My Sister's Keeper

by Jodi Picoult

  "I thought it might be Jesse who could save her. I wanted it to be Jesse."

  "We all did," Dr. Chance answers. "Listen. Twenty years ago, the survival rate was even smaller. And I've known lots of families where one sibling isn't a match, but another sibling turns out to be just right."

  *

  We only have those two, I start to say, and then I realize that Dr. Chance is talking about a family I haven't yet had, of children I never intended. I turn to him, a question on my lips.

  "Brian will wonder where we've gone." He starts to walk toward his office, holding up the pot. "What plants," he asks conversationally, "would I be least likely to kill?"

  *

  It is so easy to presume that while your own world has ground to an absolute halt, so has everyone else's. But the trash collector has taken our garbage and left the cans in the road, just like always. There is a bill from the oil truck tucked into the front door. Neatly stacked on the counter is a week's worth of mail. Amazingly, life has gone on.

  Kate is released from the hospital a full week after her admission for induction chemotherapy. The central line still snaking from her chest bells out her blouse. The nurses give me a pep talk for encouragement, and a long list of instructions to follow: when to and when not to call the emergency room, when we are expected back for more chemotherapy, how to be careful during Kate's period of immunosuppression.

  At six the next morning, the door to our bedroom opens. Kate tiptoes toward the bed, although Brian and I have come awake in an instant. "What is it, honey?" Brian asks.

  She doesn't speak, just lifts her hand to her head and threads her fingers through her hair. It comes out in a thick clump, drifts down to the carpet like a small blizzard.

  *

  "All done," Kate announces a few nights later at dinner. Her plate is still full; she hasn't touched her beans or her meat loaf. She dances off to the living room to play.

  "Me too." Jesse pushes back from the table. "Can I be excused?"

  Brian spears another mouthful with his fork. "Not until you finish everything green."

  "I hate beans."

  "They're not too crazy about you, either."

  Jesse looks at Kate's plate. "She gets to be finished. That's not fair."

  Brian sets his fork down on the side of his plate. "Fair?" he answers, his voice too quiet. "You want to be fair? All right, Jess. The next time Kate has a bone marrow aspiration, we'll let you get one, too. When we flush her central line, we'll make sure you go through something equally as painful. And next time she gets chemo, we'll--"

  "Brian!" I interrupt.

  He stops as abruptly as he's started, and passes a shaking hand over his eyes. Then his gaze lands on Jesse, who has taken refuge under my arm. "I . . . I'm sorry, Jess. I don't . . ." But whatever he is about to say vanishes, as Brian walks out of the kitchen.

  For a long moment we sit in silence. Then Jesse turns to me. "Is Daddy sick, too?"

  I think hard before I answer. "We're all going to be fine," I reply.

  *

  On the one-week anniversary of our return home, we are awakened in the middle of the night by a crash. Brian and I race each other to Kate's room. She lies in bed, shaking so hard that she's knocked a lamp off her nightstand. "She's burning up," I tell Brian, when I lay my hand against her forehead.

  I have wondered how I will decide whether or not to call the doctor, should Kate develop any strange symptoms. I look at her now and cannot believe I would ever be so stupid to believe that I wouldn't know, immediately, what Sick looks like. "We're going to the ER," I announce, although Brian is already wrapping Kate's blankets around her and lifting her out of her crib. We bustle her to the car and start the engine and then remember that we cannot leave Jesse home alone.

  "You go with her," Brian answers, reading my mind. "I'll stay here." But he doesn't take his eyes off Kate.

  Minutes later, we are speeding toward the hospital, Jesse in the backseat next to his sister, asking why we need to get up, when the sun hasn't.

  In the ER, Jesse sleeps on a nest of our coats. Brian and I watch the doctors hover over Kate's feverish body, bees over a field of flowers, drawing what they can from her. She is pan-cultured and given a spinal tap to try to isolate the cause of the infection and rule out meningitis. A radiologist brings in a portable X-ray machine to take a film of her chest, to see if this infection lives in her lungs.

  Afterward, he places the chest film on the light panel outside the door. Kate's ribs seem as thin as matchsticks, and there is a large gray blot just off center. My knees go weak, and I find myself grabbing on to Brian's arm. "It's a tumor. The cancer's metastasized."

