Chapter 46
SAM
Tears instantly pool in my eyes, hot and stinging, as Dr. Wilcott begins explaining to my family what I've already known—what I've been hiding from them.
"Sam's cancer is back..." Dr. Wilcott says gently, and the words land like stones in the pit of my stomach. My whole body tightens, every muscle contracting as if trying to physically reject the truth I've been carrying alone these past weeks.
I turn my face to the side and close my eyes, unable to meet their gaze. I'm too afraid to witness the moment their world shatters because of me. Again.
I hear Mom's sharp inhale—a sound like fabric tearing.
It's the same sound she made the first time, sitting in this same hospital, in a different room with the same terrible news. There's a beat of silence afterward—thick, dreadful, suffocating—like all the oxygen has been sucked from the room, replaced by the crushing weight of what comes next.
"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."
I keep my eyes fixed on a small scuff mark on the hospital floor. White linoleum with a black streak, like someone dragged the heel of their shoe while rushing to another crisis. I wonder how many other people have stared at that same mark while their lives unraveled.
"Her counts weren't stable," Dr. Wilcott continues. "There were abnormalities in her blasts, her platelets, and her neutrophils... enough that we were concerned her remission might not be holding."
The medical terms float around me, familiar as old enemies. I know them all by heart now, could probably recite normal ranges in my sleep. I know exactly what each deviation means—how many percentage points separate hope from devastation.
"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 another relapse of her AML. That's why she had the abdominal pain today, as well as the other acute symptoms she's experiencing. Her body is fighting, but..."
She glances at me briefly before continuing, and I feel the weight of her gaze like a physical touch. It's gentle but unbearable. I've been carrying this knowledge like a stone in my chest, and now everyone else must carry it too.
"As I discussed with Sam earlier this week, we need to move forward with salvage chemotherapy immediately since the first-line treatment hasn't been effective."
"What do you mean, 'earlier this week'?" Zach's voice cracks.
I finally dare to glance at him. His brows pull together in confusion, and there's something worse than anger in his expression—betrayal.
"Sam is already thirteen days into her outpatient chemotherapy regimen," Dr. Wilcott says gently. "Unfortunately, her blood counts continue to drop. She's not responding the way we hoped."
I watch Mom's face crumple in slow motion—disbelief morphing into horror, and then something worse. Her features contort with a grief so profound it seems to age her ten years in seconds. Her skin goes pale, then flushes red as the reality takes hold.
A scream—raw, gutted—rips from her chest. It makes my hand fly to my mouth as tears spill hot and fast, blurring everything. My body shakes with sobs I can no longer contain.
"No—no, no, please—" Mom collapses against me, her arm wrapping around my body like she could shield me from this with just her love. Like she could absorb the cancer cells into her own body if she just holds me tight enough.
"We did this already," she wails. "We—we did everything. This can't happen again. God, please..."
Her tears soak into my hospital gown, and I feel each of her sobs like they're coming from my own chest. My mother, who has tried to be strong since Dad was gone, is breaking apart against me, and it's my fault.
I did this to her by getting sick again. By not being strong enough to stay in remission. By keeping it secret until I couldn't anymore.
"You started treatment without telling us?" The hurt in my brother's voice cuts straight through me.
I can only manage a small nod, unable to form words through my tears. The betrayal in his eyes is worse than any pain I've felt today, worse than the stabbing in my abdomen that brought me here, worse than the needle they shoved into my hip for the marrow sample.
Dr. Wilcott speaks again, "First thing in the morning, we'll repeat her marrow sample, update her cytogenetics, and start planning her next course of treatment. The salvage chemotherapy is essential given how aggressively the cancer cells are multiplying."
She leans forward, her eyes steady. "We're moving quickly because we need to—but she is not going through this alone."
Alone. The word echoes in my head. I've been so alone with this, carrying it like a secret sin. The relief of having it out in the open collides with the agony of watching my family absorb the blow. It's both better and worse than I imagined.
"We also need to discuss testing her direct relatives for a potential bone marrow match."
Mom's head snaps up, her eyes wide with shock. Zach stiffens beside me, his body going rigid.
"But Sam always refused—" Mom starts, her voice trailing off as she looks at me with new understanding.
The transplant. The thing I swore I'd never do—wouldn't put my family through again. The treatment that was supposed to save Dad... and ended up killing him. The same gamble that might kill me too.
"The cancer variant she has right now is more aggressive than before," Dr. Wilcott explains gently. "I'm afraid we're running out of options. The transplant may be our best chance."
Mom turns to me, her face tear-streaked, eyes searching mine. "Sam? Are you sure about this?"
I finally meet their eyes and give a small nod. "I promised Dr. Wilcott that if the initial treatment didn't work..." My voice cracks. "I'd be open to doing the transplant."
My tears spill harder. My heart feels like it's splitting open in my chest, raw and exposed. The weight of everything—the diagnosis, the secrets, the pain I'm causing—crashes down on me all at once.
