A Dead Girl’s Guide to Living

Chapter 1

ELLIS

“How does it feel?” Dr. Mason’s voice cut through the stillness of her office, the double-glazed windows doing little to mute the ruckus of the bustling city outside.

I blinked at her dazedly, taking in her seated form across from me in her usual chair—legs crossed, pen poised over a notebook filled with me. My words, my silences, my habits, and my bullshit, all documented over months of weekly sessions.

She waited patiently, her face calm behind black-rimmed glasses, brown hair twisted into a low bun at her neck.

“Um… can you repeat the… whole question?” I asked weakly, a flush creeping up my neck. “I zoned out for a second.”

She smiled softly and nodded. “I asked how it felt to be a year post-transplant. You must be feeling very reflective today.”

I shifted uncomfortably, pulling the sleeves of my gray sweater over my hands as I swallowed. The office felt too warm. Or maybe I was just running too hot today. I was one bad thought away from overheating—or spiraling, whichever came first.

How was I supposed to answer her question?

I hadn’t wanted to come today. I hadn’t felt emotionally capable of acknowledging the spiral in my mind, but Mom had insisted. She told me today was the one day, of all days, not to miss—given the gravity of it all.

“So, how do you feel?” Dr. Mason’s voice remained calm, serene, as if afraid that even the slightest shift in tone might startle me, like some frightened animal.

Maybe in her eyes, that’s exactly what I was.

“I guess I feel alive,” I said finally, shrugging uselessly as I leaned forward, taking a glass of water from the table and downing it in a long gulp.

It was too hot in here.

Dr. Mason nodded once, hardly reacting to my blunt statement.

I wasn’t giving her much to work with, but I’d told her when I walked in that I didn’t want to be here today.

She regarded me through her glasses, giving me that calm, practiced stare.

The look of a seasoned therapist, dissecting me, waiting for me to contradict myself.

Because I always did.

“And what does alive feel like to you, Ellis?” she asked, tilting her head slightly, as if examining me under a microscope.

I stared past her, out the window at the world outside, turning her words over in my mind. Because what the hell did alive even feel like?

I knew what it was supposed to feel like. I knew the dry mechanics of it all. The scientific side of things.

For all intents and purposes, I was alive. But that didn’t mean I knew how to be.

I used to think there would be a moment. That there would be some kind of jolt in my body that would make it all feel real, make me feel real again. Something that would allow my mind to relax and recognize that I had made it. That I was still here.

But it never came.

Instead, I had spent the last year… waiting.

Waiting to wake up and feel normal, whatever normal even meant.

Waiting to feel something. Waiting to feel grateful.

Waiting for this new heart to fail me the way my last one did.

Waiting for some other organ to crash. Just waiting for the next shoe to drop.

I forced my eyes back to Dr. Mason, who showed no signs of impatience as she waited, leaving me to wrestle with my thoughts rather than pushing me to answer. It was one of the things I appreciated about her. She let me respond when I was ready.

“I guess it feels like… like I have a pulse. Lungs that work. A heart that beats.”

Dr. Mason nodded slowly, tapping her pen against the notebook. “How did you do with your assignment last week? Did you stop researching?”

I grimaced and tugged at the sleeve of my sweater. “Um, no.”

“Ellis, we talked about this,” she said gently.

“You needed to take one week off from studying the success rates of heart transplants. No Reddit forums. No TikTok videos. And no posting about it on your own channel. You’re spiraling, and you’ll continue to spiral if you spend every waking hour mapping out the approximate year you might die. ”

I clenched my jaw, trying not to flinch at the honesty in her voice, at how calmly she called me out. Swallowing past the lump in my throat, I licked my dry lips.

“I don’t want to be taken by surprise again.

” My voice came out sharper than I intended.

I clasped my hands in my lap, exhaling heavily.

“Listen, this heart is eventually going to fail me. Or something else will. Because that’s just what happens to me, okay?

I’m sorry if it’s not the positive, flowery outlook we’ve been working toward for the last ten months, but it’s just facts.

And I work better with facts. I think better. I cope better.”

I fell back into the chair, shaking my head.

“I’ve spent the better part of my life dancing with death. Do you really think I’m stupid enough to be lulled into a false sense of security? That this time is going to be any different from before?”

