My Sister's Keeper: A Novel

by Jodi Picoult

  This makes Kate laugh out loud. “God, Jess. I’m gonna miss you.”

  She says it so easily that I think it surprises both of us. I sit down on the edge of the bed and trace the little puckers in the thermal blanket. “You know—” I begin a pep talk, but she puts her hand on my arm.

  “Don’t.” Then her eyes come alive, for just a moment. “Maybe I’ll get reincarnated.”

  “Like as Marie Antoinette?”

  “No, it’s got to be something in the future. You think that’s crazy?”

  “No,” I admit. “I think we probably all just keep running in circles.”

  “So what will you come back as, then?”

  “Carrion.” She winces, and something beeps, and I panic. “You want me to get someone?”

  “No, you’re fine,” Kate answers, and I’m sure she doesn’t mean it this way, but it pretty much makes me feel like I’ve swallowed lightning.

  I suddenly remember an old game I used to play when I was nine or ten, and was allowed to ride my bike until it got dark. I used to make little bets with myself as I watched the sun getting lower and lower on the horizon: if I hold my breath to twenty seconds, the night won’t come. If I don’t blink. If I stand so still a fly lands on my cheek. Now, I find myself doing the same thing, bargaining to keep Kate, even though that isn’t the way it works.

  “Are you afraid?” I blurt out. “Of dying?”

  Kate turns to me, a smile sliding over her mouth. “I’ll let you know.” Then she closes her eyes. “I’m just gonna rest a second,” she manages, and she is asleep again.

  It’s not fair, but Kate knows that. It doesn’t take a whole long life to realize that what we deserve to have, we rarely get. I stand up, with that lightning bolt branding the lining of my throat, which makes it impossible to swallow, so everything gets backed up like a dammed river. I hurry out of Kate’s room and far enough down the hall where I won’t disturb her, and then I lift my fist and punch a hole in the thick white wall and still this isn’t enough.

  BRIAN

  HERE IS THE RECIPE TO BLOW SOMETHING UP: a Pyrex bowl; potassium chloride—found at health food stores, as a salt substitute. A hydrometer. Bleach. Take the bleach and pour it into the Pyrex, put it onto a stove burner. Meanwhile, weigh out your potassium chloride and add to the bleach. Check it with the hydrometer and boil until you get a reading of 1.3. Cool to room temperature, and filter out the crystals that form. This is what you will save.

  • • •

  It’s hard to be the one always waiting. I mean, there’s something to be said for the hero who charges off to battle, but when you get right down to it there’s a whole story in who’s left behind.

  I’m in what has to be the ugliest courtroom on the East Coast, sitting in chairs until it’s my turn, when suddenly my beeper goes off. I look at the number, groan, and try to figure out what to do. I’m a witness later, but the department needs me right now.

  It takes a few talking heads but I get permission from the judge to remove myself from the premises. I leave through the front door, and immediately I’m assailed with questions and cameras and lights. It is everything I can do not to punch these vultures, who want to rip apart the bleached bones of my family.

  • • •

  When I couldn’t find Anna the morning of the hearing, I headed home. I looked in all her usual haunts—the kitchen, the bedroom, the hammock out back—but she wasn’t there. As a last resort I climbed the garage stairs to the apartment Jesse uses.

  He wasn’t home either, although by now this is hardly a surprise. There was a time when Jesse disappointed me regularly; eventually, I told myself not to expect anything from him, and as a result, it has gotten easier for me to take what comes. I knocked on the door and yelled for Anna, for Jesse, but no one answered. Although there was a key to this apartment on my own set, I stopped short of letting myself inside. Turning on the stairs, I knocked over the red recycling bin I personally empty every Tuesday, since God forbid Jesse can remember to drag it out to the curb himself. A tenpin of beer bottles, lucent green, tumbled out. An empty jug of laundry detergent, an olive jar, a gallon container from orange juice.

  I put everything back in, except for the orange juice container, which I’ve told Jesse isn’t recyclable and which he puts in the bin nonetheless every damn week.

  • • •

  The difference between these fires and the other ones was that now the stakes have been ratcheted up a notch. Instead of an abandoned warehouse or a shack at the side of the water, it is an elementary school. This being summer, no one was on the premises when the fire was started. But there’s no question in my mind it was due to unnatural causes.

  When I get there, the engines are just loading up after salvage and overhaul. Paulie comes over to me right away. “How’s Kate?”

