Two days later, while Sadie was still in the hospital, the clinic confirmed she had been seen six weeks earlier and could provide records through its secure portal.

I opened the documents with my mother beside me.

There it was: a clinical note describing intermittent right-sided pain, abdominal fullness, and nausea.

The clinician had recommended prompt imaging and follow-up because a mass could not be ruled out.

Attached was a record that Curtis had declined the referral and said he would arrange care elsewhere.

But he hadn’t arranged care elsewhere.

I read the note three times.