The End of Miracles: A Novel, by Monica Starkman,  She Writes Press, Berkeley, CA, 2016,  400 pp.

For those of us who treasure Freud's case histories, enjoy books and film where psychiatrists and analysts play a pivotal role—like in Ordinary People—or TV shows like The Sopranos or In Treatment, here is a beautifully written suspense novel that is a great read. Fantasies, dreams, conflicts, and defenses are vividly portrayed and a psychodynamically informed therapist is a key character.

Margo Kerber is a 38-year-old assistant to the administrator of Westchester General Hospital. The hospital is facing a strike by the nurses who want the perennial issues of professionalism, hours, and salary to be addressed while the board is already fighting being in the red. Under this umbrella of conflicts about boundary issues we are introduced to Kate, a nurse, who is Margo's confidante and has introduced her to Share House where both volunteer to help mentally retarded children. Margo has already broken the rules about favoritism, and she marvels over Janie—such a beautiful face and body; womanly breasts that rest on a table of kindergarten crafts. Her attention to these breasts echoes her childhood envy of her mother's nursing her younger siblings with smiling father looking on. Margo continues her interest in how bodies function-or-not from her days of peeking at the boys skinny dipping in a nearby lake and envying their urinary prowess, to the delight in appreciating the multi-sensory experience of seeing, holding, and smelling newborns in the hospital nursery where she is also a voyeur. Her own infertility thwarts what she desires most—the sensation of “growing a baby inside of her.” And so her desire to become pregnant overrides her desire to become a parent and her barrenness is a huge narcissistic mortification. Her failure to be constant with Janie makes her have a present-day focus for more guilt.