11. To Dust

The ceiling light refracted through the bottle of spring water before me on the desk, sending a spray of multicolored light across my colleagues’ legal pads. Their eyes were not privy to this chromatic display, however, and I caught more than one of them shooting me an odd look as I moved the bottle and its trailing rainbow around.

I was fidgeting. For a human, it would have been acceptable, if slightly inappropriate. For me, it was ludicrous. If my colleagues had any idea how utterly unnecessary it was for me to keep in motion, they would have understood immediately how deeply agitated I was. I only kept in motion to avoid focusing on the conversation at hand.

Four of us were convened in the cramped office. Cliff Andrews, the head of hematology, Andrea O’Keegan, head of oncology, and Mandeep Bhattacharya, the head of pediatric oncology from Cornell’s Weil Medical School, who had driven up from Manhattan the day before to be with us.

I didn’t need Edward’s ability to know that the other three were wondering what a young general surgeon was doing in this meeting.

Three days before, Kurt and Anne Mason had asked to speak with Andrea. Not me, because, as Andrea had put it, they were “attached” to me. The conversation had been couched as a request to develop an advance directive, in the case that things got worse. But the reality, as we all knew, was that “worse” was already on us. The question, as Cliff had put it when he’d convened today’s meeting, was only how much longer we would wait for miracles.

To me, all of eternity sounded like a perfect amount of time to do that.

Spread before us on Cliff’s desk was Tony’s entire medical chart—pages upon pages of lab results and declining vital statistics. I had made a show of looking over it, although I knew every entry in it by heart. I knew he was losing weight at the rate of a third a pound a day. I knew what his lab results had been two days ago; I knew what they’d been this morning. I knew that he was battling another opportunistic infection, and that two hours ago his temperature had been an elevated 99.5 degrees Fahrenheit.

And I knew more than that. I knew that the boy whose life hung in the balance of these numbers went by Tony, not Anthony. I knew that he had picked this name for himself at the age of three because he was enamored of the mascot for Frosted Flakes, and that his father still called him “Tiger” on occasion. I knew that he loved video games, the X-Men, baseball, and his little sister, although he would never admit to the last. I knew that he hated algebra with every fiber of his being. I knew that he possessed a wit beyond his years and, moreover, that he was the only person who had truly made me laugh in almost five months.

But I didn’t know if Tony was ready to let his disease claim his life. And for that single piece of knowledge I lacked, I might as well have known nothing at all.

The conversation the other three were having washed over me in waves. I was taking it all in—my superior brain capacity couldn’t avoid letting that happen—but I wasn’t truly listening. I knew the direction of this conversation—the same direction in which I would have been leading were it about any other patient.

It was Dr. Bhattacharya’s voice that brought me fully into the conversation, “The palliative care plan calls for him to be moved to one of the hospice facilities,” he was saying.

“He won’t want that,” I said, a little more loudly than I’d intended. To the humans, it was merely a mumble, but it was enough to capture their attention. I found three pairs of eyes suddenly trained on me.

“I’m sorry, Dr. Cullen? Could you repeat that please?” Dr. Bhattacharya gave me a hard look, and added an under-the-breath mutter that came to my ears as clearly as though he’d shouted: “Nice to have you back in this meeting.”

I took a deep breath. “Ton—the patient likely won’t want to be moved out of CMC. I know that’s what we wrote, but other things have happened since then.”

“I appreciate that sentiment, Dr. Cullen, but—”

His speech was cut off by the rumble that came unbidden from my chest.

I clapped a hand over my mouth, quickly balling it into a fist and pretending to cough. Had I really just growled at one of the most well-published oncologists in the United States?

“I’m sorry,” I answered. “Allergies, I think. Does one of you have a cat?” Dr. O’Keegan did; I had already caught its scent on her pants. She smiled apologetically and scooted her chair away from mine. “At any rate,” I continued. “I think that when we talk to—to the patient, we’ll find that he would prefer to stay here.”

“Well, we wouldn’t think of forcing that decision,” said Dr. O’Keegan gently. “Of course. And you know the patient better than the rest of us.” She frowned disapprovingly.

“For all we know, he won’t want to stop treatment,” I added.

Dr. Bhattacharya rolled his eyes. “As you well know, Dr. Cullen, that decision rests in the hands of his parents.”

In the hands of his parents. The image of Elizabeth Masen came to me, her face pallid and clammy with fever, her arms turning dark with cyanosis. I recalled her beautiful green eyes—Edward’s eyes—locking me in her gaze as she begged of me, “You must do everything that is in your power. What others cannot do, that is what you must do…”

And like that, my mind took me two floors down, to Tony’s room, and I saw myself bent over his bed. I watched as my teeth sunk into the soft skin of his neck with ease. I tasted as his blood—the blood I had agonized over, the blood that was killing him—pooled into my mouth like honey. Seven would become eight. I would laugh easily again.

