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knew all the right answers. And, Rebecca here, well she was my isomer—”

«Your what?» asked Tony. He sat slouched out nearly horizontally in his seat.

«Isomermeans like a mirror image,” responded Bonnie.

«Isomerrefers to two chemical compounds,” pronounced Philip, «that have the

identical constituents in the same proportions but differ in properties because of the way

the atoms are arranged.»

«Thanks, Philip,” said Bonnie. «Maybe that was a pretentious word to use. But,

Tony, I want to say that I admire the way you`ve stuck to your resolution to signal every

time you don`t understand something. That meeting a couple of months ago when you

opened up about your shame about your education and your blue–collar work has really

given me permission to talk about some of my stuff. Okay, now back to my school days.

Rebecca was my absolute opposite, in every way—you name it. I would have died to

have a Rebecca as a friend—I would killed to havebeen a Rebecca. That`s what`s going

on in me. The last couple of weeks I`ve been flooded with memories of my nightmare

childhood.»

«That fat little girl went to school a long time ago,” said Julius. «What brings her

back now?»

«Well, that`s the hard part. I don`t want Rebecca to get angry with me...”

«Best to speak to her directly, Bonnie,” Julius interjected.

«Okay,” said Bonnie, and turning to face Rebecca. «I want to say something to

you, but I don`t want you to be angry with me.»

«I`m all ears,” said Rebecca, her attention fully fixed on Bonnie.

«When I see you operate with men here in the group—how you interest them, how

you entice them—I feel totally helpless. All those old bad feelings creep out: chubby,

insignificant, unpopular, outclassed.»

«Nietzsche,” interjected Philip, «once said something to the effect that when we

awake discouraged in the middle of the night, enemies that we had defeated long ago

come back to haunt us.»

Bonnie broke out into a big smile and turned toward Philip. «That`s a gift, Philip, a

very sweet gift. I don`t know why, but the idea of enemies I had once defeated rising

again makes me feel better. Just to have something named makes it more—”

«Wait a minute, Bonnie,” interrupted Rebecca, «I want to get back to my enticing

men here—explain, please.»

Bonnie`s pupils widened; she avoided Rebecca`s gaze. «It`s not about you. There`s

nothing you do that`s off—it`s all me, it`s my response to perfectly normal female

behavior.»

«What behavior? What are you talking about?»

Bonnie took a deep breath and said, «Preening. You preen. That`s the way it seems

to me. I don`t know how many times in the last meeting you had your barrettes out, your

hair down, flouncing your hair, running your fingers through it, but it was more times

than I can ever remember before. It`s got to be related to Philip`s entrance into the

group.»

«What are you talking about?» asked Rebecca.

«To quote the old sage, Saint Julius, a question ain`t a question if you know the

answer,” interrupted Tony.

«Why don`t you let Bonnie speak for herself, Tony?» said Rebecca, her eyes icy.

Tony was unfazed. «It`s obvious. Philip enters the group, and you change—you

change into a male...ah...what`s the right word?...you`re coming on to him. Do I got it

right, Bonnie?»

Bonnie nodded.

Rebecca reached in her purse for a tissue and dabbed at her eyes, carefully

protecting the mascara. «That`s really fucking insulting.»

«This is exactly where I don`t want it to go,” pleaded Bonnie. «This is not about

you, Rebecca—I keep saying that. You`re not doing anything wrong.»

«That doesn`t wash with me—making anen passant nasty accusation about my

behavior and then saying it`s not about me doesn`t make it less nasty.»

«En passant?» asked Tony.

«En passantmeans,” interjected Philip, «in passing—a common term in chess used

when the pawn takes two squares in its opening move and passes an opposing pawn.»

«Philip, you`re a show–off—you know that?» said Tony.

«You threw out a question. I answered it,” said Philip, entirely unaffected by

Tony`s confrontation. «Unlessyour question ain`t a question.»

«Ouch, you got me there.» Tony scanned the rest of the group and said, «I must be

gettin` dumber. I feel more out of it. Am I imagining it, or are there more big words

getting thrown out here? Maybe having Philip here is getting to others, too—not just

Rebecca.»

Julius intervened by using the group therapist`s most common and most effective

tactic—he switched the focus from content to process, that is, away from the words being

spoken to the nature of the relationship of the interacting parties. «Lots going on here

today. Maybe we can step back a minute and try to understand what`s happening. Let me

first put out this question to all of you: what do you see going on in the relationship

between Bonnie and Rebecca?»

