59 pages • 1-hour read
A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Abraham remembers a tennis lesson he once took with Pancho Segura in Carlsbad. Segura gives Abraham fundamental advice on tennis: “The ball must be hit deep, or angled away. The short ball must be punished outright—or used to attack. The game is won at the net” (271). They rally, and Segura notes Abraham’s shots are decent, but he needs to anticipate his opponent’s shots better and be more aggressive. Rather than correct the mechanics of each shot, Segura focuses more on instructing Abraham when to use each one. After the lesson, Segura smiles at a picture of Steven that Abraham shows him, and autographs it for Steven.
A week after David leaves, Abraham meets a new patient, Gato Salazar, who is also an intravenous drug user. Abraham tells Gato David’s story, and Gato reassures him that warning signs are sometimes impossible to spot in someone with addiction. Gato himself was clean for six years, and something small triggered a relapse immediately.
Abraham reflects on how his early days of friendship with David showed such promise. Tennis was vital to and symbolic of their relationship, their efforts to play earnestly and regularly giving their days order and meaning. Now with David gone, Abraham’s belief that their tennis game was heading towards a larger epiphany appears to be a delusion. He sees his life more clearly now and decides to move out of his bare apartment and into a proper, well-furnished condo.
Abraham meets Gloria at the hospital, and they discuss David. Gloria commiserates with Abraham’s hurt and betrayal but tells him that David is “destined to disappoint” even those he cares for. He was not honest with her about his history when they first got together; she, too, ignored the signs because of her feelings for him. She learned the truth from Dr. Binder when David relapsed. Gloria has stopped feeling responsible for David now and asks Abraham to warn Emily, too.
Gato is discharged after four weeks of treatment. He invites Abraham to come see him sometime, promising to give Abraham a proper tour of El Paso. He reassures Abraham he will beat his addiction this time, though they both know this is a lie.
In June, Abraham watches the French Open final between Jim Courier and Sergi Brugera, which the latter wins, effectively ending Courier’s brief dominance. Abraham has not played tennis since David left but heads to the tennis club that morning.
Abraham meets Emily at the club, where she is working at the pro shop. She tearfully tells him how difficult things have been with David leaving her to clean up the bills and mess he left behind. David has not called Abraham, as he is too embarrassed to talk to him; however, he has been continually writing to Emily. Feeling sorry for him, she went up to meet him recently.
While there, Emily attended a session with David and his therapist, the latter of whom believes sexual issues are at the root of David’s addiction. The therapist warns Emily that David may have more relapses with her. Emily feels forced to suppress her anger because David’s pain seems greater, in the moment. She resolves to stay with him for now because he needs her.
Abraham participates in the “men’s development” at the club, run by Ross Walker, which includes drills and doubles matches for all the men attending. Afterward, Ross encourages Abraham to keep coming by and playing.
Abraham finally finds a condo to move into a couple of miles away from the boys. Manuel helps him move again, reminding Abraham of his promise the last time. He notes that Abraham seems happier now. Abraham purchases proper furniture for the house but stores the taped-up cardboard box that served as his old dining table in the garage.
David returns to El Paso after rehab and calls Abraham, asking to play tennis right away. David appears buoyant and cheerful, waxing eloquent about the rehab program at Talbott-Marshall and sharing with Abraham all his new insights. They play a game, and it is as magical as Abraham remembers.
Afterward, David discusses his sexual addiction with Abraham, which is apparently at the root of his drug problem. David reveals one disappointment: Dr. Talbott does not think David should go into emergency medicine, and after this relapse, David knows he will not get the residency anyway. Abraham privately reflects that this is a good thing, as the ER is an adrenaline-fueled space, which can be triggering for someone with a cocaine addiction.
Abraham apologizes to Dr. Binder for waiting to inform anyone about David’s relapse, but Dr. Binder reassures him. He reveals that David had been plotting the relapse for months, waiting for when the pathologist who does his urine screening went on vacation. Dr. Binder reminds Abraham that what David has is a disease; there are stricter protocols in place this time to protect him as long as he complies.
Abraham speaks to Emily, who appears to be struggling with David’s return. She confesses she feels nothing for him anymore. David himself appears downcast at the hospital when Abraham sees him, reminded of what he has thrown away again. Abraham reveals he has spoken to the hospital about David doing a residency in internal medicine, if he is interested, and David is thrilled.
