Chapter 7
Carlos
Jade is quiet. We’re in the event room, setting up for the first presentation.
If she’s mad at me for something, I have no idea what it is. Perhaps she’s just upset to be here with me at all. I, after all, thought Rebecca should send someone else.
I don’t take it personally. I don’t want to be doing this with her, either.
The room holds three hundred people, rows of chairs extending out from the raised stage at the front.
Once Jade gets her laptop connected to the projector, the first slide of the presentation comes up—the familiar style and colors from the last few years of presenting.
It settles my worries slightly. Jade made updates to the slides, but the core structure has stayed the same.
It’s the first presentation and we didn’t have to call in the hotel’s tech support. That feels like a good omen. And we’ve practiced distilling Jade’s science-smarts down to something everyone can understand.
A few people filter in, and I welcome them, suggesting they take a seat.
A pharmaceutical rep I know comes in, and we chat for a few minutes about his company’s latest acquisition.
The room starts to fill—press badges in the front rows, industry professionals in the middle, patients and families toward the back.
I excuse myself to the front of the room.
Jade isn’t up there, and I check my phone. We have seven minutes until we start.
I have a few emails I can read while I wait, and at exactly four p.m., Jade climbs the steps to the stage. I shove my phone into my jacket pocket and follow her up.
That’s when I notice.
Her shoulders are too rigid. Her smile is fixed, stretched too tight across her face. When she reaches the podium, she grips it with both hands like it’s the only thing keeping her upright.
Something is wrong.
“Good afternoon,” Jade begins, and her voice has that over-controlled quality I remember from our early training sessions. Like she’s reciting from memory rather than presenting. “Thank you all for attending today’s presentation on advances in hair loss prevention for oncology patients.”
I translate into German, watching her carefully. She’s staring at the teleprompter, not making eye contact with anyone. Her face is pale.
She launches into the opening section—the one we revised three times to make it more accessible, more human. But the warmth we practiced is gone. She sounds like she’s reading a technical manual.
I translate, keep my expression neutral, and wait for her to find her footing.
She doesn’t.
She gets through the methodology section without stumbling—I’ll give her that.
She hits the data points in the right order, doesn’t skip anything, doesn’t lose her place.
Technically, it’s correct. But the patient stories we spent two training sessions on—the photographs, the names, the reason any of this matters—she delivers them like footnotes.
Like things she has to say rather than things she wants to.
The audience is polite. That’s the most alarming thing. Polite means they’re still in their seats but they stopped leaning forward ten minutes ago.
A woman in the third row—gray-haired, a press badge, someone who has probably sat through a hundred of these—has her pen out but isn’t writing anything down. A pharmaceutical rep I know from last year’s conference glances at his phone, then puts it away, then glances at it again.
In the back, where the patients sit, a woman with a headscarf is watching Jade with careful attention. She’s getting the information. She’s just not getting anything else.
I step in where I can. When Jade moves past a patient testimonial too quickly, I take an extra beat in the translation, give the German audience a moment with it that Jade didn’t leave in English. It’s the best I can do. It’s not enough.
She finishes on time, which is something.
She clicks to the final slide and invites questions in a voice that sounds like she’s asking people not to raise their hands.
One pharmaceutical rep asks about the trial size.
A doctor in one of the middle rows asks about side effects.
Jade answers both questions with precision and absolutely no color.
The applause is adequate. No one lingers.
I shake a few hands near the stage, give the rep my card, thank the patient advocacy coordinator who’s already moving toward the door.
Out of the corner of my eye, I spot Jade slinking away.
Before I follow her, I’m stopped by Agnieszka Kowalski.
I’ve known Agnieszka for three years—she runs the Polish patient advocacy network, one of the most effective in Europe, and she makes a point of attending whatever presentations she can reach.
She’s in her sixties, small, with the particular energy of someone who has spent decades fighting for things that shouldn’t require fighting for.
She lost a daughter to breast cancer eleven years ago.
She tells people this within the first five minutes of meeting them, not for sympathy but because she wants them to understand why she’s in the room.
“Your presenter,” she says, in accented English, nodding toward the stage. “She knows this subject.”
“She does,” I agree.
“She’s uncomfortable up there.” It isn’t a criticism, just an observation.
“But she cares. You can see it, even when she’s trying to hide behind the data.
” Agnieszka tilts her head. “Is she available to speak? I have some questions about the trial methodology. Specifically the quality-of-life metrics—the FACT-B scale doesn’t always capture what patients actually experience. ”
I hesitate for a fraction of a second, thinking of Jade pacing backstage. Then I think of how she’d answered Rebecca’s questions in the meeting where this tour was first proposed—the way her whole body had changed when she was talking about the patients rather than the presentation.
“Give me one moment,” I say.
I find Jade in the prep area, her arms crossed, staring at the middle distance. She looks up when I come in.
“There’s someone who wants to speak with you,” I say, before she can open her mouth. “Agnieszka Kowalski. She runs the Polish patient network. She has questions about the quality-of-life data.”
Jade stares at me. “Now?”
“She’s waiting.”
Something shifts in her expression—the self-recrimination doesn’t disappear, but it moves aside for something else. She uncrosses her arms. “What kind of questions?”
“The FACT-B scale. Whether it captures patient experience accurately.”
“It doesn’t, actually,” Jade says immediately. “It’s a validated instrument but it was designed before we had longitudinal data on chemo-induced alopecia specifically. We had to supplement it.” She’s already moving toward the door. “Did she attend the trial? Or is this—”
“She’s an advocate. Lost her daughter.”
Jade stops. Her hand is on the door. “How long ago?”
“Eleven years.”
She nods once, and there’s something in her face I haven’t seen in any of our training sessions.
I follow her out.
What happens next is not what I expected.
Jade introduces herself to Agnieszka, shakes her hand, and within thirty seconds is asking questions rather than answering them.
What does the network find most useful from industry presentations?
What are patients asking for that they’re not getting?
She listens—actually listens, the way she doesn’t on stage—and when Agnieszka describes what her daughter went through, Jade doesn’t deflect or rush to fill the silence.
She just says, “I’m sorry. Can I ask—what was the hardest part for her? ”
I stand slightly to one side and watch Jade Dixon do in conversation what she cannot yet do from a stage. She’s warm. She’s specific. She makes Agnieszka feel like the only person in the room.
I’m engaged enough listening to Jade that no one else steps up to speak to me. After ten minutes, we’re the only ones in the room.
Agnieszka reaches into her bag and pulls out a card. “I’d like to stay in touch,” she says. “If you’re open to it. We have members who would benefit from speaking directly with someone doing this research.”
Jade takes the card with both hands. “Absolutely. I’d really value that.”
When Agnieszka excuses herself, Jade turns to me. The self-recrimination is back, but it’s sitting alongside something else now.
“That was a disaster.” Her voice is flat, matter-of-fact. “How bad was it? Really.”
“It wasn’t a disaster,” I say. “You got through it. The data was correct, the structure held.” A pause. “But you weren’t there, Jade. You were reciting, not presenting. They could feel the difference. They were . . . bored.”
Jade’s shoulders tense, but she doesn’t look at me. “I know.”
She leaves, and I’m alone in the ballroom with the humming air conditioning and the weight of eleven more presentations ahead of us.
We have two days before Vienna. Two days to figure out how to get Jade that confidence that she feels off stage while she’s on stage.
I rub my face, exhausted already, and wonder—not for the first time—why Rebecca thought sending Jade was a good idea at all.