METASTATIC HEARTBREAK • by Katie Pugh

Looking at the needle, it didn’t seem like much. One inch of steel. For all it could do — would do — surely it should be bigger. The doctor, a big man, comfortable in his craft, pulled carefully at the plunger, and they watched together as the barrel fill with clear liquid. Tap, tap, tap. Three taps.

Three years. Tim’s lips moved in a silent, uncertain prayer that fumbled over his lips and teeth. Maybe it was because he had waited so long to do this. With the pain everywhere in his body, how could he hope that one prick could fix it all?

A bit of pressure made bubbles float to the needle blade’s tip. A few drops landed on his arm in the same pattern as tears, and his mind went far away, to a girl he knew wasn’t thinking of him. She could never look at him when she cried, and when she buried her head in his chest, the tears would fall in soft notes on his arm. They would sit paralyzed in the symphony of her sorrow, and, even in those painful hours, he loved her.

The doctor pressed a cottonball soaked with alcohol to Tim’s shoulder, cold, wet, clean. Purifying. What could even be there? Something left of her lips to wipe away? There, where she would mold her softness against his bony body, punctuate their goodnights with kisses in that spot, name each of his freckles after a star.

“All right,” the doctor said, a smile curving into his doughy cheeks. His eyes, blackholes magnified by very thick glasses, made Tim recoil. “It will just be a little pinch, son.”

When the doctor’s thick hand splayed warm and hard on his arm, Tim found his mouth saying, “Wait. I’m not ready.”

The room stilled for a moment. The doctor’s mouth curled down briefly and then relaxed with weathered acceptance. Surely nobody walks into these procedures with a schedule to stick to, with other plans, things to do. It must be hard for everyone, right?

She never liked needles. Not that she would have ever been here. Why did his mind keep running away to her?

“Tim, do you need to talk about this again?” the doctor asked. His white coat hung over his rotund belly, and the chair opposite the table squealed a bit as he sat down.

Again. Yes, they had been talking about it for weeks, had signed the papers, put in the required therapy hours.

You only ever think of yourself. She was right. He always just thought of himself.

The doctor removed his glasses, pinched the bridge of his nose and the blackholes shrunk into a face full of soft lines. He must have waited too long to respond. “Tim, I understand this is a hard decision, but everyone is getting this treatment these days. It’s revolutionary medicine. People are happier, healthier. No noticeable side effects, aside from the obvious, of course. You’re not the only one who has been nervous before the injection, but I can guarantee…all patients I’ve dealt with have felt better afterward. Immediately. You’ll find you no longer want for those…habits you developed after your breakup. Who knows? Maybe she did the same thing.”

He tried to see her sitting here, slim wrists pressed together as she pushed her long fingers between her knees, sleeve rolled up and ready for blissful chemical abandon. But no. All he could see was her walking out his door, bag slung on one shoulder, the softest touch of a smile that tried to be sad for him. Falling out of love had come as naturally to her as finishing the book she left on the bedside table. Her bedside. She hadn’t spent nights in the arms of whatever drug or alcohol was in easy reach, doubled-over constantly clutching some sock or undergarment found under the couch.

“Nothing kills as much as love,” the doctor said. “It started as speculative science, but… well, look at the results.” The smile made another appearance, trying to infect Tim with readiness. “A cure. A vaccine. Against love itself. You’re lucky to be here, son. Not many people can afford it. And some people wait until… it’s too late.”

Tears suddenly dropped from his eyes, heavy and silent. Yes, he had the money. Had been saving for their wedding. A house, maybe. A car. The dog she wanted. All gone so he wouldn’t be one of “some people”, covered in the filth of their loss, getting up to bathe in the warmth of another until the hot water ran cold.

He nodded once, and the syringe appeared again near his arm.

Just an inch of steel. He was glad, then, it wasn’t bigger. There was the pinch, nothing more, and he waited. Waited for the feeling to be thrown off like a heavy winter coat, waited for love to explode out through the tiny pinprick in his shoulder like a shrieking exorcised ghost.

At first, nothing. Nothing but one small drop of blood.

Then, he recalled her face. Blemishes on the chin, the crinkle of her nose, the heavy sound of her footsteps down the hall that one last evening. It only hurt faintly, like a dull hunger in an empty stomach. He felt like he was breathing for the first time in months. And his mind left her far away. He was alone.

There was a handshake exchanged after that, a familial pat on the shoulder. He stepped outside into the autumn air, greeted the falling leaves and cold, and started walking without any idea where to go.

Lovefree? Loveless? Alone.


Katie Pugh is a local writer in Pittsburgh, PA, where she lives with her husband. Originally born in Virginia, Katie moved northward after graduating from college in search of excitement and snow (she figures one out of two is pretty good). She pens urban fantasy and “strange” fiction. Her writing has been featured online on Every Day Fiction, Airplane Reading and The Shortest Fiction.


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