"The trash goes out on Wednesday," Brian adds.
"Don't walk Jesse into school. Apparently, that's anathema for sixth-graders."
She nods and listens and even takes notes, and then says she has a couple of questions. "The fish…"
"Gets fed twice a day. Jesse can do it, if you remind him."
"Is there an official bedtime?" Zanne asks.
"Yeah," I reply. "Do you want me to give you the real one, or the one you can use if you're going to tack on an extra hour as a special treat?"
"Anna's eight o'clock," Brian says. "Jesse's ten. Anything else?"
"Yes." Zanne reaches into her pocket and takes out a check made out to us, for $100,000.
"Suzanne," I say, stunned. "We can't take that."
"I know how much it costs. You can't cover it. I can. Let me."
Brian picks up the check and hands it back to her. "Thank you," he says. "But actually, we've got the transplant covered."
This is news to me. "We do?"
"The guys at the station sent out a call to arms, nationwide, and got a bunch of donations from other firefighters." Brian looks at me. "I just found out today."
"Really?" Inside me a weight lifts.
He shrugs. "They're my brothers," he explains.
I turn to Zanne and hug her. "Thank you. For even offering."
"It's here if you need it," she answers.
But we don't. We are able to do this, at least.
"Kate!" I call the next morning. "It's time to go!"
Anna is curled on Zanne's lap on the couch. She pulls her thumb out of her mouth but she doesn't say good-bye.
"Kate!" I yell again. "We're leaving!"
Jesse smirks over his Nintendo controls. "Like you'd really take off without her."
"She doesn't know that. Kate!" Sighing, I swing up the stairs toward her bedroom.
The door is closed. With a soft knock, I push it open, and find Kate in the final throes of making her bed. The quilt is pulled tight enough to bounce a dime off its middle; the pillows have been fluffed and centered. Her stuffed animals, relics at this point, sit on the window seat in gradated succession, tallest to smallest. Even her shoes have been neatly arranged in her closet, and the mess on her desk has vanished.
"Okay." I haven't even asked her to clean up. "Clearly, I'm in the wrong bedroom."
She turns. "It's in case I don't come back," she says.
When I first became a parent I used to lie in bed at night and imagine the most horrible succession of maladies: the bite of a jellyfish, the taste of a poisonous berry, the smile of a dangerous stranger, the dive into a shallow pool. There are so many ways a child can be harmed that it seems nearly impossible one person alone could succeed at keeping him safe. As my children got older, the hazards only changed: inhaling glue, playing with matches, small pink pills sold behind the bleachers of the middle school. You can stay up all night and still not count all the ways to lose the people you love.
It seems to me, now that this is more than just a hypothetical, that a parent falls one of two ways when told a child has a fatal disease. Either you dissolve into a puddle, or you take the blow on the cheek and force yourself to lift your face again for more. In this, we probably look a lot like the patients.
Kate is semi-conscious on her bed, her central line tubes blooming like a fountain from her chest. The chemo has made her throw up thirty-two times, and has given her mouth sores and such bad mucositis that she sounds like a cystic fibrosis patient. She turns to me and tries to speak, but coughs up phlegm instead. "Drown," she chokes out.
Raising the suction tube she's clutching in her hands, I clear out her mouth and throat. "I'll do it while you rest," I promise, and that is how I come to breathe for her.
An oncology ward is a battlefield, and there are definite hierarchies of command. The patients, they're the ones doing the tour of duty. The doctors breeze in and out like conquering heroes, but they need to read your child's chart to remember where they've left off from the previous visit. It is the nurses who are the seasoned sergeants—the ones who are there when your baby is shaking with such a high fever she needs to be bathed in ice, the ones who can teach you how to flush a central venous catheter, or suggest which patient floor kitchens might still have Popsicles left to be stolen, or tell you which dry cleaners know how to remove the stains of blood and chemotherapies from clothing. The nurses know the name of your daughter’s stuffed walrus and show her how to make tissue paper flowers to twine around her IV stand. The doctors may be mapping out the war games, but it is the nurses who make the conflict bearable.
