My symptoms were as nebulous as emotional suffering appeared to outsiders. I imagined people listening to me and wondering how I could have gotten so sick and still not have any answers. How could so many doctors be flummoxed?

In other words, I knew I was at risk of being told it was all in my head, even before the cowboy-boot-wearing neurologist did exactly that. In fact, after my appointment with him, anxiety was added to my electronic medical chart, a word that every subsequent doctor would see on the home page of my file. And while technically this was true—I certainly was anxious about my miserable happiness book and my poor health (it wouldn’t be until later that I’d be anxious about my breakup)—I felt as though there was no way to escape that label as the cause of my symptoms, no way to be believed.

I kept it to myself because I wanted to avoid being a woman suspected of having a wandering uterus.

And then there was this: On one of our early dates, when Boyfriend and I were in the midst of infatuation and had hours-long conversations about anything and everything, he mentioned that before meeting me, he’d gone on a few dates with a woman he really liked but when he’d learned that she had some difficulty with her joints that made it hard for her to go hiking, he’d stopped seeing her. I asked him why. After all, she didn’t have an acute illness; it sounded more like a common case of arthritis, and we were middle-aged, after all. Besides, Boyfriend wasn’t even a hiker.

“I don’t want to have to take care of her if she gets really sick one day,” he said over our shared dessert. “If we’d been married for twenty years and then she got sick, that’s different. But why get into it knowing she’s already sick?”

“But any of us could get sick,” I said. At the time, I didn’t think I fell into that category. I thought that whatever I had was temporary (a bug of some sort) or treatable (a thyroid imbalance). Later, as my Medical Mystery Tour got under way, my denial turned into magical thinking: As long as I don’t have a diagnosis, I can postpone telling Boyfriend the extent of it—indefinitely, and maybe forever—if it turns out that nothing’s wrong after all. He knew (sometimes) that I was having tests done and wasn’t feeling “myself,” but I also explained away a lot of my fatigue the way Dr. Cowboy Boots had: I was a busy working mom. Other times I’d make jokes about getting older. I wasn’t willing to test his love for me by letting him think that either I had some physical illness or I was crazy for believing that I did.

Meanwhile, I was so terrified by whatever was happening to me that I kept hoping my symptoms would simply vanish. I thought, I’m going into this future with Boyfriend, focus on that. Which is also why I ignored any hints that we might not be well suited for each other. If that future went away, I would have to contend with an unwritten book and a failing body.

But now that future has gone away.

So I wonder: Did Boyfriend leave me because I was sick—or he thought I was paranoid for believing I was? Or did he leave me because I was as dishonest with him as he had been with me about who I was and what I wanted in a partner? It turns out that we weren’t that different after all. In the hopes of making it work with a person he genuinely enjoyed, he wanted to postpone his confession for the same reason I did: so that we could continue to be together even though we couldn’t. If Boyfriend didn’t want to live with a kid under his roof for the next ten years, if what he wanted was freedom, he certainly wouldn’t have wanted to take care of me if one day I needed it. And I’d known that about him as early as that dinner-date conversation—just as he’d known I had a kid.

And now I’m doing the same thing—postponing—with Wendell, because the truth comes with a cost: the need to face reality. My patient Julie had said that she always wished she could freeze time in the few days between having a scan and getting the result. Before that call came in, she explained, she could still tell herself everything was fine—but knowing the truth might change everything.

The cost of my telling the truth isn’t that Wendell will leave me, as Boyfriend did. It’s that he’ll make me face this mystery illness head-on instead of pretending it away.