Nobody had ever called me that before, and though I was automatically furious, deep down I was also flattered that I had elicited enough emotion to be worthy of the name. People called Mom that a lot, probably because she had a hard time holding her tongue and could be brutally blunt when she disagreed with you. She’d explode like a thunderstorm, and then be fine again. Anyhow, she didn’t care that people called her a bitch. “It’s just another word for feminist,” she told me with pride. Even Dad called her that sometimes, but always in a jokey, complimentary way. Never during a fight. He knew better.

I looked up from my grammar book. There was only one person who would’ve sent this note to me, but I still scarcely believed it. I peered at the class. Everyone had their faces in their books. Except for Kim. Her ears were so red that it made the little sideburnlike tendrils of dark hair look like they were also blushing. She was glaring at me. I might have been eleven years old and a little socially immature, but I recognized a gauntlet being thrown down when I saw it, and I had no choice but to take it up.

When we got older, we liked to joke that we were so glad we had that fistfight. Not only did it cement our friendship but it also provided us our first and likely only opportunity for a good brawl. When else were two girls like us going to come to blows? I wrestled on the ground with Teddy, and sometimes I pinched him, but a fistfight? He was just a baby, and even if he were older, Teddy was like half kid brother and half my own kid. I’d been babysitting him since he was a few weeks old. I could never hurt him like that. And Kim, an only child, didn’t have any siblings to sock. Maybe at camp she could’ve gotten into a scuffle, but the consequences would’ve been dire: hours-long conflict-resolution seminars with the counselors and the rabbi. “My people know how to fight with the best of them, but with words, with lots and lots of words,” she told me once.

But that fall day, we fought with fists. After the last bell, without a word, we followed each other out to the playground, dropped our backpacks on the ground, which was wet from the day’s steady drizzle. She charged me like a bull, knocking the wind out of me. I punched her on the side of the head, fist closed, like men do. A crowd of kids gathered around to witness the spectacle. Fighting was novelty enough at our school. Girl-fighting was extra special. And good girls going at it was like hitting the trifecta.

By the time teachers separated us, half of the sixth grade was watching us (in fact, it was the ring of students loitering that alerted the playground monitors that something was up). The fight was a tie, I suppose. I had a split lip and a bruised wrist, the latter inflicted upon myself when my swing at Kim’s shoulder missed her and landed squarely on the pole of the volleyball net. Kim had a swollen eye and a bad scrape on her thigh as a result of her tripping over her backpack as she attempted to kick me.

There was no heartfelt peacemaking, no official détente. Once the teachers separated us, Kim and I looked at each other and started laughing. After finagling ourselves out of a visit to the principal’s office, we limped home. Kim told me that the only reason that she volunteered for team captain was that if you did that at the beginning of a school year, coaches tended to remember and that actually kept them from picking you in the future (a handy trick I co-opted from then on). I explained to her that I actually agreed with her take on To Kill a Mockingbird, which was one of my favorite books. And then that was it. We were friends, just as everyone had assumed all along that we would be. We never laid a hand on each other again, and even though we’d get into plenty of verbal clashes, our tiffs tended to end the way our fistfight had, with us cracking up.

After our big brawl, though, Mrs. Schein refused to let Kim come over to my house, convinced that her daughter would return on crutches. Mom offered to go over and smooth things out, but I think that Dad and I both realized that given her temper, her diplomatic mission might end up with a restraining order against our family. In the end, Dad invited the Scheins over for a roast-chicken dinner, and though you could see Mrs. Schein was still a little weirded out by my family—“So you work in a record store while you study to become a teacher? And you do the cooking? How unusual,” she said to Dad — Mr. Schein declared my parents decent and our family nonviolent and told Kim’s mother that Kim ought to be allowed to come and go freely.

For those few months in sixth grade, Kim and I shed our good-girl personas. Talk about our fight circulated, the details growing more exaggerated — broken ribs, torn-off fingernails, bite marks. But when we came back to school after winter break, it was all forgotten. We were back to being the dark, quiet, good-girl twins.

