My Sister's Keeper (10 page)

Once, Anna walked in on me when I was in the bathroom. “Hey,” I
said. “Check this out.” I dribbled some Jean Nate on the floor, her
initials. Then I torched them. I figured she'd run screaming like a
tattle-tale, but instead she sat right down on the edge of the bathtub. She
reached for the bottle of Jean Nate, made some loopy design on the tiles, and
told me to do it again.

Anna is the only proof I have that I was born into this family, instead of
dropped off on the doorstep by some Bonnie and Clyde couple that ran off into
the night. On the surface, we're polar opposites. Under the skin, though, we're
the same: people think they know what they're getting, and they're always
wrong.

Fuck them all. I ought to have that tattooed on my forehead, for
all the times I've thought it. Usually I am in transit, speeding in my Jeep
until my lungs give out. Today, I'm driving ninety-five down 95.1 weave in and
out of traffic, sewing up a scar. People yell at me behind their closed
windows. I give them the finger.

It would solve a thousand problems if I rolled the Jeep over an embankment.
It's not like I haven't thought about it, you know. On my license, it says I'm
an organ donor, but the truth is I'd consider being an organ martyr.
I'm sure I'm worth a lot more dead than alive—the sum of the parts equals more
than the whole. I wonder who might wind up walking around with my liver, my
lungs, even my eyeballs. I wonder what poor asshole would get stuck with
whatever it is in me that passes for a heart.

To my dismay, though, I get all the way to the exit without a scratch. I
peel off the ramp and tool along Aliens Avenue. There's an underpass there
where I know I'll find Duracell Dan. He's a homeless dude, Vietnam vet, who
spends most of his time collecting batteries that people toss into the trash.
What the hell he does with them, I don't know. He opens them up, I know that
much. He says the CIA hides messages for all its operatives in Energizer
double-As, that the FBI sticks to Evereadys.

Dan and I have a deal: I bring him a McDonald's Value Meal a few times a
week, and in return, he watches over my stuff. I find him huddled over the
astrology book that he considers his manifesto. “Dan,” I say, getting
out of the car and handing him his Big Mac. “What's up?”

He squints at me. “The moon's in freaking Aquarius.” He stuffs a
fry into his mouth. “I never should have gotten out of bed.”

If Dan has a bed, it's news to me. “Sorry about that,” I say.
“Got my stuff?”

He jerks his head to the barrels behind the concrete pylon where he keeps my
things. The perchloric acid filched from the chemistry lab at the high school
is intact; in another barrel is the sawdust. I hike the stuffed pillowcase under
my arm and haul it to the car. I find him waiting at the door.
“Thanks.”

He leans against the car, won't let me get inside. “They gave me a
message for you.”

Even though everything that comes out of Dan's mouth is total bullshit, my
stomach rolls over. “Who did?”

He looks down the road, then back at me. “You know.” Leaning
closer, he whispers, “Think twice.”

“That was the message?”

Dan nods. “Yeah. It was that, or Drink twice. I can't be
sure.”

“That advice I might actually listen to.” I shove him a little,
so that I can get into the car. He is lighter than you'd think, like whatever
was inside him was used up long ago. With that reasoning, it's a wonder I don't
float off into the sky. “Later,” I tell him, and then I drive toward
the warehouse I've been watching.

I look for places like me: big, hollow, forgotten by most everyone. This
one's in the Olneyville area. At one time, it was used as a storage facility
for an export business. Now, it's pretty much just home to an extended family
of rats. I park far enough away that no one would think twice about my car. I
stuff the pillowcase of sawdust under my jacket and take off.

It turns out that I learned something from my dear old dad after all:
firemen are experts at getting into places they shouldn't be. It doesn't take
much to pick the lock, and then it's just a matter of figuring out where I want
to start. I cut a hole in the bottom of the pillowcase and let the sawdust draw
three fat initials, JBF. Then I take the acid and dribble it over the letters.

This is the first time I've done it in the middle of the day.

I take a pack of Merits out of my pocket and tamp them down, then stick one
into my mouth. My Zippo's almost out of lighter fluid; I need to remember to
get some. When I'm finished, I get to my feet, take one last drag, and toss the
cigarette into the sawdust. I know this one's going to move fast, so I'm
already running when the wall of fire rises behind me. Like all the others,
they will look for clues. But this cigarette and my initials will have long
been gone. The whole floor underneath them will melt. The walls will buckle and
give.

