The notification light on my old flip phone blinked a pale blue against the mahogany nightstand, the kind of quiet pulse that usually meant another pharmacy refill reminder or a weather alert. I didn’t reach for it right away because my lower back was throbbing in that familiar, grinding way that usually signaled a bad storm rolling in off Lake Erie. When I finally dragged myself up on one elbow and flipped the cover open, the screen read 4:14 in the morning with a text from the billing department at Mercy General. It wasn’t about the medication. It was about the forty-four thousand dollars left over after insurance for the fusion surgery I was scheduled to have in less than forty-eight hours.