"Rise and shine." I pull up her shades, let the sun spill over her blankets. I sit her up and rub her back. "Let's get you dressed," I say, and I peel her pajama top over her head.

Trailing her spine, like a line of small blue jewels, are a string of bruises.

"Anemia, right?" I ask the pediatrician. "Kids her age don't get mono, do they?"

Dr. Wayne pulls his stethoscope away from Kate's narrow chest and tugs down her pink shirt. "It could be a virus. I'd like to draw some blood and run a few tests."

Jesse, who has been patiently playing with a GI Joe that has no head, perks up at this news. "You know how they draw blood, Kate?"

"Crayons?"

"With needles. Great big long ones that they stick in like a shot—"

"Jesse," I warn.

"Shot?" Kate shrieks. "Ouch?"

My daughter, who trusts me to tell her when it's safe to cross the street, to cut her meat into tiny pieces, and to protect her from all sorts of horrible things like large dogs and darkness and loud firecrackers, stares at me with great expectation. "Only a small one," I promise.

When the pediatric nurse comes in with her tray, her syringe, her vials, and her rubber tourniquet, Kate starts to scream. I take a deep breath. "Kate, look at me." Her cries bubble down to small hiccups. "It's just going to be a tiny pinch."

"Liar," Jesse whispers under his breath.

Kate relaxes, just the slightest bit. The nurse lays her down on the examination table and asks me to hold down her shoulders. I watch the needle break the white skin of her arm; I hear the sudden scream—but there isn't any blood flowing. "Sorry, sugar," the nurse says. "I'm going to have to try again." She removes the needle, and sticks Kate again, who howls even louder.

Kate struggles in earnest through the first and second vials. By the third, she has gone completely limp. I don't know which is worse.

We wait for the results of the blood test. Jesse lies on his belly on the waiting room rug, picking up God knows what sorts of germs from all the sick children who pass through this office. What I want is for the pediatrician to come out, tell me to get Kate home and make her drink lots of orange juice, and wave a prescription for Ceclor in front of us like a magic wand.

It is an hour before Dr. Wayne summons us to his office again. "Kate's tests were a little problematic," he says. "Specifically, her white cell count. It's much lower than normal."

"What does that mean?" In that moment, I curse myself for going to law school, and not med school. I try to remember what white cells even do.

"She may have some sort of autoimmune deficiency. Or it might just be a lab error." He touches Kate's hair. "I think, just to be safe, I'm going to send you up to a hematologist at the hospital, to repeat the test."

I am thinking: You must be kidding. But instead, I watch my hand move of its own accord to take the piece of paper Dr. Wayne offers. Not a prescription, as I'd hoped, but a name. Ileana Farquad, Providence Hospital, HematologyI Oncology.

"Oncology." I shake my head. "But that's cancer." I wait for Dr. Wayne to assure me it's only part of the physician's title, to explain that the blood lab and the cancer ward simply share a physical location, and nothing more.

He doesn't.

The dispatcher at the fire station tells me that Brian is on a medical call. He left with the rescue truck twenty minutes ago. I hesitate, and look down at Kate, who's slumped in one of the plastic seats in the hospital waiting room. A medical call.

I think there are crossroads in our lives when we make grand, sweeping decisions without even realizing it. Like scanning the newspaper headline at a red light, and therefore missing the rogue van that jumps the line of traffic and causes an accident. Entering a coffee shop on a whim and meeting the man you will marry one day, while he's digging for change at the counter. Or this one: instructing your husband to meet you, when for hours you have been convincing yourself this is nothing important at all. "Radio him," I say. "Tell him we're at the hospital."

There is a comfort to having Brian beside me, as if we are now a pair of sentries, a double line of defense. We have been at Providence Hospital for three hours, and with every passing minute it gets more difficult to deceive myself into believing that Dr. Wayne made a mistake. Jesse is asleep in a plastic chair. Kate has undergone another traumatic blood draw, and a chest X ray, because I mentioned that she has a cold.

"Five months," Brian says carefully to the resident sitting in front of him with a clipboard. Then he looks at me. "Isn't that when she rolled over?"

"I think so." By now the doctor has asked us everything from what we were wearing the night Kate was conceived to when she first mastered holding a spoon. "Her first word?" he asks. Brian smiles. "Dada."

"I meant when."

"Oh." He frowns. "I think she was just shy of one."

"Excuse me," I say. "Can you tell me why any of this is important?"

"It's just a medical history, Mrs. Fitzgerald. We want to know everything we can about your daughter, so that we can understand what's wrong with her."

"Mr. and Mrs. Fitzgerald?" A young woman approaches, wearing a lab coat. "I'm a phlebotomist. Dr. Farquad wants me to do a coag panel on Kate."

At the sound of her name, Kate blinks up from my lap. She takes one look at the white coat and slides her arms inside the sleeves of her own shirt.

"Can't you do a finger stick?"

"No, this is really the easiest way."

Suddenly I remember how, when I was pregnant with Kate, she would get the hiccups. For hours at a time, my stomach would twitch. Every move she made, even ones that small, forced me to do something I could not control.

"Do you think," I say quietly, "that's what I want to hear? When you go down to the cafeteria and ask for coffee, would you like it if someone gave you Coke, because it's easier to reach? When you go to pay by credit card, would you like it if you were told that's too much hassle, so you'd better break out your cash?"

"Sara." Brian's voice is a distant wind.

"Do you think that it's easy for me to be sitting here with my child and not have any idea what's going on or why you're doing all these tests? Do you think it's easy for her? Since when does anyone get the option to do what's easiest?"

"Sara." It is only when Brian's hand falls onto my shoulder that I realize how hard I am shaking.

One more moment, and then the woman storms away, her clogs striking the tile floor. The minute she is out of sight I wilt. "Sara," Brian says. "What's the matter with you?"

"What's the matter with me? I don't know, Brian, because no one is coming to tell us what's wrong with—"

He wraps me in his arms, Kate caught between us like a gasp. "Ssh," he says. He tells me it's going to be all right, and for the first time in my life I don't believe him.

Suddenly Dr. Farquad, whom we have not seen for hours, comes into the room. "I hear there was a little problem with the coagulopathy panel." She pulls up a chair in front of us. "Kate's complete blood count had some abnormal results. Her white blood count is very low—1.3. Her hemoglobin is 7.5, her hematocrit is 18.4, her platelets are 81,000, and her neutrophils are 0.6.

Numbers like that sometimes indicate an autoimmune disease. But Kate's also presenting with twelve percent promyelocytes, and five percent blasts, and that suggests a leukemic syndrome."

"Leukemic," I repeat. The word is runny, slippery, like the white of an egg.

Dr. Farquad nods. "Leukemia is a blood cancer." Brian only stares at her, his eyes fixed. "What does that mean?"

"Think of bone marrow as a childcare center for developing cells. Healthy bodies make blood cells that stay in the marrow until they're mature enough to go out and fight disease or clot or carry oxygen or whatever it is that they're supposed to do. In a person with leukemia, the childcare-center doors are opened too early. Immature blood cells wind up circulating, unable to do their job. It's not always odd to see promyelocytes in a CBC, but when we checked Kate's under a microscope, we could see abnormalities." She looks in turn at each of us. "I'll need to do a bone marrow aspiration to confirm this, but it seems that Kate has acute promyelocytic leukemia."