Chapter Text
Anthothorax: progressive pulmonary florogenesis secondary to unreciprocated attachment
T.M Santos
Abstract:
Anthothorax, historically referred to as Hanahaki disease, is a rare psychosomatic condition characterised by the proliferation of organic foreign matter, namely floral structures, within the pulmonary parenchyma. The disease is most commonly associated with unrequited or suppressed romantic attachment. Although extensively documented in anecdotal and folkloric literature, formal clinical characterisation remains limited. This report aims to document disease progression through direct observation of a single subject over the course of symptomatic deterioration.
Love was an unrelenting mistress.
It sounded ridiculously overdramatic even to her own ears, like something lifted right out of one of those Netflix dramas Crash was forever recommending. All heaving bosoms and reckless confessions; men with perfectly tousled hair and no measurable brain activity. And yet-
She was in trouble.
It hadn’t quite been a thunderclap or searing central chest pain; no swelling orchestral score, no cinematic slow motion. Not nearly as quick as love at first sight (she’d gladly leave that nonsense to the Whitakers and Javadis of the world) but it had come close enough, in retrospect, that it counted.
Which was unfortunate.
It was not an exaggeration for Trinity to say that her first day at the Pittsburgh Trauma Medical Centre had been somewhere between a fifteen-hour road trip in a van with broken A.C., a faint smell of vomit, and just her mother for company; or an afternoon spent wandering a dying mall with more graffitied steel shutters than open shops, and again, just her mother for company. Or maybe just anything, in any location, with just her mother for company.
Which meant that the fact she remembered any part of it fondly was deeply suspicious. Because despite the chaos, the paperwork, Langdon, and the absolute atrocity of Pittfest, Trinity still found herself replaying pieces of that day in her head.
Specific pieces.
Involving one person.
It was embarrassing. Worse.
It was-
She shook her head as if to empty out the offending thoughts; she couldn't say it.
Trinity Santos had zero idea what love was supposed to mean to her.
When she’d been much younger, shipped off to summer church camps because eight consecutive weeks of gymnastics was, apparently, excessive even by her parents’ standards, she’d been told that Jesus loved them all.
The counselors had sat them all down, just the girls whilst the boys happily played gaga ball in the sunshine. Identical small hands held plastic pink bibles titled, “My first love: Jesus Christ.”
He loved them so much he chose to die for them, they had said, an everlasting love that stayed as long as you weren’t a murderer (dying was uncool if it wasn’t for love) or gay (love was uncool if it wasn’t for boys).
That had all seemed a bit much. Even back then, younger Trinity had possessed excellent instincts. It all felt very Romeo and Juliet with too much dying and not near enough practicality. So she had done what any rational child would do; she looked to Mom and Dad for guidance. They were married, at least according to the picture central on the mantelpiece that Mom made her dust each morning. So they had to be in love. Presumably.
But their love seemed even worse than the silliness of Shakespeare to Trinity. Less poison perhaps but the screaming fights followed by reams of silence so complete Trinity could hear the hum of the refrigerator from three rooms away, was worse than any balcony scene.
Therefore, Trinity had bumbled through life somewhat confused.
There had been the girl in kindergarten, the one with the purple beads that would click and clack as though singing a song just for her. Trinity had pulled them out at naptime, stolen paper scissors snapping at the rubber bands one by one, until she had a small baggy of purple that sang whenever she wanted, never mind the tears she left in her wake.
In third grade, Yuna had joined them. She had smelt sweet like sugar, Trinity still remembered it with alarming clarity, her mouth perpetually stained pink or blue or some other violently artificial colour. Her hands were always sticky too. Always reaching for Trinity's hand.
Trinity had pushed her once.
Yuna had only asked for a turn on the swings.
It wasn’t even a hard push, not really. Just enough. Enough that Yuna stumbled back into the dirt, enough that Trinity’s own heart began hammering so loudly she was sure the entire playground could hear it. She had stood there, dizzy with it, watching Yuna’s expression shift from confusion to accusation.
She wasn’t sure what had been worse, the feeling in her chest when Yuna offered her candy, warm and fizzing and unbearable, or the sudden, awful quiet when that feeling vanished as Yuna stared up at her from the ground. Hurt.
By middle school, Trinity had started to make a bit more sense of the strange sensation. She could tentatively recognise it as something adjacent to love. Or at least as something that made her behave like a minor villain in a coming-of-age film.
There had been others.
Paloma, with her carefully organised pens, gel, always gel, arranged in colour gradients so precise they bordered on clinical obsession. She would hold them under Trinity’s nose and insist they really did smell like watermelon.
Trinity had snapped one clean in half.
The look on Paloma’s face had followed her for weeks.
