The trepanner known as Stan mopped his brow with a faded bandana. The desert sun, high overhead, rendered all thought impossible. Crouched next to a rare trickling spring, Stan cleaned and sterilized his drill with the kit hanging from his belt. He was from the old school, scoffed at the new electric trepans on the black market. Besides, many of his clients weren’t even on the grid. When attending them, he couldn’t count on a reliable power source, so he relied on his own strength: a right forearm bulging from years of manual drilling. Now, as the metal parts of his drill dried in the arid air, he oiled the wooden handles to a glossy sheen. Satisfied with his work, he re-cased the tool and slung the strap across his chest. He had one more client to visit before calling it a day.

Mariela was a special case. Over the past decade, Stan had trephined her three separate times. The last time her family had tried to take him to court. He crossed the border and went into hiding for a few months, until Mariela herself sent word that her family had withdrawn the lawsuit. He’d resumed his practice only recently, and had yet to visit Mariela. Just this past week, though, she’d called several times, demanding a consultation. Mariela made him wary. Most of his clients were pleased with the initial results of his work and he rarely heard from them again, except for occasional check-ups. But he worried that Mariela had become addicted to the first rush of euphoria that follows a treatment. It was not something he had encountered before.

Today Mariela met him at the door flushed and breathless.

“You’re here!”

“Mariela. Yes, I am here.”

He stepped inside the cool adobe house. Mariela ushered him to the sitting room.

“Would you like a drink?” she asked.

He made a gesture. “Just water, if you please.”

“And how are the termites?” she asked slyly.

Stan chuckled. “They are fine, Mariela.”

“To think…a grown man consorting with such horrible….eeensects,” she said in a low voice.

“Please, let us not rehash this. I know how you feel about them. Now, what is it that you have called me for?”

“Ah, yes. Always so to the point you are,” she replied. “Well, I have been experiencing headaches.”

“And when did they start?” Stan asked. “Are they mild, severe…do they last long?”

Mariela sighed. “It’s been months. Sometimes they are mild, only lasting a few minutes…other times for hours, leaving me confined to bed.”

“Any other symptoms?”

“I have not been myself, Stan. The good feelings…they are gone.”

Stan rubbed his salt-and-pepper beard. He’d heard this before. After the first trepanation. And the second.

“Mariela. I think you are expecting too much. This procedure…it’s not meant to cure what ails you.”

Mariela glared at him. “And what is that, Stan?”

Stan took a sip of water and cleared his throat. “Well, I am not a psychiatrist, of course. But I believe you are profoundly depressed, Mariela.”

“But I thought the procedure is supposed to prevent that?”

“It cannot cure a pre-existing condition, my dear. That is not what it is intended for.”

“Why, I believe you have been less than straightforward with me then, Stan. Why did you not tell me this before? I could have saved myself a lot of trouble, not to mention money.”

Stan sighed. He had told Mariela all of this before. Each time she had come to him seeking treatment he had patiently explained to her the procedure’s limitations. But she had insisted on proceeding. She even made vague insinuations bordering on threats. He had almost been thankful when the lawsuit presented itself. It seemed to him a chance to sever this problematic relationship. And yet here he was again in conference with her. He decided to sidestep the larger issue at hand for now.

“If you would permit me to examine you, Mariela? The headaches may be the result of some swelling at one of the sites.”

She consented to his expert touch. His fingers passed lightly over her scalp, seeking the healed indentations. He found all three, holding his pen light close to the skin. As he suspected the sites all appeared well-healed and healthy. Mariela’s headaches were likely either psychosomatic or possibly even related to some other condition. Here was a delicate situation that he felt an urgent growing need to extricate himself from.

“Everything looks good, Mariela. I see no reason for your headaches to be related to the treatments I have administered.”

She pouted. “What about another treatment, Stan? Maybe there is some pressure built up inside, something you cannot see?”

He shook his head. “It’s not possible. The procedure is very exact. Not once have I had a patient experience swelling of the brain. I take great care in that respect.”

He was growing agitated. This woman, she…how do you say? Pressed his buttons? Never in his long career had he encountered such a troubling patient.

Mariela now slumped in her chair, eyes glassed over.

“I am sorry, Mariela, but I must leave. It is growing late and you know how far I yet have to travel.”

Light flickered in her eyes. “Oh yes, your termite friends. Of course. Please give them my reegards,” she sneered.

Stan rose and strode to the door. “Goodbye, Mariela,” he called. There was no answer.

He stepped out into the cool early dusk. Shreds of pink and purple cotton clouds latticed the open sky, tinged with gold by the sun’s waning light. He followed a faint narrow path out into the desert. By the time he reached the termitarium it was almost dark. The termites, overjoyed at his return, milled around his feet in the sand, chattering about the work they’d completed that day. With his last bit of strength, he knelt down and climbed inside the mound. There the termites clustered around him, eager to hear his own tales of excavation.