TESSA HAD LOST track of the time. Somewhere between carrying Zoe to Noah’s car and telling her they were going on an adventure and dozing in the waiting room at the hospital, she’d become disoriented. When she opened her eyes after falling asleep, she noticed the sun had risen, slanting in disjointed rays through the window blinds.
Weston was seated next to her, slumped in his chair. Not quite asleep but not awake, either. Paige was pacing, typing furiously into her phone. Who could she be texting at this hour? Maybe their parents, or Harper. She stirred enough to check her own phone. Her battery was hovering at ten percent. She’d let Zoe play games on it while they waited in between tests. There was a message, from Harper, saying she planned to stop by the hospital later that morning.
Tessa texted her to wait since they didn’t know anything for sure yet. She stood to her feet, careful not to disturb Weston, and moved toward her sister.
“Paige?” she asked to get her attention.
Paige turned, a frown cutting across her features. “What?” she asked, her tone clipped.
Tessa didn’t let it bother her. Paige could be abrasive even on a good day, much less one like this.
“You doing okay?” she ventured.
“If you must know, not really,” Paige responded. “I don’t see what everyone is so paranoid about. Zoe is fine. There is nothing wrong. I’ve always been a good mother. I feed her organic food. I use non-GMO. I do everything I possibly can—”
“Paige. This isn’t about you,” Tessa gently reminded her. “If Zoe really is sick, it’s not a reflection on you as a mother.”
Paige and Weston had always been very involved in their careers, and she wondered if that focus had added to her sister’s guilt over this diagnosis.
Paige had never mentioned wanting kids, so Tessa had been surprised when her sister announced she was expecting. She sometimes wondered if her niece had really been a planned pregnancy, though Paige insisted she had been.
Tessa knew Paige loved Zoe. She just had a difficult time showing it. As the oldest, there had been more pressure on her to succeed, to live up to their father’s high standards for success. As the baby of the family, her parents had had more relaxed expectations for Tessa. She had wondered, more than once, if that was why it bothered Paige so much that Tessa had bailed on her wedding and then her job to work minimum wage for nearly two years. Paige would never have done something so unassuming. She was driven to climb higher and higher, earn more money, gain more status.
But at what cost? Her sister was short-tempered much of the time, and now Tessa feared she was feeling guilty for circumstances beyond her control.
“Of course it’s not,” Paige responded to her reassurance. “It’s just…I think I’d know if my daughter was sick.”
Tessa was torn between wanting to calm her sister and yet not offering false hope. “The symptoms of leukemia—”
“Stop, Tessa. Just stop. You’re not a mother. If you were, you’d understand. It’s called mother’s intuition for good reason. I would sense if my child was ill.”
Her words could not have hurt any more if they had been delivered at the end of a sharp knife. Tessa folded her arms over her chest, trying to keep herself together.
Paige had no idea of Tessa’s struggles with infertility. None of her family did. She wasn’t a mother. She likely never would be, at least not biologically. The medical diagnosis she’d received almost two years ago had made that abundantly clear. She’d done the research, weighed the costs. The odds were against her ever holding her own, flesh-and-blood child in her arms.
This knowledge was at the core of every decision she had made over the last twenty-four months. She had left her fiancé, quit her job, isolated herself from her friends who had children.
Her heart hurt for what her sister was going through. But Paige could not know the cold, hard truth behind her words. Tessa’s sister did not realize how she had wounded her. And Tessa was not about to tell her. But neither did she have the fortitude to continue their conversation. She wanted to take a break and head to her office downstairs, but she didn’t want to leave the waiting room in case there was any news.
So she sat back down, choosing a seat several chairs away from Weston. She needed some distance, even if she didn’t want to go far.
Another hour passed. Weston woke but he stared sightlessly ahead. Paige would sit for a few minutes then leap up to begin pacing once more. A throbbing pain began behind Tessa’s eyes as she watched her sister’s restless energy.
