The thing about Zoya's blood results is I kept not thinking about them.

  Yesterday, I checked my phone maybe forty times, nothing. Today morning, nothing. By lunch I'd convinced myself the hospital had lost the samples or she'd forgotten to pick them up or maybe the whole thing had been overblown and her spleen wasn't actually that enlarged and I'd made a complete ass of myself for no reason.

  Orthopedics was fracture clinic that morning. Pierce stuck me in the corner with a clipboard to document patient wait times, actual medical education right there, while he saw a parade of broken wrists and twisted ankles. The Ottawa Ankle Rules apparently meant something to him but he never bothered explaining what, just kept referring to them while examining patients and expecting me to nod along like I had any idea what he was talking about.

  Around eleven-thirty I went to get water from the cooler outside and ran into Murin in the hallway.

  He looked worse day by day. Dark circles, hair sticking up wrong, that grey undertone people get when they haven't slept.

  "You look like shit," I said.

  "Mm." He filled his cup, drank it in one go, filled it again. "Been up since four. Got called in for an emergency appendectomy."

  "They let you do anything?"

  "Held retractors for two hours while the registrar yelled at the intern about leaving necrotic tissue behind." He rubbed his eyes. "Attending asked me one question, what layer of the abdominal wall were we cutting through. I said the wrong one. He didn't correct me, just moved on. So I still don't know which layer it was."

  "Great teaching."

  "Isn't it?" He drained the second cup. "Your phone's been buzzing in your pocket for like the last thirty seconds."

  I pulled it out. Unknown number. Answered anyway.

  "Hello?"

  "Ashru? This is Zoya."

  "Hi, Aunty. Did you get the results?"

  Silence on the other end. Not long, maybe three seconds, but enough that I knew.

  "Can you... would you have time to meet? I'm still at the hospital. They want to do more tests but I don't understand what the doctor is saying and... " Her voice cracked slightly. "I'm a bit confused."

  "Where are you?"

  "Haematology department. Third floor, north wing."

  "I'll be there in ten minutes."

  Hung up. Murin was watching me. I was already walking toward the stairwell. "Tell Pierce I had to... No... Actually, tell him whatever you want. Family emergency."

  "You want me to come?"

  "No. You look like you're about to collapse. Go sleep."

  I took the stairs two at a time. The haematology waiting area where everyone knew why they were there and nobody wanted to be. Posters about blood disorders that nobody was reading. A water cooler that had been empty for probably a week based on the layer of dust on the spigot.

  Zoya sat near the window. Her hands were folded in her lap but her fingers kept moving, thumb rubbing against her palm. When she saw me she stood up too fast and had to steady herself against the chair.

  "You came so quickly."

  "Of course." I sat down next to her. "What did they tell you?"

  She pulled papers from her purse with shaking hands. Lab results, printed on that thermal paper that would fade to nothing in six months. The numbers swam when I tried to focus.

  Actually no, my hands were shaking too. I forced them still.

  WBC: 64,000

  Normal range was like 4,000-11,000. Sixty-four thousand was... fuck.

  Hemoglobin: 8.2 (low)

  Platelets: 450,000 (high)

  Peripheral smear: Excessive mature granulocytes, basophilia present, occasional blast cells

  I read it twice... No three times. The System wasn't activating and I desperately wanted it to because my brain had gone completely blank.

  "The doctor said I need a bone marrow biopsy," Zoya said quietly. "Today. They want to do it today and he used words I didn't understand... chronic something, Philadelphia something—"

  Chronic myeloid leukemia. That's what this was. The numbers, the splenomegaly, everything pointed to CML.

  "What else did he say?"

  "That they need the biopsy to be certain but that I should—" She looked down at her hands. "He said I should call my family. Get my affairs in order. Those were his actual words. 'Get your affairs in order.'"

  What kind of doctor says that before confirming a diagnosis? My jaw hurt. I was clenching it so hard my teeth ached.

  "Aunt, listen to me." I put my hand over hers, stilling that constant thumb movement. "They need more information before they can say anything definite. The biopsy will tell them exactly what type of condition this is and what the treatment options are. Modern treatment for these blood disorders is actually really good."

  "Is it cancer?" Her eyes were locked on mine and I couldn't look away.

  "I don't know," I said. "Maybe. But even if it is, there are very effective treatments. Targeted therapies. Some of them are pills you take at home, not even chemotherapy."

  That was true. CML had some of the best survival rates now with tyrosine kinase inhibitors. Five-year survival over ninety percent if caught early. If. Caught early.

  I'd found her spleen three weeks ago. Three weeks of Dr. Vernon dismissing her symptoms, of her blood counts climbing while everyone assumed it was just anemia. That useless consultation, that two-minute assessment, that complete failure to examine her properly...

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  "Ashru?"

  I realized I'd stood up without meaning to. Sat back down.

  "Sorry." Breathe. "When is the biopsy?"

  "Two hours. They said someone would come get me." She folded the lab results carefully, creasing them along lines that were already there from being folded and unfolded repeatedly. "Will you stay? Your mother would want you to stay."

  "I'm not leaving."

  A nurse appeared in the doorway. "Zoya Mirza?"

  We both stood. The nurse looked at me. "Family?"

  "Nephew," Zoya said before I could answer.

  The nurse nodded. "You can wait in the family room during the procedure. Fourth floor."

