This was in the alternate universe/fantasy/horror genre. It was set in somewhere like Appalachia. The premise was that there were men with supernatural powers who were essentially sociopathic and needed to be controlled. The villages used their powers, but they each had a "keeper" who essentially controlled access to them and their powers.
In this story, the keeper of one of these witch men was dying of an incurable disease. The story is told from her point of view.