By Blood by Ellen Ullman

It is the 1970's and a disgraced professor has come to San Francisco, awaiting the judgement of his college. A tenured professor, there is an allegation of improper student contact, and now he must wait for the wheels of collegial justice to grind out his fate. Knowing that it will take months, he has fled to another city where he is to work on research and papers. It is an unsettled time in San Francisco. The peace and love generation has given way to terrorists similar to those who kidnapped Patty Hearst. The Zodiac killer is stalking the streets. There is unease everywhere, including the professor's mind.

He takes an office in a cheap location, and there he finds his solace. He is placed next to a psychiatrist's office, and the construction is so cheap that he can hear through the walls. Not everyone; for most patients there is a white noise machine. But one patient, the one that the professor begins to think of as 'his patient' wants the machine turned off and he can hear everything she says.

The patient is caught up in the same identity crisis the professor has fought his whole life. Both feel they don't belong anywhere, that there is something unique about them that sets them apart and makes them unlovable. The patient believes it is her past as an adopted child. The professor comes from a family rife with mental disease and suicides. Both struggle to determine if they are a product of their genes, fated at birth to become what they are, or if they have the strength to define themselves apart from their heredity.
The professor has spent years in therapy and has removed himself from that setting. Yet he finds himself drawn into the struggle of the patient as she confronts her adoptive parents. He uses his research skills to find her birth mother and the truth of her background and mails the results to her pretending to be a clerk at the adoption agency. He then sits back and waits to see what will happen, if his gift will enable the patient to move forward with her life or if the truth of her background will swamp her.

Ellen Ullman has written a brooding tale that draws the reader in hypnotically. Set in short chapters, the hour long therapy sessions are juxtaposed with the actions of the professors. The story rackets up the suspense as the truth is revealed a bit at a time. Will the therapist have the skills to free the patient, and the professor who looms in the background and is just as needy? This book is recommended for all readers, an atmospheric tale that will not soon be forgotten.