  The doctor puts his hand on my shoulder. "Mrs. Fitzgerald," he says, "that's Kate's heart."

  *

  Pancytopenia is a fancy word that means there is nothing in Kate's body protecting her against infection. It means, Dr. Chance says, that the chemo worked--that a great majority of white blood cells in Kate's body have been wiped out. It also means that nadir sepsis--a post-chemo infection--is not a likelihood, but a given.

  She is dosed with Tylenol to reduce her fever. She has blood, urine and respiratory secretion cultures taken, so that the appropriate antibiotics can be administered. It takes six hours before she is free of the rigors--a round of violent shaking so fierce that she is in danger of shimmying off the bed.

  The nurse--a woman who braided Kate's hair in silky cornrows one afternoon a few weeks back, to make her smile--takes Kate's temperature and then turns to me. "Sara," she says gently, "you can breathe now."

  Kate's face looks as tiny and white as those distant moons that Brian likes to spot in his telescope--still, remote, cold. She looks like a corpse . . . and even worse, this is a relief, compared to watching her suffer.

  "Hey." Brian touches the crown of my head. He juggles Jesse in his other arm. It is nearly noon, and we are all still in pajamas; we never thought to take a change of clothes. "I'm gonna take him down to the cafeteria; get some lunch. You want something?"

  I shake my head. Scooting my chair closer to Kate's bed, I smooth the covers over her legs. I take her hand, and measure it against my own.

  Her eyes slit open. For a moment she struggles, unsure of where she is. "Kate," I whisper. "I'm right here." As she turns her head and focuses on me, I lift her palm to my mouth, press a kiss in its center. "You are so brave," I tell her, and then I smile. "When I grow up, I want to be just like you."

  To my surprise, Kate shakes her head hard. Her voice is a feather, a thread. "No Mommy," she says. "You'd be sick."

  *

  In my first dream, the IV fluid is dripping too quickly into Kate's central line. The saline pumps her up from the inside out, a balloon to be inflated. I try to pull the infusion, but it's held fast in the central line. As I watch, Kate's features smooth, blur, obliterate, until her face is a white oval that could be anyone at all.

  In my second dream, I am in a maternity ward, giving birth. My body tunnels in, my heart pulses low in my belly. There is a rush of pressure, and then the baby arrives in a lightning rush and flow. "It's a girl," the nurse beams, and she hands me the newborn.

  I pull the pink blanket from her face, then stop. "This isn't Kate," I say.

  "Of course not," the nurse agrees. "But she's still yours."

  *

  The angel that arrives is wearing Armani and barking into a cell phone as she enters the hospital room. "Sell it," my sister orders. "I don't care if you have to set up a lemonade stand in Fanueil Hall and give the shares away, Peter. I said sell." She pushes a button and holds out her arms to me. "Hey," Zanne soothes when I burst into tears. "Did you really think I'd listen to you when you told me not to come?"

  "But--"

  "Faxes. Phones. I can work from your home. Who else is going to watch Jesse?"

  Brian and I look at each other; we haven't thought that far. In response, Brian stands up, hugs Zanne awkwardly. Jesse runs toward her at full tilt. "Who's that kid
you adopted, Sara . . . because Jesse can't possibly be that big . . ." She disengages Jesse from her knees and leans down over the hospital bed, where Kate is sleeping. "I bet you don't remember me," Zanne says, her eyes bright. "But I remember you."

  It comes so easy--letting her take charge. Zanne gets Jesse involved in a game of tic-tac-toe and bullies a Chinese restaurant that doesn't deliver into bringing up lunch. I sit beside Kate, basking in my sister's competence. I let myself pretend she can fix the things I can't.

  *

  After Zanne takes Jesse home for the night, Brian and I become bookends in the dark, bracketing Kate. "Brian," I whisper. "I've been thinking."

  He shifts in his seat. "What about?"

  I lean forward, so that I catch his eye. "Having a baby."

  Brian's eyes narrow. "Jesus, Sara." He gets to his feet, turns his back to me. "Jesus."

  I stand up, too. "It's not what you think."

  When he faces me, pain draws every line of his features tight. "We can't just replace Kate if she dies," he says.