  “She’s okay,” I tell him, and I nod toward the mess. “What’d you find?”

  “He pretty much managed to gut the whole north side of the facility,” Paulie says. “You doing a walk through?”

  “Yeah.”

  The fire began in the teacher’s lounge; the char patterns point like an arrow to the origin. A collection of synthetic stuffing that hasn’t burned clean through is still visible; whoever set this was smart enough to light his fire in the middle of a pile of couch cushions and stacks of paper. I can still smell the accelerant; this time it was as simple as gasoline. Bits of glass from the exploded Molotov cocktail litter the ashes.

  I wander to the far side of the building, peer through a broken window. The guys must have vented the fire here. “You think we’ll catch this little fuck, Cap?” asks Caesar, coming into the room. Still in his turnout gear, with a smudge across his left cheek, he looks down at the debris in the fire line. Then he bends down, and with his heavy glove, picks up a cigarette butt. “Unbelievable. The secretary’s desk melted down to a puddle, but a goddamn tobacco stick survives.”

  I take it out of his hands and turn it over in my palm. “That’s because it wasn’t here when the fire started. Someone had a nice smoke while he watched this, and then he walked away.” I tip it onto the side, to where the yellow meets the filter, and read the brand.

  Paulie sticks his head in the shattered window, looking for Caesar. “We’re heading back. Get on the truck.” Then he turns to me. “Hey, just so you know, we didn’t break this one.”

  “I wasn’t gonna make you pay for it, Paulie.”

  “No, I mean, we vented the roof. This was already broken when we got here.” He and Caesar leave, and a few moments later I hear the heavy drag of the engine pulling away.

  It could have been a stray baseball, or a Frisbee. But even in the summertime, janitors monitor public property. A broken window is too much of a hazard to be left alone; it would have been taped up or boarded.

  Unless the same guy who started the fire knew where to bring in oxygen, so that the flames would race through the wind tunnel created by that vacuum.

  I look down at the cigarette in my hand, and crush it.

  • • •

  You need 56 grams of these reserved crystals. Mix with distilled water. Heat to a boil and cool again, saving the crystals, pure potassium chlorate. Grind these to the consistency of face powder, and heat gently to dry. Melt five parts Vaseline with five parts wax. Dissolve in gasoline and pour this liquid onto 90 parts potassium chlorate crystals in a plastic bowl. Knead. Allow the gasoline to evaporate.

  Mold into a cube and dip in wax to make it waterproof. This explosive requires a blasting cap of at least a grade A3.

  • • •

  When Jesse opens the door to his apartment, I am waiting on the couch. “What are you doing here?” he asks.

  “What are you doing here?”

  “I live here,” Jesse says. “Remember?”

  “Do you? Or are you using this as a place to hide?”

  He takes out a cigarette from a pack in his front pocket and lights up. Merits. “I don’t know what the fuck you’re talk
ing about. Why aren’t you in court?”

  “How come there’s muriatic acid under your sink?” I ask. “Considering that we don’t have a pool?”

  “Hello? Is this, like, the Inquisition?” He scowls. “I used it when I was working with those tile layers last summer; you can clean up grout with it. To tell you the truth I didn’t even know I still had it.”

  “Then you probably wouldn’t know, Jess, that when you put it into a bottle with a piece of aluminum foil with a rag stuffed into the top, it blows up pretty damn well.”

  He goes very still. “Are you accusing me of something? Because if you are, just say it, you bastard.”

  I get up from the couch. “Okay. I want to know if you scored the bottles before you made the cocktails, so that they’d break easier. I want to know if you realized how close that homeless guy was to dying when you set the warehouse on fire for kicks.” Reaching behind me, I lift the empty Clorox container from his recycle bin. “I want to know why the hell this is in your trash, when you don’t do your own laundry and God knows you don’t clean, yet there’s an elementary school six miles from here that’s been gutted with an explosive made of bleach and brake fluid?” I have him by the shoulders now, and although Jesse could break away if he really tried, he lets me shake him until his head snaps back. “Jesus Christ, Jesse!”

  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 thalidomide, Doctor?” I ask.

  “Of course. In fact, recently, it’s been resurrected for cancer research.”

  “And it was a milestone drug once before,” I point out. “With catastrophic effects. Speaking of which . . . this kidney donation—are there risks associated with the procedure?”

  “No more than for most surgeries,” Dr. Chance says.

  “Could Anna die from complications of this surgery?”