51 pages • 1-hour read
Notes to John
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Chapter 33-AfterwordChapter Summaries & Analyses
Content Warning: This section of the guide includes discussions of illness, death, suicidal ideation, depression, anxiety, substance use, and addiction.
Chapter 33 Summary: “8 November 2000”
Didion expresses her sustained concerns about Quintana’s mental health. She and Dr. MacKinnon discuss her habit of worrying and the potential that Quintana might choose to die by suicide. Didion shows Dr. MacKinnon an email Quintana sent her the day before where she apologized for burdening Didion. Dr. MacKinnon muses on the way Didion conflates worry and love.
Chapter 34 Summary: “29 November 2000”
Didion tells Dr. MacKinnon about her Thanksgiving holiday and her family’s plans for Christmas and New Year’s. She regrets her inability to throw holiday parties anymore. The conversation turns to aging and grief. They also discuss the way children see adults during childhood. Didion remarks that Quintana always seemed more wary of her peers than of adults.
Chapter 35 Summary: “6 December 2000”
Didion describes her difficulties from the past week. She is convinced that Quintana’s anxiety, depression, and alcohol consumption are unrelated to her work frustrations. She and Dr. MacKinnon discuss AA and the possibility of Quintana returning to Hazelden. Didion admits that she often feels that Quintana “could control her situation if she wanted to” (169).
Chapter 36 Summary: “13 December 2000”
Didion and Dr. MacKinnon discuss the relationship between physical injury and psychological distress. Didion recently broke her hip and is still recovering. The conversation shifts to how Didion sees herself. Dr. MacKinnon remarks that she seems incapable of letting herself make mistakes. He says these habits go back to her need for control.
Chapter 37 Summary: “20 December 2000”
Didion shares her anxieties over the Christmas holiday with Dr. MacKinnon. She doesn’t know what to get Quintana. She usually buys her camera equipment but Quintana has been disengaged from her work of late. The conversation shifts to money and the possibility of Didion and John giving Quintana $100,000. Dr. MacKinnon reminds Didion that she should “trust [Quintana’s] values” by giving her the money without stipulating how she spends it (176).
Chapter 38 Summary: “3 January 2001”
Didion says she’s been feeling more positive. She feels less interested in controlling Quintana, which Dr. MacKinnon identifies as a positive change. Didion then describes her family’s New Year’s holiday. Quintana was upset but said that John and Didion made her feel better.
Chapter 39 Summary: “17 January 2001”
Didion details her recent conversations with Quintana for Dr. MacKinnon. She admits she’s still trying to make Quintana feel better when she’s down. He reminds her she can’t always fix Quintana’s problems. They also discuss the possibility of Quintana starting a new rehab program.
Chapter 40 Summary: “31 January 2001”
Didion describes her frustrations with Quintana’s seeming inability to do basic things for herself. Dr. MacKinnon asserts that this is common for people with depression. They agree that Quintana’s work situation might be making her feel especially despondent. Going to treatment has also pulled her away from society, and sometimes Didion doesn’t know how to address this with Quintana in a healthy way. Dr. MacKinnon encourages Didion not to minimize Quintana’s experience.
Chapter 41 Summary: “7 February 2001”
Didion and Dr. MacKinnon discuss adoptive mothers’ relationships with their children. He shares some examples from his studies and practice. Didion wonders if she has attachment issues with Quintana and if this relates to Quintana’s addiction to alcohol. They go on to discuss suicidal ideation; Dr. MacKinnon stresses the importance of telling Quintana that she and John wouldn’t be okay if Quintana chose to die by suicide.
Chapter 42 Summary: “4 April 2001”
Didion describes her inability to take notes, write, and focus of late. Dr. MacKinnon thinks these issues relate to Didion’s ongoing concerns about Quintana. They also discuss how Didion sees herself and if she makes decisions to uphold an image.
Chapter 43 Summary: “3 July 2001”
Didion tells Dr. MacKinnon about a recent article she read. Some companies are trying to avoid hiring people with alcoholism. Dr. MacKinnon contests the ethics of this practice. They discuss AA and Rational Recovery. Didion reiterates her doubts about AA but acknowledges Quintana’s success with the program. At the same time, she fears AA is making Quintana only see herself as sick. They decide that it might be productive to have a meeting with Dr. Kass and Quintana. The conversation shifts again to Quintana’s adoption and her contact with her biological family a few years prior. While this upset Quintana, Didion admits it hurt her, too.
