McGrath checked his schedule. A new patient. He knew nothing about the man, he hadn't volunteered much information when making the appointment. All he knew was that he'd had an appointment earlier in the week and had broken it at the last minute - not uncommon of course. Would he show up for this one? A light tap on the door answered that question.

"Come in," he said, and rose to meet his new patient. "Mr. ...Kovač ? Tell me if I pronounced that wrong."

"Kovač." He had pronounced it wrong. "And it's ... Dr. Kovač actually ... but Luka's fine."

"Hello, Luka. I'm Dr. McGrath, or you can call me Brian if you prefer." He offered his hand for a handshake, and Luka accepted it.

All this time, McGrath had been rapidly assessing his new patient. A fairly thick accent, probably recently arrived from Europe. Certainly within the decade. And Kovač was, unless he was much mistaken, a Balkan name. He remembered having treated a patient with that name some years ago, for problems related to the war there. Perhaps this would turn out to be something similar. His handshake had been reasonably firm, though his palms were damp.

Physically, the man was tall and strikingly attractive, though rather thinner than he should have been. And pale, even by late-winter-in-Chicago standards. He walked with a pronounced limp, barely using the crutch that dangled from his arm. There were scars on his face, and more at the base of his hands, disappearing up under his shirt sleeves. But his eyes were what struck Brian the most. Changeable blue-green-brown. They made Brian think of the sea. Or a mood ring. He knew immediately that whenever he needed to know what this new patient was feeling, he would only have to look at his eyes. And right now, those eyes looked terrified. Like he was heading for his own execution.

"Sit wherever you like, Luka," Brian said. He had several chairs of varying types and a sofa. Luka selected the hard wooden chair; perched on the edge of it. Perhaps so he could get up quickly? Brian sat on the couch, made himself comfortable.

"So, Luka. What brings you to see me?"

"My ... ummm ... my girlfriend wanted me to come. I'm getting by ok ... I think ... but she's worried about me; thought I needed to talk to someone." He was looking around the room, moistening his lips with the end of his tongue.

"You're having problems with your girlfriend?"

"No. Not really. She's wonderful. I love her. She loves me." The first hint of a smile. "I can't believe it took me this long to find her." Still looking around. Wanted to be anywhere but here.

"What's her name?"

"Susan."

"Where did you meet her?"

"We work together. Have for a few years now."

"You're an M.D?" Luka nodded. "Where do you work?"

"Does it matter?" Suddenly tense.

"No, not really. I'm just trying to get to know you a little bit. What's your specialty?"

"Emergency medicine. I love it." Luka rubbed his bad leg, another nervous gesture. He said nothing more.

"So, why did Susan want you to see me? What kind of problems are you having?" Luka didn't answer. "Luka, I can't help you if you don't talk to me."

Luka just shook his head, shut his eyes. "I can't do this. I'm sorry, Dr. McGrath. I shouldn't be wasting your time." He started to rise, adjusting his grip on the crutch to help lever him out of the chair, and McGrath quickly rose himself, went to stand near his patient. He couldn't, wouldn't physically stop him from leaving, but his presence might provide the psychological barrier he needed.

"I promise you, Luka, there is nothing you can ever tell me that I haven't heard before, or that is going to shock me." A bitter look from his patient. "I've been in this field for 20 years now, and I've heard just about everything." A breath. "Look, you took the first step, you made the appointment. You took the second step, you showed up. Now, lets just try and get through the session. Talk about what's bothering you. We'll make a start. At the end of the hour, you can decide then if you want to come back, keep going with it."

Luka was standing now, he began to pace the room, but didn't go near the door. "It's just not ... that simple." The click of his crutch was almost louder than his voice as he walked. "There is so much. It's going to take so long to get through it ... to get through enough to even make a difference. I just can't see how it's going to be worth it to me."

"However, long it takes, we'll work through it. And at the end of it, you'll feel better, and it will have been worth it, for you and for Susan."

"But that's just it!" Fierce now. "I don't have 'however long it takes.'" He stopped walking, leaned his weight on Brian's desk. "I'm HIV positive - AIDS, actually. It's proving to be drug resistant, highly aggressive; I'm probably not going to live very long. A couple of more years ... if I'm lucky."

"All the more reason to start now, surely," Brian said quietly. "While you still have the time to take care of it before you go."

