The Sessions

After Mark proposes to his caretaker Amanda and she rejects him, he realizes that finding a traditional romantic relationship will be extremely difficult given his physical limitations. This rejection motivates him to seek professional help to finally experience intimacy before it's too late. He consults his priest Father Brendan for ethical guidance before taking this step.

Mark proposes to Amanda because he genuinely wants a romantic relationship and hopes she might accept him despite his disability. He has never experienced any form of intimacy and wants to pursue a normal relationship. When Amanda declines, it pushes him to consider professional help rather than continuing to seek romance within his existing circumstances.

This rejection sets up Mark's decision to seek a sex surrogate as an alternative path to intimacy.

Mark and Cheryl end their sessions because their professional relationship has evolved into genuine romantic feelings for each other. Both realize that continuing would blur the boundaries of their arrangement and potentially harm everyone involved, including Cheryl's husband. They decide it's more appropriate to end on good terms rather than let the situation become more complicated.

Their growing emotional connection throughout the sessions foreshadows this difficult decision.

A power outage in Mark's building causes his iron lung to fail completely, leaving him unable to breathe on his own. He is rushed to the hospital in a life-threatening emergency. This crisis forces Mark to confront his mortality directly and serves as a major turning point in the story that shifts the narrative toward themes of survival and legacy.

Susan Fernbach is a young woman Mark meets after surviving the iron lung crisis. She represents a new relationship in his life following his experience with Cheryl. At Mark's funeral in 1999, Susan reads the poem Mark had written to Cheryl, showing she remained close to him in the years after the surrogate sessions ended.

Cheryl's husband becomes jealous and emotionally threatened by the growing connection between Mark and Cheryl. When Mark mails Cheryl a love poem, her husband keeps it from her rather than letting her receive it. This act reveals the strain that Mark and Cheryl's developing feelings are putting on her marriage, even though her husband genuinely loves her.

This jealousy foreshadows the emotional complications that arise when professional boundaries blur.

Father Brendan offers compassionate support after Mark confides in him about wanting to experience intimacy. Rather than judgment, the priest provides thoughtful guidance about desire, ethics, and mortality in a humane way. He recognizes that Mark's desire for physical connection is a natural human need and helps him think through the decision respectfully.

The poem that Mark wrote to Cheryl represents his emotional depth and his journey toward expressing love and intimacy. At the funeral in 1999, Susan reads this poem aloud, bringing the story full circle. It serves as a poignant tribute to Mark's transformation from someone who had never experienced intimacy to someone capable of genuine romantic expression.

The poem was originally written during the sessions and hidden by Cheryl's husband, adding emotional weight to its later reading.

The relationship starts as a clinical arrangement with clear professional boundaries focused on therapeutic goals. As the sessions progress, trust builds and conversations become more personal. The line between surrogate and client gradually blurs as both develop genuine affection for each other, leading to a mutual sexual encounter that transforms their connection beyond the original professional framework.

Mark has lived in an iron lung since contracting polio as a child, which left him unable to breathe on his own or move his body independently. These severe physical limitations made it impossible for him to pursue romantic relationships or physical intimacy throughout his entire life. At 38 years old, he decides he doesn't want to die without ever experiencing this fundamental human connection.