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The first thought I had after I died was: How will my dog cope with this?

The second thought: I hope we can still go with open casket.

Third thought: I have nothing to wear to my funeral.

Fourth: I’ll never meet Daniel Radcliffe now.

Fifth: Did Bobby just break up with me?

* * *

Let me back up in an hour or so.

It was a quiet night at Boston City Hospital—for me. It usually was. While I worked at New England’s biggest and busiest hospital, I was a gastroenterologist. Most of our patients were diagnosed in the office before things got too critical—everyone freaks out if they can’t eat or poop, after all. So aside from the occasional emergencies—hemorrhages or burst gallbladders—it’s a pretty mellow field.

It’s also a field with a low mortality rate.

I had just checked the four patients my practice had on the unit—two elderly women, both impacted, sent in by their nursing homes for enemas, basically; one small bowel obstruction, resolving nicely on a clear-liquid diet; and one case of ulcerative colitis which my colleague would operate on tomorrow.

“So more fiber, Mrs. DeStefano, okay? Lay off the pasta and add some greens,” I said to one of the impacted patients.

“Honey, I’m Italian. Lay off the pasta, please. I’d rather die.”

“Well, eat more greens and a little less pasta.” She was ninety-six, after all. “You don’t want to get all bound up again, do you? Hospitals are no fun.”

“Are you married?” she asked.

“Not yet.” My face felt weird, as it always did when I fake-smiled. “But I have a very nice boyfriend.”

“Is he Italian?”

“Irish American.”

“Can’t win them all,” she said. “Come to my house. You’re too skinny. I’ll cook you pasta fagioli that will make you cry, it’s so good.”

“Sounds like heaven.” I didn’t point out that she no longer lived in a house. And that no matter how sweet the little old lady might be, I didn’t visit strangers, even strangers who thought I was skinny, bless their hearts. “Get some rest tonight,” I said. “I’ll check on you tomorrow, okay?”

I left the room, my heels tapping on the shiny tile floors... I always dressed for work, having come to my love of clothes later than most. I adjusted my white doctor’s coat, which still gave me a thrill—Nora Stuart, MD, Department of Gastroenterology stitched over my heart.

I could do computer work, I supposed. The nurses would love me for it. My rounds were finished, and I was just killing time, hoping that for once, Bobby would be ready to leave at the end of his shift. He worked in the ER, so the answer was usually no.

But I really didn’t want to go home alone, even if Boomer, our giant Bernese mountain dog mutt, would be there. Boomer, the bright spot in my increasingly gray life.

No. My life was fine. It was great. Best not to navel-gaze right now. Maybe I’d call Roseline, my best friend here in Boston, an obstetrician. Even better, maybe she’d be on call, and I could help deliver a baby. I texted her, but she immediately responded that she was at her in-laws’ for dinner and contemplating homicide.

Too bad. Roseline understood the grayness. Then again, maybe I’d been leaning on her too much. I wrote back suggesting various ways to dispose of the bodies, then stuck my phone in my pocket.

I ambled over to the nurses’ station. Ah, lovely. Del, one of my favorite CNAs, was sitting there, lollipop in his mouth, going through a pile of papers. “Hey, buddy,” I said.

“Dr. Nora! How’s it going?”

“Great! How are you? How’d the date go the other night?”

He leaned back in his chair, a huge smile coming over his face. “She’s the one,” he said smugly. “I knew it the second she smiled at me.”

“Really?”

“Really. I mean, she looked up, and I practically got down on one knee. It was like we’d known each other forever. Like we were made for each other, special order, you know?”

“Sure!” I said, a bit too emphatically. “Same with Bobby and me.”

Del’s smile faltered just a little.

Just then, an overhead page went off. “Attention, please. Attention, please. Dr. Stuart, Dr. Nora Stuart, to ER Eleven, stat.”

I jumped. “Oh! That’s me!” A GI call to the ER was rare enough to still be thrilling. “Off I go, then. Bye, Del!”

I ran down the hall, feeling very badass, one hand over my stethoscope so it wouldn’t bounce, wondering what the call was. Foreign body in esophagus (choking, in other words)? Hemorrhagic lower GI bleeding? Always exciting. More common in a city ER would be esophageal varices due to alcoholism or hepatitis—blood vessels in the throat that burst and can cause the patient to bleed to death.

I loved going to the ER. Gastroenterology was just as important as emergency medicine, but no one wrote shows about my specialty, did they? The ER was where the cool kids hung out, and my boyfriend was their king. Bobby often said there was little the emergency department couldn’t fix—but if they’d paged me, well, then... I was the captain now.

I ran down the stairs into the ER, over to the triage nurse. Ellen looked up and said, “Twelve-year-old with a bellyache, looks sick, number eleven.”

“Thanks, Ellen!” She failed to smile back. Bobby loved her, but to me, she was as charming as the Dementors in Harry Potter, always looking for some happiness to smite.

To Exam Room Eleven I went, walking briskly but not running. The ER was fairly quiet tonight; the usual suspects—the elderly, a few kids, a few addicts, a guy with a bloody hand who smiled as I walked past.

Gastroenterology...well. Someone had to do it, right? And I liked it, mostly. Ninety percent of my patients got better. The colonoscopies...believe it or not, there was a Zen to them. But yeah, it didn’t make the best party chatter. I couldn’t count the number of flinches I got when I told people what my field was, but they sure cared when they had an ulcer, didn’t they?

Jabrielle, one of the newer ER residents, stood outside the exam room. She was a little too infatuated with Bobby, as demonstrated when she gazed deeply into his eyes at the last party we’d gone to, one of those we can’t break eye contact because this conversation is so intense situations. Jabrielle was also irritatingly beautiful.

“Are you the GI consult?” she asked, failing to recognize me. Again.

“Yes,” I said. “I’m Nora. We’ve met. Three times.” She still looked blank. “Bobby’s girlfriend?”

“Oh. Right. Anyway, I suspect appendicitis, but his pain is a little more midline. We’re waiting on labs. I was going to scan him, but the attending wanted the consult to see if we can avoid the CT.”

The patient looked young for twelve, his skin ashen, face drawn with pain. We didn’t want to expose him to radiation from the CT scan if we didn’t have to. “Hi, bud,” I said. “We’re gonna take good care of you, okay?” I smiled at the mother as I washed my hands. “I’m Dr. Stuart. Sorry your son is having trouble.” I glanced at the chart. Caden Lackley, no trauma, eating mostly normally until today, acute abdominal pain, fever, nausea and vomiting. “Any diarrhea or mushy poop, Caden?” Like I said, not the best party chatter.

“No,” he answered.

“Okay. Let’s take a look.”