«It`s a tough call,” said Stuart, who was always the first to respond to questions

thrown out by Julius. Using his professional/medical voice, he said, «I really cannot tell if

Bonnie has one agenda or two.»

«Meaning?» asked Bonnie.

«Meaning, what`s your agenda? Do you wish to talk about issues with men and

your competition with women? Or, do you wish to take a swipe at Rebecca?»

«I see it from both points of view,” said Gill. «I can see how this dredges up

Bonnie`s old bad memories. And then I can also see why Rebecca is upset—I mean she

may have not known she was fixing her hair—and personally I don`t think that`s such a

big issue.»

«You`re tactful, Gill, «said Stuart. «As usual you try to placate all parties,

especially the ladies. But you know if you get so deep into understanding the female

point of view, you`re never going to speak out in your own voice. That`s what Philip said

to you last week.»

«I resent these sexist comments, Stuart,” said Rebecca. «Frankly, a doctor should

know better. This ‘female point of view` talk is ridiculous.»

Bonnie held up her hands and made aT. «I`ve got to call ‘time out`—I just cannot

go on. This is important stuff, but it`s surreal; I cannot go on with it. How can we go on

with business as usual when Julius has just announced last week he is dying? This is my

fault: I should never have started this topic today about me and Rebecca—it`s too trivial.

Everything`s trivial in comparison.»

Silence. Everyone looked down. Bonnie broke the silence.

«I want to back up. The way I should have started this meeting was to describe a

dream, a nightmare, I had after the last group. I think it involves you, Julius.»

«Go,” urged Julius.

«It was night. I was in a dark train station—”

Julius interrupted, «Try using the present tense, Bonnie.»

«I should know that by now. Okay—it`s night. I`m in a dark train station. I`m

trying to catch a train that`s just beginning to move. I walk faster to get on. I see the

dining car pass by filled with well–dressed people eating and sipping wine. I`m not sure

where to board. Now the train starts to move faster, and the last cars get shabbier and

shabbier, with their windows boarded up. The final car, the caboose, is just a skeleton car,

all falling apart, and I see it pull away from me and I hear the train whistle so loud it

wakes me about fourA.M. My heart was pounding, I was soaked with sweat, and I never

did get back to sleep last night.»

«Do you still see that train?» asked Julius.

«Clear as can be. Moving away down the track. The dream is still scary. Eerie.»

«You know what I think?» said Tony. «I think the train`s the group and that

Julius`s illness will make it fall apart.»

«Right on,” said Stuart, «the train`s the group—it takes you somewhere, and it

feeds you along the way—you know, the folks in the dining car.»

«Yeah, but why couldn`t you get on? Did you run?» asked Rebecca.

«I didn`t run; it was like I knew I couldn`t board.»

«Strange. Like you wanted to board, but at the same time you didn`t want to,” said

Rebecca.

«I sure didn`t try hard to board.»

«Maybe you were too scared to board?» asked Gill.

«Did I tell you all that I was in love?» said Julius.

A hush fell upon the group. Dead silence. Julius looked around, mischievously, at

the puzzled and concerned faces.

«Yes, in love with this group, especially when it works like it`s working today.

Great stuff, the way you`re working on that dream. You guys are something. Let me add

my guess—I`m wondering, Bonnie, if that train isn`t a symbol for me as well. That train

reeked of dread and darkness. And, as Stuart said, it offers nourishment. I try to do that.

But you`re frightened of it—as you must be frightened of me or what`s happening to me.

And that last car, the skeletonlike caboose: isn`t that a symbol, a prevision, of my

deterioration?»

Bonnie stammered, got tissues from the box in the middle of the room, and wiped

her eyes, «I...uh...I...I don`t know how to answer—this whole thing is surreal.... Julius,

you floor me, you knock me out the way you talk about dying so matter–of–factly.»

«We`re all dying, Bonnie. I just know my parameters better than the rest of you,”

said Julius.

«That`s what I mean, Julius. I always love your flippancy, but now, in this

situation, it kind of avoids things. I remember once—it was during that time that Tony

was doing weekend jail time and we weren`t talking about it—that you said if something

big in the group is being ignored, then nothing else of importance gets talked about

either.»

