Mrs. Stevenson was not going to die. Molly watched Ian as he sat on the edge of his bed, gazing at the fishbowl on his dresser. He looked much younger than his five years in his blue and yellow race car pajamas. Mrs. Stevenson swam erratic circles around the perimeter of the bowl, blue fins curling and uncurling. Molly was worried; there wasn’t much anyone could do for a Betta fish with tuberculosis.

“I’m not a fish doctor, sweetie. I don’t think there’s anything I can do for him,” Molly said.

Josh stuck his head in the doorway, finally home. “What’s this about the fish?”

“Daddy!” Ian jumped off the bed and landed in Josh’s arms. Still wearing his scrubs, hospital badge swinging, he looked at Molly.

“Mrs. Stevenson isn’t doing so well,” she said.

Josh set Ian back in bed. “I still can’t believe we have a Betta named Mrs. Stevenson. A male Betta.”

Ian had insisted on the name. When their elderly neighbor, Mrs. Stevenson, had brought the fish over one afternoon, he refused to consider anything else. Josh had called the fish Steven for at least two weeks before finally giving up. No one could withstand Ian for long.

“He looks just like Mrs. Stevenson,” Ian said, giggling. Molly pulled the covers up to his chin and kissed him on the head. “It’s the best name ever. And he’s going to be fine.” His voice grew quiet as he closed his eyes. “Happy fish don’t die.”

Molly closed the door carefully as she followed Josh out of the room. They stepped past the other door, the one they never open, and into their bedroom.

Josh didn’t even shut the door before he started. “Why in God’s name are you telling our son that his fish is going to die?”

His voice hit Molly like a slap and she inhaled. Patience.

“If you took a close look at that fish, you would see it’s pretty obvious,” she said. “Fish tuberculosis. Mycobacterium marinum.”

The decline had been happening for weeks—loss of appetite, reduced activity—but then one day she noticed the angulation of the fish’s spine, the sharp turn halfway down his narrow blue body. A quick Google search (“Betta fish with crooked spine”) had supplied the answer.

“How do you know that? Is it some new part of pediatrics training nowadays?” He raised his eyebrows. This was his new favorite facial expression. Somehow it managed to convey impatience, disbelief, and condescension at the same time.

“I looked it up.” Molly headed into the closet, shaking her hair loose from its ponytail. It had been a long day at the clinic, a hard day in a series of very hard days, and she was ready for bed. She wouldn’t mention her sources—various aquarium keeper websites, and a message board for Betta lovers. She didn’t want Josh’s eyebrows to raise again.

“Well, just flush it,” Josh said. Molly could tell that he had flopped onto the bed. Probably with his shoes still on.

“I’m going to see if there’s anything that can be done to treat it first.” She stepped back into the room. Yep, shoes still on.

“It’s a damn Betta fish that probably cost five bucks. Just flush it and get him a new one.” Josh stared up at the ceiling. His voice was flat, expressionless. Molly pulled on her robe.

“I’m not ready to do that,” she said. “It’s too soon.” Josh closed his eyes. Maybe he understood? Molly held her breath. Instead, Josh rolled over and stood up.

“You leave me any dinner?” He was already out the door and down the hall before Molly could respond.

Of course I did, she thought. Don’t I always?

Alone, Molly lowered herself into bed and pulled the duvet up to her neck. She thought of the day they met Mrs. Stevenson. The person, not the fish.

They had just moved into the neighborhood and Mrs. Stevenson was the first to stop by, bearing a plate of cookies. Ian wasn’t even three yet, but he had instantly warmed to her. Whenever he saw her around the neighborhood, he would run over and strike up a conversation. Mrs. Stevenson would answer him seriously, her blue eyes sparkling beneath her snowy hair.

Over the years she continued to bring over special treats for Ian and he reciprocated with tiny gifts left on her doorstep—acorns, a special leaf or an unusual rock. So it hadn’t been strange—no matter what Josh thought—when she knocked on the door a couple years later with a blue Betta fish and a small round bowl.

“I heard there’s a little boy in this house who needs a friend.” Mrs. Stevenson’s voice had been just audible from Molly’s hiding place in her bedroom. Josh had answered the door, and Molly could tell from his silence that he didn’t know what to say. But Ian had been delighted, and a few minutes later he bounded down the hall to show off his new pet.

“I’m going to name her Mrs. Stevenson,” he said, his eyes shining.

“I’m pretty sure that’s a boy fish, buddy,” Molly said, sitting up. Her brother had kept Bettas when they were little. She remembered that the males were brighter with long, flowing fins—and they had to be kept in their own individual bowls or they would fight each other to the death. Josh stood in the doorway, raising his eyebrows. Maybe that’s when the eyebrow raising had started—or when Molly first started noticing it. And being bothered by it.

