The needle touched him first. Cold, thinner than he expected, a point of ice set against the soft inside of his elbow, and Tyler's whole arm flinched before he could tell it not to.

"Hold still," Dr. Mack said.

She didn't look up when she said it. She was looking at the crook of his arm the way she'd looked at the X-ray, the way she'd looked at the receipt — like it was a thing on a screen, and she was deciding what to do with it. Her thumb pressed down over the vein and rolled it, gentle, almost kind, and the vein rose up under her thumb like it wanted to be found.

Renata's hand left his wrist.

It went up instead — palm flat, fingers spread, sliding over the sleeve of his band t-shirt and over the knob of his shoulder, and then it pressed. Not hard. Just enough. Enough that his back met the vinyl and the vinyl gave its little sigh of air and stuck to him through the cotton, and he was flat, and he was looking up at the ceiling tiles with their water stains, and Renata's breath was at his ear, warm, and she was humming something under it, low, a tune he almost knew.

"Okay," Tyler said. He didn't know what he was saying okay to. His thumb had started up against his thigh, tap, tap, tap, and he couldn't stop it, and Dr. Mack's thumb was still on the vein.

"This is going to feel warm," she said.

The plunger went down.

It was warm. It was more than warm. It came into his arm like a mouthful of whiskey swallowed too fast, heat crawling up the inside of his elbow and spreading out across his shoulder and down toward his chest, and then it turned a corner he didn't have a word for and climbed the back of his neck and settled in behind his eyes, and behind his eyes it went soft and bright at the same time, and the ceiling tiles stopped being tiles.

"There we go," Renata said, right at his ear.

She said it like she was talking to a dog that had finally laid down. Her hand stayed on his shoulder. Her thumb moved once, small, back and forth, over the bone, and Tyler tried to turn his head toward her and found that his head had gotten heavy, that the pillow was holding it the way a hand holds a bowl of water, and he gave up halfway and let it rest.

The syringe came out. He felt it leave — a small tug, a wet little pull at the skin — and Dr. Mack held it up and looked at the empty barrel and then set it down on the steel tray with a click that seemed to arrive a half-second after it happened.

"How much?" Tyler said. Or tried. His tongue had gone thick and slow, like it had been wrapped in something, and what came out of his mouth was mostly the shape of the words and not the words.

"Don't try to talk, honey." Dr. Mack reached over to the lower shelf. The extraction set was there where it had been, the little steel tools laid out in a row on a folded blue cloth, and she picked the cloth up by the corners and lifted the whole set into her palm and weighed it there, once, the way you weigh a fruit at the market to see if it's worth the price.

Tyler watched her do it. He watched it from very far away, from the bottom of a well, from the far end of a long hallway with the lights going out one at a time, and some part of him — the part that still had the callus on its hand and still knew his rent was due in six days — understood that he should be afraid, and the understanding arrived, and the fear didn't. There was a wall between them. The drug had built it.

"Whass next," he said, and it came out as one word, and his eyes were closing and opening and closing, slow, like the flickering light.

"Next," Dr. Mack said, "you rest."

Renata's hand moved.

It came off his shoulder and down his chest, slow, over the cotton, palm flat, and it didn't stop at his ribs or his stomach or the waistband of his jeans, which were still unbuttoned from before, the button hanging open and the zipper half down, and she found the gap with her fingers like she'd known exactly where it was, and she slid her hand inside.

Tyler's whole body flinched. It was the only part of him that could. His hips came up off the vinyl an inch and his hand grabbed the armrest and his thumb stopped tapping, and above the wall, somewhere, he heard himself make a sound.

"Shh," Renata said. "It's just me."

Her fingers found him through his boxers first — the soft weight of him, warm under the cotton — and she cupped him, once, the whole of him in her palm, and squeezed, gentle, and Tyler's breath came out of him in a long unsteady stream and his hips settled back down onto the chair.

"There he is," she said.

He was getting hard. He didn't want to be. He was lying in a dental chair in a room that smelled like antiseptic and his own sweat, with a drug crawling behind his eyes and a woman he'd met three hours ago reaching into his jeans, and his cock was filling under her hand anyway, thickening, the head pushing up against the seam of his boxers, and the shame of it came through the wall the drug had built — not the fear, the shame got through, shame was thinner than fear — and it sat on his chest and made his eyes sting.

"Don't," he said. It came out small. It came out like the word had been left out in the rain.

Renata's breath was at his ear again, and her hand kept moving, slow, working him through the cotton, thumb finding the ridge of him and dragging up it and back down, and her other hand came up and rested on his throat — not squeezing, just there, the weight of it, the warmth of it, her thumb against the pulse under his jaw.

