The migraine became a pattern.
Not every day, but frequently enough that Elizabeth stopped trying to hide them from her assistant, and frequently enough that her subordinates learnt to recognise the signs: the slight tension in her jaw during meetings, the way she'd retreat to her office and close the blinds, and the coldness in her voice that suggested something approaching irritability.
Ibuprofen. Codeine. Something stronger. The medication carousel became as routine as her morning coffee.
Sage noticed. Of course, Sage noticed. Sage had learnt to read Elizabeth's body like a text, decoding the small betrayals of discomfort in the set of her shoulders and the way her hand would occasionally rise to her temple mid-conversation.
"You should see a doctor," Sage said one evening, three weeks after the first devastating migraine. They were at Elizabeth's apartment, Sage cooking while Elizabeth sat at the kitchen counter, ostensibly working but mostly trying to ignore the low-level thrumming behind her left eye.
"I'm fine," Elizabeth replied automatically.
"You say that every time, and then you're not fine." Sage set down the wooden spoon with more force than necessary. "You cancelled on me twice this week. You've been taking painkillers constantly. You snapped at your assistant yesterday for something that wasn't even her fault."
"My assistant is incompetent."
"Your assistant is terrified of you." Sage turned to face her fully, and Elizabeth recognised the expression: the calm before the storm, the moment where patience crystallised into something harder. "Elizabeth, this isn't normal. This isn't just stress."
Elizabeth felt something defensive spike in her chest. She didn't like being questioned, didn't like having her behaviour analysed and found wanting. Especially not by Sage, who had no right to make demands based on three months of carefully managed affection.
"I don't recall asking for your medical opinion," Elizabeth said coolly. "If I want to see a doctor, I will. If I don't, I won't. This isn't a conversation."
The words landed like a slap. Sage's hand stilled on the wooden spoon. Elizabeth watched the hurt move across her face—just a flicker, quickly suppressed, but there. Always there, when Elizabeth was cruel enough to notice.
"Right," Sage said quietly, returning to the pasta. "Of course it's not a conversation. Conversations require two people who are willing to actually listen to each other."
Elizabeth wanted to retort, to remind Sage that this was how their relationship worked—Elizabeth decided, Sage accepted. But the migraine was intensifying, and her tolerance for conflict had deteriorated proportionally.
"Don't," Elizabeth said, hearing the edge in her own voice. "Don't do that thing where you act hurt because I won't perform the vulnerability you want from me."
Sage's laugh was bitter. "That's not what I'm doing, and you know it. I'm asking you to take care of yourself. I'm asking because I care about you."
"Caring is your choice, not my obligation."
The words hung in the air between them, brutal in their honesty. And Elizabeth meant them, genuinely meant them. She'd never asked Sage to care. She'd never promised that caring would be rewarded or reciprocated. Sage was choosing to invest in a relationship with someone constitutionally incapable of providing what she wanted.
But watching Sage's shoulders collapse slightly, watching her turn back to the pasta with mechanical precision, Elizabeth felt something uncomfortable stir in her chest. Not guilt – she didn't experience guilt, but something adjacent to it. Recognition, maybe, that she was destroying something that had value, even if she didn't understand why that value mattered.
"I'll make an appointment," Elizabeth said finally, the compromise costing her more than it should have. "Tomorrow. Happy?"
Sage didn't answer immediately. She finished preparing the pasta, plated it with deliberate care, and set it on the counter in front of Elizabeth without meeting her eyes.
"I'll be happy," Sage said quietly, "when you're a person I can actually be in a relationship with. Until then, I'm just... trying."
The clinic was aggressively clinical. White walls, the faint smell of antiseptic, and a receptionist who didn't look up from her computer even as Elizabeth checked in with the brittle efficiency of someone accustomed to being attended to immediately.
Dr Reeves was younger than Elizabeth expected, mid-fifties, dark-skinned, with intelligent eyes that assessed Elizabeth with the kind of professional distance that suggested she wasn't impressed by Elizabeth's obvious wealth or the designer suit she'd worn specifically to establish dominance.
"Migraines for how long?" Dr Reeves asked, making notes.
"Three weeks. But they're stress-related. I've had a complex acquisition..."
"Any vision changes? Nausea? Sensitivity to light?"
"Occasionally." Elizabeth didn't mention how the occasional had become increasingly frequent. How her vision had started doing strange things: blurring, doubling, occasionally tunnelling without warning. How she'd caught her reflection in a window last week and barely recognised herself, the woman looking back so drawn and exhausted.
"Any family history of migraines?"
"My mother had them. Occasionally."
Dr Reeves continued her questions with the methodical precision of someone who'd been gathering medical histories for decades. The blood pressure cuff constricted around Elizabeth's arm. The reflex hammer tapped her kneecap. The light in her eyes made her squint against its brightness.
"I think we should run some tests," Dr Reeves said finally, setting down her pen. "Routine, mostly. Some bloodwork, possibly an MRI. Given the pattern you're describing and the frequency of the migraines, I want to rule out anything more serious."