  In the hospital bed, Kate shifts, rustling the sheets. I force myself to imagine her at age four, wearing a Halloween costume; age twelve, trying out lip gloss; age twenty, dancing around a dorm room. "I know. So we have to make sure that she doesn't."

  WEDNESDAY

  I will read ashes for you, if you ask me.

  I will look in the fire and tell you from the gray lashes And out of the red and black tongues and stripes, I will tell how fire comes

  And how fire runs as far as the sea.

  --CARL SANDBURG, "Fire Pages"

  CAMPBELL

  WE ARE ALL, I SUPPOSE, beholden to our parents--the question is, how much? This is what runs through my mind while my mother jabbers on about my father's latest affair. Not for the first time, I wish for siblings--if only so that I would receive sunrise phone calls like this only once or twice a week, instead of seven.

  "Mother," I interrupt, "I doubt that she's actually sixteen."

  "You underestimate your father, Campbell."

  Maybe, but I also know that he's a federal judge. He may leer after schoolgirls, but he'd never do anything illegal. "Mom, I'm late for court. I'll check back in with you later," I say, and I hang up before she can protest.

  I am not going to court, but still. Taking a deep breath, I shake my head and find Judge staring at me. "Reason number 106 why dogs are smarter than humans," I say. "Once you leave the litter, you sever contact with your mothers."

  I walk into the kitchen as I am knotting my tie. My apartment, it is a work of art. Sleek and minimalist, but what is there is the best that money can buy--a one-of-a-kind black leather couch; a flat screen television hanging on the wall; a locked glass case filled with signed first editions from authors like Hemingway and Hawthorne. My coffeemaker comes imported from Italy; my refrigerator is sub-zero. I open it and find a single onion, a bottle of ketchup, and three rolls of black-and-white film.

  This, too, is no surprise--I rarely eat at home. Judge is so used to restaurant food he wouldn't recognize kibble if it slid its way down his throat. "What do you think?" I ask him. "Rosie's sound good?"

  He barks as I fasten his service-dog harness. Judge and I have been together for seven years. I bought him from a breeder of police dogs, but he was specially trained with me in mind. As for his name, well, what attorney wouldn't want to be able to put a Judge in a crate every now and then?

  Rosie's is what Starbucks wishes it was: eclectic and funky, crammed with patrons who at any time might be reading Russian lit in its original tongue or balancing a company's budget on a laptop or writing a screenplay while mainlining caffeine. Judge and I usually walk there and sit at our usual table, in the back. We order a double espresso and two chocolate croissants, and we flirt shamelessly with Ophelia, the twenty-year-old waitress. But today, when we walk inside, Ophelia is nowhere to be found and there is a woman sitting at our table, feeding a toddler in a stroller a bagel. This throws me for such a loop that Judge needs to tug me to the only spot that's free, a stool at the counter that looks out on the street.

  Seven-thirty A.M., and already this day is a bust.

  A heroin-thin boy with enough rings in his eyebrows to resemble a shower curtain rod approaches with a pad. He sees Judge at my feet. "Sorry, dude. No dogs allowed."

  "This is a service dog," I explain. "Where's Ophelia?"

  "She's gone, man. Eloped, last night."

  Eloped? People still do that? "With whom?" I ask, though it's none of my business.

  "Some performance artist who sculpts dog crap into busts of world leaders. It's supposed to be a statement."

  I feel a momentary pang for poor Ophelia. Take it from me: love has all the lasting permanence of a rainbow--beautiful while it's there, and just as likely to have disappeared by the time you blink.

  The waiter reaches into his back pocket and hands me a plastic card. "Here's the Braille menu."

  "I want a double espresso and two croissants, and I'm not blind."

  "Then what's Fido for?"

  "I have SARS," I say. "He's tallying the people I infect."

  The waiter can't seem to figure out if I am joking. He backs away, unsure, to get my coffee.

  Unlike my normal table, this one has a view of the street. I watch an elderly lady narrowly avoid the swipe of a taxi; a boy dances past with a radio three times the size of his head balanced on his shoulder. Twins in parochial school uniforms giggle behind the pages of a teen magazine. And a woman with a running river of black hair spills coffee on her skirt, dropping the paper cup on the pavement.

