It started slowly after you’d been doing autopsies for a while. You started noticing things, things that could be deadly, or even just potentially life-threatening. They were everywhere, these things that could kill you.

It’s just past dawn, you’ve kissed your sleeping baby goodbye, and you’re headed to the hospital on a winter highway, when a giant tractor trailer moving at warp speed passes by you with its chains rattling. That truck could easily cross the line and wipe you out, flattening your two-ton Volvo like a stick of cheap margarine. Or it could speed right by you, flinging a day’s worth of melting ice and snow at your windshield. There you’d be, facing a white oblivion, frantically reaching for the lever that controls the windshield wipers, pushing it down to its maximum speed with your panicked hand. (Too slow to react and the car might careen into the median strip and towards your certain death.)

And even after you’ve made it safely to work, what then? Look, here are some leftovers from that noontime conference with its spread of greasy pizza and those sandwiches cut in half from the corner sub shop, looking worse for wear. You greedily grab a slice and a bedraggled turkey and cheese, hurry, there’s just a few left, here’s a napkin, you’ll eat them on the run.

But how long had they been sitting there? Was the lettuce on that sandwich from an E. coli-laden bag of shredded romaine? Did the man handling the pizza “forget” to wash his hands after a quick run to the toilet? (His boss doesn’t like him leaving his station, but he wasn’t feeling so good, so maybe he chanced it, you know?)

It’s unusual to die from food poisoning, but it happens, doesn’t it? Despite all those late-generation antibiotics, those cyclines and sporins and quinolones, somehow, people still end up getting deadly infections.

The young woman you just autopsied, who died from overwhelming sepsis, despite the desperate invocation of all those antibiotics, could not be saved, could she? That pale mute body, her intravenous lines still in place, her defenses overcome by marauding bacteria, was once just like you, anxious for her life to finally begin, and now here is her uterus in your gloved hand and here is your description of it: nongravid, no signs of pregnancy either now or earlier in her short, doomed life. And there certainly will be no pregnancies forthcoming. Just an empty organ with nothing more to wait for.

Or you could be the victim of a freak accident. Some construction scaffolding could collapse on your head just as you are walking underneath it, or a random cement panel from the ceiling of a tunnel on the Massachusetts Turnpike could fall on your car, killing you instantly. (It’s been known to happen.)

Or you could be casually crossing the street on a sunny morning, and a driver, rushing to get to work, not noticing you because the sun was in her eyes, could hit you with enough force to crack your skull, doing sufficient damage to your white matter, to the neurons that make you you, so that you fall into a gray amorphous unconsciousness.

And you know what awaits you then: a long tenancy in the Intensive Care Unit, attended by an angel of an ICU nurse. But even angels cannot undo an Act of God. Your lungs gradually stiffen from the forced mechanical breathing (you’ve seen lungs like this on the autopsy table), and it becomes harder and harder to maintain adequate perfusion, the blood pressure so critical for a working brain. Your relatives are called, pale and frightened, to discuss do-not-resuscitate orders. The clinicians say, We would like to speak with you about some new developments in your loved one’s prognosis (translation: it’s not good). You can have the room afterwards to discuss these difficult decisions.

With each passing week, you become more proficient. You enter the morgue briskly, your scrubs the color of a cloudless sky, the air heavy with formaldehyde. The cadaver on the table patiently awaits you.

You learn the art of the autopsy: first, the Y-shaped incision, then the deft examination of the heart and lungs, the careful look through rinsed bowels for occult cancers, the dissection of the adrenals. You become better at guessing where a tumor originated by looking at the pattern of its metastases—lots of small ones in both lungs meaning one thing, one large lymph node in the neck, something else.

