Kayla crept around the extra-large suitcase lying open on the bedroom floor. The bag smelled musty after a year in basement storage. “Are you going somewhere, Ryan?” Warning flares exploded before her eyes, and she struggled to remain calm. “A work trip?”

“I’m leaving.” Her fiancé tossed his boxers into the half-packed suitcase. The tower of his socks toppled onto his rolled-up cashmere sweaters. Empty hangers taunted her from his side of the closet, even his winter wardrobe gone. “For good, this time.”

Why? She sat on their bed, quiet against the traffic noises rising from the busy city street. What had she done to provoke this? Once he had walked out because she wanted her parents to visit last Christmas. Once because she came home late from her shift at the hospital. Other reasons for other times—her fault, always.

Kayla never complained, not when, after a couple of days, he’d reappear at their apartment door, a big bouquet of roses in his hand and his duffel bag of dirty clothes at his feet. Maybe a gift, too; he was such a generous, thoughtful man.

“I love you,” Ryan would murmur as he gripped her in his arms, almost tight enough to bruise. “No one loves you like I do.” Not her mother, not her father, not her so-called friends who’d drifted away.

And she would whisper, “I’m so very sorry.” Her tear-streaked face would press into his shoulder; her fingers would weave through his thick, black hair. Only with his return could she breathe again as if, without him, her lungs had collapsed. “I’ll never do it again. Please forgive me.”

Ryan crouched by the suitcase, rearranging his clothing. “I met someone,” he said, finally looking at her as if anxious to assess her pain level. Ten out of ten, she’d tell him; infinity, if it were true.

As he finished packing, Ryan described the woman. Individual stab wounds—beautiful, smart, thin. Better than Kayla, he said without saying. She could translate his meaning, that special language he used.

She drew her knees against her chest as if to conceal the trauma. Those other times that Ryan had gone away, there had never been a woman, he’d sworn. He wouldn’t lie about that. Not to her.

Ryan continued talking: “You see, Isabel Scott is more suitable for a man like me.” A man who was handsome and smart and successful. He smiled at her in that way she always liked, showing the tiny crinkles by his dark eyes.

Kayla nodded and responded with a small upturning of her lips, as involuntary as an autonomic reflex. Acid rose from her empty stomach, corrosive in her constricted throat. She swallowed it down along with her pain.

The zipper tugged closed, and Ryan whisked the bag to the front door. She followed him as he’d expect her to. He clasped her left hand between both of his, so warm and smooth. His thumb rubbed over the princess-cut diamond on her fourth finger, a caress she savored until he said, “I need my grandmother’s ring back.”

Her lips wavered toward a frown, but, as Ryan slid off the gold band, her rictus of a grin reformed, this time by design. Without a smile, she looked like an old woman, he’d once told her. She had to be pretty and perfect for him, to lure him back.

The door closed behind him. She pressed her forehead against the cold metal, begging for the sound of his feet circling back from the elevator to the apartment. A ding, instead. The elevator, descending.

Still, Ryan would come back to her. Like always. No one loved her like he did. He had told her so, over and over and over.

Yet one day without him turned into two. Kayla waited: he had never been gone for more than two days. Two became three. She trembled, fearing that he was sick, injured, dead. Three multiplied into the forever of four, five….

Six, then seven days, an eternity of solitude.

Kayla drifted through the wasteland of their apartment, invisible without him. Nothing without him. Food was forgotten. Sleep eluded her. Her image in the mirror jeered at her unwashed brown hair, greasy and limp. His old college lacrosse jersey grew stale against her skin, her pungent odor replacing the enticing scent of his cologne. Her bare finger ached with the phantom weight of her engagement ring, like the pain of an amputated limb.

The hospital phoned, again and again. Kayla finally answered—the ringing hurt her head. “We desperately need you for the evening shift, Kayla,” the nursing supervisor said. “Are you able—”

“No. Can’t,” Kayla muttered before disconnecting. A shower, clean clothing, a drive to the hospital—all impossible. She felt her body’s dissipation as if maggots were feasting on her decaying flesh.

Their social media tormented her, Isabel’s and Ryan’s, yet she couldn’t stop scrolling. The relationship with that woman had started months ago: an adopted shelter dog, romantic dinners, weekends together. Oh, God, they’d stayed at the bed-and-breakfast where Ryan had proposed.

On the ninth day, new on her feed: a photo of the couple, happy and gorgeous, flaunting the engagement ring on Isabel’s outstretched hand. Their simpering smiles were a scalpel, slicing into Kayla’s unanesthetized skin.