Ian hadn’t cared if it was a boy or a girl fish. He was delighted with his new friend and insisted that the fish bowl be placed on the dresser right next to his bed, where he could see it as he fell asleep every night.

Ever since then, his bedtime routine had expanded to include a good-night to both Mrs. Stevensons. First, he would look out the window toward his favorite neighbor’s house and shout “Good-night Mrs. Stevenson!” Then he would smile at the bowl with the circulating, undulating blue fish. “Good-night Mrs. Stevenson,” he would say once again, falling against his pillow.

Shouldn’t a Betta last longer than three months?

Get up, Molly told herself. She still needed to take off her make-up, wash her face, brush her teeth. But she had nothing left for today, and she reached into the top drawer of her nightstand and retrieved a sleeping pill from a nearly empty bottle. Then she curled onto her side, closed her eyes, and waited for darkness to come.

Mrs. Stevenson continued to look worse. He became sluggish, then developed spots along his sides. Molly did more Googling at work, in the small window of time between a two year old with an ear infection and a ten year old with asthma. She looked through various fish websites and several message boards. All of them agreed: fish tuberculosis is fatal.

The information seemed reliable—and it wasn’t just from someone with the moniker BETTAS4EVAH. No treatment. Even worse, it was easily transmissible to humans if the fish or its water was handled. Molly scrolled through images of red, weeping sores on various body parts; her hands itched as she remembered changing the fishbowl water last week.

“What are you looking at Dr. M?” Molly’s medical assistant leaned across her and pointed a black-painted fingernail at the computer screen. “That looks nasty.”

Ashleei—she of the excessive vowels and poor personal space awareness—made up for her failings by her ability to give vaccinations at lightning speed and fend off irritated parents. All of Molly’s partners wanted to steal her. Over my dead body, she told them.

Molly explained briefly, then watched Ashleei’s mouth twitch as she listened. She didn’t get it. Molly clicked to the next patient’s chart. Tried not to think about Ian’s hopeful face that morning when he asked Molly to find medicine for Mrs. Stevenson.

Josh was right. Time to flush.

She made a mental note to bring home some latex gloves. Just had to figure out how to talk to Ian about it. She ignored the ache in her chest and moved on to the next patient.

The last appointment of the day was with Anna. Anna had a rare, progressive genetic disorder that was named, like most rare disorders, for the long-dead neurologists who first characterized it: Werdnig-Hoffmann. Although she had a host of specialists involved with her care, she still visited Molly regularly. If she had an ear infection, if she had an urgent issue, or even if her parents just needed to talk, they would come to Molly.

That’s what we’re here for, she always told Ashleei when she made a face at seeing Anna’s name on the schedule. That’s a pediatrician’s job.

As soon as Molly opened the door she could tell this wasn’t an ear infection or even something more urgent, like a UTI or pneumonia. Anna’s mom and dad sat close together in the brightly patterned plastic chairs, linking hands as if they were afraid of falling. Anna was sleeping in her tiny wheelchair, hands curled into fists, dark hair tied with a pink ribbon that matched her dress.

Molly set the chart and pen down before sitting on the stool. She rolled close enough that she was looking directly into their faces.

“How is Anna doing?”

Anna’s mother began to cry, silent tears spilling out onto her cheeks as her shoulders rocked. Anna’s father shook his head and rubbed his wife’s back.

“They say there’s nothing more they can do. They’re recommending hospice.” His face was gray, his shoulders slumping as if they bore a substantial load.

“And what do you think?” Molly tried to keep her voice gentle, reassuring. Professional. She had known this was coming for a long time, ever since she first received the report detailing Anna’s diagnosis. Didn’t make it any easier, though.

Anna’s mother wiped her face with the back of her hand. “I don’t think I’m ready.” She leaned her head against her husband’s shoulder, who rested his head on hers.

“No one is ever ready for this,” Molly said. She would never forget the tiny hands with the perfect translucent nails, the wispy black hair. The floppy limbs that caused the first flicker of doubt. Anna never fed well, never slept well. It had taken four long months to get a firm diagnosis. Molly would never forget that conversation, either.

Anna’s father shifted his weight in the chair. “She’s been through so much. We just want her to be comfortable. To be at peace.” He gripped his wife’s hand. “But we aren’t sure. Is this the right thing?”

They both looked at Molly. She thought: I am Anna’s doctor. She had met Anna the day she was born. Molly was the one who pronounced her absolutely perfect on that first day, wrapped her tightly in a blanket, and placed her in her mother’s arms. Molly was the one who later had to take back those words.

Molly sat with Anna and her parents for a long while that evening. They talked about Anna, about her favorite shows and stuffed animals. They talked about risks and benefits, about the burden of treatment, then about comfort and letting go. By the time they left, the office was quiet and dark. Ashleei had already called Ian’s babysitter to let her know that Molly would be late. Molly fought the urge to apologize—she didn't do this very often.

