoking break, Antonia crawled in bed with Izzy, hoping to infuse her with a heavy-duty dose of sister comfort.

Do you really think I’m sick? Izzy asked, suddenly all there, her face inches away. It was impossible to escape those two searchlights beaming into Antonia’s eyes.

Antonia didn’t know what to say: she didn’t want to dismiss Izzy’s need for professional help. But she also didn’t want her sister to feel damaged and diminished in any way. Who can speak to this? she addressed the pack of writers in her head whose work she had studied, taught, treasured, random lines spinning daily through her thoughts. Come on, guys! One of you, step up to the plate now. “Canst thou not minister to a mind diseased? Pluck from the heart a rooted sorrow?”

Ay, Izzy, Antonia crooned, rocking her sister in her arms. Here’s what I think: life is hard. Even in Kyoto, hearing—

You’re no help at all, Izzy said, shrugging off Antonia’s embrace.

Several times during the weekend, Antonia took a walk in the woods behind the hotel, down a small knoll to a brook, its shores lined with mossy boulders, the birds audible above the highway hum in the distance. Somewhere, perhaps at summer camp, where she had picked up most of her nature lore (what to do in a lightning storm, what to do about an allergic reaction to a bee sting), Antonia recalled having been told that, should she get lost in a forest, she was to locate a brook, or stream, or river, and follow it, as eventually it would lead to civilization. But what if she wanted to get away from civilization? Actually, the scenes in the hotel had to be the opposite of civilized: her sisters—not just Izzy—grandstanding, throwing tantrums, the emotional temperature at a continuous fevered pitch.