Then there had been Grace. Thirteen. From church. All sharp edges and sharp opinions, an attitude that somehow made Trinity seem positively angelic by comparison. Grace had been Trinity’s first kiss. Brief, clumsy, tasting faintly of peppermint chapstick and rebellion. And then Trinity, in a moment of catastrophic miscalculation, had told her mother.
She had never seen Grace again.
After that, it became easier to draw conclusions. Looking back over the dossier of Trinity’s long, ill-fated affair with love, it was clear the feeling had never once recognised her properly. Not in kindergarten. Not on the playground. Not in church basements that smelled like instant coffee and carpet cleaner.
No matter what she did, no matter how carefully she rehearsed kindness between back handsprings, how diligently she mirrored the other girls with boyfriends or girlfriends they spent every walking moment waxing lyrical about, it never quite aligned.
There was always a misstep. A misread. A silence that stretched half a beat too long. Something in her timing was off.
Eventually, she began to suspect something inside of her was just off too. Broken.
At least that was what her last girlfriend had said.
“Santos, sorry uhh,” Dennis’ voice interrupted her rumination.
When did she become someone like that, she wondered, someone who ruminated on things other than how to maximise her interview points. When did she also become someone who used the word ruminate unironically? Like some tortured romantic poet.
“You, uh, said to get you when the bus is in ten minutes, so here I am.” He finished with a nervous little chuckle.
Dennis had lived with her since that very first shift,when she spotted him loitering around the on-call room like a shadow that had outstayed its welcome. It had been nearly ten months now. Long enough for a baby to have been conceived and born. Long enough for him to stop sounding like he expected her to revoke his tenancy at any moment.
To be fair, she did occasionally threaten to.
“Yep, rightio,” she yelled back, closing her google document, the cursor blinking accusingly at that last word. Her eyes flitted over the room briefly, her bedroom was strictly off-limits, obviously, but caution had never killed anyone.
Well. Not in this context.
“Be right there!”
“You okay Trin? You sound a little off.”
Okay she took it back, Dennis needed to be a lot more nervous around her
“I’m fine Huckleberry, save your mothering for your farm girl and farm baby and all the little farm piggies and chickens.”
There was a beat.
“Don’t forget the goats too,” Dennis muttered, a whisper that sounded suspiciously like ‘they’re almost as stubborn as you’ accompanied his sentence.
They began the short trek to the bus stop, which very quickly devolved into a full on sprint because the timetable was perpetually out of date and neither of them had thought to photograph the updated one. Thankfully, mercifully, they made it. Missing this bus would have meant missing morning board round, and Trinity would sooner develop tuberculosis than endure that particular humiliation. According to the groupchat, Robby’s replacement was coming in today and although Trinity had dropped her kiss-assing somewhere between MS1 and 2, she did still want to make a good impression.
If everything else in her life was going to absolute shit, she at least still had work.
They climbed aboard, greeted by the familiar perfume of damp coats and industrial cleaner. The early-morning quiet hung over the passengers like a shared resignation. No one made eye contact. No one smiled. They slid into their usual seats: third row from the back, left side, close enough to the heater that rattled enthusiastically but emitted no measurable warmth.
Dennis immediately produced two foil-wrapped breakfast sandwiches from his bag with the solemnity of a man unveiling a national treasure.
He had insisted on cooking as repayment for the rent-free housing, despite her repeated assurances that it was unnecessary. But Trinity couldn’t complain. Dennis’s Great-Depression-core upbringing had rendered him offensively competent in a kitchen, and for the first time in her life she was consuming three actual meals a day instead of coffee, crumbs of what might have once been a protein bar and vibes.
“Egg scramble,” he announced proudly.
“Thrilling.”
She unwrapped hers anyway.
The smell was immediate and aggressive. Warm egg, overenthusiastic pepper, and whatever optimism had convinced Dennis that public transport was an appropriate venue for the sulphurous stench emanating from their matching parcels.
Across the aisle, a woman in a smooth beige coat that most likely cost as much as she had made since starting up at the Pitt, watched them with undisguised horror as Trinity took a bite.
Dennis, blissfully unaware in the way that small-town people always were, caught the woman’s eye and smiled at her. A bit of egg clung traitorously to his lower lip.
The woman recoiled as though he’d offered her a live chicken to pluck and skin.
Trinity swallowed down a laugh, “you have something,” she said, failing entirely to keep the amusement out of her voice.
“All good?” Dennis asked, swiping at his mouth with the back of his hand.
“Devastatingly.”
He beamed, pleased with himself.
She loved him, in a way. Not the fatal kind. The survivable kind. The kind that packed you breakfast and believed the world was fundamentally well-meaning. Like loving a golden retriever, if the golden retriever had annoyingly wrong opinions and opposable thumbs.