But at the same time (and you cannot help yourself here and Lord knows you’ve tried), you’ve begun carrying deep within you the substance, the germ, the materiality of death. You know it can happen anytime, anywhere, to anyone. We all know this by the time we are nine or ten, kinda sorta. But you actually know this; it has become part of your everyday working fund of knowledge. You know you cannot outrun death because it will seek you out. And, not to put too fine a point on it, it will find you. (When you were younger, you used to think Love would find you, but now you know it is Death that will follow you, even if you hide, to the ends of the earth).

And look, you don’t even have to leave your home. That’s how insanely efficient this whole process is. Even if you develop an agoraphobic’s attachment to your own house, your own cozy room, your comfy bed with its plush gray blankets and soft 100 percent percale sheets. Will you be safe here? Nope, uh-uh. Sorry. You could slip on a discarded piece of clothing, and fall on your tormented head late at night, as you are making your way back to your warm bed from the bowels of your cold, tiled bathroom.

That man you just left on the autopsy table, silent and mottled, he suffered precisely that little mishap, didn’t he? He developed an acute subdural hematoma after a fall in the night, and, if you had to guess, he didn’t suspect a thing. You picture him wincing as he touches his head with a gently probing finger and then slowly, carefully, climbs back under the covers. (And why wouldn’t he? He probably didn’t feel that bad).

But the headache that must have lain beneath his bruised brow was not getting any better, although he was probably getting verrrry sleepy. Sleep must have felt soothing, and he likely thought it would do him good and hoped his head wouldn’t ache so much in the morning.

His wish came true, but that was only because he was unable to feel his head. Or any of the rest of his body. Death had come softly under the cover of night by way of a torn blood vessel silently weeping blood, the blood then accumulating under his dura, the tough fibrous tissue covering his brain. And then the expanding pressure in the closed space of his skull compressed that soft and yielding organ. And then it compressed him. Until he was no longer breathing.

Sometimes, this is the way it ends. Not with a bang or through anyone’s malice aforethought but from plain old piss-poor bad luck. If you learned any lessons at all in the autopsy suite, this was probably the most important.

And speaking of malice, we haven’t even discussed murder most foul, at the hands of a stranger, or worse, at the hands of someone you know (or thought you knew). But no sense worrying about any of that now, before you’ve done your one-month rotation at the Medical Examiner’s. You’ll do a deep dive then into all the ways that someone else can do you in. (Well, no. What will actually happen is that you will learn you have a very strong stomach, and you may not want to watch the evening news while there unless you want to relive your day in gory detail. And I mean in actual gory detail.)

So, what now? You adjust. Take fewer chances. You change lanes when you see a driver in your rear-view mirror driving erratically. You turn down the questionable-looking sandwich garnished with the alfalfa sprouts of death. You wait two or three beats before you cross the street even after the little green man-light urges you to walk, watching for cars that speed up to make the light. (I mean, no sense hurrying only to be delayed by your own death.) You clear your bedroom floor of errant items of clothing by kicking them under the dresser. You won’t locate that shirt again for three months. (But better alive than well-dressed.)

So, what about now? Are you safe? Can you go about your day like a normal person, thinking idly about dinner or planning a Sunday stroll in the park with your infant daughter?

Ha, please. Not even close. What of the ticking time bomb of your own body? How will you handle that?

You start monitoring yourself almost without realizing it. What was that faint flutter deep in your chest? Too much caffeine? A benign arrhythmia? Or an early sign that a virus has infected your heart, eventually turning it into a flabby balloon, rendering it useless for its intended purposes? (Unusual, but it’s been known to happen.)

And that aching in your calf. When did that begin? Did you pull it yesterday running to make the train? Or did the hours of sitting and writing reports combined with your estrogen-heavy birth control pill (the one that you dutifully take even though you are too tired and sad to have sex anymore), cause you to develop a deep vein thrombosis, a blood clot clinging to the sides of a blood vessel in your leg? The clot then eventually escaping from its tentative moorings, becoming jetsam in your bloodstream, traveling to your lungs, where it forms a massive pulmonary embolus, stopping your blood flow and your heart in one catastrophic fell swoop.

