Discharged from Sloan-Kettering after two weeks of bed rest, I was an atrophied version of my sixteen-year-old self. Atrophied physically from lack of exercise and loss of muscle tone, but also somewhat in spirit. I sported a toe-to-thigh fiberglass cast that immobilized my right leg; my left was graced with a wicked scar. (My surgeon did not give a hoot for the aesthetics of his sutures; he was no plastics man). Weakened, in pain, but nonetheless happy to be leaving, I was wheeled through the hospital doors in a chair, then driven to our family home in Southport, Connecticut. It didn't feel like home to me; my parents had moved to Connecticut when I was away in boarding school. I knew no one there and felt isolated. And then there was the problem of autonomy, or lack thereof. Independent from day one, the family joke is that I "moved out of the house" for the first time the day I was born—two months early and put in an incubator where I "lived alone" for the first six weeks of my life. And sixteen is not an age that begs for reliance. But there were plenty of things I could not do for myself, and during those first couple days at home, that included going upstairs. The house had two floors, and if I recall correctly, I was pretty much confined to the ground level until a physical therapist could come and help me build back enough muscle strength and teach me how to properly navigate stairs on crutches. I don't know where the PT came from, but come she did, from some healthcare agency or other. I don't remember much about her, except that she was a woman of probably late middle age (she seemed old to me, but that was through the filter of a teenage mind; everyone over thirty looked old). Her skin was white, her manners Puritanical. She got me on the stairs. I remember I had gone up halfway and was turning to come back down. Confused momentarily about how to do it, here is the handy memory device she gave: "Just remember, it's like Heaven and Hell." I could hear the capital letters; this was a woman who believed these were proper nouns, names of physical places and not just states of mind. "When you go up, you lead with the good leg, like going up to Heaven. When you go down, you go bad leg first. Up with the Good, down with the Bad." I know I looked at her like she was crazy. I think I decided right then and there that I would go no farther with her. I don't remember what exactly I said, but I do know that the message was a perfect extension of her own metaphor: in so many words, I told her she could go on "down." She could just plain go to hell.