"It's over," I said to Jai. "My goose is cooked." "What do you mean?" she asked. I told her the CA 19-9 value. She had educated herself enough about cancer treatment to know that 208 indicated metastasis: a death sentence. "It's not funny," she said. "Stop joking around." I then pulled up my CT scans on the computer and started counting. "One, two, three, four, five, six …" I could hear the panic in Jai's voice. "Don't tell me you're counting tumors," she said. I couldn't help myself. I kept counting aloud. "Seven, eight, nine, ten …" I saw it all. The cancer had metastasized to my liver. Jai walked over to the computer, saw everything clearly with her own eyes, and fell into my arms. We cried together. And that's when I realized there was no box of tissues in the room. I had just learned I would soon die, and in my inability to stop being rationally focused, I found myself thinking: "Shouldn't a room like this, at a time like this, have a box of Kleenex? Wow, that's a glaring operational flaw." There was a knock on the door. Dr. Wolff entered, a folder in his hand. He looked from Jai to me to the CT scans on the computer, and he knew what had just happened. I decided to just be preemptive. "We know," I said.