She took another bite as the bus lurched forward, the gentle rocking almost enough to lull her back to sleep. They rode in companionable silence for a few minutes. From the corner of her eye, she could see Dennis staring at his phone with the intensity of someone decoding state secrets.
Then-
“No way.”
Trinity maintained her gaze at the passing trees, the greens all morphing into one, “if this is about Peepaw Huckleberry winning the state fair again, I’m not interested. We’ve had this conversation on the importance of tone.”
“No, it’s not that,” Dennis whined, “and you know Peepaw isn’t up for the state fair anymore,” he crossed his arms and angled his phone away from her with all the practice of someone used to having to hide things from Trinity. “Actually,” he said slowly, his eyebrows knitting together, “I don’t think I should tell you.”
She sighed dramatically, giving up any hope of getting some shut-eye, “you know that’s exactly what makes me want to know even more,” she reached over and yanked the phone out of his hands, ignoring his yelp of protest.
A text thread from a 412-135-1211 glowed accusingly on the screen, “Huck, you haven’t saved an-” she started, a usual teasing smirk on her face, but the actual words soon came into focus.
Langdon was back.
The words sat there, small and harmless-looking, as something in Trinity’s chest tightened.
“Oh,” she said lightly, ignoring Dennis’ guilty look, “oh,” she repeated, barely above a whisper, her windpipe sucking up the dry air in a move that she knew spelt bad news.
The cough came before she could stop it. It started as a tickle, as it always did, annoying and persistent as it shuffled and scraped its way up her throat.
She turned away from Dennis, dragging the sleeve of her hoodie over her mouth, shoulders hitching as the cough continued to force its way through her, deepening as it scratched and scarred. The quiet noise of the bus blurred into a distant, underwater roar as the heat climbed up her throat, thick and suffocating.
“Trin-”
She tried to inhale but the air wouldn’t go where it was supposed to. Another spasm seized her, violent enough to fold her forward. Pain bloomed behind her sternum, hot and spreading, as though someone had stuck a tube right inside with no local first.
“Trinity!” Dennis said again, this time more insistent as eyes started to follow her around and bags and sleeves assembled themselves into makeshift masks, their owners no doubt terrified of another pandemic.
“I’m fine,” she tried to say, but the words fractured, collapsing into another brutal fit. Her ribs ached. Her eyes watered. Each cough felt like her body was trying to expel something that did not want to leave.
Until, at last, it stopped. Cradled in the grey polyester was a single, crushed bloom. Petals bent but unmistakable. Pale, with the faintest blush of pink at the centre.
A flower.
For a second, she only stared at it, but before she could stop it, her thoughts spun backwards, carelling through memories she’d tried to suppress. It looked like one of the ones Yolanda had once brought in on a random Tuesday night. Dennis was away at the farm and the house was blissfully quiet, save for Yolanda’s big brown eyes and the strange pounding in Trinity’s chest.
“They were on sale,” she’d said, shrugging, “made me think of you,” her fingers already finding their home in Trinity’s hair as Yolanda swallowed up any reply Trinity had for her.
Her heart had stopped. Not right then, or perhaps not in the way you might be thinking, but when Yolanda had left her, spent and soaking in the feeling of sweat and a mixture of their juices, her eyes much too bright for three in the morning. Trinity had looked at the flowers and felt a deep wrongness settle in her soul.
They were only Walmart ones, the twelve dollar ninety nine price tag hung on casually, but she’d seized them and thrown them in the trash anyway. They weren’t together; it was inappropriate.
Dennis' gaze continued to remain fixed on her, trying to see the flower she had hidden away as quickly as she could.
“That’s still going on?” he whispered.
She curled her fingers around the flower quickly, crushing it further, “seasonal allergies,” her voice was still a little wobbly.
“A cold isn’t supposed to last more than two weeks,” he said carefully, discarding her lie. “You’ve been coughing for what? Three?”
“Maybe it’s tuberculosis,” she muttered, “mind your business, Fuckleberry.”
“Let me at least examine you.”
She shot him a look, “on a moving bus? I didn’t know you were so eager to show the world you’ve evolved from barely passing medical student to barely passing intern?” her mouth twisted into something ugly; something that showed her regret.
But Dennis continued unfazed, “I have my stethoscope, just let me listen or let me watch you listen. Trinity, this could be serious!”
“Absolutely not, I’m fine,” she pronounced but her voice was thinner than she intended.
Dennis didn’t push further. He just watched her in that quiet,concerned way of his which was somehow more irritating.
The bus rattled on toward the hospital. In her fist, the petals were already bruising.
It hadn’t started like this, the first time had been much quieter. Almost forgettable.
Almost.
