Metastasis is a word I first learned while working at the hospital.

It is the word we use to describe, in polite and technical terms, someone’s imminent death.

It is the word we use to explain how, yes, things can and will get worse, and how that’s actually what’s happening right now.

It is the word we use to explain to to someone’s spouse that they need to learn about wound packing; it is the word we use to try to imply that wound packing is much worse than you could possibly imagine, but people can only ever learn that first-hand.

It is a word I saw in dozens of rooms held behind doors that I would open and then close—forever static there on the 6th floor east wing of the northern tower—rooms whose inhabitants were both fresh and familiar.

Metastasis is the word that means actions must be taken; the first action will be to decide what other actions will be taken.

Metastasis is the word that hangs above the sedated bodies of very wealthy people as the emotional and legal battles begin that will herald the start of their inheritance wars—there will be no succession.

Metastasis is the word that is frozen in the eyes of very accomplished people who are wondering if they really ever did anyone any good—wondering so fervently that you can feel their thoughts radiating out of their heads.

Metastasis is the word that very brave people tuck into their cheek while they are planning out what death that they hope to greet.

Metastasis is a word that breaks every rule and all timelines while working to bring you to its mercy.

It is a word that, depending on pronunciation, is four syllables long, or 15 years, or 3 months.

Metastasis is a word that can even be invoked, like the name of an elder god—but no number of limbs, organs, or souls seem to sate it.

Metastasis is a word for both a conclusion and a summary of a life.

It is a word for how that world ends; it ends not with a bang or even the slightest hint of smoke, with freshly bloodied hands or oaths of vengeance, with any form drama that is easy to stage on- or off-Broadway—not even a whimper.

Metastasis is a word for the transition from body to corpse, guided only by paramount exhaustion, followed only by infinite silence.