After yet another hour, Tessa felt, more than heard, the waiting room door open. Noah stepped inside, and Tessa’s heart contracted. He looked exhausted. She remembered that she had torn him from a night’s rest for this emergency. She needed to thank him. It was strange that she’d assumed he was cold when she first met him. The longer she knew him, the more she saw a steady kindness that warmed her. Just now, however, she was trying to read his expression, to determine Zoe’s prognosis from his features.
Paige pounced on him before he could open his mouth. “This is ridiculous. You drag my husband and me out here, and we spend hours waiting for results. Where is my daughter?”
Tessa flinched. She should have warned Paige that the tests would take a while. But she didn’t have the energy to reassure her sister at the moment. Paige’s words from before had decimated her. All she cared about right now was finding out if Zoe was all right. She knew she’d never hear the end of it from Paige if her suspicions were wrong. But she would take a lifetime of that harassment over Zoe having cancer.
“Zoe is with the nurse. You’ll be able to see her shortly.” His tone was not unkind, but it was firm. Perhaps that was what she had missed during her last judgment of Noah’s bedside manner. He probably handled all sorts of reactions from patients’ families. Maybe, sometimes, a certain amount of grit was required. “Why don’t we all go to my office, where we can speak freely?”
This suggestion seemed to throw Paige. She could empathize with her sister’s struggle. Arguing in a hospital waiting room was one thing but sitting down in a doctor’s office was another. It spoke of something serious, of news that had to be delivered in private. Even Tessa felt shaken by the suggestion. Although perhaps Noah simply wanted to take them somewhere where Paige could calm down.
Tessa sensed bad news coming and felt a tremble of fear. Noah caught her eyes, the expression in his own bleak. And she knew then, without him saying a word.
Zoe had cancer.
* * *
NOAH WAITED TO speak until they were in his office with the door firmly closed. Paige and Weston took the chairs in front of his desk. Paige had paled since he suggested going to his office. Despite her caustic reactions up to this point, he couldn’t help feeling sympathy for her. Her world was about to change. Forever.
He knew the feeling.
He’d had to drag another chair into his office for Tessa. Now she sat, perched on its edge and off to the side, in between her sister on one side of the desk and him on the other.
He didn’t waste time. He’d been where Paige and Weston were sitting, and he knew the most important thing they wanted to hear was “yes” or “no.”
“Zoe’s tests came back positive. I’m afraid she has ALL, which stands for acute lymphoblastic leukemia.”
It never ceased to shake him how parents reacted after he delivered this devastating news. Most were in a state of shock, unable to wrap their minds around the enormity of the diagnosis. Some knew in an instant the battle that they were in for, and these would immediately burst into tears or break down crying. In one case, he’d even had a mother begin screaming hysterically. A few grew angry, threatening second opinions, too frightened to accept a fight they were unprepared for. He expected Paige to be in the latter group, but she surprised him by blindly reaching out her hand until she found her husband’s and leaning in to him.
It gave Noah pause. He had assumed, during his limited observations of their relationship, that Paige was the strong one. Weston was, for the most part, quiet and unassuming. But the way Paige leaned on him now, he wondered if he’d had it all wrong. Maybe Paige was all wind and storm while Weston was the rock that would hold them steady through the upcoming battle.
“The good news is that ALL is the most common form of childhood cancers, and has one of the highest cure rates,” he explained, beginning a speech he had offered many times before. “The bad news is that it’s not an easy fight.”
He steadied himself, trying not to think of Ginny. This was the hardest part of his job. More than fighting the cancer, he hated having to look parents in the eye and tell them their child was going to die if extreme measures weren’t taken. And even with ALL’s high cure rate, there were exceptions.
Ginny.
“We are getting Zoe ready for a blood and platelet transfusion right now. Next, we will need to place a port in her chest so we can deliver the chemotherapy.”
Paige let out a tiny sob at the word chemotherapy, and Weston went white as a sheet. Noah shifted his gaze to Tessa, suddenly needing to look at her, to see how she was faring.
She was quiet but calm. She gave him a nod of understanding, and he experienced a new appreciation of her. She didn’t shy away from battles, this woman. He admired that in her. He turned back to Weston and Paige to continue outlining the treatment plan.
“I know it’s a lot to take in, but there is no time to waste. We want to get Zoe on the path to remission as soon as possible.”
