My Sister's Keeper (29 page)

“That wasn't the issue at stake—”

“What about the consent of the donor, Anna Fitzgerald?”

Dr. Bergen looks right at me, sympathetic, which it turns out is worse even
than him thinking I'm a horrible person for filing this petition in the first
place. He shakes his head. “It goes without saying that no hospital in the
country is going to take a kidney out of a child who doesn't want to donate it.”

“So, theoretically, if Anna was fighting this decision, the case would
most likely land on your desk?”

“Well—”

“Has Anna's case landed on your desk, Doctor?”

“No.”

Campbell advances toward him. “Can you tell us why?”

“Because she isn't a patient.”

“Really?” He pulls a stack of papers out from his briefcase, and
hands them to the judge, and then to Dr. Bergen. “These are Anna
Fitzgerald's hospital records at Providence Hospital for the past thirteen
years. Why would there be records for her, if she wasn't a patient?”

Dr. Bergen flips through them. “She's had several invasive
procedures,” he admits.

Go, Campbell, I think. I am not one to believe in knights who ride
in to rescue damsels in distress, but I bet it feels a little like this.
“Doesn't it strike you as odd that in thirteen years, given the thickness
of this file and the fact it exists in the first place, the medical ethics
committee never once convened to discuss what was being done to Anna?”

“We were under the impression that donation was her wish.”

“Are you telling me that if Anna had previously said she didn't want to
give up lymphocytes or granulocytes or cord blood or even a bee sting kit in
her backpack—the ethics committee would have acted differently?”

“I know where you're going with this, Mr. Alexander,” the
psychiatrist says coldly. "The problem is that this kind of medical
situation hasn't existed before. There is no precedent. We're trying
to feel our way as best we can.”

“Isn't your job as an ethics committee to look at situations that haven't
existed before?"

“Well. Yes.”

“Dr. Bergen, in your expert opinion, is it ethically right for Anna
Fitzgerald to have been asked to donate parts of her own body repeatedly for
thirteen years?”

“Objection!” my mother calls out. The judge strokes his chin.
“I want to hear this.” Dr. Bergen glances at me again. “Quite
frankly, even before I knew that Anna didn't want to be a participant, I voted against
her donating a kidney to her sister. I don't believe Kate would live through
the transplant, and therefore Anna would undergo a serious operation for no
reason at all. Up until this point, however, I think that the risk of the procedures
was small, compared to the benefit the family as a whole received, and I
support the choices the Fitzgeralds made for Anna.”

Campbell pretends to consider this. “Dr. Bergen, what kind of car do
you drive?”

“A Porsche.”

“Bet you like it.”

“I do,” he says guardedly.

“What if I told you that you have to give up your Porsche before you
leave this courtroom, because that action will save Judge DeSalvo's life?”

"That's ridiculous. You—

Campbell leans in. “What if you had no choice? What if, today,
psychiatrists simply have to do whatever lawyers decide is in the best
interests of others?”

He rolls his eyes. “In spite of the high drama you're alluding to, Mr.
Alexander, there are basic donor rights, safeguards put into place in medicine,
so that the greater good doesn't steamroll the pioneers who help create it. The
United States has a long and nasty history of the abuse of informed consent,
which is what led to laws relating to Human Subjects Research. It keeps people
from being used as experimental lab rats.”

“Then tell us,” Campbell says, “how the hell did Anna
Fitzgerald slip through the cracks?”

When I was only seven months old, there was a block party in our
neighborhood. It's just as bad as you're thinking: Jell-O molds and towers of
cheese cubes and dancing in the street to music piped out of someone's living
room stereo. I, of course, have no personal recollection of any of this—I was
plopped down in one of those walkers they made for babies before babies started
overturning them and cracking their heads open.

At any rate, I was in my walker, tooling around between the tables and
watching the other kids, so the story goes, when I sort of lost my footing. Our
block is canted at an angle, and suddenly the wheels were moving faster than I
could make them stop. I whizzed past adults, under the barricade the cops had
put up at the end of the road to shut it off to traffic, and I was heading
right for a main drag full of cars.

