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And she knew from that first interview that Sam Greenberg was not only impressed by her credentials, he was impressed with her. Of course, she had pulled out all the stops in her performance; she’d asked the right questions, had put forth how interested she was in the position and the company, emphasized that she lived for her work, that it defined her, and she could tell he was sold. Reeling him in had been easy.

The elevator deposited her on the ground floor of the building and she exited, making her way to the security booth in the lobby. She stopped and found her name in the guestbook and signed out. The African-American guard behind the booth looked bored. Michelle set the pen down and smiled at him. “Have a nice day,” she said.

The guard nodded, still bored, and Michelle headed outside.

Downtown Lancaster was busy as always. As she made her way to the parking garage where she’d left her car, she tried to tell herself to not get her hopes up too much. Things could still back-fire. Sam, or somebody else above him, could change their mind about the position. There could be somebody else competing for the job that Sam might choose over her. There were a number of possibilities at play that might derail things.

But she truly hoped the job was hers.

For one, the firm itself was one she’d heard of and knew had been around for the better part of sixty years. A division of a firm with a similar sounding name, Corporate Financial Consultancy Group, the company had field offices in nearly every major city in the country and had satellite offices on every continent except Antarctica. There was a generous compensation package, along with matching 401k, a separate pension, and a health plan. During the interview Sam had mentioned casually that if she were in town in the winter during a snow storm, she could work from home remotely. That was a very attractive perk—most companies would rather have you come in and risk life and limb in an auto accident during a snow storm rather than let you work from home. And then there was the pay—

It was at least twice her present salary.

Michelle entered the garage on Prince Street and walked up the slight incline to her car, a 1999 Acura. She felt excited about this job. More excited about any job she’d ever interviewed for before. It still wasn’t her dream job—she’d probably never find her dream job since her tastes and skills were so narrow—but it seemed to be the next best thing.

Michelle Dowling drove home that afternoon feeling good for the first time about the future.

DONALD BECK, MD donned a rubber glove over his right hand as he asked his latest patient, a twenty-four year old male named Michael Brennan, who had come in complaining that he felt his right testicle had multiplied in size, to shuck his drawers.

The patient fumbled with his jeans nervously. Donald waited, rubber gloved hand held out and ready. The patient looked nervous, as if he were afraid of being labeled a fag because he was going to consent to having another man feel his balls. Donald could tell that thought was going through the young man’s mind as he slowly unbuttoned his jeans and pushed them down his skinny legs. He’d had similar patients matching this young man’s background come right out and express this fear, irrational that it was. Donald had pegged this patient the minute he walked into the examination room; uneducated with maybe a high school diploma, worked a blue-collar job (not that this was bad; he knew several men who worked as either mechanics or janitors who were smarter than people with college degrees), with a vocabulary that suggested he was a frequent watcher of The Man Show and Monday Night Football and that his idea of fine dining was going to Hooters. When Donald began his examination by asking the patient what the trouble was, the young man had been quick to emphasize that it was his girlfriend who told him his right nut had suddenly gotten bigger. “She kept telling me it was bigger,” the young man said. “She kept telling me it wasn’t normal and I should see a doctor.”

“Did you check it yourself?” Donald had asked casually.

“Um… ah… no,” Michael had responded, shuffling slightly. He looked embarrassed. “I mean… Suzie did the checking for me, you know what I mean?”

Donald knew what the young man meant. The patient didn’t want Donald to think he was queer for touching himself. What was the world coming to?

As they talked Donald felt the patient’s neck, checking his lymph nodes. He asked the patient to take off his shirt and then felt along his collarbone and under his armpits. Lymph nodes felt normal. He asked the patient to lie down and examined his abdomen; there was no tenderness, no abnormalities. Finally, he asked the patient to stand up and pull down his pants and underwear and that’s when the young man began displaying his nervousness.

Donald knelt down and, ignoring the young man’s obvious unease, examined both testicles. He took the patient’s scrotum in his hands gently and felt each testicle. The left was normal but the right was obviously larger. It was normal for one testicle to be slightly larger than the other, but this was abnormal. There was some definite hardness in the teste. “Does this hurt at all?” he asked the patient.

“No,” Michael said, grimacing slightly.

Donald gingerly examined the teste, rolling it around between thumb and forefinger, prodding as gently as possible. There was a hardness about the size of a small marble, and as his prodding fingers traveled along the organ he encountered the slightly spongier section of the teste. The patient hissed slightly. “Sorry,” Donald said. He released the man’s scrotum and stood up, pulling the rubber glove off. The young man had a slightly pale expression as he quickly pulled his pants up. “You didn’t notice this yourself?”

“No,” the young man said quickly. He buttoned his pants.

“When did your girlfriend notice it?”

A shrug. “A few weeks ago.”

“Any pain when you urinate?”

“No.”

“Have you been able to have normal sexual relations?”

“Oh yeah. I have no problem there.”

“Any painful ejaculations?”

A shake of the head.

“And you’re certain you haven’t felt this yourself?” Donald asked, watching his patient’s reaction. “Not even while dressing?”

“N…no,” the young man said. He sounded nervous. To Donald’s trained eye, the young man had noticed the sudden explosive growth of his right testicle and ignored it. Thank God his girlfriend pestered him into making this appointment. The young man would have likely continued ignoring the problem until it was worse. “Have you noticed any pain or discomfort anywhere else? Tingling at the base of your spine, perhaps? A numbness in any of your limbs?”

The patient shook his head. “No. Nothing like that.”

“Have trouble breathing?”

“No.”

Donald pulled a lab order out and began scribbling instructions on it. “I’d like to have a series of tests run. Blood work and a chest X-ray.” He paused as he finished completing the order and then tore the paper off and handed it to the patient, meeting his gaze. “And I’d like this done today.”

“Today?” The young man’s face fell. “I’ve got—”

Ignoring him, Donald continued. “It could very well be nothing, but I’d like to rule out testicular cancer. Blood work and a chest X-ray will help me with that diagnosis.”