And then there was the darker question, one I was certain I was alone in pondering. And one that I pondered only when I was alone. Had Anastasia lived, would she have wished that she hadn’t?

Chapter 37

“Why do we have to tell her?”

My patient’s daughter speaks in a conspiratorial voice, even as she tries to keep her expression neutral. I’ve just asked her to translate for her mother that her pancreatic cancer is spreading quickly.

Her mother, cachectic and slightly hunched, watches us with minimal interest.

“It’s unethical for me to lie to her,” I say.

“But she’s not asking if it’s gone into other organs. So you wouldn’t be lying,” pleads the daughter, a woman in her early twenties. People become experts at finding loopholes when they face losing someone they love.

“It is a lot for you to take this all in and then to translate it for your mother as well. I really do think we should bring in an official interpreter,” I say gently. But the daughter hadn’t wanted a stranger in the room for this conversation. She hadn’t realized that would mean she’d be the one who had to describe to her mother the mechanics of her demise, the brevity of daylight left to her. At the young woman’s side was a tote bag heavy with her mother’s medical records and bottles of supplements, antioxidants and turmeric and an oil of some rare tree more common back home, where no one seemed to get this kind of cancer.

The daughter took off from work to be here. She has taken many days off work to be with her mother, who cleaned houses so that she would have clothes like her classmates, a pair of roller skates, and the expensive calculator she needed for math class.

My patient puts a hand on her daughter’s shoulder. She says a few words to her daughter. Her daughter shakes her head and smiles. The mother looks at me and then back at her daughter. They exchange a few more words, and slowly the daughter’s face is transformed.

My patient didn’t come here today to find out something she didn’t know. She came so that her daughter could hear, from me, the truth behind the ache in her bones, the drag in her step.

She is wearing a paper gown and looking at me imploringly, the thin skin of her hand wrinkling as she comforts her daughter.

“I can see how much you love your mother,” I say.

“She . . . she has done everything for me,” she replies, her voice breaking with frustration.

Finding the right words is like plucking wildflowers from a tangled brush.

“She put your needs first. Let’s work on understanding her needs and wishes now.”