You get to know them as they know you, because they take the place of friends you once had in a previous life, the one before diagnosis. Donna’s daughter, for example, is studying to be a vet. Ludmilla, on the graveyard shift, wears laminated pictures of Sanibel Island clipped like charms to her stethoscope, because it’s where she wants to retire. Willie, the male nurse, has a weakness for chocolate and a wife expecting triplets.
One night during Kate’s induction, which I have been awake for so long that my body has forgotten how to segue into sleep, I turn on the TV while she sleeps. I mute it, so that the volume won’t disturb her. Robin Leach is walking through the palatial home of someone Rich and Famous. There are gold-plated bidets and hand-carved teak beds, a pool in the shape of a butterfly. There are ten-car garages and red clay tennis courts and eleven roaming peacocks. It’s a world I can’t even wrap my head around—a life I would never imagine for myself.
Sort of like this one used to be.
I can't even really remember what it was like to hear a story about a mother with breast cancer or a baby born with congenital heart problems or any other medical burden, and to feel myself crack down the middle: half sympathetic, half grateful that my own family was safe. We have become that story, for everyone else.
I don't realize I'm crying until Donna kneels down in front of me and takes the TV remote out of my hand. "Sara," the nurse says, "can I get you something?"
I shake my head, embarrassed to have broken down, even more ashamed to be caught. "I'm fine," I insist.
"Yeah, and I'm Hillary Clinton," she says. She reaches for my hand and tugs me upright, drags me toward the door.
"Kate—"
"—will not even miss you," Donna finishes.
In the small kitchenette where there is coffee brewing twenty-four hours a day, she fixes a cup for each of us. "I'm sorry," I say.
"For what? Not being made of granite?"
I shake my head. "It just doesn't end." Donna nods, and because she completely understands, I find myself talking. And talking. And when I have spilled all my secrets, I take a deep breath and realize that I have been talking for an hour straight. "Oh my God," I say. "I can't believe I've wasted so much of your time."
"It wasn't a waste," Donna replies. "And besides, my shift ended a half hour ago."
My cheeks flame. "You ought to go. I'm sure you have somewhere else you'd much rather be."
But instead of leaving, Donna folds me into her ample arms. "Honey," she says, "don't we all?"
The door to the ambulatory operating suite yawns open into a small room packed with gleaming silver instruments—a mouth gilded with braces. The doctors and nurses she has met are masked and gowned, only recognizable by their eyes. Anna tugs at me until I kneel down beside her. "What if I changed my mind?" she says.
I put my hands on her shoulders. "You don't have to do this if you don't want to, but I know that Kate is counting on you. And Daddy and me."
She nods once, then slips her hand into mine. "Don't let go," she tells me.
A nurse shepherds her in the right direction, onto the table. "Wait'll you see what we've got for you, Anna." She draws a heated blanket over her.
The anesthesiologist wipes a red-tinged gauze pad around an oxygen mask. "Have you ever gone to sleep in a strawberry field?" They work their way down Anna's body, applying gelled pads that will be hooked to monitors to t
rack her heart and her breathing. They administer to her while she's lying on her back, although I know they will flip her over to draw marrow from her hipbones.
The anesthesiologist shows Anna the accordion mechanism on his equipment. "Can you blow up that balloon?" he asks, and places the mask over Anna's face.
All this time, she doesn't let go of my hand. Finally, her grip slackens. She fights at the last minute, her body already asleep but straining forward at the shoulders. One nurse holds Anna down; the other restrains me. "It's just the way the medicine affects the body," she explains. "You can give her a kiss now."
So I do, through my mask. I whisper a thank-you, too. I walk out of the swinging door and peel off my paper hat and booties. I watch through the postage-stamp window as Anna is rolled to her side and an impossibly long needle is lifted from a sterile tray. Then I go upstairs to wait with Kate.
Brian sticks his head into Kate's room. "Sara," he says, exhausted, "Anna's asking for you."
But I cannot be in two places at one time. I hold the pink erne-sis basin up to Kate's mouth as she vomits again. Beside me, Donna helps lower Kate back onto her pillow. "I'm a little busy right now," I say.