David moves into a halfway house. With his intense schedule, including more AA and NA meetings, Abraham and David find it difficult to play as often. When they play again, Abraham finds it “lifeless”; after the initial excitement of David’s return, he now sees it is difficult to carry on as they had earlier. Afterward, David confesses to Abraham that he is finding it difficult to switch from a future in ER to internal medicine. Abraham is irked by David’s moaning.
On David’s last consult with his internal medicine rotation, they encounter Angelina Cortez again. She is irritable and looks ravaged, her addiction having taken its toll. She asks Abraham and the students to wait as she steps into the bathroom, and returns much calmer; David and Abraham deduce she stepped away to mainline heroin through her IV. David asks if they should administer some Narcan, which will reverse the effects of the heroin. Watching Angelina’s ecstatic expression, Abraham decides not to.
Gloria runs into Abraham. She has seen that David is back; he sent her a letter from Atlanta, claiming he is over her.
David telephones Abraham on New Year’s Day, 1994, while Abraham is still in bed. Abraham puts off calling him back, not wanting to make the effort to play tennis that day. He feels guilty when he hears the loneliness in David’s voice over his brief voicemail.
The next day, David tells Abraham at the hospital that Emily broke up with him. Abraham hears the rest from Emily, who confesses she could not do it anymore. David took the breakup hard, crying about losing everything in his life and being stuck in internal medicine, which he hates; Abraham is shocked and angered by this. Emily believes that David came back too soon from Talbott-Marshall; the positive attitude he returned with has been slipping for a while.
Abraham speaks to David at the end of the day, reassuring him he will find love again. From David’s expression, Abraham realizes he has already been meeting other women. Abraham also wants to speak to David about his attitude towards his career; however, he also knows that David has already made up his mind, and his pessimism will not dissipate now.
Abraham calls David the morning before he is due to begin his residency to invite him to tennis after work. David sounds wary and suspicious on the phone. When Abraham arrives at the hospital, he discovers David has resigned. Dr. Binder is sure David has relapsed; two urines were tested the day before, and one was positive for cocaine.
Dr. Binder and Abraham drive to David’s house. It is empty, but as they are about to leave, they spot David outside the house with a duffel bag. His appearance and demeanor are almost unrecognizable. David snarls at the men to leave him alone and disappears down an alleyway.
Dr. Binder and Abraham head down to the courthouse to file a protective custody order (PCO) for David to get him into detox. An older, Spanish-speaking woman approaches Abraham for help with her form. She is getting a PCO for her son, who assaulted her and destroyed her house. He is also addicted to cocaine.
Emily is distraught to hear about David, but Abraham consoles her and reminds her that ultimately, David is responsible for himself. When there is no word about David the next day, Abraham drives around the city in areas where David is likely to find cocaine and runs into Gato. Gato invites Abraham to have some caldo with him, over which they exchange stories. Abraham tells him about David, and Gato talks about how he first started using. Gato invites Abraham on a tour of the area, promising they will look for David. They do not find him but do come across multiple young men using intravenous drugs or passed out. Abraham drives around alone for a while, trying to find David. Eventually, he tires of the entire affair and heads home, wanting to push David out of his mind for a while.
Abraham does not see David again after he runs away, but Emily spots him on the street a couple of times. He refuses to talk to her or listen to her entreaties to quit. The last time she runs into him, however, he accepts the Bible and the money she gives him and asks her to thank everyone for him. David begins writing bad checks again, and in an attempt to get him into detox, Abraham and the other doctors track him down to a motel and send the cops after him with an arrest warrant for the checks. When David hears the cops at the door, he makes one panicked phone call to Mickie, who does not pick up, before shooting himself.
On March 17, 1994, Abraham is called in to identify David’s body. Abraham heads down to the morgue, and even with the shattered face because of the shooting, Abraham recognizes David. He examines David’s body thoroughly, before sadly confirming David’s identity to the coroners.
After David’s memorial, Abraham and Emily scatter his remains across a mountain trail, Abraham saving a handful to scatter on the tennis court. Abraham retells the story of his and David’s friendship to people often: The mentorship each provided the other in the hospital and on the tennis court respectively, and the sense of betrayal Abraham feels at David’s death.
