I lowered my eyes to the folder. “No.”

Pearl searched my face but didn’t press. She just reached over and squeezed my hand, and that small gesture nearly brought me to tears. My closest friend had crossed a busy street in the middle of her workday because she didn’t want me facing a doctor’s appointment alone.

My husband had wanted me to cancel it so his mother could shop for designer handbags.

A nurse soon called my name and led us to an exam room. A few minutes later my gastroenterologist came in with my chart and a tablet, reviewed my recent lab work, questioned me carefully about my symptoms, and examined my abdomen.

The more I described the worsening pain, the weight loss, the nausea, the exhaustion, the more serious his expression became.

Because my first round of medication had failed and my condition had deteriorated, the clinic had already arranged more testing. An abdominal ultrasound ruled out problems with my gallbladder and nearby organs, and after reviewing those results, my doctor scheduled an expedited upper endoscopy in the clinic’s procedure unit.