The boy stood behind her. He was shivering, June could hear his teeth chatter from way over there and it was loud, like the sound of loose pebbles hitting the underside of her car. She wondered why on earth his mother hadn’t made him wear a coat. This was Nebraska and it’s winter stupid she wanted to say, but instead just exhaled a pointed puff of indignation, spun her chair to the computer and clicked open the file.

“Oh and I’m gonna need your Driver’s License or State ID.” She was glad she remembered because lately people had gotten away with refills of OxyContin or other such drugs with stolen Medicaid cards. It was a problem these days, not just in her clinic, they were saying it on the news too, so she locked her door at night, another thing to have to remember, to have to worry about, another big-city problem seeping into her community. It made her head spin, and some mornings June just couldn’t bear the thought of having to get up out of bed to listen to it all over again. She watched the woman search through her swelled purse and pull out a ziplock bag packed with neatly rolled underwear, then another of balled-up socks. The woman burrowed both bags against the front of her sweater, found her wallet, then quickly slid them back into her purse. She picked out her driver’s license and pushed it over the counter. Fine. June slowly drew up the license, held it and the Medicaid card away from her eyes where she could see them, and squinted at the names and addresses. They matched. The town the woman lived in, or the farm outside of it June guessed, was at least two hours away. Typical for this area, but a long time to travel in the snow with the boy whose teeth were chattering, less now though he was still hugging his right arm and was still clearly in pain. June gave back the license and typed the number from the card into the box on the screen. She clicked OK. A list of names appeared.

“Peine. Michael.” She spun back to them and caught the fleeting end of a flick, a tiny nick or a twitch that had passed over the woman’s face and was gone.

“That’s his brother. This one’s Eugene.” Her voice was flat, like cardboard, and June squinted at the screen and then noticed after Peine, Michael: DECEASED. Well how was she supposed to…She scrolled down with the mouse until there he was: Peine, Eugene. Fine, OK. She clicked his name. A sudden, abrupt, bolded register appeared, running the entire length of the computer screen and listing at least fifty maybe more visits to different hospitals all around the state, some literally a five-hour drive away. The reason for each visit was there, too, and June counted: one broken arm, a broken collarbone, two concussions, dislocated shoulder, two broken ribs (twice), multiple stitches, stomach pumped (ingestion of cleaning fluids), stomach pumped (alcohol poisoning), psychotic episode (undefined), second-degree burns— My goodness, she thought. What in the world has this woman—

“He did it to himself,” she hissed,

And snatched back the Medicaid card Kathy thought she might scream this nurse was a slow cow her son was in pain where was the god damn doctor—but she couldn’t say this, not now anyway, she’d shut down like they all did and move even slower, or call in the children’s services people, and she’d have to explain again and she just couldn’t, not again, not today. So Kathy stayed quiet, waiting with Eugene standing there like he was going to leap out of his skin or break a crown his teeth were chattering so bad. She watched the nurse unload her fat ass from that comfortable chair and pick up the flat pressed clipboard with her dainty unbroken pink fingernails and prance like one of those hippos in high heels down the hallway to the examining room. Kathy pulled Eugene by his good arm and followed her. The nurse whispered something to the doctor as she handed him the clipboard, which he took and read through. The doctor led Eugene into the room and sat him down on the examining table, and then came back and shut the door, he actually shut the door right in her face. She had no other choice but to go back to the waiting room and wait, just sit there and wait. Again. But she needed to tell them—if that nurse doesn’t stop looking at me I’m gonna—and then she stopped, because she could feel her heart beating right through her sweater and didn’t want what might happen if she didn’t. Settle down, she told herself. It is going to be okay. They would fix up his arm and they could leave. She could leave. She would make sure.

Kathy opened her book and tried to read but her mind was going and each sentence she picked through just seemed pointless and disconnected, like some sort of made-up language. She shifted her weight on the plastic bench and wondered why they made the seats so hard you can barely sit, like they don’t even want you here, as if being here was anybody’s choice. She closed the book, her finger marking the page. On the way home she’d stop in town and pick up some of those pork chops, Eugene’s favorite, she’d splurge a little. To celebrate. She thought about arriving home to that big empty house, standing at the edge of those scraped fields like a singular old tooth. It would be okay, she thought. It had to be. She tried to picture herself alone in each room now, and wondered if she even made any difference, maybe that house always just was despite her and would be forever, with or without them. Him. She had tried to make a difference, no one could accuse her of not. Kathy shook her head slightly, trying to remember the wallpaper she picked out the day after her husband proposed in a voice that surprised her, it was breathless and reedy and seemed unused or just saved for special occasions, of which she supposed this was one. He had always just gestured with that roughly hewn hand held flat over his cup when she offered more coffee. Not once had he even looked at her, instead always first at his hand, then slowly out the window, though Kathy knew he noticed her because fiery red crept up the back of his deeply creased neck whenever she approached. The day he proposed she was standing behind the register. He came up to pay, which was unusual for him. He usually just carefully laid out four tired old dollar bills stacked with a few tarnished coins right there at the table and then ducked out as though hoping to remain unseen, rarely leaving her much of a tip other than maybe a shiny quarter or two. This day though, when he did finally speak, telling her he was an old man who lived a simple life but would do everything in his power to provide, and she said yes because no one else had ever asked or was even close to asking now, he left her three.