Jodie Picoult - My Sister's Keeper

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 track 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.