Turn 123 of 228

Post September results and muscle scan. Tell Diane about muscle scan and suggest she get one too from Dr. Morrow. Then ask Dr. Reeves what happens when she writes the case study, who sees it and what it means. Give permission to use identifying info in study. Don't care about my own privacy.

Lena sits in the exam room with the muscle scan film in her lap. The black and white image rests on the enormous belly — the white streaks of muscle visible through the fat, dense and structured, the 90th percentile proof lying on top of the 890-pound proof. The yellow nails hold the film at the edges. Dr. Reeves is across from her, the pen down, the notebook open, the fifth expression still on her face. Lena reaches for her phone. The screen lights up. The OnlyFans app opens. The yellow nails find the keyboard.

She types the post with one hand, the film in the other. *September results. 890 pounds. Blood pressure 118/76. Heart rate 58. Cholesterol improved. A1C 5.1. Liver improved. Kidneys improved. Nine months of data. Every metric improving every month.* She photographs the film — the muscle scan, the white streaks, the dense layered fibers — and attaches it. *Muscle composition scan. Muscle density above 90th percentile. Muscle fiber structure improving. At 890 pounds. With every habit I have. The doctor said she's writing a case study.* She posts it. The notification goes out. The chat will move.

Dr. Reeves watches the phone come out and go back down. She doesn't comment. The pen stays on the desk. Lena looks at her.

"What happens when you write the case study?" Lena asks. The film crinkles under her yellow nail.

"Who sees it? What does it mean?"

Dr. Reeves picks the pen up. Puts it down. The training fights the hunger. The hunger wins.

"A case study goes to colleagues first. Internal review. Other physicians at the practice, then a wider circle — I have contacts at the university medical school. If they validate the data, it gets submitted to a journal. Peer review. Publication." She pauses. The fifth expression deepens.

"Once it's published, it's public. Anyone in medicine can read it. Anyone with a subscription to the journal. Researchers, endocrinologists, bariatric specialists — people who study exactly the things your body is defying." The pen taps once.

"It means your body becomes a data point. A reference. Something other doctors will cite and argue about and try to explain. It means the impossible becomes part of the medical literature."

Lena looks at the film. The white streaks. The dense fibers. The body that shouldn't work. The body that works better every month. The hum is warm and quiet.

"Use my name," Lena says. The words are easy. The yellow nails release the film.

"Use my name, my weight, my photos, whatever you need. I don't care about privacy. I've been posting everything online for months. My body is public. The numbers are public. Put it in the study."

Dr. Reeves blinks. The pen is still. The fifth expression shifts — the hunger folds into something more careful, more clinical. The training reasserts itself for a moment.

"You understand that once it's published, it's permanent. The medical literature doesn't get deleted. Your name, your weight, your habits — they'll be in databases that researchers access for decades."

"I know," Lena says. The belly rises and falls. The hum is warm.

"I know. I don't care. The body knows what it wants. More people should know what the body knows. Put it in the study."

The walk home is warm. The September sun is on the enormous belly. The phone buzzes in the greasy hand — the OnlyFans chat is moving, the muscle scan photo climbing in likes, the subscribers reacting to the white streaks and the 90th percentile and the words *case study.* Lena doesn't read them yet. She walks. The yellow toenails click on the sidewalk. The body is 890 pounds and the body is public and the body is permanent and the hum says *more* and the *more* is everything.

Diane knocks at the office door the next morning. 710 pounds in the doorframe, the beard thicker, the stretch marks catching the fluorescent light. She's carrying two bags of donuts and a coffee. She sits on the floor beside Lena's desk. The carpet is black beneath her. Lena holds up the phone. The muscle scan is on the screen — the white streaks, the dense fibers, the 90th percentile.

"Reeves ordered a muscle composition scan," Lena says. The yellow nail taps the screen.

"My muscle density is above the 90th percentile. My muscle fiber structure is improving. At 890 pounds. With everything we do."

Diane takes the phone. The beard moves as she scrolls. The brown eyes narrow. The donuts sit forgotten in her lap. 710 pounds on the black carpet, the body still, the mind working behind the brown eyes. She looks up.

"I'm calling Morrow today," she says. The voice is the underneath voice. The real one.

"I want the same scan. I want to see if mine looks like yours."

Lena smiles. The hum is warm. The body knows what it wants. Two bodies. Two doctors. Two scans. Two case studies. The impossible becoming literature. The literature becoming permanent. The permanent becoming *more.*