  They took her away. I stood there in the empty waiting area, holding my phone, trying to figure out who to call first.

  My mother would panic. My father would want facts I didn't have yet. Dr. Bennett might actually have useful advice but bothering an attending about a family member's diagnosis felt like crossing some line. What to do?

  The elevator doors opened. I got in, pressed four. The elevator reached the fourth floor. I found the family waiting room; smaller than the one downstairs, with a window that looked out over the parking lot and a coffee machine that had an "out of order" sign taped to it.

  I sat down in one of those uncomfortable plastic chairs and watched cars pull in and out of parking spaces for two hours while trying not to think about anything at all.

  The haematologist who came to talk to us was maybe sixty. He found me in the family room at 4:47 PM. I know because I'd been staring at the clock, watching it not move for what felt like hours.

  "You're with Zoya Mirza?"

  "Yeah."

  "The procedure went fine. She's in recovery, bit groggy but stable. You can see her in about twenty minutes." He sat down in the chair across from me without being invited, which somehow made what was coming feel worse. "I'm Dr. Castellano. I'm one of the haematology attendings here."

  I nodded. Couldn't make my mouth work to actually say anything.

  "We got preliminary results from the bone marrow aspirate. We'll need a few days for the full cytogenetics and molecular studies, but based on what we're seeing..." He paused. Not for drama, just picking his words. "It's consistent with chronic myeloid leukemia. CML."

  There it was. The thing I'd known for three hours but hadn't let myself actually think.

  "Okay," I heard myself say. "Okay. What's the treatment?"

  "We'll start her on imatinib; that's a targeted therapy, tyrosine kinase inhibitor. It's a pill, once daily. We'll monitor her blood counts weekly at first, then monthly once she's stable. The response rates are very good. Most patients achieve complete haematologic remission within a few months."

  He kept talking, something about Philadelphia chromosome, about monitoring for blast crisis, about side effects and follow-up schedules but my brain had stopped processing words into meaning, just sounds.

  "—relatively young, otherwise healthy, so her prognosis is actually quite favorable. Ten-year around eighty-five percent. This isn't the death sentence it was twenty years ago."

  I managed to nod.

  "Does she have family? Someone who can help manage medications, bring her to appointments?"

  "My mother. We're close neighbors."

  "Good. She's going to need support, especially the first few months. The medication can cause fatigue, some GI upset, occasionally muscle cramps. Nothing unmanageable but she shouldn't be alone."

  He stood up. I stood up too, automatically. He left. I sat back down. The System finally decided to show up.

  I stared at the notification. At the fucking level up message appearing while a woman I'd known my entire life was in a recovery room learning she had cancer.

  "Not now," I said out loud. "Seriously. Read the room."

  The System didn't respond. Never did when I actually wanted it to.

  A nurse appeared in the doorway. "You can see her now."

  Zoya was in a recovery bed behind a curtain, still connected to monitors. She had a bandage on her hip where they'd done the biopsy and her face had that waxy quality people get after sedation but she was awake. I pulled a chair over and sat down.

  "Leukemia." She said. "I have leukemia."

  We sat there. The monitors beeped. Someone in the next bay was coughing, wet rattling sounds that went on too long.

  "I need to call your mother," Zoya said eventually. "She's going to... I don't know what she's going to do actually. Probably insist on moving in with me."

  "She'll want to help."

  "I know." She turned her head to look at me. Her eyes were clearer now, sedation wearing off. "You knew, didn't you? When you saw the blood results. You knew what it was."

  I wanted to lie. Seemed kinder somehow. "I suspected."

  She looked back at the ceiling. "The haematologist said the treatment is good. That I'll probably be fine."

  "You will be."

  "You don't know that."

  "No," I admitted. "But the statistics are really good. Better than most cancers."

  "Statistics." She laughed, but it wasn't a happy sound. "I'm a statistic now."

  The nurse came back to check vitals. Blood pressure, temperature, oxygen saturation. Everything normal. She marked something on a chart and left without saying anything to either of us.

  Long silence. The kind that felt like it should be filled with something meaningful but neither of us had the words.

  "I'll call my mother," I said. "Tell her you're here."

  "Not tonight. Tomorrow. Let me have one more night of... " She gestured vaguely. "Of normal, I guess."

  "Aunt... "

  "Tomorrow, Ashru. Please."

  I stood up. "Okay. But call me if you need anything."

  "I will."

  I made it halfway to the door before she spoke again.

  "Thank you. For staying."

  I nodded without turning around, got outside the hospital. My phone had seven messages. Three from my mother asking how Zoya's appointment went. Two from Akki complaining about pediatrics. One from Murin just saying "update?" And one from Pierce's secretary informing me I'd been marked absent from afternoon clinic and would need to submit a formal explanation in writing. Perfect.

  I just started walking. No particular direction, just away from the hospital. The streets were busy with evening traffic, horns blaring constantly. Someone was selling roasted peanuts from a cart on the corner.

  I hadn't eaten since morning. Should probably fix that but didn't want to. Found myself near that restaurant we'd gone to the night before everything went wrong. The System flickered on without me asking.

  "I don't need therapy from a fucking computer program," I said quietly.

  The couple standing next to me glanced over. I smiled at them like I'd just been on the phone. They went back to their conversation.