Who is in the mood for more medical talk? Remember, I'm not an expert on anything that relates to cancer and the procedures that happen with it. This chapter is on the shorter side and I spent an entire morning writing it instead of going to class (because i'm a dirty skipper) and I apologize if I have gotten anything incorrect. I don't mean to and doing research on this specific topic can only take me so far.

So I hope you enjoy this chapter and I apologize once again if there are any mistakes! ( If you know there is a mistake in the medical side of everything, please tell me and provide the correct information so I can right my wrongs!)

That same day, Nelly has an MRI for scans of her brain and spinal cord. Dr. Bishop won't tell them the results of the MRI until Nelly has her bone marrow examination the next day. The only good thing about that is that Nelly can go home for the night. She worries the whole night, but at least she's able to sleep in her own bed.

While Nelly is at home, Jacob comes back to tell her that Bella will be okay and that the vampire venom that Edward had injected into her the night Renesmée was born worked. Which obviously means that Bella is now a vampire. Jacob didn't stick around long enough to hear about Nelly's MRI and how she won't know the results until they're able to see how well the examination goes. Nelly understands the whole, kill-two-birds-with-one-stone thing, but it's killing her patience.

Paul has to take her in for the procedure. Her dad has his own doctor's appointment that he had forgotten about and Sue is taking him to that. Nelly goes in for the procedure and Paul has to wait in the waiting room, unlike the last time Nelly had this happen and her dad was able to stand outside the door and watch. She knows that it's just the way the rules are, but she'd feel way better if she knew that he was standing just outside the door.

She's introduced to the woman who will be performing the procedure, a young woman named Emily Devine who has her hair tucked into a cap. Any other time, Nelly might've taken the time to properly look at her, but she's too nervous to do anything else besides shake the woman's hand.

"So you've had this done before," Dr. Devine says. "We'll have you lie on your side so we can get the samples we need. Is your dad here with you today?"

"No, my boyfriend is," she mutters. "He wasn't allowed in, they told me. He had to wait in the waiting room. My dad forgot about a doctor's appointment so he couldn't come."

"Okay, so we'll give you a pillow to hold." Dr. Devine signals to one of the other people in the room and Nelly is given a pillow to hug. "Could you lie on your side, please?" Nelly moves as she's told and keeps the pillow tight to her chest. She's shaking and she's nervous and she's all alone. This sample will also be what tells them how well Nelly's treatment went and she's terrified to find out that it didn't work out well.

"We're just injecting you with an anesthetic, okay?" Dr. Devine says from behind her. Nelly nods and holds her breath, flinching a bit at the poke of the needle in her lower back. "It'll make you feel numb. Can you feel it, yet?"

"No," she murmurs, but then suddenly it's there and it almost feels like her back is asleep. She nods and Dr. Devine starts ordering the other people present. There's two behind her, Dr. Devine and some other person, with a man wearing blue scrubs on Nelly's side.

"Okay, Nelly, we're going to do the aspiration first," Dr. Devine tells her. "You might feel a deep ache for a few seconds, almost like a toothache, but once the needle is removed the pain will go away." Nelly nods and shuts her eyes. She feels when the needle goes in and she grips the pillow as tight as she can.

Nelly has never had a toothache before.

The needle is pulled out and the pain fades. She let's out a pained breath and waits, because she knows that she isn't done yet. The biopsy hurts the most because the needle is larger and it turns and turns and turns until a tissue sample is removed.

"Alright, we're going to do the biopsy now," Dr. Devine says. "Are you ready?" Nelly nods, even though she isn't, and clutches the pillow tightly. She holds her breath and waits, her eyes clenched shut as the doctor turns the needle. Thankfully, she only turns it twice and then takes it away. A pad of something covers where the needle was and Nelly knows that it's there to prevent bleeding.

"Good job, Nelly," Dr. Devine says, coming into Nelly's view. She's smiling softly and rests a hand on Nelly's arm. "We got everything we needed. Would you like me to go get your boyfriend?" Nelly nods and sits up with help from one of the assistants in the room. They go through explaining the aftercare, something Nelly already knows. She has to keep the pressure covering clean and dry so no showers. Dr. Devine said that she can remove it tomorrow if there's no blood coming out. There will probably be some blood, but that is completely normal. A bandage is fine on the wound is fine until it's fully healed. She could feel some pain down the back of her leg and mild bruising is normal and can occur a few days after the procedure. If you have a fever of 101 or higher, uncontrollable bleeding, unusual discharge or sever pain at the insertion site or any signs or symptoms of an infection, contact your doctor immediately.

