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It occurred to me that this was the worst time of my entire life.

I mean, when Nick cheated, yeah, that was bad. But at least Benny still had his kidneys then. At least I still had Alexis nearby. I had hope.

Now I had a dialysis machine getting delivered in a few days, Benny wasting away mentally in a bed down the hall, and a litter box in my laundry room that only I was going to clean. My best friend was two hours away and too busy with her new life to be the diversion I needed to not think about all this.

There was nothing for me to look forward to. Even the chief position was at a standstill. I had no dating prospects. No joy in my life. Not a single distraction. I hadn’t had sex in a year. I was just getting older. Heading in the wrong direction in every way, my life crumbling around me.

And I was bored.

That was the worst thing of all. The boredom. The monotony of my uneventful, unremarkable, depressing fucking life.

If Benny wasn’t a factor, I’d do Doctors Without Borders or something, walk the earth. What was the point of being in Minnesota? It was cold here, everything reminded me of Nick, or, worse, Kelly. I was alone. I didn’t even really want the chief position if I was being honest with myself. It just seemed like something everyone expected of me after Alexis left, and I figured why not, what the hell else was I doing? At least I’d be building my résumé.

This wasn’t the life I wanted. And I didn’t know how to change it. It was quicksand.

Jocelyn was at the nurses’ station when I came onto the floor clutching a triple cappuccino and feeling as tired as I looked. I had no idea how I was going to make it through the day.

“Hey, someone left something for you.” She nodded to a spot behind the counter.

I leaned over wearily to look. There was a jumbo-sized red velvet cupcake with an envelope taped to the container with my name written on it.

I smiled for the first time in days. Alexis?

“Who’s it from?” I asked.

“Don’t know. It was here when I got here yesterday.” She tapped a pen on the counter and eyed me. “Hey, you okay? You called out.”

“Fine,” I said, leaning down to pick up the card. I set my coffee on the counter and slid a finger under the seal on the envelope.

It was a letter. A long letter. Handwritten.

From Dr. Maddox.

I blinked at it. Dr. Maddox? Why?

I looked around, like he might be somewhere watching. I didn’t see him.

“Who’s it from?” she asked.

“Nobody. I’ll be right back.”

I grabbed the cupcake container and hurried to the supply closet. I shut the door behind me, sat on my toilet-paper box, and pulled the letter from the envelope. It was in black fountain pen, clear and careful writing.

Briana,

I sometimes find that journaling helps me organize my thoughts. I seem to be having a hard time saying and doing the right things recently, so I figured writing this down might be best.

I wanted to thank you for the cupcake suggestion.

You are likely unaware of this, but I deal with some social anxiety. It’s worse when I’m in a new situation with people I don’t know. Interaction doesn’t come naturally to me in those circumstances and I struggle. When I make mistakes, like I’ve done often since I got here, it makes me more uncomfortable and my anxiety gets worse. I get more nervous, and that makes me more withdrawn. It’s a bit of a self-perpetuating cycle. So your help was deeply appreciated, even though I know you didn’t have any reason to give it.

There are a few things I want to address.

You mentioned that Dr. Gibson was holding off the vote for head of emergency medicine in hopes that I might be up for the position. I have no interest in this job, nor did I convey any such thing to Dr. Gibson upon my arrival. I was unaware he was making this decision, and I have told him I do not intend to run. I’m sorry if you felt that the delayed vote was done on my behalf. I was not a part of it.

The other day when I came to your brother’s hospital room I didn’t mention that you broke my phone. I was frustrated and should have picked a better time to bring up you running into me in the hallway. But again, my anxiety sometimes makes it hard for me to gauge social cues, and I don’t always express myself the way I hope to. It was poor judgment on my part, and I apologize.

Lastly, in the supply closet, when I said that your brother could live on dialysis—my mom had chronic kidney disease when I was a teenager. She received a kidney transplant before she required dialysis, but that period of my life was a terrifying time. I remember feeling comforted by the knowledge that if her kidneys failed before she got a donor that at least dialysis would keep her alive. It wasn’t like losing your lungs or your heart. She would have time. She would have decades if she needed it.