It was early winter. The streets had yet to fill with the full parade of puffer coats and woollen scarves, but for someone like Trinity—who could differentiate white sand from yellow sand by texture alone yet remained fundamentally incompetent when it came to sleet—it was cold enough to justify wrapping herself in layers.
The on-call room had felt cavernous that night, a strange harbinger, as the night shift busied themselves with the endless traumas rolling through their doors like a two for one motel. Trinity had not been on shift that night, but she’d stayed behind to catch up on her charting. A thankless task truly, but she did help herself to the cookies stuck in the back of the shared cupboard ignoring the ‘M.King’ written all over in green sharpie.
She’d been halfway through a discharge summary when the tickle began, persistent as always. She’d assumed it was dust at first, or exhaustion, or perhaps the universe and Mel conspiring to punish her for her theft.
She’d coughed once. Then twice and then a few more times before something soft had landed in her palm.
A flower, just the one, but whole and untouched as though she’d plucked it from the ground and not birthed it from her bronchi.
She had stared at it for a long time before laughing- short, sharp and shocked.
Because there were only three possibilities.
- She was hallucinating.
- Someone had broken into her home and planted horticulture in her respiratory tract.
- She was dying.
Being a doctor, she had naturally assumed option one. She’d kept the flower in a little plastic specimen bag, the ones they used for labs, eyes flitting between it and the repetitive ‘take home drugs ordered,’ on her computer, as though it might disappear if she looked away too long.
Even now, Trinity didn’t know why it took her so long to believe she had actually coughed up a flower. No, a buttercup, white at the edges with a sunny yellow centre. But it had, and it was only until she’d snapped a photo and sent it to Dennis who confirmed that he really did see it, that the panic began to settle in.
Option two lasted approximately four minutes.
There were, admittedly, some flaws in the “opportunistic maniac florist” theory. It was winter in Pittsburgh; frost had long since executed any viable flowers. And more importantly, the specimen was pristine. Unblemished. No tearing. No trauma.
So, naturally option three was what she had left. “Coughing flower,” she’d typed first, angry at the stupid AI suggestion on the best natural remedies to treat cold and flu. Then “hemoptysis petals.” Then, with increasing irritation, “psychosomatic plant expectoration.” Nothing of substance had come up, save for a few reddit posts, some tumblr posts and Japanese websites.
One thread in particular caught her eye:
I [M21] have been coughing up all sorts of flowers ever since I moved in with my roommate [M23] and his girlfriend [F22].
She skimmed quickly, dismissing phrases like love disease and unrequited attachment as narrative nonsense.
Until the same term appeared again.
And again and again. Until she finally clicked on the first result, using the auto translate feature. Hanahaki, it read, the psychosomatic manifestation of suppressed romantic attachment. Psychosomatic, was another word, like idiopathic, words doctors used to excuse their own stupidity whilst patients suffered. It wasn’t real and yet the flower continued to stare up at her, the yellow defiant.
She stared at the words for a long time, a tragically fatal disease reported in some eastern Asian cultures in which the afflicted coughs up flowers and eventually succumbs to respiratory failure, unless their love becomes requited. “That’s stupid,” she said aloud to the empty room.
It read like fanfiction; it read like myth. But still, the buttercup remained, whole and impossibly real.
Her lungs felt suddenly, inconveniently present inside her chest.
Her first thought when faced with the possibility of death was confession.
An ever close possibility because since that fateful day, she’d spent most of her hours coughing, some buttercups, of course in all shades from pale yellow to startling violet mixed in amongst every flower it seemed. Some roses, red enough to steal away her breath, a few tulips, pink and soft like Yolanda’s lips, a few forget me nots, some carnations. It was so much that it was impossible for her to deny, especially when added with the x-ray she’d begged a favour to have done. The flowers forming radiopaque tufts all over.
Perhaps it was the Catholic upbringing, a million Sundays kneeling on unforgiving pews, imbibing on the body and blood of Christ as though ritual alone could cauterise human stupidity, that brought confession to mind. The choreography of guilt had been drilled into her early: confess, and be cleansed.
Because if she said it, if she told Yolanda, she might live.
It had to be Yolanda, there was no point in denying it; no point in dying politely. No merit in taking secrets to the grave like some tragic Victorian heroine with lace at her throat and consumption in her lungs.
The logic assembled itself with clinical efficiency. The disease, allegedly, resolved if the love was requited. Therefore the variable was not the flower. Not the lung. Not the bronchi staging their quiet coup.
It was Yolanda.
Her name alone felt incriminating, like contraband tucked beneath Trinity’s tongue.