The first engine reaches the scene just as I get back to my car and Pull the
binoculars out of my trunk. By then, the fire's done what it wants to—escape.
Glass has blown out of windows; smoke rises black, an eclipse.

The first time I saw my mother cry I was five. She was standing at the
kitchen window, pretending that she wasn't. The sun was just coming up, a
swollen knot. “What are you doing?” I asked. It was not until years
later that I realized I had heard her answer all wrong. That when she said mourning,
she had not been talking about the time of day.

The sky, now, is thick and dark with smoke. Sparks shower as the roof falls
in. A second crew of firefighters arrives, the ones who have been called in
from their dinner tables and showers and living rooms. With the binoculars, I
can make out his name, winking on the back of his turnout coat like it's
spelled in diamonds. Fitzgerald. My father lays hands on a charged line, and I
get into my car and drive away.

At home, my mother is having a nervous breakdown. She flies out the door as
soon as I pull into my parking spot. “Thank God,” she says. “I
need your help.”

She doesn't even look back to see if I'm following her inside, and that is
how I know it's Kate. The door to my sisters' room has been kicked in, the
wooden frame around it splintered. My sister lies still on her bed. Then all of
a sudden she bursts to life, jerking up like a tire jack and puking blood. A stain
spreads over her shirt and onto her flowered comforter, red poppies where there
weren't any before.

My mother gets down beside her, holding back her hair and pressing a towel
up to her mouth when Kate vomits again, another gush of blood.
“Jesse,” she says matter-of-factly, “your father's out on a
call, and I can't reach him. I need you to drive us to the hospital, so that I
can sit in the back with Kate.”

Kate's lips are slick as cherries. I pick her up in my arms. She's nothing
but bones, poking sharp through the skin of her T-shirt.

“When Anna ran off, Kate wouldn't let me into her room,” my mother
says, hurrying beside me. “I gave her a little while to calm down. And
then I heard her coughing. I had to get in there.”

So you kicked it down, I think, and it doesn't surprise me. We
reach the car, and she opens the door so that I can slide Kate inside. I pull
out of the driveway and speed even faster than normal through town, onto the
highway, toward the hospital.

Today, when my parents were at court with Anna, Kate and I watched TV. She
wanted to put on her soap and I told her fuck off and put on the scrambled
Playboy channel instead. Now, as I run through red lights, I'm wishing that I'd
let her watch that retarded soap. I'm trying not to look at her little white
coin of a face in the rearview mirror. You'd think, with all the time I've had
to get used to it, that moments like this wouldn't come as such a shock. The
question we cannot ask pushes through my veins with each beat: Is this it?
Is this it? Is this it?

The minute we hit the ER driveway, my mother's out of the car, hurrying me
to get Kate. We are quite a picture walking through the automatic doors, me
with Kate bleeding in my arms, and my mother grabbing the first nurse who walks
by. “She needs platelets,” my mother orders.

They take her away from me, and for a few moments, even after the ER team
and my mother have disappeared with Kate behind closed curtains, I stand with
my arms buoyed, trying to get used to the fact that there's no longer anything
in them.

Dr. Chance, the oncologist I know, and Dr. Nguyen, some expert I don't, tell
us what we've already figured out: these are the death throes of end-stage
kidney disease. My mother stands next to the bed, her hand tight around Kate's
IV pole. “Can you still do a transplant?” she asks, as if Anna never
started her lawsuit, as if it means absolutely nothing.

“Kate's in a pretty grave clinical state,” Dr. Chance tells her.
“I told you before I didn't know if she was strong enough to survive that
level of surgery; the odds are even slighter now.”

“But if there was a donor,” she says, "would you do it?”

“Wait.“ You'd think my throat had just been paved with straw.
”Would mine work?"

Dr. Chance shakes his head. “A kidney donor doesn't have to be a
perfect match, in an ordinary case. But your sister isn't an ordinary
case.”

When the doctors leave, I can feel my mother staring at me.
“Jesse,” she says.

“It wasn't like I was volunteering. I just wanted to, you know, know.”
But inside, I'm burning just as hot as I was when that fire caught at the
warehouse. What made me believe I might be worth something, even now? What made
me think I could save my sister, when I can't even save myself?

Kate's eyes open, so that she's staring right at me. She licks her lips—they're
still caked with blood—and it makes her look like a vampire. The undead. If
only.

I lean closer, because she doesn't have enough in her right now to make the
words creep across the air between us. Tell, she mouths, so that my
mother won't look up.

