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Chapter 1

“Is there a medical professional aboard the plane?”

I think all young doctors live with a certain amount of trepidation about hearing this question. What a terrible summons to get at 35,000 feet in the air, removed from all medical equipment or access to healthcare facilities or colleagues to consult. The question is equal parts known and unknown: you know why you are being called, and yet you have no idea to what. What if you are a throat specialist being called to deliver a premature baby, or a dermatologist being called to a life-threatening heart attack?

But on June 9, as we prepared for our flight to Seattle, Dave and I were not concerned with anything like that. It was a glorious early-summer day. June really is the best time of year in Chicago. After our long, notoriously difficult winters—the vestiges of which can remain parked like a gloomy, uninvited guest through May—the city and all of its inhabitants come surging back to life.

It was the ideal sort of summer day: clear, sun-drenched, a balmy temperature that lures you outdoors and insists on putting you in a good mood. And Dave and I were certainly both in good moods as we hopped into a taxi and headed to O’Hare Airport.

I checked my phone as the driver weaved through rush-hour traffic. My parents had responded to an email we had sent with our hotel information and flight itinerary. Dave’s mom had replied to a text message from Dave that had included a photo of me standing in profile, my baby bump clearly visible against the backdrop of the Chicago River. Dave and I were tracking the size of the baby on a weekly basis on an iPhone app, and Dave had sent out the photo with the message “Five months, the size of a papaya!” His mother texted us back: “Cutest little papaya I have ever seen. Enjoy the trip and the much-needed rest and relaxation. You both deserve it.”

Dave smiled and clicked off his phone. We agreed. We were both exhausted and eager for some time together. I had just delivered a big round of edits on my latest novel, and felt as if both my brain and my body had limped over the finish line. Dave, a third-year resident in orthopedic surgery at Rush University, was wrapping up a grueling few months; his most recent rotation was a self-directed research block, and he was working on no fewer than twenty-four different medical papers. The pace he kept at work still struck me, after many years of his medical training, as untenable—he seldom slept more than four hours a night.

As we sat side by side in the cab, relieved to be heading someplace where we could sleep and relax and enjoy the rare opportunity to spend several days in each other’s company, I glanced sideways at my husband and thought to myself how lucky I was. It was one of those out-of-body moments when you take a step back and take stock of the present moment, and as I did that, I thought: I am so lucky. I did not say it aloud, but I remember so distinctly that I thought it. I looked at Dave with eleven years of shared history to color my view—a college courtship, a young, largely untested relationship post-graduation in the wilds of New York City. Medical school and marriage and residency, moves around the country and a rescue dog, all parts of the life we had woven together, and now a new baby that would be equal parts Dave and me. I loved Dave as much as I’d first loved him in college, but the love was different now, more textured, you might even say better, made stronger by the fact that it was broken in and tested and bolstered with years of friendship and understanding and so much shared life.

This is not some rosy retrospective—I remember it as clearly as I remember the taxi and the rush-hour traffic and the sunny June day. I remember exactly what I thought as I stared at him in that car ride to the airport. I thought, to be precise: I am so lucky to have Dave.

We were both in busy, hard-charging careers, careers that forced us to spend more time apart than we would have liked, and yet we could not help but feel like we were stepping together into an exciting new phase in our lives. After more than a decade of medical training, Dave was on the cusp of becoming a senior resident. After years of being the overworked underling, he was about to start reaping the rewards of his intense labor and sacrifice and sleep-deprivation. At thirty years old, he had spent more than a third of his life working toward this goal, pouring himself into this medical training, and the finish line was finally on the horizon.

I, too, felt like I was riding a wave of momentum in my own career; after two tough but successful book launches in two consecutive years, I was now working on my most ambitious, most exciting book yet. It had been a risk for me to leave my stable day job in news in order to pursue my passion of fiction writing. I had worked hard, and it was an unpredictable but exciting time as I tried to build my career.

And best of all—Dave and I were about to become parents. Earlier in our marriage, we had made the decision to put off starting a family for a few years because of his grueling medical training (plus, it was not exactly possible to conceive when we never saw each other). But here we were. We were finally ready. Parenthood was just around the corner—a little girl, we had found out the week before—and that was going to be the most important adventure of our lives.

“We are on time, can’t wait to see you in Seattle!” Dave typed the text message to his eldest brother, Scott, as our plane prepared to take off from Chicago. En route to our “babymoon” in Hawaii, we planned to make a three-day stopover in Seattle to visit two of Dave’s older brothers who lived out there. I had never been, and we had even scheduled a quick one-night getaway up the Pacific Coast to Vancouver.

I remember it all with such crystalline clarity: the rush-hour traffic moved, the airport security line was short, and we had a windfall of time to stop at Chili’s for a quick dinner. While we waited for our food, I ran across the terminal to grab a couple of books from Hudson Booksellers, feeling giddy at the thought of vacation and so much free time for leisurely beach reading.

It was all so remarkably ordinary, the last ordinary night we would spend as the inhabitants of that life. We spoke about the fact that former Olympic athlete Bruce Jenner had recently reemerged into the public eye as a woman named Caitlyn. We spoke about work and family and the fact that Dave’s beloved Chicago Blackhawks would be playing in the Stanley Cup finals while we were in Hawaii. We looked through Dave’s phone at his recent pictures of our sweet dog, a little female mutt whom we had left with friends and were already missing.

