Mary, can you tell me when you started having these feelings about the pen?

Mary and her husband Derek sat on the couch across from me in my office.

It was our first meeting.

It was clear to me that Mary had no interest in being here.

But that was nothing new for me.

Many of my patients don't think they need therapy.

It comes with the territory of being a psychiatrist.

I wouldn't know until later that nothing about Mary's case was normal.

Nothing was routine.

If I had known, maybe I could have done something to stop, what happened.

Mary gently held the cheap black pen in her cupped hands.

She made no attempt to answer my question.

She didn't even move her gaze from the pen. I wasn't sure she had even heard me.

Mary? Derek said. The doctor asked you a question.

Hmm? Mary said, looking up at her husband and then me.

An apologetic smile on her face.

I'm sorry, Dr. Johannes.

What was the question?

Please, Mary, call me Henry, I said.

I asked if you could tell me when you started having these feelings about the pen.

Oh, Mary said softly, still smiling, gazing back down at the writing utensil in her hands. I don't know. It seems like I've always adored this pen. In fact, it's more than just a pen, you know?

I don't know how you can't see that. Mary and Derek were in their late 30s.

...