My Sister's Keeper (16 page)

The ridiculous irony is that Campbell was attracted to me because I stood
apart from everyone else at The Wheeler School; and I was attracted to Campbell
because I desperately wanted a connection with someone. There were comments, I
knew, and stares sent our way as his friends tried to figure out why Campbell
was wasting his time with someone like me. No doubt, they thought I was an easy
lay.

But we weren't doing that. We met after school at the cemetery. Sometimes we
would speak poetry to each other. Once, we tried to have an entire conversation
without the letter “s.” We sat back to back, and tried to think each
other's thoughts—pretending clairvoyance, when it only made sense that his
whole mind would be full of me and mine would be full of him.

I loved the way he smelled whenever his head dipped close to hear what I was
saying—like the sun striking the cheek of a tomato, or soap drying on the hood
of a car. I loved the way his hand felt on my spine. I loved.

“What if,” I said one night, stealing breath from the edge of his
lips, “we did it?”

He was lying on his back, watching the moon rock back and forth on a hammock
of stars. One hand was tossed up over his head, the other anchored me against
his chest. “Did what?”

I didn't answer, just got up on one elbow and kissed him so deep that the
ground gave way. “Oh,” Campbell said, hoarse. “That.”

“Have you ever?” I asked.

He just grinned. I thought that he'd probably fucked Muffy or Buffy or Puffy
or all three in the baseball dugout at Wheeler, or after a party at one of
their homes when they both still smelled of Daddy's bourbon. I wondered why,
then, he wasn't trying to sleep with me. I assumed that it was because I wasn't
Muffy or Buffy or Puffy, but just Julia Romano, which wasn't good enough.

“Don't you want to?” I asked.

It was one of those moments where I knew we were not having the conversation
that we needed to be having. And since I didn't really know what to say, never
having crossed this particular bridge between thought and deed before, I
pressed my hand up against the thick ridge in his pants. He backed away from
me.

“Jewel,” he said, “I don't want you to think that's why I'm
here.”

Let me tell you this: if you meet a loner, no matter what they tell you,
it's not because they enjoy solitude. It's because they have tried to blend
into the world before, and people continue to disappoint them. “Then why are
you here?”

“Because you know all the words to 'American Pie,' ” Campbell
said. “Because when you smile, I can almost see that tooth on the side
that's crooked.” He stared at me. “Because you're not like anyone
I've ever met.”

“Do you love me?” I whispered.

“Didn't I just say that?”

This time, when I reached for the buttons of his jeans, he didn't move away.
In my palm he was so hot I imagined he would leave a scar. Unlike me, he knew
what to do. He kissed and slipped, pushed, cracked me wide. Then he went
perfectly still. “You didn't say you were a virgin,” he said.

“You didn't ask.”

But he'd assumed. He shuddered and began to move inside me, a poetry of
limbs. I reached up to hold on to the gravestone behind me, words I could see
in my mind's eye: Nora Deane, b. 1832, d. 1838.

“Jewel,” he whispered, when it was over. “I thought. .
.”

“I know what you thought.” I wondered what happened when you
offered yourself to someone, and they opened you, only to discover you were not
the gift they expected and they had to smile and nod and say thank you all the
same.

I blame Campbell Alexander entirely for my bad luck with relationships. It
is embarrassing to admit, but I have only had sex with three and a half other
men, and none of those were any great improvement on my first experience.

“Let me guess,” Seven said last night. “The first was a
rebound. The second was married.”

“How'd you know?”

He laughed. “Because you're a cliche.”

I swirled my pinky in my martini. It was an optical illusion, making the
finger look split and crooked. “The other one was from Club Med, a
windsurfing instructor.”

“That must have been worthwhile,” Seven said.

“He was absolutely gorgeous,” I answered. “And had a dick the
size of a cocktail frank.”

“Ouch.”

“Actually,” I mused, “you couldn't feel it at all.”

Seven grinned. “So he was the half?”

I turned beet red. “No, that was some other guy. I don't know his
name,” I admitted. “I sort of woke up with him on top of me, after a
night like this one.”

“You,” Seven pronounced, “are a train wreck of sexual
history.”

But this is inaccurate. A runaway train is an accident. Me, I'll jump in
front of the tracks. I'll even tie myself down in front of the speeding engine.
There's some illogical part of me that still believes if you want Superman to
show up, first there's got to be someone worth saving.

Kate Fitzgerald is a ghost just waiting to happen. Her skin is nearly
translucent, her hair so fair it bleeds into the pillowcase. “How are you
doing, baby?” Brian murmurs, and he leans down to kiss her on the
forehead.