  Inside me, everything stops. I wait for her to lift her face--to see if this could possibly be who I think it is--but she turns away from me, blotting the fabric with a napkin. A bus cuts the world in half, and my cell phone begins to ring.

  I glance down at the incoming number: no surprise there. Turning off the power button without bothering to take my mother's call, I glance back at the woman outside the window, but by then the bus is gone and so is she.

  *

  I open the door of the office, already barking orders for Kerri. "Call Osterlitz and ask him whether he's available to testify during the Weiland trial; get a list of other complainants who've gone up against New England Power in the past five years; make me a copy of the Melbourne deposition; and phone Jerry at the court and ask who the judge is going to be for the Fitzgerald kid's hearing."

  She glances up at me as the phone begins to ring. "Speaking of." She jerks her head in the direction of the door to my inner sanctum. Anna Fitzgerald stands on the threshold with a spray can of industrial cleaner and a chamois cloth, polishing the doorknob.

  "What are you doing?" I ask.

  "What you told me to." She looks down at the dog. "Hey, Judge."

  "Line two for you," Kerri interrupts. I give her a measured look--why she even let this kid in here is beyond me--and try to get into my office, but whatever Anna has put on the hardware makes it too greasy to turn. I struggle for a moment, until she grips the knob with the cloth and opens the door for me.

  Judge circles the floor, finding the most comfortable spot. I punch the blinking light on the call row. "Campbell Alexander."

  "Mr. Alexander, this is Sara Fitzgerald. Anna Fitzgerald's mother." I let this information settle. I stare at her daughter, polishing a mere five feet away.

  "Mrs. Fitzgerald," I answer, and as expected, Anna stops in her tracks.

  "I'm calling because . . . well, you see, this is all a misunderstanding."

  "Have you filed a response to the petition?"

  "That isn't going to be necessary. I spoke to Anna last night, and she isn't going to continue with her case. She wants to do anything she can to help Kate."

  "Is that so." My voice falls flat. "Unfortunately, if my client is planning to call off her lawsuit, I'll need to hear it directly from her." I raise a brow, catch Anna's gaze. "You wouldn't happen to know where she is?"

  "She went out for a run," Sara
Fitzgerald says. "But we're going to come down to the courthouse this afternoon. We'll talk to the judge, and get this straightened out."

  "I suppose I'll see you then." I hang up the phone and cross my arms, look at Anna. "Is there something you'd like to tell me?"

  She shrugs. "Not really."

  "That's not what your mother seems to think. Then again, she's also under the impression that you're out playing Flo Jo."

  Anna glances out into the reception area, where Kerri, naturally, is hanging on our words like a cat on a rope. She closes the door and walks up to my desk. "I couldn't tell her I was coming here, not after last night."

  "What happened last night?" When Anna goes mute, I lose my patience. "Listen. If you're not going to go through with a lawsuit . . . if this is a colossal waste of my time . . . then I'd appreciate it if you had the honesty to tell me now, rather than later. Because I'm not a family therapist or your best buddy; I'm your attorney. And for me to be your attorney there actually has to be a case. So I will ask you one more time: have you changed your mind about this lawsuit?"

  I expect this tirade to put an end to the litigation, to reduce Anna to a wavering puddle of indecision. But to my surprise, she looks right at me, cool and collected. "Are you still willing to represent me?" she asks.

  Against my better judgment, I say yes.

  "Then no," she says, "I haven't changed my mind."

  *

  The first time I sailed in a yacht club race with my father I was fourteen, and he was dead set against it. I wasn't old enough; I wasn't mature enough; the weather was too iffy. What he really was saying was that having me crew for him was more likely to lose him the cup than to win it. In my father's eyes, if you weren't perfect, you simply weren't.

  His boat was a USA-1 class, a marvel of mahogany and teak, one he'd bought from the keyboard player J. Geils up in Marblehead. In other words: a dream, a status symbol, and a rite of passage, all wrapped up in a gleaming white sail and a honey-colored hull.

  We hit the start dead-on, crossing the line at full sail just as the cannon shot off. I did my best to be a step ahead of where my father needed me to be--guiding the rudder before he even gave the order, jibing and tacking until my muscles burned with effort. And maybe this even would have had a happy ending, but then a storm blew in from the north, bringing sheets of rain and swells that stretched ten feet high, pitching us from height to gulley.