Nelly is lead out of the room and straight to where Paul is standing with Dr. Devine. He smiles softly at her and links her arm with his. Dr. Devine is saying something to her, but Nelly can't hear a word of it. It's like fog in her ears. She rests her head on Paul's shoulder and closes her eyes, tired and sore and ready to go home. On the drive home, Paul keeps a hand on her leg the entire time, only moving it if he absolutely needs to.

Her dad is waiting outside when they pull up to the house. Jacob is nowhere to be seen, but that's to be expected. Nelly always comes second to Bella. Nelly will probably come third, now that Jacob has imprinted on Bella's baby. She doesn't see the shocked look on her dad's face, unknowingly having said all of this out-loud. Paul just takes her inside and has her lie down on her bed. She smiles at him in thanks and hums when he presses a kiss to her forehead.

She falls asleep soon after that.

**

Three days later, while Nelly and Paul are sitting together at her piano and her dad is at the table playing solitaire, the phone rings. Nelly is in the middle of teaching Paul how to play a simple scale, but she freezes when the phone starts ringing. She knows that it might not be the hospital, but it's been a few days since she had the procedure done and her nerves are killing her.

Nelly watches as her dad moves to the phone and holds her breath while he answers.

"Hello? Yes, this is her father. Alright, good. Tomorrow?" Nelly sucks in a sharp breath. Her heart is hammering. She's going to find out her results tomorrow? That's too soon! Paul pulls her to his chest and wraps her in a hug. Nelly tries to breathe through her nerves and doesn't hear the rest of the conversation, thankfully.

"We're going in tomorrow morning at ten," Billy tells them. Nelly nods and doesn't move from where her face is hidden.

She lets out a shaky breath.

Tomorrow.

**

Nelly tries calling her brother several times the next morning, but all of her calls are being sent to voicemail immediately. Her dad tries calling him as well, but no such luck. Paul is with them so that's a comfort in and of itself, but he isn't her brother and it isn't the same. But they can't wait any longer so they leave. Nelly writes a quick note and leaves it on the counter for Jacob to find if he ever comes home and goes out to the truck.

The ride there is silent and tense. Paul is driving and her dad is in the front seat with Nelly directly behind him. When they get to the hospital, Paul helps Billy out of the truck and they all head inside. They go up to the floor where Nelly has been several times for chemo and head to a different part where a lot of patients are resting and waiting. All of them are cancer patients.

Billy goes to the front desk and checks them in while Paul and Nelly take a seat. They aren't sitting for long, though, as Dr. Bishop comes out almost immediately. Nelly's nerves skyrocket. That doesn't seem good.

They're all taken to his office and sit down in the chairs opposite him. He has a folder of papers on it and another of what Nelly thinks looks like X-Ray scans. She takes in a deep breath and shuts her eyes, clinging tightly to her father's hands.

"So we have your results," Dr. Bishop starts and then stops.

"And?" Billy says. "Is my daughter okay?"

Dr. Bishop opens his mouth and then shuts it with a sigh. He has a very solemn look and Nelly knows instantly that what she's about to hear is bad news. She covers her mouth with her free hand and feels tears start running down her cheeks.

"I'm afraid that Nelly's cancer is a lot worse than we originally thought," her doctor says quietly. Nelly's heart explodes and she starts sobbing. Her dad sucks in a sharp breath and pulls her into a hug, letting her cry on his shoulder. "The pegaspargase didn't do anything to stop the cells from growing and expanding. They've started to move to her spinal cord. Fortunately, there's no sign of cancer in her brain so that's good."

Nelly pulls away and sits back down in her seat properly. Paul reaches over and grabs her hand, pulling it to his mouth and kissing it. Nelly looks at him and tries to smile, but it falls flat. Paul has tears in his eyes and he nods, like he's saying that he's okay and that she doesn't have to worry about him.

"So what can we do?" Billy asks.

"I'm going to suggest that Nelly receives a lumbar puncture," Dr. Bishop says. "This is just to confirm that the cancer has spread to her spinal cord in case the MRI scans are wrong. It'll be just like getting a bone marrow exam, but instead of bone marrow we're testing your spinal fluid."

