Blood and Mercy

Cassie

The break room smells like burnt coffee and something else I can’t quite place. Maybe it’s the trash nobody’s taken out in three days, or maybe it’s just the weight of too many double shifts soaking into the walls. I don’t know anymore.

It’s three in the morning. The fluorescent lights overhead are buzzing, that constant hum that gets under your skin after the first hour and doesn’t leave.

I’ve been staring at my phone for the last ten minutes, watching the screen light up and go dark, light up and go dark.

Seven missed calls and angry texts.

All from Mara. I know what they say without even opening them.

‘Where the hell are you?’

‘Jonah had another nightmare.’

‘You promised you’d be home by midnight.’

‘I can’t keep doing this alone.’

My thumb hovers over the notifications, but I can’t make myself tap them. Not yet. Not when I already know I’ve failed her again.

The coffee in front of me has gone cold. There’s a brown ring around the rim where I took one sip an hour ago and gave up. My scrubs are stiff with old coffee stains—some patient’s daughter bumped into me earlier in the hallway, spilled her entire cup down my side, didn’t even turn around to apologize.

I should go home.

I should leave.

But I’m too tired to get up.

The door swings open and I don’t even look up. Just another nurse coming in for their break, probably. Someone else as tired as I am, running on fumes and spite.

“Cassie.”

That voice makes me look up.

Dr. Patel’s standing in the doorway. He’s holding a Manila folder. The kind that doesn’t weigh much but somehow looks heavy in his hands.

Something cold slides down my spine.

“Don’t.” The word comes out before I can stop it.

He moves into the room, slow, like he’s got all the time in the world even though we both know he doesn’t.

“I need you to come to my office.” His voice is too gentle. The kind of gentle people use when they’re about to wreck you.

I shake my head. “Just tell me here.”

“Cassie—”

“Whatever it is, just say it.”

He glances at the door, then back at me. His jaw works like he’s chewing on words he doesn’t want to swallow.

“Not here. Come on.”

He doesn’t wait for me to answer. Just turns and walks out, still holding that folder like it’s something fragile.

***

His office is at the end of the hall. Small and cramped. There’s a desk buried under files and patient charts, a dying plant on the windowsill that nobody’s watered in weeks, a picture of his grandkids that I haven’t seen in a while on his desk and a clock on the wall that ticks too loud.

He closes the door behind me and that sound—god, that sound makes my chest tighten.

“Sit down,” he says.

“I’m fine standing.”

“Cassie, please.”

But I can’t. If I sit down, if I let my body relax even a little bit, I’ll break. So I stay on my feet, cross my arms over my chest, and I wait.

Dr. Patel exhales through his nose and opens the folder. His hands are shaking just a little and that’s when I know. I know before he even opens his mouth.

“Your mother’s test results came back this early morning.”

The floor shifts under me.

I reach out, grab the edge of his desk. My fingers dig into the wood and I focus on that—on the solid, real feeling of it—because if I don’t, I’m going to fall.

“It’s not good.” He’s looking at the papers now, not at me. “The tumor’s larger than we initially thought. Advanced stage. Aggressive. She’s going to need surgery, and we need to schedule it soon.”

The walls are too close. I can hear my pulse in my ears, loud and fast, drowning out the sound of that damn clock ticking.

“How soon?”

He closes the folder. Sets it on the desk between us like he can’t hold it anymore. “Ideally? Within the next three months. Sooner if we can get her on the schedule. The longer we wait—”

“What happens if we wait?” My voice doesn’t sound like mine.

He really looks at me then and I see it in his eyes before he says it.

“Six months,” he says quietly. “Maybe less.”

A laugh bubbles up in my throat. I don’t know where it comes from but it’s there, sharp and wrong, and I have to press my hand over my mouth to stop it.

Six months.

Maybe less.

I think I’m still breathing. I think my heart’s still beating. But everything feels far away, like I’m watching this happen to someone else.

“The surgery.” I force the words out even though my throat feels like it’s closing. “How much does it cost?”

Dr. Patel hesitates.

That hesitation tells me everything I need to know.

“With your mother’s insurance, you’re looking at $75,000 to $80,000 out of pocket.” He rubs his hand over his face, and he looks older than he did five minutes ago. “The hospital has payment plans. Financial assistance programs. I can help you apply for charity care—”

“I don’t have eighty thousand dollars.” I cut in, sharp.

He flinches.

“I don’t even have eight thousand.” My voice is rising now and I can’t stop it. “I barely have eight hundred in my account right now. So unless you’ve got a miracle hiding in one of those filing cabinets, I don’t know what you want me to do.”

“We’ll figure something out, Cassie.”

“How?” The word comes out sharp.

“How are we going to figure it out? She doesn’t have time for fundraisers or charity applications or whatever else you’re about to suggest. You just said she has six months if we don’t operate. So tell me, Dr. Patel. What am I supposed to do?”

He doesn’t answer.

Because there isn’t an answer.

“I’ll leave the paperwork at the nurses’ station,” he says finally. “Take your time looking it over. And Cassie—I’m sorry. I really am.”

I don’t say anything.

I just turn around and leave.

***

The hallway outside his office is empty. Everyone’s either in with patients or grabbing whatever sleep they can in the on-call rooms. I slide down the wall until I’m sitting on the floor, knees pulled up to my chest, head in my hands.

Eighty thousand dollars.

Three months.

I run the numbers in my head because that’s all I know how to do anymore. It’s the only thing that makes sense when nothing else does.

I make eighteen dollars an hour. Forty hours a week when I’m lucky. Sometimes less when they cut shifts.

After rent—twelve hundred for a two-bedroom walk-up in the Bronx that has hot water maybe three days a week—after groceries, after keeping the lights on and the internet connected so Jonah can do his homework, after Mara’s school supplies and bus passes and Jonah’s inhaler refills, insurance only covers half—

My phone buzzes in my pocket.

I pull it out.

A text from Miles. ‘Hey kiddo. Can you spot me? Just til Friday. I promise.’

He won’t.

He never does.

But he’s on parole and if I don’t send it, if I let him spiral, he’ll end up back inside. And I can’t—

I can’t.

Mom’s face flashes in my mind and I have to close my eyes against it. The way she looked last week when I brought her soup after my shift. So pale. So thin. But she smiled at me anyway, like she wasn’t in pain, like she wasn’t dying.

“I’m fine, baby,” she’d said. “Don’t worry about me.”

Like I could do anything else.

I ignore Miles for now and look at Mara’s texts again.

I should call her. I should tell her I’m sorry. That I’ll be home soon. That I’ll figure this out.

But I don’t know how to lie to her right now.

So I sit there on the floor in an empty hallway at four in the morning, trying to figure out how to save my mother’s life with money I don’t have.