Lee’s new memoir, Dimestore will be published in March, 2016 by Algonquin Books of Chapel Hill.

Click to hear Lee Smith read a portion of The Last Girls.

Showing up for Work

I had done a lot of historical research but had barely begun my novel "On Agate Hill" when my beloved son Josh died in his sleep on Oct. 26, 2003. The cause of death was acute myocardiopathy, the collapse of an enlarged heart brought about in part, I believe, by all the weight he had gained while taking an anti-psychotic drug. He was 33; he had been sick for half his life, doing daily battle with the brain disorder that first struck during the summer between his junior and senior years in high school.

In many ways, our old Josh died then -- that wild funny boy of 17, that brilliant musician, poet, break dancer, skateboarder and camper.

The hospitalizations began, alternating with intermittent, heartbreaking tries at returning to normalcy, then to group homes and day programs. Finally the new drug clozapine gave him back his life, or some of it, in 1992. He moved out of the hospital into a group home, then into an apartment. He completed a vocational rehabilitation program. He got a job.

And we got to know Josh all over again, now a huge whimsical man of immense kindness, with a special sort of gravity and eccentric insight. In this later stage of schizophrenia, he was like the bodhisattva, a person who has achieved the final apotheosis, beyond desire and self. It was comforting to be with him. As a friend said, he was a man like a mountain.

But then we lost him for good.

This time, my grief -- and rage -- were indescribable: "oceanic," to use a doctor's terminology. He told me that there are basically two physiological reactions to grief. Some people sleep a lot, gain weight, become depressed and lethargic.

I had the other reaction -- I felt like I was standing with my finger stuck into an electrical outlet, all the time. I couldn't sleep. I couldn't read, I couldn't eat, I couldn't remember anything, anything at all. I forgot how to drive to the grocery store. I couldn't find the school where I had taught for 20 years. I left a trail of glasses, jackets, pocketbooks everywhere I went. In group situations, I was apt to blurt out wildly inappropriate remarks, like a person with social Tourette syndrome. I cried all the time. I lost 30 pounds.

Finally, enough

Weeks passed, then months. I was wearing out my husband and my friends. But I couldn't calm down. It was almost as if I had become addicted to these days on fire, to this intensity. I felt that if I lost it, I'd lose him even more.

Finally I went to a psychiatrist, a kind, rumpled man who formed his hands into a little tent and listened to me scream and cry and rave for several weeks.

Then came the day when he held up his hand and said, "Enough."

"What?" I stared at him.

"I am going to give you a new prescription," my psychiatrist said, taking out his pad and pen. He began to write.

"Oh good," I said, wanting more drugs, anything.

He ripped the prescription out and handed it to me.

"Write fiction every day," it said in his crabbed little hand.

I just looked at him.

"I have been listening to you for some time," he said, "and it has occurred to me that you are an extremely lucky person, since you are a writer, because it is possible for you to enter into a narrative not your own, for extended periods of time. To live in someone else's story, as it were. I want you to do this every day for two hours. I believe that it will be good for you."

"I can't," I said. "I haven't written a word since Josh died."

"Do it," he said.

"I can't think straight, I can't concentrate," I said.

"Then just sit in the chair," he said. "Show up for work."

Vocational rehabilitation, I thought. Like Josh. So I did it. For three days. The fourth day, I started to write.

And my novel, which I'd planned as the diary of a young girl orphaned by the Civil War, just took off and wrote itself. "I know I am a spitfire and a burden" Molly Petree begins on May 20, 1874, "I do not care. My family is a dead family, and this is not my home, for I am a refugee girl ... but evil or good I intend to write it all down every true thing in black and white upon the page, for evil or good it is my own true life and I WILL have it. I will."

Molly's spitfire grit strengthened me as she proceeded to "give all her heart," no matter what, during a passionate life journey which included love, betrayal, motherhood, and grief (of course, grief).

But by the time we were done with it, Molly and I, two years later, she had finally found a real home, and I could find my way to the grocery store. I could laugh. And yes, through the mysterious alchemy of fiction, my sweet Josh had managed to find his own way into the final pages of the novel after all, as a mystical bluesman and healer living wild and free at last in the deep piney woods he used to play in as a child.

A balm and an escape

When Joan Didion published "The Year of Magical Thinking," with its close observation of her life in the painful year immediately following her husband's death, a friend wondered, "How can she do that -- write at such a time?"

"The right question is, how could she NOT do that?" I answered. Writing is what Joan Didion does, what she has always done. It's how she has lived her life.

In a different way, I realized, this is how I have lived my life, too. Of course, writing is an escape: As Anne Tyler once said, "I write because I want to have more than one life." I do, too. But writing is also a source of nourishment and strength. It cannot bring our loved ones back, but it can sometimes fix them in our fleeting memories as they were in life, and it can always help us make it through the night.

My psychiatrist's prescription may benefit us all. Whether we are writing fiction or nonfiction, journaling or writing for publication, writing itself is an inherently therapeutic activity. Simply to line up words one after another upon a page is to create some order where it did not exist, to give a recognizable shape to the sadness and chaos of our lives.