«Two things,” said Rebecca. «First, Bonnie, wewere talking about something

important just now—several important things—and, second, my God, what do you want

Julius to do? Heis talking about this.»

«In fact,” said Tony, «he even got pissed that we heard it from Philip rather than

from him personally.»

«I agree,” said Stuart. «So Bonnie, whatdo you want from him? He`s handling it.

He said he`s got his own support network to help him deal with it.»

Julius broke it off—it had gone far enough. «You know, I appreciate all this

support from you guys, but when it`s this strong then I begin to worry. Maybe I`m getting

loose, but do you know when Lou Gehrig decided to retire? It happened one game when

everyone on the team gushed compliments about how he fielded a routine ground ball.

Maybe you`re considering me too fragile to speak for myself.»

«So, where do we go with this?» said Stuart.

«First, let me say to you, Bonnie, that you`re showing a lot of guts by jumping in

and naming the thing that`s too hot to touch. What`s more, you`re absolutely right: I have

been encouraging some...no,a lot of denial here.

«I`m going to make a short speech and lay it all out for you. I`ve had some

sleepless nights lately and a lot of time to think about everything, including what to do

about my patients and this group. I haven`t had any practice at this. No one practices

endings. They only happen once. No textbooks are written about this situation—so

everything is improvisation.

«I`m faced with deciding about what to do with the time I have left. Look, what are

my options? Terminate all my patients and end this group? I`m not ready to do that—I`ve

got at least a year of good health, and my work means too much to me. And I get a lot out

of it for myself. Stopping all my work would be to treat myself as a pariah. I`ve seen too

many patients with fatal illness who`ve told me that the isolation accompanying their

illness is the worst part of all.

«And the isolation is a dual isolation: first, the very sick person isolates himself

because he doesn`t want to drag others down into his despair—and I can tell you for a

fact that`s one of my concerns here—and, second, others avoid him either because they

don`t know how to talk to him or because they want nothing to do with death.

«So, withdrawing from you is not a good option for me and, what`s more, I don`t

believe for you either. I`ve seen a lot of terminally ill people who underwent change,

grew wiser, riper, and had a great deal to teach others. I think that`s already starting to

happen to me, and I`m convinced that I`ll have a lot to offer you in the next few months.

But if we`re to keep working together, you may have to face a lot of anxiety. You`ll not

only have to face my approaching death, but you may be confronted with your own. End

of speech. Maybe you all have to sleep on this and see what you want to do.»

«I don`t need to sleep on it,” said Bonnie. «I love this group and you and everyone

in it, and I want to work here as long as possible.»

After members echoed Bonnie`s affirmation, Julius said, «I appreciate the vote of

confidence. But group therapy 101 underscores the daunting power of group pressure. It`s

hard to buck group consensus in public. It would take superhuman resolve for any of you

to say today, ‘Sorry, Julius, but this is too much for me, and I`d rather find a healthy

therapist, someone hale enough to take care of me.`

«So, no commitments today. Let`s just stay open and keep evaluating our own

work and see how everyone feels in a few weeks. One big danger which Bonnie

expressed today is that your problems start to feel too inconsequential to discuss. So we

have to figure out the best way for me to keep you working on your own issues.»

«I think you`re doing it, «said Stuart, «by just keeping us informed.»

«Okay. Thanks, that helps. Now let`s go back to you guys.»

A long silence.

«So, maybe I haven`t liberated you. Let me try something. Can you, Stuart, or

others, lay out our agenda, what`s here on the table—what are the open issues today?»

Stuart was the informal group historian: he was blessed with such a retentive

memory that Julius could always call on him for an account of past or present group

events. He tried not to overuse Stuart, who was in the group to learn how to engage

others, not to be a recorder of events. Wonderful with his child patients, Stuart was

socially at a loss whenever he left the perimeter of his pediatrician role. Even in the group

he often carried some of the accoutrements of the trade stuffed in his shirt pocket: tongue

depressors, penlight, lollipops, medication samples. A stable force in the group for the

past year, Stuart had made enormous progress in, as he had put it, «project

humanization.» Yet interpersonal sensitivity was still so undeveloped that his recounting

of group events was entirely without guile.

Leaning back in his chair, he closed his eyes before responding. «Well, let`s see—

we began with Bonnie and her desire to talk about her childhood.» Bonnie had been

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