We didn’t mind anymore. In fact, over the years that reputation has served us well. If, for instance, we were both absent on the same day, people automatically assumed we had come down with the same bug, not that we’d ditched school to watch art films being shown in the film-survey class at the university. When, as a prank, someone put our school up for sale, covering it with signs and posting a listing on eBay, suspicious eyes turned to Nelson Baker and Jenna McLaughlin, not to us. Even if we had owned up to the prank — as we’d planned to if anyone else got in trouble — we’d have had a hard time convincing anyone it really was us.

This always made Kim laugh. “People believe what they want to believe,” she said.

4:47 P.M

Mom once snuck me into a casino. We were going on vacation to Crater Lake and we stopped at a resort on an Indian reservation for the buffet lunch. Mom decided to do a bit of gambling, and I went with her while Dad stayed with Teddy, who was napping in his stroller. Mom sat down at the dollar blackjack tables. The dealer looked at me, then at Mom, who returned his mildly suspicious glance with a look sharp enough to cut diamonds followed by a smile more brilliant that any gem. The dealer sheepishly smiled back and didn’t say a word. I watched Mom play, mesmerized. It seemed like we were in there for fifteen minutes but then Dad and Teddy came in search of us, both of them grumpy. It turned out we’d been there for over an hour.

The ICU is like that. You can’t tell what time of day it is or how much time has passed. There’s no natural light. And there’s a constant soundtrack of noise, only instead of the electronic beeping of slot machines and the satisfying jangle of quarters, it’s the hum and whir of all the medical equipment, the endless muffled pages over the PA, and the steady talk of the nurses.

I’m not entirely sure how long I’ve been in here. A while ago, the nurse I liked with the lilting accent said she was going home. “I’ll be back tomorrow, but I want to see you here, sweetheart,” she said. I thought that was weird at first. Wouldn’t she want me to be home, or moved to another part of the hospital? But then I realized that she meant she wanted to see me in this ward, as opposed to dead.

The doctors keep coming around and pulling up my eyelids and waving around a flashlight. They are rough and hurried, like they don’t consider eyelids worthy of gentleness. It makes you realize how little in life we touch one another’s eyes. Maybe your parents will hold an eyelid up to get out a piece of dirt, or maybe your boyfriend will kiss your eyelids, light as a butterfly, just before you drift off to sleep. But eyelids are not like elbows or knees or shoulders, parts of the body accustomed to being jostled.

The social worker is at my bedside now. She is looking through my chart and talking to one of the nurses who normally sits at the big desk in the middle of the room. It is amazing the ways they watch you here. If they’re not waving penlights in your eyes or reading the printouts that come tumbling out from the bedside printers, then they are watching your vitals from a central computer screen. If anything goes slightly amiss, one of the monitors starts bleeping. There is always an alarm going off somewhere. At first, it scared me, but now I realize that half the time, when the alarms go off, it’s the machines that are malfunctioning, not the people.

The social worker looks exhausted, as if she wouldn’t mind crawling into one of the open beds. I am not her only sick person. She has been shuttling back and forth between patients and families all afternoon. She’s the bridge between the doctors and the people, and you can see the strain of balancing between those two worlds.

After she reads my chart and talks to the nurses, she goes back downstairs to my family, who have stopped talking in hushed tones and are now all engaged in solitary activities. Gran is knitting. Gramps is pretending to nap. Aunt Diane playing sudoku. My cousins are taking turns on a Game Boy, the sound turned to mute.

Kim has left. When she came back to the waiting room after visiting the chapel, she found Mrs. Schein a total wreck. She seemed so embarrassed and she hustled her mother out. Actually, I think having Mrs. Schein there probably helped. Comforting her gave everyone else something to do, a way to feel useful. Now they’re back to feeling useless, back to the endless wait.

When the social worker walks into the waiting room, everyone stands up, like they’re greeting royalty. She gives a half smile, which I’ve seen her do several times already today. I think it’s her signal that everything is okay, or status quo, and she’s just here to deliver an update, not to drop a bomb.

“Mia is still unconscious, but her vital signs are improving,” she tells the assembled relatives, who have abandoned their distractions haphazardly on the chairs. “She’s in with the respiratory therapists right now. They’re running tests to see how her lungs are functioning and whether she can be weaned off the ventilator.”