Introduction

Kai Ingersohn was motivated to become a psychiatrist after a childhood of dysfunction with her tempestuous and manic-depressive grandmother, Dumpling. Now divorced, in private practice, and raising two teenagers, she starts work with Stephanie, a young grad student with acute leukemia, who has returned to Charleston and its mystic healing waters and marsh to fight for her life. Stephanie braves the revelations of shocking family secrets, while Kai seeks peace with her own past as the therapy unfolds. Both women emerge with new capacities for love, life, and spiritual truths. This is a powerful work from a novelist whose story reflects her real-life experiences as a psychiatrist in Charleston. Set against a lush Lowcountry backdrop of Spanish moss, salt marshes, silent oaks, and the pounding sea, The Hours Between Us is an artful exploration of the heartbreaking struggles and unbreakable spirits of two extraordinary women.

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Excerpt

My first impression of Stephanie was that she was a caged tigress, relentlessly pacing the confines of my small waiting room. As I walked into the secretarial reception area to speak to Sarah about a prescription call to a pharmacy, I glanced up through the small sliding glass window to the waiting room and saw her. She was tall and thin, moving with a feline grace that couldn’t conceal a tightly confined, almost frenetic energy within. She wore a light blue warm-up suit and white tennis shoes, their winged symbol splashed across the jacket’s pocket and sides of the shoes. Her long, blond hair was pulled into a ponytail and laced through the back of a white baseball cap with the matching Nike logo front and center. She was alone in the waiting area. It was five o’clock and she was my last patient of the day. She had asked for a two-hour session and I had conceded to ninety minutes, which was the ideal time for an evaluation.

As my gaze lingered, she turned presciently and our eyes locked. She strode to the window and motioned Sarah to open it, her bright green eyes holding mine.

“Dr. Ingersohn,” it almost sounded like a challenge. “Yes,” I replied. “Stephanie?”

“The one and only,” and we both smiled.

Her beauty was radiant, natural. She wore no makeup. Freckles sprinkled across her nose and high-boned cheeks saved her from perfection. She certainly didn’t look like she had almost died several weeks ago.

“I’ll be with you in a moment,” I spoke reassuringly and turned back to Sarah for final instructions.

I experienced a small feeling of anticipation as I walked back into the hallway leading to the waiting room door.

When Stephanie entered my inner office, she stood in the middle of the room and inspected it like a prospective buyer. I waited in the doorway for her to finish her appraisal. Most patients head for the peach loveseat along the wall to the left of the doorway, or one of the pale green wing chairs flanking the single window on the other wall. French doors stood at the end of the room and opened onto a deck. Above the doors was a large, lighted exit sign, a strict requirement of the Charleston County Fire Department. Its large red lettering certainly marked the way out in case of an emergency. I always considered it a rude contrast to the soft and tranquil décor.

Stephanie turned to face the light flooding in through the French doors.

“Doesn’t look like what I envisioned for a psychiatrist’s office,” she said. “I like the light. I’m not sure I could have stayed if it had been dark in here.”

“Do you feel you can stay, then?” I asked.

She looked over her shoulder at me without answering and stepped closer to a large painting over the loveseat. It was a still life of a fine porcelain pitcher filled with pale pink blooming azaleas, with matching antique tea cups and saucers set on a round, white, chipped wooden table. She stared at it intently. “Does this painting have a name?” she asked softly.

“It’s called, ‘My Mother’s House is a Fragile Place’.” “Did one of your patients paint it for you?”?I was surprised that she would ask that. “Yes. She painted it for me in response to the work we had done together. We traded her therapy for it.”

When patients sat on the loveseat, the painting was a backdrop that always reminded me of the incredible journey of the artist, a former patient who progressed from alcoholism and depression back to creative freedom and wellness.

Stephanie continued to gaze at it. ?

“Is the painting speaking to you?” I asked.

“Did her mother love her?” She almost breathed the question.?

This time, I was shocked.

