What did I know at the time? I was eighteen when I chose my path. All the girls I grew up with on Long Island were doing the same, becoming nurses, teachers. Pink collar jobs, they call them now. I don’t know if my job at Bellevue was in the same league, though. I spent most of my days restraining patients and hooking them up to Ativan drips. Nothing about the job felt particularly pink.
I first learned about psychoanalysis from Dr. Kestenbaum. He came to Bellevue from Brown for his psych residency. Always so gentle, but still effective with the patients, even the wildest ones, whom no one on staff could tame, not even the most grizzled of career nurses—the ones who came from Riker’s and were used to handling the criminally insane. Dr. Kestenbaum—Drew, he told me to call him—would somehow get through to them. I’d come in with the benzos, then he’d come in with his sweet demeanor, his expert bedside manner, and patients would soften. The most standoffish, terrifying individuals, like putty in his hands.
Drew was a consummate professional and never made a move on me, though sometimes I suspected he wanted to. I would’ve been happy if he had. Would’ve reciprocated, gladly. I’m sort of relieved he never did, though. Instead, he left the memory of him completely untarnished. Ours remained a cerebral connection.
He brought me to Freud and Jung. Gave me his own tattered copy of The Interpretation of Dreams. Saw potential in me. Thought I might go to med school. Follow in his footsteps. I fell in love with the analysis of it all. I liked books and theory more than I liked medicine. Preferred the art of what we did to the science.
Drew finished residency and accepted a fellowship at Stanford. Bellevue wasn’t the same without him. It felt empty, pushing meds every day without him in the trenches. Looking back on it now, maybe I’d fallen in love with him, but I never truly let myself indulge in the thought.
It was the fall after he left for Palo Alto that I applied to study at the psychoanalytic institute. He wrote me a letter of recommendation, which I never got to read. All I could do was imagine what he said.
____
The institute was housed in an old vine covered brick building on the Upper West Side. It smelled like fresh brewed coffee and tobacco inside. Each room was covered in dusty Turkish rugs and comfy old furniture—worn in leather couches and deep, cushy armchairs where generations of analysts had sat throughout their training. There was a grumpy old cat named Herbert who lurked from room to room, hissing at anyone who tried to pet him.
For six years I studied to become an analyst. Classes were held at night and I still worked per diem at the hospital, dreaming of the day I’d graduate and could finally start building my own practice. I would make it mine. Trade in psychotic patients in need of sedation for neurotic housewives and Columbia professors in need of an uninterrupted fifty minutes of monologuing. I was ready to swap my scrubs for Eileen Fisher cardigans, to build out a lucrative practice in an old post-war building. I’d offer my clients organic peppermint tea and, after they’d left, read Philip Roth and Elena Ferrante. I could see it so clearly.
The vision of that life pulled me through draining shifts at Bellevue followed by late nights studying. Long subway rides home from the institute to Bay Ridge, where I rented a basement level studio apartment from an older Italian couple whose kids had grown up and long since moved away. On my long commutes, I’d dream about the day that I owned my own brownstone, just down the block from my office. I was married, in the fantasy, to a man who was well-read and charismatic. Maybe a Columbia professor, like the ones I imagined I’d be seeing in my practice. Or maybe a doctor. When I thought long and hard about his face, he always ended up looking just like Drew.
When I finally graduated, my family took the LIRR into the city for the day and we got spaghetti dinner at Carmine’s. They couldn’t quite understand what I’d been up to for the last six years and why, after all that time, money, and effort, I didn’t have the letters “MD” or “PhD” after my name. Still, they were proud of me. My parents gave me a Hallmark card with a crisp $100 bill inside. I put in my two weeks’ notice at Bellevue; the other nurses decorated the break room and brought in cupcakes and brownies. I cried happy tears as I walked out the front doors and onto First Avenue for the final time.
____
It was difficult to build out my client roster at first. A few people who I’d treated during my training followed me to my private practice when I told them I was graduating and starting off on my own. They were the ones who’d grown attached to me. For the first time in my life, I was the object of transference. What Freud described as the unconscious redirection of feelings toward prior relationships, like parents, was suddenly thrust onto me, the analyst.
They’d warned us about this phenomenon in school. The way clients would project entire lives onto us—consciousnesses, histories, desires. We were to remain quiet about our personal lives. Our backgrounds. Our families. Our spouses and pets and what we did on the weekends and where we were spending our holidays. We were to make ourselves into blank slates, empty canvasses, so our clients could focus on delving deep into their own unconscious and not on the worldly things that defined their analysts. This left so much room for the imagination. To the clients who followed me into private practice, I could be anyone. Anything. They could imagine me perfect.
It was kind of nice to be thought of so flatteringly. To be thought of at all. I had one client who told me that his friends knew me as his beautiful analyst. When he referred to me in conversation, which he often did—he told me—it was always that way. My beautiful analyst.
When I worked as a nurse at Bellevue, the patients would say all sorts of shit to me. Would hit on me, every day. But it meant nothing to me. They were out of their minds. But I wanted my clients to think of me as beautiful. They were lawyers and financiers and, yes, Columbia professors. Good husband material, some of them. Had they not been clients of mine.
