A nephrologist reviewed her treatment schedule and discussed realistic options.

None of it was miraculous.

The appointments, uncertainty, and fatigue continued.

Desmond offered to pay the balance.

I thanked him but asked first for a reliable salary, a written employment contract, and boundaries that would protect Pearl as well as me.

“You’re afraid a gift would make you dependent,” he said.

“I’m afraid of any arrangement in which gratitude could be mistaken for permission.”

He considered that.