"And her treatment? What of that?" Billy questions. "Is there a specific type of treatment she'll be getting because the cancer has spread?"

"We could try radiation therapy," Dr. Bishop suggests. "It isn't usually used for people with AML, but it's sometimes used for those with leukemia that has spread to the brain and spinal fluid. However, radiation therapy is very expensive and might not be the best course of action for Nelly. It can also leave some lasting side effects that might never go away."

"Does it work, though? Will it kill her leukemia cells?"

"It does work, but the only way to find out if it works for Nelly is to have her undergo treatment. In my honest opinion, though, I don't think she needs radiation therapy. I believe that if we give her a stronger dose of a different drug, the cells in Nelly's body will dissipate." Dr. Bishop looks at them and then rises. "I'll give you a moment to process this information and then when I come back we can decide what to do next." He smiles and then leaves the room.

It's silent for a second, and then Billy speaks up. "Well, what do you want to do?"

"I don't know," Nelly croaks. "Dr. Bishop believes that just undergoing chemotherapy will get rid of my leukemia cells, but at what cost? He said a higher dosage of a different drug which means new side effects to deal with."

"And some side effects are really serious," Paul quietly adds. Nelly nods.

"It's up to you, Nells," her dad says. "It's your body, you get to decide what to do."

Nelly almost wants to say that she wants to stop treatment all together and just weather the storm. She'll likely die and will have to watch as her family watches her slowly fade into nothing. She almost says it. But she doesn't want to die. Nelly isn't ready for death, she's only sixteen, for crying out loud.

So she says, "No radiation. I'll do the chemo." Billy smiles at her sadly and grips her hand tight. He nods and they all sit quietly until Dr. Bishop returns five minutes later.

"So," he says, sitting down again. "What do you think?"

"I'll do more chemo," Nelly tells him.

"Great," he smiles. "I think this time around, we'll give you a drug called cytarabine. It's a powder that is mixed with liquid and can be injected intravenously, under the skin, or into the fluid-filled space of the spinal canal here at the hospital."

"And what of the side effects?" Billy hedges.

"It can cause a severe decrease in the number of blood cells in her bone marrow," Dr. Bishop explains. "That means that it can increase the risk of developing a serious infection or bleeding. It can also cause nausea, vomiting, diarrhea, stomach pain, loss of appetite, sores in the mouth and throat, hair loss, muscle or joint pain, tiredness, and sore or red eyes. Most of what Nelly will feel will be like what she endured during her previous treatment."

"But will it work?" Billy says.

"I believe so," Dr. Bishop replies. "And if it doesn't, there are still other treatments that we can try. If they don't, then radiation therapy will be our last resort. But I think chemo alone will get rid of her cells."

"Alright," Billy says. "When does she start?"

"She only finished treatment a few weeks ago," Dr. Bishop says, "so I think we should wait at least another two weeks for her body to full heal itself before starting a new round of chemotherapy. Just to be safe."

"And what if it gets worse?" Paul jumps in. They all turn their gazes to him. "What if, in the two weeks we're waiting, Nelly gets worse? What will happen then?"

"If it does get worse, we'll treat her and ready her for cytarabine," Dr. Bishop answers. "Any other questions?" Nelly shakes her head, beyond ready to go home. "Alright then. We'll make the appointment and then you can be on your way."

Nelly leaves the room with Paul glued to her side. It's a small comfort, but does little to stop her thoughts from moving. Now that she knows that her cancer has spread and is worse than ever, Nelly is actually beginning to think that death is a possible outcome. Before, it used to only be a passing thought, an idea stuck in the very back of her brain that was sometimes brought to the surface at the worst times. Like that time with Paul at the hospital. But knowing what she does now, that the leukemia is spreading at a faster rate than anticipated... It's scary.

They get home and Nelly climbs out of the truck. "I'm going for a walk," she mutters.

"I'll come with you," Paul offers.

"No," she says firmly. "I'm going on my own. I'll be back later. You can go home, if you want." Then she turns and heads for the woods. The back of her left leg is a bit sore, like the doctor at the hospital said it would be, but she doesn't care. She pushes on and stomps through the forest, no specific destination in mind. She simply needs to be alone for a while.

After maybe five minutes, Nelly turns and can no longer see her house. She's probably lost but she has her phone so she can just call Paul and he'll come get her. She continues walking a bit longer and then sits down on a fallen tree. She pulls her phone out and starts playing a game. Her mind keeps running the thought of death over and over again and it's driving her insane.