Dr Mason watched me carefully, her expression unreadable. I wondered what her mind sounded like as she worked through me, like I was an overcomplicated Rubik’s Cube she just couldn’t quite solve, but continued to think she was getting close.

“You speak as if you’re still dying, Ellis.”

I let out a humorless laugh and looked at her. “Aren’t I? I mean, technically, I could argue that we’re all dying.”

Her gaze softened, and a small smile tugged at her lips, but she didn’t let up. “You aren’t dying, Ellis.”

I hissed between my teeth and looked up at the ceiling, trying to disengage from the burning behind my eyes. Running my palms over my jeans, I took a steadying breath.

“How long do heart transplant patients typically live?” I asked aloud, voicing the morbid question I had typed into my search bar so many times that my phone could autofill it after just seeing the word how.

“The first year is the most critical,” I recalled, remembering the conversations I’d had with specialists and doctors.

Good old Google always backed up their statements.

“So if that’s the case, then I should be celebrating, right?

Well, I mean, I will be. Mom’s hosting this huge party tonight to celebrate the whole living another year thing, but also my birthday. ”

“Well, everyone has a party on their birthday,” Dr. Mason murmured, a little facetiously, if you asked me. “We all celebrate making it another year, you know? A birthday isn’t unique to you.”

I ignored her and continued, wanting to drive the point home.

“I’m one of the lucky ones. Basically, if I was going to reject the heart, I would have by now.

I mean, there’s still a possibility I could.

It’s not like I’m out of the woods, I’m just not running through it screaming bloody murder.

” I refilled my glass from the small jug.

“I’m not stupid. I’m not going to think that suddenly my body knows a year has passed and my immune system will be like, Hey, it’s been one whole year.

Let’s not turn on this foreign organ in our body. Like, really?”

Dr. Mason said nothing. She just let me go. Let me get it out.

“Ten to fifteen years.”

My voice dropped on the words, and I rested my elbows on my knees, frowning at my now-full glass, recalling the statistic I had read over and over again.

“That’s the number that sticks out the most. It’s the answer on every website. Every medical journal. Every blog post from some unlucky sucker who’s already gone through this shit and needs another heart.”

I sucked in a breath and shook my head.

“In ten years, I’ll be thirty-one. In fifteen, I’d be thirty-six.

” My voice wavered, but I pushed forward.

“That’s if I even make it that far. And what happens if I do?

Would I be lucky enough to find another donor?

Do I have to go through it all again? Or does this so-called miracle just turn into chronic heart failure or… or coronary artery disease?”

Dr. Mason pressed her lips together but remained quiet. I took a calming sip of water, the glass sounding too loud when I set it back on the table.

“And look, if none of the above kills me,” I continued, “it’ll be the side effects from the immunosuppressants I’ll be on for the rest of my life. Kidney failure. Infections. Cancer. Take your pick. It’s like a lottery for health risks.”

I ran a hand down my face in some futile attempt to calm myself.

“So forgive me if I don’t feel like celebrating. Forgive me if I can’t… if I can’t just move on and pretend like I don’t have an expiration date stamped on my chest.”

My words hung heavily between us. Dr. Mason watched me carefully, tapping her pen once against the notebook before leaning back in her chair.

“So, what does that mean for you, then, Ellis?”

I frowned. Had she not been listening?

“I mean, what does that mean for the rest of your life?” She set down her pen and leaned forward slightly. “You’ve spent an entire year researching, right? Preparing? Mapping out every possible way this could go wrong for you. But what about mapping out what happens if it goes right?”

I blinked at her. “Goes right?”

“Yes.”

I let out a dry laugh, staring at her in disbelief. “I don’t think about shit like that. Hopeful thoughts of happy endings left me a long time ago. There’s no ending to this nightmarish loop I’m stuck in. Just death—when it eventually comes for me. I don’t get an after.”

“An after?” Dr. Mason murmured, picking up her notepad again. “Explore that with me. What does that mean. Where does that statement come from?”

“Because it’s always been about after,” I told her with a shaky laugh. “Except there’s never been one. You know, I can’t even remember the first time I got sick. All I remember are hospitals and my mom crying, like all the time.”

I rubbed my temples and took another sip of water, as if that could soothe the tension clawing at me.