Rosie seemed preoccupied with her shoe. She was bent over and busy with the lace, so Isabelle looked at the back of her head. “Belle,” Rosie began, aiming her words at the sand, “I don’t want to beat a dead horse but we need to talk some more about the doctors.”

Isabelle watched her twist her shoe lace as she formed the final loop. “You’re making a granny bow.”

“You’re changing the subject.”

“But your lace will come undone again. I can show you …”

“It won’t come undone,” Rosie enunciated as she doubled the knot. Her tone was tight and parental.

Isabelle led them to the firm sand near the water and turned north. “Okay. Talk to me about the doctors.”

Half a minute passed. Rosie spoke: “Look. I know you hate it when I order you around, but that’s not where I’m coming from. I love you. You’re my best friend. I want you here, alive, for me as much as for you. I’m probably being selfish: I want you to do whatever is necessary to prolong your life. Right now, I guess I care more about quantity,” she paused and smiled up at Isabelle, “than quality.”

“Hmmm.”

“Hmmm?” Rosie managed to load her murmur with sarcasm. She also stopped walking. Isabelle felt compelled to respond.

“Rosie, they don’t have a surefire protocol. They admit their chemo/radiation/surgery mix has only succeeded, so far, with a third of the cases and, so far, we’re talking less than three years of remission. That’s how new it is.

“And it’s nasty. The patient is sick or debilitated throughout. For what? A couple of years, ill and ill-tempered? I’d rather be remembered now.”

They plodded on side by side. Their heels cut scallops in the cinnamon sand while Spot zigzagged ahead. Isabelle continued:

“I’m sorry, Sweetie, but I just don’t have confidence in the MDs. They’ve never been right for me. Shit: their pregnancy tests didn’t even work!

“I can’t bear it. It may not make sense, but I just can’t smell the hospital smells again, or lie there again in miserable discomfort, waiting for some strangers to treat my body and ignore my self. I did it at 36, with the ruptured cyst and hysterectomy. I did it a lot at 49, with what should have been a simple case of food poisoning. I just can’t go there again. Death is better.”

Rosie was silent. She couldn’t summon a good argument. She’d known Isabelle since they were 17, and it was true that her friend had never had a meaningful medical diagnosis. Isabelle mostly didn’t need doctors. She rarely felt ill and when she did, she always seemed to understand what she had and what she needed, but it was a different matter, entirely, to convince the doctor. Then tests were necessary and time had to pass, with the result that healing took longer. “I don’t know what to say,” Rosie admitted. “You know I love you and respect you. I hope you’ll change your mind.”