And those bruises on your legs. Just another indication of your clumsiness? Or a sign your platelet count has plummeted to near-zero because your bone marrow has been infiltrated with leukemic cells, cells that mimic your own white blood cells but are actually hapless pretenders that couldn’t battle a bacterium to save their own lives (not to mention yours).

But okay, here, here’s a little something. Let me throw you a bone (haha). This might make you feel better. At least you know you will not be dying by your own hand. I mean, no. That would be frankly preposterous, although it’s been known to happen to medical residents in the early morning gloom of a night on-call, residents that have access to sedating drugs and syringes and who are too disturbed and lonely to say they are disturbed and lonely. (For one thing, you are a pathology resident, and you only have access to jars of awful smelling formaldehyde solutions. Good luck offing yourself with that.)

And after surviving yet another day, another night, the hours steeped in death, in the sights, smells, and vocabulary of death, your hair reeking like embalming fluid, your small infant an island of bright light beckoning, floating on a foreign sea, after running through a virtual gauntlet of the ways that life can kill you, things no one else thinks twice about but you do because you’ve been given the keys to that particular distressing kingdom (and apparently there’s no way to give them back), do you think, do you really think, that you would let your private sorrows eat through you like a hungry worm through a cadaver, leading you to take your own life?

No. No, I think not.

Racing to catch the 7:25 train, your husband will meet you at the station. Here it is, quick, watch the door, get on, before it pulls away. Crowded as usual, packed in with the other working stiffs, released on their own recognizance till tomorrow morning. Look, your station, coming up next. You squeeze past twenty identical tan L.L. Bean down jackets, stepping carefully over the abandoned water bottles rolling down the aisle. Then down the steps, and off onto the platform, careful, watch for ice, you could slip and break your pelvis, releasing globules of fat and cells from deep within the bone’s marrow, the fat cruising through your bloodstream, landing in your lungs, and compromising your breathing. (Okay, this one is really rare—but it’s been known to happen.)

You stand in the parking lot and squint into the distant dark air. Where is he? Where’s the car? (Jesus, so cold now, keep forgetting to take the puffy jacket out of the downstairs closet, remember to do it this weekend, put it on the list), where is the damn car? There it is, parked at the very end. Here he is, your spouse, angry about something, you try but can’t remember what it might be (could be anything, sky’s the limit). Oh well, it’ll pass into the day’s mists.

Peck his cheek. How was your day? Fine, fine. Not too bad. What about you? Okay. Cold. Yup, feels like snow tonight.

Here we go, no one’s behind us, down the street, up the hill, here are the lights, turning yellow, go, go, go, around the curve (when did that Thai place close?), up the lane, almost there, nearly there. And—there! Finally. We’re here.

The driveway, glittering under the streetlights, your house silhouetted against the frigid black sky, a smattering of frozen stars. Warm light pours out of your living room window like the afternoon rays through a stained-glass sun.

You pause at the bottom of the stairs. The sutures holding your heart together starting to dissolve, the strictures narrowing your airways loosening, your parasympathetic nervous system coaxing the adrenaline out of your bloodstream, your pulse slowing. The racket inside your noisy, cluttered, fearful brain begins to hush.

Up the stairs now, two at a time, stopping just below the landing. Shhhh. Listen: the sound of water gurgling, a cough, a rustle, a long sigh. Your au pair getting ready for her night on the town, preparing for the hand-off, the infant relay race, your daughter, the baton.

A moment’s pause, two milliseconds, you hold your breath. And, at last, there it is— your baby’s soft laugh. A sharp prism of happiness flies down to meet you and you ride that radiant, angular beam into the bath-warm entryway, your cold hands tingling like soda bubbles.

You take in another breath and your lungs fill and rise in your chest—you are buoyant, weightless, insubstantial. Then, light as air, your body an afterthought, you float through the kitchen and into the evening. Incorporeal, as though you had met your end and were already a ghost.