After living in Israel, upstate New York and Berkeley, Myra Sherman now lives and writes in Lake County, California. She received a Master’s in Social Welfare from The University of California, Berkeley and is a licensed clinical social worker in California. Her story collection, JAILED, is forthcoming from Desperanto Press. More about her other writing and contact information can be found at myrasherman.com

From Eros to Thanatos (April 20, 2011. Issue 27.)

Perla knocks and takes the seat by my desk. The sign on my door says Steve Peters PhD, I shouldn't be attracted to her, tell myself I'm not. Her clingy metallic skirt rides up when she crosses her legs. I don't know if she dressed up for her last day in the program, or has a big Friday night date. Well maybe not a date, she's married, but then again her cop husband sounds like a jerk, so she could be stepping out.

"I got these," she says, pointing to a purple canvas tote with the motto Live Well in pink script. The bag's stuffed with pamphlets and books from the Health Education Center—Coping with Depression, Sleep Hygiene, Mindfulness Meditation in Everyday Life. "I wanted to make sure I have everything, for when I won't be here."

Seductive clothes, vanilla-musk perfume, sitting close enough to touch her chocolate hair, lick that crème caramel skin. Shit, I don't know what the fuck I'm thinking, what's wrong with me. Patients are off limits. She's not even my type. Both my ex-wives are thin freckled blondes.

I swallow the lump in my throat, shift in my chair. "You look nice," I say. "Going out later?"

Perla laughs and flushes, covers her cleavage with her left hand. Her long red nails look freshly manicured. The diamonds on her wedding set sparkle. "Hubby's taking me for my birthday," she says.

"Feel good about graduating, moving on?" I ask.

"I'm a little afraid, on my own after being here everyday. The three months went so quick."

"You've done really well."

"Still…"

"There's Transition on Tuesdays."

"That's your group? I want to be with you."

I imagine the two of us naked. Her fleshy bubble butt and full breasts, the gold belly ring I noticed the day she wore low-slung jeans. Me with a paunch and thinning hair, twice her age, knowing she wouldn't look at me if I wasn't her therapist and the director of the day program she's just finished.

"I want to be in your follow-up group," Perla says.

Of course she does. She's the patient. I'm the doctor. I'm a damn fool.

Perla waves as she walks out the door. My work week is over. No professional role to hide behind, no diversion, another Friday night alone. There's the Chili's a block away, happy hour drinks and fried snacks, young hopeful gals straight from the office, the chance for drunken sex, flesh meets flesh, the beast with two backs, the quick desperate get away from the studio apartment or dilapidated house with three roommates.

But I'm too old for that kind of shit. I'll be fifty in a few weeks, the age where if you don't take care of yourself you never get it back. No, it's the gym for me. A good workout, some takeout Thai, Netflix, unless that pretty lady with the long pigtail is at the gym, maybe invite her for a drink, maybe, maybe nothing.

24 Hour Fitness is crowded. My pretty lady isn't there. Except for the sagging septuagenarian I'm the oldest guy in the gym. With Springsteen on my IPod I do twenty minutes on the elliptical, twenty on the treadmill, go to the weight room. The music doesn't stop me from thinking about Perla. For months she was just another patient, prettier than most, not as sick as some, a depressed girl unhappy with her husband and her life, until today when I looked at her and wanted her and knew all I had to do was… Fuck and double-fuck, I'm losing it big time. Like some horny teenager and not a middle-aged psychologist, who's supposed to follow a code of ethics and it's not like I'm even that attracted to Perla, more like my fantasies are a symptom, which doesn't make anything better, maybe even worse, because how the hell did I let myself get so miserable and screwed up. Concentrate on what you're doing old man. Triceps, triceps, count reps, breathe.

I'm wiping sweat off my face when I sense someone behind me. Her blurred mirrored reflection shows a tall woman in black lycra with a messy mass of curly red hair and sharp features.

The woman smiles. "Remember me, Alida? When I volunteered at the State Hospital you did the trainings."

My gut clenches. I'm sweating like a pig.

"Were you afraid?" I don't know what I'm asking, don't recognize my croaking voice.

"Nothing to fear, but fear itself," she shrills.

"JFK?"

"FDR."

I'm out of body, seeing the puffy red-faced man in a U2 tee and the wiry woman who's nothing like Perla but just as sexy, who comes close and tears off her top, bares her chest, small breasts, rosebud nipples against my back, hands over my lips, bending over me, licking the sweat off my neck, kissing my eyes, massaging my sore muscles, the two of us rolling on the gym floor, naked asses, pumping rhythm, pounding away, pounding.

"Mister, you okay?"

I see Maryanne, my long-ago patient, glittering eyes dulled.

"Somebody call a doctor or something."

Hear her final scream.

"Get the manager."

Feel afraid.

"Fucking idiots, call 911. The dude's croaking."

I come to in the Emergency Room, lying on a gurney with an IV in my arm and an oxygen mask over my face. I remember being in the gym, doing triceps, the woman in black, thinking of Maryanne. I've never been a patient before. I'm embarrassed, afraid of seeing someone I know. The psych clinic is adjacent to the hospital, part of the same HMO. I know the medical staff, go to the same meetings.