Whenever I saw the client who referred to me exclusively as his beautiful analyst, I thought of Drew. Thought of everything I’d projected onto him, simply because I’d only known one version of him. Didn’t know what he was like at home. Never asked him if he dated. Didn’t want to know. Not about other girls, anyway. But I did want to know what he was like in bed. What it was like to see him in that animal state. Wished I knew what he liked, what his secret proclivities were. He was such a buttoned up, straight-A student. I would’ve paid good money to know him the way those other girls must’ve.
I didn’t really know him, but I looked for him in the faces of other men in New York City. As my client—the one who called me beautiful—spoke, I tried to listen intently, but mostly, I stared at him as he lay there on my couch. Began to think about Drew. Thought that, in fact, their two faces might actually rhyme. Allowed my mind to wander as he went on and on, and think about what he might be like in bed. It would cost me my license —would cost me six years—to find out the answer to that question, but there were no rules against simply wondering.
I tried to be grateful for what I had, I really did. What I’d earned. For no longer needing to pin down 250 pound men in the midst of psychosis. And yet, I felt all the emptier for no longer having something to strive towards. I missed the warmth of the institute. The promise that when this chapter was closed, things would be profoundly different. Better. That I’d finally shed that outer borough shame. Even with my analyst credential, though, there was no shaking off the fact that, at my core, I was still who I always was. No matter how hard I tried, people could still hear the Long Island in my voice.
Six months into starting my private practice, I found his email on the Stanford website. He was faculty now. An attending in the psychiatry department. I told him what an impression he had made on me. Bragged about having graduated from the institute. Having built up my own little practice, to the extent that it was built. Thanked him again for The Interpretation of Dreams. I’d been using it with my clients, I explained. Instructed them always to write down what they dreamt. To bring them to me. Fresh material. We’d talk about them, together. Uncover their hidden desires, buried deep in the recesses of their psyches.
Drew never replied. Don’t know if he ever even saw it. It was probably buried under a mountain of work emails, I reassured myself. But really, I was tremendously disappointed. Felt myself growing hopeless. Some part of me had still been holding out hope that maybe he was my husband, the one in the brownstone with the good job. The one who read books and talked about them with me. I’m not sure what exactly I had in mind. That he’d move back to New York? Confess that he’d been in love with me this entire time? I suppose I wanted him to become real. I wanted him to be more than the projection I’d so carefully constructed. I wanted to sleep with him, to see him as a full person, one who might be even more perfect for me than the version I’d imagined.
It was nothing, though. It would be nothing. Certainly couldn’t be anything if he wouldn’t so much as reply to an email.
____
The benzos started with a public speaking engagement. Just four small, white Ativan pills to take the edge off before addressing a group of incoming students at the institute. I took double what my shrink prescribed, just to be safe. To make sure I really felt something when they hit. The drugs brought me back to my days at Bellevue. Back when I envied my patients who knocked out so easily even in the throes of mania with a steady Ativan drip. The way they’d slip in and out of consciousness—only emerging as the meds fully wore off. We rarely let them wear all the way off.
The relief was so gradual that I hardly noticed the transition happening. I was still present enough to say what I had to say to the students, but far enough away that I wasn’t listening to myself saying it. The impostor syndrome I felt over speaking on the panel melted away. In short order, I was floating on a soft cloud.
It occurred to me, after that first time—after securing a prescription quite breezily from my chill psychiatrist—that I could feel this way all the time, if I really wanted to. In session with my clients, in particular. No longer would I need to worry about what to do with my hands or where to look or whether my eyes had that glazed over look that tended to happen twenty minutes into a session.
It wasn’t simply that they repeated themselves because they’d forgotten what they’d told me previously. It was the repetition of the human psyche that really wore me down. The fact that we, as people, seemed to almost universally obsess over the same couple details, never actually letting go of anything at all. In fact, the more I indulged any given theme in a session, the more my clients seemed to hyperfocus on it. Worse yet, I’d been trained in the field of analysis—our goal wasn’t to cure our patients, or even to treat them therapeutically. It was more to understand their psychic patterns and processes. Simply to uncover the buried meaning and origins of their fears, their desires, their neuroses.We were not interested in “cures.”
One day, after a particularly long session, I upped my dose. Layered Ativan with Klonopin and washed it down with a glass of cabernet sauvignon when I got home. All I remember now is pouring myself the glass of wine. Sitting down on the old corduroy couch in front of the TV. Must’ve put on Housewives, or Sex and the City, or else whatever movie I’d been halfway through at the time.
All I know is when I woke up the next day, my head was pounding and my mouth was bone dry. Still laying on the couch, having evidently not made it to the bedroom. I turned over my phone, whose battery was drained to 8%. A one-sided text conversation was open.
Drew
Drew
Answer me.
Why are you ignoring me.
I switched from texts to calls to find nine unanswered calls to Drew Kestenbaum.
I miss you.
Come back.
***
Emma Burger is a Chicago-based writer, originally from New York City. She is the author of two novels, Little Rich Kids (2025) and Spaghetti for Starving Girls (2021). You can find her work in Hobart, X-R-A-Y Lit, and The Republic of Letters, at emmaburgerwrites.com, or on Substack at emmakaiburger.substack.com. She is an essays editor at Zona Motel.
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image: Spencer Eckart
Rejection Letters 