The venom that filled my mouth snapped me back to my senses as quickly as I had lost them. Tony had parents. A sister. A family that would be just as lost without him as I was without my own son.

But they will lose him either way… The venom surged again.

I shot to my feet, trying desperately to choke back the deadly liquid.

“I’m sorry,” I said through clenched teeth. “I’ve lost track of the time. I’m not usually here during the day, and I’m to pick my daughter up in Syracuse.” This was a lie only by omission—Alice’s train was to arrive in several hours.

The other three eyed me suspiciously.

“Are you sure you’re all right, Carlisle?” Cliff asked gently. It was the first time in the entire meeting he’d addressed me directly.

I nodded. “Quite. Just being a forgetful father, is all.” I managed to gulp down enough of the venom to give them a sheepish smile and made a fast exit.

“I was going to suggest that he be the one to discuss this with the parents,” I heard Cliff say as I fled. “But I guess I can do it…”

By striding quickly and purposefully as though I had just received an urgent page, I managed to stalk my way through the entire hospital and out to the parking garage without interruption. Running a shaking hand through my hair, I slid into the driver’s seat and dropped my forehead to the steering wheel, my chest heaving with unnecessary breaths.

What was I doing? I forced myself to bring Anne and Kurt Mason to mind. Tony’s real parents; just as Edward and Elizabeth Masen had been to my young patient eighty-seven years ago. But Elizabeth and Edward had died before their son had suffered by my hand.

This time I growled only at myself. Why was I even thinking about this? I was no longer the desperately lonely beast I had been in 1918. I was a man with a family. A wife. Five children. I had sworn that Emmett would be the last.

Jamming my key into the ignition, I lit out of the parking garage so fast that my tires squealed, my mind desperate for the release a lengthy drive would provide.

I would just get to Syracuse a few hours early, that was all.

Alice stood beside a car parked at the curb outside the Amtrak station, her expression thoughtful and far away as always. My daughter lived her life in a world that was a few steps ahead of the rest of ours, patiently waiting for the moment her visions would fall into place just as she’d seen them. I wondered what she was seeing now. Obviously something to do with me; she had specifically asked Jasper to stay at home. I wondered briefly if she had seen the meeting this morning and realized that of course she had.

There was no driver in the car she stood behind, so I punched on my hazard lights as I approached in preparation for a quick double-park job. Just as I pulled up however, a man rushed out of the train station, jumped into the car, and pulled away quickly, opening the spot right in front of me. I smiled as I parked neatly and exited the car. One month without Alice, and I’d already forgotten to trust her judgment.

Beaming, Alice bounded to me, her messenger bag flopping behind her. I braced myself just in time for her to crash into my torso as she flung her arms around my neck and kissed my cheek.

“Welcome home,” I said, and she grinned.

“It’s good to be home,” she answered quietly, as she disentangled us. There was a solemnity to her voice for a brief moment, but she returned in only a moment and cocked her head towards the car. “Shall we? I’m anxious to see Jasper.”

I nodded, taking her bag. We all had perfected small mannerisms that masked our true natures in the presence of humans: holding doors, allowing glasses to spill and break, carrying belongings for one another. But the fact that we didn’t need to do these things also made them a greater kindness than they were otherwise, and Alice smiled shyly as she passed the heavy bag to me and climbed into the car.

Alice was uncharacteristically silent as I pulled away from the station. We were well underway on the freeway before she spoke.

“How are things at home?” she asked.

I thought about this a moment. I had of course been more absorbed at the hospital than usual, but I was careful not to make the same error I had in December. Although I had been offered a second visiting lecturer position in the College of Human Ecology, I had declined, opting instead to give only a few guest lectures in the same Epidemiology seminar I had taught the previous term. This left me more time to be with my family, and I was trying to make good use of it. Even Rosalie had begrudgingly joined Emmett, Jasper and me in a game of Five-Card Stud two days before. Jasper, ever the unreadable stoic, had beaten us roundly no matter what he was dealt. In hindsight, I wondered if he had influenced our decision-making processes.

“What did Jasper buy you with his poker winnings?” I asked, hoping she wouldn’t return to her question if I deflected it properly.

“Oh, he hasn’t bought it yet,” Alice replied, smiling. “But he’s decided on a new bag from the latest Fendi line. In case I want to make another trip to Biloxi. It’s pretty. I like it.”

There was a pause for a moment while she considered the bag and I considered her words.

“Do you think you will?” I asked quietly.

