I shake my head, confused. What is she saying? “She wanted you to help with her pain?” I ask. “She wanted you to make the pain go away?”

She shakes her head; she laughs. “You’re an idiot,” she says.

She composes herself then. She wipes at the spit, stands upright. Looks at me defiantly, more like the Imogen I know now, no longer in pieces.

“No.” She continues undaunted. “She didn’t want me to help her live. She wanted me to help her die.”

My breath leaves me. I think of the step stool, out of reach of Alice’s feet.

“What did you do, Imogen?” I force out.

“You have no idea,” she says, her tone chilling. “You have no fucking clue what it was like to hear her cry in the middle of the night. Pain so bad at times that she couldn’t help but scream. She’d get all excited about some new doctor, some new treatment, only for it to fucking fail again, her hopes dashed. It was hopeless. She wasn’t getting any better. She was never going to get any better. No one should have to live like that.”

Imogen, with tears dripping from her eyes, starts at the beginning and goes through it again. The day began like any other day. She woke up; she went to school. Most days Alice would be waiting in the foyer when she came home. But that day Alice wasn’t there. Imogen called out to her. There was no reply. She started searching the house when a light in the attic lured her to the third floor. There she found her mother standing on the step stool, the noose around her neck. She’d been that way for hours. Alice’s knees were shaking in fear, in exhaustion, as she tried in vain to will herself from the stool. She’d left a note. It was lying on the floor. Imogen has it memorized. You know as well as I do how hard this is for me, the note read. It’s nothing you did. It doesn’t mean I don’t love you. But I can’t keep living this double life. Not a Dear John note but Alice’s suicide note, which Imogen picked up and slipped into the pocket of her sweatshirt that day. Imogen at first tried to talk her down from the stool. To convince her to stay and live. But Alice was decided. She just couldn’t take the plunge. Help me, Imogen, she begged.

Imogen looks straight at me, says, “I yanked that fucking stool from beneath her feet. It wasn’t easy. But I closed my eyes and I yanked for dear life. And I ran. I ran faster than I have in my life. I ran to my bedroom. I hid beneath the fucking pillow. And I screamed my head off so I didn’t have to hear her die.”

I catch my breath. It was not suicide, not exactly, but also not as malevolent as I once believed. It was assisted dying, like those doctors who slip a lethal dose of sleeping pills to a terminal patient to let them die of their own accord.

I’ve never been that kind of doctor.

My job is to help patients live, not to help them die.

I stare at Imogen openmouthed, thinking: What kind of person could do that? What kind of person could grab ahold of the step stool and pull, knowing full well what the outcome would be?

It would take a certain kind of person to do what Imogen has done. To act on impulse and not think of what comes next. She just as easily could have called for help in that moment that she pulled. She just as easily could have cut down her mother’s noose.

Before me she cries; she convulses. I can’t stand to think what she’s been through, what she’s seen. No sixteen-year-old should ever be put in such a position.

Shame on Alice, I think.

But also: shame on Imogen.

“You did the only thing you knew to do,” I lie, saying it only to console her because I think she needs to be consoled. I reach hesitantly for her, and for a split second, she lets me. Only a second.

But as I wrap my arms gingerly around her, scared and just barely touching, it strikes me that I’m holding a murderer, even if the reasons for it were justified in her mind. But she is repentant and grieving now. For the first time Imogen displays an emotion other than anger. I’ve never seen her like this before.

But then, true to form, as if she can hear the thoughts in my mind, she stands suddenly upright. She swats at her tears with a sleeve. Her eyes are vacant, her face deadpan.

She gives me a sudden shove in the shoulder. There’s nothing gentle about it. It’s rough, hostile. The spot where her fingertips press violently into the thoracic outlet, that tender place between the collarbone and ribs, stings. I fall a step back, tripping over a rock behind me, as she says, “Get your fucking hands off me or I’ll do to you what I did to her.”

The rock is large enough that I lose my balance completely and fall to my seat on the wet, snowy earth.

I stifle a gasp. I stare up at her, standing over me, unspeaking. There’s nothing to say.

She finds a fallen stick on the ground. She grabs for it, coming at me quickly like she might hit me again. I flinch, throw my hands inadvertently to my head to protect it.

This time, she steps down.

Instead of hitting me, Imogen screams so loudly that I feel the earth beneath me shake, “Leave!” the single word drawn out.

I find my feet. As I walk quickly away, terrified to turn my back to her though I do, I hear her call me a freak for good measure, as if the death threat wasn’t enough.

SADIE

I drive home that night, pulling onto our street, heading up the hill. It was hours ago that I left Imogen at the cemetery. It was early afternoon then and now it’s night. It’s dark outside. Time has gotten away from me. There are two calls on my phone that I’ve missed, both from Will, wondering where I am. When I see him, I’ll tell him how I spent the day. About my conversation with Imogen at the cemetery. But I won’t tell him everything because what would he think of me if he knew I stole a woman’s keys and broke into her home?

As I drive past the vacant house next door to ours, my eyes go to it. It’s dark as it should be; the lights won’t turn on for a while still. Snow accumulates on the drive while others have been shoveled clean. It’s so obvious no one lives there now.