Folie à Deux

Amalia Rosenblum

Translated from the Hebrew by the author


Gates of Israel Hospital on New York City’s Lower East Side is a large building with few windows and no courtyard. Six floors share a ventilation system that ferries bacteria from one wing to another. On most wards you can open some windows to let air in, but on the geriatric psychiatric ward the windows are locked for safety reasons. Some days the ward smells so bad that we interns prefer to skip lunch purely so that we won’t have to go back to the ward and re-adapt to the stench. Within the first thirty minutes on the ward you’re greeted by the smell of sweat, urine, feces, drool, and denture breath. That’s on top of the smell of hospital food.

Which is why I had my nose buried in my scarf when I walked into the ward that Monday morning. Jenna was already in the interns’ room. A sunny blonde with a flexible approach to life, Jenna wasn’t born in New York and didn’t intend to stay in the city once she got her Clinical Psych PhD. I took off my wool hat. My hair, charged with static electricity, stuck out in all directions. “Two new cases,” said Jenna, and handed me two folders.  The two new cases had the same last names. I scanned the intake summaries while Jenna briefed me. “Seventy-five-year-old identical twin sisters,” she said. “The police brought them in last night following a stabbing incident. You should see them,” she added, “they seem quite ordinary, like two cute grandmothers, grey from head to toe, hardly five feet tall.”


Jenna said the neighbors had heard suspicious noises, not a fight exactly, just shouting. Contrary to popular belief, when it comes to dealing with crazy people, New Yorkers are quick to call the police. “When the police broke into their apartment,” she continued with repressed excitement, “they found one of the sisters crying and the other very calm though bleeding heavily from her chest.” Jenna put one hand over to the left side of her chest under the shoulder. “The twins couldn’t explain to the cops what had happened, but it became apparent that the one who was weeping had stabbed her rather calm sibling. The police brought them to the ER and, after the doctors took care of the chest wound, they sent both of them here for observation.” Karen, the ward secretary, told Jenna that when they had walked the twins to their hospital room, the stabber kept crying while her sister, wrapped in bandages, calmed her down. “We gave them both shots,” Jenna said, “just to be on the safe side. They will probably calm down soon, I really hope they’ll attend our group meeting tomorrow, I can’t wait to see them up close.”


“Shared Madness,” ruled Prof. Michael Zohar and added, without waiting for further details, “‘Folie à Deux’, fascinating. Two people sharing a psychosis.” On a uselessly small napkin in front of him was a raisin-nut roll. He picked it up and split it in half. “The way we’d share this roll. Only this roll — this psychosis — is not really ours. Simply put, it is mine,” he took one half of the roll, “and you are only sharing it with me”, he handed me the other half, “because you’re dependent on me, or because I’ve isolated you from the rest of the world, or simply because you’re submissive and weak and I’m so charismatic and crazy.” He laughed. For the first time in my life I wanted to sleep with someone I had just met.

We were sitting in a cafe outside his university on the Upper West Side when I told Prof. Zohar about the new female patients on the ward. I thought the twins would make an excellent conversation starter for my first meeting with him. The deadline for submitting my dissertation proposal was approaching, and I had to find three faculty members who’d agree to serve as my dissertation advisors. I‘d already secured two advisors from my department, but I didn’t really think much of them, which is why I was courting Prof. Zohar who taught at a university much more prestigious than mine and had published groundbreaking research on cults, brainwashing and propaganda. I was hoping he’d agree to meet with a fellow Israeli in New York. I predicted he’d initially refuse my request for mentorship, already swamped by demanding doctoral students and endless bureaucratic tasks. But I was relying on Zohar falling for the youthful charm I was pretty sure I had, and I hoped that after expressing some formal objections he’d nevertheless agree to serve as my third advisor.

Things were progressing according to plan. Half an hour into the meeting, we were already eating soup served in cardboard cups at the cafe near campus. “’Folie à Deux’.” He turned the words over in his mouth. “Damn it, you rarely get to see something like that out in the field,” he said, “but that’s the beauty of working in mental health in New York City. Loonies from all over this huge country congregate here. You’re a lucky girl.”