Yolanda, with her careful hands and infuriating calm. Yolanda, who had once bought her coffee without asking how she took it and gotten it exactly right. Yolanda, who had laughed at something Trinity said, actually laughed even as the patient screamed on the exam bed, and then looked at her for half a second too long.
Or perhaps Trinity had imagined that part. She was, apparently, prone to psychosomatics.
The thought had flooded her head like a warning beacon, flashing amber each second as they spent their fourth night in a row, together that week.
“You’re kind of getting good at that,” Yolanda teased. She was naked, her lacy black bra that seemed rather impractical for days in the OR, flung into some crevice or the other, her underwear wrapped possessively around Trinity’s wrists. She hadn’t offered a reply for a while, Yolanda being naked had the unfortunate effect of distracting her, much more than the thought of her imminent death.
“Uh,” she found her voice at last, “I guess I had a good teacher,” she teased, noting the way Yolanda’s eyes lit up, “Bianca in MS3, she really was the best so-”
But her words were cut off as Yolanda grabbed her once more, tongue finding tongue as words were done away with for a little while longer.
As always, an always Trinity wished she could change, once the clock by her beside began to inch closer to the early hours of the morning, Yolanda gathered her things, brushed her teeth hurriedly in a way that made Trinity irrationally jealous of the blue plastic, and made her way out into the dark.
“Stay,” she whispered, trying her best to inject some humour into it, anything that might hide the vulnerability coursing through her veins, “I mean it’s really dark now, you never know which monsters might be lurking in the dark.”
“I’m a big girl,” Yolanda shook her head, though she did offer a kiss. Small and delicate right on Trinity’s brow. “Surgery list for tomorrow is looking like a right pain now,” her fingers scrolled past something on her phone, “you still sure you want to double board?”
“Uh-huh,” Trinity nodded, her mind still fixated on her best to drop a love confession in a way that said I’m casual, we’re casual but maybe if you don’t love me back, I might lowkey die?
“Of course, you and your big brain,” Yolanda sounded affectionate, fond almost, “I’ll miss you once you get in, I mean we’ll still be friends but,” she leaned in closer, her kiss turning from chaste to downright sinful, “I’ll miss this.”
“Whoever came up with anti-fraternisation clauses anyway,” Trinity laughed, but with too much bitterness for the lightness of the moment.
Yolanda stood straight up, “see you,” she said with a small wave, “and rain check for tonight, I haven’t seen my apartment properly in a while now, definitely don’t want to crowd you guys.”
No, Trinity wanted to call out, crowd me please, but the moment was lost. It was clear that Yolanda saw them only as friends, sure friends that sometimes give each other mind blowing orgasms but friends nonetheless. At least, if she didn’t say the words, she had hope, and that might just be enough to sustain her.
Unfortunately, there was an aspect she had not considered: the fact that hope could be false. Hope meant a wish, a desire in your hearts of hearts for something to be true, so how then could it be false? It made little sense like most things to do with love but what it meant was that despite her hope, Trinity only began to grow worse with each passing bloom.
She timed the coughing between patient encounters, learnt which stairwells were least trafficked, which bathrooms had paper towels thick enough to serve as both gag and evidence disposal. She kept specimen bags in her pockets now, folded flat like secrets. The flowers now came with thorns, thick and sharp enough to make her bleed.
She lost weight too. Not in a dramatic, worrying way at first, just enough that Mel started stealing glances at her during sign-out, offering her the cookies she used to steal as her eyes narrowed in the way of someone who’d noticed a discrepancy and filed it away for later interrogation.
Then came the shortness of breath. The kind that made her pause halfway up a single flight of stairs, palm flattening against her sternum as though she could physically remind her lungs of their job description. The kind that made her take the long way around the hospital, even if it meant being late.
She started coughing up petals at night. She woke with them stuck to her tongue, damp and papery, the taste faintly bitter, like aspirin dissolved too slowly. They weren’t whole and unblemished anymore, instead they arrived shrivelled and stained with blood as though mimicking her bleeding heart.
Dennis noticed first.
He noticed because Dennis noticed everything, because he was the sort of person who clocked changes in milk consumption patterns, switching out the dairy for oat anytime her period came round, and mood shifts measured in micro-expressions. He noticed because he lived with her, because he loved her. He noticed because she stopped letting him do her laundry.
“Trin,” he said one evening, leaning against the kitchen counter while she pretended very hard to be interested in an email about mandatory wellness modules Dr Al had sent through. “Why are there flowers in the trash can?”
She didn’t look up. “Define flowers.”
He stared at her.
“In a botanical sense,” she continued lightly, “or-”
“Trinity.”
She sighed. Slowly. The kind of sigh that was meant to signal patience but mostly conveyed guilt. “They’re not… from outside.”
Dennis blinked. Once. Twice. “I’m sorry, what?”
