She did the thing she always did with paperwork she had been avoiding. She put it in the center of the blotter and went through it the way she would have gone through a chart.
The diary at home was in its drawer, the ribbon between the same pages. She was not going back to it this morning.
Most of the top of the stack was hospital boilerplate from his admission: an ER summary, transfer notes from the medical floor, insurance pre-authorization, two batches of consent forms in different hands and on different forms, his signature on the ones below the line and the date on those already two days into the silence. Halfway down she found the intake interview from the medical floor, three paragraphs by a resident she did not know, ending in the small steady note patient nonverbal, cooperative. Below that a family contact sheet. One number, one name, Irene Kent, the handwriting on it clean and not his, the way handwriting tends to be when a clerk takes information out of a wallet.
She put the sorted sheets in two piles to the left of the blotter and lifted the file that lived with them at the bottom of the desk. The chart cover went open without resistance. The corner had a number on it now, written in the same red marker Clara used for transfer flags. Eight.
The remainder of the stack — about a third of its thickness — was a clipped packet of its own, set apart by a paper band the floor used for documents that came in with a patient instead of being generated about him. She had eleven minutes before he came in. She put the packet on top of the blotter, untouched, and went to the corner cabinet for the cards.
The deck was the standard one. Forty cards, one word per card on heavy stock, set in a serif a stationery shop had decided was clinical, packed in a plain navy box that had been on top of the cabinet for as long as she had had the cabinet. She brought it down and fanned the cards out on her side of the table in two arcs of twenty, the way she always laid them out, and stood looking at them long enough to make sure none had stuck to another. The angle of the chairs was ninety. The notebook was on the table between them as before, closed, with the pen across the rule. The cards stayed on the corner, on her elbow side. They could be moved to him later.
The dark silver ring on her right hand sat where it had sat at midnight. It had not given any ground back.
At nine he came in.
The watch on the left wrist. The coat hung carefully on the back of the door. He took the further chair and put his hands on his knees, in the same arrangement they had taken yesterday, with the slight forward tilt of the right shoulder that came from a man who used to be taller in a room.
"We'll try something different today," she said, and laid one hand near the deck without touching it. "These are vocabulary cards. Forty of them, single words on each. You don't have to read aloud or write back. Sometimes patients find it useful to choose one — for the session, for the week, for any reason at all. You can choose more than one, or none. You can keep them on your side. Nothing leaves the room."
His attention found the cards.
"I'll put them where you can reach. The choice is yours. You don't need to show me."
She slid the two arcs across the table to his side, between his place and hers. The cards traveled with a small dry sound on the lacquer. He did not move while they crossed. When they came to rest he looked at them the way he had looked at the notebook on the first day, without surveying, as if he had recognized them as a category and was now reading each one in turn.
She let the room hold its rhythm.
He took close to ten minutes. His eyes went across the cards and then back. Twice she watched him pause on one for longer than the others and then move on. His hands stayed where they were. When he finally moved, his right hand came up off his knee and went to a card near the inner edge of the second arc. He drew it from the row without turning it toward himself to read. He laid it face-down on the table beside the notebook, on his side, the long edge parallel to the rule of the page.
His hand returned to his knee.
The rest of the session held the shape of the room around the card. His hand rested on his knee. The notebook lay closed between them. The card on his side stayed where he had set it, white back, blank.
At the hour he stood. He left the card. He buttoned the coat, looked once at her hands, and went out.
She gathered the rest of the deck in the order she had laid them, slid the cards back into the box, and put the box back on top of the cabinet. The chosen card stayed where he had left it.
Then she came back to the stack.
She slid the paper band off the packet. It dragged once against the envelope's edge and let go, the small friction of cheap kraft on cheap kraft, and the loose ring of it settled on the blotter beside her wrist.
The packet under the paper band was thicker than the rest of the paperwork put together. It had come up with him from intake, an older clinic envelope marked in the field for referring practice with a line drawn through it: he had come into the ER without a referring practice, the way a person came in if a passing motorist called an ambulance. The pencil note on the paper band read for clinician.
The cover sheet was a form she knew. A self-referral request to the Center, single sheet, the kind a patient filled in when they came to the clinic directly rather than through an internist. There was a check-box for the speech-language service, and a check-box that said requesting specific clinician (please specify). It was checked. In the field beside it, in a hand she had now seen on three pieces of paper, was her own name, in full, as it appeared on the door. The date at the bottom was three weeks before the accident.
The field marked reason for referral held two lines of his writing. Professional and personal interest in the Lang Family Archive. Hoping for a consultation regarding aphasia in literary biography. Between personal and interest a single word had been crossed out and rewritten; the original was illegible.
Behind the request form, clipped to it with a small steel clip, was a second sheet.
A printout, formatted as a system receipt from the request portal of a private archive. The header read Lang Family Archive. Request received. Acknowledgement to be sent within ten working days. A name on it: Noah Kent. A timestamp two days later than the date on the consultation request. A reference number she could find again without trying. The list of materials had been entered in two lines.
Editorial correspondence 1907–1912.
Materials related to Nathaniel Kerr.
She set the two sheets on the blotter side by side, the consultation request on the left, the archive receipt on the right.
She had been in the office of a stranger an hour ago.
He had been waiting.
A small thing in the room moved without her seeing it move, a shift of pressure, or her own breath finding its way past her teeth without permission. She set her hand flat on the blotter between the two papers and held it there.
After a while she went around the table to the further chair.
The card was where he had put it, white back up, the long edge parallel to where the notebook had been. She picked it up by the edges, the way one picked up something one did not want to crease, and turned it over.
The word printed on it was in the same clean serif as the rest of the deck, lower-case, centered on the card. Recognition.
She held it a moment with both sides of the card visible to her, the blank white back of the choice he had made an hour ago, and the word he had chosen, and stood in the quiet of the room with the two papers behind her on the desk and his chair empty in front.
The clock on the wall went on at its measured pace.
She kept the card in her hand. The session was not over.