“Is it the stress of city life that drives them crazy?” I asked.

“If they were born here, then yeah, it might be stress-induced, but many of them come here from small towns or from remote communities that spew them out. They blend in far better in the big city.”

“Safety in numbers”, I joked, “like a herd of gazelles.”

“More or less.” He smiled.

I examined his tan skin, the graying curls, the thin frame of his glasses and the tailored shirt that hid a small middle-age paunch. I wondered how many good years we would have if we left everything and ran away together.

“What do you plan to do after you get your PhD?” Zohar asked.

I knew that even if it looked like lunch, it was more of a job interview. “I want to continue doing research and clinical work.” A vague answer to buy me time to think of a better one.

“I hope you have full confidence in the subject matter you are pursuing,” Zohar said, looking directly at me from above the rims of his glasses. “A doctoral dissertation takes up a lot of time and energy. It’d be a shame if in three years you wake up and realize you’re working on something that doesn’t truly interest you.”

I wiped my mouth with a paper napkin.

“Anyway, you’re not one of those girls who plan to move back to Israel a day after graduation, get married, have kids and entirely ruin their momentum, right?” He was half-asking and half-stating a fact.

It was a pretty accurate description of what might happen to me.

“No way,” I said, “God forbid.”

When we left the cafe, Prof. Zohar asked me to send him a draft of my dissertation proposal on ​​”Immigration and Mental Health.” He promised to review it soon and to consider my request seriously.

I wanted to talk to him some more, but he hurried to a lab meeting. We shook hands politely and went our separate ways. He turned toward the huge university building, and I walked to the subway.

Standing on the platform, I checked my cell phone. I had seven missed calls and thirteen text messages, all from Ronen.


“I can’t believe you did that,” Ronen said.

“What did I do?” I asked.

“It doesn’t even look good on you,” he said, keeping his back to me as he cooked. He was making fish couscous for dinner, and it smelled really good.

“I’ve told you a thousand times that a short haircut doesn’t flatter any woman, not even you, even if you are the most beautiful woman in the world. So shaving your head?!”

I shrugged my shoulders, even though I couldn’t believe I had done it either. Until then, I had never got my hair cut without Ronen. Ronen hated short hair and was always making sure that he, I and the guy cutting my hair agreed on the number of inches that were going to be lost. He would sit on the fake-leather sofa throughout the process making sure the hairdresser didn’t get carried away by some creative fantasy.

“It’s not even about how short it is,” he said for the fourth time, “It’s just…I don’t understand why you didn’t consult me about such a thing. It’s not like you’ve got bangs, you know…you’re a skinhead.”

I sat there for a moment and then went to the bathroom.

I turned on the water in the shower. I had to wash off the tiny hairs that had stuck to my skin. Waiting for the hot water, I studied my new image in the mirror. Slowly, the steam began to cover my reflection. When I could no longer see anything, I undressed and stepped into the shower.

Twenty minutes later, when I walked into the bedroom, Ronen was lying in bed watching television. I wore my pajamas and lay down next to him. He was watching a program on the Discovery Channel about the drilling and crushing methods used to create railway tunnels.

A month and a half earlier, I’d told Ronen I wanted to break up. The first time I’d said it, he‘d not responded at all and I’d wondered whether he’d even heard me.

On TV, the narrator explained that if the railway tunnel is dug through hard rock, the debris needs to be blasted away with explosives. Construction workers sometimes use a scaffold known as a Jumbo to disperse the explosives. The Jumbo is placed at the face of the tunnel and workers mount drills on it and penetrate several holes into the rock bed. The depth of the holes varies according to the rock type, but typically the holes are 10 feet deep with a diameter of merely inches. At that point, workers pack the explosives into the holes, evacuate the tunnel and detonate the explosives from a distance. Next, they vacuum out the poisonous fumes and cart away the muck and debris. They repeat this process again and again, blowing up rocks, until gradually they manage to create a tunnel that cuts through the belly of the mountain.

“I’m serious,” I said, sitting on the farthest corner of the bed. “I want us to separate.”