She dropped her phone onto the bedside table. This time, he wasn’t coming back.

Her eyes flickered closed, sightless but for the blood red and night black imprinted upon her lids.

Ryan had said it often: Kayla was nothing without him. She knew it to be true. His words were the hollow needles from the hospital supply cabinet, safe until unsheathed.

She grasped for a pen. Dear Ryan, she began her note. Against the white paper, the black ink was like dried blood on sterile gauze.  I love you, she continued. I can’t go on. Not without you.  He had taught her to need him. Only him.

A handful of old pills, swallowed.

A white blanket, wrapping her like a winding-sheet.

A letter, addressed to Ryan. My love.

Kayla lay on their bed, ready for her reprieve from a shadow existence without Ryan. Pictures and sounds emerged, unheeded, from the flat screen mounted on the wall. Daylight devolved into darkness. Am I still alive? she wondered. To her surprise, her rasping voice joined the televised talk show cacophony. How? She checked her carotid pulse as she did for patients in extremis in the Emergency Department. Slow but steady, it marched on despite her wishes, holding fast to life. One, two, three….

She wouldn’t ignore it.

Her arms were weak, yet she reached for her phone.

***

Three. Two. One.

The starting gun fired.

Kayla advanced out of the parking lot with the other runners in the 5K. Slow, at first, until the mass of people spread onto the boulevard, emptied of traffic. She sped up. Clouds hid the autumn sun; tall buildings blocked the cold wind gusting from the lake. In her hand was the letter she had written to Ryan three months ago, folded into an imperfect square.

“You’ve been hurting for a long time, haven’t you, Kayla?” her psychiatrist had said at their first session in the inpatient ward. Behind his thick glasses, he had kind, understanding eyes.

“A year?” Kayla had said, twisting the hem of her hospital gown. “Maybe longer? I don’t know.” And she hadn’t known. Even with her nursing training, she hadn’t recognized her symptoms until the doctor pointed them out. Familiar clinical terms from her textbooks, from her patient charts: anhedonia, insomnia, loss of appetite, low energy. Hopelessness, above all. Or maybe she hadn’t wanted to acknowledge the diagnosis: major depression.

Think strong. She focused on her running mantra. The first mile marker of the course was close. Sunshine peeked between the clouds, now fleeing from the breeze. Music played in the distance, too far away to make out the song over the loud beating of her heart.

Medication and psychotherapy had improved her symptoms, but it was the 5K training suggested by her psychiatrist that had lured her out of her apartment, back into the world. Kayla had started from nothing: walk, walk-run, then run. From that first tentative walk, the folded letter accompanied her, its sharp edges cutting into the left hand that once bore Ryan’s ring, spurring her on. Those same corners had dulled as the weeks progressed.

Be strong. The second mile marker surprised her—how had she come so far? She flew past the water station without stopping. Ahead, Kayla glimpsed a tall, dark-haired man in gray sweatpants, running with an easy stride. Ryan?

Kayla increased her pace, her bent arms slashing up and down, pushing to overtake him. Damn Ryan, for preying on her vulnerability, for scouring her weeping wounds with acid. Only her disordered thoughts could have interpreted his careless cruelty as love. She knew better now.

The distance between her and the man diminished. Now, side by side, she could hear his labored pants, his plodding footfalls. She threw a glance at him. No, it wasn’t Ryan. Kayla passed the stranger and didn’t look back: she didn’t need to. Fuck Ryan, anyway—he was in the past. Only forward now.

Her breath quickened; her feet pounded against the road. She was tired, but the third mile marker was behind her.

The strong get stronger.

Only a tenth of a mile more. Her laugh combined with her sob—she was going to finish; until now, she hadn’t believed she could. Her sweaty hands clenched, crushing the old note. The black ink bled out on her skin, blotting out the words of her past despair until the marks were indecipherable.

She turned the corner, and there it was: the end, within sight.

A blue banner, fluttering.

A display clock, counting up the minutes, the seconds: 35:27, 35:28….

Mom and Dad, cheering and waving, a big sign unfurled between them: This pain will pass; finishing lasts forever.

Her arms raised, Kayla sprinted across the timing mat. At the finish line, she tore up her suicide note, tossing it into the air like celebratory confetti. The scraps scattered over her running shoes, and, with her face tilted up to the cloudless sky, warmed by the brightest sun, she danced.

Maria Wolfe lives, runs, and writes in northeast Ohio, where she also practiced as a surgeon. Her fiction has appeared in The Examined Life Journal, Please See Me, and Coffin Bell. She is currently working on a novel.