Weston tried to focus on him. “Then there’s hope?”
He hesitated, remembering his words to Tessa. Hope is a disease.
“There is a very high remission rate for ALL,” he said. “But you have to be prepared for the road ahead.” He drew a breath and began offering information. It would be a challenge for them to remember it all, which was why the staff would supply literature and offer to answer questions throughout the course of treatment.
Over the next few weeks, Zoe would be spending the majority of her time at the hospital, receiving treatments while he and the other staff tracked her progress. He explained that Zoe would need intrathecal therapy in the first month in order to administer the chemo into her cerebrospinal fluid.
“Intra…thecal?” Weston’s tongue struggled with the words. He looked from Noah to Tessa. “What’s that?”
This part was particularly difficult for parents to hear. “Lumbar punctures,” he said.
The reaction was immediate. Paige’s grip on her husband’s hand tightened. Weston gave a little gasp. From the corner of his eye, Noah saw Tessa’s head lower, as if unable to witness her family’s distress.
At some point, one of the nurses would go over the treatment in more detail, including the fact that intrathecal therapy occasionally caused seizures in some patients. But he didn’t want to add that possibility to their burden right now. They would have their hands full dealing with Zoe as she experienced the standard side effects of treatment, including diarrhea, nausea, vomiting, fatigue. He was giving them the larger scope at the moment. Other details could be addressed later.
“There will be at least a couple intrathecal treatments in her first month, possibly more depending on how the cancer responds. We will continue with this course for a couple of months until we reach the intensification stage.”
He knew Paige and Weston were overwhelmed, but he wanted to at least give them an overview of what their lives would look like for the next six months. He sensed Tessa paying close attention, cataloguing the details for when her sister and brother-in-law had recovered from their shock enough to ask questions.
After he felt he’d provided sufficient treatment descriptions, he asked if they had any questions. The couple appeared shell-shocked.
“Is our daughter going to die?”
It was the most common question he heard from parents, but voiced now, by Paige, it softened him toward her.
“I will do everything in my power to keep that from happening,” he said, knowing he could make no guarantees. Julia’s heartbreak prevented him from making promises he couldn’t keep.
You said she would live! You lied!
“I don’t get to decide what happens to these children, but I will fight for them with every breath I take.” That was the vow he had made after Ginny’s death. That was how he tried to make amends for his failure to her. It was his absolution, should he be worthy of it.
“I know this is a lot to absorb right now, and you’ll likely have more questions later. Feel free to ask them at any time.” He drew a deep breath. “I’m sure you want to see Zoe now.”
This offer seeped through their shock and moved both of them to their feet. Typically, he would have led them to the patient himself, but he’d found the conversation had drained him more than usual. He needed a minute to regain his composure. Perhaps it was the personal connection he had to Zoe, even though he’d only just met her. Maybe she reminded him too much of Ginny. Or maybe just having Tessa in the room had infiltrated too many of his barriers.
“Tessa, would you mind taking Paige and Weston to Zoe’s room?” He consulted the chart. “She’s in 414.”
He didn’t quite meet Tessa’s eyes, but he sensed her watching him carefully.
“Of course.” There was hesitation there. She knew too much about him now. It was why he’d kept himself guarded from others. He didn’t want her pity, didn’t need her to worry if he was going to be all right. She had changed him too much already, her quiet kindness drawing him out little by little. He couldn’t give her any more opportunities to get into his work…or his heart.
“Do you—”
“I just want to review Zoe’s chart a bit more before we proceed.”
His words were cold, a chilly difference from his tone when he’d spoken to Paige and Weston. Tessa backed off. He felt it even though he didn’t look at her.
“Okay,” she said and moved to usher her family from the room.
Only when the door was closed behind them did he lower his forehead to his desk and squeeze his eyes shut to hold back the tears for all he had lost, and the struggle for Zoe still ahead.
* * *
THE NEXT FEW hours were overwhelming. Tessa took the job of communicating with the family. She placed calls to Weston’s parents on the West Coast, updated Harper via text and then rang up her mom and dad. No one had told Allan and Vivienne Worth what was happening while they waited for answers. But now that they knew the worst, Tessa had to tell them their granddaughter had cancer.
