Chapter 26
AREK
The Monday of the last week of school started like every other Monday.
Alarm at six. Shower. Shave. Downstairs before the boys, coffee started, lunches assembled—turkey and Swiss for Jules, PB&J with the crusts cut off for Kace because Kace still liked his crusts cut off and I’d keep cutting them until he told me to stop.
Apple slices and a banana for both. Granola bars. Water bottles filled.
Breakfast. Kace was loud, Jules quiet, so it was the usual symphony.
Permission slips for the end-of-year field day were signed and in Jules’s backpack because if I gave them to Kace, they would magically vanish again.
Backpacks zipped, shoes on, teeth brushed—Kace needed reminding, Jules didn’t—and out the door at seven-thirty, the same time every morning, the machine running on schedule.
Four more days. Four more mornings of this, and then summer.
I stood in the kitchen after the boys left and looked at the lunch assembly station I’d built on the counter—the bread, the deli containers, the assembly-line layout that allowed me to make two lunches in under four minutes.
In five days, I wouldn’t need it. No lunches to pack.
No backpacks to check. No seven-forty-five deadline.
Just ten weeks of open, unscheduled, formless days stretching out ahead of me like a road with no lane markers.
I had two weeks off in July, but other than that, I’d still be working, and the boys would be on their own.
My hands were shaking. I noticed it clinically—fine motor tremor, bilateral, consistent with fatigue and elevated cortisol—as I put the bread away, wiped the counter, and told myself it was just coffee on an empty stomach.
I hadn’t eaten breakfast. I’d made the boys’ lunches, poured their cereal, reminded them about the permission slips, and I hadn’t eaten breakfast. The pattern was so familiar it didn’t even register as a pattern anymore.
Feed them first. Take care of them first. Make sure they have what they need and then, if there’s time, if there’s anything left, attend to yourself.
There was never anything left.
I ate a granola bar as I drove to the clinic, feeling slightly guilty about it thanks to Mac—a new experience.
The morning was warm, genuinely warm, the kind of early June heat that announced summer with authority.
School buses passed me going the other direction.
In four days, those buses would stop running and the streets would fill with bikes and skateboards and the loose, unstructured chaos of children with nowhere to be.
My chest tightened.
The clinic was full. Mondays were always full, but this Monday had the added pressure of people trying to get appointments in before summer vacations.
I saw my first patient at eight-fifteen—routine physical, straightforward, smile and handshake with the Dr. Jacobson show in full effect.
Second patient, a follow-up on blood pressure meds.
Third, a kid with allergies that were blooming with the warm weather.
The morning moved, and I moved with it, the rhythm carrying me the way it always did, the schedule telling me where to be, what to do, who to help.
Between patients, I answered six emails. I reviewed lab results for three patients and flagged one for follow-up. I ate half a granola bar standing up over the trash can and thought about Mac reminding me to eat an actual meal. Feeling guilty again, I put the other half in my coat pocket for later.
Fir passed me in the hall at eleven. “Lunch at noon?” he asked.
“I’ll grab something later.”
He gave me a look, seeing more than I wanted him to see. “Arek.”
“I’m fine, Fir. Just busy.”
The word. The word I’d promised to stop using. It came out smooth and automatic, the reflex of a man who’d been saying it so long the lie had calcified into something that felt like truth.
Fir looked at me for one second longer than necessary and went to see his next patient, and I went to see mine. The morning continued its relentless, structured, reassuring march toward noon.
At twelve-forty, I saw Mary King for a routine checkup she’d been postponing.
Her last labs had raised some concerns, and I was glad she’d come back in.
“Everything looks better, Mary,” I told her.
“Blood pressure’s still a little elevated, but your cholesterol levels have improved, and so has your A1C.
So keep doing what you’ve been doing, and let’s recheck in three months. ”
“Thank you, Dr. Jacobson.” She buttoned her cardigan and smiled. “Any big plans for the summer?”
The question was casual. Conversational. The kind of thing you said to your doctor while gathering your purse and heading for the door. A pleasantry. Nothing. “The boys are out of school on Friday,” I said. “So we’ll have a full house.”
“Oh, isn’t it wonderful? Ten whole weeks. My grandkids are coming in July, and I just can’t wait. There’s nothing like a house full of children in the summer, is there?”
