Did the fact that my friend and partner’s husband, someone else whom I enthusiastically considered a friend, was busy looking for Bill Miller’s estranged wife qualify as a dual relationship?

Probably not, for all of the same reasons.

But I wasn’t totally sure. I didn’t know if I should be contemplating additive effects. If a wasn’t greater than z, and b wasn’t greater than z, and c wasn’t greater than z, did I have to be concerned whether a + b + c was greater than z?

Ethical algebra hadn’t been covered in graduate school.

I interrupted my obsessing over the Bill Miller conundrum to address a practical problem: Diane was still missing, and Thursday was the day she was supposed to be back in her office seeing patients. Although Diane and I shared space, our practices were separate businesses: I didn’t know how many patients she was scheduled to see, nor did I know any of their names.

My problem was that I had to figure out some innocuous yet compassionate way to notify Diane’s patients that their doctor would not be in the office that day. My solution was to post a note on the front door, the patient entrance to our little building. It read:

To Anyone With An Appointment With Dr. Diane Estevez:

Dr. Estevez is unexpectedly away from the office to deal with an urgent situation.

She is unable to cancel her appointments personally, but will not be in today.

She will contact each of you individually upon her return,

and she appreciates your understanding, and your patience.

Dr. Alan Gregory

At the bottom of the note, I belatedly scrawled a handwritten offer that anyone with a clinical emergency should call me, and I left my pager number.

When I’d returned Bill Miller’s call, the offer for an appointment that I eventually made to him wasn’t any more straightforward than was the prevaricating note I had left for Diane’s patients. “I’m not sure I can see you, Bill. I may have an ethical conflict.”

“How?” he said. “We haven’t spoken in, well, years.”

“It’s complicated,” I said, lamely. “It’s not even clear to me that I actually have a conflict. I’m just concerned that I might.”

“Well, how about this,” he said. “Let’s schedule a time. In the interval between now and then you can think about your ethical problem. We’ll talk, I’ll run my concerns past you, and you can decide if you’re able to help.”

He sounded eminently reasonable. I was reminded that even during the session with his wife so many years before, Bill Miller had always seemed levelheaded and reasonable. Almost, I also reminded myself, to a fault.

“How about eleven forty-five?” I asked.

Bill Miller was close to ten minutes late for his appointment. Since I was meeting with him over the brief window in my day that would have constituted my lunch hour, I’d greedily used the free time to devour an energy bar from the emergency stash in my desk.

“Déjà vu, huh?” he said as he settled onto the chair across from me. “It feels odd to be here without Rachel. That was one day that I will never ever forget.”

My natural human instinct was to offer condolences to Bill, to be sympathetic about whatever had happened with Mallory, to reflect on the sad outcome of the situation with Rachel. But I didn’t. Instead I contemplated the fact that after so many years between visits with me his first association in my presence was to his long-estranged wife, and not to the tragedy of his recently absent daughter.

Ironically, one of the most difficult things about the psychotherapeutic relationship is the necessity for the therapist to, at times, put brakes on reflexive human kindness. Were I to presuppose to start this interaction with Bill Miller with expressions of compassion, or even overt sorrow, at his plight-or by giving him a big hug, a pat on the back, and a hearty “hey, big guy”-I might unwittingly interfere with whatever motivation he’d had for picking up the phone.

So I waited. The truth was that most of the time, when I reached over my shoulder into my therapeutic quiver I ended up drawing out the dullest arrow, the one that was marked SHUT UP AND WAIT.

“I bet you’d like to know why I’m here,” Bill said.

“Yes,” I said evenly. “I would. That’s a good place to start.”

Bill was dressed in wool flannel trousers, good leather loafers, and a crisp blue dress shirt that was the color of his eyes. His sport-coat wasn’t new, but it looked like cashmere, and hung on him with the drape of good tailoring. He wore no tie; few men in Boulder did.

“What’s your ethical problem?” he asked. The question was neighborly. He could have been inquiring about a problem I said I’d been having with my gutters.

“Explaining the circumstances would lead to a whole different ethical dilemma for me. It’s something I’m going to have to deal with on my own. When I reach a determination, I’ll let you know.”

“But you’ve obviously dealt with it enough to have this meeting?”

“I’m hoping to get a better understanding about why you’ve come to see me. That might make my concerns moot, or it might clarify things so I’ll have a clearer sense of what I should do.” That was the plan, anyway.

Bill closed his eyes for a moment, a long moment that grew into seconds. Five, then ten. Finally he opened his eyes, looked right at me, and with pain etched in his brow, he said, “You’ve been at my house twice over the past two days. Why?”

In the same way that a boxer who has just absorbed a right uppercut has many options as he’s lying on the canvas staring straight up at the klieg lights listening to a referee count “eight, nine,” at that moment I had many options.

I could have reached back into my quiver for the safety of my SHUT UP AND WAIT arrow.

Or I could have said something classically therapeutic, and classically arrogant, like, “This isn’t about me, Bill. This is about you.”

Or, of course, I could have out-and-out lied: “I don’t know what you’re talking about.”

Instead, almost purely instinctively, I chose an alternative that I hoped might buy me a moment to think while at the same time it reinforced the separation that existed between, and needed to continue to exist between, my chair and that of my patient. What I said in reply to Bill’s question about why I was at his house was, “And that’s why you’re here, Bill?”

“Well, I don’t think it’s a coincidence.”

“Excuse me?” I was honestly perplexed by his quick reply. Bill Miller was implying that my appearance at his neighbor’s house was coincident with what, exactly? I really wanted to know. “What kind of coincidence are you talking about?”

“Why would you be at my next-door neighbor’s house twice in two days with two different people?”

He apparently wasn’t eager to answer my question; I was certainly not about to answer his. Discussing with Bill Miller that I’d been at his neighbor’s house because I’d been concerned about the apparent disappearance of another one of my patients, and the disappearance of my partner and friend, wasn’t about to happen.

“Is this meeting”-I waved my hand between us-“a professional meeting? Did you come to see me for psychotherapy, or for something else?”

He hesitated long enough that I knew he had hesitated, which told me that he’d had to think about how to answer my question.

I said, “The distinction is important. If we’re going to work together, the distinction is important.”

“Yes, yes, of course it’s professional,” he said. “I need your help, Dr. Gregory. But I’m also concerned why you’ve been… so close to my home in the past few days.”

Was that a reasonable concern for him to have? I could have argued yes, I could have argued no. But was reasonableness the point? “Go back three days please, Bill. Were you considering calling me for psychotherapy then?”