The conflict came to a head at the time of the senior prom.

Cassi came home from school beside herself with excitement and anticipation. The prom was to be held in a fashionable local country club, followed by a breakfast back at the school. Then the entire class was to head down to the New Jersey shore for the rest of the weekend.

Unexpectedly Cassi had been asked to the prom by Tim Bartholomew, one of the more popular boys in the school. He’d talked with Cassi on a number of occasions following a physics class they shared. But he’d never asked Cassi out, so the invitation came as a total surprise. The thrill of going out with a desirable boy to the biggest social event of the year was almost too much for Cassi to bear.

Cassi’s father was the first to hear the good news. As a rather dry professor of geology at Columbia University, he didn’t share the same enthusiasm as Cassi but was pleased she was happy.

Cassi’s mother was less enthusiastic. Coming in from the kitchen, she told Cassi that she could go to the prom but had to come home instead of going to the breakfast.

“They don’t cook for diabetics at such affairs,” said Mrs. Cassidy, “and as far as going to the shore for the weekend, that is completely out of the question.”

Not expecting this negative response, Cassi was ill-prepared to deal with it. She protested through tears that she’d demonstrated adequate responsibility toward her medicine and diet and that she should be allowed to go.

Mrs. Cassidy was adamant, telling Cassi that she was only thinking of her welfare. Then she said that Cassi had to accept the fact that she was not normal.

Cassi screamed that she was normal, having emotionally struggled with that very issue for her entire adolescence.

Mrs. Cassidy grasped Cassi’s shoulders and told her daughter that she had a chronic, life-long disease and that the sooner she accepted the fact the better off she’d be.

Cassandra flew to her room, locking her door. She refused to talk with anyone until the next day. When she did, she informed her mother that she’d called Tim and told him that she couldn’t go to the prom because she was ill. She told her mother that Tim had been surprised because he’d not known she had diabetes.

Staring at her reflection in the hospital mirror, Cassi brought herself back to the present. She wondered to what degree she had overcome her disease intellectually. Oh, she knew a lot about it now and could quote all sorts of facts and figures. But had that knowledge been worth the sacrifices? She didn’t know the answer to that question and probably never would. Her eyes strayed up to her hair, which was a mess.

After taking out her combs and hairpins, Cassi gave her head a shake. Her fine hair tumbled down around her face in a disorganized mop. With practiced hands she carefully put it back up, and when she emerged from the bathroom she felt refreshed.

The few things she’d brought with her for the overnight in the hospital fitted easily into her canvas shoulder bag despite the fact that it already contained a large folder of reprinted medical articles. She’d had the bag since college, and although it was soiled and threadbare in places, it was an old friend. It had a large red heart on one side. Cassi had been given a briefcase on graduation from medical school, but she preferred the canvas bag. The briefcase seemed too pretentious. Besides, she could get more into the bag.

Cassi checked her watch. It was five-thirty, which was just about perfect timing. She knew that Thomas would be heading down the stretch, seeing his last office patients. As Cassi hefted her things, she remarked to herself that the regular schedule was another benefit of psychiatry. As a medical intern or pathology resident, she was never finished much before six-thirty or seven, and at times worked to eight or eight-thirty. On psychiatry she could count on being free after the four to five afternoon team meeting, provided she wasn’t on call.

Stepping into the corridor, Cassi was initially surprised to find it empty. Then she remembered that it was dinner-time for the patients, and as she passed the common room, she could see most of the patients eating from their trays in front of their TV sets. Cassi ducked into her cubbyhole office and collected the charts she’d been extracting. She only had four patients, including Colonel Bentworth, and she’d spent a portion of the afternoon carefully going over their charts and making three-by-five index cards on each case.

With the canvas bag over her shoulder and the charts in her arms, Cassi went down to the nurses’ station. Joel Hartman, who was on call that night, was sitting in the station, talking to the two nurses. Cassi deposited the charts in their respective slots and said good night. Joel told her to have a good weekend and to relax because he’d have her patients cured by Monday. He said he knew just how to handle Bentworth because he had been in ROTC in college.

As she walked down to the first floor, Cassi could feel herself beginning to relax. Her first week on psychiatry had been a trying and difficult period, one that she would not like to relive.

Cassi took the interior pedestrian crosswalk to the Professional Building. Thomas’s office was on the third floor. She paused outside the polished oak door, gazing at the shining brass letters: THOMAS KINGSLEY, M.D., CARDIAC AND THORACIC SURGERY, and felt a thrill of pride.

The waiting room was tastefully decorated with Chippendale reproductions and a large Tabriz rug. The walls were powder blue and hung with original art. The door leading to the inner office was guarded by a mahogany desk occupied by Doris Stratford, Thomas’s nurse-receptionist. As Cassi entered, Doris looked up briefly, then went back to her typing when she recognized who it was.

Cassi approached the desk.

“How’s Thomas doing?”

“Just fine,” said Doris, her eyes on her paper.

Doris never looked Cassandra in the eye. But over the years Cassi had become accustomed to the fact that her illness made some people uncomfortable. Doris was obviously one of them.

“Would you let him know I’m here?” said Cassi.

Cassi got a fleeting glimpse of Doris’s brown eyes. There was an aura of petulance about her expression. Not enough for Cassi to complain about but enough to let her know that Doris did not appreciate the interruption. She didn’t answer Cassi but rather depressed the button on an intercom unit and announced that Dr. Cassidy had arrived. She went directly back to her typing.

Refusing to allow Doris to irritate her, Cassi settled herself on the rose-colored couch and pulled out the articles she wanted on borderline personality. She started to read but found herself looking over the top of the paper at Doris.

Cassi wondered why Thomas kept Doris. Granted she was efficient, but she seemed moody and irritable, hardly the qualities one would like in a physician’s office. She was presentable although not overly attractive. She had a broad face with large features and mousy brown hair pulled back in a bun. She did have a good figure; Cassi had to admit that.

Letting her eyes drop back to her paper, Cassi forced herself to concentrate.

Thomas looked across the polished surface of his desk at his last patient of the day, a fifty-two-year-old lawyer named Herbert Lowell. Thomas’s office was decorated like his waiting room, except the walls were a forest green. The other difference was that the furniture was authentic Chippendale. The desk alone was worth a small fortune.

Thomas had examined Mr. Lowell on several occasions and had reviewed the coronary arteriograms done by Mr. Lowell’s cardiologist, Dr. Whiting. To Thomas the situation was clear. Mr. Lowell had anginal chest pain, a history of a mild heart attack, and radiographic evidence of compromised arterial circulation. The man needed an operation, and Thomas had told Mr. Lowell as much. Now Thomas wanted to terminate the visit.