“Any trouble sleeping? Or using the bathroom?”

She shook her head.

“How about food? Are you getting lots of good, healthy stuff?”

She brightened. “I like cucumber sandwiches!”

“Who doesn’t like a good cucumber sandwich?” He turned to me, beaming. “She’s perfect, Allison. I vote you keep her.” Then he lowered his voice and took my arm. “Let’s talk outside for just a minute.”

My heart stuttered. Had he seen the quiz I’d been working on? Had I done, or said, something to give myself away?

I handed Ellie the iPad and walked out into the hallway as a young woman, one of the medical students who assisted in the office, stepped in to keep an eye on the patient. “Do you like Broadway musicals?” I heard my daughter ask, as Dr. McCarthy steered me toward the window at the end of the hallway.

“I just wanted to hear how you were doing. Any questions? Any concerns?”

I tried to keep from making too much noise as I exhaled the breath I’d been holding. Maybe I’d picked Dr. McCarthy for shallow reasons—he was the first pediatrician we’d met with who hadn’t called me “Mom”—but he’d turned out to be a perfect choice. He listened when I talked, he never rushed me out of his office or dismissed any of my ridiculous new-parent questions as silly, and he provided a necessary balance between me, who was prone to panic, and Dave, who was the kind of guy who’d wrap duct tape around a broken leg and call it a job.

Dr. McCarthy put Ellie’s folder down on top of the radiator. “How’s the eczema?”

“We’re still using the cream, and we’re seeing Dr. Howard again next month.” Skin conditions, I’d learned, were one of the treats that went along with the sensitive child—that, and food allergies.

“And is school okay?” He paged through Ellie’s chart. “How was the adjustment from preschool to kindergarten?”

I grimaced, remembering the first day of school and Ellie clinging to my leg, weeping as if I were sending her into exile instead of a six-hour day at the highly regarded (and very expensive) Stonefield: A Learning Community. (In my head, I carried out an invisible rebellion by thinking of it as just the Stonefield School.) “She had a rough few weeks to start with. She’s doing fine now . . .” “Fine” was, perhaps, an exaggeration, but at least Ellie wasn’t weeping and doing her barnacle leg-lock at every drop-off. “She’s reading, which is great.”

He looked at her chart again. “How about the bad dreams?”

“They’ve gotten better. She still doesn’t like loud noises.” Or movies in theaters, or any place—like the paint-your-own-pottery shop or the library at storytime—where more than two or three people might be talking at once. I sighed. “It’s like she feels everything more than other kids.”

“And maybe she does,” he replied. “Like I said, though, most kids do grow out of it. By the time she’s ten she’ll be begging you for drum lessons.”

“It’s so hard,” I said. Then I shut my mouth. I hated how I sounded when I complained about Ellie, knowing that there were women who wanted to get pregnant and couldn’t, that there were children in the world with real, serious problems that went far beyond reacting badly to loud noises and the occasional rash. There were single mothers, women with far less money and far fewer resources than I had. Who was I, with my big house and my great job, to complain about anything?

Dr. McCarthy put his hand on my forearm and looked at me with such kindness that I found myself, absurdly, almost crying.

“So tell me. What are you doing to take care of yourself?”

I thought for a split second about lying, giving him some story about actually attending yoga classes instead of just paying for them, or how I was taking Pilates, when, in fact, all I had was a gift certificate from two birthdays ago languishing in my dresser drawer. Instead I said, “Nothing, really. There just isn’t time.”

He adjusted his stethoscope. “You’ve got to make time. It’s important. You know how they tell you on planes, in case of an emergency, the adults should put their oxygen masks on first? You’re not going to be any good to anyone if you’re not taking care of yourself.” His blue eyes, behind his glasses, looked so gentle, and his posture was relaxed, as if he had nowhere to go and nothing more pressing to do than stand there all afternoon and listen to my silly first-world problems. “Do you want to talk to someone?” I didn’t answer. I didn’t want to talk to someone. I wanted to talk to him. I wanted to go to his office—it was small but cozy, with cluttered bookshelves, and a desk stacked high with charts, and a comfortably worn leather couch against the wall. He’d offer me a seat and a cup of tea, and ask me what was wrong, what was really wrong, and I would tell him: about Dave, about Ellie, about my dad, about my mom. About the pills. I’d tuck myself under a blanket and take a nap while the volunteers kept Ellie amused in the waiting room and Dr. McCarthy came up with a plan for how to fix me.

