It was small and frivolous and never should have sent me careening. I missed the next three days of school, staying home to brood about what a terrible person Martine was and wonder how I’d allowed myself to look forward to something as dumb as prom. I went back to school the Monday after prom weekend. Martine avoided me, put off by my sullen face and the way I clanged my locker shut between classes.

Antonia spent those evenings, and so many others, plucking thorns from my soul.

You miss them, she said. That’s grief, and grief is nothing but the far brink of love. Love is the sun, grief is the shadow it casts. Love is an opera, grief is its echo. You cannot have one without the other. But if you follow that grief, you’ll find your way back to love. You haven’t let yourself do that yet, and you need to—in your own way. So cry, scream, run, sleep, pray, or write love notes in the sand. But grieve, so you can get back to love, because love is a better place to be.

I brush my teeth and slip into pajamas remembering Mom’s words. She’d shocked me then, connecting my reaction to prom with the hole in my heart.

In the last decade, taking care of patients, I’ve learned more about grief.

Mothers lie on stretchers next to hospital beds, drinking in their children’s faces while they can. Husbands sit in waiting rooms holding cups of coffee that went cold long ago. Brothers show up with gift-shop teddy bears, wishing they could rewind the years.

Grief starts before anyone has gone missing.

I roll onto my side and squeeze my eyes to shut out the light of the pale moon.

Chapter 41

I am on the number 7 train going home, my finger running over the edges of a square of paper on which I’ve written an address while reviewing scans and upcoming appointments. Shair will return to clinic in two days to hear me explain how best to keep him alive, a discussion I may be uniquely unqualified to lead in this case. I don’t stand up when the train reaches my station. Instead, I watch the doors slide closed and watch the brick buildings blur as the train accelerates. The number 7 train rumbles deeper into the borough that is a compressed capsule of the world.