Abraham reads multiple theories and talks to therapists about David’s situation, eventually forming his own conclusion about David’s death. Both had experienced their fair share of childhood struggles, but when they set down a dark path in adulthood, Abraham’s journey diverged from David’s. Abraham’s escape came from a network of human connections, which ironically included David; David, on the other hand, sank into isolation, drugs providing an escape while also furthering the isolation. Abraham believes that being in the medical profession contributed to David’s continuing addiction due to the stress, the loneliness, and the lack of space for physicians to express their emotions. It is not individual doctors who are at fault for their conditions, but rather the way the system is designed.
Abraham remembers a moment with David on their secret tennis court when they switched off the lights and the stars came into view. The moment of awe and insignificance they felt was almost immediately followed by a feeling converse to that one: “The universe and our very lives depended on […] one thing: Get the ball back over the net just one more time” (342).
After David’s death, Abraham seeks to understand what happened in David’s life and their relationship. His research into The Disease of Addiction as well as the people and incidents in David’s life enable Abraham to understand how David’s struggles with Navigating Loneliness and Conflict in Relationships and The Power of Ritual interacted with his disease to produce such a tragic outcome. Though David and Abraham both experienced loneliness and conflict in relationships, and both sought out comfort in rituals, especially with each other, David’s disease interfered with his ability to confront his issues head-on or develop the sort of social support system and community that helps Abraham navigate his own troubles.
The final chapters chart David’s decline as his addiction takes hold once again. David returns from rehab to complete his internship with the fresh insight that sex addiction is what truly lies at the root of his problems. His newfound optimism shines through in the first game of tennis he and Abraham play, which is as “magical” as Abraham remembered. However, there are early signs that all is not entirely well. David expresses his disappointment at being unable to continue his residency in emergency medicine. Abraham sees that a high-adrenaline environment like the ER is dangerous for someone with an addiction to stimulants, but David’s disease still causes him to crave the adrenaline and chafe at his slower-paced internal medicine residency.
The way The Disease of Addiction progresses is illustrated through Angelina Cortez’s reappearance at the hospital. Her deteriorating physical and mental state foreshadows the rapid decline that awaits David. As David soon will, Angelina lies to conceal her drug use, even though it is obvious to the doctors. Likewise, David initially conceals his relapse from his loved ones, including Abraham and Emily. When it becomes impossible to conceal, Emily breaks up with him, and David withdraws from Abraham’s friendship. With the collapse of his support system, the addiction progresses fast, forcing him to withdraw from professional life as well. When Abraham next sees him before he runs away from his apartment, he is shocked at David’s appearance. His description of David is reminiscent of how David perceived his reflection in the mirror during his last relapse: He seems like a completely different person.
The progress of David’s addiction during his final, tragic relapse illustrates the complicated interconnection of conflict, isolation, and The Disease of Addiction. David’s relapse is in part a response to the pain he feels because of the conflicts in his close relationships, including those with Emily and his mother. While David’s pain is understandable, the avenues he chooses to cope with the pain only further isolate him; he refuses to talk to Emily or quit using, despite her numerous entreaties to return and seek help. His addiction exacerbates the problems that he uses substances to try to cope with, intensifying his pain and loneliness and reinforcing his urges to use. The tragedy of addiction as a disease is the way it can feed on itself until, as it does for David, it becomes a deadly downward spiral.
The way David’s disease undermines his relationships is especially sad and ironic for Abraham since David was an essential part of the support system that helped Abraham overcome his struggles. Abraham’s final recollection of David in the book, on their special tennis court, displays the paradox their relationship contained: Despite the tragic ending, their friendship was, in many moments, a beautiful and special thing—two men bound together by a game that often felt like their “very lives depended on” (342). For David, tennis did not prove to be enough, but in the wake of David’s death, Abraham does begin to confront the parts of his life he needs to change. He moves out of his tiny, unfurnished apartment, and returns to tennis again for the first time in months. While helping him move into his comfortable new condo, Manuel the mover comments on how Abraham looks happy this time. Abraham breaks out of his old, stagnant rituals and moves on with his life in a positive way. He recognizes that the connections he has cultivated and maintained have protected him through difficult times, and he is grateful for them all—including his connection with David, as tragically as it ended.



Unlock all 59 pages of this Study Guide
Get in-depth, chapter-by-chapter summaries and analysis from our literary experts.