The pain stops him from eating, not that he’s feeling hungry anyway. He’s been vomiting too. The mass growing inside him has sent molecules into the air of this room, a metallic and meaty scent.

“Who lives with you, Mr. Nabi?”

His heavy eyebrows form a steeple.

“My wife,” he says. “And one daughter.”

“Do you have any other children?”

“Two more,” he says, then becomes tight-lipped, as if he will offer nothing more about them.

I picture the children staring at me, his son revolted by the blood on my clothes. That boy is a man now.

“Are any of them here with you today?”

He shakes his head.

“No, I’m driving no problem,” he says, as if transportation is the issue.

Sons rarely accompany parents to their visits. Typically, it’s daughters and spouses who help navigate appointments and medical care. Sometimes I find out a loved one has chosen to sit in the waiting room and needs to be invited in, because there’s no way they won’t be involved in the care.

It is highly unusual for a man with a family to come alone.

“Does your family know you are here?” I ask.

“I tell them I go for checkup,” he says, which means he has kept this to himself.

I pause.

“Mr. Nabi,” I say, doing my best to sound curious and not accusing. “Where are you originally from?”

“Afghanistan,” he says. “But I am here long time. Fifteen years. I never have this problem before.”

This problem is gastric cancer. It has spread beyond his stomach. Strange as it seems, cancers can be ranked, and this is one of the worst ones to have. I tell him he will need surgery, chemotherapy, and maybe radiation. I tell him we will need to take more pictures before surgery, and that he should bring his family in with him when he returns. We must move quickly. I watch for his reaction.

His face is serious, self-possessed. I can already tell he will not share this news with his wife or children because, if he cannot contain the cancer’s spread in his body, he will at least control how news of it spreads through his family.

I will not confront him today. I want him to trust me, to come back to me ready to talk.

Adam meets me at the subway station. I wrap my arms around him. It’s a simple show of affection, but it’s taken me a long time to make it look like it comes easy.

“Rough day?” he asks, planting a kiss on my cheek.

“I’ve seen worse,” I reply, taking in the scent of his cologne. I normally don’t mind it, but today it tightens the vise on my head. I squeeze his hand before pulling away from him.