The name on the chart, Winnaker, tightened my throat. Funny how, decades later, a word can evoke a memory that evokes a physical response. It's a good thing the evil woman's name hadn't been Smith. But – Winnaker – it couldn't be her, my high school English teacher. She'd be long dead now and criticizing Lucifer for his diction in front of his exultant minions. 

I asked the medical student to present the patient.
"Ms. Winnaker is a seventy-six-year-old woman with a history of breast cancer who was admitted yesterday with severe headache, nausea and vomiting." He rocked back and forth on stiff legs. "CT scan revealed a four-by-seven-centimeter mass in her right parietal lobe, and at least three other smaller lesions consistent with metastatic disease."
With a nod from me, his speech accelerated fractionally as he described her history of breast cancer, surgery, chemotherapy and follow up. The rest of her medical history was negative.
"Regarding social history, she lives alone, never married, no children. She's a retired English teacher..."
I lost focus then. How many elderly retired English teachers named Winnaker could there be in the state?
I continued to nod at appropriate places but heard little else from the medical student. I could read his write-up later.
"Okay, let's go in and see her," I said.

I knocked, opened the door and approached the elderly woman sitting nearly upright in bed. She looked twenty years older than her seventy-six years, and a hundred years older than my high school tormenter.
"Good morning, Ms. Winnaker." The phrase echoed in my head from all those years ago when we were compelled to say it each day or risk a solo performance.
She eyed me critically. In recognition? More likely that's how she looked at everyone. For all she'd changed in thirty years, I'd changed more, from that terrified, insecure fifteen-year-old.
"I'm Dr. Stevens from Internal Medicine." I shook the bony, veined hand that had scarred my essays with red, and gave me the only ‘B' of my education career. The B that made me salutatorian.
How shallow am I?
"And this is my team."
She stared vaguely at the group as they introduced themselves, then interrupted. "I'd like to speak to you alone, doctor."
"This is a teaching hospital and—"
"I realize that, Vicky, but I am the patient."
She recognized me. Instantly diminished, a rustling occurred behind me. My chief resident said, "We'll wait in the hall."
I could refuse, or come back after rounds, but I didn't. I also didn't sit, or hold her hand, not this time.
"I'm dying," she said. "I don't want a biopsy or treatment. I want something I can take at home and be done with this."
It wasn't the first time I'd been asked.
"I'm afraid euthanasia is illegal in this state. There are other places, Oregon for one—"
"I want to die at home. Not in Oregon." No longer frail, her voice took me back, made me small. "You vowed to ‘Do no harm.' Forcing me to die a slow, painful death is harm."
"Our lawmakers don't see it that way." I could lose my license, or worse.
She shook her head with the same disappointment I remembered all too well. "You were my last hope."
"You already knew," I said.
"Of course I knew, but my doctor refused to help me. I thought, I hoped, that you would. That you would want to pay me back..."
I recoiled. "You thought I still hated you enough to kill you?" Could she possibly think me so merciless?
She paled, lips trembling. "Hated? No." A tear rolled down her wrinkled cheek. "Esteemed."

I stared at this woman I blamed for my high school misery. The woman who single-handedly pushed valedictorian from my reach. All I had was my academic record. All my pride and self-worth in one small basket, until she ripped a hole in it in front of my classmates.

"I thought you would help me out of gratitude. Everyone patted you on the head and told you how smart you were. I taught you that life is more than grades, that only your best is good enough, that life isn't fair."
My head spun. At the time it wasn't life I thought unfair, but her, Mrs. Winnaker.
"I've followed your career, your honors and awards. I nominated you for the alumni award."
She nominated me? Memories of her were the reason I skipped the ceremony. Not, as I told my parents, because I was on call.
"Please, Vicky, if not out of love, how about out of hate?"