Just outside this operating room a dozen people are waiting to cut my daughter open. They want to take her heart out of her chest and give it to someone else. Lungs, liver, and kidneys too. And bowel? Did I hear that right? I didn’t even know they did that. They’re going to cannibalize her for parts like a stolen car.

Her name is Emily. We named her for Emily Brontë because I love Wuthering Heights, but when she was little she fell in love with the poem “‘Hope’ is the thing with feathers” and would dance around the house in a white dress chanting, “I’m Emily Dickinson!” She wrote poems often as a child and kept notebooks her entire life. If an idea for something came to her, she would be almost frantic for a pen and a scrap of paper—a napkin or an envelope—if she didn’t have her notebook with her. Even as a young adult she preferred writing down her notes to typing them into her phone.

The notebooks changed over time. When she was younger they would have colorful covers, stickers of hearts, flowers, and dolphins, and sometimes those flimsy locks that you could open with a special key. Then there was her embossed-leather-and-gilt-edges phase, followed by a 180-degree turn to Moleskine, black only. After high school she finally settled on simple, hardbound sketchbooks with unlined paper, so she could draw and paste things into them. The essence of Emily spilled over into her notebooks.

One time when I was cleaning her room—I think she was about twelve—one of her notebooks fell open to a page with only one sentence written on it in huge letters: I HATE HER. She was referring to me.

The preteen years weren’t always tough. Sometimes we could talk to each other when I brushed her hair and put it up in a bun for her ballet class. It was long and shiny, a rich shade of chestnut with gold highlights. I made sure her bun was perfect, the kind that looks like a flawless donut. We’d talk about boys, books, and movies and laugh occasionally. Those moments felt like sunshine warming my skin.

She started using in high school. On weed she was unusually sweet to me. I didn’t like any of her friends, if you could call them that. Young people often hear concern as disapproval and can’t see worry as coming from unbearable love, so all we did when she was in high school was fight. When we weren’t fighting, she would still explode every time I opened my mouth, as if whatever I was saying was so unbelievably frustrating that she couldn’t stand the sight or sound of me. She hated me for not being the mother she wanted: a permissive buddy, rather than someone whose job it was to guide her toward safety.

In college, binge drinking landed her in the ER so many times that by her sophomore year the mere sound of my phone ringing would make my palms sweat. It was a miracle she never choked on her own vomit. When at last she decided to take a semester off and move back in with us for a while, I didn’t know whether to feel relief or despair.

Ice cream and therapy helped keep the peace. A new creamery had opened up in town, walkable from our house. It seems silly now to think of the amount of time we spent discussing the various flavors, debating the merits of this topping or that, yet the laughter and ease of those walks to and from the shop stand out in my memory. My husband, gruff on the outside, kind on the inside, would order something that matched his sweeter interior: blueberry with crushed Frosted Flakes. I would get cold brew with chocolate chunks, and Emily would go all out with butter almond topped with hot fudge and toasted coconut. The ice cream would soften quickly in the summer warmth. We would tease each other about whose cone was getting the messiest and how sticky our fingers were, luxuriate in the cool, sweet tastes melting over our tongues, and lose ourselves in the joy of it all.

One unusually cold autumn night, Emily and I had a huge fight. It unraveled into a brutal picking of old sore spots—how we were afraid to trust her judgment, how she felt she couldn’t talk to us because of how we judged her, her attitude, our lack of understanding, her selfishness, our selfishness, and after what felt like hours of lunging and parrying and burning sensations in our chests, she finally marched up to her room, took all her notebooks off her bookshelf, and starting hurling them into the fireplace. I burned my arm trying to save them, and probably hurt Emily shoving her aside and throwing my body over the other notebooks like a mother bird trying to protect her chicks.

“You’re fucking insane, you know that?” she yelled.

My arm was in excruciating pain, but I held my position over the notebooks and managed to hiss, “Just…don’t.” She left the house slamming the door behind her.

Emily overdosed on fentanyl days later while hanging out with strangers. It’s like trying to remember a nightmare now, while still in it. I hazily remember a phone call, police, a cold, sick hole in my chest, the glass walls of her room in the intensive care unit, the repetitive sound of a ventilator breathing for her, discussions I could barely pay attention to, forms to sign, terrible lighting, startling beeps everywhere, always shivering in the hospital even with layers on, wondering if she was warm enough, brain scans, cafeteria food I couldn’t eat, kindness and coldness all in one place. A resident new to her service brought up fentanyl infusions. The attending physician decided to stick to two sedatives that began with P.

I refused to get fentanyl for a procedure last week, which I could tell irritated the doctor. She wanted an explanation. I know she was just trying to do her job, understand where I was coming from, but I didn’t feel I owed her one. It was too painful to say out loud, “My daughter almost killed herself with fentanyl.” What could she say in reply—“Don’t worry, we won’t kill you?” It wasn’t about that. It was just that the very word in my proximity lacerated my heart.

While she was in the ICU and we were waiting, barely breathing, for a change for the better, I started to read her notebooks. I smiled, then cried, over the ones from long ago, when she was little and none of this pain was in her life. Why didn’t she tell me she had fallen in love in high school, then had her heart broken. Why didn’t she tell me what happened in college, when she went to Planned Parenthood by herself to end a pregnancy. I would have gone with her, held her hand. She didn’t give me a chance. We grow accustomed to the dark.

The change we want never comes. Her heart is beating, but her brain is barely alive. The worst part about all of this is that we were getting better. She was better. She just made one mistake. Her brain, her beautiful brain that created poems and loved dogs and knew how to dance the mambo and could understand multivariable calculus and was so hungry to notice the small wonders in her world, slipped like someone hitting a patch of ice.

I hate the phrase “withdrawal of care.” These doctors and nurses still care—I can see that. And we will never stop caring.

Before they bring her to the operating room, I do her hair, brush it and form a perfect bun high on her head. They let us come to the OR to be with her one last time before the organ harvest. Where did you go? I want to ask her. She is here but not here. Even if it means a lifetime of trying and failing to understand each other, I want her back.

But this is it, the last moment. I’m overwhelmed with memories of our happiest times together, her childhood and infancy. To this day, the happiest moment of my life was the morning Emily first smiled at me. I peered over the edge of her crib to see if she was awake, and her chubby cheeks lifted and her eyes sparkled, and I lifted her into my arms and squeezed her little body to myself as hard as I could.

They want to take Emily’s heart out of her chest and give it to someone else. I hope it hurts less in there.

Cristina Legarda was born in the Philippines and spent her early childhood there before moving to Bethesda, MD. She is now a practicing physician in Boston but when not in the hospital enjoys writing about women’s lived experience, cultural issues, medicine, and finding grace in a challenging world. Her work has appeared or is forthcoming in America Magazine, The Dewdrop, Plainsongs, FOLIO, HeartWood, and others. She can be found on Instagram @poetintheOR.