The Slippage

          After she died, I collected my friend’s favorite belongings and put them in a box I hid from her brothers, who came to pack up her room. A necklace with beads the color of blood; a childhood book she’d read so often, pages had split from the spine; a set of small jade turtles. I stole these objects from her bereaved family.
          Her brothers asked me to tell them about her last moments again and again. Her father asked too, over the phone. He was a doctor. He had medical questions. He became obsessed with the autopsy report, as if, by dissecting every detail, he could find an answer that explained how this could be: his daughter, dead at thirty-two.

          We met when Sonya came to see a room in the apartment I shared with college friends. She sublet the room. Within a few months, she and I had fallen head over heels into friendship and moved into an apartment of our own.
          I was twenty three. Sonya was eight years older. She’d recently dropped out of medical school. Our whole friendship unfolded inside what, had she lived, she might have looked back upon as a long in-between period, the wandering time after abandoning medicine, before she’d set off in a new direction.
          Our futures were hazy, and being in that place of uncertainty and daydreams—without life partners or careers or children—together, we made a home.

          Sonya always got lost when she was driving. We were transplants in Boston, a city of oddly intersecting one-way streets where a single missed turn sweeps a driver irreparably toward a new, unintended destination. Lost, we’d lose ourselves in long conversations about everything, the windows cracked so we could blow cigarette smoke out, cold air rushing in and swirling our hair into knots, and in the end, we didn’t ever mind how we never arrived at the place we’d set off to reach.
          She’d left Miami, and her third year of medical school, to come to this city where she knew no one, in order to be a patient at McLean Hospital, the psychiatric hospital Girl, Interrupted made famous. She described how her depression came over her “like black drapes” falling closed. The medication she took softened this sensation, but also made it impossible for her to think clearly: it distorted her memory, destroyed her creativity, fragmented her focus. Pill by pill, it erased her, only not so entirely that she didn’t notice what was missing.
          Her depression had begun within the all-consuming milieu of medical school. More and more she understood she didn’t want to be a doctor. She told me about a young girl, a patient at the teaching hospital where third-year students, Sonya among them, were on a clinical rotation. The girl was Hispanic, poor, with a deep gash on her face. The student instructed to stitch up her wound had never given anyone sutures. His hands shook. The doctor in charge gave no guidance. The girl, supine on a hospital bed, gasped and grimaced, tears rolling toward her ears as the student’s botched stitches crawled crookedly across her cheek, bunching the wound closed. Her face would forever bear the scar a practiced hand could have lessened.
          Sonya, with her talent for listening deeply, would have made an exceptional doctor, but she didn’t want to use poor people’s flesh to practice her stitching. She’d drifted into medical school without a sense of vocation, carried by the current of her father’s hopes.
          Now, having abandoned that path, she thought she might want to become a research scientist. She went to lectures and panels, trying to pinpoint an area in which to specialize. One of these lectures was at MIT, the university that employed me. Afterward, she described how neurophysiologist Giacomo Rizzolatti had seemed to “dance onstage,” compelling her to listen because of the graceful way he’d carried himself and the musical cadences of his voice.
          My boss, an editor of neuroscience books, lit up with pleasure when she told me she’d met my roommate at this lecture. How they discovered they had me in common, I don’t know, but I can imagine it. Sonya talked to people, drew them in with her warmth.

          She hoped it would be simple: choose a new path, then stop taking pills and she could resurrect herself, whole and competent again.
          Her antidepressant hadn’t been working for her, but not taking it was worse. She stopped her medication cold turkey. She told me this was okayed by a new psychiatrist she’d begun to see. But, perhaps not the cold turkey part. Was she supposed to taper?
          Tapering might have helped, but not necessarily. In the New York Times in 2018, Benedict Carey and Robert Gebeloff reported that tapering antidepressant doses, even by a fraction at a time, does not allay withdrawal symptoms for all people. Meanwhile drug makers, who have enormous financial incentive to ignore the difficulty and risk involved in stopping use of their products, have not studied long-term use, never mind withdrawal following it. That the existing literature often refers to withdrawal as “discontinuation syndrome,” and maintains its symptoms are “mild and short-lived,” points to the insidious way marketing efforts shape discourse when there is a void in scientific knowledge.
          The medication Sonya stopped using can cause a multitude of withdrawal symptoms: aggression, irritability, agitation, anxiety, confusion, rebound depression, paranoia, repetitive thoughts, nightmares, insomnia, dizziness, sensory disturbances that include “electric shock-like sensations,” loss of balance, pins and needles, spinning sensations, numbness, severe internal restlessness, changes in appetite, nausea, vomiting, diarrhea, cramps, crying spells, exhaustion, and flu-like symptoms.