“I think you should get an MRI,” he said, without looking at me, “You might have a tumor putting pressure on something in your brain, or maybe you got hit and don’t remember it, you know, like that guy you told me about who had a crowbar lodged in his brain.”

Phineas Gage, a 19th-century American railroad worker, suffered a head injury that propelled him into the history of psychiatry. An iron bar entered his head and destroyed most of his brain’s left frontal lobe. Reportedly, following this injury, Gage’s personality changed. He became irritable, rude, impatient and capricious. The case of Phineas Gage changed the way scientists perceived the relationship between personality and brain structure and gave birth to the concept of brain localization. I knew it was out of character for me to walk into a hair salon and have my head shaved half an hour after lunch with Professor Zohar. But when I stroked my smooth skull, I knew there was no iron bar.

Before going to sleep, we had sex. I was thinking about Michael Zohar, and Ronen was careful not to touch my shaved head. Afterwards, he curled up on his side of the bed, wrapping the blanket around him. I was cold but didn’t pull the cover over to my side, because I didn’t want him to think I was picking a fight.


“They call it Shared Madness, isn’t that poetic?” I remarked the next day in the Freud and Lacan seminar.

Each of us had brought a clinical case to present, and I was proud of this unusual one. The geriatric psychiatric ward wasn’t as sexy as the wards other students interned on, so I rarely had anything colorful to report.

“Absolutely, but what I don’t understand,” said John, who was wearing a T- shirt with the confusing message LESBIAN, “is how a person merged so symbiotically with her sister could experience the passion it takes to stab her?”

John was a stellar psychoanalysis student in New York, one of the few places in the world where psychoanalysis still had a star system. Everyone’s admiration for him had been second only to his admiration for himself. He had already published three papers in the most important journals in the field, but this time, I thought that he was wrong. “Why do you assume that if they suffer from a low degree of individuation, they can’t be angry with one another? Why wouldn’t they be able to fight? ”

“It’s not what I assume”, he said, ‘I’m only suggesting that according to Lacan, desire is always for the desire of the Other. So for desire to exist there must be an Other that is separate from you, and you can feel — and want to become the object of — the Other’s desire. But in the case of these twins — or in the case of people in this state of ‘Shared Madness’ — well, they don’t experience each other as separate beings. Therefore, they can’t feel any passion for each other, whether a violent passion or a romantic one,”

“What do you mean?” I didn’t really want to understand him.

“I mean that I’d predict that any couple in this state of ‘Shared Madness’, which I guess isn’t uncommon…” he paused for laughs, “wouldn’t be able to experience erotic tension. Desire wants to possess an Other. So in order for desire to exist between two people, there must be some permanent distance between them. In short, my bet is that regardless of who stabbed whom, it wasn’t the result of a fight — or that’s what Lacan would predict.” John then went on to present a patient who’d participated in the group therapy he was leading on the Criminally Insane Ward at Bellevue Hospital.

No one in the seminar said anything about my new hairstyle.


After the seminar, I rushed to the hospital to be on time for the art therapy group that Jenna and I led together.

“Good for you,” Jenna said as she saw my shaved head, “I always thought that was a noble thing to do.”

I looked at her questioningly.

She pointed to my head, “To give your hair to people with cancer.”

“Oh, yes, thank you.” I replied.

“Well done,” she nodded and picked up all the magazine clippings we had worked on for hours.

I held the tray of UHUs and blank pages, and we went to the dining room where the art therapy group met. At the start of our internship, we tried asking patients to draw. That was a mistake. Even “healthy” people panic when they are given a blank sheet and asked to draw something. So we switched to collages. For hours on end, we neatly cut images from magazines for our patients to work with. Due to the specific nature of the magazines we had at home, our crazies’ collages consisted of lots of perfume bottles, lipsticks, fit girls in bikinis, and white bowls containing yogurt and a slice of fruit.

On our way to the cafeteria, Jenna said that during the night, the nurses had found the twins sleeping head to toe in the same bed. “Apparently, that’s how they’ve been sleeping since they were little girls,” she said, explaining that they’d lived in the same house from the day they were born until the day they were brought to the hospital. They continued living together in the house even after their parents died. Inseparable, even as adults.

