Chapter 1
Lydia
The crack in my windshield had grown another inch overnight.
The list was long. The list was always long.
I pulled into the Creekside Senior Living parking lot at ten till six. Ten minutes early. Always ten minutes early, because ten minutes early was the difference between being someone people could count on and being someone who let things slip, and I did not let things slip.
The staff bathroom had a fluorescent light that buzzed at a frequency designed to make everyone look like they'd been dead for about three hours.
I changed into my scrubs—lavender, size small, bought in a two-pack from the Walmart in Harlan because the facility didn't provide them—and made the mistake of looking in the mirror.
The twenty-two year old woman looking back could have passed for thirty.
The shadows under my eyes had gone from suggestion to statement, bruise-purple against skin that hadn't seen enough sunlight or enough sleep.
My jaw was set in the way I'd stopped noticing until it started hurting—molars pressed together, muscle bunched tight enough to feel from the outside.
The headache that had been sitting behind my left eye for three days pulsed once, a thumbtack pushed a quarter-turn deeper, and I looked away from the mirror and pulled my hair back into the ponytail that meant I was working and there wasn't time for anything else.
There was never time for anything else.
Morning rounds started at six sharp. Twelve residents, three hours, one aide because Tammy had called off again and the agency nurse wasn't coming until eight. I didn't waste time resenting it.
Dot first. Room 3. Eighty-seven years old, advanced dementia, the widow of a man who'd spent forty-two years pulling coal out of the mountains and died with lungs full of dust and a pension that didn't cover half of what Creekside charged.
Dot didn't know what year it was. Most mornings she didn't know where she was.
But she knew when she was frightened, and she was frightened of everyone on the morning rotation except me.
I let myself into her room softly, the way you'd enter a church. "Morning, Dot. It's Lydia."
Her eyes were open, fixed on the ceiling, her thin fingers gripping the blanket edge with a force that didn't match her body.
I started humming before I reached the bed.
The tune was"Coal Miner's Daughter," same as always, because somewhere deep in the parts of Dot that the disease hadn't erased, Loretta Lynn still lived.
The grip on the blanket loosened. Her eyes found me.
Something in her face, not recognition exactly, but acceptance.
A settling, like a bird deciding a branch was safe enough to land on.
I helped her dress the way I'd learned: slowly, narrating every step, hands warm, voice steady.
Left arm first because the right shoulder was stiff.
The blue cardigan because she reached for it every time and I'd stopped offering alternatives.
I hummed the whole time, and by the time I had her shoes on she was almost smiling.
Mr. Kaplan in Room 8 needed his pillows arranged in a specific way that no one else had bothered to learn: one behind his head, one under his left knee because of the replacement, the small decorative one from home wedged between his right hip and the bedrail because it was the exact width to keep pressure off the sore he wouldn't let the doctor look at.
I did it without asking. He watched me with sharp dark eyes and said, "You remembered," and I said, "Of course," and something passed between us that didn't need more words than that.
Jean in Room 14 hadn't touched her breakfast. The oatmeal sat cooling on the tray table, the plastic wrap still on the juice cup, the spoon exactly where dietary had placed it.
Jean always ate. Jean was the resident who asked for seconds and hid crackers in her nightstand drawer.
I made a mental note to check back after rounds and moved on because the clock didn't care about my instincts and I had eight more rooms to cover before nine.
The morning meeting happened at nine-fifteen in the break room that smelled permanently of burnt coffee and the specific despair of people who were doing essential work for twelve dollars an hour. I sat in my usual chair and opened my notebook.
Debbie stood at the front of the room with a printout I recognised before she said a word.
I recognised it because I'd written it. Three hours last Tuesday, my day off, sitting at my kitchen counter with my laptop open and my clinical assessment notes spread out beside me. It was about the new resident in Room 6. A detail of the resident’s confusion, her low-grade fever that kept appearing and resolving, the change in urine colour that the PA had waved off during her ten-minute visit.
I'd written a detailed care review. Flagged the UTI signs.
Cited the protocol. Used the language I'd learned in my nursing program before I'd had to leave it, precise and clinical and impossible to dismiss.