They took it well. She was able to catch them at home, together, before her dad headed to the Delphine for the day. She was grateful they were in town at the moment and not at their penthouse in DC. Findlay Roads was closer to the hospital so they’d be able to get there sooner.
“How is Zoe?” her mom asked.
Tessa felt a little dart of pain to her chest. “I haven’t gotten to see her yet. Paige and Weston are with her and the nurse right now.”
“And how are they?” her dad questioned. She had asked her mom to place themselves on speakerphone so she could talk to them both at the same time.
“They’re…in shock, I think. But obviously distraught.”
“Zoe’s a tough kid. She’s going to get through this.”
This was what Tessa loved most about her dad. He might have exacting expectations, and he could be an intimidating force. But when faced with a crisis, all those elements made him someone you could rely on. He would have done well as an army general, leading men into battle. And that was what it felt like they were doing right now. Heading into battle.
“I know,” she answered, more because she had to act confident than because she really felt it.
“Find out if Paige and Weston want anything from their house. I can make the drive into the city to pick up some things for them,” Allan offered.
“I’ll get together some food,” her mom said. “I’m guessing they haven’t eaten much. Or you. I’ll be there as soon as I can.”
Tessa felt some of the burden ease from her shoulders. She loved how her family drew together during tough times. When her grandmother had been ill, she’d been the only one living in Findlay Roads, so the bulk of Nana’s care had fallen to Tessa. But her family had helped out when and where they could—visiting, staying overnight to give Tessa a break, bringing food to store in the freezer and asking what she needed.
It was a nice reminder that she always had her family’s support. It made her doubt her decision not to tell them the real reason she had left Burke standing at the altar almost two years ago. She swallowed at the memory. But she didn’t want her family’s pity. She couldn’t bear the thought of her sisters, especially Paige, trying to offer their advice. She knew they’d mean well, but how could they understand? And right now, all the family’s focus needed to be on Zoe.
“Thank you,” she managed to force out. “I’m sure Weston and Paige will appreciate the help.”
“You tell Zoe to hang in there,” her dad said.
“Send our love, and we’ll be there soon,” Mom added.
“Okay. I will.”
She wrapped up the call but remained standing in the empty waiting room. She should go check on Paige and Weston, see what they needed. And she hadn’t had the chance to talk to Zoe. Her niece had still been with the nurses when they’d emerged from Noah’s office.
Noah.
She was grateful to him. If it hadn’t been for his keen observations, who knew how long Zoe would have gone undiagnosed? Tessa wasn’t certain how early they’d caught the disease in her niece, but every day was an advantage. She was heartsick at what lay ahead for Zoe, but she was also glad more time hadn’t passed before they’d caught the signs. Thanks to Noah.
“Tessa?”
She turned at the sound of her name. Elise, one of the nurses, was standing in the doorway to the waiting room. “Your niece is in her room. She’s asking for you. Her parents are with Miranda, going over the treatment schedule.”
“Of course, I’m coming. Thanks.”
Elise, bless her, looked concerned. She understood what a tough blow this was for families.
“What’s Zoe’s room number again?”
“414.”
“Okay, I’ll be right there.”
She offered a wavering smile, and Elise took the hint. She stepped out of the waiting room, leaving Tessa alone once more.
Tessa drew a deep breath, gathering her composure. There was a mirror in the waiting room, and she checked it, to make sure there was no evidence of tears or distress. She wanted to be strong for her niece’s sake.
The face that stared back at her was open, pleasant. She tested out her smile. It appeared natural. But her eyes… There was sadness there…and uncertainty. She blinked, but it remained. Maybe that look had been there for a long time—ever since her doctor had sat down with her and explained the symptoms she didn’t understand in the weeks leading up to her wedding.
Early-onset menopause.
She remembered her reaction clearly. The baffled uncertainty.
“But I’m not even thirty years old yet. How can I be going through menopause?”
“It’s somewhat rare, but not entirely unusual,” Dr. Natalie had explained.