“Will what?”

“Make another trip to Biloxi.”

The faraway look returned to my daughter’s eyes.

“I’m not sure,” she said finally. “There’s not much for me there.”

I nodded solemnly, not taking my eyes off the road even though I had no need to see it fully. What she spoke of had been one of the reasons I had never returned to London. My time there had faded in my mind, and even the few places of which I had fleeting memory were long gone. The last time I had returned to my roots had been in the seventeen-eighties, before I’d joined a voyage to the New World. Even then the graveyard behind my father’s old church had already been reduced to little more than a tangle of weeds, and it was only by accident that I found his grave next to my mother’s and my own in the underbrush. The soapstone markers had already begun serious decay—“SLE” had been all of my given name that I’d been able to make out. The church burned some time later and was never rebuilt, its land eventually taken over by the bustling metropolis that would become modern London.

But unlike me, Alice still had ties. “What of your niece?” I asked.

Alice smiled. “She seems neat. Feisty. One of those women you know has always been an upstart. I saw her flirting with a man who must have been ten years younger than her at the retirement home. Her husband passed away of a heart attack about five years ago.”

“She’s like her aunt,” I supplied, and Alice grinned.

“I didn’t go see about her family,” she added thoughtfully a moment later. “I didn’t want to. That was just—too much.” She turned away and looked out her window.

“I understand.” Although the truth was, I didn’t. The only person I had left behind me in my human life was my father, and he and I had been at such odds through most of my adolescence and young adulthood that I had hardly mourned for him. He had passed away only a few years after I was turned, and I had chosen then to leave England for good.

In all honesty, I barely remembered the man.



“What happened, do you think?”

It took me a second to realize what she meant. “To you?”

She nodded. “Do you know what it was? I know you’ve thought about it.”

And like that, Alice plunged us into previously unknown territory. She was right; knowing what I did about the ways Edward’s and Jasper’s gifts had manifested themselves when they were human, I had of course given thought to hers. Discovering that she had been turned while in an asylum corroborated my original theory. Perhaps this was why she asked me to pick her up alone. I almost laughed—it was rather self-centered of me to think the first thing Alice would want to discuss on her way home would be Tony.

“Temporal lobe epilepsy is my best guess,” I answered carefully. “Admittedly, I’m no neurologist. But it often presents with hallucinatory seizures. In the 1910s, we didn’t know how to treat that. We were just barely beginning to understand there was such a thing as neurological disease.” I prayed that she wouldn’t read between the lines of my statement, but it took her only a split second to do exactly that.

“Would you have advised my parents to send me to the asylum?”

I squeezed my eyes shut for a second. “Yes.”

She did not answer.

The pavement on the freeway had been poured in regularly-spaced chunks, and I counted four hundred sixty-three rhythmic thumps as we sped over the cracks in silence. Finally, I took my right hand off the steering wheel and placed it on my daughter’s slim shoulder. “Alice, we simply didn’t know any better then.” Remembering what Jasper had relayed about the date on her tombstone matching her admission date to the asylum, I added, “I would not have advised your parents to pretend you no longer existed.”

“I understand,” she said quietly, looking down. A moment later, she chuckled.


“It’s just that as a human, my family locked me up and pretended I was dead. And now I live in a family of monsters, and you rearrange your schedule so that you can drive an hour to pick me up at the train station. The irony.”

I smiled. “Sometimes it is in losing that we gain.”

Alice nodded. “Yes. We both ended up with families.” She reached over and rubbed my hand. “Thank you for that.”

A strange lump lodged in my throat, and Alice rubbed my hand more firmly.

“So, how are you?” she asked a moment later.

I swallowed. “I’m fine.”

“Edward hasn’t called again?”

The lump got a little bigger. “You know he hasn’t.”

“One can hope.” She sighed. “I’m not really watching him, you know. He asked me not to, and I’m respecting that as best I can. I only see it when he makes really drastic decisions.”

“And he hasn’t made any of those lately?”

“No. You’ve been the only one doing that.” She gave me a pointed look.

She did know about the meeting this morning. I recalled the exact vision that had assaulted my senses and gulped, knowing that Alice had seen every sordid bit of it.

“So…you saw that.”

“Carlisle.” She laughed a hard laugh. “What else am I going to do on a five-hour train ride?” She paused. “I know that you already understand that it’s a bad idea.”

I looked away. “Yes.” As I recalled my vision, the venom actually pooled in my mouth once more.

Alice saw this but said nothing.

