Chapter 21
twenty-one
SOPHIE
The PowerPoint slide clicks over to reveal today’s class agenda, and an unfamiliar spark of anticipation shoots through me.
Advanced Physiology and Pathophysiology isn’t usually the highlight of my week—it’s three hours of dense medical terminology that makes even the most dedicated nursing students contemplate dropping out. But today’s agenda changes everything.
Professor Mahoney clears her throat. “Today, you’ll be working in groups to assess a fictional patient’s care needs based solely on their medical record.”
A collective groan ripples through the room, but I straighten in my seat, pulse quickening. This is exactly the kind of practical application I’ve been craving—the reason I dragged myself through endless lectures on cellular pathology and biochemical interactions.
Mahoney continues, unaffected by the room’s lack of enthusiasm. “You’ll have forty-five minutes to review the case and develop a comprehensive care plan. I expect detailed assessment of physical needs, psychological considerations, and long-term management strategies.”
I pull my laptop closer, already mentally organizing how I’d approach this. Even before Mom’s diagnosis, this was what attracted me to nursing. Not just treating symptoms, but seeing the whole person and understanding how to advocate for them when they’re at their most vulnerable.
Mom always said that was the heart of nursing. Even when she complained about twelve-hour shifts, difficult doctors, and hospital bureaucracy, she’d circle back to those moments when she knew she’d made a difference. When she fought for a patient who couldn’t fight for themselves.
“I’m assigning you to groups of four,” Mahoney announces, starting to read names from her tablet.
I listen for mine, half hoping I’ll get paired with Maya.
But when my name is called, it’s with three people I barely know: Ethan, who sits in the back row and asks questions that are both intelligent and annoying; Brielle, whose highlighted hair catches the morning light perpetually Instagram-ready even during 8:00 a.m. lectures; and Damian, who I’ve literally never heard speak a single word.
We shuffle awkwardly to a corner of the room, dragging our chairs into a loose circle. Ethan immediately springs up—because of course he does—practically jogging to the front where Mahoney is distributing manila folders. His Cole Haan loafers click against the linoleum with unnecessary authority.
“I can type up our notes if someone else wants to lead discussion,” Brielle offers, pulling out her rose-gold MacBook and flashing perfectly manicured nails.
“I’m happy to focus on the holistic care aspects,” I say, knowing Damian isn’t going to volunteer for anything.
Damian nods again—apparently his signature move—and I’m grateful for how smoothly this is going.
Group projects usually involve at least fifteen minutes of awkward negotiation while everyone tries to avoid doing actual work, but at least three of us seem keen to get on with it, and the fourth isn’t blocking our way.
Ethan returns with our folder, slightly out of breath despite the twenty-foot journey. “We got multiple sclerosis,” he announces.
The air leaves my lungs and my fingers turn to ice as I take the folder from him, the manila paper suddenly weighing a thousand pounds. This can’t seriously be happening. Of all the chronic conditions they could have assigned us…
I force my trembling hands to open the folder, to look at the neatly typed patient profile. Female, forty-two, diagnosed with relapsing-remitting MS eight years ago. Mobility issues primarily affecting the right side. Fatigue. Cognitive fog during flares.
Different from Mom’s presentation. Mom’s symptoms attack her balance more viciously, and she gets those strange tingling sensations that make her describe her skin as “angry bees.” But the similarities overwhelm me… the unpredictability… the progression… the way a body can betray you.
They’re talking around me, but their voices sound underwater. I stare at the paper, trying to focus, but all I can see is Mom on our kitchen floor two years ago. The morning sun streaming through the window, illuminating dust motes that danced while she lay there, unable to stand.
It wasn’t the first time she’d collapsed (Hazel’s soccer game has that honor) but it was the worst, and she’d tried to make a joke—“Well, this is one way to avoid making breakfast”—even as her words slurred slightly, the consonants softening at the edges.
“Sophie, are you OK?” Brielle’s voice cuts through the memory. “You look really pale.”
“I’m fine,” I say automatically, but my lungs have forgotten their job description. Each breath comes shallow and rapid.
“You don’t look fine,” Damian says, and hearing words from him is shocking enough to penetrate my panic for half a second. “You’re hyperventilating.”
Am I?
I press a hand to my chest, feeling the frantic flutter beneath my ribs.
