Chapter 17
Chapter Seventeen
Maya
The regret feels like a low-grade fever, an ache beneath my skin that’s been there for four days, ever since I kissed Zachary and then pushed him away.
My head replays the moment on a loop: the earnest look in his eyes, the warmth of his hand on my wrist, the sudden, intoxicating pressure of his mouth on mine.
Then, the subsequent flood of everything else—my mother’s voice on the phone, the weight of Trevor’s scrutiny, the constant, simmering anxiety of my lupus—dousing the spark before it could catch.
I should have just gone with it. I should have invited him in, let myself have one night where my body wasn’t a battleground, where a man’s touch was just a man’s touch and not a complication to be managed.
But the shivery, weak feeling that has settled deep in my bones tells me it’s more than just regret.
It’s the familiar, unwelcome prelude to a flare.
A flu that never quite arrives, leaving me in a state of perpetual, aching anticipation.
Luckily, I have my scheduled check-up with Dr. Sharma, my rheumatologist today.
Flick sits beside me in the waiting room, the vinyl of the chair sticking to the back of my thighs. She must sense the storm clouds gathering inside my head because she doesn’t push. She doesn’t ask about Zachary, or my mom, or school. Instead, she has her nose buried in a crossword magazine.
“Okay, what’s a seven-letter word for a mythical creature that’s half-lion, half-eagle?” she asks, tapping a pen against the puzzle page.
“Griffin,” I murmur, my eyes tracing the bland, repeating pattern on the institutional carpet. G-R-I-F-F-I-N. It feels like an immense effort to spell it in my head.
“Got it. Thanks.” She scribbles it in. “Five letters, ‘to publicly praise.’”
“Extol.”
“And finished. You’re so good at these.” She flips a page, the crinkling sound abnormally loud in the quiet room. “Ooh, look. Here’s a knitting one.”
I try to smile, but my face feels tight and foreign.
My body is a stranger to me today. Every joint is a tinderbox waiting for a spark, and a deep, familiar ache is blooming just under my ribs on the right side, the ghost of kidney pains past. I wrap my arms around my middle, a useless gesture of protection.
“Maya Gershawn?”
The nurse’s voice cuts through the haze.
My heart gives a painful thud against my ribs.
Flick immediately folds her magazine, shoves it into her oversized tote bag, and stands up with me.
As we walk toward the door, she reaches for my hand, her fingers warm and firm around my cold ones.
She doesn’t let go as we follow the nurse down the hall, past posters explaining joint inflammation and the benefits of vitamin D.
She doesn’t let go when we sit in the two chairs facing Dr. Sharma’s large wooden desk.
Her hand is an anchor in a churning sea of anxiety.
Dr. Sharma comes in a moment later, her smile as warm and professional as ever. She has kind eyes that crinkle at the corners, but today they seem to hold a measure of professional gravity that sets my teeth on edge.
“Maya, Flick, good to see you both,” she says, sitting down and pulling my chart up on her computer monitor. “How have you been feeling, Maya?”
“Okay,” I lie. It’s the standard answer. ‘Fine or okay.’ Anything more feels like complaining, like a confession of failure. But the lie feels flimsy today, transparent. “A little tired, maybe. The start of the school year.”
Dr. Sharma nods, her fingers tapping on the keyboard. “The fatigue is always a factor, I know. I have the results from the bloodwork you did last week.”
This is it. The moment of truth. My blood is a traitor, always ready to tell on me, to reveal the microscopic chaos my body is so good at hiding. I squeeze Flick’s hand harder, and she squeezes back.
“We look at a lot of things, as you know,” Dr. Sharma begins, turning the monitor slightly so we can see the columns of numbers and medical abbreviations.
“Your inflammatory markers are a bit elevated, which isn’t a huge surprise given that you’re feeling rundown.
But the number I’m concerned about is your GFR. ”
GFR. Glomerular filtration rate. A fancy term for how well my kidneys are doing their one essential job: cleaning the garbage out of my blood. The words hang in the air, heavy and menacing.
“It’s down,” Dr. Sharma says, her voice gentle but firm. “Normally, we want to see it at sixty or higher. Yours has dropped to forty.”
Forty. The number rings in my ears, a death knell.
Sixty is the benchmark for normal. Forty is…
not. A chasm opens in my stomach. This is it.
This is the thing I have dreaded more than anything else since my diagnosis.
I can live with the aching joints, the butterfly rash that blooms across my face in the sun, the crushing fatigue that feels like walking through wet cement.
I can manage those. But my kidneys. The stories are the stuff of nightmares—friends of friends in online support groups whose kidneys failed, who now spend three days a week tethered to a dialysis machine that cleans the blood their own bodies no longer can.
Their lives, suddenly revolving around a machine.
“What does that mean?” Flick asks, her voice steady and clear, a lighthouse beam cutting through my fog of panic.
“It means the lupus is causing inflammation in the kidneys, what we call lupus nephritis,” Dr. Sharma explains, her eyes on me.
