Lucy is no longer embarrassed, can talk about anything with him. In the beginning, it was a different story, a horror and humiliation that a benign pituitary macroadenoma—a brain tumor—was causing an overproduction of the hormone prolactin that fooled her body into thinking she was pregnant. Her periods stopped. She gained weight. She didn’t have galactorrhea, or begin to produce milk, but had she not discovered what was wrong when she did, that would have been next.

“Sounds like you’re not seeing anyone.” He slides her MR films out of their envelopes, reaches up, and attaches them to light boxes.

“Nope.”

“How’s your libido?” He dims the lights in the office and flips on the light boxes, illuminating films of Lucy’s brain. “Dostinex is sometimes called the sex drug, you know. Well, if you can get it.”

She moves close to him and looks at her films. “I’m not having surgery, Nate.”

She stares dismally at the somewhat rectangular-shaped region of hypointensity at the base of the hypothalamus. Every time she looks at one of her scans, she feels there must be a mistake. That can’t be her brain. A young brain, as Nate calls it. Anatomically, a great brain, he says, except for one little glitch, a tumor about half the size of a penny.

“I don’t care what the journal articles say. No one’s cutting on me. How do I look? Please tell me okay,” she says.

Nate compares the earlier film to the new one, studies them side by side. “Not dramatically different. Still seven to eight millimeters. Nothing in the suprasellar cistern. A little shift left to right from the infundibulum of the pituitary stalk.” He points with a pen. “Optic chiasm is clear.” Points again. “Which is great.” He puts down the pen and holds up two fingers, starts with them together, then moves them apart to check her peripheral vision. “Great,” he says again. “So almost identical. The lesion isn’t growing.”

“It isn’t shrinking.”

“Have a seat.”

She sits on the edge of the couch. “Bottom line,” she says, “it’s not gone. It hasn’t burned out from the drug and become necrotic, and it never will, right?”

“But it’s not growing,” he repeats himself. “The medication did shrink it some and is containing it. All right. Options. But what do you want to do? Let me say that just because Dostinex and its generic have been linked to heart valve damage, I’m not sure you need to worry. The studies are dealing with people who take it for Parkinson’s. At your low dose? You’ll probably be fine. The bigger problem? I can write you a dozen prescriptions, but I don’t think you’ll find a single pill in this country.”

“It’s manufactured in Italy. I can get it over there. Dr. Maroni said he will.”