Elizabeth bristled at the implication. "It's stress. I've had an extraordinarily demanding quarter-"
"I'm sure you have," Dr Reeves said mildly. "But stress doesn't usually cause the kind of persistent neurological symptoms you're describing. I'd rather be thorough than miss something."
"You think something's wrong with me," Elizabeth said flatly.
"I think something might be wrong with you," Dr Reeves corrected. "And I think it's worth investigating rather than assuming. When can you come in for the blood work?"
Sage drove her to the hospital three days later for the MRI. Elizabeth had wanted to refuse her company, to maintain the pretence that this was routine, insignificant, and not worth Sage's time. But somehow she'd ended up accepting the offer, accepting Sage's hand on her arm as they walked into the imaging centre.
The MRI machine was claustrophobic and loud. Elizabeth lay on the platform, sliding into the tube's embrace, trying not to think about being buried alive. Trying not to think about the fact that this much medical attention seemed disproportionate to stress-related migraines.
Twenty minutes later, she was lying on the patient bed again, and Dr Reeves was studying the images on her screen with an expression that had gone very still.
Elizabeth recognised the expression. It was the expression people got when they were preparing themselves to deliver bad news.
"Elizabeth," Dr Reeves said, turning away from the screen. "I need to be direct with you. The MRI has revealed some abnormalities. There's a mass... a growth in your brain. It appears to be located in a region that could potentially affect vision, cognition, motor function..."
The words continued, but Elizabeth stopped processing them. A mass. A growth. A thing in her brain that shouldn't be there, growing and expanding and consuming her from the inside.
This isn't happening. This is a mistake. I don't get sick. People like me don't get sick.
"-need to refer you to a neurologist. Potentially an oncologist. We'll want to do a biopsy to determine if it's benign or-"
"Cancer," Elizabeth said flatly. It wasn't a question.
"We don't know yet," Dr Reeves said gently. "That's why we need the biopsy. But I'll be honest with you; given the location, the symptoms, the imaging characteristics... we need to prepare for the possibility that this is malignant."
Elizabeth stood up. She needed to stand up. Needed to do something other than sit there and absorb the fact that her body was betraying her, that she wasn't as invincible as she'd spent her entire life believing.
"How long?" she asked.
"How long until what?"
"Until I die."
Dr Reeves's expression softened with something that might have been compassion. "We need to do the biopsy first. We need more information before we can make any projections about prognosis or timeline. But Elizabeth..."
Elizabeth walked out before Dr Reeves could finish. She walked out of the imaging centre, past the waiting room where Sage was sitting with a book she wasn't reading, and walked straight out into the London afternoon, as if leaving behind a life that had already ended.
Sage found her in the car park, standing beside Elizabeth's car, her hands visibly shaking.
"Elizabeth? What happened? What did she say?"
Elizabeth couldn't find words adequate to the occasion. There were no words. No strategic response, no calculated deflection, no way to maintain her carefully constructed image when everything underneath had suddenly fractured.
"I have a tumour," she said finally, the words landing like foreign objects, things her mouth wasn't supposed to form. "In my brain. They need to do more tests, but the MRI shows there's something growing in there."
Sage went very still. Elizabeth watched her process this information and watched her carefully constructed patience shatter into something rawer and more honest.
"Okay," Sage said finally, her voice shaking. "Okay. We'll call your parents. We'll get you a second opinion. We'll... we'll figure this out."
But even as she spoke, Elizabeth could see the fear in her eyes. The recognition that this changed everything. That the carefully maintained dynamic of their relationship had just become irrelevant in the face of actual mortality.
"I'm going to die," Elizabeth said, testing the words. They felt true in a way that most things in her life had never felt true. Solid. Inevitable. Unchangeable.
"You don't know that," Sage said, but her voice lacked conviction. "People survive brain tumours all the time. We need more information-"
"I've spent my entire life ensuring outcomes. Controlling variables. Dominating challenges." Elizabeth turned to look at Sage, and for the first time, she let her see the complete absence of control beneath her surface. "This is the one thing I can't control. This is the one thing I can't acquire my way out of or strategise around."
Sage moved closer and pulled Elizabeth into an embrace. Elizabeth stood rigid for a moment, unaccustomed to being held, to allowing physical comfort without calculation.
But the news had fractured something essential in her architecture. The narcissistic certainty that had protected her from feeling now felt paper-thin, utterly inadequate.
She collapsed into Sage's arms, letting her support her weight, letting someone else be strong for once.
"I'm scared," she whispered, the admission costing her everything.
"I know," Sage said, her hand moving through Elizabeth's hair in that same gesture she'd performed the night of the first migraine. "I know. But you're not alone. I'm here."
And Elizabeth, for the first time in her meticulously controlled life, believed her. Not strategically, not as part of some calculated dynamic, but as a simple truth, that Sage would stay. That Sage had been waiting for this moment when Elizabeth's armour would shatter completely, revealing the frightened person underneath.
That Sage had never really been collecting her at all.
Sage had been waiting. Waiting for Elizabeth to become human enough to be loved.