She finally looked at him then, met his eyes squarely, “I’m fine.”
“That is not an answer to the sentence I just heard.”
“They’re not from outside,” she repeated, as though enunciating more clearly might magically render the statement less insane. “They’re, uh- internal, from me.”
The silence that followed was profound.
Dennis opened his mouth. Closed it. Opened it again. “I-okay,” he said eventually, nodding as though he’d just been informed of a minor scheduling conflict. “Okay. That’s. That’s… okay.”
She waited for him to scream. Or faint. Or demand she go to the emergency department immediately.
Instead, he rubbed his face with both hands, “the cough you got in the winter.”
“Yeah,” Trinity shrugged with a nonchalance that was out of place, “it’s called Hanahaki, some Japanese thing. Don’t look it up,” she added, knowing he would do so anyway. “And before you say anything, I’m managing, you don’t need to worry.”
The intervention happened three days later. She should have known Dennis wouldn’t listen, they didn’t teach good manners in the country.
She came home to find her living room occupied in a way that felt frankly unconstitutional.
Victoria was perched on the arm of the sofa like a gargoyle,some iced frappe atrocity in hand, big eyes sharp. Samira had claimed the floor, legs crossed, leaning back against the couch with the air of someone who had come prepared for either emotional vulnerability or hand-to-hand combat. Mel stood near the window, arms folded, expression doing that polite thing it did when she was five seconds away from saying something devastatingly incisive.
Perlah and Princess were there too, sitting side by side on IKEA dining chairs stolen from the kitchen, solemn as judges.
Dennis hovered near the kitchen doorway, wringing his hands. Guilty.
“Oh,” Trinity said faintly, “is this a coup?”
“It’s an intervention,” Mel said brightly.
Perlah spoke first, “hi, Santos. Dennis says you’re dying.”
“I’m not dying,” but her voice chose that moment to go all wobbly, like a pensioner asking for directions. “Traitor,” Trinity muttered to herself.
The room went very quiet.
Dennis cleared his throat, “she’s been coughing up flowers,” he said, as though reading from a grocery list. “Actual ones. Like, chlorophyll-having, petal-bearing-”
“Hanahaki,” Samira said calmly.
Trinity stiffened as everyone looked at Samira.
“What,” she said with a shrug. “I had a thing for niche folklore diseases in undergrad. It’s… a thing.”
“It’s not a thing,” Trinity snapped, “It’s a myth. A narrative device. It’s-”
“It’s you,” Dennis cut in, “it’s been you for months.”
Mel leaned forward, “It’s true Santos, you’ve been declining shifts. I don’t like to comment on women’s looks but you look like hell. And now there are flowers involved.”
“I prefer to think of them as a symptom,” Trinity said stiffly.
“A symptom of being in love,” Victoria interjected quietly.
Silence again.
“No,” Trinity said immediately. Too immediately. “Absolutely not.”
“It’s Garcia, isn’t it?” Dennis continued, far too brave for his own good, “she hasn’t been round here in ages and you’ve just withered away in the meantime.”
It was true, since early in the summer, Yolanda offered more rainchecks than date ideas, which was stupid because it precisely did not rain in the summer. Trinity tried not to think about the fact that it coincided with her putting in her application for surgery. She hadn’t told Yolanda of course but the PTMC was a small world. Too small.
“I’ll appreciate it if you keep the flower puns to the minimum Shittleberry,” Trinity fired back, “and it’s none of your business,” she spun around to face the whole jury, “none of any of you guys’ business.” And with that, she marched her way into her bedroom, letting the door slam behind her in a move that she hoped would send them all running, but her hope counted for nothing nowadays.
Through the door she was forced to listen. They told her she had to say it, that it was stupid not to, that she was a doctor and therefore uniquely unsuited to dying of something this narratively avoidable. They told her that love didn’t have to be fatal, that silence wasn’t noble, that hope wasn’t a treatment plan.
She listened. She let them talk. She let them plead.
And then she shook her head.
“No. I won’t,” she said, voice steady despite the ache blooming behind her ribs. “If I don’t say it, there’s still potential. If I hear her say she doesn’t love me back,” her voice broke, “I don’t think I’ll survive it.”
They all had their answers to that of course, but save for Yolanda herself confessing her love to her, Trinity wasn’t budging.
Sometimes Trinity wished that she wasn’t so stubborn.
She couldn’t help it. From her very first moment on earth, she’d come out screeching in the faces of perplexed obstetricians, grabbing at the forceps that had very impolitely displaced her from the warmth of her mother, and since then she hadn’t stopped wanting things to go her way. Though of course, she wouldn’t say her death was things going her way.
She’d hobbled into work that morning on pure momentum and spite.
