“I’m not telling you this to elicit any sympathy. I’m telling you this so that you understand me better. I have never ever agreed to mentor anyone, and it is not just because my Asperger’s puts me at a social disadvantage. I feel I don’t have the time for other people’s nonsense, and this includes Ph.D. students as well as medical students. You were a first. I thought your foster care experience would make you thrive in the lonely pursuit of science and that you should have been given a chance.”

“I think you’re right,” Pia said. “I know I struggle with social issues as well.”

“Pia, commitment to research has to be total. Two days ago you came in here and told me that, yes, you were going to take me up on my offer to do your Ph.D. here in my lab. At the same time you told me you were going to do a simultaneous residency in internal medicine. And then you expected me to be pleased. Pia, that old myth of the doctor doing both clinical medicine and research at the same time is totally passé. It wasn’t even true when it was current. Research is more than a full-time job.”

For one of the first times in their three and a half years of knowing each other, Pia and Rothman held each other’s eyes. It was a kind of Mexican standoff. Both were conflicted. Pia had struggled hard and surmounted considerable obstacles in her drive to become a doctor. And now she was so close. In months she would be getting her M.D. degree. The problem was she wouldn’t yet be a doctor, one that can get a license from the state. A resident was on his or her way to becoming a real doctor. If she didn’t take a residency, she’d always be a medical student with an M.D.

Both individuals looked away.

“I realize that I’m hard to read,” Rothman said, breaking a short silence, “or at least my wife tells me so. She advised me to have a conversation with you.”

“She knows about me?”

“She knows about everything in my life. It is the only way we could have survived as a couple. I’m not easy to live with.”

Rothman had been rehearsing this speech for days so he was relatively comfortable once he had started talking.