“I do understand that.” The words come out more forcefully than I intend. “I understand it better than anyone, Dr. Steel. You’re not talking to someone off the street. You’re talking to a former surgeon.” I stand. “Do you not think I’ve had my own failures? That mistakes I’ve made haven’t led to terrible consequences for my patients, up to and including death? If there is one person who does understand the ramifications of this choice, it’s me.”
 
 Her eyes flicker with something I can’t quite identify. “Good,” she replies. “Now we need to work on accepting it.”
 
 Acceptance. The word hangs heavy in the room. Her response to what I just said doesn’t make sense. Acceptance of what exactly? The possibility that I may never regain full function of my hand?
 
 I’ve already had to accept that.
 
 Why the hell are we even having this ridiculous conversation?
 
 “You’ve accepted the reality of your condition, yes,” she continues, “but accepting the potential outcomes of this surgery is a different matter altogether.”
 
 I let out a laugh at that, unable to mask the irritation creeping into my voice. “You’re implying there’s something left to lose, Dr. Steel. I think we both know that’s not the case.”
 
 She remains silent a moment longer. “Dr. Lansing,” she finally says, “there’s always more to lose.”
 
 The room goes silent as her words settle in the air between us. I feel my resolve waning under her relentless matter-of-factness and the truth of her words. The energy to argue with her is draining away, leaving me feeling tired and old.
 
 I’ve lost my child and my wife. I’ve lost the life I built, both at home and at work.
 
 What more could I possibly lose?
 
 And then I realize.
 
 Angie.
 
 I could lose her.
 
 But that’s stupid, isn’t it? I barely know her. She’s a hot little student that I’ve been messing around with because it’s forbidden.
 
 But even as I think those words, I know I’m lying to myself.
 
 There’s something more with Angie. Perhaps if I lost the total use of my hand, she wouldn’t want to be with me anymore. People have broken off relationships for a lot less.
 
 Already I know Angie wouldn’t do something like that, but still…
 
 I could lose her.
 
 Or I could lose my life. Patients sometimes die on the operating table for no apparent reason.
 
 “Maybe you’re right,” I finally concede, my voice barely above a whisper. “Maybe there is more to lose.”
 
 “I know this isn’t easy for you,” she says, her tone softer now. “But it’s important that we proceed carefully. That we consider all potential outcomes and ensure that you’re prepared for them.”
 
 “And what if I’m not?”
 
 I can see the empathy in Dr. Steel’s eyes as she leans forward, placing her notepad on the table beside her. “Then we work on getting you prepared,” she says gently. “You’ll need to go back to therapy.”
 
 I shake my head vigorously. “I won’t. I won’t see Dr. Morgan again.”
 
 “No, I don’t recommend that you see Dr. Morgan. I’ll recommend someone else.”
 
 “So you’re saying no surgery.”
 
 I want to shout. Tell her I hate her. Tell her she’s a bitch.
 
 But that won’t help her decide I’m mentally fit.
 
 It will convince her that I’m not.