Gildiner’s final patient in the book is also the final patient of her career: Madeline Arlington, aged 36. Because Gildiner encounters Madeline after counseling her father, Duncan, Gildiner first summarizes her experience with Duncan.

Duncan is a very wealthy man in his seventies. At his first appointment, he brings his partner, Karen, with him, despite Gildiner insisting she is not a marriage counselor. Duncan and Karen had been in a relationship in high school, but both went on to marry other people. Since both their marriages had ended, they had rekindled their relationship. Although they had lived together for four years, Duncan is technically still married to Charlotte, Madeline’s mother. Karen expresses her anger at Duncan’s refusal to share more of his money with her. Duncan asserts that he will not commit to marriage with Karen nor extend more of his financial resources to her. As a result, Karen has barred Madeline from entering their home, which angers Duncan. The couple has only a few sessions with Gildiner, and both are unable or unwilling to budge in their respective positions.

Years later, Gildiner ends her career as a psychologist and enters a new career, as a writer of novels and memoirs.