Page 64 of Madness

And then there's the other nagging thought, the one I've been trying to push away: Miles and Chloe. The coincidence of their deaths, the possibility that they were together... it's like a puzzle with mismatched pieces, and I can't stop trying to fit them together.

But should I? Do I really want to uncover a truth that could potentially destroy everything?

I sink onto a nearby bench, suddenly exhausted. The cool metal seeps through my jeans, grounding me in the present.

I have an exam in less than ten hours. An exam that could determine the course of my future, and my ability to provide for Roman. I can't let my personal life derail everything I've worked for.

And yet...

I pull up the photo of Dakota and Roman building a pillow fort in the living room. Their smiles, so genuine and carefree, make my heart ache. This is what I'm fighting for, I realize. Not just a degree, not just a better future, but the chance at a family, at happiness.

But at what cost?

With a deep breath, I put my phone away and pull out my flashcards, squinting at them in the low light of a nearby post. Beta-blockers, ACE inhibitors, calcium channel blockers... I can do this. I have to.

As for Dakota, Miles, Chloe, and all the unanswered questions... they'll have to wait. At least for tonight.

But as I force myself to focus on pharmacology, I can't shake the feeling that everything is about to change. For better or worse, I'm not sure.

All I know is that when the dust settles, I need to be standing – for myself, for Roman, and maybe, just maybe, for Dakota, too.

The scratch of pencils on paper fills the air, punctuated by the occasional cough or shuffle of feet. The exam room smells of anxiety and cheap floor cleaner, a combination that turns my stomach. I shift in my hard plastic chair, trying to find a comfortable position as I stare down at my test booklet.

Question 17: "A 65-year-old patient with hypertension and diabetes is currently taking lisinopril. Which of the following would be contraindicated?"

I close my eyes briefly, taking a deep breath. The fluorescent lights hum overhead, matching the buzz of tension in my body. I know this. ACE inhibitors, diabetes... my mind races, flipping through mental flashcards.

A sudden vibration against my thigh makes me jump. My phone. I'd forgotten to turn it off completely. Panic floods through me as I fumble to silence it, my hands shaking. Sweat beads on my forehead as I pray the proctor hasn't noticed.

Heart pounding, I glance around the room. Other students are hunched over their papers, some frantically writing, others staring blankly ahead. The proctor paces slowly at the front of the room, her eyes scanning for any sign of cheating. I let out a shaky breath.

But now my concentration is shattered. Who was calling? Was it Dakota? Is he okay? Or worse, is he not okay?

Stop it, I tell myself firmly. Focus. This exam is everything. Your future depends on it. Roman's future depends on it.

I turn back to the question, willing my racing heart to slow. Contraindications for ACE inhibitors... The answer comes to me suddenly. Potassium-sparing diuretics. I fill in the bubble, a small surge of confidence flowing through me.

Question 18: "List three potential side effects of beta-blockers."

I start writing: Fatigue, cold extremities, bradycardia...

The clock on the wall ticks loudly, each second a reminder of the time slipping away. Two hours left. My stomach churns as I realize I'm only a quarter of the way through the exam.

Question 19: "Explain the mechanism of action for calcium channel blockers in the treatment of hypertension."

I close my eyes, visualizing my textbook.

As I write the answer, I'm acutely aware of the pressure building behind my eyes, the beginnings of a stress headache. I roll my shoulders again, trying to release some tension.

A student two rows ahead stands up abruptly, startling me. They hand in their exam and leave. I glance at the clock again. How did they finish so quickly? Doubt creeps in. Am I going too slowly? Did I miss something?

No. Focus. One question at a time.

Question 20: "A patient experiences a dry cough after starting a new hypertension medication. Which class of drugs is likely causing this side effect?"

ACE inhibitors, I think, immediately. At least, that's straightforward.

As I move through the questions, time seems to both crawl and fly. My hand cramps from writing, and my eyes burn from the strain of reading. But I push through, each answered question a small victory.

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