My novel Call It Madness, slated for publication in a year and half (a small eternity away?), is arranged by places — or vessels in my mind. An apartment, an unheated farmhouse, the center of a frozen lake. To my way of thinking, places shape who we are.

Friday, wheeled on my back into a procedure room at Dartmouth-Hitchcock, I answered the usual name and date of birth and then a third question: why are you here today? A moment, a pause, and then I answered I was there for a specific biopsy.

Words are magical things, and magic is powerful. In the Dartmouth waiting room, laughing with my brother about memories from our childhood (he cheated at Monopoly, yes, I hit him over the head with a metal rod), the thought kept pulsing through my mind how much I didn’t want to be there (get out! walk out!), for this appointment I had worked so hard to finagle. But saying those words aloud sealed this very first step.

On the long drive home, the full Beaver Moon rose, lit the river and interstate, the ubiquitous Vermont hayfields still green in this lingering late autumn, the sky a blush of pink , reminding us, again, of the sheer luck of millennia of sunsets and the sailing moon, each dearly unique.

Later, later, lying on the couch, my brother and youngest sit opposite me, drinking beer and talking, eating the prized Club crackers that I never buy and a kind neighbor left. My brother disappears into the kitchen and returns.

“Cheese!” my daughter says, sparkling with happiness.