Swallowing down copious amounts of venom for the second time that day, I took a steadying breath. Of course I knew it was a bad idea. I had known it was a bad idea to get attached to Tony from the second I’d connected his name with Edward’s. Yet out of my own grief, I had allowed it to happen. Now I was paying the price. How many thousands of patients had slipped through my fingers over the centuries? I hadn’t even known most of their names. But now, once again, I had let one young man get under my skin, and I was in agony.

“I just wish I knew this was his choice,” I said finally, my fingers digging into the steering wheel.

“Would that help?”

“Would what help?”

“If you knew it was his decision.”

It took me a moment to realize what Alice was offering. I finally took my eyes off the road and found she was surveying my face as though she’d never seen it before. And I supposed she hadn’t, not really. She had never before seen the anguish I knew was written in the lines of my jaw and brow. Alice and Jasper had entered our lives ten years after all the chaos had ended. Edward had come home, Rosalie had found her mate and through him, made some modicum of peace with her new life, and Esme and I had been enjoying a relationship which grew more effortless by the day.

And now here I was, plunged back into the tumult of the years Alice had never experienced, when Edward’s absence had ripped a searing hole in my own existence. Esme’s own sadness and her feelings of inadequacy to quell mine had made those three years that much more unbearable. Now faced with the same pain once more, I was clinging desperately to the only bit of light I had. It was foolish; I knew it was. But paradoxically, I couldn’t relinquish my grip until I knew that I was not calling the shots for Tony. In 1918 I had made a decision about one boy’s life, healing myself from almost three centuries’ loneliness, but at the same time thrusting him into almost nine decades of his own. My gut wrenched as I imagined Edward, alone wherever he was now, sick with worry over the girl he’d waited so long to find.


“Yes,” I said quietly, returning my gaze to the long stretch of freeway ahead, seeing not the pavement before me but the waif of a boy who awaited me in my evening shift. I heaved a sigh of surrender. “Yes. If I knew it was his decision, I could let him go.”

Alice nodded once, and we drove the rest of the way home in silence.

Steam rose off my skin as I reached for my towel. Esme had spent the last several weeks gutting the cast-iron pipes that had been installed in the house in the early nineteen hundreds and replacing them with the more modern copper. For having to work with a house which had contained no plumbing for most of its existence, Esme had done a remarkably nice job of retaining the original feel of the house while still giving it all of the modern conveniences. She had chosen to mask the shower’s existence by building it directly into the walls and ceiling of the bathroom itself. There were no curtains and no glass walls—just water from three directions that drained into the floor.

Finishing with my towel, I began to dress. As I reached for the shirt hanging on the back of the door, I caught a glimpse of myself in the antique mirror over the sink. My reach had exposed the full line of my neck and collarbone, and the matching set of crescent scars that appeared there. I traced them with my fingers, the awful day resurfacing in my memory at once. Edward, entering our home with his eyes shining a foreign, honeyed burgundy, and his strength fierce as a result of the human blood he’d consumed. I had been too new to fatherhood then to recognize that my compassionate forgiveness would only anger him further. He had slipped, but more than that he had allowed himself to slip and had taken pleasure in doing so. He had wanted me to hate him. He had needed the permission my anger would grant before he could allow himself to leave. Soothing had turned to shouting, shouting had turned to screaming, and before I had realized what was happening, Edward had shattered my clavicle as he lunged for my neck. Seized by pain, I had broken his nose in my attempt to throw him off me.

We had both healed physically in a few hours, but the pain of that fight and its three-year aftermath still lingered for us both. Many times in the decades since, I had caught Edward staring at his marks when he saw me shirtless. For him, they were a sharp reminder of the years he considered his greatest personal failure.

To me, they were a testament that I had loved him enough to let go.

I massaged my shoulder as my thoughts turned, as they always did, to my wayward son. Again, nearly two months had passed since I’d heard from him. Alice had gotten no glimpses of him in that time, as she wasn’t truly looking for him. She had been home from Mississippi two weeks now, and I had nearly succumbed on several occasions to the desire to have her just check on Edward. He wouldn’t need to know. But I had not. I had respected his privacy, and kept Alice’s promises.

I stroked the scar once more before it disappeared under the light blue fabric of my shirt. Fully dressed, I left the bathroom and descended the stairs at a human’s pace, listening to the sounds of my family as they drifted up towards me. Jasper was entertaining Alice and Esme with saccharine country songs on the guitar, while Emmett fought an obvious boredom to keep up with Rosalie’s fast-flowing commentary about the blueprints Esme had drawn for their new home. Rosalie had managed to veto somewhere around three dozen houses during her and Emmett’s periodic stopovers in the past months. It was finally decided that we would buy some land outside of town and Esme would design exactly what Rosalie wanted. The plans currently called for a house that would rival the one we had in Forks.