“No,” I replied. “Her mother’s fragility and wounds kept her from being able to love...even her daughter. That core wound was the primary focus of her therapy.”

Stephanie reached out and gently traced the outline of the cream-colored Victorian tea cup. Just at that moment, she stood in silhouette as the late afternoon sun streamed around her. It could have been a still frame of “now” reaching across some timeless divide between past brokenness and healing, from despair to hope. Stephanie broke the spell by turning around and plopping into the wing chair that happened to have my yellow writing pad in it.

“I’m sorry,” I said, “ that is my chair. I’m happy to offer you its twin, or the loveseat, or even the desk chair.” She laughed and moved to the matching chair kicking off her shoes. We both settled in and Stephanie tucked her long legs up under her.

“I guess Dr. Gellman told you about my problem.”

“Very briefly. He said you were assembling a team of specialists to help you with your treatment. He said you wanted to interview me as a prospective member of your team.” I said it with a hint of a smile.

“Your name came up from several sources. Dr. Gellman and my parents’ rector at Grace Episcopal spoke of you. They both called you Dr. Kai. I had lunch with the Right Reverend McKenna last week. He told me you were old friends from the annual Medicine and Ministry of the Whole Person conference. He seemed to think you might fit the bill of what I am looking for in a psychiatrist. The good reverend came to Grace Episcopal the year I went to Princeton, so I’ve only known him peripherally. My mother sent some of his sermons on tape to me when she feared for my salvation. She calls the Ivy League schools ‘dens of iniquity’. You know, all those years in the Episcopal Church have hardly dented the Catholic in her. Anyway, one of the sermons she sent last Easter was called ‘Eternal Life’, sort of based on Hans Küng’s book. You know any of Küng’s work?”

“Ironically, I was given one of his books by a patient last Christmas.” He had been diagnosed with Lou Gehrig’s disease and felt Küng’s writing helped him cope with his progressive debilitation and pending death.

“Did you read it?”

“I did. It’s deep. It covers medical, philosophical and theological aspects of actual death, dying and afterlife. Fascinating...and heavy!”

“Did Dr. Gellman tell you I’m in graduate school at the University of Chicago? This is what I am studying. I mean metaphysics and spiritual beliefs.”

I nodded that I knew she was in that field.

“I don’t profess to understand everything Küng says, but it challenges me to stay open and keep learning,” I responded. Stephanie looked piercingly at me. “ That’s what I need from you, Dr. Ingersohn. I need you to stay open and walk along with me. I want a straight, honest relationship with you.

When I ask you a question, I don’t want you to turn it around on me and say, ‘Now, how do you feel about that?’ We need a set of guidelines that work for me, so I took the liberty of writing some of them down.”

She reached into her blue backpack with the ever-present Nike/Mercury symbol, and pulled out a folded piece of white paper. She scanned it quickly, and then handed it over to me. It read:

1) We are equals. I defer to your training in medicine and psychiatry and you defer to my knowing my own truth.

2) No psychobabble. Straight talk only, and honesty. Always honesty.

3) You agree to share some of your life as I share mine. (I know this is different, but a must for me.)

4) No religious dogma. I will quit if you try to push religion down my throat. I’m pretty confused and angry with God. I think I still believe in God, but that’s all I can say right now.

5) Help me integrate my mind and emotions with my physical body and my spirituality.

6) Help me try to live.

I read her contract. It was obviously done on a computer, with lines at the bottom for both of us to sign.

I looked at Stephanie.

“We are equals and I will always respect your truth as preeminent,” I said. “That must always be at the core of therapy. That, and trust. We must both learn to trust each other. Without that, we won’t be able to work together.

As for number two, I may lapse into psychobabble. Just tell me when I do and I’ll try to use words that don’t block your understanding. And I will tell you when I think you are avoiding or being dishonest with either one of us.”

“Number three, I can share some of my life, particularly if I think it can help you. I have ups and downs just like everybody. But, you are here as the ‘patient.’ You’re not paying me to tell you my problems.”

