As I administered the injection, she distracted herself by looking at me. Her eyes dropped to my stomach, then back up to my face. “Are you having a baby in there?” she asked, her voice small and innocent. “I am,” I smiled warmly at her, maintaining eye contact.

“A little girl.” Lily was quiet for a moment as I began to thread the sutures. Elias was dead silent behind me, though I could hear his ragged breathing. Then, Lily leaned her head forward. She looked nervously over my shoulder at her father, who was staring at the floor, before turning her gaze back to me.

She tugged weakly on the sleeve of my scrubs. I leaned down closer to her face so she wouldn’t have to strain. In a hushed, conspiratorial whisper, Lily said, “Are you the lady Daddy cries about in his car?” I froze, the needle hovering just millimeters above her skin.

Lily kept whispering, unaware of the bomb she was detonating in the quiet room. “My mommy told him that if he didn’t leave you and come back to live with us, she was going to take me away to another country and he would never, ever get to see me again.

He told me he had to leave the person he loved to keep me safe.” The silence in the room suddenly felt entirely different. It wasn’t the silence of shock anymore; it was the deafening silence of a horrible, tragic truth. I slowly stood up straight and looked over my shoulder.