When I reached the sitting room, Esme and Rosalie were excitedly discussing the house, Emmett was ribbing Jasper good-naturedly about the music, and Alice and Jasper were snuggled with each other on the couch as Jasper played. Alice had an expression of content as she leaned against her husband; Esme was laughing over the idea of another thousand square feet; Emmett was pulling faces at Jasper as Rosalie bored him with the house plans. As I looked around the room, a swell of pride and a terrible pain came over me at once.

My family was happy.

This moment had both taken too long and come too soon. As I looked around the living room, I saw the six of us as Edward must have always seen us; indeed, as I knew he had always seen us—three pairs of blissfully matched partners, with Edward as the unnecessary excess, merely taking up space in a world that did not truly include him.

I closed my eyes as the harmonious peal of Edward’s laughter came to the ears of my memory as surely as though he were in the next room. My son had come so close to knowing what he had stood on the outside of for almost ninety years. For six months I had watched him unfold, until he was but the blithest reflection of his former self. Bella Swan lit him up from the inside, and his joy had become my own.

How fleeting that moment had turned out to be.

I sank to the stairs, resting my head in the palm of one hand. The rustling of the blueprints ceased as Rosalie’s voice fell quiet. Jasper’s song stopped on an unresolved chord, and the strings of his guitar slowly throbbed their way into silence.


It was Esme’s voice. She had been at my side the moment I’d sat, and her hands now frantically roamed my face, searching for the source of my sudden melancholy.

How was I supposed to tell my ebullient wife that her joy was the source of my sorrow?

“Carlisle, what’s wrong?”

“This,” I whispered.

My wife gave me a confused look. “What’s wrong with this?”

It was like one of those puzzles you give little children: what’s missing from this picture? A happy family, sitting in the living room, laughing, singing, enjoying one another’s company. Rockwellian, almost, if he had ever seen fit to paint the supernatural. My eyes glanced quickly to the piano, which sat closed, they keyboard cover undisturbed since Christmas when Rosalie had managed to play only one piece for us before stopping. Esme followed my gaze and nodded sadly when she recognized where I was looking.

“Edward is all right, darling,” she said soothingly, taking my hand. “He’ll be all right. He’s survived away from us before.”

The words were meant to be comforting, but they weren’t. I recalled again the scene my memory had played for me minutes ago in the bathroom. Edward’s eyes that day in 1927— sullied by human blood, burning with anger, and yet painfully, unmistakably full of fear. And then, eighty years later, the same sentiment in his voice this Christmas Eve—“I’m scared.”

I wanted him to grow. I wanted him to make mistakes and experience that loving someone sometimes meant personal pain. But I also harbored an undeniable urge to just take him by the hand and personally keep him from harm. It had been this urge that had driven my actions that cold October morning when I’d leapt to my feet and growled at my wife. Some terrible, beastly part of me had shrugged my usual control and responded fully to the threat of losing my son once more. And now, he was gone again and it was I who was in pain.

I felt a cold rage flush through me.

“Jasper, no!” Alice’s voice rang out as the words I would regret slipped through my clenched teeth:

“I wasn’t the one who asked him to leave.”

Four pairs of eyes snapped to the staircase. That Esme’s face screwed up was a testament to habits that still lingered from her human days—clenching shut eyes to stem the flow of tears that were no longer forthcoming. When she did open her eyes a second later, my wife’s face was twisted with a wounded anger I’d never seen before. She rose from the steps slowly, lifting her hands from my face. She stood over me like that for a moment, motionless in the way only our kind could manage, before she found her voice again.

“You aren’t the only one who misses him, Carlisle,” she said darkly, and then she was gone. I heard our bedroom door click shut.

The rush of anger left me as quickly as it had come, and my stomach twisted as I realized what I had just allowed myself to say. It was only then that I became aware of Alice’s frantic voice as she asked the same question of Jasper again and again: “Why?”

I looked over to where they sat on the couch, feeling Rosalie’s and Emmett’s eyes follow me as I did so. Jasper’s hangdog expression told me exactly what had happened.

“Jasper?” My voice was steady again, and I was relieved to hear my usual self-control.

“You were never going to tell her,” he said quietly. “And that’s been bothering you for almost five months.”

Had it? I hadn’t consciously been angry. But Jasper had a better read on it than I did. As I thought about it, I supposed he had been right. I had been careful not ever to bring up that morning, knowing how Esme berated herself for Edward’s departure. To add my own disapproval would be simply cruel.

“You had to start talking,” Jasper added quietly. “But I’m sorry, Carlisle. I didn’t foresee that she would stalk off like that.”

“Yeah, too bad there isn’t anyone who could have seen that for you,” Alice snapped.