As Molly finished her charting, she looked up to see Anna’s parents walking out of the clinic. Anna’s father pushed the wheelchair with one arm and encircled his wife with the other. From a distance, they looked like a single body moving down the hall. Molly was not envious of their circumstance, but she was envious of that.

Josh was home in time for dinner that night and Molly was embarrassed there was nothing more than leftover chicken and vegetables. She hadn’t had much time to make anything else, and besides—when had Josh last made it home for dinner in the middle of the week?

Ian bounced up and down on his chair. “Daddy, after dinner can you go outside with me and look for bugs for my bug catcher?” He wouldn’t let Molly look for bugs with him. Daddy had given him the bug catcher, and Daddy would be the one to use it with him.

“Sorry, buddy. I have to get back to the hospital tonight.” Ian’s face fell.

“You haven’t been home for dinner in weeks,” Molly said. “Why do you have to leave again?” She knew her voice was taking on the petulant tone that Josh hated, but she didn’t know how to stop it.

Josh raised his eyebrows. “I have a procedure to do tonight. A patient to take care of. I was trying to be helpful by coming home for a bit. Guess I should have stayed at work.”

“You’re always at work,” Molly said, glancing at Ian. He seemed absorbed in chasing a few peas around his plate.

“We have nearly a half million dollars in student loan debt between the two of us,” Josh said. “A part-time pediatrician’s salary is certainly not going to pay that off, especially not the way you practice. We have a mortgage and two car payments. Somebody has to bring in some money.”

She wanted to fire back—somebody has to pick up our son from school, somebody has to make dinner, go to Costco, pick up the dry cleaning. But she stayed quiet. Her cheeks grew hot and she closed her eyes. When had this become their marriage?

They had always seemed on the same track, through the never-ending years of medical school and residency. Studying together, supporting each other through the long hours, the short nights, the many exams. In the beginning, Molly was always the most driven—top of the class, matched into her first-choice residency.

But when she started practicing, Josh continued training. Fellowship after fellowship, until he was so specialized even Molly wasn’t quite sure what he actually did. Molly cut back her hours when Ian was born, left her prestigious academic position and joined a local community practice. She hadn’t even minded. That wasn’t true—it had bothered her, but they couldn’t both keep up that pace. This had been creeping on us, Molly thought, but we were managing. Then life hit with a silent sledgehammer three months ago and they hadn’t recovered.

That night, hours after Josh kissed Ian and walked out the door, Molly tucked Ian into bed. As usual, she ended up next to him in the narrow bed, her body angled to allow him the most space. She couldn’t find it in her to talk to Ian about Mrs. Stevenson’s impending demise. Not yet.

So they went through the normal good-night routine, ending with a final glance at the fish bowl. Mrs. Stevenson wasn’t looking so busy anymore. The water was getting murky—Molly didn’t dare touch it—and the fish seemed to slump rather than swim.

“Mrs. Stevenson isn’t going to get better, is he Mom?” His hair tickled Molly’s chin.

“I don’t think so, buddy.”

“Mrs. Stevenson gave him to me because I was sad.” He buried his face in her neck. “We were both sad, weren't we Mommy?”

Molly nodded. Ian’s hair smelled of strawberry shampoo mixed with sweaty little boy. She missed the baby-sweet smell of his tiny head when he was an infant.

“Daddy wasn’t as sad as us, but we were sad, right Mom?” Molly squeezed her eyes shut. She should have said, of course Daddy was sad. But she wasn’t sure.

The next day was Molly’s day off. Ian had a half day of school in the morning, and Molly usually spent the time working out and running errands. Well—she used to do that, before. Lately she had spent the hours in bed, staring at the ceiling, hands resting on her abdomen.

But today, she needed something to distract her. She brought her laptop into bed and hacked at the keys: Humane ways to kill a fish.

Apparently flushing was not considered humane.

There seemed to be quite a controversy regarding the most effective and gentle methods to dispatch a sickly pet fish. Some recommended placing the fish in a bag of water and then freezing it. This was felt to cause prolonged discomfort to the fish by most commenters, however. Others recommended decapitation with a butcher knife or snapping the fish’s neck sharply against your counter. Molly shuddered, thinking of tiny Mycobacteria spreading throughout her kitchen. She continued searching.

Tricaine methanesulfonate was FDA approved for anesthetizing fish and could be used at higher doses for euthanization, but it had to be ordered online and Molly didn’t have that kind of time. BETAS4EVAH recommended anesthetizing the fish with clove oil and then placing it in vodka until it died. Apparently it only took a few breaths.

She imagined the elevation of Josh’s eyebrows when she explained why there was a dead, clove-scented fish floating in a bottle of vodka. No way.

She slammed the laptop shut and glanced at the clock. Almost time to pick Ian up from school and she hadn’t even showered yet.