          Before a holiday party at the school where she worked as a Hebrew teacher, Sonya baked almond cookies to share with her students. Only after the cookies had cooled did she reread a memo about what teachers could and couldn’t bring to their classrooms. The school prohibited nuts as part of its policy for avoiding allergic reactions. She sent an email inquiring whether an exception might be made in this case, since the cookies were baked. The answer was no. She felt singled out and, flooded with distress, could not stop herself from sending multiple distraught messages to administrators at the school. She arrived late, with some donuts she’d picked up at a supermarket. She was fired soon thereafter.
          Periods of mania gave way to the blackest of moods, a kind of elemental despair. Her sudden outbursts of pent-up emotion, so out-of-proportion with their triggers, shocked me. Some days she fumed or fretted over an interaction she’d had, or her uncertainty about the future. She’d pace, twitchy with agitation. Other days, she couldn’t muster the energy to get out of bed, shower, dress, eat.
          Winter gripped the city, and daylight turned to darkness at ever earlier hours. I’d come home from work in an evening that already felt like midnight, and every light in every room of the apartment would be blazing. Sonya would be curled in her bed, not moving, not sleeping, her bedroom windows wide open to the winter air, heat pumping ineffectually from the radiators in an endless, expensive battle with the drafts.
          At some point, it occurred to me I needed to find somewhere else to live. The struggle that consumed her was starting to consume me, too. I was dismayed by my own thoughts. Maybe I wasn’t equipped to drag her out of this pain. But who else would try?

          It was late, after 11:00 p.m. I’d just returned home from another friend’s house. I began to get ready for bed. Hearing a crash, loud even through the closed door, I spat toothpaste into the sink and went into the hall. “Sonya?” No response.
          I found her on the kitchen floor, wearing a scarf and coat, the scarf covering her face. “Sonya?” I said again as I leaned over her. Her body shook as if she were laughing, but when I pulled back the scarf, her face was gray. Her eyes didn’t focus, didn’t blink.
          She’d fallen from the stool we sometimes used to reach the upper shelves of our cabinets. That was my first hypothesis. The stool stood undisturbed, impossibly far from where she lay.
Dying seems the least likely explanation, at first.
          I had, at some point in my life, been certified in CPR. I’d given breaths to a smooth-faced dummy, pressed the heel of my hand to his fake chest. This provided me with little discernable advantage in terms of executing CPR well during a crisis.
          Effective CPR requires a lot of force, enough to sometimes break ribs. Today, CPR is just chest compressions, but a decade ago, giving breaths simultaneously was standard, and this required tracking time, though time had become gummy and strange for me, each second stretched and warped by shock.
          The 911 operator asked me if she was breathing. I said no, then yes, then no. I’m not sure how much time elapsed between answers, but I know now why they changed. More than half of cardiac arrest victims gasp and moan reflexively. Gasping seems like breathing, but it’s not. The sudden gasping frightens many people. Lay responders often stop pressing on the chest, even though a gasp signals that chest compressions are working, and should be continued.
          When Sonya gasped, her chest lifted and her whole body shuddered.
          A brain, starved of oxygen, dies within six minutes. Permanent damage sets in after four.
          We lived on the ground floor of a Victorian house perched near the top of a steep, narrow, one-way street that curved off another one-way street, an easily missed appendage. Three ambulances arrived, eventually.
          The EMTs used defibrillating paddles. They injected epinephrine. One asked me for Sonya’s driver’s license, and I moved around our apartment, dazed, unable to find her purse, the world a blur. My blundering about seemed a fitting symptom of a world turned on its head, and at no point did it occur to me I couldn’t find the purse because I literally couldn’t see. It wasn’t until the next day I realized: I’d already taken out my contact lenses.
          The flashing lights drew our landlady downstairs. She lived on the upper two floors, and I ran into her from time to time, but we’d never advanced beyond a distant courtesy. She offered to drive me to the hospital. Yes, I said. Please.
          At the ER, we waited. I called Sonya’s father on his cell phone, left another message.
          A doctor came and said he was sorry. He led me into a white room to say goodbye. The landlady came too, weeping. Her tears made me feel like something was wrong with me. I was dry-eyed, and at my elbow, this woman who didn’t love Sonya sobbed.
          The circles around Sonya’s eyes were so dark it looked like she’d been punched twice in the face. Her eyes themselves were bloodshot. Her skin gray, lips tinged blue. Someone had pulled a sheet up over her exposed chest, hiding her shredded clothing, which had been sliced open with scissors in our kitchen.
          I felt no communion with the friend I loved through the body she’d left. This slippage—spirit split from flesh—was terrible, and to touch her on her eyelids, a place I wouldn’t touch on a living person, seemed invasive, artificial, a gesture that only affirmed my horror and her goneness, yet I berated myself: I must close her eyes. As if, by repeating a gesture familiar from countless TV shows and movies, I could restore dignity to her body.
          I had lost her. I both knew and couldn’t believe it. Worse, she had lost the world. She would no longer know all my secrets. Everything I did from here on out, everything anyone did, would be a secret that excluded her.

