Alexandre Vidal Porto - Sergio Y.

But he never mentioned anything that I could have interpreted as indicating any conflict over his sexual identity. Not once. I have no idea how many layers of fear drowned out this secret inside of him. It was all hidden. He, of course, knew what was happening and willingly said nothing. He did not have the obligation to tell me anything. We must respect the patient’s will.

Eduardo did not seem shocked at my professional failure. One of the first comments he made after I told him of my anguish was, “I don’t know why you care so much about a case that’s unsolvable. Death really has no solution, Armando. All of these therapies we do only have meaning while we’re alive. The dead are useless to us. Sergio Y. died, right? Things are not so black-and-white. This obvious fact is what I want to impress upon you. The responsibility you feel you have in the case of Sergio Y. is unfounded, almost ridiculous. Wake up, Armando! You’re merely one of the many factors in the equation that resulted in the death of this twenty-three-year-old. You weren’t the determining factor here. You have no idea under what circumstances his death occurred. The sad truth, Armando, is that in this case, your role was minimal. I know you. I know it’s hard for you to accept a minor role, but I think that’s what you need to try to do.”

At the time I did not understand that I had inadvertently reproduced in my mind the stereotype that the death of a transsexual is always caused by the tragic circumstances of his life.

But the death of Sergio Y. — regardless of whether he was a transsexual or not — might have been random. His life might not have been tragic at all. This also happens. That was the conclusion I should try to reach. If he had been hit by a stray bullet, or lightning, or a runaway car in São Paulo or in New York, he would be just as dead. Still young, transsexual and dead, regardless of the agent of his death.

With this psychological guidance in mind, I went on with my life. Gradually, I went back to seeing my regular patients and to going to the gym in the mornings. I felt at peace, but I still thought daily of the nature of my role in the untimely death of my former patient.

Time, however, wears everything down, and gradually the feelings of responsibility for having harmed Sergio Y. began to dissipate. The more I managed to distance myself from the problem, the more my guilt began to turn into doubt.

Reviewing my datebook, I see that I decided to call Tereza on March 19.

It was raining heavily. From my window, I could see the headlights reflected on the wet highway below. The sound of rain drowned out the hum of the traffic. The soaked and tense city grew dark. That afternoon, the main concern of the inhabitants of São Paulo was to get home.

My Thursday patient called at 5:20 P.M. telling me he would not be arriving on time for his session. His call gave me thirty free minutes before my next meeting — a student who wanted my opinion about a project, but who might also not make it because of the rain.

I decided to take advantage of the additional time to answer e-mails and to pay my credit card statement online. From my bank page, I started surfing the web aimlessly, until, don’t ask me how, I arrived at the Brazilian Oncology Association page.

I only mention my wanderings on the computer because that was how I arrived at photos of the National Cancer Institute anniversary dinner. The third picture showed Tereza and Salomão Yacoubian with the president of the institute. Salomão wore a dark blue suit, white shirt and burgundy tie; his wife wore a gray dress and looked directly at the camera. It was not a look of celebration, but they hid their sorrow with dignity.

That afternoon, on impulse, I called Tereza Yacoubian. It crossed my mind that this call could be seen as inappropriate, but I decided to interpret the fact that they had been photographed at a social event as evidence that their mourning had come to an end. I chose to believe that photo meant they were accessible.

That was what I was thinking when I picked up the telephone to call.

“Tereza? How are you? This is Armando, I was Sergio’s therapist. Do you have a moment? I’m sorry to call you like this, out of the blue. But I’ve been reviewing my notes from our sessions and I had some questions I wanted to ask you, if you don’t mind. I’ve had dreams of Sergio. In my dream, he wore an apron. I think it’s the image you gave me when we met in supermarket.”

“I was buying cheese for a soufflé… ”

“How did this happen, Tereza? What happened to Sergio?”

“Doctor, we still don’t understand fully. I can’t speak about this just yet. It’s not that I don’t want to. I’d like to talk to you about Sergio. Just like you have questions for me, I also have questions for you. It’s just that I can’t now. I’m afraid I’ll fall apart. You know how important you were in the decisions he made. If you have questions of a medical nature, I can give you his doctor’s e-mail in New York. If you like, I can write to her and say you’ll be in touch. Her name is Cecilia Coutts. She can explain what happened to Sergio. But as I said, it’s still too painful to talk about my son’s death. Please write down Dr. Coutts’s e-mail.”

“Of course, Tereza. Please excuse the call,” I said.

I wrote down the address she gave me. “As soon as I’m able to, we’ll talk,” she said before hanging up.

I felt embarrassed by the call. At that moment, I felt sorry that I had given in to my impulse.

I had attempted to satisfy my curiosity without regard for the feelings of a mother who had lost her only son. I felt awful. How much lower could I go? I wanted her to understand that what seemed like mere curiosity on my part was not curiosity at all but concern. When someone shows concern for a child who has died, he gives comfort to the surviving parents because that interest is noble and resuscitating.

“Doctor Armando, I appreciate your interest in my son, but I can’t help you now. I’ll help when I feel up to it.”

Suddenly, I realized that for Tereza, Sergio was still unburied.

I would stay up until late reading the news online. I would wake up at around 8 A.M. I would make coffee and feed the cat. I would see the patients I had to see, I would return phone calls, and through it all life apparently remained the same.

The only conspicuous change in my routine was the absence of my cleaning lady, Rosa, who was on maternity leave. Her cousin Rosangela came instead. The presence of one made up for the absence of the other. Nonetheless, in the months that followed Sergio Y.’s death, much had changed for me. I had become cowardly and less committed as a doctor. The death of Sergio Y. had made me a worse person.

A sense of guilt began to weigh on me, and a sadness, which I did not want anyone to know, filled my heart. I did not feel diminished, but I was filled with shame.

Sergio had been the great failure of my professional life. I believed I had never been so wrong with a patient as I was with him. It was only fair that my hands should feel dirty with a blood so real I could almost smell it. But I did not want anyone to know how vulnerable I was.

The only person who knew was Eduardo, my friend from college, who was discreet by nature and always sensible in his advice. He understood how I felt without ever blaming me in any way.

Mariana was born on the eve of my forty-fourth birthday. By then I already had white hair and a belly. I never expected to have children. It was a surprise when Heloísa told me she was pregnant.

Even nowadays it is hard to understand the transformation that occurs when a child is born. One’s worldview changes. Old worries fade; others, new ones, emerge. Important things become trivial. This is true even with cats and dogs.