Page 18 of Cava with My Colleague

Something is wrong.

“Good afternoon,” Jade begins, and her voice has that over-controlled quality I remember from our early training sessions. Like she’s reciting from memory rather than presenting. “Thank you all for attending today’s presentation on advances in hair loss prevention for oncology patients.”

I translate into German, watching her carefully. She’s staring at the teleprompter, not making eye contact with anyone. Her face is pale.

She launches into the opening section—the one we revised three times to make it more accessible, more human. But the warmth we practiced is gone. She sounds like she’s reading a technical manual.

I translate, keep my expression neutral, and wait for her to find her footing.

She doesn’t.

She gets through the methodology section without stumbling—I’ll give her that. She hits the data points in the right order, doesn’t skip anything, doesn’t lose her place. Technically, it’s correct. But the patient stories we spent two training sessions on—the photographs, the names, the reason any of this matters—she delivers them like footnotes. Like things she has to say rather than things she wants to.

The audience is polite. That’s the most alarming thing. Polite means they’re still in their seats but they stopped leaning forward ten minutes ago.

A woman in the third row—gray-haired, a press badge, someone who has probably sat through a hundred of these—has her pen out but isn’t writing anything down. A pharmaceutical rep I know from last year’s conference glances at his phone, then puts it away, then glances at it again.

In the back, where the patients sit, a woman with a headscarf is watching Jade with careful attention. She’s getting the information. She’s just not getting anything else.

I step in where I can. When Jade moves past a patient testimonial too quickly, I take an extra beat in the translation, give the German audience a moment with it that Jade didn’t leave in English. It’s the best I can do. It’s not enough.

She finishes on time, which is something. She clicks to the final slide and invites questions in a voice that sounds like she’s asking people not to raise their hands. One pharmaceutical rep asks about the trial size. A doctor in one of the middle rows asks about side effects. Jade answers both questions with precision and absolutely no color.

The applause is adequate. No one lingers.

I shake a few hands near the stage, give the rep my card, thank the patient advocacy coordinator who’s already moving toward the door.

Out of the corner of my eye, I spot Jade slinking away.

Before I follow her, I’m stopped by Agnieszka Kowalski.

I’ve known Agnieszka for three years—she runs the Polish patient advocacy network, one of the most effective in Europe, and she makes a point of attending whatever presentations she can reach. She’s in her sixties, small, with the particular energy of someone who has spent decades fighting for things that shouldn’t require fighting for. She lost a daughter to breast cancer eleven years ago. She tells people this within the first five minutes of meeting them, not for sympathy but because she wants them to understand why she’s in the room.

“Your presenter,” she says, in accented English, nodding toward the stage. “She knows this subject.”

“She does,” I agree.

“She’s uncomfortable up there.” It isn’t a criticism, just an observation. “But she cares. You can see it, even when she’s trying to hide behind the data.” Agnieszka tilts her head. “Is she available to speak? I have some questions about the trial methodology. Specifically the quality-of-life metrics—the FACT-B scale doesn’t always capture what patients actually experience.”

I hesitate for a fraction of a second, thinking of Jade pacing backstage. Then I think of how she’d answered Rebecca’s questions in the meeting where this tour was first proposed—the way her whole body had changed when she was talking about the patients rather than the presentation.

“Give me one moment,” I say.

I find Jade in the prep area, her arms crossed, staring at the middle distance. She looks up when I come in.

“There’s someone who wants to speak with you,” I say, before she can open her mouth. “Agnieszka Kowalski. She runs the Polish patient network. She has questions about the quality-of-life data.”

Jade stares at me. “Now?”

“She’s waiting.”

Something shifts in her expression—the self-recrimination doesn’t disappear, but it moves aside for something else. She uncrosses her arms. “What kind of questions?”

“The FACT-B scale. Whether it captures patient experience accurately.”

“It doesn’t, actually,” Jade says immediately. “It’s a validated instrument but it was designed before we had longitudinal data on chemo-induced alopecia specifically. We had to supplement it.” She’s already moving toward the door. “Did she attend the trial? Or is this⁠—”

“She’s an advocate. Lost her daughter.”