The case closed. Not cleanly. Not completely. But enough that nothing more could be done. The report was signed. The addendum entered. The FISH result documented. The file moved into the same place all completed cases eventually went—finished, archived, absorbed. At the lab, it disappeared almost immediately.

At home, it didn’t. That evening, James took his guitar out. He hadn’t planned to. It caught his eye as he walked past the case, sitting where it always sat. He stopped, almost as if he had forgotten it was there, then bent down and opened it. The familiar smell of wood and case lining rose up faintly.

He sat in the chair near the window and lifted the guitar onto his lap. The weight settled against him the way it always had. His left hand found the neck without thought. His fingers moved into position before he had decided what to play.

The first chord rang out. Full. Clean. Exactly right. He waited.

The second chord followed. Then a progression he had played for years, something so familiar that it usually took him out of himself within seconds. On hard days, tired days, even angry days, music had always met him somewhere words could not.

He kept playing. A minute. Two. Then longer. Nothing happened. He stopped. The chord faded. He sat there, still holding the guitar. “That’s not right,” he said quietly.

He adjusted the tuning, though he knew it wasn’t the tuning. Played again. Perfect. Technically perfect. Still nothing. No lift. No release. No warmth. No entrance into that place where sound became more than sound.

He tried a different line. Something older. Something from before medical school, before Deanna, before children, before laboratories and clients and diagnoses that followed people into the rest of their lives. His fingers remembered. He didn’t.

After a while, he stopped playing and looked down at the instrument as if it had withheld something from him. This had never happened before. Not once. Even when he was exhausted, even when he was distracted, even when his hands felt stiff or his mind was somewhere else, there had always been some small return. Some confirmation that the part of him that lived there was still awake. Now the guitar sounded right. But it gave him nothing. He closed the case slowly. Not because he was angry. Because he didn’t know what else to do.

Dinner was already on the table. Deanna had been in the kitchen longer than usual. He had heard her earlier—cabinet doors, water running, the dull sound of a baking sheet being set down too hard, then moved again.

When he sat, she placed a small plate in front of him.

Pão de queijo.

He looked at it for a moment.

“You haven’t made this in years,” he said.

“I know.”

She sat across from him but didn’t reach for one.

He picked one up. Still warm. Slightly crisp outside.

“Do you remember the first time?” she asked.

He almost smiled. “Your apartment.”

“You were late.”

“I was a resident.”

“That was always your explanation.”

“It was usually true.”

She smiled, but lightly. “You stood in my kitchen doorway,” she said. “Like you weren’t sure if you were allowed to come in.”

“I was being polite.”

“You were nervous.”

“So were you.”

She didn’t deny it. “I had never made them for anyone before,” she said.

“You watched me take the first bite.”

“I was waiting to see if you lied.”

“Did I?”

“No,” she said. “That’s why I made them again.”

He took a bite now. Chewed. Swallowed. “It’s good,” he said.

Deanna watched him. “James.” 

He looked at her. “It’s really good.”

“You know what it’s supposed to mean,” she said.

That landed more deeply than he expected. He set the rest of it down. “I know what it should taste like,” he said.

“That’s not the same.” No. It wasn’t.

Tess came in carrying another dish, covered with foil. She set it down in the center of the table, then removed the foil carefully. Chicken adobo. Garlic rice beside it. The smell rose immediately—vinegar, soy, garlic, bay leaf.

“This is the way my mother made it,” Tess said.

James looked up. “You haven’t made this before.”

“No.”

“For us?”

“No.”

She said it simply. Then, softer: “I thought maybe tonight.”

Deanna looked at her, then back at James. Tess served him without asking. Not too much. Just enough. He took a bite. It was good. He knew it was good. The balance was right—the sharpness, the salt, the garlic rice holding it all together.

“It’s good,” he said.

Tess remained standing. “You don’t like it.”

“I do.”

She looked at him for another second. “You don’t receive it.”

James didn’t answer. Tess sat down slowly. “When someone cooks like this,” she said, “you know if it reaches them.”

Deanna was quiet. Selah wasn’t there. The empty chair made the table feel slightly off balance. James looked at the food again. “I’m sorry,” he said.

Tess shook her head. “No. Do not apologize for what you cannot taste.” That was worse somehow.

