Darlene set the clipboard on her left knee because the paper edge dug into her right. The pen had someone else's tooth marks near the clip, deep ones, and she turned it over twice before she pressed it to the line that said *signature*. The technician in teal was already halfway through the curtain, already talking to someone else, a name that wasn't Darlene.
Four pages - stapled crooked, and she didn't pry the fold open. Her thumb ran across *voluntary* and then *no cost to you* and then a paragraph that started with *including* in a font sized for someone with better eyes, and her thumb kept moving. The looping D she'd been signing since Mrs. Petrocelli's third-grade class landed on the line, the same D she used on birthday cards and permission slips and the lease for the apartment on Grover Street.
The letter had a logo she recognized from the teal technician's lanyard, a swooping blue arc - and she turned it over once to see if there was anything on the back before she turned it face-up again. *Risk stratification modeling* sat in the second paragraph like a phrase from a different language, a language for rooms she had never been in, and her coffee went cold while she sounded it out. She set the letter on top of the electric bill and then moved it under, and then she got up and stood at the window for a while with her hands around the mug.
She found the number on the back of her insurance card, the one she kept behind her library card - and she dialed it standing at the counter while the refrigerator hummed its one long note. The woman on the line read something aloud, a clause with the word *aggregate* in it, and Darlene pressed her thumb into the edge of the counter tile that had been lifting since March. The portal loaded slow on her phone and the new number sat there in red, $340, and below it a small gray line that said *risk adjustment* and below that a word she had to zoom in to read - *genomic*, next to a date that was the same Tuesday she'd worn the paper gown.
Mia found it under the takeout menus, the four pages still crooked-stapled, and she pressed the crease flat with her palm the way she ironed her scrub tops, slowly - with the heel of her hand. She read the third page twice with her finger under the words, the way she used to read aloud to their grandmother, and then she said *third-party research partnerships* and then she said *de-identified at the discretion of* and then she stopped. The overhead light buzzed once. Darlene set down the dish she was drying and didn't pick up another one.
She took the pages from Mia without looking at her face. The drawer needed the hip-lift it always needed, and she put the four pages under the ShopRite circular, under the Bed Bath & Beyond mailer with the twenty-percent-off that expired in February - and pressed the drawer shut with both hands flat against the wood until she felt the click. The dish was still in her other hand, still damp.
