Dr. Michaels usually remembered to take off his white coat before he went into Allison’s room, and today was not an exception. He put it on one of the nicer hangers and made sure the name tag on his breast pocket was clearly visible when the closet door was opened.

Allison was doing better, he thought. Not as well as they had hoped, but expectations could get unreasonably high. She was definitely better. The cowering was less vigorous—the diving motion had mostly gone, and now she sort of huddled into the pillow more tenderly. The change was doing wonders for her neck problems, actually. Dr. Michaels was a good physician and knew that it was important to find the positives in these situations. Optimism was too rare a thing these days, he said.

There was always a moment of pause outside her door, a little steeling of the nerves. It was not that he wasn’t happy to get a chance to see her; on the contrary, he enjoyed these visits. It was so rewarding to see her progress, even if it were slower than would be optimal. Her company was not half bad once she came out from the pillow. But he needed these brief hesitations.

“Good morning, Allison.” Very gentle, but more than the whisper they had worked with at first. Yes, there was the pillow move, but it was definitely less jerky. A kind of collapse, now. Dr. Michaels reminded himself to be pleased, and he was.

“Isn’t it beautiful outside?” He opened the curtains to let some sunshine leak in. Good on the weather for giving her some sun today.

“It’s going to be a gorgeous day. Perfect for a walk!”

She shook her head into the pillow.

“The legs still acting up, then?”

Was that a nod? It seemed like a nod. Allison’s legs had been giving her some trouble for a while now. They hadn’t done any scans for a few weeks—there was still some uncertainty about whether or not they were helping, and of course they were very expensive. She didn’t like to look at the images anyway. But now there was stasis, and Dr. Michaels had to admit that he was quite disappointed at the lack of improvement in this area. When it had been the arms, she had at least been able to go for walks outside. It did her so much good to get out of the hospital.

“What would you like us to do today, Allison?”

She extended an arm, and he reached for the sphygmomanometer. Her arm froze as he fitted the cuff, but that was not a cause for concern. He reminded her to relax it, and she did a little.

“Looking great!”

“Numbers, please,” she said. Her voice was still so quiet, but it had a nice tone. She could probably be a pleasant singer.

“We’re at 152 over 91.” Dr. Michaels felt some lingering uneasiness about giving her the numbers. She always responded like this, with a moan and a new slump into the pillow.

“It will never get lower!” She was crying, which didn’t happen every time but was especially hard on him when it did.

“Of course it will. It’s already lower.” That was not wholly true but not wholly false either. There was fluctuation. It was nowhere near the 179 over 111 she had come in with.

“I’m dying. I can feel it. It’s different from before, I can feel it.” She was speaking through tears, which really did make him all twisted up in his chest. She was very pale, too.

“You’re not dying, Allison. You’re doing so much better.”

“I’m dying. I’m dying and nobody believes me.”

“You’re doing so well. You’re looking stronger every day.”

He thought about when they had tried her in the other ward, and how that not been a good time for anyone. But this wasn’t a great improvement, if he was honest with himself, which he always tried to be. Dr. Michaels valued optimism and honesty equally highly, and rejected the idea that they should come into conflict. He got quite distressed, actually, when people would try to convince him that their negative thinking was more honest than his looking-on-the-bright-side philosophy. That was a sad view of the world, he thought, and part of his distress was pity for those people who were closing themselves off that way. But he wanted to be truthful, and he had to conclude that this was not a happy situation.

“I’m getting weaker. I can feel it. I know what it feels like.”

Allison was curled up, and her words came very softly. Dr. Michaels dried his face with the sleeve of his yellow shirt.

“You’re doing great.”

He thought, as he always did when in this room, that he wanted to feel that metastasising darkness, to understand the frenzied certainty that her body was crumbling. But he did not know what it felt like, and he did not know how to help her. He did not know what she would know next week. He did not know which part of her would be the next part to scream through her fraying nervous system that it was failing.

“You’re doing so well,” he said.