“I think I might have to blow off the Ironman competition,” Kate
jokes.

Anna is hovering at the door in front of me; Sara holds out her hand. It is
all the encouragement Anna needs to crawl up on Kate's mattress, and in my mind
I mark off this small gesture from mother to child. Then Sara sees me standing
at the threshold. “Brian,” she says, “what is she doing
here?”

I wait for Brian to explain, but he doesn't seem inclined to utter a word.
So I paste a smile on my face and step forward. “I heard Kate was feeling
better today, and I thought it might be a good time to talk to her.”

Kate struggles to her elbows. “Who are you?” I expect a fight from
Sara, but it is Anna who speaks up. “I don't think it's such a good
idea,” she says, although she knows this is the very reason I've come
here. “I mean, Kate's still pretty sick.” It takes me a moment, but
then I understand: in Anna's life, everyone who ever talks to Kate takes Kate's
side. She is doing what she can to keep me from defecting.

“You know, Anna's right,” Sara hastily adds. “Kate's only
just turned a corner.”

I place my hand on Anna's shoulder. “Don't worry.” Then I turn to
her mother. “It's my understanding that you wanted this hearing—”

Sara cuts me off. “Ms. Romano, could we have a word outside?” We
step into the hallway, and Sara waits for a nurse to pass with a Styrofoam tray
of needles. “I know what you think of me,” she says.

“Mrs. Fitzgerald—”

She shakes her head. “You're sticking up for Anna, and you should.
I practiced law once, and I understand. It's your job, and part of that is
figuring out what makes us us.” She rubs her forehead with one
fist. “My job is to take care of my daughters. One of them is
extremely ill, and the other one's extremely unhappy. And I may not have it all
figured out yet, but… I do know that Kate won't get better any quicker if she
finds out that the reason you're here is because Anna hasn't withdrawn her
lawsuit yet. So I'm asking you not to tell her, either. Please.”

I nod slowly, and Sara turns to go back into Kate's room. With her hand on
the door, she hesitates. “I love both of them,” she says, an
equation I am supposed to be able to solve.

I told Seven the Bartender that true love is felonious.

“Not if they're over eighteen,” he said, shutting the till of the
cash register.

By then the bar itself had become an appendage, a second torso holding up my
first. “You take someone's breath away,” I stressed.
“You rob them of the ability to utter a single word.” I
tipped the neck of the empty liquor bottle toward him. “You steal
a heart.”

He wiped up in front of me with a dishrag. “Any judge would toss that
case out on its ass.”

“You'd be surprised.”

Seven spread the rag out on the brass bar to dry. “Sounds like a
misdemeanor, if you ask me.”

I rested my cheek on the cool, damp wood. “No way,” I said.
“Once you're in, it's for life.”

Brian and Sara take Anna down to the cafeteria. It leaves me alone with
Kate, who is eminently curious. I imagine that the number of times her mother
has willingly left her side is something she can count on two hands. I explain
that I'm helping the family make some decisions about her health care.

“Ethics committee?” Kate guesses. “Or are you from the
hospital's legal department? You look like a lawyer.”

“What does a lawyer look like?”

“Kind of like a doctor, when he doesn't want to tell you what your labs
say.”

I pull up a chair. “Well, I'm glad to hear you're doing better
today.”

“Yeah. Apparently yesterday I was pretty out of it,” Kate says.
“Doped up enough to make Ozzy and Sharon look like Ozzie and
Harriet.”

“Do you know where you stand, medically, right now?”

Kate nods. “After my BMT, I got graft-versus-host disease—which is sort
of good, because it kicks the leukemia's butt, but it also does some funky
stuff to your skin and organs. The doctors gave me steroids and cyclosporine to
control it, and that worked, but it also managed to break down my kidneys,
which is the emergency flavor of the month. That's pretty much the way it
goes—fix one leak in the dike just in time to watch another one start spouting.
Something is always falling apart in me.”

She says this matter-of-factly, as if I've grilled her about the weather or
what's on the hospital menu. I could ask her if she has talked to the
nephrologists about a kidney transplant, if she has any particular feelings
about undergoing so many different, painful treatments. But this is exactly
what Kate is expecting me to ask, which is probably why the question that comes
out of my mouth is completely different. “What do you want to be when you
grow up?”

“No one ever asks me that.” She eyes me carefully.
“What makes you think I'm going to grow up?”

“What makes you think that you're not? Isn't that why you're doing all
this?”