"Feeling better?"

The nurse feels my pulse, takes my blood pressure.

"What happened?"

The nurse walks away without answering.

My eyes feel heavy, my head hurts. The clock on the wall says 7:30 PM, just three hours since I sat in my office with Perla.

The next thing I know an hour's gone by and the ER doc is bending over my chest, listening with a stethoscope. His breath smells like coffee. His eyes are bloodshot. He tells me I collapsed at the gym, that I was incoherent. When I ask what the problem is he talks about tests. The tPA injection to thin my blood, the differential diagnosis of TIA, the EKG and CAT scan.

The tests take hours. By the time they're done I'm feeling better, anxious to leave. Whatever's wrong with me is past the emergency stage. Being a patient in the ER, the one in the bed, makes me think of dying, especially after the geezer in the next alcove codes and the HERT comes running, but for all their work the guy does a death rattle that's enough to scare the shit out of you and croaks anyway.

Then as if I wasn't feeling bad enough the on-call psychiatrist who comes for a 5150 is Bette Silverstein, who stares at me like she's seeing a ghost. When I wave she turns red and looks away. Like being a patient changes who I am, and we didn't see each all the time, and in fact even split an Angelo's pesto pizza for lunch earlier in the day.

The ER doc finally comes back. "We're admitting you," he says.

"I'd rather go home," I say.

"I'm afraid that won't be possible," he says.

Anything's possible I want to shout, haven't you heard of outpatient follow-up, signing out AMA, just plain leaving and saying the fuck to all of you.

"What's the diagnosis?" I ask.

"A neurologist will talk to you," the ER doc says.

I immediately go to panic zone, thinking of brain tumors and strokes, wondering what my chances are, if I could end up dying. In six hours I've gone from fantasies about sex to fearing death. From Eros to Thanatos, to use Freud's jargon, which I never bought into, but now can't stop thinking of.

"Got someone to call?" the orderly who wheels me to a medical floor asks.

I'm still on the gurney, holding a plastic bag with my clothes and possessions.

"Not really," I say. My mind's racing, wondering what he knows that I don't. If the ward he's taking me to is for terminal patients.

"Better to have a family member take your valuables," he says.

The hospital room is wedge-shaped and small. The TV on the wall is tuned to Letterman but the sound's muted. If there's a remote I don't see it. A nurse is standing at the side of my bed. The blonde pony-tailed neurologist is at the foot. She reminds me of my first wife, when she was young, when we were happy.

"We'll keep you a few days," the neurologist says. "Better conservative than sorry. Mini-strokes are serious. Think of it like angina, a warning that worse could come."

"You're certain that's it?"

My voice sounds hollow, like I'm talking in a tunnel. The neurologist is talking too fast, her voice rises after each sentence. Listening to her, the generational differences in speech patterns that defines everyone under forty, makes me feel old. I remember how my father used to get on me for slurring sentences and using slang, my father, who died of a stroke at fifty-four. His funeral was a nightmare. The cliché rainstorm and muddy cemetery, my mother crying and clutching the closed casket.

"Family history, hypertension…I'm ordering an MRI, just to be sure."

"What are the odds of a real stroke?"

"Ten per cent have a stroke within ninety days, one-half within the first two days. But don't worry. I'm here for the weekend. Then you'll be working with Dr. Pope. We'll take good care of you."

I want to tell her to fuck off and get me a grownup doctor. I want to run out of the room. When the night nurse comes to check on me and calls me sweetie I feel like screaming.

"You want something to help you sleep?" she asks.

"No sedatives. I'm fine."

But as the night drags on, as hours pass and I can't sleep I wish I'd taken the Ativan or whatever the nurse had in that little paper cup. When I finally call her she says it's too late, almost dayshift, and they don't want me drugged in case I need more tests.

I'm counting breaths, trying to relax myself into sleep when I think of Maryanne, who never took sleeping pills, who died thinking her life was wasted.

I was an intern then, on a two week rotation in oncology. The terminal patients were beyond surgery, chemo or radiation. I was supposed to talk to them, to help with the emotional work of dying.

Most of the patients didn't want to be bothered. They had their families, their hope, their real doctors. Only Maryanne wanted to see me. She was thirty-two, five years older than me. Emaciated and bald, her teeth lost to radiation, her skin yellowed from liver failure. She had a peculiar sweet smell, like fermenting fruit.

"I had sex the first time when I was thirteen," she told me the first day. "An older man while I was hitchhiking, I let him just two blocks from my house in his car, on a side street. When I got home my family was barbequing in the backyard. I got yelled at for being late. I got yelled at for being rude. I wanted to tell my parents what I'd done but didn't. I never told them."

"I got pregnant when I was seventeen," she told me the next time. "The guy wouldn't marry me and I wasn't sure I wanted to anyway. My parents put me in a home for unwed mothers, probably the last of its kind, I was there for six months. I had a baby girl and gave her up for adoption without ever seeing her."

