Chapter 7

In my previous life, at that dingy clinic in New Jersey, the nurses used thick, blunt needles. If they missed the vein the first time, they simply jabbed a second or third time until my arms were a canvas of deep purple bruises and clotted blood.

That was the reality of the American healthcare system. Money was the only thing that dictated the quality of mercy.

With money, you stayed in a VIP suite, accessed the latest experimental drugs, and commanded the attention of the world's leading specialists.

Without it, you waited four hours in a plastic chair, submitted to outdated equipment, and wept when the bill finally arrived.

On the tenth day of my stay at Memorial Sloan Kettering, Dr. Walton entered my room carrying a thick folder. She sat on the edge of my bed, her expression a complex knot of professional detachment and human empathy.

"Ava, I have the results," she said softly. "The news is... complicated."

My heart skipped a beat, the cold air of the room suddenly feeling very thin.

"We found something," she continued, looking me in the eye. "It is adenocarcinoma. However, we caught it very early—Stage 1A, to be precise."

She leaned in, showing me the scans. "The tumor is small and localized. There is no evidence of lymph node involvement. With treatment, the survival rate is over ninety percent."

She paused, her voice softening. "I am so sorry. I know this is terrifying news. But you found this exceptionally early. Most patients at this stage show absolutely no symptoms at all."

As I listened to her, tears began to track down my cheeks.

They weren't tears of terror.

They were tears of overwhelming relief.

For the first time, I knew I actually had a chance to survive.

"Can you... can you treat it?" My voice shook, thin and brittle.

"Of course we can," Dr. Walton said firmly. "We will start with surgery to resect the tumor, followed by adjuvant chemotherapy to scavenge any remaining microscopic cancer cells. Given the early stage, we can utilize targeted therapies with fewer side effects."

She reached out and squeezed my hand. "Ava, you are going to be okay. I promise."

I signed the consent forms that very afternoon.

The surgery was scheduled for the following week, with chemotherapy to begin once I had recovered from the procedure.

Dr. Walton designed a personalized regimen for me: Keytruda, a state-of-the-art targeted drug, combined with low-dose chemotherapy. It would be six cycles, administered once every three weeks.

"The side effects will be manageable," she reassured me. "Hair loss, fatigue, some nausea. It won't be as grueling as traditional high-dose chemo. We will monitor you every step of the way."

The projected costs were astronomical.

The surgery alone was one hundred and twenty thousand dollars.

Each chemotherapy session cost thirty-five thousand; six rounds totaled two hundred and ten thousand dollars.

The targeted immunotherapy drugs were forty thousand dollars a month, adding another two hundred and forty thousand over half a year.

Including the VIP room at twenty-five hundred dollars a day for a month-long stay, the total far exceeded six hundred thousand dollars.

When the administrative nurse brought me the itemized estimate, she spoke with a hesitant, gingerly tone. "Mrs. Costello, if you prefer, we can discuss a structured payment plan..."

I didn't let her finish. I pulled out the American Express Black Card Vince had given me.

"Charge the full amount," I said.

She blinked, stunned for a moment, then nodded quickly. "Of course. I will process this immediately."

In my previous life, I couldn't even afford a ten-thousand-dollar down payment.

That New Jersey clinic had demanded cash upfront before they would even put me on the surgical calendar. I had gone to them with five thousand dollars—every cent I had made from hocking my mother's jewelry—and begged them to take it. They refused.

"We need at least fifty percent upfront, Ma'am. It's hospital policy," they had told me.

I remembered kneeling on the cold linoleum outside the billing office, sobbing and pleading with the financial supervisor.

"Please," I had gasped. "I'm dying. I'll find a way to pay the rest, I swear it..."

She had looked at me with a flicker of pity, but it was buried under the weight of bureaucracy.

"I'm sorry," she said. "Truly. But I don't make the rules."

In the end, I had to forgo the surgery. I spent my final days numbed by painkillers bought on the gray market—expired OxyContin that cost ten dollars a pill. I only took one when the agony became unbearable, because I couldn't afford a steady supply.

Now, I lay in a plush bed at one of the best cancer centers in the world, watching the sun set over the New York City skyline.

In this life, I had the money, the doctors, and the miracle of a second chance.

But what was the price?

I was tethered to a man who no longer loved me, a man who had already betrayed me once in the shadows of my memory.

Was it worth it?

I looked down at the wedding ring on my finger.

The black diamond caught the light, sparkling with a cold, unforgiving beauty.

Yes.

To stay alive, everything was worth it.