The thing about waking up and not knowing what to do with yourself is something nobody warns you about.

Elliot Lewis learned this on a Tuesday in October, when his patient Megan O'Connor sat in his office chair and told him, in the flat tone of someone reading from a script she had memorized but no longer believed, that she didn't think she was sick. She just felt wrong when she was awake. Like the world was slightly too loud and the light was slightly too bright and nothing she did mattered enough to make the getting-to-bed part of the night worth postponing.

"How long has this been going on?" Elliot asked, pen hovering over his notebook in that half-hearted way that made most patients think he wasn't really listening.

"Since March," Megan said. "Maybe February. I can't remember."

That was the first red flag. Not the sleeping—people slept for all sorts of reasons, some medical, some not. The red flag was that she couldn't remember when it started, even though she was sitting in a therapy office in Brooklyn, paying out of pocket because her insurance had lapsed when she quit her job at the small publishing house where she worked as an editorial assistant.

Megan O'Connor was twenty-two, a New York University graduate with a degree in English literature, and she lived alone in a one-bedroom apartment in Queens that she described as "fine if you don't think about it." Her parents had separated when she was twenty. Her father moved to Miami. Her mother moved to Connecticut. Megan stayed in New York because she had a lease and a cat and a degree that was, in her words, "not worth much to anyone."

Elliot had seen this pattern before—not the exact one, but the shape of it. People who lost the architecture of their lives and then couldn't figure out how to build a new one because architecture isn't something you learn in school. It's something you absorb from the people who built it around you.

He tried the standard approach first. Cognitive behavioral therapy for insomnia, except inverted—not trying to help her sleep but trying to help her stay awake with purpose. Sleep hygiene education, even though she didn't have a sleep problem so much as a wakefulness problem. Progressive muscle relaxation. A journal to track her waking hours.

For three weeks, it worked a little. Her waking hours went from about three a day to maybe six. Then it plateaued. Then it got worse.

The breakthrough came on a Thursday in November, during a session where Megan was absentmindedly humming. It was a song Elliot recognized—not from the radio, because radio was barely radio anymore, but from the indie rock scene that had been bubbling under everything else in 2015. The song was by a band called The Mountain Goats, and Elliot had the album on CD because he was old-fashioned like that.

After the session, he went to the small shelf of CDs in his office and found it. He held it in his hand for ten minutes, thinking about whether bringing it to the next session was appropriate. It wasn't. He brought it anyway.

"Is this—" Megan's eyes went wide in a way Elliot had never seen before. Not happiness. Recognition. "This is the one my mom used to play. In the kitchen. Before everything."

"You know it?"

"I used to sing it in the shower. Before I forgot that I knew it."

Elliot set the CD player on his desk and pressed play. The first three notes filled the room, and Megan closed her eyes. When the song ended, she opened them and said, very quietly, "Thank you."

That became the pattern. Not treatment, exactly, but something that felt like treatment. Elliot would bring something—a song, a book, a newspaper article about a bridge being repaired in his neighborhood—and Megan would listen or read or look, and her waking hours would stretch just a little further.

Then came the setback. April 2016. Megan's waking hours dropped from six back to three. Elliot visited her apartment—the first home visit he had ever made, approved by Martha, the senior therapist at the clinic.

Her apartment was exactly what he expected: clean, small, and utterly devoid of anything that suggested a future. No plans on the calendar, no books she was reading, no weekend arrangements. She ate when she woke up, scrolled through her phone until she got tired, and went back to bed.

"It's not that I don't want to wake up," Megan said, watching him look around. "It's that when I do, there's nothing there."

Elliot did something that may have violated at least three lines of his professional code. He invited her to a live music show in Williamsburg. Not a therapeutic intervention. Just a kid who liked music asking a person who also liked music to go see a band.

"If I fall asleep," she said, "what happens?"

"I'll bring you home."

"Really?"

"Really."

She fell asleep during the second song. About four minutes. Elliot sat on the floor beside her at the edge of the crowd, and when she woke up, he said two words: "Welcome back."

She smiled. It wasn't a big smile. It was small and uncertain and the most honest thing Elliot had ever seen.

In the next session, she said, "Elliot, I want to take a painting class next week."

It was the first sentence about a future week that Elliot had ever heard her say. Before her father left, she had talked about next week like it was a place she expected to visit. After he left, next week became a country she didn't have a passport for anymore.

Three months later, Megan was sitting on a park bench in Brooklyn, sketching in a notebook, when her phone rang. It was her mother. She answered with one hand and didn't stop drawing with the other.

Elliot didn't know the details of what came next. He knew she would have good days and bad days. He knew the thing that had brought her here wouldn't go away entirely. But he also knew this: when she woke up, she had something to do. And in a city of eight million people, that was probably the most anyone could hope for.

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Author Note & Copyright:

Author Note & Copyright: