"Read this! It's making me better!"

She's in her sixties. She lives alone. Her son lives on the East Coast. She sees him once a year.

One night she lies awake and thinks, I may live twenty more years. That means I may only see my son twenty more times...or less!

And soon, it's hard for her to think about anything else. She had felt so young before...or at least, not old. When did the future start shrinking?

So she brushes aside my questions about meds, mood ratings, and side effects. Not today, doctor! We're talking about how to live, how to get through this. She's thrusting a newspaper clipping into my hands. "Read this! This is helping me! I'm showing it to everyone!"

We read it together. It's the New York Times, quoting Joan Didion.

"I'm not telling you to make the world better, because I don't think that progress is necessarily part of the package," she said. "I'm just telling you to live in it. Not just to endure it, not just to suffer it, not just to pass through it, but to live in it. To look at it. To try to get the picture. To live recklessly. To take chances. To make your own work and take pride in it. To seize the moment. And if you ask me why you should bother to do that, I could tell you that the grave's a fine and private place, but none I think do there embrace. Nor do they sing there, or write, or argue, or see the tidal bore on the Amazon, or touch their children. And that's what there is to do and get it while you can and good luck at it."

My patient's eyes sparkle. "Do you know that Joan Didion uses her best silver every single day? She says that today is all we have!"