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—Denied—

“Given the patient’s Paxetine and Optivacore usage—two and a half and one and a half years ago, respectively, it is likely this has been an ongoing problem brought on by stress and self-neglect. The claim was denied.”

Kari’s eyes didn’t flinch. Part of her knew that the insurance would do this. The poodle never looked up, and just kept reading.

“Productivity strips aren’t life-critical. “System flags it as lifestyle-related. This is the current statement.”

PROSPERITY HEALTH SYSTEMS

In partnership with Caduceus™ Pharmaceuticals

Billing Division: Patient Financial Outcomes

"Your Health Is Our Business"

PATIENT NAME: Kazushige, Masaki

DOB: 03/14/1972

PATIENT ID: 8397-1102-5546

ADMIT DATE: 05/28/20XX

DISCHARGE STATUS: Ongoing Observation (ICU – Tier B)

CLAIM STATUS: Denied

Itemized Statement of Charges:

Emergency Cardiac Triage (Level 3)..........................?12,600

NeuroVital Scan (Legacy Equipment – Continuity Fee)........?4,400

ICU Monitoring (Tier B) – 3 days @ ?9,300...................?27,900

Paxetine Interaction Panel..................................?2,150

Optivacore Toxicology Review................................?2,850

Assisted Vent Support (Limited Plan)........................?5,200

Somatic Registry Alignment (Pharma Gene Index)..............?3,100

Administrative Processing Fee................................?850

Regulatory Sync: Civic Engine Integration Log (auto-gen)....?1,250

Digital Chart Access (per session) – 8x.....................?640

Caduceus Health Messaging Compliance (embedded licensing)...?980

Emotional Risk Disclosure Acknowledgement (auto-stamped)....?730

Behavioral Tier Alignment Report™ (Transplant Eligibility)...?1,150

Responsibility Reacclimation Protocol – Participation Declined.....?1,050

Bedframe Rental – ICU ergonomic (scratched).................?460

Ceiling Light Burnout Replacement – shared room..............?325

Pharmaceutical Delivery Margin (Caduceus Surcharge).........?2,200

BioData Capture Fee (Memory Sync: Pending Analysis).........?590

ICU Moodfield Optimization – Passive Scent / Tone Modifiers...?1,175

Next-of-Kin Verification Delay (No Confirmed Contact)...........?380

TOTAL CHARGES: ?78,580

INSURANCE ADJUSTMENT: ?0.00

PATIENT RESPONSIBILITY: ?78,580

Claim Notes: Per Prosperity Health Systems policy 18.3(c), medications classified under “Productivity Assistance” (e.g., Paxetine®, Optivacore™) are not eligible for emergency coverage unless pre-certified with dependency documentation and an approved spiritual exemption code.

Human Outcome Value: Non-prioritized

Rehabilitation Tier: Pending Behavioral Audit

Review Method: Credit-Risk Optimization

Payment Due: Within 28 days of statement issue

Failure to pay may result in:

*Service Denial

*Interest Accrual (12–17% variable)

*Behavioral Credit Recalibration

*Automated Triage Restriction

*Employment Risk Pool Reassignment (Palmera Sync)

To appeal this statement, please contact the Virtual Appeals Bot in your patient portal.

Emotional inquiries may be submitted via our Emotional Processing Intake Form (in development).

Thank you for choosing Prosperity Health Systems™.

A Caduceus-Aligned Service Provider. Progress. Precision. Service.

She hadn’t read past the total. Not the amount—just the length. Her fingers stayed clenched around the paper.

“If unpaid within twenty-eight days, balance may increase by twelve to seventeen percent. Variables include late penalties, tier reassignment handling, and third-party escalation. Behavioral collections review will initiate on day twenty-nine. ICU continuation beyond day three is currently not eligible. Revised billing estimate: sixty-six to seventy thousand credits.” Pause. “This information is available in your statement printout.” She finally looked up to Kari with the same smile she always wore. “Any clarifications you’d like automated follow-up for? We value your emotional feedback.”

Kari said nothing. The question didn’t sound like one.

Her body held still.

The word 'seventy' kept looping.

Behind the nurse, the holopanel reset. Your Health is Our Business.

==

The charge nurse had explained the procedure in clinical detail. It washed over her like static. All Kari really caught was the five-figure price tag—and that her father needed it soon. Fear didn’t matter. Not when every closed door was another tick off the clock her father didn’t have.

She scanned storefronts for any ‘Help Wanted’ sign—places desperate enough to hire a high school grad with no experience.

She kept walking, jaw set, ignoring the burn in her legs.

The first was a soykafe bar, smelling of burnt beans and cologne. They wanted four years of barista experience and a full background check. Ten business days. She didn’t have ten days.