Debbie read it word for word. My words. My phrasing. The sentence about "early-stage urological indicators consistent with ascending infection" — I'd looked that up, I'd been proud of it, I'd felt for one rare moment like the education I couldn't finish had been worth something.
She read it as though she had written it.
The facility director nodded. "Good catch, Debbie. This is exactly the kind of initiative we need more of."
Debbie smiled. She didn't look at me. I didn’t look at her.
My fingers tightened on my pen. Something huge and hot rose in my chest—a feeling with teeth, a feeling that wanted my mouth open and my voice raised and the word mine ringing off the break room walls.
I swallowed the feeling.
The meeting ended. I stood up, tucked my notebook under my arm, and went back to the floor, because Jean in Room 14 still hadn't eaten and somebody needed to find out why.
My first break came at quarter past one. I'd been on my feet for seven hours and fifteen minutes with nothing but three sips of water from the fountain and half a granola bar I'd shoved in my mouth.
The break was supposed to be thirty minutes.
It was going to be fifteen because Mrs. Colley in Room 11 had slipped trying to get to the bathroom on her own.
She was fine, nothing broken, but the fear in her eyes when I'd found her on the floor had been the kind you couldn't walk away from, so I'd stayed.
Held her hand. Told her she was okay. Filed the incident report with one hand while rubbing her back with the other.
Fifteen minutes. I could work with fifteen minutes.
The staff room was a windowless box between the supply closet and the medication room, furnished with a table that wobbled on three legs and a faulty microwave. I pulled my turkey and American cheese sandwich from the fridge and sat down.
Two bites. I got exactly two bites in, my jaw protesting each one because three days of clenching had turned chewing into an act of minor violence against myself.
Then my phone buzzed on the table, screen-up, and the name on it was Mama, and I knew.
I always knew. The way animals know weather, not in the thinking part of the brain but deeper, in the body, in the pattern-recognition system that had been running since long before I was old enough to name what it was recognizing. My hand was on the phone before the second buzz.
"Hey, Mama."
"Oh, honey." Two words, and I had the whole picture.
The thickness in her voice—not crying, past crying, the swollen aftermath of crying that said she'd been at it for a while before she called.
The mountain drawl pulling her vowels long and soft the way it did when she was hurting, turning honey into three syllables.
"I'm sorry to bother you at work, I know you're busy—"
"You're not bothering me. What happened?"
What happened was what always happened. Phil, my father, had been drinking.
Jim Beam, probably. The bottle he kept in the truck.
He'd come home mean. Said something about Mama's cooking, or her weight, or the way she breathed too loud when he was trying to watch TV—the specific cruelty didn't matter because the engine behind it was always the same.
She didn't know what to do. She needed me to listen.
So I listened.
He'd said she was useless. He'd said he should have left years ago. He'd knocked over the lamp in the front room and hadn't picked it up. The shade wasn't broken but there was a chip in the base. Would superglue would hold it?
"It might," I said. "Try the gel kind, not the liquid. It holds better on ceramic."
I was eight years old again, sitting on the stairs in my nightgown.
The carpet was brown and my bare feet were cold on the wooden edge of the step.
Downstairs, my mother was crying at the kitchen table.
The screen door was still vibrating from the force of my father's exit, a high thin rattle like a struck cymbal fading out.
The truck engine started. Gravel sprayed.
And I sat on that step and understood, with the clarity that children have when survival requires it, that someone needed to go down there and make it okay.
I went. I made it okay. I was eight, and I made it okay, and I'd been making it okay every day since.
"—and I just don't know, Lyddie, I just don't know what to do anymore, he wasn't always like this, you remember—"
"I know, Mama."
"—before the mine closed he was different, your daddy was a good man—"
"I know."
"But enough about me," Sandra said, and the guilt-pivot was so familiar I could have mouthed the words along with her. "How are you, baby? Are you eating?"
"I'm fine, Mama. Yeah, I'm eating." The sandwich sat on the table in front of me, two bites missing, the bread already going stale at the edges.
"You work too hard. You've always worked too hard. You get that from me, you know."