So, she screams.

It's a loud, very angry scream and it scares some birds that are sitting in some nearby trees. When she's done, her throat hurts but she feels somewhat better. She goes back to playing on her phone and then freezes when she hears something running through the woods. For some reason, Nelly's immediate thoughts go to vampires and she stands up and runs to a big tree. She sits there and hides, hugging her knees to her chest. She breathes slowly to try and calm her scared beating heart, but it doesn't work.

The footsteps get closer and closer until suddenly they're right behind the tree. Nelly holds her breath and buries her face in her legs.

"Nelly?"

She snaps her head up and sees Jacob standing there with a confused expression.

"Jacob?" She asks. "What are you doing?" She takes his offered hand and stands up, wiping off the back of her pants.

"I was on my way home and heard screaming," he answers. "Was that you?"

She nods and crosses her arms. "Yeah, it was."

"Well, are you alright?" He asks, looking over her for any wounds.

Nelly opens her mouth, ready to say yes, that everything is fine, she's okay, she just needed to let out some steam, but then she pauses. Jacob was at the Cullens' house the entire time and didn't answer any of their calls and didn't even go home to see everything was alright? No, she's not okay.

"Where the hell were you?" She says angrily, stepping forward and shoving her twin back. "Why the fuck didn't you answer your phone?"

"I didn't hear it ringing," he says, confused. "And I was with Ne-"

"With Nessie, yes," she sneers. "Always with Nessie, always with Bella, never with me."

"Nelly, you know what Renesmée is to me. Why are you so upset?"

"You've been gone since I was released from the hospital," she answers with a glare. "Wanna know what's happened in those days?"

"What-"

"I went and had another bone marrow examination," she starts, her voice getting louder and louder as she continues. "I had to do it all alone because Dad had his own doctor's appointment and they wouldn't let Paul in the room because he's not family. And then three days later, I get a call that's telling me to come in because my results are in and they want to discuss them. You weren't there, either. And today we go in and the doctor tells me that my cancer has spread to my spinal cord!" She shoves him back again. "Jacob, I am your sister and I am dying and all you can think about is Bella's fucking child! Which, by the way, is the grossest thing ever!"

"Nelly!" Jacob sounds scandalized. "That's not how it-"

"I don't care because that's where it's bound to end up! It's disgusting and it's still more important than me!" She has tears running down her face, but she doesn't want to wipe them away. She wants Jacob to know what he's doing. She wants him to know that it hurts. "You promised me that I would never have to go alone again. You promised. So where the hell were you? Making nice with the Cullens so that when Edward's baby is of age she can date you and you can live happily ever after? You might think that you have all the time in the world, but Jacob I don't. And I'm tired of chasing you around so you can understand it." Nelly turns around and walks away.

**

Surprisingly, Nelly doesn't get lost. She walks back the way she came and there's her house. She goes inside, her blood boiling, and wants to scream so badly. She ignores her dad and Paul and goes straight to the piano. She slams her hands down on all of the keys and revels in the loud noise that consumes the house. She continues to play, the music loud and powerful as she works out her anger and frustration and sadness.

She's tired of always coming second to Jacob. She knows that she will never always be the only girl in her brother's life, as is already known, but at least to be recognized some of the time would be a nice change. Especially during this time and especially since he promised. He promised to be around more, promised to spend more time with her. She can't believe that she believed him. Of course he wouldn't show up, not when he's too busy being in love with a child.

She sighs and starts playing softer. That's not fair to him, she knows that he didn't mean to imprint on Bella's daughter, and knows that it just happens. But it doesn't mean that he can just ignore Nelly whenever he wants. He doesn't get to pick when it's convenient for him to care about her, it doesn't work like that.

Nelly ends the song with five loud bangs, exactly like the ones she began with. When she's done, she sits there and lets the notes fade out. She's slightly out of breath from playing so angrily, but it doesn't bother her. Once the notes are gone, she slowly stands up and turns to face the room. She's unsurprised by the looks on her dad and Paul's faces like they can't believe what they just heard. Jacob is standing in the kitchen, a heartbroken look on his face. Nelly shakes her head and walks away to her room.

---------

Songs used in this chapter:

-DRAMATIC, EMOTIONAL and POWERFUL piano song "Heartbroken"- An Original Composition by Peter Vamos.