Dune rushed along behind the sirens in their little rusted brown Chevy, Mama Vivian in the passenger seat, chaste in her uniform of mismatched pajamas, a worn-down terrycloth robe, slippers and furrowed brow. The quiet ride through the overgrown fields and strange new buildings that characterized this part of Detroit felt eternal.

When Dune reached the emergency room she asked everyone where Kama was. The woman behind the counter responded in a flat voice, asking about insurance. The air caught in Dune’s body. They didn’t have insurance. Mama Vivian had something, Medicaid, but it wasn’t much. Kama always said they would save money instead of spending it on something they might never need. Dune was pretty sure there wasn’t much saved.

The woman was wearing a printed hospital top beneath a face that discouraged complex responses. Dune thought of how she and Mama Vivian must look, a panicking Black girl so boyish she was still being carded halfway through her twenties, with her confused Asian grandmother in house clothes. They weren’t formidable, weren’t used to wielding power with strangers; Kama did that. Dune began to beg, but the woman waved her off. “Honey, we’ll treat her. It’s just gonna cost you.”

The doctors at Henry Ford couldn’t find anything medically wrong with Kama. They initially concluded that she was in shock, possibly due to an allergic reaction.

Kama was a full-figured blue-black woman. She had been wronged early and often in life. She grabbed everything by the collar and pulled it in too close—love, babies, joy, pain, disaster. Her anger was as contagious as her laughter. Now her quiet was terrible and grand, filling up the small space behind the curtain and then the room she was moved into.

For four days they fed Kama through a tube, hydrating her intravenously as she stared at the wall. Her lips moved sometimes, but no sounds came out. A rotation of doctors asked Kama tons of questions that garnered no response. They plugged and poked and knocked her, snapped in front of her; always shaking their heads and making serious faces. They had conversations that Dune didn’t want to be a part of, didn’t want to hear; considering and then ruling out heat stroke, aneurysm, blood on the brain and a heart attack. They did scans of her mother’s chest and head, ultrasounds of her belly, an MRI.

They were befuddled by her apparent health.

On the third day, Dune heard someone say the words “spontaneous brain death” in the hall outside the room. She walked out to calmly confront the speaker, kept her voice contained enough that if no one heard the words, they wouldn’t know she was streaming obscenities. It was a kid, a nurse’s aide. He apologized, red-faced, said that he’d been careless. He didn’t take it back, his shoulders pulled in close as he sidestepped away.