          On the table when Sonya died: an angry note to me about the recycling. I’d failed to take our bin out, or maybe the point was I habitually neglected this chore. One of the EMTs read it, probably looking for a suicide note.
          I didn’t like to reorder the things Sonya had last touched. The note remained on the table for days, and one of Sonya’s brothers read it. He laughed, amused even friends as close as we’d been had clashed over chores the way people sharing living space inevitably do, but that note anguished me. Did she write it just before her death? Sometimes, even now, the note seems a clue. Sudden Cardiac Death can be triggered by strong emotion. An angry heart is a vulnerable heart. Did Sonya see my neglect of a chore as neglect of our friendship? Did terrible feelings rush through her chest, swarming like bees under her ribs?
          There are other clues, pointing down other avenues. Years after her death, studies began to amass evidence that the drug she’d used and chemically similar drugs could prolong the heart’s QT interval and lead to abnormal heart rhythms, ultimately causing dizziness, fainting, or even sudden death. Being female is a further risk factor; testosterone shortens the QT interval, naturally countering the drugs’ effect. Regulatory agencies lowered the maximum recommended dosage of these drugs in response to the findings.
          Unable to cope with the side effects of withdrawal, had she returned to taking her antidepressant, only to be felled by a far worse adverse effect—death itself?

          Not long after Sonya died, a neighbor and her two children showed up on my doorstep. Sonya had befriended the woman in the street, easily, as she befriended countless people, and she’d connected her with legal aid to fight an impending eviction. The neighbor and her family had emigrated from the Dominican Republic, and they’d teased Sonya about her Argentine Spanish, the way ‘y’ sounds turned to shushing ‘sh’ sounds in her mouth.
          I spoke Spanish fluently, too, so I told the woman why Sonya had not been to see her. Breaking the news to various people on the fringes of Sonya’s life in Boston was my responsibility by default, but I was still teaching myself to believe my friend was dead. Declaring her goneness reconstituted my own confounded disbelief, and from within this sensation it was difficult to order words in any language. What I wanted to convey, humankind had no words for, and in a language that was not my first, I had no delicacy.
          The neighbor screamed. She cursed me, calling me a liar and worse, her small children wide-eyed and staring, touching her legs. I couldn’t calm her down.
          Only when Sonya’s brother appeared next to me in the doorway to reinforce what I’d said did the woman believe it might be true. She talked with him in my living room for a long time. Very pointedly, she didn’t look at me or speak to me again, as if her desire for me not to have revealed the truth had erased me from my own home. I’d shocked her, I knew, but this didn’t extinguish the fury I felt.
          No doubt the neighbor was terrified of the court date rushing toward her, the judge she would face without the ally she’d expected beside her. No doubt she’d cared about Sonya. Maybe it had been difficult for her to trust me, with my white skin and English-speaker Spanish. This didn’t occur to me at the time, in part because Sonya and her family were white, too, and yet their status as Jewish immigrants from Argentina blurred easy categorizations.
          I never found out if the woman was evicted. I don’t remember encountering her again. Perhaps the grief that made me oblivious to so much rendered her invisible.
          Probably, she and her children and husband were gone, forced from their home.

