David's mouth went bone-dry. He gazed at the blank wall behind the desk and tried not to imagine what it had looked like after the incident. "How awful," David said. "Was he married?"

"Unfortunately," Dr. Yansen said with a nod. "Wife and two young boys. A real tragedy. I knew something was wrong. All of a sudden he stopped playing basketball on Saturday mornings."

"He didn't look good the last time I saw him," David said. "Was he ill? He'd looked as if he'd lost a lot of weight."

"Depressed," Kelley said.

David sighed. "Boy, you never know!"

"Let's move on to a happier subject," Kelley said after he'd cleared his throat. "I took you at your word, Dr. Wilson. We've scheduled patients for you this morning. Are you up to it?"

"Absolutely," David said.

Kevin wished David well and headed back to one of the examining rooms. Kelley introduced David to Susan Beardslee, the nurse he'd be working with. Susan was an attractive woman in her mid-twenties, with dark hair cut short to frame her face. What David immediately liked about her was her lively, enthusiastic personality.

"Your first patient is already in the examining room," Susan said cheerfully. She handed him the chart. "When you need me, just buzz. I'll be getting the next patient ready." She disappeared into the second examining room.

"I think this is where I leave," Kelley said. "Good luck, David. If there are any questions or problems, just holler."

David flipped open the cover of the chart and read the name: Marjorie Kleber, aged thirty-nine. The complaint was chest pain. He was about to knock on the examining room door when he read the diagnostic summary: breast cancer treated with surgery, chemotherapy, and radiation. The cancer had been diagnosed four years previously at age thirty-five. At the time of the discovery, the cancer had spread to the lymph nodes.

David quickly scanned the rest of the chart. He was mildly unnerved and needed a moment to prepare himself. A patient with breast cancer that had metastasized, or spread from the breast to other areas of the body, was a serious case with which to begin his medical career. Happily Marjorie had been doing well.

David knocked on the door and entered. Marjorie Kleber was sitting patiently on the examining table dressed in an examining gown. She looked up at David with large, sad, intelligent eyes. Her smile was the kind of smile that warmed his heart.

David introduced himself and was about to ask about her current complaint when she reached out and took one of his hands in hers. She squeezed it and held it to her chest at the base of her neck.

"Thank you for coming to Bartlet," she said. "You'll never know how much I have prayed for someone like you to come here. I'm truly overjoyed."

"I'm happy to be here," David stammered.

"Prior to your corning, I've had to wait up to four weeks to be seen," she said as she finally released David's hand. "That's the way it's been since the school's health-care coverage was switched to CMV. And every time it's been a different doctor. Now I've been told that you will be my doctor. It's so reassuring."

"I'm honored to be your doctor," David said.

"Waiting four weeks to be seen was so scary," Marjorie continued. "Last winter I had the flu so bad that I thought it was pneumonia. Luckily, by the time I was seen I was over the worst of it."

"Maybe you should have gone to the emergency room," David suggested.

"I wish I could have," Marjorie said. "But we're not allowed. I did go once the winter before last, but CMV refused to pay because it turned out to be the flu. Unless my problem is life-threatening, I have to come here to the office. I can't go to the emergency room without prior approval from a CMV physician. If I do, they won't pay."

"But that's absurd," David said. "How can you know in advance if your problem is life-threatening?"

Marjorie shrugged. "That's the same question I asked, but they didn't have an answer. They just reiterated the rule. Anyway, I'm glad you're here. If I have a problem I'll call you."

"Please do," David said. "Now let's start talking about your health. Who is following you in regard to your cancer?"

"You are," Marjorie said.

"You don't have an oncologist?" David asked.

"CMV doesn't have an oncologist," Marjorie said. "I'm to see you routinely and Dr. Mieslich, the oncologist, when you think it is necessary. Dr. Mieslich is not a CMV physician. I can't see him unless you order it."

David nodded, recognizing that there were realities about his new practice that would take time to learn. He also knew he'd have to spend considerable time going over Marjorie's chart in detail.

For the next fifteen minutes, David applied himself to the process of "working up" Marjorie's chest pain. While listening to her chest and in between her deep breathing, he asked her what she did at the school.

"I'm a teacher," Marjorie said.

"What grade?" he asked. He took his stethoscope from his ears and began preparations to run an EKG.

"Third grade," she said proudly. "I taught second grade for a number of years, but I much prefer third. The children are really blossoming then."

"My daughter is to start the third grade in the fall," David said.

"How wonderful," Marjorie said. "Then she'll be in my class."

"Do you have a family?" David asked.

"My word, yes!" Marjorie said. "My husband, Lloyd, works at the computer software company. He's a programmer. We have two children: a boy in high school and a girl in the sixth grade."

Half an hour later David felt confident enough to reassure Marjorie that her chest pain was not at all serious and that it had nothing to do with either her heart or her cancer, Marjorie's two chief concerns. She thanked him profusely once again for coming to Bartlet before he stepped out of the room.

David ducked into his private office with a sense of exuberance. If all his patients were as warm and appreciative as Marjorie, he could count on a rewarding career in Bartlet. He put her chart on his desk for further study.

Taking the file from its holder on the second examining room door, David perused his next patient's chart. The diagnostic summary read: leukemia treated with massive chemotherapy. David inwardly groaned; it was another difficult case that would require more "homework." The patient's name was John Tarlow. He was a forty-eight-year-old man who'd been under treatment for three and a half years.

Stepping into the room, David introduced himself. John Tarlow was a handsome, friendly man whose face reflected intelligence and warmth equal to Marjorie's. Despite his complicated history, John's complaint of insomnia was both easier and quicker to deal with than Marjorie's chest pain. After a short conversation it was clear to David that the problem was an understandable psychological reaction to a death in the family. David gave him a prescription for some sleeping medication that he was certain would help John get back to his usual routine.

After he was through with John, David added his chart to Marjorie's for further review. Then he searched for Susan. He found her in the tiny lab used for simple, routine tests.

"Are there a lot of oncology patients in the practice?" David asked hesitantly.

David very much admired the sort of people who chose to go into oncology. He knew himself well enough to know that he was not suited for the specialty. So it was with some trepidation that he discovered his first two CMV patients were both dealing with cancer.

Susan assured him that there were only a few such patients. David wanted to believe her. When he went back to get the chart out of the box on examining room one, he felt reassured. It wasn't an oncological problem; the case concerned diabetes.

David's morning passed quickly and happily. The patients had been a delight. They'd all been affable, attentive to what David had to say, and, in contrast to the non-compliant patients he'd dealt with during his residency, eager to follow his recommendations. All of them had also expressed appreciation for David's arrival, not as fervently as Marjorie, but enough to make David feel good about his reception.