My sister and I walked the same road—same medical school, same sleepless nights. But when it was over, our parents cleared her debt… and left mine behind.

On my second Friday in Baltimore, Dr. Fleming slid a stack of forms across her desk. “You’re officially the principal analyst of Cohort A,” she said. “It’s more administrative headache than glory, but it means the committee trusts your brain.” Then, softer, “Your brain is not the only thing we need, Audrey. Protect your sleep. Call your sister. Call your therapist if you need one. Excellence without a human attached to it is just a paperweight.”

I nodded, trying not to make a joke. I had spent so many years proving I could do hard things that I sometimes forgot to be a person while I did them.

Two weeks later, a thick envelope arrived from home. My parents had mailed printed photos from Jessica’s celebration, as if the night would look kinder on glossy paper. There I was, slightly off-center in frame after frame, smiling politely while my parents steered conversations back to Jessica with the social grace of seasoned surgeons. Tucked among the photos was a handwritten note in my mother’s looping script: We are proud of both our girls. Dinner when you’re home? Love, Mom. Below, in my father’s careful print: Very proud. Dad.

I placed the note in a drawer with Elaine’s locksmith card and left the photos on the table until the edges curled.

The first child I consented into our study was a boy named Theo who loved space documentaries and hated needles. His mother asked the kind of careful questions that usually indicate an online rabbit hole. “How many children have been through this protocol? What are your pre-specified endpoints? Has the FDA made noises about the pharmacologic component?”

I answered each one, grateful for the hours I’d spent with the institutional review board. When we finished, she exhaled and said, “I didn’t mean to give you a hard time. The last month has made me into someone I don’t recognize.”

“I think she’s called ‘a mother,’” I said. We signed. Theo flinched at the blood draw and then told me the moons of Jupiter in order.

That night Jessica texted a photo from a break room where a resident class sat on the floor in wrinkled scrubs, eating cold hospital pizza from the box. Her caption: Nobody told me the mozzarella would have PTSD. I sent back a picture of the Inner Harbor lights and the caption: Nobody told me the lights would look like ECG tracings.