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Chapter 1 - 1 ; Expiration Date

"No response," I repeated the words. I stared numbly at the confusing chart on the doctor's desk, my eyes tracking lines that made no sense, yet told the only story that mattered. "None."

"I'm so sorry," Dr. Robertson responded. She shifted in her chair. "There's really no point in keeping you on the dark side any longer, Amanda. We have to be honest about where we are."

"But you assured me that it's the only way possible," I whispered. My voice was trembling. It had to work. The statistics, the clinical trials, the expensive infusions, they were supposed to be my shield. I can't die. Not yet. I haven't even decided what I want to do with the rest of my life, let alone said goodbye to it.

"Amanda, I have your latest lab results right here." She tapped the open folder . "Your white blood cells are continuing to climb at an aggressive rate. Right now, the only thing the Alemtuzumab is doing is decreasing your life span. The toxicity is winning, but the cancer isn't losing."

I leaned forward, my vision tunneling until the only thing in the room was that piece of paper. I could see my name at the top of the chart: Amanda Ann McCann. There I was, summed up lifelessly in black and white, a collection of data points and failures. My height, which was a little less than average, seemed even smaller now, as if I were physically retreating from the world. My date of birth , barely twenty-two years ago looked like a cruel joke.

Then there was my weight. It had fallen from a casual "I'd like to lose ten pounds" to terrifying double digits. I looked at my hands, the skin translucent and clinging to the bone. To me, cancer had always been a distant concept: pink ribbons, surgical scars, and brave, middle-aged women losing their hair but keeping their smiles. I hadn't realized how the reality would be so much more predatory. I hadn't realized how it could steal all my strength, my zeal, my dreams, and then, when there was nothing left to take, burn my fat and consume even my muscles to feed itself as I wasted away.

"There must be other things to try," I pushed further, my voice rising with a frantic edge. "Some other chemotherapy? A different combination? I'll do anything."

"I'm very sorry," the oncologist said again. The words were a practiced shield. "The other therapies were ineffective. That's why their use was discontinued; they simply don't prolong life. In fact, on average, they shortened it by causing organ failure. Alemtuzumab was our realistic shot. It was the gold standard for your specific pathology."

I should get a second option or opinion, I thought. The idea flashed in my mind like a strobe light in the dark. Except Dr. Robertson was my second option. I was at Cleveland Hulgo's private hospital, for God's sake. People traveled across the country to be seen here. If the best doctors in the best facility were looking at me with pity instead of a plan, where else could I go?

"So," I said, the word feeling heavy and cold. "Five months, then."

"It could be that long," Dr. Robertson said carefully. The "could" was the knife. It wasn't a promise; it was a ceiling.

I felt the tears burning my eyes, hot and humiliating. I blinked them away, refusing to break down in this room that smelled of antiseptic and shattered hopes. "You promised me seven months and that wasn't even a month ago. You told me we were buying time."

Dr. Robertson had a bulletin board on her office wall. It was a mosaic of survival full of happy pictures and handwritten notes from those she had cured. There were photos of kids at graduation, couples on vacation, and even a felt, grateful letter from those she hadn't been able to save, thanking her for her "kindness in the end."

Mine wasn't going to go there. I wouldn't know what to say. 'Thanks for trying' didn't seem quite appropriate enough for a death sentence. Anything more would have been fake, a lie written to comfort the living while I turned into dust.

"Amanda, cancer has a different rate of progression for everyone. We can only project based on the data we see."

"I know," I said, cutting her off. I was being unfair. I knew it, and the guilt made me want to scream inside. Dr. Robertson wasn't the enemy; the cells in my blood were.

But I didn't want to be fair. Damn it, I just wanted to live. I wanted the mundane problems back the stress of exams, the worry over a bank balance, the sting of a bad breakup.

"I'm turning twenty-three in two months," I continued, my voice cracking. "I'm graduating from the University of Cleveland in six months. I've already applied for grad school. I have my whole life mapped out on a calendar that you're telling me I'll never get to use."

"I know, Amanda." There was a genuine sympathy there, flickering behind the professional walls that kept her insulated from all the people she couldn't save. She looked at me not as a patient, but as a girl, a girl who was about to lose everything before she'd even had it.

I looked away from her, staring back at the chart. Amanda Ann McCann. Average height. Double digit weight. Dying.

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