I had parents, but one was a ghost story and the other treated raising me like a debt she truly resented paying. By my senior year, I had learned how to be entirely low-maintenance. I kept my grades high, worked a part-time job at the local library, and did all of my own laundry.

I made my own medical appointments and rarely asked anyone for a ride. I never complained when my dinner portions were smaller than Chloe’s or when I was left behind. I think my potential to succeed frightened my mother more than my failure ever would have.

If I became successful, it meant I might eventually leave, and she was not ready to lose her favorite target. So, when the sharp pain hit me again in the middle of class, I did not raise my hand to ask for help. I put my head down on the cool surface of my desk and pretended to study the equations.

A cold bead of sweat rolled down the back of my neck. The fluorescent lights in the classroom suddenly felt much too bright, and the humming sound they made seemed to sharpen in my ears. I swallowed hard against a sudden wave of nausea and tried to breathe slowly through my nose.

Five minutes passed, and then ten more, but the pain did not fade away. It gathered itself into a localized heat in my lower right side, feeling as though a hot nail had been driven into my flesh. I knew enough from my health classes to be terrified of the word appendix.

However, fear did not make me brave enough to speak up. Fear only made me think of how my mother would react if she had to leave work. If the school nurse called her, she would be annoyed by the interruption.

If I told her it hurt badly, Rick would ask if I was dying or just being a drama queen. If Chloe had plans for the afternoon, I would be viewed as the problem that ruined her day. The thought of dealing with their collective irritation was almost as unbearable as the physical pain itself.

People who grow up in loving homes do not always understand the hesitation. When you are neglected for a long time, asking for help feels like setting off a fire alarm in a building where everyone already blames you for the smoke. I managed to last another seven minutes before my vision started to go grainy around the edges.