Chapter 44 Summary: “26 December 2001”
Didion expresses her frustrations with Quintana’s work situation. She has used most of the money she and John gave her. She also used a lot of the money her grandmother gave her. Didion and John want her to get a job, but Quintana is reluctant. Dr. MacKinnon encourages Didion not to give her more money, noting that it’s enabling her. She wouldn’t be cutting Quintana off, but compelling her to support herself and form new habits.
Chapter 45 Summary: “3 January 2002”
Didion details her and John’s recent discussions with Quintana about her future. She and John are supportive of Quintana’s idea to take a three-month trip on her own, but worry about her well-being. Dr. MacKinnon reminds her to let Quintana live her own life.
The editor includes a note, marking this diary entry as Didion’s last report on her sessions with Dr. MacKinnon. They kept working together until 2012, and Dr. MacKinnon died in 2017.
Chapter 46 Summary: “Jan 9 03 Dr. Kass”
The editors include a digital journal entry found on Didion’s computer after her death. The entry details a session she had with Dr. Kass, Dr. MacKinnon, and Quintana.
Quintana shows up late, visibly inebriated. The doctors suggest that they can’t do anything else for her if she doesn’t want to stop drinking or help herself. They decide to connect her with a colleague named Marc Galantar who specializes in substance abuse and addiction. Quintana agrees to the meeting.
Afterword Summary
The editors describe the events of Didion’s family life in the following years. Quintana got married in 2003. Not long later, she contracted the flu and was hospitalized. She then developed pneumonia, which led to septic shock. She was still in the hospital when John died of a heart attack. Quintana then had pulmonary complications but was discharged in time for her father’s funeral.
In 2004, Quintana was admitted to the Rusk Institute at New York University Medical Center for further treatment. She then developed pancreatitis in 2005. She was admitted for surgery, but due to further complications, she died in August of that year.
The editors include a portion of an entry Didion wrote on Quintana’s death. She ultimately didn’t know if Quintana’s death was related to her alcohol addiction, depression, or general health issues at the end of her life.
Chapter 33-Afterword Analysis
The gaps in Didion's accounting of her final sessions with Dr. MacKinnon convey the challenges she faced during this period to maintain her therapy while caring for her daughter. Throughout the early sections of the text, Didion keeps a more regular journal of her weekly therapy meetings. In this final excerpt of the text, there are more and more gaps between Didion’s entries. The timestamps jump from February to April to July, and finally to December and January. The missing entries underscore Didion’s previous discussion of her Writing as a Means of Survival in which she noted that when she’s focused on Quintana, she finds it difficult to write. The sparse and infrequent nature of her entries during this period implies that Didion was no longer able to keep up with this note-taking practice as her personal life took a toll on her writing habits.
Throughout her final therapy sessions, Didion repeatedly remarks on her growing inability to focus—personal frustrations that reiterate her reliance on her work. The less capable she feels of taking notes, the less like herself she feels. She relies on writing to process her experiences (even informally), and when she feels incapable of writing, her mental health suffers. For example, in Chapter 42 she notes the difficulty that she and John each experience staying focused and grounded during this time of emotional turmoil:
I said yes. I said that I was more and more aware of this, that you were too, that we had talked about it, that both of us had trouble thinking of words or maintaining a thought long enough to follow it through, that I had said to you that it was emotional overload, stress, and to some extent I supposed it was but it was worrisome (188).
Didion finds her sudden detachment from language and note-taking troubling because she regards writing as an essential facet of her identity. When Didion’s diary entries become increasingly scant in the last section of Notes to John, it points to an inability to process her fraught familial dynamics on the page.
The collective session between Didion, Quintana, and both of their psychiatrists emphasizes Didion’s central internal conflict across the text—the tension between her need to care for and protect Quintana and Quintana’s need for independence and autonomy. In Chapter 46, the editors include a digital diary entry Didion wrote about this final session, which depicts the mother and daughter at a proverbial standstill. As the doctors indicate, because Quintana is unwilling to help herself at this juncture, there is no longer anything that they or Didion can do to usher her toward change. Didion’s voice stays at the margins of this account, which underscores her feelings of helplessness in this situation.
The afterword, written in the voice of the editors, functions in a similar way as the introduction—summarizing Didion and Quintana’s relationship in the years of the diary entries and providing context for the narrative. This closing section functions as a historical account of Didion’s life at the time of both John’s and Quintana’s death. The editors avoid telling the reader how to experience these events, allowing Didion’s private writings to speak for themselves.
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