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Leann sat beside me on a popsicle-orange plastic chair, wearing an over-sized college sweatshirt and gym pants. Her small feet were hooked on the metal rungs of the chair; she had one hand on my knee. The other sleeve was pushed past her elbow and on the pale skin of the inside of her arm was a small patch of cotton fastened with medical tape. She read a pamphlet about colitis; other thin booklets of information, printed on cheap recycled paper, lay in her lap. Stroke, HIV, Acid Reflux Disease — they fanned out across her slim gray thighs. She read them one by one, cover to cover, and then carefully placed them on the low table next to her chair.

“Hey,” she asked me finally, “doesn’t Uncle Mort have colitis?”

“I believe so,” I said.

“It sounds disgusting.”

“That’s always been my understanding.”

Her hair was pulled back in a loose ponytail, momentarily tamed by an elastic, but then it sprang out and fell down in her back in a spray of unruly curls. I thought of the conditioners and balms, the slimy feel of all the products I had pulled through it over the years. She inherited this hair from her father, who kept his cropped close to his head — his was now mostly silver, less peppery than it used to be. He did not know where we were — that is, a hospital in the town where Leann attends college, fifty miles from our home — a visit I had passed off as casual: a lunch, a shopping trip, the purchase of a refrigerator for her dorm room.

A nurse appeared in a doorway then — doors that were that green painted metal common to medical facilities. She was holding a clipboard and she said Leann’s name while scanning the room, her eyes slightly above our heads — even though we were the only people in sight. Leann stood up. She squeezed my hand and smiled — when she did I saw that scar on her forehead, a slash mark between her eyebrows that has been there since she was a baby and fell over in her highchair. She wore no makeup, no jewelry; she had the scrubbed healthy look of a Mormon girl. This was not due to the day’s event, the sober reason for the trip: Leann never wore makeup, never pierced herself; she has been a vegetarian since the age of eight.

Picking her up in front of her dorm earlier — a grim brick building at the edge of a massive parking lot — I watched her peers spill out of the doors, baring their midriffs aggressively, wearing jewelry in the unlikeliest of places — and that was only what was visible to the naked eye. When she skipped down the steps a few moments later Leann seemed like a refugee from a place without television and fashion magazines, the kind of girl on whom the media has had no effect at all. I was grateful for that at least.

“Be careful,” I told her as she walked away, and she turned around and gave me a wink. I watched her put her hand on the nurse’s shoulder as they passed through the doors and the gesture suggested it was Leann who was doing the ushering inside, the one offering comfort.

When she was gone I picked up the pamphlets she’d left and flipped through them. Then I shredded their edges into confetti and poured it from one hand to another. My coffee had gone cold and I dumped it into a potted ficus and snapped satisfying little pieces from around the lip of the cup. I accumulated a handful of this garbage and then looked around for a place to dispose of it. Eventually, at a loss, I tucked it in the silk-lined pocket of my raincoat, where it made a soft little pouch against my hip.

An hour or so ago, when we pulled into the hospital parking lot, Leann was craning her neck, looking for trouble. It made me smile. She more than half wanted protestors thronged at the doors, shouting bloody threats, holding up signs and awful things pickled in jars. It was typical of Leann to want to wade into such a fight, to battle for her rights. She has that kind of self-righteous fire — over the years she has applied it to the plight of circus animals and harp seals, deforestation, dolphins caught in nets, whale hunting, other atrocities I can no longer recall.

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