“Stop right here, Doc,” she said. “I know you must have your problems. If I can’t see your problems, I won’t be able to trust you. If you come o like some know-it-all guru, I will just discredit you.”

“You may discredit me anyway, Stephanie. You sound like you’re fully capable of discrediting anybody you want to discredit. I’m not perfect. Please don’t ask me to be. If I say something or do something you don’t like, then you will need to tell me. Not just quit. So, may we add number seven to this contract— that we will honestly confront differences and decide together if one of us needs to quit therapy?”

“You mean you quit therapy with a patient?” she retorted. “I have,” I answered.?

“Like when?”?

I immediately thought of a case many years before when I could not continue therapy with a patient who had survived advanced ovarian cancer. I began telling the story to Stephanie, purposefully cloaking it.

“I had worked with her for a year, even bringing in her husband for couples work. She was committed to unhappiness. She had actually survived surgery and chemo for one of the most lethal cancers in existence and had been cured. But, she had no gratitude for it. She was angry, cruel and miserable, but not depressed, which her oncologist thought when he referred her to me years after the initial diagnosis. I had never had a patient, before or since, so committed to playing the role of victim. I tried everything, finally confronting what I saw. She admitted it. She came to therapy to complain and blame and saw no reason to fundamentally change. She hated her husband, but didn’t believe in divorce. She never had children and didn’t want them. She had no intention of returning to the work she had once enjoyed. She was ‘hostilely dependent’ on those who supported her, including her parents and siblings. Finally, I quit. We talked it out and she was able to leave by blaming me. And I had failed her by being unable to help her break out of the neurotic lock of blame, anger and judgment. Paradoxically, I would have failed myself just as much by being an ongoing repository for her venom with no hope of healing.”

The story seemed to give Stephanie a lift.?“You know, I think you are the right ‘shrink’ for me.”

“Because I can quit?”

“Because I think you’re strong enough for me. The last psychiatrist I saw in high school was a wimp. My mother made me go so she could tell him what he had to do to fix me, which meant making me do things her way.” Her lip almost curled as she was talking. “She even wanted me to take drugs to make me more compliant. That mealy- mouthed shrink tried to get me to take lithium. He gave everybody lithium, and, get this, he ultimately put her on it.” She laughed out loud at the memory, straightening her legs out in front of her and visibly relaxing. “So, can we sign the contract?”

“One more thing,” I interjected. “Number four, about religious dogma. Stephanie, it will never be my job to force you into any kind of boxes, psychological or spiritual. My job is to help you do your own healing – not only your body, but your heart, mind and spirit. To walk along with you and help you stay on the pathway, to be a guide.”

“So, you will be my guide in the dark,” she whispered.

Her words hung between us like a promise received. It was a good place to close. I switched gears back to the practical. “How often do you want to see me?”

“Every week for now,” Stephanie replied.

I wondered where in my crowded schedule I would find another hour a week. “I may have to work you into cancellations until a regular time opens up.”

“I only have time right now, and you will find time for me,” she said resolutely.

I underlined “No religious dogma” under item four of her contract, added item seven governing “quitting,” and signed my name to the bottom: Dr. Katherine Ann Ingersohn, Guide. Stephanie did the same, playfully adding Guide-ee alongside her name.

It was 6:45 p.m. and time to stop. Stephanie stood and reached up in a full body stretch, then bent over and put both hands at on the carpeted floor. I watched with envy as I could not remember the last time I had been that limber. She straightened, turned and shook my hand… view abbreviated excerpt only...

Discussion Questions

How do you think the main character's point of view is similar or different from the author's point of view or background?

What moral/ethical choices did the characters make? What did you think of those choices? How would you have chosen?

How does the setting of the book impact the story?

If you had to choose one lesson that the author was trying to teach us with this story, what would it be?

Do the characters seem real and believable? Can you relate to their
predicaments? To what extent do they remind you of yourself or someone you know?

How would you react if you were in the same situation?

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