Chapter 1 — Permission to Breathe

I was ten years old when Nana carried me into a small prairie clinic with my back brace held shut by a tiny steel padlock.

“Disobedient children stay right where they’re placed,” she told the receptionist, looking her in the eye, and she did not offer up the key.

When the surgeon finally cut the lock away and the little chain slid off and hit the linoleum floor, I looked up at him and asked whether I finally had permission to breathe again.

I have thought about that question many times since — that a ten-year-old would ask a stranger for permission to breathe, and would think it a reasonable thing to ask, because permission was the only currency I had known for a very long time.

The room smelled of sharp bleach and burnt filter coffee.

I had not eaten a single bite of breakfast, because Nana had a rule that a child who complained on the morning of an appointment did not need food sitting in her stomach to make her sick on the drive.

My ribs ached in the dull, constant way I had stopped really noticing, the way you stop noticing a sound that never turns off.

I held myself very still on the exam table, because I had learned, without anyone teaching me, that stillness was the cheapest way to keep the pressure from getting worse.

The surgeon crouched down beside the cut plastic and lifted one end of the little chain, careful not to let his gloves touch my skin, as though the skin itself were the tender thing that had to be protected now.

Somewhere behind him a big fly kept tapping against the window screen, patient and stupid, trying to get out through a thing it could not understand was there.

I understood the fly.

I had spent a year of my life pressed against something clear and hard that no one else seemed able to see.

Chapter 2 — The Seat Belt

His name tag said Dr.

Shepherd, and I fixed my eyes on it, because looking at a fixed thing was another trick I had for getting through appointments.

Nana folded my winter coat across her lap and smoothed the wool with both hands, slow and even, the way she did everything in front of other people — carefully, for an audience.

“She takes it off the moment my back is turned,” she said, shaking her head with a sorrowful little patience.