I don’t look up as I read the next two questions. “On a scale from one to nine, one being no difficulty and nine being extreme difficulty, how would you rate the difficulty you experience in NOT collecting, keeping or purchasing more things than you can use, need or afford?”

“Five.” I start to write it down. Lettie coughs. “Six.” I cross out the five and write a six neatly next to it. I need to clean my fingernails. It’s funny how when you don’t look at someone you become more aware of their movement than when you’re looking straight at them. I can feel Lettie breathing.

“On a scale from one to nine, one being no distress and nine being extreme distress, how would you rate the emotional distress you experience caused by the amount of things you acquire that you are unable to get rid of and/or the clutter in your home?”

She’s quiet. But I don’t look up. I sit, pen hovering over the paper, focus on the question mark and wait. My ear itches. I ignore it.

“Eight.” Her voice is quiet. I write it down, gently looping the top and bottom of the number. Going over it again to make it darker. The last question’s waiting.

“On a scale from one to nine, how would you currently rate the negative effects on your life (financial, social and family relationships; employment or study; daily routine, etc.) caused by clutter and/or your need to acquire and/or the difficulty you experience in discarding things?” Does Lettie have family? I flick a glance at her. She is staring at her hands clasped in her lap, the fingers squeezing through each other like desperate worms. The fingertips are dark pink but the nails are white.

She takes a deep breath. “Nine.” The answer’s so quiet I wonder if I willed my ears to hear something that’s not there. Nine would be bad. It can’t be nine. It would be obvious if her life was a nine. I think of you. I think of me since you’ve been gone. I write down the nine.

I read the wording under the questions.

“So? How’d I do?” Lettie’s voice sounds dusty.

I don’t want to answer.

“Well? Spit it out. I’m not made of porcelain.”

My tongue’s heavy. “Scoring indicating clinically significant hoarding . . .”

“Well? Get on with it.”

I look at her answers: seven, seven, six, eight, nine. “A score of four or above for questions one, two and three, in addition to a score of four or above for question four and/or question five.”

Lettie sits back. I don’t know where to look, so I look at her feet. Her shoes look comfortable, even though I can see the shape of her toes through the sides of them.

“Well. I’m stuffed, then.”