“Alice,” I said, and she gave me a doleful look and was quiet.

“Esme’s right, though,” came a voice from across the room. Emmett was striding towards me, his face pained. “You aren’t the only one, Carlisle. I want—” he paused just long enough for me to wonder if he was actually getting choked up “—I want that little twerp back here, too.”

Emmett’s face was grim; sadder than I’d ever known it. I knew that he was unhappy with Edward’s absence; Rosalie availed herself of every opportunity to remind me of this. But to see grief etched on his usually grinning face said more than his wife could ever hope to.

Behind him, Rosalie nodded. I expected to see a triumphant glower on her face at my breakdown, but there was only a pained sadness in her eyes. I glanced over at the piano and remembered her single song on Christmas Eve, her utter avoidance of the instrument otherwise.

“It’s not the same, without him,” Alice whispered. “You and Esme are the only ones who’ve done this before.”

“And you two aren’t holding up well,” Jasper added.

From my perch on the stairs I surveyed the living room: the silenced guitar on its end leaning against the couch, the house plans recoiled into a loose tube on the middle of the dining room table. My children, the four who had completed the tiny family I’d made with Esme and Edward, looked back at me.

I had been wrong to think it too soon that they were happy. We were sad together. It was just that no one else had let grief stop them in their tracks.

I stood from my seat on the stair step to head towards my bedroom and Esme, but found that Emmett had fully advanced on me. For a split second I wasn’t sure what he would do—Emmett’s methods of dealing with his emotions tended to involve some sort of physical match-up.

But this evening was different. This evening he just held his arms out slightly from his body, palms up. He shrugged his shoulders as he met my eye, and I understood. I fell more than moved into his crushing hug and we stood there like that for several minutes in the silence as my other children looked on.

A few minutes later, my pager began to beep.

“Dr. Cullen.”

I recognized Janine Debenedetto, one of our volunteers from the Tompkins county hospice services. “Janine.” I nodded to her.

She gave me a sad and exhausted smile. “He’s been waiting for you,” she said quietly, nodding to the patient room she had just exited. She gave me a reassuring pat on the shoulder before disappearing down the corridor. The emphasis on the word waiting was very subtle, but I understood her meaning immediately. It wasn’t uncommon for patients, especially those who had battled a long illness, to hold out for someone they wanted to see. Over the centuries, I had watched patients who for all medical purposes should have expired within minutes cling to life for hours and even days while they waited for their loved ones to be with them.

That Tony felt I was worth waiting for was humbling.

I entered the darkened room. Per standard protocol, the curtains had been drawn and only a few lights were still on. The boy on the bed was a far cry from the one who had recommended video games to me in December. His body was emaciated in some places, but in others had added weight from the chemotherapy so that the overall effect made him look inhumanly disproportionate. His hair was gone now, and like many patients, he had taken to wearing bandanas. Like everything, he had taken this in stride. Just a week before he had complained about not being able to get his ear pierced to have the full pirate effect.

His eyes brightened when he saw me, and I saw his oxygen mask move in what I could only assume was his muscles pulling into a smile. He lifted a shaking hand and tugged the mask down just long enough to address me plainly in a hoarse croak:

“You look like hell, Dr. C.”

“Anthony!” His father looked shocked, but I could only manage to laugh as I went to my patient’s bedside.

“Look who’s talking,” I said quietly as I took his hand, and the mask moved again as Tony gave me a sheepish grin. His temperature was significantly elevated; his body’s last attempt to ward off the inevitable. My hand must have felt like holding ice. But he didn’t release it from his grip.

Kurt cleared his throat, putting an arm around Anne. “Dr. Cullen,” he said quietly, “Tony told us earlier that he had some things he wanted to ask you in confidence.” He nodded solemnly to his son. “We’ll leave you for a moment, if that’s okay?”

I raised my eyebrows as Tony’s eyes met mine. I nodded, and Kurt and Anne disappeared after each kissing their son’s forehead. I dragged a chair across the room to Tony’s bedside, and took his hand again.

“Tony?” I asked quietly.

He nodded to me and beckoned me closer with one hand. Again he deftly pulled down his mask—he had clearly been doing this often—and asked clearly, “Is it going to hurt?”

I let out a sigh.”No,” I answered quietly. “But it might seem frightening. Are you scared?”

He nodded, and I squeezed his hand.

“It’s normal to be scared,” I told him, and my mind shot back to a crowded, dirty hospital in Chicago. I had spoken these same words to Edward so many years ago. I swallowed, and went on. “Your body is just going to do something it normally does. It has a process for this, just like it has a process for everything else. It’s like turning out the lights, one by one. Your eyes adjust as you go.”