“Are they coming to group?” I asked.

“I hope so,” said Jenna. “Attending group therapy is the only way they can see each other. After they found them sleeping in the same bed, the doctors separated them. Soon we’ll find out which sibling is the psychotic one.” Jenna ended her report smiling as she said that the twins had insisted they’d never quarreled and didn’t understand why they were being held in a locked unit.


“I want you to promise me we’re going to stay together. If you promise me that, I will change any way you want me to,” Ronen said, emptying the disposable sushi plates into the recycle bin.

“It doesn’t work that way,” I said.

“It has to work that way,” he said.

This conversation repeated itself every few days. I hadn’t told him yet, but I’d decided to get a tattoo of a Celtic snake swallowing its own tail.

I left the kitchen and sat down at the computer. An email arrived from Psychiatry Research, the journal to which I had submitted my MA thesis on immigration and mental health in a public clinic in the Bronx. My eyes scanned the text and gravitated to the word “Unfortunately.” A house of cards collapsed in front of me. My article was not accepted. Zohar would refuse to mentor me. My PhD would be as mediocre as the letters of recommendation I would get from my mediocre dissertation committee at the mediocre university I was attending.

Ronen asked me, “What’s wrong?” with concern in his voice and came over to me to read through the email. “Assholes. Idiots. Who do they think they are?” He scrolled down the email and opened the file that was attached to it, comments from the reviewer who had rejected my paper. The editorial team at Psychiatry Research highly recommended that I study the comments if I wish to resubmit.

I had started reading the comments when Ronen blocked my view with his hands.

“Are you nuts?” he asked, “I will not let you read it. Why would you want to mess yourself up with some bullshit from some condescending, hollow American prick sitting in his corduroy pants in some shithole in Iowa City, Iowa, and stepping on young people because he is threatened by their brilliant ideas?!”

I laughed. I did not agree with him, but he made me feel better.

Ronen removed my hand from the mouse and took over. I looked at the screen. “What are you doing?”

“That’s it. Gone.” He said with a smile, after wiping out the email. “And now it doesn’t exist here either,” he said, erasing it from the trash folder of our shared email box.

I laughed again, but my eyes were still moist. “What a bummer”, I said. “I really needed this publication. Professor Zohar hinted that I needed to have at least one paper out if I want him to become my advisor. Why couldn’t they accept it conditionally and just ask for specific revisions? Well, maybe it just wasn’t a good paper. Zohar did say my research topic didn’t sound focused enough…”

“God, I’m sick of all those pompous farts, really, Professor Zohar, the one and only, just another macho ex-pat who wants to force you through the eye of the Academe’s needle. Besides, isn’t that exactly what your advisors are supposed to do? To help you focus?” And suddenly he added, surprised and almost offended, “You really haven’t told me how the meeting with that Zohar person went.”

“It was okay,” I said. “I think. I don’t know. I don’t know anything.”

We stayed where we were. I was sitting at the desk chair and Ronen was standing next to me, slightly bent, his hand still on the mouse. I lay my head against his shirt. Through the luxurious and soft fabric of the shirt I was able to feel his stomach rising and falling with every breath.

He almost touched the back of my shaved head, but then withdrew. “Why are you doing this to me?”

“I’m sorry,” I said.

“Do you love me?”

I remained silent, thinking of the twins lying head to toe in the narrow hospital bed, like a strange playing-card queen.


The next morning, the ward was unusually turbulent. During the night, the police had brought in a young man who was spotted wandering naked along the Brooklyn Bridge. No other locked unit had any available beds, and so he found himself with us: the senile and the abandoned, those who soiled themselves and those who roamed the corridors in slippers, wearing reading glasses mended with masking tape. As I approached, Karen the secretary and two black orderlies tried to restrain him. He yelled and cursed them in English, but when he saw me, he suddenly shouted out in Hebrew, “Hey you, the Israeli girl, you think I can’t see you?!”

Bewildered, I took the folder from the cart and went to the interns’ room.