I answer, just as silent. Tell? l want to make sure I've got it
right.

Tell Anna.

But the door to the room bursts open and my father fills the room with
smoke. His hair and clothes and skin reek of it, so much so that I look up,
expecting the sprinklers to go off. “What happened?” he asks, going
right to the bed.

I slip out of the room, because nobody needs me there anymore. In the
elevator, in front of the NO SMOKING sign, I light a cigarette.

Tell Anna what?

SARA

-1991

BY PURE CHANCE, or maybe karmic distribution, all three clients at the hair
salon are pregnant. We sit under the dryers, hands folded over our bellies like
a row of Buddhas. “My top choices are Freedom, Low, and Jack,” says
the girl next to me, who is getting her hair dyed pink.

“What if it's not a boy?” asks the woman sitting on my other side.

“Oh, those are meant to be for either.”

I hide a smile. “I vote for Jack.”

The girl squints, looking out the window at the rotten weather. “Sleet
is nice,” she says absently, and then tries it on for size. “Sleet,
pick up your toys. Sleet, honey, come on, or we're gonna be late for the Uncle
Tupelo concert.” She digs a piece of paper and a pencil stub out of her
maternity overalls and scribbles down the name.

The woman on my left grins at me. “Is this your first?”

“My third.”

“Mine too. I have two boys. I'm keeping my fingers crossed.”

“I have a boy and a girl,” I tell her. “Five and three.”

“Do you know what you're having this time?”

I know everything about this baby, from her sex to the very placement of her
chromosomes, including the ones that make her a perfect match for Kate. I know
exactly what I am having: a miracle. “It's a girl,” I answer.

“Ooh, I'm so jealous! My husband and I, we didn't find out at the
ultrasound. I thought if I heard it was another boy, I might never finish out
the last five months.” She shuts off her hair dryer and pushes it back.
“You have any names picked?”

It strikes me that I don't. Although I am nine months pregnant, although I
have had plenty of time to dream, I have not really considered the specifics of
this child. I have thought of this daughter only in terms of what she will be
able to do for the daughter I already have. I haven't admitted this even to
Brian, who lies at night with his head on my considerable belly, waiting for
the twitches that herald—he thinks—the first female placekicker for the
Patriots. Then again, my dreams for her are no less exalted; I plan for her to
save her sister's life.

“We're waiting,” I tell the woman.

Sometimes I think it is all we ever do.

There was a moment, after Kate's three months of chemotherapy last year,
that I was stupid enough to believe we had beaten the odds. Dr. Chance said
that she seemed to be in remission, and that we would just keep an eye on what
came next. And for a little while, my life even got back to normal:
chauffeuring Jesse to soccer practice and helping out in Kate's preschool class
and even taking a hot bath to relax.

And yet, there was a part of me that knew the other shoe was bound to drop.
This part scoured Kate's pillow every morning, even after her hair started to
grow back with its frizzy, burned ends, just in case it started falling out
again. This part went to the geneticist recommended by Dr. Chance. Engineered
an embryo given the thumbs-up by scientists to be a perfect match for Kate.
Took the hormones for FVF and conceived that embryo, just in case.

It was during a routine bone marrow aspiration that we learned Kate was in
molecular relapse. On the outside, she looked like any other three-year-old
girl. On the inside, the cancer had surged through her system again,
steamrolling the progress that had been made with chemo.

Now, in the backseat with Jesse, Kate's kicking her feet and playing with a
toy phone. Jesse sits next to her, staring out the window. “Mom? Do buses
ever fall on people?”

“Like out of trees?”

“No. Like… just over.” He makes a flipping motion with his hand.

“Only if the weather's really bad, or if the driver's going too
fast.”

He nods, accepting my explanation for his safety in this universe. Then:
“Mom? Do you have a favorite number?”

“Thirty-one,” I tell him. This is my due date. “How about
you?”

“Nine. Because it can be a number, or how old you are, or a six
standing on its head.” He pauses only long enough to take a breath.
“Mom? Do we have special scissors to cut meat?”

“We do.” I take a right and drive past a cemetery, headstones
canted forward and back like a set of yellowed teeth.

“Mom?” Jesse asks, “is that where Kate will go?”

The question, just as innocent as any of the others Jesse would ask, makes
my legs go weak. I pull the car over and put on my hazard lights. Then I
unbuckle my seat belt and turn around. “No, Jess,” I tell him.
“She's staying with us.”

