CHAPTER fifty-eight #9
Her voice breaks.
Another nurse jumps in. "Any nausea? Fever? Dizziness?"
Sam squeezes her eyes shut, nodding weakly. "Everything... hurts..."
"Okay," the nurse says gently, already checking her vitals. "We've got you. We're going to take you inside and get you some help."
Zach is right beside the gurney, one hand on Sam's shoulder even as they start wheeling her in. His face is pale, jaw clenched so tight it trembles.
"Angel, I'm right here," he says, voice rough. "I'm not leaving. I'm right here."
I hurry beside him, tears burning at the corners of my eyes.
We follow them through the sliding doors, hearts in our throats, dread pulling tighter with every step — and absolutely no idea what we're about to walk into.
It's been hours.
Long, heavy, nauseating hours since we rushed Sam into the ER.
The hallway outside her room feels cold, too bright, too quiet except for the occasional beep of machines and the soft shuffle of night-shift nurses.
I've been pacing between a chair and the wall, crying without even realizing I'm crying, my hands still shaking every few minutes like my body can't figure out how to feel safe.
Zach and Charlene are inside Sam's room with the doctor.
I stayed outside to give them space... but the door is open just enough that I can hear everything.
Dr. Wilcott — Sam's hematologist/oncologist from the South Florida Comprehensive Cancer Institute — arrived about an hour ago. She'd been in surgery, which was why she couldn't come sooner. The ER team saw Sam's labs, learned her medical history from Zach, and called her immediately.
She drove straight here herself, still in her scrub jacket.
"Sam's cancer is back..." Dr. Wilcott says gently.
My whole body tightens.
Tears instantly pool in my eyes.
Inside the room, I hear Charlene's sharp inhale — a sound made of pure, maternal terror.
There's a beat of silence — thick, dreadful, suffocating.
"When Sam came in last month because she was feeling fatigued and showing bruising along her lower back and underarms," Dr. Wilcott begins, her voice calm but heavy with meaning, "we ran a full panel — CBC, smear, marrow markers.
Her counts weren't stable. There were abnormalities in her blasts, her platelets, and her neutrophils.
.. enough that we were concerned her remission might not be holding. "
She pauses, exhaling softly — not dramatically, just the way doctors do when they wish they could give better news.
"We ordered a follow-up marrow study, repeated her labs, and... the trends confirmed what we were afraid of. All of the indicators were consistent with a relapse of her AML."
Another pause.
"That's why she had the abdominal pain today, as well as the other acute symptoms she's experiencing. Her system is under significant stress, and we need to start treatment as soon as possible."
Charlene breaks.
A scream — raw, gutted— rips from her chest and echoes down the hallway.
It makes my hand fly to my mouth as tears spill hot and fast, blurring everything.
"No—no, no, please—" Charlene sobs. "We did this already. We—we did everything. This can't happen again. God, please..."
I hear Zach inhale sharply — not a gasp, not even a cry, but a sound like someone just crushed all the air out of him.
He doesn't speak.
I don't think he can.
Dr. Wilcott continues softly, "I know how much she's fought. And I know how unfair this feels after everything she endured before."
Charlene cries harder, muffled in her hands.
Dr. Wilcott pauses, and when she speaks again, her voice dips with empathy, "But she responded well to treatment last time.
That history still matters. First thing in the morning, we'll repeat her marrow sample, update her cytogenetics, and start planning her next course of treatment.
We're moving quickly because we need to — but she is not going through this alone. "
My tears spill harder.
My heart feels like it's splitting open in my chest.
From inside the room, Sam's voice finally breaks through — cracked, trembling, barely recognizable.
"I'm so sorry..." she cries. "I'm so sorry I didn't tell you sooner. When Dr. Wilcott told me..." Sam's voice cracks, thin as paper. "I felt everything inside me drop. Like my whole world just... stopped."
She's sobbing now, breath hitching, every word scraped raw.
"I didn't want to accept it. I didn't know how to face it—how to face everyone with it."
She swallows, but the sound is broken.
"I kept thinking, if I don't tell you... if I don't say it... then maybe it won't be real."
Another sob breaks loose.
"Maybe I could pretend for just a little longer that it wasn't happening again. That I wasn't about to live in a hospital for months... hooked up to machines... getting poison pumped into me until it wipes out everything inside me—what's left of me."
Her voice collapses, trembling.
