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Just that. Probably the most important word of our lives, delivered like a lane change.

“Yes?” My voice does something undignified on the vowel.

“Yes. I want this. I want it with you, and I want it in that house, and I’m terrified, and the answer’s still yes.” He glances over, once, and there’s a small teasing smile reserved for just me. “Ask me again so I can say it better.”

“Do you want to start a family with me, Luke?”

“Yes,” my husband says, and takes my hand and holds it to his chest, and drives us home.

Here is a thing nobody tells you about deciding to have a baby: you can’t announce it immediately, because that requires choreography, and I refuse to waste news this good on a Sunday night. I spend Monday morning vibrating at a frequency only dogs can hear. By 10:00 I’ve drafted and deleted a family group text, an Instagram caption, and – in a low moment between patients while Ramanputhra wasn’t looking – a draft press release. Luke’s contribution, via text, is: Tell no one until we’ve told everyone. Followed, four minutes later, by: That includes Dr. Ramanputhra.

Monday afternoon, I go back to the psych ward, and Rachel is eating.

I find out the way you find out everything on a ward – from the chart first, then the day nurse, then the evidence itself: a tray in front of her, diminished. She’s doing it resentfully. She eats like the food has personally wronged her. But she’s doing it, and she’s apparently been doing it since Saturday, and when I sit down in the chair she doesn’t look up from her book.

“Before you get a face about it, I want it on the record that this has nothing to do with you.”

“Noted.”

“I started eating because your brie story was so pathetic it made me hungry. That’s it. I heard about a grown man eating a wheel of cheese at his mother, and my body said, we can do better than that.”

I accept the insult the way you accept a bouquet – with both hands, at face value, careful of the thorns. In twenty years, when she tells this story to someone she trusts, the brie will have done its work and I’ll be a footnote, which is the correct size for me in her story. That’s the job on this ward. You don’t get to be the reason. You get to be the pathetic anecdote that made someone hungry, if you’re lucky.

“The brie would be honoured,” I say, standing.

“Get out. Don’t you have something better to do?” she says, and almost smiles, and eats another bite while pretending not to, and I put patient tolerated presence, appetite improving in the chart and leave while I’m ahead.

I’m on my way out when I pass the Neonatal Intensive Care Unit(NICU).

I’ve passed it a thousand times without stopping. It’s on the route between psych and the south elevators. There’s a stretch of glass where the bassinets line up, and you can see all the babies sleeping.

Today I stop.

There are six of them on the other side of the glass. Tightly swaddled like burritos, wearing hats like tiny sailors, each one in a clear plastic bassinet with a name card and a corresponding chart. One of them is working an entire fist into its mouth with total, bomb-squad focus. One is aggressively sleeping. They’re mere days old. They know nothing. They have never disappointed anyone, never performed a feeling, never eaten a wheel of anything at anyone. Everything about them is still just possibility with a pulse.

I stand there a long time. Long enough that a passing nurse slows, takes in my badge, my coat, my face, and asks, “Are you lost?”

“No,” I say. “I think I’m finding something.”

We tell Elena that night.

She’s at the kitchen island with a stack of documents from Catherine letterheaded THE YORK FOUNDATION, a highlighter, and a bowl of Count Chocula. We come in and stand across from her, side by side, formal as a delegation with prepared remarks. She looks up at us, and puts the highlighter down before either of us has said a word.

“We talked,” I begin. “This weekend. About your offer, and about–”

“About damn time,” Elena cuts me off.

I had a speech. It had three movements and a callback, and it dies right there in my chest, unperformed, which is its own small funeral. A part of me dies inside.

That’s it. That’s the whole response. She picks the highlighter back up, uncaps it, and returns to Catherine’s paperwork like we’ve told her the mail came and there was nothing in it for her.

“That’s all?” Luke says. “‘About time’?”

“What do you want, Lucas, a speech? I made the offer weeks ago. I ran the numbers before I said it out loud. You two are the only people in this family who treat a decision like it needs a permit.” She spears a piece of Count Chocula out of the bowl, eats it, and looks at us. “You’re sure.”

“We’re sure.”

“Both of you. Not one of you sure and one of you agreeing.”