“I don’t know how much more of this I can take,” said Marianne after sitting on the boy’s legs for ten minutes. She was a massage therapist. It had been a long day and her hands were tired. When Lucas was a baby, she loved to touch him. She thought of how he had smelled then, a scent so clean and full of hope it made her cry with gratefulness.

“I think he’s asleep,” Richard said. Lucas’s mouth hung open to the side, a small puddle of saliva gathering on the floor. Richard carried him into the living room and laid him out on the sofa. Then he went to the refrigerator and got himself a beer.

Richard settled into his easy chair and looked at his son. How had he ended up with a child like this? He remembered holding the boy in his arms for the first time. He remembered trying to slip his finger into the baby’s tiny fist. He took a sip of beer, knocked his tooth against the bottle, and felt a tingling nerve of pain drive into his mouth. Like this, he thought, I’ve done everything wrong.

Marianne was in the kitchen, scraping excess food from their dinner into the garbage disposal. So much macaroni and cheese. Why hadn’t she made something better, with vegetables and vitamins? In the past she had tried brown rice, tofu, and tahini, but the family refused to eat it. Eventually she had grown tired of arguing and turned to the cookbooks of her mother, recipes that started with a stick of butter.

On her own she still browsed books at health food stores (broccoli is an upper!); spent afternoons at a Hare Krishna café, quizzing the chef on vegan cooking. She considered potions, spells. She remembered sliding her own toenail clippings into a glass of punch and giving it to a boy she liked when she was twelve, convinced it would make him fall in love with her. Now she pulled out Joy of Cooking and checked the index for health and nutrition, studying the metric conversions. She hoped that somehow the next recipe would have an answer, the next one would tell her what to do.

When the school counselor called to say that Lucas was having problems behaving in class, Richard and Marianne accepted her reference to a local clinic. Lucas began to receive monthly sessions of psychotherapy from a middle-aged woman named Dr. Snow, who consulted the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, wrote a diagnosis on his chart: 314.01—Attention-Deficit/Hyperactivity Disorder, and gave the parents a prescription for Ritalin. It made everyone feel better. Something was being done. Dr. Snow said that his outbursts were a phase, and that by the end of puberty, he’d be over it.