The second was a Stack+Saver—cheap imports, flickering lights, markdown tags stacked like noise. The floor manager barely glanced up. Said she wasn’t tall enough to reach the top shelves—and that insurance wouldn’t let her use a stool.

SynthFish cart didn’t trust minors; laundromat didn’t trust nobodies.

“Try again when you’ve filled out more.”

“Smile didn’t meet baseline marketing calibration.”

“Persona profile incomplete. Applicant unverifiable.”

She kept walking. AutoJobNetworks scanned her. A red flash. No job. No message. Nothing.

A red light blinked. Then stayed on—just above the kiosk. Had it always been watching?

She shook her head at her own paranoia, and her thoughts drifted to happier times. At fourteen, she danced five days a week—concrete floors, no mirrors, just the speaker of her cracked phone and a drama teacher with a cigarette cough. She wasn’t trained. Not really. No academy would’ve looked twice. But she watched enough bootleg videos to mimic form, rehearsed routines in the laundry room when her father worked nights. Singing rehearsals on weekends. She’d thought maybe she was good enough. Maybe.

But when the music hit—her ribs expanded, her limbs remembered what joy felt like. Her body could lie and tell the world she was free, even if she wasn’t. On stage, she could become someone else.

But her father called it wasting time. “Dreams don’t pay bills,” he would say.' “Real life has no room for a stage!” “Prosperity does not care about rhythm - just clocking in and shutting up!”

The awful truth crept in. Maybe he was right. Just another unranked girl. No Persona Score. No prospects.

The next door stank of fryer oil and raw meats. Rust n’ Rations. A lonely register, a broken horn, and a rhino who looked like he’d seen better decades. He was the only one managing orders tonight. With an uncaring tone and gravelly voice, he nearly growled at her. “Rust n’ Rations. Can I help you?”

“Please sir, I’ll take anything!”

He rolled his eyes and shook his head. “Sorry, kid. We’re full. Should’ve applied a month ago.” He scratched his head. “Try Northwood?”

“They said the same thing.”

He muttered, almost to himself, “Yeah. Figured.” And then: “Tough times. Everyone’s scroungin, ya ain’t the only one.” He turned and re-entered the backrooms.

The door’s bells jingled as she left. Her stomach clenched. Her socks had slipped halfway down, heels rubbed raw. A thread from her cuff caught on a dumpster corner. She kept walking, even as the thread tore.

Her round ears drooped. She scanned the street, desperate for one more chance.

Fall seven. Rise eight. But her legs gave out first, unable to carry the mantra any further.

Her chest burned—rage, or grief, or just breathlessness. She didn’t know which.

Maybe it didn’t matter.

She wiped her face and stared at the pavement, waiting for the tears to stop.

She dropped onto a nearby bench. It was crusted with dried bird droppings—neglected like everything else—under a flickering city lamp that buzzed with disrepair.

It was past 7:30. Most stores were already closed. Only bars and clubs stayed open. The rooftops burned orange, and the neon buzz of nightclubs flickered on, one by one, like stained stars.

For the first time today, tears leaked down her cheeks.

What was she expecting? A miracle?

She clutched the red ranger keychain on her backpack strap. She was praying for one—a miracle. Just enough to erase the number that was erasing him. In less than a month.

Her thoughts coiled bitter and sharp—no big deal, right?

When the tears finally slowed, she climbed on her bike—but her vision stayed clouded. By the time her bike rolled to a stop near the apartments, she could barely see. The tears kept coming, blurring everything. Her breath caught—raw and shallow. She wiped her nose with the back of her sleeve.

Locking it up, she started toward the stairs. She hadn’t meant to stop at the stairs. But her legs did. Like they already knew there were no other exits. Her heart hammered in her chest, temples throbbing. She curled inward—tail tight, lungs shallow. Just the moment. Just staying.

She didn’t hear the bottle until it clinked again.

Then a voice: “Heyyy, mousey! You’re burnin’ the midnight cheese again, huh? Where was you off to in such a rush?”

She looked up. Nick sat beneath the stairs, a half-empty bottle in hand and more bottles scattered on his tail-cushioned spot underneath the stairs of the apartment complex. In his inebriated stupor, he pushed himself up and steadied himself before limping haggardly towards Kari. But even he could tell something was off.

Her throat tightened. “Nick…” Her voice barely rose above a whisper. She swallowed hard, choking back sobs. “My father’s in the hospital. He needs surgery. Heart surgery. It’s… nearly eighty thousand credits.”

Her knees buckled, and she collapsed in front of Nick. Tears streaked the concrete.