Black spots dance at the edges of my vision, little warning signs that my body is about to stage its own rebellion.
I badly want Maya, but as I glance around, I see she’s locked in discussion with her group, and I don’t want to ruin this project for her.
“I need to go,” I stammer, finally, grabbing my backpack with numb fingers. “Sorry.”
“Should I get Professor Mahoney?” Ethan half-rises, already playing the hero in his own medical drama.
“No!” The word explodes out of me, louder than I intended. “No, I just need some air.”
My legs wobble as I stumble toward the door, hyperaware of eyes tracking my graceless exit—my group members with their mixture of confusion and concern, other students grateful for the distraction from medical jargon, Professor Mahoney whose expression I can’t bear to interpret.
Get to the library. Bottom floor. Far corner. No people.
It’s my anxiety mantra, a GPS coordinate for my personal panic room.
The library basement is my sanctuary, a place where the only sounds are the prehistoric wheeze of the HVAC system and the occasional rustling of someone excavating journals that haven’t seen daylight since the Clinton administration.
I clutch my laptop and notebook against my chest as my feet carry me across campus on muscle memory alone. My mind keeps playing that patient profile on repeat: female, forty-two, relapsing-remitting MS. Not Mom, but close enough to make my chest compress tighter with each breath.
I’m so deep in my spiral that the solid wall of muscle catches me completely off guard. Strong hands, warm even through my cardigan, steady my shoulders before I can stumble backward and turn my laptop into expensive debris or hurt myself going to the ground.
“Sorry, I wasn’t—” I look up and the words dissolve, because apparently I can only have meltdowns in the presence of Mike.
“Sophie?” His brow furrows, creating lines that somehow make him more attractive, which seems scientifically unfair. “What’s wrong?”
I try to arrange my face into something that broadcasts nothing, I’m fine, please move along , but apparently my facial muscles have joined the rebellion. My chin develops a humiliating quiver, and when I try to speak—just that single word, fine —my voice cracks.
Mike’s hazel eyes sharpen, going from casual concern to focused attention in a heartbeat. Without a word, he guides me toward a nearby bench beneath a maple tree that’s given up on its leaves. His hand stays on my elbow, a warm anchor that I hate how much I need right now.
“Hey,” he says softly as we sit, his voice dropping to that register that probably makes hockey opponents want to confess their sins. “Talk to me.”
“Just a bad moment in class,” I finally manage, hating how small my voice sounds. “We’re doing patient assessment case studies.”
Mike waits. Like always, he doesn’t rush me or fill the silence with platitudes. He just exists there beside me, solid and patient, and somehow that makes it easier to continue.
“My group got assigned a patient with MS,” I whisper. “And, well, let’s just say everyone thinks I’m weird now.”
Understanding floods his eyes immediately. No confusion, no need for explanation. Just recognition. “Shit,” he says quietly. “That’s rough.”
Something about his complete lack of empty reassurances loosens the knot in my chest. He doesn’t say it’ll be fine or don’t worry so much or any of the useless phrases people usually deploy when faced with someone else’s anxiety.
“I completely lost it,” I admit, the words tumbling out now.
“Couldn’t breathe, couldn’t think. All I could see was Mom getting worse, needing a wheelchair, losing her independence, maybe her job…
” My voice catches. “All the things I try not to think about every single day just came crashing down at once.”
“So you had a panic attack,” Mike says simply. “It happens.”
“Not to future nurses who are supposed to handle medical situations.”
“Pretty sure even nurses are allowed to have feelings about their own families.” He shifts slightly, and his knee brushes mine. The contact sends an unexpected jolt through me. “Having emotions about your mom doesn’t make you weak. It makes you human.”
I drop my hands and look at him, taking in the earnest expression on his stupidly handsome face. “How are you always so… reasonable?”
“It’s a new feature I’m testing out,” he says with that crooked smile that does unfortunate things to my ability to think clearly. “Limited warranty.”
Despite everything—despite the panic attack and the public humiliation and the fact that my mascara is probably somewhere around my chin—a small laugh escapes me.
“So,” he asks after a moment, his voice gentle, “how do you usually handle it? The anxiety about your mom?”
A sharp-edged laugh escapes this time. “Handle it? I don’t handle it. I just… coexist with it.”
“That sounds exhausting.”