They were passionately involved for most of that year. The year after, they seemed to drift apart. No arguments, but fewer dates, fewer nights together. Then the pace picked up for another six months. Then another hiatus.

They never talked about it. Matt wasn’t certain whether these peaks and valleys were his fault or hers. Whether they were even a bad thing. He knew for a fact, however, that a pattern had been established. Nearly ten years had passed since Annie Gates stepped through that office door for the first time. Mart’s hair had grayed at the temples and run back a little from his brow, and Annie had developed frown lines at the corners of her eyes, but ten years was an eyeblink, really, and at no point in that time had they ever been entirely separate… or entirely together.

Lately they had drifted through another vacuum, and he wondered how she would take this invitation for Friday evening. As a courtesy? Or as a suggestion to spend the night?

And which did he prefer?

The question lingered.

He showed Beth Porter into his consulting room, down the hall from Anne’s.

The consulting room was Mart’s enclave, a space of his own creation. Its centerpiece was a set of authentic Victorian oak medical cabinets, purchased at a rural auction in 1985. Behind his desk was a creaking leather chair that had formed itself to the precise contour of his behind. The window looked crosstown, beyond the sweltering marina to the open sea.

Beth Porter took her place in the patient chair while Matt adjusted the blinds to keep out the afternoon sun. Annie had recently equipped her office with vertical blinds, covered in cloth, which looked exactly sideways to Matt. His consultancy announced: Tradition. Annie’s replied: Progress. Maybe that was the invisible hand that conspired to pull them apart.

She was on his mind today, though, wasn’t she?

He took his seat and looked across the desk at Beth Porter.

He had examined her file before he called her in. Matt had been Beth’s regular doctor since her eleventh birthday, when her mother had dragged her into the waiting room: a sullen child wearing a cardboard party hat over a face swollen to the proportions of a jack-o’-lantern. Between rounds of birthday cake and ice cream, Beth had somehow disturbed a hornet nest in the cherry tree in the Porters’ backyard. The histamine reaction had been so sudden and so intense that her mother hadn’t even tried to pry off the party hat. The string was embedded in the swollen flesh under her chin.

Nine years ago. Since then he’d seen her only sporadically, and not at all since she turned fifteen. Here was another trick of time: Beth wasn’t a child anymore. She was a chunky, potentially attractive twenty-year-old who had chosen to wear her sexuality as a badge of defiance. She was dressed in blue jeans and a tight T-shirt, and Matt noticed a blue mark periodically visible as her collar dipped below the left shoulder: a tattoo, he thought, God help us all.

“What brings you in today, Beth?”

“A cold,” she said.

Matt pretended to take a note. Years in the practice of medicine had taught him that people preferred to make their confessions to a man with a pen in his hand. The lab coat didn’t hurt, either. “Bad cold?”

“I guess… not especially.”

“Well, you’re hardly unique. I think everybody’s got a cold this week.” This was true. Annie had come to work snuffling. Lillian Bix, in the waiting room, had been doing her polite best to suppress a runny nose. Matt himself had swallowed an antihistamine at lunch. “There’s not much we can do for a cold. Is your chest congested?”

She hesitated, then nodded. “A little.”

“Let’s listen to it.”

Beth sat tensely upright while he applied his stethoscope to the pale contour of her back. No significant congestion, but Matt was certain it wasn’t a cold that had brought her in. The ritual of listening to her lungs simply established a doctorly relationship. A medical intimacy. He palpated her throat and found the lymph nodes slightly enlarged—hard pebbles under the flesh—which raised a small flag of concern.

He leaned against the edge of his desk. “Nothing too much out of the ordinary.”

Beth inspected the floor and seemed unsurprised.

“Maybe it isn’t a cold you’re worried about. Beth? Is that a possibility?”

“I think I have gonorrhea,” Beth Porter announced.

Matt made a note.

She surprised him by reciting her symptoms without blushing. She added, “I looked this up in a medical book. It sounded like gonorrhea, which is kind of serious. So I made an appointment. What do you think?”

“I think you made a reasonable diagnosis. Maybe you ought to be a doctor.” She actually smiled. “We’ll know more when the test comes back.”

The smile faded. “Test?”

Annie came in to chaperon and distract Beth while Matt took a cervical culture. There was the inevitable joke about whether he kept his speculum in a deep-freeze. Then Annie and Beth chatted about Beth’s job at the 7-Eleven, which was, Beth said, as boring as you might think, selling frozen pies and microwave burritos until practically midnight and catching a ride home with the manager, usually, when there was nothing on the highway but logging trucks and semitrailers.

Matt took the cervical swab and labeled it. Beth climbed down from the table; Annie excused herself.

Beth said, “How soon do we know?”

“Probably tomorrow afternoon, unless the lab’s stacked up. I can call you.”

“At home?”

Matt understood the question. Beth still lived with her father, a man Matt had treated for his recurring prostatitis. Billy Porter was not a bad man, but he was a reticent and old-fashioned man who had never struck Matt as the forgiving type. “I can phone you at work if you leave the number.”

“How about if I call here?”

“All right. Tomorrow around four? I’ll have the receptionist switch you through.”

That seemed to calm her down. She nodded and began to ask questions: What if it was gonorrhea? How long would she have to take the antibiotics? Would she have to tell—you know, her lover?

She paid careful attention to the answers. Now that she had popped the cassette out of her Walkman, Beth Porter began to impress him as a fairly alert young woman.

Alert but, to use the old psychiatric rubric, “troubled.” Enduring some difficult passage in her life. And tired of it, by the pinch of weariness that sometimes narrowed her eyes.

She was twenty years old, Matt thought, and seemed both much older and much younger.

He said, “If you need to talk—”

“Don’t ask me to talk. I mean, thank you. I’ll take the medicine or whatever. Whatever I have to do. But I don’t want to talk about it.” A little bit of steel there.

He said, “All right. But remember to phone tomorrow. You’ll probably have to come by for the prescription. And we’ll need a follow-up when the medication runs out.”

She understood. “Thank you, Dr. Wheeler.”

He dated the entry in her file and tucked it into his “done” basket. Then he washed his hands and called in Lillian Bix, his last patient of the day.

Lillian had skipped a period and thought she might be pregnant.

She was the thirty-nine-year-old wife of Mart’s closest friend. The conversation was genial, rendered a little awkward by Lillian’s tongue-numbing shyness. She came to the point at last; Matt gave her a sample cup and directed her to the bathroom. Lillian blushed profoundly but followed instructions. When she came back, he labeled the sample for an HCG.