But Kate came out of nowhere and ran after me. She somehow managed to grab
me by the back of my shirt moments before I got hit by a passing Toyota.

Every now and then, someone on the block brings this up. Me, I remember it
as the time she saved me, instead of the other way around.

My mother gets her first chance to play lawyer. “Dr. Bergen,” she
says, “how long have you known of my family?”

“I've been at Providence Hospital for ten years now.”

“In those ten years, when some aspect of Kate's treatment was presented
to you, what did you do?”

“Come up with a plan of action that was recommended,” he says.
“Or an alternate, if possible.”

“When you did, at any point in your report did you mention that Anna
shouldn't be a part of it?”

“No.”

“Did you ever say this would hurt Anna considerably?”

“No.”

“Or put her in grave medical danger herself?”

“No.”

Maybe it's not Campbell, after all, who will turn out to be my white knight.
Maybe it's my mother.

“Dr. Bergen,” she asks, “do you have kids?”

The doctor looks up. “I have a son. He's thirteen.”

“Have you ever looked at these cases that come to the medical ethics
committee and put yourself in a patient's shoes? Or better yet, a parent's
shoes?”

“I have,” he admits.

“If you were me,” my mother says, “and the medical ethics
committee handed you back a piece of paper with a suggested course of action
that would save your son's life, would you question them further… or would you
just jump at the chance?”

He doesn't answer. He doesn't have to.

Judge DeSalvo calls a second recess after that. Campbell says something
about getting up and stretching my legs. So I start to follow him out, walking
right past my mother. As I pass by, I feel her hand on my waist, tugging down
my T-shirt, which is riding up in the back. She hates the spaghetti-strap
girls, the ones who come to school in halters and low-riders, like they're
trying out as dancers in a Britney Spears video instead of going to math class.
I can almost hear her voice: Please tell me that shrank in the wash.

She seems to realize mid-tug that maybe she shouldn't have done this. I
stop, and Campbell stops, too, and her face goes bright red. “Sorry,”
she says.

I put my hand over hers and tuck my shirt into the back of my jeans where it
should be. I look at Campbell. “Meet you outside?”

He's giving me a look that has Bad Idea written all over it, but he
nods and heads down the aisle. Then my mother and I are nearly alone in the
courtroom. I lean forward and kiss her on the cheek. “You did really great
up there,” I tell her, because I don't know how to say what I really want
to: that the people you love can surprise you every day. That maybe who we are
isn't so much about what we do, but rather what we're capable of when we least
expect it.

SARA

KATE MEETS TAYLOR AMBROSE when they are sitting side by side, hooked up to
FVs. “What are you here for?” she asks, and I immediately look up
from my book, because in all the years that Kate has been receiving outpatient
treatment I cannot remember her initiating a conversation.

The boy she is talking to is not much older than she is, maybe sixteen to
her fourteen. He has brown eyes that dance, and is wearing a Bruins cap over
his bald head. “The free cocktails,” he answers, and the dimples in
his cheeks deepen.

Kate grins. “Happy hour,” she says, and she looks up at the bag of
platelets being infused into her.

“I'm Taylor.” He holds out his hand. “AML.”

“Kate. APL.”

He whistles, and raises his brows. “Ooh,” he says. “A
rarity.”

Kate tosses her cropped hair. “Aren't we all?”

I watch this, amazed. Who is this flirt, and what has she done with my
little girl?

“Platelets,” he says, scrutinizing the label on her IV bag.
“You're in remission?”

“Today, anyway.” Kate glances at his pole, the telltale black bag
that covers the Cytoxan. “Chemo?”

“Yeah. Today, anyway. So, Kate,” Taylor says. He has that rangy
puppy look of a sixteen-year-old, one with knobby knees and thick fingers and
cheekbones he hasn't yet grown into. When he crosses his arms, the muscles
swell. I realize he's doing this on purpose, and I duck my head to hide a
smile. “What do you do when you're not at Providence Hospital?”

She thinks, and then a slow smile lights her up from the inside out.
“Wait for something that makes me come back.”

This makes Taylor laugh out loud. “Maybe sometime we can wait
together,” he says, and he passes her a wrapper from a gauze pad.
“Can I have your phone number?”