“Okay, so what are my treatment options?”
Dr. Natalie fell silent after this question, and it was then that the enormity of her diagnosis began to sink in.
“We can manage the symptoms, but, Tessa…there is no way to reverse it.”
Dr. Natalie explained that hormone therapy might relieve her symptoms, but it could not restore what was being taken.
Tessa had trained as a nurse, but she was still slow to reach the most heartrending conclusion of her diagnosis. It wasn’t until the doctor started discussing premature ovarian failure that it hit her.
“Wait, does that mean… I mean, I can…I can still have kids, right?”
Dr. Natalie looked at her with pity. That was when Tessa felt the weight settle on her shoulders, a mantle of shock and embarrassment.
“There are options,” Dr. Natalie began. “In vitro treatments, supplementation or egg donation.”
Tessa felt her world coming apart at the seams.
“Egg donation?” she’d rasped, having to force the words past her tightening throat. “You mean, not my own? The baby wouldn’t be mine?”
Dr. Natalie was so unbelievably calm that Tessa wanted to slap or shake her. The violence of this kind of reaction only served to unsettle her even more.
“A family member might—”
“No.” She was not about to go begging her sisters to use their eggs so she could conceive.
“You don’t have to worry about any of that right now. Take some time to let all this sink in…”
And she had. With only two weeks before her wedding, she began researching her options. She didn’t tell Burke. She didn’t tell anyone. But she went online, visited message boards and forums, and her sadness grew into a full-blown depression. It was difficult enough to read other women’s sorrow over their inability to conceive. They suffered through treatment, cycles of hope, disappointment and grief. But then she stumbled upon forums for men whose wives were unable to conceive.
The messages there twisted her up inside so that at one point, she had to run to the bathroom, gagging into the wastebasket. How could she tell Burke she would likely never bear his child, if there was any chance this would be his response?
My wife and I tried IVF over and over. It never worked. I started seeing another woman, and when she got pregnant, I left my wife…
No matter how much you love her, if you want a biological child, that love will eventually turn to hate. It’s better off for both of you if you leave her and find someone else…
It’s a tough choice, but you owe it to yourself to carry on your family line…
Just do what’s best for you. Your wife will understand…
I love my wife, but the idea of adopting someone else’s kid leaves me cold…
I can’t look at her the same way…
And on the messages went, some more cruel than others. The hardest were the ones where the guy obviously loved his wife but didn’t know how to deal with having his hopes of his own kids being taken away. The ones that didn’t want to leave but couldn’t reconcile how to stay.
Some men spoke up and defended their wives, reminding others that it was not their fault, and that the world was not the place it had once been. It was perfectly acceptable in this day and age to adopt or remain childless. No shame in it.
But Tessa had always dreamed about being a mom, longed for the day she’d have children of her own. It seemed grossly unjust that her body had betrayed her the way that it had. Everyone had always told her she’d be a great mother—she’d heard it nearly every day when she’d worked as a pediatric nurse, parents marveling at her care and skill with their children.
She burned with resentment at her own womb for failing her, stealing her future hopes and her lifelong dream. She ached with shame and sorrow and fear, and she couldn’t bring herself to share it with anyone. She was embarrassed, feeling as though she was somehow letting others down by admitting they were wrong. So she carried that burden alone, for weeks, right up until the day of her wedding when she realized she could not possibly ask Burke to join his life to hers when the family they’d dreamed about could never happen. Or at least, not happen as they’d planned.
Burke was a good man. She knew he would have married her regardless, supported her no matter what. But she had always had a sense of something between him and Erin, and she could not bear to think of him comparing her to someone else, especially in this regard. So she ran. No explanation. No excuse.
Her family had thought she was crazy. They had no context to her decision, nor the decisions that followed. She’d quit her job because she couldn’t be around children and parents on a daily basis. She wasn’t sure she’d ever tell them. Because she knew they’d try to convince her it was no big deal, that plenty of women had the same struggle, that there were options, she could still find fulfillment, and so on. But those words would ring hollow. She had already tried them out on herself, hundreds of times. It couldn’t change the way she felt.