His balls smoke in my hands.

"Guitar, huh?" I hear myself ask.

"Yeah," he says, distant over the sound of my tools.

I hunch over his groin for a better angle. "In a band or something?"

"Mm-hm," he says.

I push his scrotum to the side and close my eyes, feeling for the right place to cauterize. Ten years of vasectomies, it's kind of like riding a bike.

"That's cool," I say, and mean it. When I was in high school, I'd always wanted to play the guitar. It was that Hot for Teacher video. I wore my Van Halen t-shirt for three weeks straight. Had a big poster of Eddie in my bedroom, and vowed I'd learn to play Eruption someday.

Of course, then David Lee Roth left and they turned into Van Hagar. Nothing against Sammy, but things were never the same. Maybe it was me, growing out of my hair-metal phase, refining my tastes.

Still, I've always wished I could remember the name of that teacher.

"Play any Van Halen?" I ask.

"No," he says, and his voice sounds tight. "Bluegrass."

I look up and catch his expression. He has the look of a man whose balls are smoking. Bluegrass. Sure, the long hippie hair, flannel shirt untucked and wrinkled. Looks like one of those guys that sits in the corner at Starbucks. There's usually a group of them, like Kurt Cobain stunt doubles.

Of course, Kurt didn't play bluegrass.

Come to think of it, those guys probably don't either. I'm not really sure why I connect them. Maybe it's the music that plays while I'm there, getting my usual white chocolate mocha with whipped cream and sprinkles.

It's an easy order, not like the powersuit woman this morning with her skinny caramel macchiato. I have no idea what that is, and as I finish searing my patient's tube, I concede it may not be a very difficult order, just something I've never heard of.

"Doctor?"

It's Janine, my nurse, on the intercom.

I look at my Cobain stunt double patient and pull away from his balls. "One second," I say. "Yes, Janine?" I ask, pushing the button.

"Your wife's on the phone."

"Can you tell her I'm busy?" I give Kurt an exasperated roll of the eyes.

"I did," says Janine. "She says it's urgent."

Of course it is. "I'll take it in here." I turn back to Kurt, mounted in the patent leather chair with his pants puddling his ankles. "I'm sorry," I say, draping a green surgical cloak over his still-smoking manhood. "It'll just be a moment."

He doesn't say anything, just fidgets and nods, and I feel for him. But I'm still taking the call.

I put her on speaker.

"Hi sweetie," I say, trying not to sound like I'm at work on another man's member. "What's up?"

"Glad I caught you," she says over the blaring tv. "Can you stop at the store on your way home?"

"For what?"

"I need some more tampons," she says. "And milk. We're out of milk, too."

This is the emergency. Tampons and milk.

"No problem," I say. "Anything else?"

"Nope," she says. "When will you get here?"

I check my watch. 2:38. "I don't know. Depends on traffic. Maybe five?"

"Okay, see you soon."

When I turn around, Kurt's got a smirk on his face, like maybe he's forgotten whose balls are smoking. It bothers me, more than it should, and for both of our sakes, I know I better not jump back into things.

"I'm sorry," I say. "I have to go to the bathroom."

The smirk disappears. "What?"

"Trust me, it'll steady my hand."

"Sure," he says, and I can see that he's pissed. "Whatever."

As I come out of the john, it strikes me this is twice today I've been annoyed over nothing. When I pulled out of Starbucks, this douche in a Hummer went nuts on his horn. Like I'd cut him off, when not ten feet ahead cars were stopped at a red. In my rearview, I could see him swearing and shooting the bird. I just stared, telepathically asking how far would you get if I hadn't pulled out? Eight, maybe nine feet? I don't think he heard me. So when the light changed and the other cars went, I stayed where I was. It looked like his head would explode. Finally, when the other lane cleared and he started pulling around, I hit the gas and left him behind.

But why that reaction? Who really cares? I could have turned up Mike and Mike in the Morning and just tuned him out.

Same goes with my patient. Is it so bad he laughed at me buying tampons? Especially when I took the call while he's getting snipped? Other way around, I'd laugh my ass off, then pray there wasn't a slip of the hand.

I take a deep breath as I step in my office. There's a stack of mail on the desk. Mostly bills. Carroll Electric. Cox Communications. Verizon Wireless. Looks like I'm eligible for a super-low rate on a Visa Platinum from CitiBank. There's a clearance sale at Frank Fletcher Honda, third time this year. And if I act now, I can join Marriott Rewards and get 20,000 bonus points. Towards what, I'm not sure. Maybe a free night's stay or a monogrammed towel.

Tossing the stack on my desk, I check my messages. Nothing. Would've been a fine place to find out I needed to buy tampons and milk, but whatever. My Daytimer shows I've got the afternoon off when I get done with Kurt, and it looks like tomorrow morning has cancelled.

I stop by the reception desk before heading back. Janine's on the computer, surfing the net for what looks to be men in a four-hour radius.

"Any calls?"

She doesn't look up. "Your wife."

"Again?"

"Nope."

I sigh. "Any calls I haven't already taken?"

"How long a drive's Olympia?" she asks.

It would be simple to repeat myself, but pointless. She knows I already know the answer.

"Took us three hours last summer," I say. "Without kids."

Her finger taps the glass under a picture of a twenty-some boy with blond hair, blue eyes, and washboard abs.

"Who's Rascal Flatts?" she asks.

I shrug. She's not looking. "No clue," I say. "That the new guy?"

"Maybe. If he's lucky."

Who isn't? I'm thinking. "Little young, isn't he?"

She snorts. She's thirty-eight, going on fifty. Survived the eighties with only a daughter, fake tits, and a lifetime's supply of jean jackets. Still, she's a good nurse.

"Don't you have a patient, doctor?"

"I'm getting there."

Her chair swivels, and I've finally got her attention. "You're not done?"

I shake my head. "Not yet."

"And he's . . . "

"Covered up with a gown."

She smiles, taps her pen on her chin. "Have a few drinks over lunch?"

I wave her off as I turn towards the room where Kurt's waiting. "Hold my calls," I say. "And get back to work."

"Waiting on you," she calls as I open the door.

"Sorry," I say, and he's got a fistful of gown in each hand. He looks properly contrite, so I pick up my tools to finish the job.

It's only a matter of seconds before smoke's rising again. A few minutes later, we're done.

"That's it," I say.

The look on his face makes me think I should always let my patients stew in the chair by themselves. There's genuine relief, as opposed to the usual awkwardness when they wonder what words best follow another man handling your balls for a quarter of an hour.

"That's awesome," he says, with no trace of remorse, no regret over the fact he will never have children again. In every man I've neutered, there's been an inkling they might miss some of their manhood. But not Kurt, not this time, and I can't believe the favor I've done him. He's so happy to leave, it doesn't faze him at all. This walkabout in mid tube-searing procedure might revolutionize my practice.

"Janine will be in with instructions, and if you have any questions, feel free to call."

"Okay," he says.

"Ice those balls, Kurt," I say as I open the door.

"Jeff," he says.

"What?"

"It's Jeff."

"Right. Sorry," I say. "Ice those balls, Jeff, and don't lift anything heavy."