Kate scribbles it down as Taylor's IV begins to beep. The nurse comes in and
unhooks his line. “You're outta here, Taylor,” she says.
“Where's your ride?”

“Waiting downstairs. I'm all set.” He gets out of the padded chair
slowly, almost weakly, the first reminder that this is not some casual
conversation. He slips the piece of paper with our phone number into his
pocket. “Well, I'll call you, Kate.”

When he leaves Kate lets all her breath out in a dramatic finish. She rolls
her head after him. “Oh my God,” she gasps. “He is
gorgeous.”

The nurse, checking her flow, grins. “Tell me about it, honey. If only
I were thirty years younger.”

Kate turns to me, blooming. “You think he'll call?”

“Maybe,” I say.

“Where do you think we'll go out?”

I think of Brian, who has always said that Kate can date… when she's forty.
“Let's take one step at a time,” I suggest. But inside, I am singing.

The arsenic, which ultimately put Kate into remission, worked its magic by
wearing her down. Taylor Ambrose, a drug of an entirely different sort, works
his magic by building her up. It becomes a habit: when the phone rings
at seven P.M., Kate flies from the dinner table and hides in a closet with the
portable receiver. The rest of us clear the dinner plates and spend time in the
living room and get ready for bed, hearing little more than giggles and
whispers, and then Kate emerges from her cocoon, flushed and glowing, first
love beating like a hummingbird at the pulse in her throat. Every time it
happens, I can't stop staring. It is not that Kate is so beautiful, although
she is; it's that I never really let myself believe that I would see her all
grown up.

I follow her into the bathroom one night, after one of her marathon phone
sessions. Kate stares at herself in the mirror, pursing her lips and raising
her brows in a come-hither pose. Her hand comes up to her cropped hair—after
the chemo, it never grew back in waves, just thick straight tufts that she
usually cultivates with mousse to look like bedhead. She holds her palm out, as
if she still expects to see hair shedding.

“What do you think he sees when he looks at me?” Kate asks. I come
to stand behind her. She is not the child that mirrors me—that would be
Jesse—and yet when you put us side by side, there are definite similarities.
It's not in the shape of the mouth but the set of it, the sheer determination
that silvers our eyes.

“I think he sees a girl who knows what he's been through,” I tell
her honestly.

“I got on the internet and read up on AML,” she says. “His
leukemia's got a pretty high cure rate.” She turns to me. “When you
care more if someone else lives than you do about yourself… is that what love's
like?”

It is hard, all of a sudden, to pull an answer through the tunnel of my
throat. “Exactly.”

Kate runs the tap and washes her face with a foam of soap. I hand her a
towel, and as she rises from the cloud of it, she says, “Something bad's
going to happen.”

On alert, I search her out for clues. “What's the matter?”

“Nothing. But that's the way it works. If there's something as good as
Taylor in my life, I'm going to pay for it.”

“That's the stupidest thing I've ever heard,” I say out of habit,
yet there is a truth to this. Anyone who believes that people have ultimate
control of what life hands to them needs only to spend a day in the shoes of a
child with leukemia. Or her mother. “Maybe you're finally getting a
break,” I say.

Three days later, during a routine CBC, the hematologist tells us that Kate
is once again throwing promyelocytes, the first slide down a steep slope of
relapse.

I have never eavesdropped, at least not intentionally, until the night that
Kate comes back from her first date with Taylor, to see a movie. She tiptoes
into her room and sits down on Anna's bed. “You awake?” she asks.

Anna rolls over, groans. “I am now.” Sleep slips away from her,
like a shawl falling to the floor. “How was it?”

“Wow,” Kate says, and she laughs. “Wow.”

“How wow? Like, tonsil hockey wow?”

“You are so disgusting,” Kate whispers, although there's a smile
behind it. “But he is a really good kisser.” She dangles this like a
fisherman.

“Get out!” Anna's voice shines. “So what was it like?”

“Flying,” Kate answers. “I bet it feels just the same
way.”

“I don't get what that has in common with someone slobbering all over
you.”

“God, Anna, it's not like he spits on you.”

“What does Taylor taste like?”