I know what I did in that day room was wrong. I can recite the violations: dual relationship, boundary crossing, sexual contact with a patient under my professional oversight. I know the words and I know the consequences and I know that any licensing board would revoke my credentials if they saw the footage.
But when I try to access the feeling that's supposed to go with that knowledge—the hot flush of shame, the sick twist of guilt—there's nothing there. Just the memory of his fingers and the low rough sound of his voice sayinggood girland the way every nerve in my body fired at once, two words and I wanted him to say them again.
The dent in my brain doesn'tmakeme want him. That's important. The wanting is real, mine, grown from months of conversations and observations and the way he looks at me when no one else is watching.
The dent just keeps the noise off while I do it.
I flip back to the chapter's opening paragraph.Ethical violations rarely begin with conscious intent. They emerge gradually, through accumulated rationalizations and the erosion of professional distance.
I haven't been rationalizing. I've been choosing. Clear-eyed, unashamed choices that would horrify the woman who bought this textbook seven years ago.
That woman had an intact amygdala and a normal fear response and she would never have let a patient's hand under her skirt.
But I'm not her anymore.
My phone buzzes. Aunt Kathy's name on the screen.
"I was just thinking about you," I say.
"Well, that's either very good or very troubling." Her voice is warm. I can hear wind in the background—she's probably in her garden, phone wedged between her shoulder and her ear while she does something complicated with her roses. "You missed Sunday dinner. Steve said you were working."
"Steve lies for me without being asked. It's one of his better qualities."
"So where were you really?"
I hesitate. The textbook is still open in front of me, Chapter 14 staring up at me.
"Thinking," I say. "About some things I probably should have thought about months ago."
"That sounds heavy. Hold on—" A rustling, a muffled curse, then she's back. "Fucking aphids. Every year. Anyway. What kind of things?"
"The kind you're better at than I am."
She doesn't answer right away. I hear her settle into what I know is the wrought-iron chair by the back fence, the one she drags to wherever the afternoon light falls best.
"This about your work? Or about a person?"
"Both. Neither. I don't know."
"Well, that narrows it down."
I laugh despite myself. "There's someone. At the facility. And I know all the reasons it's complicated, and I know what it looks like from the outside, but—"
"But it doesn't feel complicated from where you're standing."
"No."
"Hmm." More rustling. "Is he good to you?"
The question catches me off guard. Notis it appropriateorhave you thought this throughor any of the hundred concerned questions I've been bracing for.
"He is," I say. "In ways I didn't know I wanted."
"And you're telling me because you want someone to say it's okay, or because you want someone to talk you out of it?"
I think about the textbook. The self-assessment questions.
"I don't think I want to be talked out of it."