"I didn't want you to look at me like that again," she whispers. "I didn't want to see you break because of me."
Her voice fractures completely, collapsing into broken weeping.
The sound of her crying — it's the kind that guts you, high and sharp and hopeless, a sound that says she's been terrified and alone with this for too long.
My heart plummets.
"Oh sweetheart..." Charlene sobs, voice shredded.
Then Zach — God... His voice.
"You should've told us," he whispers. It's not angry. It's not loud. It's just shattered. "You should've come to us. To me. You didn't need to carry this alone. You don't ever have to carry something like this alone."
He breaks — just a little — on the last word.
"I didn't want you to worry about me again," Sam whimpers.
"I'm your big brother," Zach says, voice rough with helplessness, "I'm supposed to worry. I'm supposed to know when you're hurting. I'm supposed to protect you... and right now I don't even know how to fix this."
Sam tries to speak, but all that comes out is another sob — aching, frightened, small.
"I'm sorry, Zachy," she cries. "I was so scared. I didn't know how to say it."
"I know," he says, broken and earnest. "I know you were. And I'm scared too. But we're going to fight this — do you hear me? We're going to fight this with you. Every step."
Charlene sobs harder, grief shaking through her.
I slide down the wall outside the room, shaking, one hand clamped over my mouth as tears stream uncontrollably. Every word they say feels like a punch to the chest. I can't breathe around it.
Inside, the crying continues — grief, fear, love... all tangled into something unbearable.
A family unraveling after battling so much already.
A family who does not deserve another war like this.
And nothing, absolutely nothing, feels more terrifying.
*****
ZACH
A week.
That's how long it's been since we brought my sister into the hospital—Sam clutching her stomach, pale and shaking, trying to breathe through a pain so sharp it stole her words.
At first, I kept telling myself it was nothing serious. Maybe she ate something bad. Maybe it was just cramps. Anything... anything but what it really was.
But then the doctors started throwing around words no brother ever wants to hear again.
Typhlitis. Neutropenic Enterocolitis.
A dangerous intestinal infection that hits when your immune system is bottomed out—when your body has no soldiers left to fight.
And that only happens to people battling cancer.
Yeah. That's right. Cancer.
And not just any cancer — it's Acute Myeloid Leukemia. The same monster that clawed at her when she was eight years old, then again in high school. And now, here it is—back for a third fucking round like it forgot it already ruined her childhood twice.
I sit in the uncomfortable plastic chair right beside her bed, elbows on my knees, palms pressed to my face like I'm trying to hold myself together. It's just me and her right now.
Mom had to drive back to Naples earlier to grab more of Sam's things and sort out an extension for her leave at work—she didn't want to go, but there was no way around it.
And Caroline just left a few minutes ago too, promising she'd grab clean clothes for both of us and come straight back.
Sam's sleeping now—finally. Her breathing's steadier, the fever broke yesterday, the swelling in her abdomen has gone down. She's even managed to eat half a cup of soup today.
The doctors and nurses have been in and out nonstop all week—IV antibiotics dripping constantly, pain meds around the clock, labs every few hours. CBC trends, metabolic panels, inflammatory markers... half of the time I don't even know what test they're running anymore.
I just watch her flinch every time someone touches her IV line, and I want to scream.
Typhlitis comes with every horrible thing you can imagine—fever, severe abdominal pain, nausea, diarrhea, her body curled over itself like she's trying to escape from her own insides. And she faced all of it quietly, apologizing to me for "being a burden," even while she was shaking in pain.
I still can't believe this is happening.
Again.
For the third goddamn time.
Like what is this—some cosmic joke?
Third time's the charm?
She hasn't suffered enough, so the universe wants another shot?
I drag a hand down my face, staring at her. Her skin looks a little less gray today. Her lips less cracked. She's not trembling anymore. She looks... stable. Fragile, but stable.
And the whole time, this thought keeps cutting through me:
How didn't I see it sooner?
She told me that her checkup last month went fine. "Still cancer-free," she said with that bright smile she's always had.
And I believed her. God, I just believed her.
I didn't question the way she got tired so easily. I didn't question how she skipped meals some days. How she brushed off pain. How she said she was "just busy" when she avoided coming to see me.
She lied.
And I didn't see it.
I should've pushed. I should've known. I should've been paying attention like a real older brother instead of being so wrapped up in my own life.