          I didn’t fly to Miami for Sonya’s funeral. I was too broke to afford last-minute plane tickets, too addled to figure out a workable plan B when I could hardly get out of bed, and too young to understand what a funeral bestows upon survivors, and why I might later regret missing this one. Later, with her brothers, I held a memorial service at the apartment, but there is a closure that comes from seeing a coffin lowered into the ground that sharing stories, however cathartic, doesn’t offer.
          About a year after her death, I had a series of strange dreams. These dreams didn’t have content in the usual sense: a plot, however fragmented; a visual landscape; me as a character, acting or reacting. Sonya did not appear in them. They were waves of intense emotion, nothing else. The emotions varied—fear and sadness, yes, but also love and peace. The dreams were immersive, and spilled over into my waking world. I’d rise from bed saturated with feelings that seemed to simultaneously spring from outside of myself and be intensely private and personal. It was as though my subconscious were reminding me other sensations existed in the universe besides pain.
          We urge mourners to move on as if it were possible for the grief-stricken to return to the people they were before the loss. Healing is inevitable, even if it happens more slowly than others find comfortable, but recovering from grief doesn’t mean a loss disappears. We don’t “get over it.” It becomes a part of ourselves we accept, an invisible scar, an absence we feel as a palpable presence even as others around us forget.
          I still have the box of Sonya’s belongings I kept. Most items stay in the box most of the time, though a few have been adopted into my daily life: an empty bottle of her favorite perfume and five jade turtles sit on my dresser, and I wear the blood-red beads. Keeping some of her belongings felt vitally necessary, even though the inert objects of her room could not resurrect her except as a haunting, a memory, something far less than the living woman for whom I longed.
          There were also items much too large for a box that I kept by default rather than scheming, like the dresser Sonya had purchased at a thrift store. She’d changed out one of its drawer pulls for a knob with an oversized ladybug hand-painted onto it. I’d lugged this dresser, with its single mismatched knob, from apartment to apartment, from Massachusetts to Michigan to Pennsylvania, until finally my husband and I bought a house, the master bedroom of which could accommodate only one of our two dressers. The more easily child-proofed of the two won out. Sonya’s dresser had started to fall apart anyway, the finish peeling off in shaggy strips.
          We carried it to the curb with our trash. I hoped a passerby would claim it, but no one did.
          My husband and son watched the garbage collectors heft it into their truck, and the compressors come down. I wasn’t present for this destruction, but my husband told me how, in an instant, the dresser buckled and was gone: splinters and shards. No longer a dresser, just meaningless pieces.
          Sonya’s death was sudden and meaningless, but her life. Her life brimmed with the connections she forged so willingly. I imagine all the fellow mortal beings Sonya laughed with, listened to, whose worries she lightened, most of whom live and breathe still, and the thought comes out of concealment, shocking, familiar, not very profound: why her and not us? In the weeks after her death, I’d observe strangers, their lives mysteries to me, and think at each: better if you were the dead one.
          Sonya’s brothers have married and had children, and like them, I’ve made a home again, a family, knowing how precarious life is.
          Family life is joyous, too. Full of small surprises. Today, holding one arm raised, my son drops coins down his sleeve. He shakes his arm and coins rain upon the floor. His wonder remakes the world for me: here is the pleasure of throwing objects without using hands, of taking what is hidden in the dark of a sleeve and revealing it, of making a ringing thunder until all that change lies loose and shining at your feet.
          He loves copper pennies best. He slips them into his tiny pockets, and later, I feel the fiercest love as I pluck them from the bottom of the washing machine, wet and smelling of blood.


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