Just when I think she isn't going to answer me, she speaks. “I always
wanted to be a ballerina.” Her arm goes up, a weak arabesque. “You
know what ballerinas have?” Eating disorders, I think.

“Absolute control. When it comes to their bodies, they know exactly
what's going to happen, and when.” Kate shrugs, coming back to this
moment, this hospital room. “Anyway,” she says. “Tell me about
your brother.”

Kate starts to laugh. “You haven't had the pleasure of meeting him yet,
I guess.”

“Not yet.”

“You can pretty much form an opinion about Jesse in the first thirty
seconds you spend with him. He gets into a lot of bad stuff he shouldn't.”

“You mean drugs, alcohol?”

“Keep going,” Kate says.

“Has that been hard for your family to deal with?”

“Well, yeah. But I don't really think it's something he does on purpose.
It's the way he gets noticed, you know? I mean, imagine what it would be like
if you were a squirrel living in the elephant cage at the zoo. Does anyone ever
go there and say, Hey, check out that squirrel? No, because there's
something so much bigger you notice first.” Kate runs her fingers up and
down one of the tubes sprouting out of her chest. “Sometimes it's
shoplifting, and sometimes it's getting drunk. Last year, it was an anthrax
hoax. That's the kind of stuff Jesse does.”

“And Anna?”

Kate starts to pleat the blanket in folds on her lap. “There was one
year when every single holiday, and I mean even like Memorial Day, I was in the
hospital. It wasn't anything planned, of course, but that's the way it happened.
We had a tree in my room for Christmas, and an Easter egg hunt in the
cafeteria, and we trick-or-treated on the orthopedic ward. Anna was around six
years old, and she threw a total fit because she couldn't bring sparklers into
the hospital on the Fourth of July—all the oxygen tents.” Kate looks up at
me. “She ran away. Not far, or anything—I think she got to the lobby
before someone nabbed her. She was going to find herself another family, she
told me. Like I said, she was only six, and no one really took it seriously.
But I used to wonder what it would be like to be normal. So I totally
understood why she'd wonder about it, too.”

“When you're not sick, do you and Anna get along pretty well?”

“We're like any pair of sisters, I guess. We fight over who gets to put
on whose CDs; we talk about cute guys; we steal each other's good nail polish.
She gets into my stuff and I yell; I get into her stuff and she cries down the
house. Sometimes she's great. And other times I wish she'd never been
born.”

That sounds so patently familiar that I grin. “I have a twin sister.
Every time I used to say that, my mother would ask me if I could really, truly
picture being an only child.”

“Could you?”

I laugh. “Oh… there were definitely times I could imagine life without
her.”

Kate doesn't crack a smile. “See,” she says, “my sister's the
one who's always had to imagine life without me.”

SARA

AT EIGHT, KATE IS A LONG TANGLE of arms and legs, sometimes resembling a
creature made of sunlight and pipe cleaners more than she does a little girl. I
stick my head into her room for the third time that morning, to find her in yet
a different outfit. This one is a dress, white with red cherries printed across
it. “You're going to be late for your own birthday party,” I tell
her.

Thrashing her way out of the halter top, Kate strips off the dress. “I
look like an ice cream sundae.”

“There are worse things,” I point out.

“If you were me, would you wear the pink skirt or the striped
one?”

I look at them both, puddles on the floor. “The pink one.”

“You don't like the stripes?”

“Then wear that one.”

“I'm going to wear the cherries,” she decides, and she turns
around to grab it. On the back of her thigh is a bruise the size of a
half-dollar, a cherry that has stained its way through the fabric.

“Kate,” I ask, “what's that?”

Twisting around, she looks at the spot where I point. “I guess I banged
it.”

For five years, Kate has been in remission. At first, when the cord blood
transplant seemed to be working, I kept waiting for someone to tell me this was
all a mistake. When Kate complained that her feet hurt, I rushed her to Dr.
Chance, certain this was the bony pain of recurrence, only to find out that
she'd outgrown her sneakers. When she fell down, instead of kissing her
scrapes, I'd ask her if her platelets were good.

A bruise is created when there is bleeding in tissues beneath the skin,
usually—but not always—the result of a trauma. It has been five whole years,
did I mention that? Anna sticks her head into the room. “Daddy says the
first car just pulled up and if Kate wants to come down wearing a flour sack he
doesn't care. What's a flour sack?”

Kate finishes hiking the sundress over her head, then pulls up the hem and
rubs the bruise. “Huh,” she says.