“It’s impairing their ability to filter waste.
It doesn’t mean they’re failing, Maya. It means we need to intervene aggressively to protect them and stop the damage from progressing. ”
My mind is a static storm. I hear words, but they don’t connect. Aggressively. Damage. Progressing.
“The first step is a biopsy,” she continues. “We need to take a tiny sample of kidney tissue to see exactly what’s happening on a cellular level. That will tell us how much damage there is and how to best treat it. I can get you scheduled for that in about two weeks.”
Two weeks. Two weeks of waiting, imagining the worst.
“In the meantime, I want to start you on two medications. The first is an ACE inhibitor. It’s a blood pressure medication, but in this context, it works to reduce pressure inside the kidneys and prevent further injury. The second is a course of corticosteroids.”
The word lands like a physical blow. Corticosteroids.
Prednisone. The devil’s Tic Tacs. A wave of nausea, sharp and acidic, rises in my throat.
I remember the last time. The six months of high-dose steroids that felt like a chemical lobotomy.
I didn’t feel sad; I felt nothing. A profound, terrifying emptiness, a gray void where my personality used to be.
I would sit and stare at a wall for an hour, unable to muster the energy or inclination to move, to speak, to feel.
My face swelled up into a puffy, unrecognizable moon.
I was a ghost in my own life. I can’t go back there. I can’t.
“No,” I whisper, the word escaping before I can stop it. “Not the steroids. Please.”
Dr. Sharma’s expression softens with sympathy. “I know you had a difficult experience with them before, Maya. But your body changes, and your reaction might be different this time on a different dosage. They are the most effective tool we have for rapidly reducing this kind of inflammation.”
My vision starts to tunnel. The edges of the room blur. All I can see is that gray, empty feeling waiting to swallow me whole. It’s worse than the joint pain, worse than the fatigue. It’s the loss of myself.
It’s Flick’s voice that pulls me back. “Is there any other option? Anything else she can try first while waiting for the biopsy?” she asks. Her tone is respectful but unyielding. In this moment, she’s not just my friend; she’s my advocate.
The image of my ex, Sam, flashes in my mind, sharp and unwelcome.
If he were sitting here, he would be nodding along with the doctor, patting my knee and telling me to listen to the expert.
He would have seen the steroids as the fastest route back to stability, the quickest way to get my body ready for the family he was so desperate to start.
“If you get pregnant, it will be safer for the baby if the lupus is under control,” he’d said once, completely bulldozing my fears about what the drugs did to my mind.
My mental health was an inconvenient variable in his life plan.
He would have ignored the terror in my eyes and agreed to the prescription, for my own good.
For his own good. To start the family he wanted.
“What about the hydroxychloroquine?” Flick suggests, remembering what I’ve told her about the early days of my diagnosis. “And maybe a stronger anti-inflammatory. At least until the test results are back and you know exactly what’s going on.”
Dr. Sharma looks at me, really looks at me, seeing the silent, desperate plea in my eyes. I’m trying so hard not to cry, swallowing against the lump in my throat until it feels like I’m choking on glass.
She lets out a slow breath. “Alright,” she says, finally.
“Let’s try that. We’ll restart the hydroxychloroquine and I’ll prescribe a course of naproxen.
But, Maya, you must monitor your symptoms closely.
Any increase in swelling, any shortness of breath, any significant pain, you call me immediately.
And we are still doing the biopsy in two weeks.
If it shows significant inflammation, we will have to have a serious conversation about the corticosteroids again. Agreed?”
I can only nod, a wave of relief so profound it makes me dizzy.
I feel boneless, exhausted. The rest of the appointment passes in a blur.
Scheduling, prescriptions sent to the pharmacy, instructions I know I won’t remember.
All I know is that Flick’s hand is still holding mine.
When we finally walk out of the office and into the too-bright hallway, I feel hollowed out, a fragile shell. Flick steers me toward the elevators.
“Here,” she says, digging into her tote bag and pulling out a brown paper bag. “Noah dropped this off this morning at Knit Happens. He made a special batch just for you. Pumpkin and dried cranberry with a cinnamon nutmeg drizzle.”
She opens the bag, and the warm, sweet, spicy scent of the sourdough bread wafts out. Normally, it would be my favorite smell in the world, a scent of comfort and care. But right now, my stomach churns in protest. The smell is thick, cloying, unbearable.
“I can’t,” I say, my voice raspy. I turn my head away. “Thank you. But I can’t eat.”
“Okay,” she says, instantly closing the bag. “Later, then.”
She doesn’t push. She just guides me into the elevator, through the lobby, and out into the glaring afternoon sun.
The world feels loud and sharp, an assault on my senses.
I feel like I’m moving through water, every step a monumental effort.
Flick leads me to her car, opens the passenger door, and waits for me to buckle myself in.
I lean my head against the cool glass of the window, grateful beyond words that I don’t have to drive, that I don’t have to think, that for this short car ride home, I can just fall apart in silence, with one of my best friends at the wheel.