"Anna's asking for you," Brian repeats, that's all. Donna looks from him to me. "We'll be fine till you get back," she promises, and after a moment, I nod.
Anna is on the pediatric floor, one that doesn't have the hermetically sealed rooms necessary for protective isolation. I hear her crying before I even enter the room. "Mommy," she sobs. "It hurts." I sit down on the side of the bed and fold her into my arms. "I know, sweetie."
"Can you stay here?"
I shake my head. "Kate's sick. I'm going to have to go back."
Anna pulls away. "But I'm in the hospital," she says. "I'm in the hospital!"
Over her head, I glance at Brian. "What are they giving her for pain?"
"Very little. The nurse said they don't like to overmedicate kids."
"That's ridiculous." When I stand, Anna whimpers and grabs for me. "Be right back, honey."
I accost the first nurse I can find. Unlike the staff in oncology, these RNs are unfamiliar. "She was given Tylenol an hour ago," the woman explains. "I know she's a little uncomfortable—"
"Roxicet. Tylenol with codeine. Naproxen. And if it's not on the doctor's orders call and ask whether it can be put on there."
The nurse bristles. "With all due respect, Mrs. Fitzgerald, I do this every day, and—"
"So do I."
When I go back to Anna's room, I am carrying a pediatric dose of Roxicet, which will either relieve her aches or knock her out so that she no longer feels them. I walk in to find Brian's big hands fumbling a Lilliputian clasp on the back of a necklace, as he hangs a locket around Anna's neck. "I thought you deserved your own gift, since you were giving one to your sister," he says.
Of course Anna should be honored for donating her bone marrow. Of course she deserves recognition. But the thought of rewarding someone for their suffering, frankly, never entered my mind. We've all been doing it for so long.
They both glance up when I come through the doorway. "Look at what Daddy got me!" Anna says.
I hold out the plastic dosage cup, a poor second-best.
Shortly after ten o'clock, Brian brings Anna to Kate's room. She moves slowly, like an old woman, leaning on Brian for support. The nurses help her into a mask and gown and gloves and booties so that she can be allowed in—a compassionate breach of protocol, as children are not usually allowed to visit protective isolation.
Dr. Chance stands beside the IV pole, holding up the bag of marrow. I turn Anna so that she can see it. "That," I tell her, "is what you gave us."
Anna makes a face. "It's gross. You can have it."
"Sounds like a plan," Dr. Chance says, and the rich ruby marrow begins to feed into Kate's central line.
I place Anna on the bed. There is room for both of them, shoulder to shoulder. "Did it hurt?" Kate asks.
"Kind of." Anna points to the blood running through the plastic tubes into the slit in Kate's chest. "Does that?"
"Not really." She sits up a little. "Hey, Anna?”
“Yeah?"
"I'm glad it came from you." Kate reaches for Anna's hand and places it just below the central line's catheter, a spot that falls precariously near her heart.
Twenty-one days after the bone marrow transplant, Kate's white cell counts begin to rise, proof of engraftment. To celebrate, Brian insists that he is taking me out to dinner. He arranges for a private-duty nurse for Kate, makes reservations at XO Cafe, and even brings me a black dress from my closet. He forgets pumps, so I wind up wearing my scruffy hiking clogs with it.
The restaurant is nearly full. Almost immediately after we are seated, the sommelier comes to ask if we want wine. Brian orders a Cabernet Sauvignon.
"Do you even know whether that's red or white?" I do not think, in all these years, I have seen Brian drink anything but beer.
"I know it's got alcohol in it, and I know we're celebrating." He lifts his glass after the sommelier pours it. "To our family," he toasts.
We click glasses and take sips. "What are you getting?" I ask.
"What do you want me to get?"
"The filet. That way I can taste it if I get the sole." I fold my menu. "Did you hear the results of the last CBC?"
Brian looks down at the table. "I was sort of hoping that we could come here to get away from all that. You know. Just talk."
