My Sister's Keeper

"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 A

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."

A

"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 A

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 A

"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 A

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 A

"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 A

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 A

I have explained to her that Kate isn't feeling good, and that the doctors need to take something from A

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," A

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 A

And then she holds up a syringe.

"It's only a little stick," the doctor promises, exactly the wrong words, and A

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 A

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

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.