"That's just what Susan said."

"Smart girl." Brian kept his tone neutral.

Luka didn't respond, but, after another moment, sat down again in the chair, put his face in his hands. At first Brian thought he was crying, but he wasn't. He was just sitting there, clearly waiting for Brian to say something.

"Is Susan still well?"

"Yeah. We got together after I'd already been diagnosed. We haven't had intercourse."

"By mutual agreement?"

A slight shake of the head. "She wants it. I ... can't."

Brian was already getting the sense that this new patient of his was a man who was going to volunteer little, but who might respond well to direct, even blunt questioning from him. "You're impotent?"

"Not physically, no. I just ... don't feel anything anymore."

Any more. "So, this is a new problem?" A nod. "How new?"

"About a year. A little less." Luka rubbed his leg again, looked around the room. "I ... I'm told it's not uncommon ... not an uncommon response, psychologically, after being raped."

Ok. Now they were getting somewhere. "You were raped?"

"Yeah."

"Is that how you contracted the HIV?"

"Presumably so."

"Susan knows about this?"

"Of course. I told her. She still wants to have sex." Another faint smile. "I guess love makes you stupid."

"Well you're here, aren't you? Am I right in thinking that are also interested in trying to have intercourse?"

"I love her too. I guess the stupidity is mutual." Luka's smile deepened a little and, for the first time he met Brian's eyes, relaxed back into his chair slightly.

"You said the impotence isn't physical. You get erections?"

"Sometimes, at night, sometimes I'll wake up with one." The tension was back instantly. "It goes away."

"Do you masturbate?"

"No."

"Nocturnal emissions?"

"I've had ... a few." He was paler now. Sweating a little.

"How do those make you feel?"

"Sick. I go into the bathroom and throw up."

"It sounds like this is a bit more than just 'not feeling anything," McGrath said quietly. No response from Luka, except to get up again, start pacing the room again. "So ... the rape happened last winter, is that right?"

"Spring."

"And you and Susan weren't together at the time?"

"I told you ... no. We've just been together a few months. I knew her then, but just as a co-worker, a friend."

"Were you in a sexual relationship at the time? With someone else?"

"Yeah." Again, Luka clearly wasn't in the mood to volunteer anything.

"What was her name?"

"Gillian. She's a nurse. It wasn't anything serious."

"She works at your hospital too?"

"No."

"How long were you together?"

Luka turned abruptly from the window, where he'd been staring out at the gray winter sky. "Listen ... I am here because Susan asked me to come see you. She wants for us to be able to make love ... have some kind of a sexual relationship. We can't do that because I can't even stand for her to touch me. When she touches me I get sick, I throw up. Can we just talk about that? If we can deal with this one problem, I'll be ok. The rest of it ... it doesn't really matter."

"The rest of it does matter, Luka. Your sexual problems are just a symptom. We need to treat the cause. And I think you know that. You're a doctor. Even if I had a magic pill to offer, that would let you go home and make love to Susan tonight, I wouldn't give it to you. I don't have such a pill anyway, and we both know that the only way to treat this 'one problem', is to get to the heart of it." Luka nodded, perched himself on the edge of the window sill. Brian took a deep breath. "When Susan touches you, and you get sick ... what's going through your head? What are you thinking?"

"I'm not really thinking anything. I kind of ... black out almost. Like I'm trying to get away from it. I know it's her, but I'm feeling ... Them ... touching me."

"Them? So it was a gang rape?"

"Of course it was! Do you think I couldn't have fought off one man?! Do you think I'm that weak?!" Luka caught his breath, steadied himself. "I'm sorry. Of course you didn't know that. I hadn't said ..."

The session was finally over. Luka looked almost gray, physically exhausted as he shook Brian's hand and walked out the door, leaning very heavily on his crutch. He had an appointment for next week - he'd agreed to try coming twice a week for a while. Would he keep the next appointment? Brian could only hope that he would. They had covered a lot of ground, enough that Brian knew the truth of Luka's words, there was 'so much,' and it was going to take them a long time to get to the root of his problems. He had treated many rape survivors over the years, both men and women; it was a common enough cause of PTSD. But in Luka he sensed, that there was something far beyond the rape itself, and the AIDS, and even the physical injuries (a subject they had barely had time to touch on today) that was causing him such deep pain, such intractable shame.