He nodded solemnly, and for a long moment, the only sound was the soft hiss of the oxygen. I didn’t offer any more; I simply watched him as he watched me. A breeze from the window on the other side of the room rustled the charts at the end of the bed and I looked to Tony to see if he was bothered by it. When I met his eyes, however, I discovered that his gaze was transfixed on my arm.

A shaft of sunlight, maybe two inches wide, was streaming through the curtain where the wind had pushed it slightly open. It shone directly over my forearm where I had reached out to Tony. His heart rate sped as he looked at the band of my skin glimmering against the rest of my arm.

For a split second, I panicked, and the vision I’d had two weeks before rushed at me. I could hear the weakening throb of Tony’s heart and the whoosh of the blood flowing through his jugular vein. It would be too easy. His neck would yield easily to my teeth, his blood would flow into my mouth like the most refreshing water. We were on the second floor of the hospital, and his room overlooked the woods. I could spring out the window with him and race away into the forest. No one would ever need to hear from the Cullen family again.

But I left my hand where it was placed reassuringly on his arm, and let him stare at the light for a while longer.

He waved a little, and pointed to his mask. I lifted it, fearing what he might say. His voice was trembling, his eyes wide and incredulous.

“You’re…not human,” he whispered.

I closed my eyes. This was after all, the boy who had pinned my physical age exactly in one of our earliest conversations. Of course he would come to the correct conclusion. Looking back at him, I slowly shook my head.

“But…real?” He looked confused.

I nodded. “I’m very real.”

His head cocked to one side, and he beckoned me to give him the mask back, but only took a quick breath before speaking again.

“An angel?”

An angel. Not “demon,” not “vampire.” Not something evil, or threatening, or even frightening. A force of good, sent by God. I closed my eyes and bowed my head over Tony’s bed. After more than three centuries of life, after ninety years of questioning the rightness of my own action, here I stood here over the deathbed of another young man who had captured my heart. And he had the audacity to presume first that I was an angel.

Tony’s guess was praise beyond what I deserved—had I not just entertained the idea of biting him?—and yet, as I looked into his beseeching eyes, I knew that he needed to see an angel right now more than he needed my honesty. Perhaps later he would look down from Heaven and see the conflicted, melancholy beast where he had imagined there to be a seraph. But for now, all he saw was his Dr. C. And he thought me an angel.

It was a bizarre absolution, and there was only one answer I could give him that might satisfy us both.

“Tony, I’m a doctor,” I whispered, squeezing his hand. “That’s all I am.”

Tony smiled and nodded slowly as he closed his eyes. I pulled my arm out of the sunlight, and moved to close the curtain once more.

“Dr. Cullen?”

I turned to see Kurt and Anne reentering the room, both red-eyed. That happened a lot—that families would be brave for their patient, but the moment they were out of reach of the room, they let emotion fly. I gestured to the bed.

“We’re finished talking,” I said quietly, and Tony’s eyes opened a crack.

Tony’s parents gave me tiny smiles as they moved to his bedside.

“I will be here on my shift,” I said quietly, as I edged toward the door. “You can have a nurse page me, if you’d like.”

Tony shook his head violently, and his father looked to him and gave him a sad smile in acknowledgement.

“I believe Tony would like you here,” he said to me. “That is, if you’re able to stay.”

I was floored. It was a very unusual request, and no one had ever made such a request of me before. But then, I had been very careful about developing attachments to patients after Edward.

Perhaps too careful.

I nodded to the Masons, and took a seat in the corner of the darkened room. I heard Anne mentioning something about Tony’s sister—it seemed they had decided she was too young to accompany them and she was with a grandparent. I wondered about this. In my experience, children often were capable of far more understanding than we adults gave them credit for.

As Kurt and Anne spoke quietly to their son, I let my mind wander. It went all the way back to that terrible October morning five months earlier. My young patient, bleeding out under hands I’d thought were sure. His weeping parents, breaking my confidence in my own son’s state. Esme’s terrifying suggestion—and yet, it had been a good suggestion. Even as much as I missed him, I had to admit that Edward seemed to be faring better with his newfound purpose than he had ever managed at home.

But Jasper was right. I was not managing without him. Venom surged again as I remembered what I had nearly done just a short while before. I closed my eyes to stem these thoughts and Edward’s face swam before me; first joyous, laughing, as he had been with Bella, and then abruptly the corpse-like figure that had greeted me the morning he’d left.

I was almost lost to the terrible image when my pants pocket vibrated, at the same time that I heard a tentative, “Dr. Cullen?” I looked up first to see Kurt Mason’s wet eyes and knew immediately that the page was from Alice, even before I looked down to see the words that at the same time were frightening and a relief:

It is his choice

the pager read.

