I was dead tired, but decided I should visit Lilly before leaving the hospital. I planned to be on Nantucket the next day and, with the progress Lilly had already made, I wasn't sure how long she would be an inpatient.

I found her seated in an armchair by her bed, staring out the window. Her blond, curly hair was tied back with a little black bow. I knocked at the door to her room. She glanced at me, then resumed her vigil.

"Mind if I come in?" I asked.

She shrugged dismissively.

I felt as though I might have done something wrong, something to shake Lilly's trust in me. But I couldn't imagine what that might have been. I hadn't breached her confidence by talking to her family members. I hadn't even shared detailed clinical impressions of her with her internist or surgeon. I'd shown up every time I had said I would. Was she still upset I hadn't agreed to continue seeing her as an outpatient?

"Just because you feel she's lost trust," the voice at the back of my mind said, "doesn't necessarily mean she's lost trust in you."

That was true. Even during the briefest psychotherapy, the psychiatrist is a blank screen onto which a patient will project feelings he or she harbors for other important figures in their lives. Lilly's silence and standoffish body language might be meant for me, but might be a reflection of her anger toward someone else, like her husband or grandfather.

I walked in. I saw that Lilly was connected to just two IV bottles. Her leg was still wrapped in gauze, but it looked less swollen. She was less pale. She was getting better.

Without turning her gaze from the window she took a deep breath, let it out. Her sky-blue eyes thinned in a way that hinted at stormy thoughts. "That fucking bastard," she said. "All those years. He really screwed me up."

I sat down in the armchair next to her. "Who are you thinking about?" I asked, already pretty sure of the answer: Lilly's mind had begun to channel her self-loathing into rage at her grandfather.

She shook her head. What looked like a wave of nausea swept over her beautiful face. She swallowed hard. "I was a little girl," she said. "He was getting his rocks off manipulating a child."

"You've been remembering your grandfather," I said.

"His stupid comments," she said, still looking straight ahead. "The way he checked me out."

I waited to see if she would share her memories.

She looked at me. Several seconds passed without a word.

I didn't break the silence. I wanted her to know she was the one in control of what she revealed and what she kept private.

"My friend Betsy was turning nine," Lilly said finally. "I was nine, too. I remember getting dressed for her birthday party. It was summer, and my mother helped me put on a pale yellow, blowzy dress. It had little butterflies embroidered on it in white thread. I guess you could see my underwear through it. Pink cotton underwear." She rolled her eyes. "I remember my grandfather looking at me, some stupid smile on his face." Her hands closed into fists. "And then he said, 'Keep wearing dresses that show your panties, and all the boys will be staring at you. I know I would be.'"

He would be. He would be staring at his granddaughter's panties. "Do you remember how you felt at the time?" I asked.

"I've been trying to bring it all back," she said. "Because you told me to run into the images, not away from them." She paused to collect her thoughts. "Partly, I think I felt foolish, because I didn't really understand what the hell he was talking about. Why would anyone care about my underwear? But the way he looked at me, I knew I was doing something he liked, or at least something that got his attention. And I was sort of proud of it, but embarrassed, too." She shook her head again, in disgust. "The way he said panties. I remember that. He lingered on the word, like he was… tasting it."

I wanted Lilly to keep her disgust flowing, to keep her emotional wound open and let her infection drain. "He liked saying it," I said. "It excited him."

She closed her eyes. Instead of growing angrier, she blushed. "Here's something weird: It's one of the things that my husband likes, too, I guess. On the honeymoon, he asked me to let him look at me in… my panties."

"Did you let him?" I asked.

She nodded bashfully.

"He just wanted to look at you dressed that way?" I said, inviting her to divulge more.

Her cheeks turned crimson. "While I touched myself," she said quickly.

I felt as though we were only halfway to the core of the problem. Lilly hadn't attacked her husband for admiring her body. She had assaulted herself, injecting herself with dirt. The trigger for her pathology was her shame. "How about you?" I asked. "Did you like it when he watched you that way? When you were touching yourself?"

"I guess I did. I mean I…" She stopped herself mid-sentence. "You know."

"You had an orgasm," I said.

"But then, like a minute later, I felt so disgusting," she said.

"Right," I said. Lilly's trouble was in separating her adult sexuality from the confused, frightened, disgusting sexual intimacies shared by word and glance with her grandfather. "It's going to take time to get enough distance on your past experiences with your grandfather to feel good enjoying the present with your husband. You've got to expect a lot of conflicted emotions. And you've got to give yourself the time to feel them and to get over them."

"But I will?" she asked. "I will get over them?"

"Yes," I said.

"I called Dr. James's office," she said. "We have an appointment in a week."

"I'm glad." I felt gratified that she had followed up with Ted. I also felt a pang of regret that I hadn't continued seeing him myself. I missed him-his clear thinking and steady hand. I would have liked his advice on Julia. "He can help you as you remember more. You can trust him completely."

"I'll try to," she said. She looked at me in a way that showed she was still very needy and very vulnerable. "Will you stop by before I leave?" she asked. "They told me I'll be here a few more days. It would just help to know I'm not on autopilot until discharge."

"You'll handle the controls better and better," I said. "But, yes. I'll see you before you leave."

17

I grabbed a cab back to Chelsea and walked through the door of my loft at 9:17 p.m. By 9:22 I had already gotten the number for Dr. Marion Eisenstadt from Manhattan Directory Assistance, dialed her up, and convinced the woman at her answering service to page her. I hung on for her more than five minutes.

"Dr. Eisenstadt," she said finally. Her voice was younger than I had expected.

"This is Dr. Frank Clevenger, in Boston," I said. "I'm a psychiatrist working with the Bishop family, on Nantucket."

"Yes?" she said.

"I'm calling to…"

"You're a forensic psychiatrist," she said. "Is this a police matter?"

Having a reputation isn't always an advantage. "Not formally," I said. "The Bishops allowed me to evaluate their son, Billy. Now I'm learning as much as I can about the entire family, so I have a complete picture of him when I testify at his trial."

"Okay," Eisenstadt said tentatively.

"And Julia Bishop told me you've treated her. She suggested I call you."

A few moments went by. "I don't think I can tell you much without a release of information from Ms. Bishop."

I felt as though a weight had been lifted from my soul. First of all, Eisenstadt actually existed. Secondly, Julia was clearly her patient. "I completely understand," I said. "We haven't had time to dot our i's or cross our t's. You probably know Billy is still at large. I've had contact with him by phone. Anything you can share with me could help me-either to reach out to him now, or to help him in court later."