Her body had worsened overnight. She hadn’t slept well, couldn’t, really, and the dark circles beneath her eyes stood out starkly against skin that had gone sallow, almost translucent, as though the blood had abandoned ship entirely. What little remained of it now resided on the soaked petals hidden beneath layers of rubbish in her bag, carefully wrapped, carefully concealed, in the hopes that Dennis wouldn’t find them and stage Intervention: The Sequel.
It had been the wrong decision.
Ignoring the fact that Dennis hadn’t woken her for the bus (an omission so pointed it bordered on betrayal) she’d forked out fifty-seven dollars on an Uber. The driver, an elderly man with a soft voice and far too much empathy, had glanced at her in the rear-view mirror and asked if she was heading in for chemo.
She hadn’t corrected him.
By the time she made it into the hospital, at least three people had mistaken her for a patient.
Dana had been the worst of them.
“Oh! I’m so sorry,” Dana said, immediately switching into her customer-service voice, hand already hovering near Trinity’s elbow. “Are you lost? Oncology’s on three.”
“Dana, it’s Santos,” Trinity said flatly.
Dana blinked. Looked her up and down. “You… sure?”
“Yes.”
A pause. Dana flushed. “Right. Of course. Sorry Dr Santos. You just look-”
“Like hell?” Trinity supplied helpfully.
Dana winced, “I was going to say tired.”
“Bold lie.”
She made it through exactly half of the morning board round before it all went to shit.
She was standing at the back of the room, arms folded tightly across her chest, when the familiar tickle flared, sharp and immediate, like a match struck too close to skin. She turned away instinctively, coughing into her sleeve, willing it to pass. It didn’t.
The cough tore through her, deeper this time, harsher. She tasted metal. Heard the scrape, the awful internal drag of something coming loose where it absolutely should not have been.
“Trinity?” Mel’s voice cut through the room.
She shook her head, hand raised in a universal don’t, but it was too late. The spasm bent her double, breath tearing out of her in jagged bursts. She staggered, barely managing to catch herself on the edge of the table.
Something wet landed against her palm.
She closed her fist around it immediately, heart slamming so hard it made her dizzy.
The room had gone very quiet.
“I’m fine,” she said hoarsely, straightening too quickly. Black spots danced at the edges of her vision. “Excuse me.”
She didn’t wait for permission.
She made it as far as the stairwell before she was coughing again, pressed against the cool concrete wall, lungs burning, vision blurring. When it finally stopped, she looked down.
The stem was thick. The petals dark, bruised purple at the edges like an old bruise. Thorns bit into her skin, sharp enough to draw blood.
She laughed, breathless and hysterical.She didn’t go back to board round.She didn’t go back to the floor. Instead, she kept climbing.
Each step sent a sharp protest up through her calves, her thighs, her chest tightening in complaint, but she ignored it, fingers curling hard around the railing as she hauled herself upward. The stairwell smelled like dust and disinfectant and old heat, the kind of place no one ever stayed in longer than they had to.
The door to the roof was heavy. It scraped as she pushed it open, sunlight spilling through in a way that felt almost offensive, but that didn’t matter as the city stretched out below her, Pittsburgh laid bare in concrete and glass and rivers cutting clean lines through it all. Cars moved like toys. People crossed streets, waited at lights, laughed into phones, carried coffee, argued, and lived.
None of them knew.
The jealousy surprised her. It was sharp and sudden, a spike low in her chest, not anger, not bitterness exactly, but something like envy stripped down to its bones. They were all still moving forward, unthinking, they had errands, appointments and plans that extended beyond the end of the week.
She pressed her palm flat against the low wall and leaned into it, breathing shallowly and watching.
This is it, she thought, with a strange, detached calm, this is how it ends.
There was no great swell of emotion or sudden clarity like the movies showed. Just the quiet understanding that whatever hope she’d been hoarding was running out. She had done everything right, studied, worked and sacrificed yet, she was here, coughing up proof that love, apparently, was fatal to her.
Maybe she’d tell Yolanda.
The thought came gently, almost tenderly.Not as a cure, that much was certain, but as a way to leave something behind. She could write it down, even. A letter. Something clean and unambiguous. So she wouldn’t die with the words still lodged somewhere deeper than the flowers.
“So,” a voice said behind her, amused,”didn’t know you were one for people-watching?”
Trinity startled, breath catching painfully in her chest as she turned.
Yolanda stood a few feet away, hands in the pockets of her coat, hair pulled back loosely, eyes soft in a way that made Trinity’s heart stutter. She hadn’t seen her, really seen her, in a few weeks now. She smiled despite herself, “come to tell me I look like shit too? I think everyone and their mother might have beat you to it.”
Yolanda winced, “I was going to ease into it.”
