The other part — the part that lived not in Irene’s kidney but in the place where she had learned not to trust her own pain — was slower, and it did not respond to surgery, and for that Martha found them a licensed adolescent and family therapist, and insisted, over Mark’s evident discomfort, that the work be done properly and with help.

Mark came to the sessions.

And in one of the early ones, he made the mistake Martha had half-expected him to make: he began, gently and plausibly, to build the case for himself.

He talked about the depression that had settled over him after the job loss.

He talked about the crushing weight of having been raised to be the provider, the shame of failing at it, the way that shame had made him someone he didn’t recognize.

It was not untrue, any of it.