“Time for my pills,” he said after we had eaten. “Cal, can you hand me my pill bottles? They’re in the glove compartment.”

There were five or six different bottles. I handed them to Presto and he tried to read their labels, slanting his eyes. “Here,” he said, “steer for a minute.” I leaned over to take hold of the wheel, closer to Bob Presto than I wanted to be, while he struggled with the caps and shook out pills. “My liver’s all fucked up. Because of this hepatitis I picked up in Thailand. Fucking country almost killed me.” He held up a blue pill. “This is the one for the liver. I’ve got a blood thinner, too. And one for blood pressure. My blood’s all fucked up. I’m not supposed to eat so much.”

In this way we drove all day, reaching San Francisco in the evening. When I saw the city, pink and white, a wedding cake arrayed on hills, a new anxiety took hold of me. All the way across the country I had absorbed myself in reaching my destination. Now I was there and I didn’t know what I would do or how I would survive.

“I’ll drop you wherever you want,” Presto said. “You got an address where you’re staying, Cal? Your friend’s place?”

“Anywhere’s fine.”

“I’ll take you up to the Haight. That’ll be a good place for you to get your bearings.” We drove into the city and finally Bob Presto pulled his car over and I opened my door.

“Thanks for the ride,” I said.

“Sure, sure,” said Presto. He held out his hand. “And by the way, it’s Palo Alto.”

“What?”

“Stanford’s in Palo Alto. You should get that straight if you want anyone to believe you’re in college.” He waited for me to speak. Then in a surprisingly tender voice, a professional trick, too, no doubt, but not without effect, Presto asked, “Listen, guy, you got any place to stay?”

“Don’t worry about me.”

“Can I ask you something, Cal? What are you, anyway?”

Without answering I got out of the car and opened the back door to get my suitcase. Presto turned around in his seat, a difficult maneuver for him. His voice remained soft, deep, fatherly. “Come on. I’m in the business. I might be able to help you out. You a tranny?”

“I’m going now.”

“Don’t get offended. I know all about pre-op and post-op and all that stuff.”

“I don’t know what you’re talking about.” I pulled my suitcase off the seat.

“Hey, not so fast. Here. At least take my number. I could use a kid like you. Whatever you are. You need some money, don’t you? You need an easy way to make some good money, you give your old friend Bob Presto a call.”

I took the number to get rid of him. Then I turned and walked off as though I knew where I was going.

“Watch out in the park at night,” Presto called after me in his booming voice. “Lot of lowlifes in there.”

My mother used to say that the umbilical cord attaching her to her children had never been completely cut. As soon as Dr. Philobosian had severed the cord of flesh, another, spiritual connection had grown up in its place. After I went missing, Tessie felt that this fanciful idea was truer than ever. In the nights, while she lay in bed waiting for the tranquilizers to take effect, she often put her hand to her navel, like a fisherman checking his line. It seemed to Tessie that she felt something. Faint vibrations reached her. From these she could tell that I was still alive, though far away, hungry, and possibly unwell. All this came in a kind of singing along the invisible cord, a singing such as whales do, crying out to one another in the deep.

For almost a week after I disappeared, my parents had remained at the Lochmoor Hotel, hoping I might return. Finally, the NYPD detective assigned to the case told them that the best thing to do was return home. “Your daughter might call. Or turn up there. Kids usually do. If we find her, we’ll let you know. Believe me. The best thing to do is go home and stay by the phone.” Reluctantly, my parents took this advice.

Before leaving, however, they had made an appointment with Dr. Luce. “A little knowledge is a dangerous thing,” Dr. Luce told them, offering an explanation for my disappearance. “Callie may have stolen a look at her file while I was out of my office. But she didn’t understand what she was reading.”

“But what would make her run away?” Tessie asked. Her eyes were wide, imploring.

“She misconstrued the facts,” Luce answered. “She oversimplified them.”

“I’ll be honest with you, Dr. Luce,” said Milton. “Our daughter called you a liar in that note she left. I’d like an explanation why she might say something like that.”

Luce smiled tolerantly. “She’s fourteen. Distrustful of adults.”

“Can we take a look at that file?”

“It won’t help you to see the file. Gender identity is very complex. It’s not a matter of sheer genetics. Neither is it a matter of purely environmental factors. Genes and environment come together at a critical moment. It’s not di-factorial. It’s tri-factorial.”

“Let me get one thing straight,” Milton interrupted. “Is it, or is it not, still your medical opinion that Callie should stay the way she is?”

“From the psychological assessment I was able to make during the brief time I treated Callie, I would say yes, my opinion is that she has a female gender identity.”

Tessie’s composure broke and she sounded frantic. “Why does she say she’s a boy, then?”

“She never said that to me,” said Luce. “That’s a new piece of the puzzle.”

“I want to see that file,” demanded Milton

“I’m afraid that’s not possible. The file is for my own private research purposes. You’re free to see Callie’s blood work and the other test results.”

Milton exploded then. Shouting, swearing at Dr. Luce. “I hold you responsible. You hear me? Our daughter isn’t the kind to just run off like that. You must have done something to her. Scared her.”

“Her situation scared her, Mr. Stephanides,” said Luce. “And let me emphasize something to you.” He rapped his knuckles against his desk. “It is of tantamount importance that you find her as soon as possible. The repercussions could be severe.”

“What are you saying?”

“Depression. Dysphoria. She’s in a very delicate psychological state.”

“Tessie,” Milton looked at his wife, “you want to see the file or should we get out of here and let this bastard go screw himself.”

“I want to see the file.” She was sniffling now. “And watch your language, please. Let’s try to be cordial.”

Finally, Luce had given in and let them see it. After they had read the file, he offered to reevaluate my case at a future time, and expressed hope that I would soon be found.

“I’d never take Callie back to him in a million years,” my mother said as they left.

“I don’t know what he did to upset Callie,” said my father, “but he did something.”

They returned to Middlesex in late September. The leaves were falling from the elms, robbing the street of shelter. The weather began to turn colder, and from her bed at night Tessie listened to the wind and the rustling leaves, wondering where I was sleeping and if I was safe. The tranquilizers didn’t subdue her panic so much as displace it. Under their sedation Tessie withdrew into an inner core of herself, a kind of viewing platform from which she could observe her anxiety. The fear was a little less with her at those times. The pills made her mouth dry. They made her head feel as though it were wrapped in cotton, and turned the periphery of her vision starry. She was supposed to take only one pill at a time, but she often took two.

There was a place halfway between consciousness and unconsciousness where Tessie did her best thinking. During the day she busied herself with company—people were constantly stopping by the house with food, and she had to set out trays and clean up after them—but in the nights, approaching stupefaction, she had the courage to try to come to terms with the note I’d left behind.