My Sister's Keeper (5 page)

Kate is going to die. It took me a long time to be able to say that. We all
are going to die, when you get down to it, but it's not supposed to be like
this. Kate ought to be the one who has to say good-bye to me.

It almost seems like a cheat that after all these years of defying the odds,
it won't be the leukemia that kills her. Then again, Dr. Chance told us a long
time ago that this was how it usually worked-a patient's body just gets worn
down, from all the fighting. Little by little, pieces of them start to give up.
In Kate's case, it is her kidneys.

I turn my telescope to Barnard's Loop and M42, glowing in Orion's sword.
Stars are fires that burn for thousands of years. Some of them burn slow and
long, like red dwarfs. Others-blue giants-burn their fuel so fast they shine
across great distances, and are easy to see. As they start to run out of fuel,
they burn helium, grow even hotter, and explode in a supernova. Supernovas,
they're brighter than the brightest galaxies. They die, but everyone watches
them go.

Earlier, after we ate, I helped Sara clean up in the kitchen. “You
think something's going on with Anna?” I asked, moving the ketchup back
into the fridge.

“Because she took off her necklace?”

“No.” I shrugged. “Just in general.”

“Compared to Kate's kidneys and Jesse's sociopathy, I'd say she's doing
fine.”

“She wanted dinner over before it started.”

Sara turned around at the sink. “What do you think it is?”

“Uh… a guy?”

Sara glanced at me. “She's not dating anyone.”

Thank God. “Maybe one of her friends said something to upset
her.” Why was Sara asking me? What the hell did I know about the
mood swings of thirteen-year-old girls?

Sara wiped her hands on a towel and turned on the dishwasher. “Maybe
she's just being a teenager.”

I tried to think back to what Kate was like when she was thirteen, but all I
could remember was the relapse and the stem cell transplant she had. Kate's
ordinary life had a way of fading into the background, overshadowed by the
times she was sick.

“I have to take Kate to dialysis tomorrow,” Sara said. “When
will you get home?”

“By eight. But I'm on call, and I wouldn't be surprised if our arsonist
struck again.”

“Brian?” she asked. “How did Kate look to you?”

Better than Anna did, I thought, but this was not what she was
asking. She wanted me to measure the yellow cast of Kate's skin against
yesterday; she wanted me to read into the way she leaned her elbows on the
table, too tired to hold her body upright.

“Kate looks great,” I lied, because this is what we do for each
other.

“Don't forget to say good night to them before you leave,” Sara
said, and she turned to gather the pills Kate takes at bedtime.

It's quiet, tonight. Weeks have rhythms all their own, and the craziness of a
Friday or Saturday night shift stands in direct contrast to a dull Sunday or
Monday. I can already tell: this will be one of those nights where I bunk down
and actually get to sleep.

“Daddy?” The hatch to the roof opens, and Anna crawls out.
“Red told me you were up here.”

Immediately, I freeze. It is ten o'clock at night. “What's wrong?”

“Nothing. I just… wanted to visit.”

When the kids were small, Sara would stop by with them all the time. They'd
play in the bays around the sleeping giant engines; they'd fall asleep upstairs
in my bunk. Sometimes, in the warmest part of the summer, Sara would bring
along an old blanket and we would spread it here on the roof, lie down with the
kids between us, and watch the night rise. “Mom know where you are?”

“She dropped me off.” Anna tiptoes across the roof. She's never
been all that great with heights, and there is only a three-inch lip around the
concrete. Squinting, she bends to the telescope. “What can you see?”

“Vega,” I tell her. I take a good look at Anna, something I
haven't done in some time. She's not stick-straight anymore; she's got the
beginnings of curves. Even her motions—tucking her hair behind her ear, peering
into the telescope—have a sort of grace I associate with full-grown women.
“Got something you want to talk about?”

Her teeth snag on her bottom lip, and she looks down at her sneakers.
“Maybe instead you could talk to me,” Anna
suggests.

So I sit her down on my jacket and point to the stars. I tell her that Vega
is a part of Lyra, the lyre that belonged to Orpheus. I am not one for stories,
but I remember the ones that match up with the constellations. I tell her about
this son of the sun god, whose music charmed animals and softened boulders. A
man who loved his wife, Eurydice, so much that he wouldn't let Death take her
away.

