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VEDA

The elevator opens on the seventh floor, and I smell pancakes before the doors finish parting. Wednesday. The kitchen sends them up every Wednesday, and half my patients will eat two bites, and that’s it.

I’ll allow it. Appetite is a negotiation on this floor, and I never spend leverage on breakfast.

Rosa waits at the nurses’ station with the census printed and folded in thirds. Fourteen names this morning. Two probable discharges if the labs behave. One admission. And Milo.

“He peeled the numbing cream off again,” Rosa says. “Threw the tube behind the radiator. His mother fished it out with a ruler.”

“Access is still set for nine?”

“Unless you’d rather fight him at eight.”

“Nobody wins the eight o’clock fight.” I sign the top sheet and hand it back. “Have her reapply at eight fifteen. I’ll talk to him.”

Priya first, room 703. Sixteen, osteosarcoma, five days out from a limb salvage that went better than she believes. She sits with the leg propped on two pillows and her phone face down on the blanket, which means the group chat said the wrong thing again.

“Scale of one to ten,” I ask from the doorway.

“Four.”

“And the real rating?”

“Six.” She picks at the hem. “It’s worse at night.”

“Then night gets its own plan. I’m moving your evening dose up an hour and adding a bridge for the gap between doses. You’ll sleep.” I check the incision. The margins sit clean and pink, no drainage, no heat under my fingers. “Pathology came back this morning. Your necrosis numbers are excellent. The chemo did its work before we ever went in.”

Her eyes come up. “Excellent meaning what?”

“Above ninety percent. It means the plan is working, and my whole goal for you from here on out is boring.”

“Boring.” She turns the phone face up. “You should put that on a poster.”

“I’m saving it for a mug.” I write the order at the wall station while she fiddles on her phone. Before I go, she asks whether she can watch the physical therapist’s session schedule change too, and I tell her yes, and that asking to see the plan is a sign she’s starting to believe in one.

She rolls her eyes at me for that. I would too, if I were in her shoes. But I’ll celebrate every bit of positivity I can get here.

In 708, Josie is eighteen months old and furious about her own nap. Neuroblastoma, resected, healing on schedule. Her mother sleeps upright in the recliner with one hand through the crib rail, and Josie grips my badge in her fist while I listen to a chest that sounds clear on both sides. I write my note without waking either of them.

At nine, Milo sits cross-legged on his bed with his arms folded and a plastic tyrannosaurus lying face down beside him. Seven years old, forty-eight pounds, acute lymphoblastic leukemia, nearing the maintenance phase. The port sits under the skin below his right collarbone, and the cream over it has survived, which I count as a win.

His mother stands at the window holding coffee she isn’t drinking.

“I heard the cream got thrown,” I say.

“It’s slimy,” Milo says.

“It is slimy. That’s a fair complaint.” I pull the stool over and sit, which puts my eyes below his. “Here’s my problem. Bruce is due for a port access too, and nobody has taught him the steps.”

Milo looks at the dinosaur. “He doesn’t have a port.”

“Then he’s very behind. Can you teach him while Rosa sets up? He needs the order, or he’ll panic. You know the order.”

He unfolds his arms one at a time. “Clean. Poke. Flush. Sticker.”

“Four steps, and the sticker is nonnegotiable. Who runs the countdown?”