Reverently, I went to Tony’s bedside. His eyes were closed now, but the fact that they were closed meant that his muscles were still in control. His breathing was shallow and intermittent, but it was still there.

His father gave me an anxious look, which I understood at once.

“He’s still here,” I said quietly. Reaching for Tony’s father’s hand, I laced it through his son’s fingers, and whispered, “Talk to him.”

Anne mirrored this action, and together the two of them held Tony’s hands. They took turns stroking his hair, telling him over and over that they loved him, reassuring him even as he slipped away. I bowed my head again. I, too, had told my son that I loved him. And like the Masons, I also wondered if my words had fallen on already-deafened ears.

The room was still except for the voices of Tony’s parents, and I stood by quietly, respectfully, my head bowed as I waited, and listened to sounds I had heard hundreds of times before. But today they weren’t the sounds of hundreds.

Today, they were the sounds of only one.

In Tony’s rattling cough, I heard Edward’s, as fluid flooded his lungs just minutes after his mother’s final breath.

As Tony’s breathing faltered, it was Edward’s breath instead that came in short, intermittent gasps, signaling the beginning of four days of excruciating pain.

And when the sound of Tony’s heart shuddering to a stop seemed to echo in the room, it was my own son’s heart that I heard forever cease its beating as he lay in my arms on the twin bed in the tiny flat in a city ravaged by influenza.

To Kurt and Anne, nothing seemed different, I was sure. Their beautiful son only lay still, a tiny, strange smile still playing on his lips, even as his muscles lost their ability to keep it there. But to me, the silence of the now spiritless body before me was deafening. I had no need for my stethoscope, but Kurt and Anne would need to see me use it. Putting it on, I slid it under Tony’s hospital gown, and listened for the quiet I already knew was there.

The Masons had embraced each other before I even looked up from my patient to confirm what they, like I, already knew. I nodded solemnly, and they met my gaze with wet eyes. Bowing my head, I was moving toward the door to give them privacy when Kurt’s arm extended and caught mine.

“Dr. C,” he said.

I was startled. Kurt and Anne had always been cautious to call me “Dr. Cullen,” leaving the affectionate shortened form only to their son.

“Dr. C., thank you,” he whispered shakily. “For everything.”

I shook my head. If I were truly worthy of thanks, they would be taking Tony home now. He would be laughing. He would play more video games. He would tease his sister to tears again and again.

If I were worthy of thanks, Tony would not be gone.

“I couldn’t do enough,” I answered, but Kurt shook his head, barreling on in a shaking voice.

“You did everything you could. We watched you fight this. You threw everything you had at our boy, and I’ll never know why. But he stayed fighting because of you.”

I began to protest again, but his next words caught me up short.

“You did everything that it was in your power to do. We know that.” He gulped. “Thank you.”

Everything in my power. The sob that ripped from my throat took me by surprise and I threw a hand over my mouth to stifle it.

“You’re welcome,” I managed, regaining my voice as I said the words that were familiar to me, from thousands and thousands of patients over the years, “It was a pleasure treating Tony.”

The Masons gave me identical sad smiles, and nodded solemnly before looking back to their son.

I stepped out into the hallway, the unnecessary breaths coming short as I remembered the words of my patient’s father, his inadvertent echo of a mother I’d known so briefly eighty-seven years ago. Was this what Elizabeth Masen had meant me to do? To give it my all, but in the end to let her son—my son—simply slip away? Surely no parent would wish death on their child, but in its place, would she have wanted Edward to suffer as he was suffering now? My thoughts were so overtaken as I moved to go back to my office that I almost missed the woman waiting for me in the hallway, even feet from me as she was.

Esme was in the middle of the corridor, standing firmly as people brushed past her on both sides. Her arms were crossed over her chest comfortably as she waited, and her concerned eyes tracked my every movement as I approached her.

“Alice,” I whispered, and she nodded. Of course Alice would have sent her. A part of me was stunned to see my wife before me, and another part chastised me for even doubting her ability to lay aside what I had said to come to me now.

“Esme, I’m sorry,” I began, but she shushed me, putting her arms around me and twining her fingers in my hair as she pulled my head to her shoulder.

“Not now,” she whispered, just barely loud enough for me to hear. “Not right now, Carlisle.”

Gratitude and grief together flooded through me as I collapsed into the stillness of my wife’s arms. We stood locked together, the anguished parents of another lost child, as the voices and sounds of the bustling hospital around us blended to a single, tranquil hum.

By the sweat of your brow you shall eat bread until you return to the ground,

for out of it you were taken;

you are dust,

and to dust you shall return.

Genesis 3:19 (NRSV)


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