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When she left her position in 2008, Allison had insisted it was because she was a generalist by inclination and wanted to pursue various areas of academic study. It was a nice, pat reason she’d known would roll smoothly off her tongue and leave her superiors with few openings to urge that she reconsider her choice. Dreams and goals represented the intangible and, precisely for that reason, were hard to poke holes in. If she’d told the truth, namely, that her decision had been based on mental fatigue, there would have been a barrage of suggestions and incentives, which she’d have had to swat off one by one. Take some downtime, ease your caseload, and how about we shift more of the obviously tough and complicated cases over to other therapists till you’ve reenergized your battery? Meanwhile, we can certainly slot you in for more frequent out-of-town conferences. Arrange for you to occasionally travel inside and outside the country. Rome, for example. Have you been to Rome? There’s also Milan. Or our Paris branch. In springtime. Where enchanted music rises from the banks of the Seine and perfume fills every boulevard.

Allison had always appreciated the respect she got from the Agency. She had likewise known it was much deserved. Her success rate was in the upper percentile-meaning she kept most of her patients productive or curbed their dropout rate. Her bosses therefore would have bent over backward to accommodate her if it meant she’d stay on; she was sure of it because they’d done it in the past. But at the time of her resignation she’d been disinclined to keep fouling off their pitches, however well-intentioned they might be.

And so Allison had claimed she needed a change based on personal objectives beyond and distinct from the job, and let it stand at that. She’d been careful to say nothing about the intensity in the eyes of her patients, and what it was like to feel them searing into her own, those looks speaking volumes about the fires burning inside them, communicating hidden rage, guilt, anxiety and, for some, nightmarish horrors beyond what they were able to share in words. Nor had she mentioned the nights she’d spent lying awake in the dark, agonizing over each one of those patients, worrying what might happen if she committed the smallest error in judgment or just had a momentary slip of attention. There were many individuals with aggression issues, deep-rooted guilt, even core identity conflicts, often compounded by drug or alcohol abuse. Some were trying to reacclimate themselves after returning from some foreign hell. Others had been on covert assignments and were trying to maintain some inner balance between their secret lives and honest, open relationships with families and friends.

Shortly before leaving the Agency, Allison had read an air force study that said over half the airmen on foreign deployment who committed suicide had attended regular counseling sessions. She’d had a strong hunch the numbers were similar, or greater, in the CIA. While she had been fortunate enough to have never lost a patient, Allison had spoken with other highly capable mental health professionals within the organization who weren’t quite as lucky and beat themselves up regularly over the ones they had failed to save. And although she’d known better than to make her thoughts known to them, she always wondered, as they doubtless did, what key point in someone’s unraveling had been missed. And why.

The questions had plagued her throughout her tenure at the Agency. Shrinks were as vulnerable to obsessive fears as anyone, and the one that had haunted Allison during her frequent sleepless nights was the possibility that her concentration might blink while someone was baring a dark, pained corner of his soul, just blink as some vital, wounded part of him briefly reared like a fanged undersea serpent from some hidden inner recess, and that she’d wake up the next day to read about him taking a Glock to his head and pulling the trigger, or overdosing on some prescription tranquilizer cocktail, or hanging himself while alone in a cheap roadside motel room. Or maybe taking the wife, kids, and brand-new puppy with him when he drove his car off a cliff.

As a therapist, Allison knew, your humanity was the tether that connected you to your patients; in fact, it could be a lifeline to some of them. But she recognized it was also a potential trip wire for the most volatile personalities. There was very little margin for error when interacting with them, and the danger, in her mind, was that the slightest lapse could have grave ramifications. Was it that you suddenly realized you’d forgotten to mail your loan payment in time to avoid late fees? Locked yourself out of the car? Neglected to open the pet door for the cat that morning? Or maybe to schedule a visit with the dermatologist to remove the suspicious little bump over your eyelid?

At the CIA Allison had frequently dealt with the institutional stigma against admitting to psychological problems. It had worn rather thin at times from the very beginning, but the real strains had sprung from the reality that she was very often playing for mortal stakes.

Now Allison, a tall, willowy blonde in her midthirties with her hair pulled back in a French twist, wearing small, round diamond earrings, a long-sleeved Ralph Lauren stretch polo under a matching gray sweater jacket, gray wool dress pants with flared bottoms, and peep-toe black suede dress heels, entered her second-story office with its window overlooking the poplar trees and cobblestone sidewalks along Murielle Lane. Pausing to pour herself a strong black cup of Italian roast, she went swiftly across the room from the coffee maker, then sat down behind her large oak desk. The antique pendulum wall clock to her right-a made-in-Germany Hermle Black Forest she’d picked up at a yard sale near her niece’s home in Oak Creek, Wisconsin, of all places-said it was a quarter to ten. Jonathan Harper was due for their hastily scheduled powwow in fifteen minutes. But if he held true to form, he would arrive in no more than ten, barring a calamitous traffic jam on the Capital Beltway.

She drank her coffee, settling in for the presumably brief wait. She hadn’t thought about her CIA days for a while. But then it had been quite some time since she’d gotten a call from Harper, though he was still nominally under her care. Looking back on her eight years with the Agency, she considered it sad irony that its intelligence gatherers had assembled comprehensive reports on the major causes of death for every country and region in the world-not to mention almost every profession-but had failed to address its own problems in that regard. If you were interested in what took people’s lives in Belarus, Algeria, or the Indian subcontinent, the information could be instantly plucked from its databases with a scroll and a click. Reach into the intercontinental grab bag for any of that data, and the Agency could-and typically did-generate reams of material on who was dying from childhood leukemia or old age, genetic conditions or environmental contaminants, pandemics, accidents, violent crime…and so on and so forth, including self-inflicted means. Incorporating these analyses into its overall intelligence tapestry, the CIA made recommendations on foreign strategy and policy to diplomats, and the loftiest of generals and heads of state…yet as an organization still had not quite figured out how to look inward. Or as one fellow academic, who wrote a white paper on the subject, had put it to Allison, the Agency was choking on evolutionary exhaust when it came to maintaining the mental health of its employees.