My Sister's Keeper Read online

  *

  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--his 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 DLI. 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 DLI. 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.

  And then she holds up a syringe.

  "It's only a little stick," the doctor promises, exactly the wrong words, and Anna starts thrashing. Her arms clip me in the face, the belly. Brian cannot grab hold of her. Over her screams, he yells at me. "I thought you told her!"

  The doctor, who's left the room without me even noticing, returns with several nurses in tow. "Kids and phlebotomy never mix well," she says, as the nurses slide Anna off my lap and soothe her with their soft hands and softer words. "Don't worry; we're pros."

  It is a deja vu, just like the day Kate was diagnosed. Be careful what you wish for, I think. Anna is just like her sister.

  *

  I'm vacuuming the girls' room when the handle of the Electrolux smacks Hercules' bowl and sends the fish flying. No glass breaks, but it takes me a moment to find him, thrashing himself dry on the carpet beneath Kate's desk.

  "Hang on, buddy," I whisper, and I flip him into the bowl. I fill it with water from the bathroom sink.

  He floats to the top. Don't, I think. Please.

  I sit down on the edge of the bed. How can I possibly tell Kate I've killed her fish? Will she notice if I run to the pet store and get a replacement?

  Suddenly Anna is next to me, home from morning kindergarten. "Mommy? How come Hercules isn't moving?"

  I open my mouth, a confession melting on my tongue. But at that moment the goldfish shudders sideways, dives, and starts to swim again. "There," I say. "He's fine."

  *

  When five thousand lymphocytes don't seem to be enough, Dr. Chance calls for ten thousand. Anna's appointment for a second donor lymphocyte draw falls in the middle of the gymnastics birthday party of a girl in her class. I agree to let her go for a little while, and then drive to the hospital from the gym.

  The girl is a sugar-spun princess with fairy-white hair, a tiny replica of her mother. As I slip off my shoes to trek across the padded floor, I try desperately to remember their names. The child is . . . Mallory. And the mother is . . . Monica? Margaret?

  I spot Anna right away, sitting on the trampoline as an instructor bounces them up and down like popcorn. The mother comes over to me, a smile strung on her face like a row of Christmas lights. "You must be Anna's mom. I'm Mittie," she says. "I'm so sorry she has to leave, but of course, we understand. It must be amazing, going somewhere no one else ever gets to go."

  The hospital? "Well, just hope you never have to do the same."

  "Oh, I know. I get dizzy going up an elevator." She turns to the trampoline. "Anna, honey! Your mother's here!"

  Anna barrels across the padded floor. This is exactly what I'd wanted to do to my living room when the kids were all small: cushion the walls and floor and ceiling for protection. And yet it turned out that I could have rolled Kate in bubble wrap, the danger for her was already under the skin.

  "What do you say?" I prompt, and Anna thanks Mallory's mother.

  "Oh, you're welcome." She hands Anna a small bag of treats. "Now, have your husband call us anytime. We'd be happy to take Anna while you're in Texas."

  Anna hesitates in the middle of a shoelace knot. "Mittie?" I ask, "what exactly did Anna tell you?"

  "That she had to leave early so your whole family could take you to the airport. Because once training starts in Houston, you won't see them until after the flight."

  "The flight?"

  "On the space shuttle . . .?"

  For a moment I am stunned--that Anna would make up such a ridiculous story, that this woman would believe it. "I'm not an astronaut," I confess. "I don't know why Anna would even say something like that."

  I pull Anna to her feet, one shoelace still untied. Dragging her out of the gymnasium, we reach the car before I say a word. "Why did you lie to her?"

  Anna scowls. "Why did I have to l