Dr. Kendricks came in looking very much like a pudgy Einstein, his gray mustache peppered with crumbs. He slipped his glasses into the tangle of hair on his large head and sat across from her.

“How are you feeling?” he said, opening a file folder.

“Much better,” she said. She knew he meant the pneumonia. “I cough a little at night, but nothing like it was before. It doesn’t feel like someone’s sitting on my chest anymore.”

“Good, good,” he said, smiling. She’d been going to Dr. Kendricks since she was twenty. He was a nice man, a little scattered at times, but an excellent quarterback when it came to dealing with all of the specialists in her life. “You still have enough puffs in that inhaler?”

She nodded. “More than enough.”

“Good.” He closed the folder. “Look, what I’m going to say shouldn’t come as a shock. The pneumonia took a lot out of you. Putting aside the fact that you’ve been undernourished and dehydrated, this one really walloped your system. Your lupus levels, well, they’re off the charts. That’s the problem with your condition. You’re open to just about any virus or bacteria that comes your way which then weakens you enough to make your lupus flare up. And the worse it flares up, the more susceptible you are to illness and infection.”

He was right: this was about as shocking as learning that reality television had nothing to do with reality. Or that the earth was round.

Kate’s stomach still cramped up. “How bad is it?”

His elbow on the desk, the doctor rested his chin in his hand. He looked at her the way any father would a sick child. “We’re almost at the point where chemo is our best option.”

Nothing instilled cold fear in Kate quicker than the word chemo. Chemo meant losing her hair. It was vomit and cramps and utter exhaustion. It was taking her illness to a brand-new circle of hell, without any guarantees it would work. And if it didn’t – well, my dear, lupus didn’t give a damn. It was just dumb enough to knock off its own host.

“I don’t want chemo,” she said, sitting straighter in her chair. What she wanted was to bolt right out of there and pretend she hadn’t heard him.

“I know. And I don’t want to have to go that route. In fact, I’m going to do everything I can to avoid it. But you’re going to have to go through some pretty unpleasant treatments.”

“Fine. I don’t care. Whatever it is, I’ll just have to suck it up. When would they start?”

He rubbed his chin. “Today.”

“Today?” She felt her resolve quiver. “What’s the treatment?”