“You callous bastard”, I heard myself shout. Then a little more sympathetically, I asked him to tell me how he felt. “It doesn’t matter if it sounds like a cheap nineteenth-century novel; it doesn’t have to be earth-shattering. Come on, Nat! At this moment I’m able to run intellectual rings round you. Are you always like this?”

He stared at the sky and eventually said he felt sorry for me, for all I had to put up with.

“I can handle that myself, Nat”, I replied. We laughed. Nat knows the suicide rate is highest amongst doctors, especially those who practice psychiatry or psychology. The analyst-patient relationship balances precariously; simultaneously both distanced and intimate. I believe that many of its faults lie with too rigid an adoption of the traditions laid down by the early pioneers.

I was glad to see that his physical wounds, at least, were healing. Nat was a little shocked at just how rapidly the dressings became lighter. Aware of his sensitivity to the passage of time, I asked him how old he felt.

“No age at all” he eventually uttered.

FRI DEC 21

It has now been one month since I first met Nat. I have declared him fit enough for light work, though I continue to sign for his sickness benefit to which, as his mother pointed out, he is entitled. I feel that Nat should be able to hold down a job, and that this would be very therapeutic, demonstrating his fitness.

Over these last four weeks Nat has shunned his friends, forcing his family to take phone calls. He never overcame a childhood aversion to telecommunications. He never answers the door. Inquisitive acquaintances are informed that “Nat is not at home at the moment”. He tells me that his peers are not true friends, but just people “you’re thrown together with at school”.

He insists that he is not pessimistic about relationships, but seeing as how he’s taken on such a reclusive lifestyle, significantly more sequestered to my mind than before his blow-up, it does not seem imminent that he will become involved. It certainly seems, at least from the outside, that Nat is still very fragile. Delicate.