"I'm so sorry..." I cry. "I'm so sorry I didn't tell you sooner. When Dr. Wilcott told me..." my voice cracks, thin as paper. "I felt everything inside me drop. Like my whole world just... stopped."
I sob, breath hitching, every word scraped raw from my throat. "I didn't want to accept it. I didn't know how to face it—how to face everyone with it."
I swallow, 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, tearing through my chest. "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."
The truth pours out of me now, unstoppable. "I didn't want you to look at me like that again," I whisper. "I didn't want to see you break because of me."
The sound of Mom crying cuts through me—it's the kind that guts you, high and sharp and hopeless, a sound that says she's terrified and probably blaming herself for not noticing anything.
"Oh honey..." Mom sobs, voice shredded.
She reaches for my hand, and I let her take it.
Then Zach—God... My brother's voice is broken and helpless. "You should've told us. 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.
His eyes, usually so confident and steady, are liquid with fear. He runs a hand through his hair—a nervous gesture I've seen a thousand times—but now his fingers tremble.
"I didn't want you to worry about me again," I manage, the words feeling pathetic as soon as they leave my mouth.
"I'm your big brother," he says, voice rough, "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."
I try to speak, but all that comes out is another sob.
I feel like a child again, wanting my big brother to chase away the monsters under my bed. But this monster is inside me, multiplying in my blood and bones, and no amount of brotherly protection can drive it away.
"I'm sorry, Zachy, I was so scared. I didn't know how to say it." The childhood nickname slips out, making me feel even more vulnerable.
"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."
He moves closer to the bed, taking my other hand. Mom on my left, Zach on my right. They form a circle around me.
"Will you take the test?" I ask Zach, my voice barely audible. "For the marrow match?"
His eyes flash with something fierce. "You even have to ask? Of course I will. In a heartbeat."
"Me too," Mom says immediately, wiping tears with the back of her hand. "First thing tomorrow."
Dr. Wilcott nods, making a note on her tablet. "We'll arrange for testing right away."
The logistics begin—the familiar hospital choreography. Forms to sign, nurses to call, a room to prepare. Mom steps out to make some calls, probably to her work, explaining why she won't be coming in for... weeks? Months? Who knows how long this time.
Zach stays by my side, his hand still holding mine. When we're alone for a moment, he leans in closer.
"Why didn't you tell me, angel? Why did you lie to me?" he asks, his voice low and raw. "The second you found out. Why didn't you tell me?"
I stare at our joined hands.
"Because you have your own life, Zachy. You just got Caroline back. You're finally getting your life together again—hockey, everything." My voice shakes. "I didn't... want to be the reason you put everything on hold. Again."
"That's bullshit, angel," he says, but there's no heat in it. Just sadness. "Nothing in my life is more important than you. Nothing."
"I wanted to be more than this," I whisper. "More than the sick sister. I wanted you to see me as someone strong, someone who was moving forward with her life. Not someone who keeps getting dragged back into the same nightmare."
"You are strong," he insists, squeezing my hand. "The strongest person I know. And this—" he gestures at the hospital room, at all of it, "—this doesn't define you. It never has."
But it does. It always has.
The cancer has shaped every decision, every relationship, every moment of my life since I was eight. And now it's back, reshaping everything again, bending my future into unknown shapes.
"I'm so tired, Zach," I admit, the words heavy with more than physical exhaustion. "I'm so tired of fighting."
His face crumples for a second before he composes himself. "I know you are. But you're not fighting alone anymore. I'm right here with you. And we're going to beat this thing again, do you hear me?"
I nod, but inside I'm not so sure.
The weight of another battle feels impossible to bear. The thought of more chemo, more sickness, more pain—it stretches before me like an endless road.
"Promise me something?" I ask.
"Anything," he says immediately.
"If I don't—"
"Don't," he cuts me off sharply. "Don't you dare."
"Zach, please," I say, gripping his hand tighter. "I need to say this. If things don't go the way we hope... promise me you won't put your life on hold. Promise me you'll keep living—really living."
His jaw clenches, a muscle jumping beneath his skin. "We're not having this conversation."
"We have to," I insist. "Because I can't fight this if I'm worried about what it's doing to you. To Mom. I need to know you'll be okay, whatever happens."
He stares at me for a long moment, his eyes bright with unshed tears. "I promise," he finally says, voice thick. "But only if you promise to fight like hell. No giving up. Not even for a second."
"I promise," I whisper, though the words feel hollow. How can I promise something I'm not sure I can deliver?
But I'll try. For Zach. For Mom. For Eli. For myself. Even if every cell in my body feels too tired to continue the battle, I'll try.
Dr. Wilcott returns with a nurse, ready to start the admission process. The machinery of the hospital springs into motion around us—familiar, terrifying, necessary.
"We'll get through this," Zach says, not letting go of my hand even as the nurse begins inserting a new IV line into my arm. "Together."
I nod, letting his certainty wash over me like a wave. Maybe if I borrow enough of his strength, I can make it through one more day. And then another. And another after that.
One breath at a time. One moment at a time. The future—uncertain and frightening as it is—will have to wait.
Right now, all I can do is hold on.