"Open the window,” he ordered, getting up from his chair and leaning against the wall.

“Why, Sam? Are you too warm in here?” I asked, confused (it was December).

He didn’t answer. He stood straight, opened his long wool coat, looked at me—and farted. Twice. First, I heard the squeaky, prolonged noise, then—unfortunately, and despite opening the window next to me—I smelled it.

“Why did you do that, Sam?” I asked after a moment.

“What? What’s the problem?”

“What’s the problem with farting in your therapist’s office?”

“Yes, Mr. Therapist, what’s the fucking problem with farting in your office? Would you rather I keep it in? Does that sound ‘empathic’ to you?”

“Well, no, I mean . . . I was just surprised. I didn’t expect that.”

“Do you even listen to yourself? I have gastroenterological problems, for God’s sake! Do you know what that means? Did they teach you that in school, or did they only teach you how to ask stupid, unhelpful questions?”

I met Sam in my internship at a psychiatric clinic in a large hospital in Manhattan. He was a veteran of the clinic—knew all the doctors, the social workers, the administrative staff. “This place sucks,” he warned me early on. “Everyone is up his own ass—we’ll see if that includes you.”

We were assigned to meet for a year for…