Downstairs, there are twenty-five second-graders, a cake in the shape of a
unicorn, and a local college kid hired to make swords and bears and crowns out
of balloons. Kate opens her presents—necklaces made of glittery beads, craft
kits, Barbie paraphernalia. She saves the biggest box for last—the one Brian
and I have gotten her. Inside a glass bowl swims a fantail goldfish. Kate has
wanted a pet forever. But Brian is allergic to cats, and dogs require a lot of
attention, which led us to this. Kate could not be happier. She carries him
around for the rest of the party. She names him Hercules.

After the party, when we are cleaning up, I find myself staring at the
goldfish. Bright as a penny, he swims in circles, happy to be going nowhere.

It takes only thirty seconds to realize that you will be canceling all your
plans, erasing whatever you had been cocky enough to schedule on your calendar.
It takes sixty seconds to understand that even if you'd been fooled into
thinking so, you do not have an ordinary life.

A routine bone marrow aspiration—one we'd scheduled long before I ever saw
that bruise—has come back with some abnormal promyelocytes floating around.
Then a polymerase chain reaction test—one that allows the study of DNA—showed
that in Kate, the 15 and 17 chromosomes were translocated.

All of this means that Kate is in molecular relapse now, and clinical
symptoms can't be that far behind. Maybe she won't present with blasts for a
month. Maybe we won't find blood in her urine or stools for a year. But
inevitably, it will happen.

They say that word, relapse, like they might say birthday
or tax deadline, something that happens so routinely it has become
part of your internal calendar, whether you want it to or not.

Dr. Chance has explained that this is one of the great debates for
oncologists—do you fix a wheel that isn't broken, or do you wait until the cart
collapses? He recommends that we put Kate on ALL-TRANS Retinoic Acid. It comes
in a pill half the size of my thumb, and was basically stolen from ancient
Chinese medics who'd been using it for years. Unlike chemotherapies, which go
in and kill everything in their path, ATRA heads right for chromosome 17. Since
the translocation of chromosomes 15 and 17 is in part what keeps promyelocyte
maturation from happening correctly, ATRA helps uncoil the genes that have
bound themselves together… and stops the abnormalities from going further.

Dr. Chance says the ATRA may put Kate back into remission.

Then again, she might develop a resistance to it.

“Mom?” Jesse comes into the living room, where I am sitting on the
couch. I've been there for hours now. I can't seem to make myself get up and do
any of the things I am supposed to, because what is the point of packing school
lunches or hemming a pair of pants or even paying the heating bill?

“Mom,” Jesse says again. “You didn't forget, did you?”

I look at him as if he is speaking Greek. “What?”

“You said you'd take me to buy new cleats after we go to the
orthodontist. You promised.”

Yes, I did. Because soccer starts two days from now, and Jesse's outgrown
his old pair. But now I do not know if I can drag myself to the orthodontist's,
where the receptionist will smile at Kate and tell me, like she always does,
how beautiful my children are. And there is something about the thought of
going to Sports Authority that seems downright obscene.

“I'm canceling the orthodontist appointment,” I say.
“Cool!” He smiles, his silver mouth glinting. “Can we just go
get the cleats?”

“Now is not a good time.”

“But—”

“Jesse. Let. It. Go.”

“I can't play if I don't get new shoes. And you're not even doing
anything. You're just sitting here.”

“Your sister,” I say evenly, “is incredibly sick. I'm sorry
if that interferes with your dentist's appointment or your plan to go buy a
pair of cleats. But those don't rate quite as high in the grand scheme of
things right now. I'd think that since you're ten, you might be able to grow up
enough to realize that the whole world doesn't always revolve around you.”

Jesse looks out the window, where Kate straddles the arm of an oak tree,
coaching Anna in how to climb up. “Yeah, right, she's sick,”
he says. “Why don't you grow up? Why don't you figure out that
the world doesn't revolve around her?”

For the first time in my life I begin to understand how a parent might hit a
child—it's because you can look into their eyes and see a reflection of yourself
that you wish you hadn't. Jesse runs upstairs to slam the door to his bedroom.

I close my eyes, take a few deep breaths. And it strikes me: not everyone
dies of old age. People get run over by cars. People crash in airplanes. People
choke on peanuts. There are no guarantees about anything, least of all one's
future.

With a sigh I walk upstairs, knock on my son's door. He has just recently
discovered music; it throbs through the thin line of light at the base of the
door. As Jesse turns down the stereo the notes flatten abruptly. “What.”

“I'd like to talk to you. I'd like to apologize.” There is a
scuffle on the other side of the door, and then it swings open. Blood covers
Jesse's mouth, a vampire's lipstick; bits of wire stick out like a seamstress's
pins. I notice the fork he is holding, and realize this is what he has used to
pull off his braces. “Now you never have to take me anywhere,” he
says.