Sleep did not come easily that night. He lay beside Deanna and listened to the sound. It had become clearer since the case closed. Not louder in a measurable way, maybe, but nearer. As if it had moved from somewhere outside him to somewhere behind his eyes. He turned onto his side. Then onto his back.

Deanna did not ask at first. That was one of the things he loved about her. She didn’t rush the question just because she already knew the answer. After a while, she said, “How long?”

He knew what she meant. “A week.”

“Longer.”

He closed his eyes. “Yes.”

The next morning, he sat at his desk and typed his password. It didn’t work. He stared at the screen. Typed it again. Nothing. He slowed down and tried once more, carefully, as if the problem were his fingers. Still wrong. For a few seconds, he couldn’t move. It was not fear exactly. It was blankness. He knew the password. He had typed it every day. Hundreds of times. Thousands. But the sequence had disappeared. He reached for his phone, opened the notes app, and found it. Typed it in. Access granted. He sat there without opening the first case.

Devon appeared in the doorway. “You okay?”

James looked up. “Yes.”

Devon watched him. “You sure?”

“Yes.”

Devon nodded, but something in his face did not fully accept the answer. “Okay,” he said.

He left.

James turned back to the screen. The first case loaded.

Benign keratosis.

Straightforward.

He knew it before reading the clinical note. He signed it. Felt nothing.

At lunch, Ron was talking. James heard his voice. Heard Susan answer. Heard Elise make some dry correction that normally would have amused him. But the words passed by without catching.

Ron looked at him. “What do you think?”

James blinked. “About what?”

Ron leaned back. “You weren’t listening.”

“I was.”

“No, you weren’t.”

Susan looked over, not sharply, but carefully. “You’ve been quiet,” she said.

“I’m tired.”

“That’s not the same thing,” Ron said.

James picked up his fork.

“I didn’t sleep well.”

Ron’s expression changed just enough. “How long?”

“A few nights.”

Susan didn’t believe that. Neither did Ron. But neither pushed. That was mercy. Or discomfort. Sometimes they looked the same.

That afternoon, Devon came into his office with the courier schedule. “San Diego wants the pickup adjusted,” he said. “I can handle it.”

James nodded. “Go ahead.”

Devon didn’t move. “You don’t want to review it?”

“No.”

“You usually do.”

“I don’t need to.”

Devon looked down at the paper, then back at him.

“Okay. Devon looked out across the lab. “You want me to bring you anything?”

“No.”

“Coffee?”

“No.”

“You sure?”

James looked at him. Devon stopped. “Okay,” he said again, quieter this time.

By the time James got home, the guitar case was still where he had left it. He noticed it immediately. Then walked past it. Selah came by later that evening. She had not planned to stay long. He could tell from the way she carried her bag—still over her shoulder, keys in hand, shoes not fully off. Then she saw him.

She stopped. “You look worse,” she said.

“I’m fine.”

“No.”

He tried to smile. She didn’t let him. “No,” she repeated. “Don’t do that.”

“What?”

“That thing where you make it smaller before anyone else can name it.”

Deanna looked up from the kitchen but didn’t interrupt. Selah set her bag down. “When did you last sleep?”

“I slept.”

“That wasn’t the question.”

He didn’t answer.

“At the clinic,” she said, “when someone says they’re fine and then doesn’t answer the actual question, we start asking different questions.”

“This isn’t the clinic.”

“No,” she said. “But you’re still a person.”

That quieted him. She sat across from him. “Are you eating?”

“Yes.”

Deanna said nothing. Selah looked at her mother, then back at him. “Are you tasting food?”

James looked away. Selah’s face changed. Not dramatically. But enough. “What’s going on?” she asked.

“The case is closed.”

“That’s not what I asked.”

“I know.”

She waited. He could feel Deanna in the room. Tess somewhere in the kitchen, pretending not to listen and absolutely listening.

“I don’t know,” he said finally.

Selah leaned back. “You do know something.” He looked at her. “You always know something,” she said. “Even when you don’t know the whole answer.”

He almost answered reflexively, but stopped. She was not a child asking for reassurance. She was twenty-six. She had patients who trusted her. Families who called her. Volunteers who waited for her decisions. She had seen enough suffering now to recognize when someone was disappearing in plain sight.

“I’m not sleeping,” he said.

“I know.”