"You're doing so good," she said. "Just let it happen."

Dr. Mack had set the extraction set back down on the shelf. She hadn't left. She stood at the head of the chair with her arms folded and her weight on one hip, watching, and her face had gone quiet in a way Tyler couldn't read, and her manicured thumbnail tapped once against her elbow, once, and stopped.

"He's responsive," she said. Not to Tyler. To Renata.

"He is," Renata said.

Her hand slipped under the waistband of his boxers.

Skin on skin, then. Her palm was warm and dry and her fingers closed around the shaft of him and Tyler made another sound, a low one, and his head rolled on the pillow toward the wall and his eyes were wet and the ceiling tiles blurred and he couldn't tell if it was the drug or the tears and it didn't matter, and his hips moved under her hand without asking him, one small roll, and she felt it and laughed, soft, right against his ear.

"Oh, he likes it," she said.

"They usually do," Dr. Mack said.

Renata stroked him. Long, slow, root to tip, her grip loose enough to be gentle and firm enough that he felt every inch of the slide, and her thumb came over the head of him on every pass and spread the wet that was already beading there, and the sound it made was small and wet and obscene in the quiet room, under the hum of the fish tank, under the flicker of the light.

Tyler's hand was still on the armrest. His knuckles had gone white. He could feel the vinyl under his back, the cold of it, the stick of it, and he could feel the heat of her hand and the heat behind his eyes and the two heats were the same heat now, they'd met somewhere in the middle of him, and he couldn't tell where one stopped.

"Please," he said. He didn't know what he was asking for.

"Please what, honey?" Renata said.

He didn't answer. He couldn't. His mouth was open and nothing was coming out of it but breath, and his hips were moving now in time with her hand, small, helpless, a rhythm he hadn't chosen, and every stroke pulled something tighter down low in his belly and he was climbing toward something he didn't want to climb toward and he couldn't stop climbing.

Dr. Mack uncrossed her arms. She stepped closer, to the side of the chair, and looked down at him — at his face, at his open mouth, at the wet at the corners of his eyes — and then down at where Renata's hand was moving under the open waistband of his jeans, and something moved across her face and settled, and her eyes were the same pale blue they'd been at the door.

"Look at me," she said.

He looked at her. He didn't want to. His head turned anyway, on the pillow, toward her, and she was standing over him with the light behind her head and her bun pulled tight and her porcelain smile nowhere on her face, just the flat line of her mouth, and he looked at her and she looked back and neither of them said anything and Renata's hand kept moving.

"That's it," Dr. Mack said. "Keep your eyes on me."

He did. He couldn't have looked away if he'd wanted to. His whole body had narrowed down to two points — her eyes above him and Renata's hand below — and everything else had gone dim and far, the tray, the pick, the extraction set on its blue cloth, the fish tank, the clock, the receipt in Dr. Mack's coat pocket, all of it receding down the long hallway with the lights going out, and the only things left lit were the two of them, and he was climbing, and he was climbing, and he was going to —

"There," Renata said, and her grip tightened, and her thumb came over the head of him one more time and pressed, and her mouth was at his ear, "there, there, there," and Tyler's hips came up off the chair and his heels dug into the footrest and every muscle in his body pulled taut at once and he came.

It came out of him in pulses, hot, into her palm, and she kept stroking him through it, slow, working every last one out of him, and his mouth was open and his eyes were open and locked on Dr. Mack's and he was making a sound that wasn't a word, and his body jerked in the chair, once, twice, three times, and then it let go and he sank back into the vinyl and lay there with his chest going up and down and his eyes still on hers and his come warm and slick in Renata's hand.

Renata pulled her hand out of his jeans. She held it up in the light, palm up, fingers spread, and looked at it the way you look at a coin you've found in a coat pocket, and then she wiped it on the tail of his own band t-shirt, unhurried, and stood up straight and stretched her back and hummed a bar of the tune she'd been humming before.

"Good boy," she said.

Dr. Mack reached down and took Tyler's chin between her thumb and forefinger and turned his face toward her, and she looked at his eyes, one, then the other, and let go.

"Six o'clock," she said. "You'll be back."

Tyler's eyes were closing. The wall was coming down the hallway toward him, all the lights going out behind it, and he tried to say something — he didn't know what, he didn't know if it was yes or no or the word for the thing that had just happened to him — and his tongue wouldn't hold it, and the last thing he saw before the light went out was the two of them standing over the chair, Renata buttoning nothing back up because nothing had come unbuttoned, Dr. Mack folding the blue cloth over the extraction set, both of them looking down at him the way you look at a thing you've finished working on and set aside to dry.