Jodie Picoult - My Sister's Keeper

The room is large, with jungle murals painted on the walls. The linear accelerators are built into the ceiling and a pit below the treatment table, which is little more than a canvas cot covered with a sheet. The radiation therapist places thick lead pieces shaped like beans onto Kate's chest and tells her not to move. She promises that when it's all over, Kate can have a sticker.

I stare at Kate through the protective glass wall. Gamma rays, leukemia, parenthood. It is the things you cannot see coming that are strong enough to kill you.

There is a Murphy's Law to oncology, one which is not written anywhere but held in widespread belief: if you don't get sick, you won't get well. Therefore, if your chemo makes you violently ill, if radiation sears your skin—it's all good. On the other hand, if you sail through therapy quickly with only negligible nausea or pain, chances are the drugs have somehow been excreted by your body and aren't doing their job.

By this criterion, Kate should surely be cured by now. Unlike last year's chemo, this course of treatment has taken a little girl who didn't even have a runny nose and has turned her into a physical wreck. Three days of radiation has caused constant diarrhea, and put her back into a diaper. At first, this embarrassed her; now she is so sick she doesn't care. The following five days of chemo have lined her throat with mucus, which keeps her clutching at a suction tube as if it is a life preserver. When she is awake, all she does is cry.

Since Day Six, when Kate's white blood cell and neutrophil counts began to plummet, she has been in reverse isolation. Any germ in the world might kill her now; for this reason, the world is made to keep its distance. Visitors to her room are restricted, and those who are allowed in look like spacemen, gowned and masked. Kate has to read picture books while wearing rubber gloves. No plants or flowers are permitted, because they carry bacteria that could kill her. Any toy given to her must be scrubbed down with antiseptic solution first. She sleeps with her teddy bear, sealed in a Ziploc bag, which rustles all night and sometimes wakes her up.

Brian and I sit outside the anteroom, waiting. While Kate sleeps, I practice giving injections to an orange. After the transplant Kate will need growth factor shots, and the chore will fall to me. I prick the syringe under the thick skin of the fruit, until I feel the soft give of tissue underneath. The drug I will be giving is subcutaneous, injected just under the skin. I need to make sure the angle is right and that I am giving the proper amount of pressure. The speed with which you push the needle down can cause more or less pain. The orange, of course, doesn't cry when I make a mistake. But the nurses still tell me that injecting Kate won't feel much different.

Brian picks up a second orange and begins to peel it. "Put that down!"

"I'm hungry." He nods at the fruit in my hands. "And you've already got a patient."

"For all you know that was someone else's. God knows what it's doped up with."

Suddenly Dr. Chance turns the corner and approaches us. Donna, an oncology nurse, walks behind him, brandishing an IV bag filled with crimson liquid. "Drum roll," she says.

I put down my orange, follow them into the anteroom, and suit up so that I can come within ten feet of my daughter. Within minutes Donna attaches the bag to a pole, and connects the drip to Kate's central line. It is so anticlimactic that Kate doesn't even wake up. I stand on one side, as Brian goes to the other. I hold my breath. I stare down at Kate's hips, the iliac crest, where bone marrow is made. Through some miracle, these stem cells of Anna's will go into Kate's bloodstream in her chest, but will find their way to the right spot.

"Well," Dr. Chance says, and we all watch the cord blood slowly slide through the tubing, a Crazy Straw of possibility.

AFTER TWO HOURS OF LIVING with my sister again, I'm finding it hard to believe we ever comfortably shared a womb. Isobel has already organized my CDs by year of release, swept under the couch, and tossed out half the food in my refrigerator. "Dates are our friend, Julia." She sighs. "You have yogurt in here from when Democrats ruled the White House."

I slam the door shut and count to ten. But when Izzy moves toward the gas oven and starts looking for the cleaning controls, I lose my cool. "Sylvia doesn't need cleaning."

"That's another thing: Sylvia the oven. Smilla the Fridge. Do we really need to name our kitchen appliances?"

My kitchen appliances. Mine, not ours, goddammit. "I'm totally getting why Janet broke up with you," I mutter.

At that, Izzy looks up, stricken. "You are horrible," she says. "You are horrible and after I was born I should have sewed Mom shut." She runs to the bathroom in tears.

Isobel is three minutes older than me, but I've always been the one who takes care of her. I'm her nuclear bomb: when there's something upsetting her, I go in and lay waste to it, whether that's one of our six older brothers teasing her or the evil Janet, who decided she wasn't gay after seven years into a committed relationship with Izzy. Growing up, Izzy was the Goody Two-shoes and I was the one who came up fighting—swinging my fists or shaving my head to get a rise out of our parents or wearing combat boots with my high school uniform. Yet now that we're thirty-two, I'm a card-carrying member of the Rat Race; while Izzy is a lesbian who builds jewelry out of paper clips and bolts. Go figure.

The door to the bathroom doesn't lock, but Izzy doesn't know that yet. So I walk in and wait till she finishes splashing cold water on her face, and I hand her a towel. "Iz. I didn't mean it."

"I know." She looks at me in the mirror. Most people can't tell us apart now that I have a real job that requires conventional hair and conventional clothes. "At least you had a relationship," I point out. "The last time I had a date was when I bought that yogurt."

Izzy's lips curve, and she turns to me. "Does the toilet have a name?"

"I was thinking of Janet," I say, and my sister cracks up. The telephone rings, and I go into the living room to answer it. "Julia? This is Judge DeSalvo calling. I've got a case that needs a guardian ad litem, and I'm hoping you might be able to help me out." I became a guardian ad litem a year ago, when I realized that nonprofit work wasn't covering my rent. A GAL is appointed by a court to be a child's advocate during legal proceedings that involve a minor. You don't have to be a lawyer to be trained as a GAL, but you do have to have a moral compass and a heart. Which, actually, probably renders most lawyers unqualified for the job. "Julia? Are you there?"

I would turn cartwheels for Judge DeSalvo; he pulled strings to get me a job when I first became a GAL. "Whatever you need," I promise. "What's going on?"

He gives me background information—phrases like medical emancipation and thirteen and mother with legal background float by me. Only two items stick fast: the word urgent, and the name of the attorney.

God, I can't do this.

"I can be there in an hour," I say.

"Good. Because I think this kid needs someone in her corner.”

“Who was that?" Izzy asks. She is unpacking the box that holds her work supplies: tools and wire and little containers of metal bits that sound like teeth gnashing when she sets them down. "A judge," I reply. "There's a girl who needs help." What I don't tell my sister is that I'm talking about me.

Nobody's home at the Fitzgerald house. I ring the doorbell twice, certain this must be a mistake. From what Judge DeSalvo's led me to believe, this is a family in crisis. But I find myself standing in front of a well-kept Cape, with carefully tended flower gardens lining the walk.