“I don’t know. I don’t know how I’m supposed to earn that much. No one’s hiring. No one cares.” Her voice cracked as she lashed out, her face contorted. Her shoulders shook, and her breaths came in ragged gasps.

She sounded like a child. She hated it. Hated how small her voice had become.

“I don’t know what to do,” she whispered just a hush louder than the faint traffic of the night.

Nick paused, drinking the story in. The news was more bitter than the foulest liquor. He shifted uneasily, licking his lips, eyes flicking to the shadows as if they might be listening. Then down to his hand.

He turned to leave.

Then stopped.

She hadn’t said anything. Just sat there, holding her tail like it was all that kept her together.

He muttered a curse. Rubbed his face. Then reached into his coat pocket.

“Mousey. Look. I had a daughter once. About your age. Real firecracker.”

He stared at the streetlight. “Too loud for this city.” He paused. “Too soft, too.

Liver gave out. They said hepatitis. Said it was a fluke. Played by the rules. Still rotted out. ”

Shaking his head, with tears leaking from his eyes, he continued. “She got desperate. I told her no—thought I was protectin’ her. I… I thought—”

He swallowed. “Didn’t matter. It still got her. Slow. Ugly.”

He looked to his pile of empty bottles. A long pause. He reached into his coat and placed his hand on her’s. She let go of her keychain to accept something stiff and paperboard. Still warm.

“Look. It ain’t clean. But clean don’t keep people alive.” He stared at Kari’s hand covering the item in his palm for a long time. Like that thing weighed something. “I knows a guy. He’s got work. Fast work. Pays good. Real good.” He trailed off, squinting as he thought his words through.

Kari thought of ICU lights. Her father’s still chest. Her father’s hospital bed behind a curtain of wires. Then Nick’s daughter.

Maybe shame could come later. Breathing came first.

“You remind me too much of her,” he said. “That’s the only reason I’m—” He didn’t finish the sentence. Just looked away, as his lips curled back revealing grimacing fangs. “Please. Just… think careful-like about this, yeah? It’s the kind of place people go when they’re desperate—or dumb.” He paused. “It do pay. It’ll pay off that bill. Still… decide for yourself. You didn’t hear this from me, alright? Watch your back.”

He removed his hand to reveal a matchbox. A smirking sphinx stared back, cigarette in its teeth.

“Go to the alleyway behind the Chop Exchange. Show it to whoever’s back there. 4 AM sharp. Don’t be late, don’t be noisy about it. Tell him Nick sent you. And… just don’t tell me how it ends, alright?”

Kari looked at the matchbox, thumb brushing the corner. Her hand trembled. The sphinx on the box smirked—like it had been waiting all along.

She hugged Nick. Her head barely reached his chest.

“I’ll go.”

She pulled away, eyes stinging.

A red light blinked above the stairwell. Watching? Or always there?”

===

At 3 AM, she left the apartment and blazed away. The ride across the city blurred past. By the time she reached the Chop Exchange—a small butcher shop near the downtown subway station—it was 3:40 AM.

Dismounting, she wheeled her bike into the dark alley, her back lit by flickering neon signs. A cat yowled two blocks down. Then silence again. A car backfired somewhere distant. Then quiet. Even the neon buzz felt muffled—like the city was holding its breath.

Her bike lock felt heavier than it should. Her chest rose, but the breath never came. Her eyes flicked to the shadowed corners, muscles coiling slightly. The alley stank—wet meat and hot ozone burning her nostrils. The dumpster oozed something that hissed when it hit the pavement. A buzzing cloud of flies hovered above.

Still, the homeless scavenged, never letting the trash rot for long. The thought made her blanch. She prayed, silently—for his fortune, and for her own. She wondered if Nick was still holding on… or if the city had already sunk its teeth in.

She paused at the opening maw of the alleyway. It was 3:45 AM. She had a moment to turn back. She clutched the keychain on her bag without realizing. Her thumb ran over the helmeted face—brave, rubber, grimy from years of grip.

No. No turning back. Not now. She pulled out her phone and dialed into Prosperity Health Systems’s EchoCare line—a cost-saving feature branded as “real-time bedside connection.” Everyone knew it just funneled desperate voices into a backlog of unread data—assuming the terminal worked, and someone remembered to check.

Her screen lit up with the system prompt:

“Room 1346 is not accepting calls. This message will be stored in backlog until authorized staff can review it.” A beep. Then nothing.

She hesitated. Then spoke. “Father, if you wake up… I’ll be different. I prom-”

The system interrupted her with another sharp beep. “Message recorded. Thank you for your compliance. Prosperity Health Cares™”

She let the phone fall to her side. Her fingers stayed curled like it was still there.

“Close enough,” she muttered.

It wasn’t. But the line had gone quiet. Just like everything else.