In 1986, a patient is referred to Gildiner after a urologist determines that his erectile dysfunction is psychological, not physical. The patient, Peter Chang, plays in a band and works as a piano tuner. Gildiner begins by taking Peter’s family history. His Chinese parents immigrated to Canada by way of Vietnam. Peter’s father passed away recently from diabetes complications which, Peter says, were the result of his mother forcing sugary foods which hastened his death. He excuses his mother’s behavior by explaining that she had to do what was best for the family and that she worked exhausting hours at the family’s Chinese restaurant. Peter reveals, too, that his mother—unable to afford childcare—regularly locked him in the attic of the restaurant as a child, isolating him from human interaction during the formative years of his life. Peter defends his mother, saying her actions were not abusive but his fault because he did not behave well when in the restaurant.

Peter explains that the loneliness was the worst aspect of the neglect and that he desperately wanted companionship. When his mother gave him a toy piano, Peter pretended it was his friend, nicknaming it “Little Peter.” His mother continued to work several jobs and meticulously saved money until Peter’s father lost $31,000 in a business investment.