Ten whole weeks.
The words landed on something that was already cracked, and the crack spread.
I smiled at Mary. I walked her to the door. I said something appropriate—“Enjoy your summer, see you in September”—and then I closed the exam room door behind her, stood holding the handle, and felt the floor tilt.
Ten weeks. No school bus at seven-thirty.
No lunches to make. No homework to supervise.
No permission slips, no library books, no seven-forty-five deadline.
No structure. No scaffolding. Just me and the boys and the long, bright, open days, and the question I’d been outrunning for months finally catching up: what do you do when there’s nothing left to do?
The tremor was back. Not just my hands this time—my arms, my chest, a vibration deep in my core that felt like something about to give way.
My heart rate was climbing. I could feel it, the physician in me noticing the symptoms with detached precision while the rest of me stood in an exam room and came apart.
Tachycardia. Diaphoresis. Tremor. Narrowing visual field. Textbook panic attack, Doctor. Physician, heal thyself.
Except I couldn’t. I couldn’t heal myself because I’d been trying to heal myself for years, for decades, filling every second with tasks, service, and usefulness, but the healing had never come, only the exhaustion.
And the exhaustion was here now, total and complete, and my legs weren’t working properly.
I sat on the exam table. The paper crinkled under me, the sound absurdly medical, absurdly normal.
I put my hands on my knees and tried to breathe.
Five things I could see: the blood pressure cuff, the hand sanitizer, the eye chart, the window, the ceiling.
Four things I could touch: the paper, my knees, my coat, the stethoscope around my neck.
The classic grounding technique. The one I’d used on patients but never on myself, and here I was, sitting on an exam table in my own clinic, clutching that mechanism for dear life.
Three things I could hear: the air conditioning, the muffled phone at reception, my own breathing, fast and shallow, not nearly as controlled as I wanted it to be.
The grounding helped. The panic receded from a roar to a hum. But what was underneath the panic—the bone-deep exhaustion, the emptiness, the gray, flat nothing where my energy used to be—that didn’t recede. That sat on my chest like a stone and didn’t move.
I don’t know how long I sat there. Long enough for my next appointment to pass. Long enough for Janine to knock once, twice, and then open the door.
“Dr. Jacobson? Your one-fifteen is—” She stopped. I don’t know what I looked like, but it was enough to make Janine, who had thirty years of medical reception under her belt and had seen everything, go quiet. “I’ll get Dr. Everett,” she said, and left.
Fir appeared in under a minute. He closed the door behind him, sat in the patient chair across from me, and didn’t say a word. He just looked at me with those steady, warm, unflinching eyes and waited.
“I can’t do this,” I said.
“Can’t do what?”
“Any of it. All of it. The summer. The boys home all day. No schedule, no structure… Ten weeks of me being responsible for everything without a framework to hang it on. And I know how that sounds. I know it sounds ridiculous. Every parent survives summer break, but I can’t—” My voice cracked.
The actual, physical crack of vocal cords failing, and the sound of it—the sound of my own competence breaking—was so foreign that it scared me more than the panic had.
“It doesn’t sound ridiculous,” Fir said.
“I’m a doctor, Fir. I help people with anxiety every day. I prescribe coping strategies and breathing exercises and I can’t even—”
“Arek.” Gentle. Firm. “Stop diagnosing yourself and tell me what you need.”
What I needed. The question Mac had asked me on the mountain the morning of the birthday call. What do you need? Not what do the boys need, not what do the patients need, not what does the clinic need. What do you need?
“I need to not be here right now,” I said, and the admission felt like falling.
Fir nodded. “I’ll cover your patients.” He pulled out his phone. “Who do I call?”
“Mac,” I said, and my voice broke again on the single syllable. “Call Mac.”
I don’t know what Fir said to him. I sat in my office with the door closed, my white coat hanging on the hook and my hands wrapped around a glass of water Fir had brought me, and I waited.
The water trembled in the glass from the shaking I couldn’t stop, tiny concentric circles radiating out from the center, a visual representation of the vibration that had taken up residence in my body.
Twenty-two minutes. That’s how long it took Mac to get from the mountain to the clinic parking lot. I knew because I watched the clock, and twenty-two minutes was fast, much faster than the drive should’ve been.
Then my door opened, and Mac was there.