Instead, I swallowed hard. “I’m okay,” I said, in a slightly hoarse voice, and I gave him a smile, the same one I’d given my mother on my way out of the taxi on my eighth birthday.

“Are you sure? I know how hard this part can be. Even if you can find twenty minutes a day to go for a walk, or just sit quietly . . .”

Twenty minutes. It didn’t sound like much. Not until I started thinking about work, and how time-consuming writing five blog posts a week turned out to be, and how on top of my paying job I’d volunteered to redesign the website for Stonefield’s annual silent auction. There were the mortgage payments, which still felt like an astonishing sum to part with each month, and the Examiner, where it was rumored there’d be another round of layoffs soon. There was the laundry that never got folded, the workouts that went undone, the organic vegetables that would rot and liquefy in the fridge because, after eight hours at my desk and another two hours of being screamed at by my daughter because she couldn’t find the one specific teddy bear she wanted among the half-dozen teddy bears she owned, I couldn’t handle finding a recipe and preparing a meal and washing the dishes when I was done. We lived on grab-and-heat meals from Wegmans, Chinese takeout, frozen pizzas, and, if I was feeling particularly guilty on a Sunday afternoon, some kind of casserole, for which I’d double the recipe and freeze a batch.

Dr. McCarthy tucked Ellie’s folder under his arm and looked down at the magazine in my hand. “Are you reading one of those ‘How to Be Better in Bed’ things?” he asked. I gave a weak smile and closed the magazine so he couldn’t see what I was really reading. This was craziness. I didn’t have a problem. I couldn’t.

He glanced over my head, at the clock on the wall. From behind the exam-room door, I could hear Ellie and the medical student singing “Castle on a Cloud.” “Nobody shouts or talks too loud . . . Not in my castle on a cloud.”

I gave him another smile. He gave my arm a final squeeze. “Take care of yourself,” he said, and then he was gone.

I pushed the magazine into the depths of my purse. I got Ellie into her clothes, smoothing out the seam of her socks, buttoning her dress, re-braiding her hair. I held her hand when we crossed the street, paid for parking, and then, before I drove southwest to Federal Donuts for the hot chocolate I’d promised my daughter, I reached for the Altoids tin in my purse.

No, I thought, and remembered the quiz. Have you ever planned not to use that day but done it anyway? What excuse did I have for taking pills?

Maybe my mother had been cold and inattentive . . . but it had been the 1970s, before “parent” became a verb, when mothers routinely stuck their toddlers in playpens while they mixed themselves a martini or lit a Virginia Slim. So I had a big house in the burbs. Wasn’t that what every woman was supposed to want? I had a job I was good at, a job I liked, even if it felt sometimes like the stress was unbearable; I had a lovely daughter, and, really, was being a little sensitive such a big deal? I was fine, I thought. Everything was fine. But even as I was thinking it, my fingers were opening the little box, locating the chalky white oval, and delivering it, like Communion, to the waiting space beneath my tongue. I heard the pill cracking between my teeth as I chewed, winced as the familiar bitterness flooded my mouth, and imagined as I started the car that I could feel the chemical sweetness untying my knotted muscles, slowing my heartbeat, silencing the endless monkey-chatter of my mind, letting my lungs expand enough for a deep breath.

At the corner of Sixth and Chestnut, I saw a woman on the sidewalk. Her face was red. Her feet bulged out of laceless sneakers, and there was a paper cup in her hands. Puckered lips worked against toothless gums. Her hands were dirty and swollen, her body wrapped in layers of sweaters and topped with a stained down coat. Behind her stood a shopping cart filled with trash bags. A little dog was perched on the topmost bag, curled up in a threadbare blue sweater.

Ellie slowly read each word of her sign out loud. “ ‘Homeless. Need help. God bless.’ Mommy, what is ‘homeless’?”

“It means she doesn’t have a place to live.” I was glad Dave wasn’t in the car. I could imagine his response: It means she doesn’t want to work to take care of herself, and thinks it’s someone else’s job to pay for what she needs. I’d known my husband was more conservative than I was when I married him, but, in the ten years since, it seemed like he’d decided that anything that went wrong in his life or anyone else’s was the liberals’ fault.