My Sister's Keeper Read online

  He stares at me, his face blank. "Are you about done?"

  I let him go and he backs away, teeth bared. "Then tell me I'm wrong," I challenge.

  "I'll tell you more than that," he yells. "I mean, I totally understand that you've spent your life believing that everything that's wrong in the universe all traces back to me, but news flash, Dad, this time you're totally off base."

  Slowly, I take something out of my pocket and press it into Jesse's hand. The Merit cigarette butt settles in the hollow of his palm. "Then you shouldn't have left your calling card."

  There is a point when a structure fire is raging out of control that you simply have to give it the distance to burn itself out. So you move back to safety, to a hill out of the wind, and you watch the building eat itself alive.

  Jesse's hand comes up, trembling, and the cigarette rolls to the floor at our feet. He covers his face, presses his thumbs to the corners of his eyes. "I couldn't save her." The words are ripped from his center. He hunches his shoulders, sliding backward into the body of a boy. "Who . . . who did you tell?"

  He is asking, I realize, whether the police will be coming after him. Whether I have spoken to Sara about this.

  He is asking to be punished.

  So I do what I know will destroy him: I pull Jesse into my arms as he sobs. His back is broader than mine. He stands a half-head taller than me. I don't remember seeing him go from that five-year-old, who wasn't a genetic match, to the man he is now, and I guess this is the problem. How does someone go from thinking that if he cannot rescue, he must destroy? And do you blame him, or do you blame the folks who should have told him otherwise?

  I will make sure that my son's pyromania ends here and now, but I won't tell the cops or the fire chief about this. Maybe that's nepotism, maybe it's stupidity. Maybe it's because Jesse isn't all that different from me, choosing fire as his medium, needing to know that he could command at least one uncontrollable thing.

  Jesse's breathing evens against me, like it used to when he was so small, when I used to carry him upstairs after he'd fallen asleep in my lap. He used to hit me over and over with questions: What's a two-inch hose for, a one-inch? How come you wash the engines? Does the can man ever get to drive? I realize that I cannot remember exactly when he stopped asking. But I do remember feeling as if something had gone missing, as if the loss of a kid's hero worship can ache like a phantom limb.

  CAMPBELL

  DOCTORS HAVE THIS THING ABOUT being subpoenaed: they let you know, with every syllable of every word, that no moment of this testimony will make up for the fact that while they were sitting on the witness stand under duress, patients were waiting, people were dying. Frankly, it pisses me off. And before I know it, I can't help myself, I am asking for a bathroom break, leaning down to retie my shoe, gathering my thoughts and stuffing sentences with pregnant pauses--whatever it takes to keep them cooling their heels just a few seconds more.

  Dr. Chance is no exception to the rule. From the onset he's anxious to leave. He checks his watch so often you'd think he was about to miss a train. The difference this time around is that Sara Fitzgerald is just as anxious to get him out of the courtroom. Because the patient who is waiting, the person who is dying, is Kate.

  But beside me, Anna's body throws heat. I get up, continue my questioning. Slowly. "Dr. Chance, were any of the treatments that involved donations from Anna's body 'sure things'?"

  "Nothing in cancer is a sure thing, Mr. Alexander."

  "Was that explained to the Fitzgeralds?"

  "We carefully explain the risks of every procedure, because once you begin treatments, you compromise other bodily systems. What we wind up doing for one treatment successfully may come back to haunt you the next time around." He smiles at Sara. "That said, Kate's an incredible young woman. She wasn't expected to live past age five, and here she is at sixteen."

  "Thanks to her sister," I point out.

  Dr. Chance nods. "Not many patients have both the strength of body and the good fortune to have a perfectly matched donor available to them."

  I stand up, my hands in my pockets. "Can you tell the Court how the Fitzgeralds came to consult Providence Hospital's preimplantation genetic diagnosis team to conceive Anna?"

  "After their son was tested and found to be an unsuitable donor for Kate, I told the Fitzgeralds about another family I'd worked with. They'd tested all the patient's siblings, and none qualified, but then the mother got pregnant during the course of treatment and that child happened to be a perfect match."

  "Did you tell the Fitzgeralds to conceive a genetically programmed child to serve as a donor for Kate?"

  "Absolutely not," Chance says, affronted. "I just explained that even if none of the existing children was a match, that didn't mean that a future child might not be."

  "Did you explain to the Fitzgeralds that this child, as a perfectly genetically programmed match, would have to be available for all these treatments for Kate throughout her life?"

  "We were talking about a single cord blood treatment at the time," Dr. Chance says. "Subsequent donations came about because Kate didn't respond to the first one. And because they offered more promising results."

  "So if tomorrow scientists were to come up with a procedure that would cure Kate's cancer if Anna only cut off her head and gave it to her sister, would you recommend that?"

  "Obviously not. I would never recommend a treatment that risked another child's life."

  "Isn't that what you've done for the past thirteen years?"

  His face tightens. "None of the treatments have caused significant long-term harm to Anna."

  I take a piece of paper out of my briefcase and hand it to the judge, and then to Dr. Chance. "Can you read the part that's marked?"

  He puts on a pair of glasses and clears his throat. "I understand that anesthesia involves potential risks. These risks may include, but are not limited to: adverse drug reactions, sore throat, injury to teeth and dental work, damage to vocal cords, respiratory problems, minor pain and discomfort, loss of sensation, headaches, infection, allergic reaction, awareness during general anesthesia, jaundice, bleeding, nerve injury, blood clot, heart attack, brain damage, and even loss of bodily function or of life."

  "Are you familiar with this form, Doctor?"

  "Yes. It's a standard consent form for a surgical procedure."

  "Can you tell us who the patient receiving it was?"

  "Anna Fitzgerald."

  "And who signed the consent form?"

  "Sara Fitzgerald."

  I rock back on my heels. "Dr. Chance, anesthesia carries a risk of life impairment or death. Those are pretty strong long-term effects."

  "That's exactly why we have a consent form. It's to protect us from people like you," he says. "But realistically, the risk is extremely small. And the procedure of donating marrow is fairly simple."

  "Why was Anna being anesthetized for such a simple procedure?"

  "It's less traumatic for a child, and they're less likely to squirm around."

  "And after the procedure, did Anna experience any pain?"

  "Maybe a little," Dr. Chance says.

  "You don't remember?"

  "It's been a long time. I'm sure even Anna's forgotten about it by now."

  "You think?" I turn to Anna. "Should we ask her?"

  Judge DeSalvo crosses his arms.

  "Speaking of risk," I continue smoothly. "Can you tell us about the research that's been done on the long-term effects of the growth factor shots she's taken twice now, prior to harvest for transplant?"

  "Theoretically, there shouldn't be any long-term sequelae."

  "Theoretically," I repeat. "Why theoretically?"

  "Because the research has been done on lab animals," Dr. Chance admits. "Effects on humans are still being tracked."

  "How comforting."

  He shrugs. "Physicians don't tend to prescribe drugs that have the potential to wreak havoc."

  "Have you ever heard of thalidom