Molly was planning on taking Ian to the zoo that afternoon, but on the way she needed to stop by the office and sign a few forms. Ian loved the clinic. One of Molly’s partners was his pediatrician, and everyone there adored him. When they walked in, Ashleei greeted them.

“Hey Dr. M. Hey Ian dude!” They fist bumped and Ashleei led him toward the sticker jar. As Molly worked through the paperwork, Ashleei tugged on her arm and pointed.

“You got flowers,” she said, grinning. Molly followed her extended finger to a large bouquet of red roses in an oversized crystal vase.

Molly turned back to her paperwork, feeling brittle, as if she would snap and crumble if she moved too quickly. Only Josh would send flowers to my clinic on a day I’m not even working, she thought.

Ashleei retrieved the flowers and pushed them toward Molly, so she could see the inscription on the card.

Thinking of you on this day. I love you, Josh.

“Keep them,” she said to Ashleei, then reached a hand out to Ian. “Ready for the zoo, buddy?”

Molly caught Ashleei’s expression as they walked out the door. She didn’t understand. But Josh should have. Molly knew she had told him what flowers meant to her now. Within a few short days they would wilt, the petals darkening and curling at the edges. Flowers have an absurdly short lifespan, Molly thought as she clutched Ian’s small hand. Even less than a Betta fish.

That night, Josh came home in time for dinner again, and this time he didn’t leave. Molly was silent as he took Ian outside and filled the bug catcher. He gave Ian a bath and helped him put on his blue and yellow race car pajamas. He sat on the other side of the bed from Molly as they went through Ian’s bedtime routine.

Molly watched Mrs. Stevenson. He was barely moving. Halfway tilted over, like a tiny capsizing ship.

Molly couldn’t sleep that night. Josh had fallen into bed easily, fully asleep within minutes—the sleep of the innocent, Molly thought. She rolled over and slipped down the dark hallway, into Ian’s room again. Even in the dim glow of the nightlight it was obvious that Mrs. Stevenson was dead.

Molly managed to make it halfway down the hall before she started crying. She slid down the wall, pulled her knees into her chest. Ridiculous! A fish. Then she realized where she was—by the door to the room that had never been slept in. She lowered her head to her knees, pressed her hand to her mouth to muffle her sobs.

By then Josh was up, coming toward her in the dark, sitting down, his eyebrows drawn together.

“Mrs. Stevenson is dead,” Molly said.

Josh sighed, leaning his head against the wall behind him. “I don’t know what to do to help you, Molly.”

“I don’t want you to help me.” Why couldn’t he understand?

“I just feel so bad for you—”

“I don’t want you to feel bad for me, Josh.” Her voice broke. “I want you to feel bad with me. I want you to hurt with me. It’s like you don’t even care that we lost her.”

“Of course I care. It’s just that you’ve been through so much, and I didn’t want to make it worse. You’re hurting more than me. I realize that. But…I am hurting.” Molly glanced at his face, at the hollows in his cheeks and the shadows under his eyes. Not just from the long hours at work, she realized.

But she couldn’t shake the thoughts—irrational but irrepressible: I should have noticed that she wasn’t moving as much. I should have gone straight to the hospital. Why did I stay at work all day? By then it was too late.

Today, Molly thought. Today she would have been here. Nine months of looking forward to this day—six months, with anticipation. Three months, with dread.

Josh moved closer so his shoulder touched Molly’s. She heard soft footsteps and Ian’s door opened. He climbed into his parents’ laps and snuggled between them.

“Mrs. Stevenson is dead,” he whispered. “He’s belly-up in his bowl.”

Josh’s arm settled carefully around Molly, its weight an anchor. He wrapped the other arm around Ian. Molly closed her eyes and leaned against Josh’s chest, listening to the steady rhythm of his heart.

It was a full moon and none of them could sleep, so they crept into the backyard and found a spot under the apple tree. Mrs. Stevenson loves apples, Ian said. Josh and Molly glanced at each other. Which Mrs. Stevenson?

Molly helped Ian dig a small hole as Josh held the fishbowl, wearing the gloves Molly had brought from the clinic. Josh carefully poured the contents of the bowl into the hole. Mrs. Stevenson dropped, last of all, like a fragment of deflated balloon. They shoveled dirt back into the hole and placed a flat rock on top. Molly made a mental note to keep Ian away from this area for a while.

“Do you think Mrs. Stevenson will be mad that we didn’t invite her to the funeral?” Ian asked.

Josh raised his eyebrows at Molly over the top of Ian’s head. She smiled. “I think she’ll understand, buddy.”

They walked into the house, holding hands, and tucked their boy into bed.

Bradeigh Godfrey is an assistant professor in Physical Medicine and Rehabilitation at the University of Utah. She divides her time between research, clinical practice, and teaching. She enjoys creative writing.