“Mr. and Mrs. Fitzgerald?” the producer says. “This is where
we'll put you.”

We sit down on the set at the TV studio. We've been invited here because of
our baby's unorthodox conception. Somehow, in an effort to keep Kate healthy,
we've unwittingly become the poster children for scientific debate.

Brian reaches for my hand as we are approached by Nadya Carter, the reporter
for the newsmagazine. “We're just about ready. I've already taped an intro
about Kate. All I'm going to do is ask you a few questions, and we'll be
finished before you know it.” Just before the camera starts rolling, Brian
wipes his cheeks on the sleeve of his shirt. The makeup artist, standing behind
the lights, moans. “Well, for God's sake,” he whispers to me.
“I'm not going on national TV wearing blush.”

The camera comes to life with far less ceremony than I've expected, just a
little hum that runs up my arms and legs.

“Mr. Fitzgerald,” Nadya says, “can you explain to us why you
chose to visit a geneticist in the first place?”

Brian looks at me. "Our three-year-old daughter has a very aggressive
form of leukemia. Her oncologist suggested we find a bone marrow donor—but our
oldest son wasn't a genetic match. There's a national registry, but by the time
the right donor comes along for Kate, she might not… be around. So we thought
it might be a good idea to see if another sibling of Kate's matched up.”

“A sibling,“ Nadya says, ”who doesn't exist."

“Not yet,” Brian replies.

“What made you turn to a geneticist?”

“Time constraints,” I say bluntly. “We couldn't keep having
babies year after year until one was a match for Kate. The doctor was able to
screen several embryos to see which one, if any, would be the ideal donor for
Kate. We were lucky enough to have one out of four—and it was implanted through
IVF.”

Nadya looks down at her notes. “You've received hate mail, haven't
you?”

Brian nods. “People seem to think that we're trying to make a designer
baby.”

“Aren't you?”

“We didn't ask for a baby with blue eyes, or one that would grow to be
six feet tall, or one that would have an IQ of two hundred. Sure, we asked for
specific characteristics—but they're not anything anyone would ever consider to
be model human traits. They’re just Kate's traits. We don't want a
superbaby; we just want to save our daughter's life.”

I squeeze Brian's hand. God, I love him.

“Mrs. Fitzgerald, what will you tell this baby when she grows up?”
Nadya asks.

“With any luck,” I say, “I'll be able to tell her to stop
bugging her sister.”

I go into labor on New Year's Eve. The nurse taking care of me tries to
distract me from my contractions by talking about the signs of the sun.
“This one, she's gonna be a Capricorn,” Emelda says as she rubs my
shoulders.

“Is that good?”

“Oh, Capricorns, they get the job done.”

Inhale, exhale. “Good… to… know,” I tell her.

There are two other babies being born. One woman, Emelda says, has her legs
crossed. She's trying to make it to 1991. The New Year's Baby is entitled to
packs of free diapers and a $100 savings bond from Citizens Bank for that
distant college education.

When Emelda goes out to the nurse's desk, leaving us alone, Brian reaches
for my hand. “You okay?”

I grimace my way through another contraction. “I'd be better if this
was over.”

He smiles at me. To a paramedic/firefighter, a routine hospital delivery is
something to shrug at. If my water had broken during a train wreck, or if I was
laboring in the back of a taxi—

“I know what you're thinking,” he interrupts, although I haven't
said a word out loud, “and you're wrong.” He lifts my hand, kisses
the knuckles.

Suddenly an anchor unspools inside me. The chain, thick as a fist, twists in
my abdomen. “Brian,” I gasp, “get the doctor.”

My OB comes in and holds his hand between my legs. He glances up at the
clock. “If you can hold on a minute, this kid's gonna be born
famous,” he says, but I shake my head.

“Get it out,” I tell him. “Now.”

The doctor looks at Brian. “Tax deduction?” he guesses.

I am thinking of saving, but it has nothing to do with the IRS. The baby's
head slips through the seal of my skin. The doctor's hand holds her, slides
that gorgeous cord free of her neck, delivers her shoulder by shoulder.

I struggle to my elbows to watch what is going on below. “The umbilical
cord,” I remind him. “Be careful.” He cuts it, beautiful blood,
and hurries it out of the room to a place where it will be cryogenically
preserved until Kate is ready for it.

Day Zero of Kate's pre-transplant regimen starts the morning after Anna is
born. I come down from the maternity ward and meet Kate in Radiology. We are
both wearing yellow isolation gowns, and this makes her laugh.
“Mommy,” she says, “we match.”

