Katie drove home slowly, trying to make sense of the evening. How could she have missed the signs? And where had Ellen gotten diazepam?

Katie had met Ellen over a year ago while doing a residency rotation with her current partners. She’d learned that Ellen and Christopher were newly married and had relocated from Chicago to Baxter after Christopher’s mother died. There was certainly more to the story if a son only moves home after his parents are dead, but Katie had never pursued it. She understood the need for parental distance.

Ellen had switched her care to Katie three months ago when Katie started working with Emmett and Nick Hawkins. And now the police were suggesting suicide. Katie agreed with Beth. She couldn’t accept it.

But what was the alternative? Ellen had accidentally swallowed an entire bottle of diazepam?

Katie pulled into her driveway and killed the engine. The lights were still on in the dining room. Caleb was awake.

She took a moment to breathe in the comforting smell of wood smoke and autumn leaves. She let herself in the side door and dropped her bag on the kitchen counter. Her brother, Caleb, sat at the paper-strewn dining room table, hunched over his laptop. His hair was long, and he hadn’t shaved in a couple of days. She’d grown used to his pirate look when he was involved in a large software-coding project. He looked up and smiled as she entered the room.

“You’re back earlier than I expected. Is your patient doing better?”

Katie pressed her lips together and shook her head. She wavered between the desire to go straight to bed and the desire to tell Caleb about her evening. Knowing she wouldn’t be able to sleep, talking won. She pulled out a chair and sat.

It was always a struggle to convey her concerns without violating privacy laws. In the past, not ever saying the patient’s name had been good enough. But in a small town like Baxter, the news would be in the public domain before morning.

She focused on the two things that bothered her the most: the idea of the suicide itself and the fact that she didn’t remember writing the prescription that led to Ellen’s death.

When she finished her brief recap, Caleb said, “I’m so sorry, Katie.”

“I don’t know if I can do this, Caleb.” Katie pressed the heels of her hands to her eyebrows. “I can’t believe I didn’t see this coming—again.”

“Katie”—Caleb pushed his laptop away and touched her hand—“none of this is your fault.” He leaned forward and held her gaze. “Just like Mom wasn’t your fault.”

Tears pricked at the back of Katie’s eyes, and she looked away. Why did he always see right through her?

She had only been thirteen. Their mother had been sick for a year, the chemo and surgery draining the life right out of her. But Katie never stopped hoping that a miracle might occur.

She’d known her mother was in horrible pain, but when she started to refuse her pain meds, Katie had thought that maybe things were getting better.

She ran home from school each day hoping her mother would meet her at the door. Every day she let herself in with her key and raced up the stairs to her mother’s bedroom. They couldn’t afford a full-time nurse, but a visiting nurse came every day at lunchtime to check in.

Katie sat with her mom every afternoon and did her homework, chatting about her day and watching for any sign of improvement. But in those last weeks, her mother became silent.

“I’m sorry, Katie-girl,” her mother said. “I don’t think I can hang on any longer. You’re too young to understand, but I can’t take the pain anymore.”

Katie rummaged on her mother’s table and found the bottle of pain medicine. There were only a few tablets left.

“Don’t these work anymore?”

“I think they’ll work just fine, love.”

“Do you want one now?” Katie heard the urgency in her own voice. She wanted her mom back. The healthy mom who used to sing and dance while she cooked dinner. The one who read bedtime stories and did all the voices, even when Katie was too old for bedtime stories.

“No, not yet.” She took the bottle from Katie and set it gently back on the table.

Katie heard nine-year-old Caleb thundering up the stairs. He stayed at a friend’s house every afternoon until their dad brought him home after work. Katie always went to make dinner when Caleb came home.

“Dad brought pizza!” Caleb exclaimed. “Hi, Mom. How are you today? Do you want to have some pizza with us?”

“No, thank you, sweetie. I’m not hungry.”

Caleb’s face fell.

“Why don’t you sit here with me for a minute?”

He pulled up a chair near the bed.

“Tell me about your day.” Her voice was hoarse and quiet. “What did you do at recess?”

Katie slipped out and went downstairs. Her dad had just opened a Coors—the first of what would likely be many for the night. She’d never seen her dad drink more than one beer—except on Sunday while watching football—until her mom got sick. Now he sat and drank like his life depended on it. Katie was grateful that he usually just fell asleep; she knew from her friends that sometimes people got loud, or mean, or silly when they drank. Katie’s dad just checked out.

“How’s your mom?” he asked.

“The same. She says she’s not hungry. I know she’s in pain, but she doesn’t want any medicine right now. I think she needs more.”

Her dad held up a medicine bottle. “I picked up a refill on my way home. I’ll bring it up to her in a minute and talk her into taking some.” He drained the beer bottle. Katie had noticed that he never went to see her mom without at least one beer in his stomach.

Caleb came into the kitchen. He glanced at the beer bottle on the counter, looked at Katie, and hung his head. “I’m gonna watch SpongeBob and eat my pizza.”

“I’ll watch with you,” Katie said.

She heard her dad’s heavy, slow tread on the stairs.

She wished, later, that she remembered more about that night. What she had watched, what she and Caleb had laughed at, and what time her dad had passed out. But it all became a blur the next morning when she went to say good-bye to her mom on the way to school.

She knew the minute she walked into the room. It was too still, as if all her mother’s items were holding their breath, waiting for someone to discover their dead owner. The smell in the room was stronger this morning. Katie had gotten used to the faint odor of decay and medicine that lingered around her mother. She walked slowly to the bed. Her mom’s face was gray. She lay still and quiet, not breathing.

Katie glanced at her mother’s bedside table and saw three empty bottles of medicine. They hadn’t been there the last time Katie was in the room. She grabbed all three and read the labels. And then she started to cry.

“Katie?” Caleb moved his hand in front of her face, breaking the spell of memory.

She would never come right out and say it, but she was grateful for Caleb. They had stuck together as their father fell deeper into his grief and alcohol. Shuttled from one relative to another while in school, they ended up living all over Michigan. And they had only been separated for the four years that Katie was in college. He knew her better than anyone. He knew about the guilt that she could never quite shake.

In medical school interviews, they always asked, “Why do you want to be a doctor?” Katie’s answer was that her mother died of cancer, which would elicit a sympathetic face and rapid progression to the next question. But that wasn’t really the whole story. Her mother didn’t actually die of cancer, and Katie had so far spent her adult life in a daily do-over. She never wanted to miss a cry for help or a subtle sign of illness again. And now she had.

She gave him a small, reassuring smile. “I know. Sometimes people don’t want to be helped.”

Caleb relaxed into his chair. He’d heard what he was hoping to hear.

Katie said good-night and went to her room. After a quick trip to the bathroom to brush her teeth, she climbed into bed. She knew that she wouldn’t be able to sleep right away. She picked up the photo of her mother that she kept by her bed. It had been taken a year or so before the diagnosis, and her mom still had her beautiful strawberry-blonde curls and perfect skin. Katie shared her mom’s deep-blue eyes and upturned nose. Katie’s hair was just as curly, but darker. She missed her every day. And felt guilty every day.

Caleb might know her better than anyone, but he didn’t know everything.