"I'd like to talk," I admit. But when I look at Brian, the information that leaps to my lips is about Kate, not us. I have no call to ask him about his day—he has taken three weeks off from the station. We are connected by and through sickness.
We fall back into silence. I look around XO Cafe and notice that chatter happens mostly at tables where the diners are young and hip. The older couples, the ones sporting wedding bands that wink with their silverware, eat without the pepper of conversation. Is it because they are so comfortable, they already know what the other is thinking? Or is it because after a certain point, there is simply nothing left to say?
When the waiter arrives to take our order, we both turn eagerly, grateful for someone who keeps us from having to recognize the strangers we have become.
We leave the hospital with a child who is different from the one we brought in. Kate moves cautiously, checking the drawers of the nightstand for anything she might have left behind. She has lost so much weight that the jeans I brought do not fit; we have to use two bandannas knotted together as a makeshift belt.
Brian has gone down ahead of us to bring the car around. I zip the last Tiger Beat and CD into Kate's duffel bag. She pulls a fleece cap on over her smooth, bare scalp and winds a scarf tight around her neck. She puts on a mask and gloves; now that we are venturing out of the hospital, she is the one who will need protection.
We walk out the door to the applause of the nurses we have come to know so well. "Whatever you do, don't come back and see us, all right?" Willie jokes.
One by one, they walk up to say their good-byes. When they have all dispersed, I smile at Kate. "Ready?"
Kate nods, but she doesn't step forward. She stands rigid, fully aware that once she sets foot outside this doorway, everything changes. "Mom?"
I fold her hand into mine. "We'll do it together," I promise, and side by side, we take the first step.
The mail is full of hospital bills. We have learned that the insurance company will not talk to the hospital billing department, and vice versa, but neither one thinks that the charges are accurate—which leads them to charge us for procedures we shouldn't have to cover, in the hopes that we are stupid enough to pay them. Managing the monetary aspect of Kate's care is a full-time job that neither Brian nor I can do.
I leaf through a grocery store flyer, an AAA magazine, and a long-distance rate announcement before I open the letter from the mutual fund. It's not something I really pay attention to; Brian usually manages finances that require more than basic checkboo
k balancing. Besides, the three funds we have are all earmarked for the kids' education. We are not the sort of family that has enough spare change to play the stock market.
Dear Mr. Fitzgerald:
This is to confirm your recent redemption from fund #323456, Brian D. Fitzgerald Custodian for Katherine S. Fitzgerald, in the amount of $8,369.56. This disbursement effectively closes the account.
As banking errors go, this is a pretty major one. We've been off by pennies in our checking account, but at least I've never lost eight thousand dollars. I walk out of the kitchen and into the yard, where Brian is rolling an extra garden hose. "Well, either someone at the mutual fund screwed up," I say, handing the letter to him, "or the second wife you're supporting is no longer a secret."
It takes him one moment too long to read it, the same moment that I realize that this is not a mistake after all. Brian wipes his forehead with the back of one wrist. "I took that money out," he says.
"Without telling me?" I cannot imagine Brian doing such a thing. There have been times, in the past, where we dipped into the children's accounts, but only because we were having a month too tight to swing the cost of groceries and the mortgage, or because we needed the down payment for a new car when our old one had finally been put to rest. We'd lie awake in bed feeling guilt press down like an extra quilt, promising each other that we would put that money right back where it belonged as soon as humanly possible.
"The guys at the station, they tried to raise some money, like I told you. They got ten thousand dollars. With this added to it, the hospital's willing to work out some kind of payment plan for us."
"But you said—"
"I know what I said, Sara."
I shake my head, stunned. "You lied to me?"
"I didn't—"
"Zanne offered—"
"I won't let your sister take care of Kate," Brian says. "I'm supposed to take care of Kate." The hose falls to the ground, dribbles and spits at our feet. "Sara, she's not going to live long enough to use that money for college."
The sun is bright; the sprinkler twitches on the grass, spraying rainbows. It is far too beautiful a day for words like these. I turn and run into the house. I lock myself in the bathroom.
My Sister's Keeper Page 21
