“This is where, in a case like Isabelle’s, things become most tricky. With other children, you help get at the why of things.”

“How?”

“You talk. You listen, and you talk. You discuss.”

Ruth feels her heart fall. This doctor, it seemed, was taking a new direction with things; now they seem back to square one—the only way for Isabelle to speak again is to speak about why she won’t.

“And the difficulty with Isabelle—”

“Is that she won’t speak,” Ruth interrupts. “She can’t talk, you can’t listen, the two of you can’t discuss.” She cannot hide the frustration in her voice.

“Exactly,” the doctor says. He sniffs. “And in the weeks or months preceding this silence, did you notice anything unusual? Could Isabelle have experienced some trauma? Was there anything that could have precipitated this? I’m sure you’ve been asked these questions over and over again, but I have to ask, you understand. Perhaps something will occur to you now that hasn’t before.”

Ruth sits back in her chair. She has been asked these questions, again and again. Isabelle’s silence had started as joylessness, in Ruth’s mind. She pictures Isabelle sitting among springtime bloom at the Conservatory Garden, blaming her watery eyes on allergies when she’d never in her life had allergies before. She thinks of Isabelle’s habit of retiring to her room before the sitter had arrived whenever Ruth and Wilson went out at night, leaving the puzzled teenager who’d come armed with cookie dough and games sitting in their living room as if alone. She remembers the time she scolded Isabelle for not saying thank you to the ice cream man at Russo’s, thinking her silence simply rudeness. Isabelle had cast her eyes downward, had let the ice cream melt down the sides of the cone before finally tipping it into a garbage can. Ruth had been so frustrated! If only she had paid better attention to these moments, these quirks. “Well,” she says. “There was no specific event that I can think of. That I know of.”

“But there could have been.”

“I suppose. But it was gradual. It wasn’t sudden.”

“What do you mean by gradual?”