Two weeks go by with Kate on ATRA. “Did you know,” Jesse says one
day, while I am getting her pill ready, “a giant tortoise can live for 177
years?” He is on a Ripley's Believe It or Not kick. “An
Arctic clam can live for 220 years.”

Anna sits at the counter, eating peanut butter with a spoon.

“What's an Arctic clam?”

“Who cares?” Jesse says. "A parrot can live for eighty years.
A

cat can live for thirty."

“How about Hercules?” Kate asks.

“It says in my book that with good care, a goldfish can live for seven
years.”

Jesse watches Kate put the pill on her tongue, take a swig of water to
swallow it. “If you were Hercules,” he says, “you'd already be
dead.”

Brian and I slide into our respective chairs in Dr. Chance's office. Five
years have passed, but the seats fit like an old baseball glove. Even the
photographs on the oncologist's desk have not changed—h is wife is wearing the
same broad-brimmed hat on a rocky Newport jetty; his son is frozen at age six,
holding a speckled trout—contributing to the feeling that in spite of what I
believed, we never really left here.

The ATRA worked. For a month, Kate reverted to molecular remission. And then
a CBC turned up more promyelocytes in her blood.

“We can keep pulsing her with ATRA,” Dr. Chance says, "but I
think that its failure already tells us she's maxed out that course.”

“What about a bone marrow transplant?"

“That's a risky call—particularly for a child who still isn't showing
symptoms of a full-blown clinical relapse.” Dr. Chance looks at us.
“There's something else we can try first. It's called a donor lymphocyte
infusion—a DLL Sometimes a transfusion of white blood cells from a matched
donor can help the original clone of cord blood cells fight the leukemia cells.
Think of them as a relief army, supporting the front line.”

“Will it put her into remission?” Brian asks. Dr. Chance shakes
his head. “It's a stop-gap measure—Kate will, in all probability, have a
full-fledged relapse—but it buys time to build up her defenses before we have
to rush into a more aggressive treatment.”

“And how long will it take to get the lymphocytes here?” I ask.
Dr. Chance turns to me. “That depends. How soon can you bring in
Anna?”

When the elevator doors open there is only one other person inside it, a
homeless man with electric blue sunglasses and six plastic grocery bags filled
with rags. “Close the doors, dammit,” he yells as soon as we step
inside. “Can't you see I'm blind?”

I push the button for the lobby. “I can take Anna in after school.
Kindergarten gets out at noon tomorrow.”

“Don't touch my bag,” the homeless man growls.

“I didn't,” I answer, distant and polite.

“I don't think you should,” Brian says.

“I'm nowhere near him!”

“Sara, I meant the DLL I don't think you should take Anna in to donate
blood.”

For no reason at all, the elevator stops on the eleventh floor, then closes
again.

The homeless man begins to rummage in his plastic bags. “When we had
Anna,” I remind Brian, “we knew that she was going to be a donor for
Kate.”

“Once. And she doesn't have any memory of us doing that to her.”

I wait until he looks at me. “Would you give blood for Kate?”

“Jesus, Sara, what kind of question—”

“I would, too. I'd give her half my heart, for God's sake, if it
helped. You do whatever you have to, when it comes to people you love,
right?” Brian ducks his head, nods. “What makes you think that Anna
would feel any different?”

The elevator doors open, but Brian and I remain inside, staring at each
other. From the back, the homeless man shoves between us, his bounty rustling
in his arms. “Stop yelling,” he shouts, though we stand in utter
silence. “Can't you tell that I'm deaf?”

To Anna, it is a holiday. Her mother and father are spending time
with her, alone. She gets to hold both of our hands the whole way across the
parking lot. So what if we're going to a hospital?

I have explained to her that Kate isn't feeling good, and that the doctors
need to take something from Anna and give it to Kate to make her feel better. I
figured that was more than enough information.

We wait in the examination room, coloring line drawings of pterodactyls and T-Rexes.
“Today at snack Ethan said that the dinosaurs all died because they got a
cold,” Anna says, “but no one believed him.”

Brian grins. “Why do you think they died?”

“Because, duh, they were a million years old.” She looks up at
him. “Did they have birthday parties back then?”

The door opens, and the hematologist comes in. “Hello, gang. Mom, you
want to hold her on your lap?”

So I crawl onto the table and settle Anna in my arms. Brian gets stationed
behind us, so that he can grab Anna's shoulder and elbow and keep it
immobilized. “You ready?” the doctor asks Anna, who is still smiling.