By the time I finish, we are lying flat on our backs. “Can I stay here
with you?” Anna asks.

I kiss the top of her head. “You bet.”

“Daddy,” Anna whispers, when I think for sure she has fallen
asleep, “did it work?”

It takes me a moment to understand she is talking about Orpheus and
Eurydice.

“No,” I admit.

She lets loose a sigh. “Figures,” she says.

TUESDAY

My candle burns at both ends;

It will not last the night;

But ah, my foes, and oh, my friends—

It gives a lovely light!

—EDNA ST. VINCENT MILLAY, “First Fig,” A Few Figs from Thistles

ANNA

I USED TO PRETEND that I was just passing through this family on my way to
my real one. It isn't too much of a stretch, really—there's Kate, the spitting
image of my dad; and Jesse, the spitting image of my mom; and then there's me,
a collection of recessive genes that came out of left field. In the hospital
cafeteria, eating rubberized French fries and red Jell-O, I'd glance around
from table to table, thinking my bona fide parents might be just a tray away.
They'd sob with sheer joy to find me, and whisk me off to our castle in Monaco
or Romania and give me a maid that smelled like fresh sheets, and my own
Bernese mountain dog, and a private phone line. The thing is, the first person
I'd have called to crow over my new fortune would be Kate.

Kate's dialysis sessions run three times a week, for two hours at a time.
She has a Mahhukar catheter, which looks just like her central line used to
look and protrudes from the same spot on her chest. This gets hooked up to a
machine that does the work her kidneys aren't doing. Kate's blood (well, it's
my blood if you want to get technical about it) leaves her body through one
needle, gets cleaned, and then goes into her body again through a second
needle. She says it doesn't hurt. Mostly, it's just boring. Kate usually brings
a book or her CD player and headphones. Sometimes we play games. “Go out
into the hall and tell me about the first gorgeous guy you find,” Kate'll
instruct, or, “Sneak up on the janitor who surfs the Net and see whose
naked pictures he's downloading.” When she is tied to the bed, I am her
eyes and her ears.

Today, she is reading Allure magazine. I wonder if she even knows
that every V-necked model she comes across she touches at the breastbone, in
the same place where she has a catheter and they don't. “Well,” my
mother announces out of the blue, “this is interesting.” She waves a
pamphlet she's taken from the bulletin board outside Kate's room: You and
Your New Kidney. “Did you know that they don't take out the old kidney?
They just transplant the new one into you and hook it up.”

“That creeps me out,” Kate says. “Imagine the coroner who
cuts you open and sees you've got three instead of two.”

“I think the point of a transplant is so that the coroner won't
be cutting you open anytime soon,” my mother replies. This fictional
kidney she's discussing resides right now in my own body.

I've read that pamphlet, too.

Kidney donation is considered relatively safe surgery, but if you ask me,
the writer must have been comparing it to something like a heart-lung
transplant, or some brain tumor removal. In my opinion, safe surgery is the
kind where you go into the doctor's office and you're awake the whole time and
the procedure is finished in five minutes—like when you have a wart removed or
a cavity drilled. On the other hand, when you donate a kidney, you spend the
night before the operation fasting and taking laxatives. You're given
anesthesia, the risks of which can include stroke, heart attack, and lung
problems. The four-hour surgery isn't a walk in the park, either—you have a I
in 3,000 chance of dying on the operating table. If you don't, you are
hospitalized for four to seven days, although it takes four to six weeks to
fully recover. And that doesn't even include the long-term effects: an
increased chance of high blood pressure, a risk of complications with
pregnancy, a recommendation to refrain from activities where your lone
remaining kidney might be damaged.

Then again, when you get a wart removed or a cavity drilled, the only person
who benefits in the long run is yourself.

There is a knock on the door, and a familiar face peeks in. Vern Stackhouse
is a sheriff, and therefore a member of the same public servant community as my
father. He used to come over to our house every now and then to say hi or leave
off Christmas presents for us; more recently, he's saved Jesse's butt by
bringing him home from a scrape, rather than letting the justice system deal
with him. When you're part of the family with the dying daughter, people cut
you slack.