Aboard the plane, Dave hoisted our two suitcases overhead. We took our seats toward the back of the plane. Five months pregnant, I was always up for a nap, so I promptly fell asleep after takeoff. A sleep-deprived resident, Dave usually did the same, having learned years ago while in medical school to grab sleep wherever and whenever he could. And yet that evening, for some reason, he decided not to sleep. He decided to stay awake to finish up some research work. We could not possibly have known in that moment what was going on inside his body, or the fact that his decision to stay awake just might have made the difference between life and death. I did not know any of that as the plane took off, leaving Chicago behind, and I drifted off into blissful, hormone-induced sleep.

I awoke to Dave nudging my arm. “Yeah?” I turned to him, groggy, unsure of how long I had been asleep. His laptop was open on his tray table. Through the window, the sun was just about to dip below the horizon.

Dave’s voice was quiet, but with an uncharacteristic edge to it—a rare, discomfiting urgency as he asked: “Does my right eye look weird?”

I felt my heart tighten in my chest. Yes, his right eye looked weird. His pupil was bizarrely dilated, so large and black that I could barely see the beautiful green of his iris. But the strangest thing was the asymmetry of it—only the right eye was dilated, the left eye appeared completely normal.

“I can’t see anything out of it.” Dave blinked, casting a listless glance around the plane.

I sat up straighter, any residual sleepiness entirely gone. “Open the shade; see if the bright light makes it contract.”

Dave lifted the window shade, blinking out at the clear view of coming evening from 30,000 feet high. Outside, the last rays of early-summer sunlight pierced a low cloud cover. Dave turned back to me, shaking his head. “I can’t see anything.”

Alarmed, I threw out the most outrageous, most hyperbolic question I could think of. I went for the worst, lobbing my darkest fear so that it could be debunked with Dave’s reply of “No, that’s ridiculous,” and a laugh of dismissal. I asked: “Dave, are you having a stroke?”

“Maybe,” he replied, his voice eerily quiet.

My heart dropped. Dave was not an alarmist. I tend to be the alarmist, convinced that a swollen gland is cancer or a persistent cough is surely pneumonia. But Dave never gets ruffled about that sort of thing. In fact, it would frustrate me sometimes, how hard I had to work to ruffle him when I was convinced that I had some freak medical condition (I had accurately self-diagnosed a hernia a few years prior, and I believed that that entitled me to at least a few years of self-righteous medical opinions). But Dave rarely went for it; I guess after you’ve seen enough gunshot wounds and car accidents, you learn how to not sweat the small stuff.

And yet, Dave was clearly alarmed now. And that realization—that was scary.

“I’m going to get help, be right back.” I shot up out of my seat and ran to the rear of the plane, charging toward the unsuspecting Alaska Airlines flight attendant. “You need to make an announcement—we need a medical professional. My husband can’t see a thing, and his right eye is weirdly dilated.”

The flight attendant, a petite woman with tidy blond hair and a wide, kind face, read the alarm on my features and mirrored it back to me. “What seat are you in, honey?” I told her, and she picked up the cabin phone to make the announcement over the loudspeaker, asking for any medical professional aboard the flight to meet us at Dave’s seat.

As it turned out, there was a nurse seated right behind us, and she hopped into our row and began speaking to Dave. I returned to our row in time to see her questioning him: “Close your left eye, look just with your right eye. Now, how many fingers am I holding up?”

“I can’t tell,” Dave answered, his voice vacant, unnaturally quiet. And then he shut his eyes. Fell asleep, without ceremony or pronouncement. Just like that, he was gone. I did not know it then, but it would be a very long time before Dave came back.

Chapter 2

New Haven, Connecticut

September 2003

It was not exactly love at first sight. In fact, in the beginning, I got Dave Levy all wrong.

We met for the first time in the early autumn of our freshman year. “Camp Yale” is what it is called, a manic and fabulous time right before classes begin, when everyone on the freshman quad is buzzing about, wide-eyed and name-tagged, working hard to set course schedules and learn building names. All interactions in those first few weeks unfold around valiant efforts to find commonalities, exploratory questions to sniff one another out, efforts to gauge whether initial and tenuous points of connection might potentially bloom into genuine friendship.

Oh, you’re from Annapolis? My roommate is from Baltimore! Do you know her?

Oh, you’re interested in ancient Greek philosophy? I loved My Big Fat Greek Wedding!

Oh, you’re on the field hockey team? I am seriously considering intramural Ultimate Frisbee.

And so it goes.

I was out with a big group of people on a Thursday night. It was a quintessential college bar called Old Blue, attached to the lobby of a New Haven hotel, with green carpeting and a big wooden bar in the center with cheesy gold accents. We were freshmen, only eighteen at the time, and so we were not exactly permitted to walk in through the front door of this bar. Our way in came instead from sneaking down the adjacent alley, hopping a chain-link fence, and slipping through the back door of the hotel. From there, after a discreet amount of time (spent hiding in the hotel lobby bathroom), we would slide our way through the lobby and into the bar, hopefully without catching the attention of the doorman on the other side. It was not a sure thing; Thursday nights at Old Blue were notoriously risky, made all the more fun by these thrilling elements of adventure and mischief and, if successful, triumph.

That night, our attempt was successful, and my friend Marya and I slipped giddily into the bar. Very quickly, Marya became engaged in a chummy conversation with a guy I had not yet met. Marya played on the women’s lacrosse team, and I quickly gathered that this guy, Dave, was on the men’s lacrosse team, and that the two of them already had mutual friends and experiences in common.

As I stood there, the unathletic odd one out, I observed Dave. I noted his fit, well-built physique, his quick quips and easy laughter. His interest in a friendly chat with Marya. His apparent lack of interest in talking with me. At one point he turned to me and asked: “Where do you go to college?”

I stared at him in silence, taken aback. I went to the same college he did. The college whose campus literally enfolded the bar in which we stood. The college after which this bar, Old Blue, was named. Had he really just asked me that?