Jenna sat there. “Have you heard the news about the twins?” she asked.

“No,” I said, “you said they separated them, right?”

“Yes, and you won’t believe what happened,” she said, “the stabber, the one who was crying constantly? Well, she is actually improving. They gave her some cognitive function test this morning and her thinking is actually quite clear, considering the overall situation. But the calmer twin, the one who was stabbed? Well, turns out she hears voices, sees shadows, apparently she’s totally psychotic. ”


“Buzz,” said Prof. Zohar the second he saw my shaved head at the cafe.

I stood up to welcome him and smiled. He smiled back and sat down.

It was pointless to tell him my paper had been rejected. If he’d agree to work with me, we’d have the chance to write other, much better papers together. I settled for giving him the twins’ newsflash.

“Interesting…” he said, somewhat preoccupied. Then he conjectured that the calm sibling — he called her “the dominant one” — had persuaded her sister to extricate a transmitter of some sort, presumably in her chest. “She probably believes that the universe is using this transmitter to send her messages, and she pressured her passive sister to stab her so she could remove the transmitter. Something like that.”

I looked at him. He still looked handsome and attractive but this time he seemed out of reach. He existed on the other side of my Mount Marriage, a mountain made of hard rock through which no tunnel could be dug. I was surprised that only a week earlier Zohar had seemed so real.

Ronen, who knew my schedule precisely, texted me, “Has Zohar fallen for you yet?”

I did not answer.

“Imagine if she’d not stabbed her,” Zohar said, “let’s say there’d been no stabbing incident, no blood or shouting. Had the police not shown up and intervened, they could have gone on like this forever. Some truly radical external event needs to happen in order to break apart a pair that’s caught up in this type of situation.”

When we finished the soup, we went to get an espresso from the counter and sat down again. Our time was almost up. Zohar looked at me, inhaled deeply and pushed himself slightly away from the table. “I’m about to disappoint you,” he said.

My heart skipped a beat.

“I don’t have the time, I really don’t. I would have liked to take you on, but it would simply be irresponsible on my account. I don’t want to mislead you.”

I sank into the chair. I felt my body giving in. Everything is going to stay the same, forever.

“Are you okay?” he asked, trying to get me to smile.

I looked straight into his eyes. He didn’t avoid me. We stared at each other silently. I felt the blood pumping through my body.

“To tell you the truth, in some sense this is a relief,” I told him, not taking my eyes off him for a moment.

He swallowed.

I inhaled.

Zohar’s cell phone rang but he ignored it.

It rang again and Zohar turned the phone off without looking at it.

Eventually, he surrendered, “Fine, you’ve got it. We’ll meet every other Tuesday.”

I nodded, smiling only with my eyes.

“It’s funny,” he said when we were putting our coats on, bracing ourselves for the harsh weather outside the café, “you tell yourself someone is being abused in a relationship, and you have no idea that this person has in fact been manipulating their partner for years.”

When we left the café, he walked me to the subway. Before I entered the station, I held out my hand to shake his. But this time, instead of stretching out his arm, he held my arm and drew me towards him. He then kissed me goodbye on the cheek. It was a social gesture, but we both knew it lasted a moment too long. Then, for a brief moment, I felt his warm hand caressing my shaved head. “I had to,” he said. I did not dare look into his eyes, but I knew he was smiling.

I buried my blushing face in my scarf and hurried away down into the belly of the subway station. My train had just arrived, and some passengers were running to catch it. I let them pass me by as I got out my phone and sent Ronen a text message: I love you.


Click HERE to read the Hebrew version of this work in Granta Hebrew

Amalia Rosenblum is a writer, psychologist and screenwriter. Her fiction and non fiction books received critical acclaim and awards. Her Young Adults novels were translated into German and Italian where they were very well received. Amalia was head co-writer of two Israeli TV drama series. She is the author of Israel’s most popular relationship blog, appearing on the prestigious Haaretz newspaper website. Her next novel will be out this December (Keter Publishing), and her new non fiction book, about separation and divorce is due next Fall. Amalia holds a PhD in psychology from the New School University in New York.


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