“The tinnitus is worse.”

“How much worse?”

“Constant.”

Selah swallowed. “And the case?”

“It’s done on paper. Not here.”

She looked down at her hands. “We had a patient last week,” she said. “Older man. Came in for something minor. Everyone thought he was just difficult. Missing appointments, not answering calls, irritated with the staff.” She paused. “Then one of the volunteers sat with him long enough to ask the right questions.”

James moved closer.

“He wasn’t sleeping. Wasn’t eating. His wife had died three months earlier, but he kept saying he was fine because he didn’t want his kids to worry.”

She looked up. “He wasn’t fine.”

“I’m not him.”

“No,” she said. “You’re not.”

Then, softer: “But you’re doing the part where you think functioning means you’re okay.”

He didn’t answer. Because that was exactly what he was doing. She stayed longer than she meant to. Talked about the clinic. A grant problem. A patient navigator who might quit. A family who had brought tamales for the staff because they didn’t know how else to say thank you.

Normally, James would have asked questions. Followed the threads. Made some dry comment that would irritate her and make her smile at the same time. He listened. He understood. But the responses didn’t come.

At one point, Selah stopped mid-story. “You’re trying,” she said.

He looked at her.

“To listen,” she said.

He felt something then. Not enough. But something.

“I’m sorry,” he said.

Her face softened. “I don’t want you sorry,” she said. “I want you here.” That hurt. Because he was trying to be.

After she left, the house felt too quiet. Deanna sat beside him on the sofa. For a while, neither of them spoke. Then she said, “She sees it.”

“Yes.”

“So does Tess.”

“I know.”

“So do I.”

He nodded.

Deanna took his hand. “You’re pulling away.”

“I’m here.”

“You are physically here.”

He looked at her. She did not say it harshly. That made it harder.

“You look at me,” she said, “but sometimes I don’t know if you’re receiving anything. Food. Music. Conversation. Us.”

He closed his eyes. “I know.”

“I’m not accusing you.”

“I know.”

“I’m afraid.”

He opened his eyes. That, she had not said before. “I’m afraid because I don’t know what part of this is exhaustion, what part is the case, what part is the sound, and what part is something else.”

He held her hand more tightly. “I don’t either.”

Later, after Tess had gone to her room and the house had settled, James walked past the guitar again. Stopped. Opened the case. Sat down. Played the same progression. The notes came out clean. Beautiful, even. He knew that objectively. But still nothing opened. He stopped sooner this time. Closed the case.

Deanna had watched from the doorway. He hadn’t known she was there.

“You heard?” he asked.

“Yes.”

“It sounds right.”

“I know.”

“That’s the problem.”

She stepped into the room. “Because you don’t feel it.”

He nodded. “I don’t feel anything from it.”

The words came out flat. He hated that. Deanna sat beside him.

“That has never happened to you.”

“No.”

“Not once?”

“No.”

She absorbed that. Not as information. As grief.

That night, he sat on the edge of the bed before lying down. The light was still on.

Deanna sat beside him.

Close enough that he could feel her without having to look.

“You’re not sleeping,” she said.

“No.”

“The sound?”

“Yes.”

A pause.

“And the rest of it?”

He didn’t answer immediately. Because the question was no longer about the case. It was about him.

“I picked up the guitar,” he said.

“I know.”

“It sounded right. Everything was right.”

He stared ahead. “I just didn’t feel anything.”

She reached for his hand. 

“I kept playing,” he said. “Waiting for it to come back.”

He shook his head once. “It didn’t.”

The room was quiet.

“I forgot my password this morning.”

Deanna didn’t react outwardly.

“I’ve used it every day,” he said. “Same one.”

He let out a breath. “Nothing came.”

Now he looked at her. Not panicked. Not broken. Just clear.

“I don’t think this is just stress.”

Deanna held his gaze. “No,” she said quietly. “I don’t think it is either.”

He nodded. Not agreement. Recognition.

“I don’t feel like I’m in control of it,” he said.

That was the closest he came. Deanna didn’t soften it. She didn’t tell him he was fine. She didn’t say it would pass. She just held his hand and said, “Then we need to understand what it is.”

He turned off the light. Lay back. The sound was still there. Unchanged. But something else had shifted. He wasn’t waiting for it to pass anymore.

And that changed everything.

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