Trinity snorted, then coughed, sharp and unavoidable. She turned away instinctively, pressing her fist to her mouth. When it passed, she looked down at her hand. Another flower, smaller this time but still dark.
Yolanda’s expression shifted immediately. “I’m sorry,” she said quietly, “I’ve been a stranger.”
Trinity shrugged, forcing nonchalance into her shoulders, “it’s no bother. I mean, I’m just some random R2.”
Yolanda shook her head. “No,” she said firmly, “you’re not.”
Another cough tore through her before Trinity could stop it. She laughed weakly after, wiping her hand on her scrub pants like it was nothing. “You have to stop saying things like that,” she said.
“Things like what?”
“Things that can confuse me.”
Yolanda studied her for a long moment. The city hummed around them, distant and indifferent.
“I thought you wanted casual,” Trinity went on, words spilling faster now, buoyed by the strange courage that came with having nothing left to lose. “I’m bad at relationships. I don’t know how to read people properly. I thought that was the agreement.”
“I did,” Yolanda said softly, “at first.”
Trinity shook her head, “I don’t believe you.”
Yolanda stepped closer, “It’s true. I was scared, Trin,” the nickname softened her heart, “scared of losing my job. Of you losing yours. Of my reputation. Of rules that feel enormous until suddenly they don’t.” She reached out, tentative, and brushed her thumb over Trinity’s knuckles.“All I’m scared to lose now is you.”
The world tilted.
“It’s just a cold,” Trinity said faintly, reflexively, even as something warm and dangerous bloomed in her chest. “Did Dennis tell you something? Or Samira? Mel? Victoria?”
Yolanda smiled, gentle and reassuring. “It’s okay. Relax. I don’t know what you’re talking about,” she shook her head, “I just heard you were sick, and I had to see you. To apologise.”
She squeezed Trinity’s hand.
“Because I love you.”
Hope flared, bright, sudden and almost painful, so much that Trinity recoiled from it.
She pulled her hand back just enough to create space, her chest tightening again, suspicion threading its way through the warmth.
“No,” she said quietly, “you don’t just get to say that.”
Yolanda stilled. “Say what?”
“That you love me,” Trinity replied. “Not like that. Not now.” She laughed once, sharp and brittle. “You can’t fix things by lying, Yolanda. I’m not, this isn’t a movie.”
Yolanda didn’t interrupt her. She just listened, eyes steady and patient.
“I know what this looks like,” Trinity went on, words tumbling faster. “I’m sick, I’m dramatic, I’m… convenient. You feel bad. You want to make it better.” Her voice faltered despite her effort. “But don’t do this unless you mean it.”
Yolanda took a breath. “I did mean it,” she insisted, “long before today.”
Trinity shook her head in disbelief, “since when?”
Yolanda smiled, small and a little sad, “since your first day.”
Trinity blinked, “that’s not-”
“You were so eager,” Yolanda continued, cutting gently through the protest. “So confident. Like you belonged there already, even though you were clearly terrified.” Her eyes softened at the memory, “I remember thinking I just… wanted to be close to you.”
Trinity swallowed.
“I thought about you constantly,” Yolanda said. “Which was deeply inconvenient, by the way, and then you stabbed me in the foot.”
Trinity flushed despite herself, “I apologised.”
“You begged to sew it up,” Yolanda corrected, a smile tugging at her mouth. “Who does that?”
“I was trying to be helpful.”
“You were unforgettable,” Yolanda said simply. “You were someone I’d never seen before. And it was overwhelming. That’s why I called you trouble.”
Trinity’s laugh came out weak and disbelieving, “you called me trouble because I am trouble.”
“No,” Yolanda said, “I called you trouble because I knew then that I couldn’t just go back to living my life the way I had before I met you.”
Something in Trinity’s chest shifted, tentative and fragile.
“You said you’re not good at relationships,” Yolanda went on, voice quieter now. “I’m not either. I mess things up. I hide when I shouldn’t. I overthink and then say nothing at all.”
She reached for Trinity’s hand again, this time waiting until Trinity let her.
“But I’m happy to wait,” Yolanda said. “To learn. To figure it out together. As long as I have you.” Her thumb brushed over Trinity’s knuckles, grounding, real. “And time on my side.”
Trinity searched her face for cracks. For pity. For fear.
She found none.
“Oh,” she whispered, something inside her finally, cautiously giving way.
She let herself believe it.
But hope, as it turned out, was a dangerous thing. As Yolanda walked her down the stairwell, hand in hand, the flowers quieting, just for a moment, a phone screen lit up unseen by either of them.
Yolanda’s.
A browser tab still open.
Hanahaki disease: how to convince someone you love them even when you don’t.