When Quintana wakes up, Didion reassures her and promises to stay until they can leave together. She realizes that, ever since she and John adopted Quintana, her promise to take care of Quintana has been the foundation of their relationship. As Quintana grew older, Didion realized she could not always protect her. Didion comes to understand that her lifelong fear of things being out of her control is coming true.

She tries to ascertain what exactly happened to Quintana. Since Quintana had been on anticoagulants, the bleed she suffered could have been either the cause or an effect of her fall. Didion tries to find out which it was from the doctors but soon realizes that the question is irrelevant, since either way the consequences remain the same. The doctor tells her that the coma could last for days or weeks, and that while they’re optimistic, it would be several days before they know what shape her brain is in. This concern pales in comparison to the possible consequences of re-infection, pneumonia, or further swelling that would necessitate re-operation.

During the twenty-four days Didion spends at the hospital, she reads and re-reads Intensive Care: A Doctor’s Journal by John F. Murray, which documents one four-week period during his tenure as an attending physician in an ICU. With information gained from the book, Didion is able to ask pointed and informed questions of the doctors. She often does not understand what the doctors are saying to her, so she buys a copy of Clinical Neuroanatomy, which turns out to be virtually incomprehensible. However, one story from the appendix stands out, a mysterious narrative called the “gilded boy story” that can be used to test memory and comprehension in patients coming out of a comatose state. The story concerns a young boy who was dressed as an angel 300 years ago to celebrate the coronation of the pope but who died from the poisonous gold foil he was wrapped in. Patients are then asked to retell the story in their own words. The strange, nonsensical story seems to represent the confusion of the entire situation that Didion faces.

Back in late January at Beth Israel, Didion identified an experience she called “the vortex effect.” While lost in her thoughts, she had a sudden memory of a former colleague at Vogue, “X,” who had an abortion in the same hospital, an event that Didion had fictionalized in her novel Play It As It Lays. The memory of writing the novel inevitably brought her back to memories of Quintana, which set off the vortex effect, a phenomenon in which Didion becomes swept up in a series of intense reminiscences about her life with John and Quintana. To prevent the vortex effect while in Los Angeles, she will have to avoid any venue that might remind her of the twenty-four years she lived there with her family. Her hotel, the Beverly Wilshire, is an unusual exception, despite the fact that it had been the family’s home base while working on a film. Instead of triggering the vortex effect, the hotel gives her a sense of familiarity and security.

Didion establishes a routine of ordering the same breakfast every morning, driving the same daily route to the hospital, returning to the hotel in the afternoon to rest, and having dinner with friends in the evening. Despite her careful precautions, she often finds herself blinded by tears while driving past a landmark she had not remembered to avoid. In one instance, while preparing to go to the hospital, she sees a commercial that features a stretch of coastal highway that sets off a flood of memories about a house the family rented after Quintana was born. In another instance, while driving to Rite Aid, she remembers a bistro she and John had frequented, which in turn set off memories of a trip she took with John to Bogota. The vortex effect of these memories prevents her from making it to Rite Aid.


Quintana’s illness sets the vortex effect into motion, a recurring motif that Didion uses to demonstrate how every aspect of her life is completely bound to her identity as John’s wife and collaborator and Quintana’s mother. The vortex effect strikes unexpectedly and occurs when a moment of contemplation or passive observation triggers powerful memories and an intense emotional response. Once again, Didion finds that she has no control, realizing that her perception of the world is inevitably informed by her memories. While magical thinking is a process through which Didion attempts to manage her feelings and responses by imagining a degree of control over the world around her, the vortex effect is a passive experience that reminds her of the limits of her control. The fact that the vortex effect happens so naturally and suddenly highlights her fragile emotional state. Though she may be trying to manage her situation by remaining stoic and taking charge, the vortex effect functions as a painful reminder of her husband’s death and her daughter’s illness and her inability to do anything about them.