This week’s story, “The Readers,” takes the form of a one-sided conversation between a male writer and a female therapist. He’s addressing her as he analyzes his feelings about a decision she’s made not to read his writing. How painful is it for writers when they believe they’re going unread?

One thing he seems to be doing (consciously or not) is running a “stress test” (to use a cardiac term) on their relationship—testing whether she’ll be able to keep to their agreement not to read his writing once the writing is about the therapy, once it’s addressed to her. Or maybe this story only became possible for him because he does trust that she’ll never look? If that’s true, going unread by her is helping him make new work for other readers, new life on the other side of his medical and mental crises.

I think the fiction is designed to make us wonder: Did the narrator tell the therapist that he’d written this, that he was going to publish it? Did they discuss what it all might mean for them—how it might be thought of as an homage or as a kind of hostility, as an ode to holding boundaries or a violation of one? Will it move his therapy forward or ruin it?

And then: yes, it’s a one-sided conversation—but a conversation meant to be overheard by readers, by anyone who wants to listen in, anyone except the addressee. (It’s a kind of inversion of therapeutic confidentiality.) And that is an ancient literary dynamic—a lyric condition, and a version of apostrophe, of addressing someone who can’t respond.

It’s a multidimensional one-sidedness, to use a ridiculous phrase.

The therapist, too, is a writer. The narrator, having determined that he won’t read her work, either, soon feels that he must, at the very least, assess that there’s nothing disqualifying about it. (“I know all sorts of brilliant people who are bad writers; it must be possible for a brilliant therapist to be such a person, and yet I felt that if your prose were horrendous it would make it impossible for me to trust you.”) Does he have less discipline than the therapist—or a more porous sense of boundaries?

He has no discipline! But then, there isn’t a prohibition against his reading the therapist’s writing. I’m friends with therapists who have written fiction, very personal essays, etc., that are easy to find online. I’m always curious about (and maybe suspicious of) how they reconcile publishing such work with their desire to reveal in their practice as little of their own personality and experience as possible so that patients can project feelings and fantasies onto them—I mean, how does the published writing of a therapist (or, for that matter, an Instagram page or a Facebook account, which plenty of therapists have) interfere with or facilitate transference? Surely this is something therapists must think about? I also know multiple writers who have recently decided to “retrain” as analysts and so maybe that was on my mind—people who’ve published books of poems or works of fiction. The narrator has no boundaries, but if he reads her writing, and it affects their work together, is that his boundary violation or hers?

I realize I’m answering your questions with catalogues of questions. I just think this story, any story, is an orchestra of ambiguities. (You know how Melville has that subtitle for “Pierre”—“Pierre; or, The Ambiguities”? I feel like there is an implied “or, the Ambiguities” attached to every piece of writing worth reading.)

As ever in your fiction, your narrator, while a fictional creation, shares certain biographical details with you. At the center of this story, is the narrator’s experience of having open-heart surgery, something that you, too, went through last year. You wrote a nonfiction piece about this for The New York Review of Books. Why did you want to return to the surgery—and that essay itself—in fiction?

I wrote that essay or prose poem or whatever it is really early in my recovery—I started it just a week after the surgery—when I had this desperation to capture something about what had happened and was happening to me. And it is also written in the second person, also involves a complex mode of address. And I wanted—I felt I needed—certain people to read it. Which is not how I usually feel. I don’t mean I needed them to like it—but I wanted my people to know how it was for me, to accompany me via reading. I sent it to the friends and family who took care of me and also to a couple of the doctors and nurses. (I was just thinking about this incredible nurse I had: Kaiko Torres de Sa. Bless him.) But then, at the same time, there were people I really didn’t want to read it, at least not right away—my kids, for example. (There’s a poem in my last book of poetry also called “The Readers”—a poem thinking about the pressures placed on writing when you imagine your children potentially reading your work.) And then I of course was making it available for strangers through publication. Really all I’m trying to say is that the nonfiction piece involved a particularly intense and concrete instance of address for me, of working with the “you”; that’s probably part of the prehistory of this story.

Both the heart surgery and this fiction involve stopping and going on, stopping in order to go on. Literally stopping the heart so that a repair can happen, so it can go on beating, hopefully for a long time. The therapist stops him from approaching her with his essay—“dead in my tracks,” as he puts it—so that he can go on with his life after his crisis. That parallel between surgery and therapy was propulsive for me.

And then I was also drawn to the idea of building a bridge between the nonfiction and fiction pieces so that one might slightly change or charge the other.

In the final section of the story, the tone changes. Up to this point, the narrator’s been an interrogative, at times combative presence. But the rhythm of the story becomes much gentler as he describes the essay of the therapist’s that, earlier, he’d seemingly glanced at in order to assess her style. It’s an amazing pivot. Did you always know you’d end up here, or did this ending come to you as you were writing?

I did know—which is very rare for me—that the story would, unless I abandoned it, get to his projecting himself into her writing and life, that he would be her reader, fantasizing about what experiences she might be holding or holding at bay in their interactions. But I had to write my way to the tone. I can never anticipate or plan a tone.

But now that I say that, I think the tone at the end of the nonfiction heart piece might be similar to the tone at the end of the story?

You published your latest novel, “Transcription,” earlier this year. It has a tripartite structure and, in the opening section, your narrator, a writer, goes to interview his mentor, Thomas, who is nearing the end of his life, yet the narrator can’t confess that he’s dropped his iPhone in water and will not be able to record him. In the final section, the narrator’s friend Max, Thomas’s son, recounts his own final conversations with his father. It’s an intricately constructed novel, yet it leaves abundant room for ambiguity and mystery, both within the fictional confines of the text and in the way that text might overlap with any influences in your life outside the boundaries of the novel. Have you been reading your reviews? Are you interested in the ways people read you?

I don’t have the discipline never to look, but I can’t really focus my eyes on them. I sometimes look and look away simultaneously—kind of like what the story’s narrator does with his therapist’s writing at the beginning of the piece.

Among other things, this story is about the possibility of therapeutic boundaries at a time when we leave so many personal traces online, whether the people in question are writers or not. But this question of boundaries is an issue for literary work itself—how does an art work acknowledge or ignore the larger media system in which it exists, manage how information about an author might intrude into the story, how does it make all this a live question within the work? It might be that in an era in which few go un-Googled, blurring the boundaries between biography and fiction becomes a way to regain a little mystery and ambiguity—because it becomes harder for the readers to sort person from persona.

But then, the writer himself might get confused about which is which. ♦