On the third day, "I've been married and divorced three times, but I've never been in love. I spent my time doing work I hated, trying to discover what I wanted and thinking I was trapped. My life has been a miserable waste."

On the fourth day, "I'm not a person to you. Not a woman. You look at me and see a living corpse. The way you talk down to me, like I'm an imbecile. You're no help. I don't know what you're doing here."

"I'm sorry," I said.

"You're sorry? Wait until it's your turn. You think dying is a game? You don't know anything. Wait…"

Maryanne didn't want sleeping pills because she was dying. She wanted to experience every minute, no matter how bad. At the time I wondered why she told me about having sex, giving up her baby, not finding love. It didn't seem she'd care anymore. I even thought she was trying to shock me. I didn't understand.

The next morning I have the MRI. I'm scared shitless, entering the chamber naked in a hospital gown, a faceless patient who wants to cry but doesn't. When the coils that create the magnetic field turn on the loud thumping and humming is a mental jackhammer, an assault to my brain.

In the darkness with my eyes closed I imagine a winged white-gowned Maryanne floating over my body, like Emma Thompson in Angels in America. Your turn, she yells with each tap of the coils.

When the chamber opens and I get off the pallet I'm shaking.

"You did real well," the technician said. "Kept so still and quiet. Good job."

See how it feels, Maryanne laughs.

As bad as the weekend was, the endless hours of nothing, waiting and waiting, Monday is worse. With the hospital fully staffed I keep seeing people I know. The phlebotomist was my patient, referred by EAP after a suicide attempt. The housekeeper was in my couples group. I know Margie, the nurse-supervisor, from the interdisciplinary meetings where we're the only non-MDs. They all say hello but don't make eye contact. They're uncomfortable, I'm mortified. Especially when the housekeeper, with her cheating husband and ungrateful kids, who never spent a day she didn't have a reason to cry, says I need to keep my spirits up. "You just gotta put a smile on," she tells me as she empties the trash.

The neurologist comes during afternoon visiting hours. Not that I have visitors but I hear the announcement, the footsteps, people laughing and talking in nearby rooms, hear enough to feel sorry for myself, stuck in a hospital bed with no one to care.

"Nothing to be concerned about," Dr. Pope says. "Regular follow-up, blood pressure checks, reasonable life style, you'll do fine."

"The other neurologist said it could be a sign of worse to come."

"The high risk period is over. I'd say you're out of the woods, providing you take care of yourself."

"Can I go home today?'

"Don't see why not."

"And return to work?"

"Next week. The nurse will have your discharge instructions."

Two hours later, I'm in my own clothes, sitting in a wheelchair as an aide wheels me to the lobby.

Later that night I go out for a drink. I don't want to be alone. Don't want to be sick. The double Glenlivit makes me sleepy. There's an attractive single woman at the other end of the bar but the thought of approaching her makes me tired. I feel too old for women, for sex, for life. Remembering how I fantasized about Perla makes me uneasy. Remembering my delusions about the woman at the gym scares me.

I've never just stayed home without rushing away on vacation. Places with people and things to do, like Tahoe or Cabo, where I can lose myself in the crowd. Pacing around the condo, without my job to hide behind, is an ass-kicker. No friends, no hobbies, the proverbial loser, empty life, lonely man. I go to the grocery store, cook myself a rib-eye dinner. Decide to fix up the second bedroom I use for storage. Sorting through the junk is exhausting. Dealing with empty packaging, old computers, clothes that don't fit, the guitar I gave up years ago, remnants of my sorry life. I go shopping, buy a sofa bed and desk, pretend I'm not stressed and everything is normal.

Going back to work should be a relief, but isn't. I feel stripped of empathy, burdened by negativity. I'm uncomfortable when my patients ask how I am. I turn the conversation to their problems, their feelings, pretend I care.

After my morning appointments I go to the hospital for a meeting. Being there brings everything back, the assault to my integrity, the fear. I'm already shaky when I see Perla by the elevators.

"Dr. Peters," she yells. "Wait up."

Perla's dressed in cargos and a t­-shirt, her hair pulled back. I'm not attracted to her, which is good, but worrisome. I've heard of heart patients losing their libido, never thought it would happen to me.

"I'm sorry you were sick last week," she says. "I missed you in group. But the other doctor did a good job."

When I ask if she's visiting somebody she beams.

"You'll never guess," she says. "I've been to OB. I'm pregnant, six weeks."

Looking at Perla, her smiling face, I suddenly think of Maryanne. Maybe she and Perla will always be joined in mind, reminders of my hospitalization, my fears.

I remember a day near the end, when Maryanne seemed desperate and for the first time afraid. "Will you remember me?" she asked. When she smiled her cracked lips started bleeding. I patted her lips with a tissue.

"I'm glad you're better," Perla says. "You're the best shrink I ever had."

I can't say she doesn't make me feel good. Especially when I notice her clingy top, her breasts, which might be a tad inappropriate but feels like a step to normality.

As I walk away I wonder what Maryanne looked like before she got sick. Imagine her vibrant and sexy, a woman who loved her life. I don't want to keep thinking of her, but can't stop.