She has been given a pediatric cocktail for sedation, and under any other
circumstance, this would be funny. Kate can't find her own feet. Every time she
stands up, she collapses. It strikes me that this is how Kate will look when
she gets drunk on peach schnapps for the first time in high school or college;
and then I quickly remind myself that Kate might never be that old.

When the therapist comes to take her into the RT suite, Kate latches on to
my leg. “Honey,” Brian says, “it's gonna be fine.”

She shakes her head and burrows closer. When I crouch down, she throws
herself into my arms. “I won't take my eyes off you,” I promise.

The room is large, with jungle murals painted on the walls. The linear
accelerators are built into the ceiling and a pit below the treatment table,
which is little more than a canvas cot covered with a sheet. The radiation
therapist places thick lead pieces shaped like beans onto Kate's chest and
tells her not to move. She promises that when it's all over, Kate can have a
sticker.

I stare at Kate through the protective glass wall. Gamma rays, leukemia,
parenthood. It is the things you cannot see coming that are strong enough to
kill you.

There is a Murphy's Law to oncology, one which is not written anywhere but
held in widespread belief: if you don't get sick, you won't get well.
Therefore, if your chemo makes you violently ill, if radiation sears your
skin—it's all good. On the other hand, if you sail through therapy quickly with
only negligible nausea or pain, chances are the drugs have somehow been
excreted by your body and aren't doing their job.

By this criterion, Kate should surely be cured by now. Unlike last year's
chemo, this course of treatment has taken a little girl who didn't even have a
runny nose and has turned her into a physical wreck. Three days of radiation
has caused constant diarrhea, and put her back into a diaper. At first, this
embarrassed her; now she is so sick she doesn't care. The following five days
of chemo have lined her throat with mucus, which keeps her clutching at a
suction tube as if it is a life preserver. When she is awake, all she does is
cry.

Since Day Six, when Kate's white blood cell and neutrophil counts began to
plummet, she has been in reverse isolation. Any germ in the world might kill
her now; for this reason, the world is made to keep its distance. Visitors to
her room are restricted, and those who are allowed in look like spacemen,
gowned and masked. Kate has to read picture books while wearing rubber gloves.
No plants or flowers are permitted, because they carry bacteria that could kill
her. Any toy given to her must be scrubbed down with antiseptic solution first.
She sleeps with her teddy bear, sealed in a Ziploc bag, which rustles all night
and sometimes wakes her up.

Brian and I sit outside the anteroom, waiting. While Kate sleeps, I practice
giving injections to an orange. After the transplant Kate will need growth
factor shots, and the chore will fall to me. I prick the syringe under the
thick skin of the fruit, until I feel the soft give of tissue underneath. The
drug I will be giving is subcutaneous, injected just under the skin. I need to
make sure the angle is right and that I am giving the proper amount of
pressure. The speed with which you push the needle down can cause more or less
pain. The orange, of course, doesn't cry when I make a mistake. But the nurses
still tell me that injecting Kate won't feel much different.

Brian picks up a second orange and begins to peel it. “Put that
down!”

“I'm hungry.” He nods at the fruit in my hands. “And you've
already got a patient.”

“For all you know that was someone else's. God knows what it's
doped up with.”

Suddenly Dr. Chance turns the corner and approaches us. Donna, an oncology
nurse, walks behind him, brandishing an IV bag filled with crimson liquid.
“Drum roll,” she says.

I put down my orange, follow them into the anteroom, and suit up so that I
can come within ten feet of my daughter. Within minutes Donna attaches the bag
to a pole, and connects the drip to Kate's central line. It is so anticlimactic
that Kate doesn't even wake up. I stand on one side, as Brian goes to the
other. I hold my breath. I stare down at Kate's hips, the iliac crest, where
bone marrow is made. Through some miracle, these stem cells of Anna's will go
into Kate's bloodstream in her chest, but will find their way to the right
spot.

“Well,” Dr. Chance says, and we all watch the cord blood slowly
slide through the tubing, a Crazy Straw of possibility.

JULIA

AFTER TWO HOURS OF LIVING with my sister again, I'm finding it hard to
believe we ever comfortably shared a womb. Isobel has already organized my CDs
by year of release, swept under the couch, and tossed out half the food in my
refrigerator. “Dates are our friend, Julia.” She sighs. “You
have yogurt in here from when Democrats ruled the White House.”