Peel the wax paper backing from the plastic case, but leave the syringe inside as the medicine thaws. You haven’t cleaned the countertops in weeks. Don’t think about the intern you saw earlier today, who is neat and beautiful and ironed, even her hair. How her kitchen must sparkle like her engagement ring, which slides along her finger as she examines your peeling hands, asking if you’ve ever been diagnosed with psoriasis. You wonder if words like comorbidity ever crossed your mind—back in the days when the pain was negligible, would leave quickly to plague the people you saw on television. All those sterile commercials, all those lined, white faces. Hearing the black box warnings, you wondered: why no grapefruit juice? Now you know. Your uncle says knowing is the price we pay for not dying young. He is a black man who knows that even old accounts must be settled. Be careful when handling; this medicine costs more than you make in a month. Your mother will be proud to know this. You might not have a good job, but you’ve got good insurance. You have arrived. Don’t think of distances, of home, of the people who are not thinking of you because they’ve been taught how to avoid being afraid. Hold the syringe up to the light. How little it takes. How clear the solution. Don’t think about lymphoma. The clouded X-rays. That this could kill you faster but you could leave a certain kind of whole. Don’t wonder about whether or not that makes sense. Start your favorite song on your phone and then wash your hands because it’s your phone. No one else is here, but don’t think of it as loneliness. You’re a rotary of symptoms you don’t want them to see. Maybe when your elbows aren’t swollen and you can lift your arms to comb your hair—maybe then. The alcohol pad and cap removal are easy, and if the song ends before you’re ready, hit replay with your knuckle. Count to three. The pain is never as bad as you remember. In fact, someday you’ll do this absentmindedly, while slipping into a printed dress for brunch. You’ll become a person who takes for granted that being healed means being pierced. Push the button, watch the plunger sink towards your flesh. It’s OK to wonder if this is how faith should feel, a closed circuit of questions: the hand, the dosage, the stigmatic skin above your ileum. You might remember that you didn’t pray, and you can do it now. Just be honest; God can see right through you, how you’ve been wanting to ask: are you still considering the birds?

first appeared in Baltimore Review