This is my earliest memory:

It was my first night in a new apartment. I lay atop a thin comforter spread on a worn carpeted floor. The room was silent and black but for a dim light that bled through the bare window. It cast a deep blue glow on the television stand, yet I don’t remember a television. Shadows of long, thin leaves fanned wide on the wall like an open palm, yet I don’t remember a plant. The cold sent a violent, painful shiver up my spine into the base of my skull. My jaw clenched and my baby teeth gnashed. I don’t remember feeling that sensation before, but I’ve certainly felt it since. I take comfort in its familiarity.

The psychiatrist who asked me to recount this did not look up from his yellow note pad. Instead, he tickled the paper with the ball-point tip of his thick Montblanc pen. He had a long beige face and round glasses that slid down his long beige nose. His thin gray hair was slicked to his scalp; his gray mustache and goatee were thick but tidy.

I sat in a dusty arm chair facing him, his mahogany-stained desk between us. A couch—the couch—idled in the dull yellow lamplight. Its faded red cushions were flattened from decades of therapy. The Persian floor rug disintegrated to threads between the couch and the door.

Was I supposed to lie on the couch? This was my first time in therapy and I didn’t know the protocol. I made the appointment because I was obsessed with stepping in front of a moving train, I explained to the doctor when I first arrived—at least I think I explained. I’m not sure. He immediately asked about my medical history (none) and those of my parents (a standard array of chronic conditions), and then about my earliest memory.

“Was this new apartment better or worse than the one you lived in before?” he asked indifferently.

“I don’t recall how things were before my earliest memory, so I have no basis for comparison,” I retorted. It was a stupid question.

We spent the next 30 minutes glancing over my other family relations (sibling, grandparents), love life (one current sexual partner) and resumé (four years a scientist, six years an editor). A grimace conveyed my irritation, and in the awkward silence that comprised our session, his yawns proclaimed his boredom. At no point did we discuss my desire to die. Finally, the doctor showed me what he’d been sketching on his note pad: a diagram of disease across three generations of my family. He deduced that I was at risk of developing depression and type 2 diabetes.

Without breaking his gaze on the sketch, the doctor ordered me to submit my copay to his receptionist before leaving the office. As I marched out, no less obsessed with suicide, the receptionist asked if I wanted to schedule my next appointment. I don’t remember my exact response, but it was probably something like, “No.”