That cancer — vicious, sudden, angry metastatic cancer of the liver — will lay you out, yes. And the doctor will call your semi-estranged daughter and tell her she must come now. You’ll see her briefly, exchange a few words, and that will be that. But before that, you, Irene Petrie are not dying of cancer. You are living with cancer. As you have for the past decade, give or take, since your mastectomy. And you have always done a bang-up job of it, if you do say so yourself.

The fact is, however, you are now in your seventies and you’re not as spry as you used to be. This annoys you, because you are busy. There are doctor’s appointments to be kept — for both you and your disabled daughter, Kelli. Every appointment means bundling Kelli into the car, coaxing her into a given office building, performing a series of negotiations to get on the elevator, once going up and once (always the worst of the two trips now that she’s been reminded of her loathing for these contraptions) going down. Between the two of you — an old lady living with cancer, an intellectually disabled woman with chronic ear infections — there are a lot of doctor’s appointments.

Then there is the house. It’s big, for a lone septuagenarian to care for by herself — especially a septuagenarian who was brought up with the impeccable domestic standards of Irene Petrie, a trained nurse who came up in an era where nurses, especially those who did their training in Catholic hospitals, were taught to think of themselves not as medical professionals but as priestesses of a sort. Priestesses of the bedpan; of cleanliness and efficiency. Priestesses not because they wielded any sort of authority but because what they were doing was considered a sacred vocation — a calling. They served a higher purpose. (“This is not about you,” Irene often recalled her glowering supervisor announcing to the fidgeting assembly of white-­wearing, vestal-virginlike student nurses their first day on the ward. “Get that out of your heads, ladies. You’re not special. You’re not saintly. You do not heal. You create the environment for healing. You have been called to serve. To soothe. To care for the sick. And what does that make you? What does that make you?” The students knew the answer because the instructor had told them already, at the beginning of her speech. “Grateful,” they murmured in unison.)

You, Irene Petrie, have never not had someone to look after, even long after you retired from nursing, and it has never occurred to you to be anything but grateful for that particular burden. Dutifully, therefore, you spend your days creating the environment for healing, even though your daughter, of course, can never be healed of her particular malady. Maybe that’s why every so often, in those last few years anyway, you fall down a little on the job. Once, maybe, one day in the middle of cleaning out the bottom cupboard, a cushion from the living room placed as a buffer between the hard linoleum and your old-lady knees, it occurs to you that there is no head nurse, no instructor or supervisor lingering around the corner to assess your work. There hasn’t been in multiple decades. Not only is there no head nurse, there is, for that matter, no one. No one who exists, anywhere on the planet, who will give a good goddamn whether or not the inside of your bottom cupboards are clean.