The pain in his side also reminded him that he’d been meaning to cancel his upcoming appointment with his neurologist in Binghamton. He’d had four appointments with the man in less than four months, and they seemed increasingly pointless, unless the only point was to send Gurney’s insurance company another bill.

He kept that phone number with his other medical numbers in his den desk. Instead of continuing into the bathroom for the ibuprofen, he went into the den to make the call. As he was entering the number, he was picturing the doctor: a preoccupied man in his late thirties, with wavy black hair already receding, small eyes, girlish mouth, weak chin, silky hands, manicured fingernails, expensive loafers, dismissive manner, and no visible interest in anything that Gurney thought or felt. The three women who inhabited his sleek, contemporary reception area seemed perpetually confused and irritated by the doctor, by his patients, and by the data on their computer screens.

The phone was answered on the fourth ring with an impatience verging on contempt. “Dr. Huffbarger’s office.”

“This is David Gurney, I have an upcoming appointment that I’d—”

The sharp voice cut him off. “Hold on, please.”

In the background he could hear a raised male voice that he thought for a moment belonged to an angry patient reeling off a long, urgent complaint—until a second voice asked a question and a third voice joined the fray in a similar tone of loud, fast-talking indignation—and Gurney realized that what he was hearing was the cable news channel that made sitting in Huffbarger’s waiting room insufferable.

“Hello?” said Gurney with a definite edge. “Anybody there? Hello?”

“Just a minute, please.”

The voices that he found so abrasively empty-headed continued in the background. He was about to hang up when the receptionist’s voice returned.

“Dr. Huffbarger’s office, can I help you?”

“Yes. This is David Gurney. I have an appointment I want to cancel.”

“The date?”

“A week from today at eleven-forty A.M.”

“Spell your name, please.”

He was about to question how many people had appointments on that same day at 11:40, but he spelled his name instead.

“And when do you wish to reschedule it?”

“I don’t. I’m just canceling it.”

“You’ll need to reschedule it.”

“What?”

“I can reschedule Dr. Huffbarger’s appointments, not cancel them.”

“But the fact is—”

She interrupted, sounding exasperated. “An existing appointment can’t be removed from the system without inserting a revised date. That’s the doctor’s policy.”

Gurney could feel his lips tightening with anger, way too much anger. “I don’t really care much about his system or his policy,” he said slowly, stiffly. “Consider my appointment canceled.”

“There will be a missed-appointment charge.”