Vern's face is like a souffle, caving in at the most unexpected places. He
doesn't seem to know whether it's all right for him to enter the room.
“Uh,” he says. “Hi, Sara.”

“Vern!” My mother gets to her feet. “What are you doing at
the hospital? Everything all right?”

“Oh yeah, fine. I'm just here on business.”

“Serving papers, I suppose.”

“Um-hmm.” Vern shuffles his feet and stuffs his hand inside his
jacket, like Napoleon. “I'm real sorry about this, Sara,” he says,
and then he holds out a document.

Just like Kate, all the blood leaves my body. I couldn't move if I wanted
to.

“What the… Vern, am I being sued?” My mother's voice is far too
quiet.

“Look, I don't read them. I just serve them. And your name, it was
right there on my list. If, uh, there's anything I…” He doesn't even
finish his sentence. With his hat in his hands, he ducks back out the door.

“Mom?” Kate asks. “What's going on?”

“I have no idea.” She unfolds the papers. I'm close enough to read
them over her shoulder. THE STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS,
it says right across the top, official as can be. FAMILY COURT FOR PROVIDENCE
COUNTY. IN RE: ANNA FITZGERALD, A.K.A. JANE DOE.

PETITION FOR MEDICAL EMANCIPATION.

Oh shit, I think. My cheeks are on fire; my heart starts to pound.
I feel like I did the time the principal sent home a disciplinary notice
because I drew a sketch of Mrs. Toohey and her colossal butt in the margin of
my math textbook. No, actually, scratch that—it's a million times worse.

That she gets to make all future medical decisions.

That she not be forced to submit to medical treatment which is not in
her best interests or for her benefit.

That she not be required to undergo any more treatment for the benefit
of her sister, Kate.

My mother lifts her face to mine. “Anna,” she whispers, “what
the hell is this?”

It feels like a fist in my gut, now that it's here and happening. I shake my
head. What can I possibly tell her?

“Anna!” She takes a step toward me.

Behind her, Kate cries out. “Mom, ow, Mom… something hurts, get the
nurse!”

My mother turns halfway. Kate is curled onto her side, her hair spilling
over her face. I think that through the fall of it, she's looking at me, but I
cannot be sure. “Mommy,” she moans, “please.”

For a moment, my mother is caught between us, a soap bubble. She looks from
Kate to me and back again.

My sister's in pain, and I'm relieved. What does that say about me?

The last thing I see as I run out of the room is my mother pushing the
nurse's call button over and over, as if it's the trigger to a bomb.

I can't hide in the cafeteria, or the lobby, or anywhere else that they will
expect me to go. So I take the stairs to the sixth floor, the maternity ward.
In the lounge, there is only one phone, and it is being used. “Six pounds
eleven ounces,” the man says, smiling so hard I think his face might
splinter. “She's perfect.”

Did my parents do this when I came along? Did my father send out smoke
signals; did he count my fingers and toes, sure he'd come up with the finest
number in the universe? Did my mother kiss the top of my head and refuse to let
the nurse take me away to be cleaned up? Or did they simply hand me away, since
the real prize had been clamped between my belly and the placenta?

The new father finally hangs up the phone, laughing at absolutely nothing.
“Congratulations,” I say, when what I really want to tell him is to
pick up that baby of his and hold her tight, to set the moon on the edge of her
crib and to hang her name up in stars so that she never, ever does to him what
I have done to my parents.

I call Jesse collect. Twenty minutes later, he pulls up to the front
entrance. By now, Deputy Stackhouse has been notified that I've gone missing;
he's waiting at the door when I exit. “Anna, your mom's awfully worried
about you. She's paged your dad. He's got the whole hospital being turned
inside out.”

I take a deep breath. “Then you better go tell her I'm okay,” I
say, and I jump into the passenger door that Jesse's opened for me.

He peels away from the curb and lights a Merit, although I know for a fact
he told my mother he stopped smoking. He cranks up his music, hitting the flat
of his hand on the edge of the steering wheel. It isn't until he pulls off the
highway at the exit for Upper Darby that he shuts the radio off and slows down.
“So. Did she blow a gasket?”