My Sister's Keeper: List 1

Poison, sprinkled on her cereal. A wicked undertow off the beach. Lightning striking.
In the end, though, I did not kill my sister.

I guess maybe my brother had his moment in the sun for the four years he was alive before Kate got diagnosed, but ever since then, we've been too busy looking over our shoulders to run headlong into growing up.

It's strapless, what a star might wear sashaying down a red carpet—totally not the dress code for a suburban house in Upper Darby, Rl.

"Actually," I interrupt, "you're wrong. Smith v. Whately, Edmunds v. Womens and Infants Hospital, and Jerome v. the Diocese of Providence all involved litigants under the age of eighteen. All three resulted in verdicts for Mr. Alexander's clients. And those were just in the past year."

"I don't want any Girl Scout cookies," Campbell Alexander says. "Although you do get Brownie points for tenacity. Ha."

"I have an iron lung," Campbell Alexander says curtly, "and the dog keeps me from getting too close to magnets. Now, if you'd do me the exalted honor of leaving, my secretary can find you the name of someone who—"

"I sued the Diocese of Providence, on behalf of a kid in one of their orphanages who needed an experimental treatment involving fetal tissue, which they felt violated Vatican II. However, it makes a much better headline to say that a nine-year-old is suing God for being stuck with the short end of the straw in life."

Simply put, people who have been backed into a corner will do anything to fight their way to the center again. For some, this means throwing punches. For others, it means instigating a lawsuit.

On the periphery of my desk Kerri has arranged my messages the way I prefer—urgent ones written on green Post-its, less pressing matters on yellow ones, lined up in neat columns like a double game of solitaire.

The first time I gave something to my sister, it was cord blood, and I was a newborn. She has leukemia—APL—and my cells put her into remission. The next time she relapsed, I was five and I had lymphocytes drawn from me, three times over, because the doctors never seemed to get enough of them...

It sounded callous—having a subsequent child just in case the first one happens to die—yet it had been eminently practical once.

I tap my pen on the desk, and Judge—my dog—sidles closer.

Plus, the case will generate a ton of publicity for me, and will jack up my pro bono for the whole damn decade.

“Campbell Alexander. Your last name is a first name, and your first name is a last name.” She pauses. “Or a soup.”
“And how does that have any bearing on your case?”

Kerri has an aunt who makes her living as a psychic, and every now and then this genetic predisposition rears its head. Or maybe she’s just been working for me long enough to know most of my secrets.

“She says your father’s taken up with a seventeen-year-old and that discretion isn’t in his vocabulary and that she’s checking herself into The Pines unless you call her by...” Kerri glances at her watch.

“Campbell,” Kerri presses, relentless, “you can’t expect a kid to fend for herself.”

Pale towheads bent together, they are a matched set. Jesse looks more like me—skinny, dark, cerebral.

Pale towheads bent together, they are a matched set. Jesse looks more like me—skinny, dark, cerebral.

"You get yourself out of the tub this minute," I tell Jesse.
He stands up, a sluice of four-year-old boy, and manages to trip as he navigates the wide lip of the tub.

"So who subpoenaed you?" I ask Brian. "The defendant?"
"The prosecution. The insurance company paid out the money, and then had him arrested for twenty-four counts of arson. I got to be their expert."

At one point I truly believed that was what I wanted to be—but that was before I'd been handed a fistful of crushed violets from a toddler. Before I understood that the smile of a child is a tattoo: indelible art.

Sure enough, there is cereal spilled all over the kitchen table, and a frighteningly precarious chair poised beneath the cabinet that holds the corn flakes.

When the pediatric nurse comes in with her tray, her syringe, her vials, and her rubber tourniquet, Kate starts to scream.

Ileana Farquad, Providence Hospital, Hematology/Oncology.
"Oncology." I shake my head. "But that's cancer." I wait for Dr. Wayne to assure me it's only part of the physician's title, to explain that the blood lab and the cancer ward simply share a physical location, and nothing more.

There is a comfort to having Brian beside me, as if we are now a pair of sentries, a double line of defense.

A young woman approaches, wearing a lab coat. "I'm a phlebotomist. Dr. Farquad wants me to do a coag panel on Kate."

Think of bone marrow as a childcare center for developing cells. Healthy bodies make blood cells that stay in the marrow until they're mature enough to go out and fight disease or clot or carry oxygen or whatever it is that they're supposed to do. In a person with leukemia, the childcare-center doors are opened too early. Immature blood cells wind up circulating, unable to do their job.

We have no protocol for this situation. Our only baby-sitters are still in high school; all four grandparents are deceased; we've never dealt with day care providers—taking care of the children is my job.

As he stares at me, the genial smile sloughs off his face.

It is a psychedelic tie-dye, with a crab on the front, and the word Cancer.

Today, she is reading Allure magazine. I wonder if she even knows that every V-necked model she comes across she touches at the breastbone, in the same place where she has a catheter and they don't.

A spider plant languishes, brown, on a windowsill. I hope he is better with people.

"Kate will start a week of chemotherapy, in the hopes that we can kill off the diseased cells and put her into remission. She'll most likely have nausea and vomiting, which we'll try to keep to a minimum with antiemetics. She'll lose her hair."

"What will it be like," I hear myself ask, "if she dies?"
Dr. Chance looks at me. "It depends on what she succumbs to," he explains.

That's the purpose of chemotherapy—to wipe out all the leukemic cells. To this end, a central line has been placed beneath Kate's collarbone, a three-pronged port that will be the entry point for multiple medication administrations, IV fluids, and blood draws.

This is what starts coursing through her veins: the Daunorubicin, 50 mg in 25 ccs of D5W; Cytarabine, 46 mg in a D5W infusion, a continuous twenty-four-hour IV; Allopurinol, 92 mg IV. Or in other words, poison.

Brian brings Jesse to the hospital for his blood test: a simple finger stick. He needs to be restrained by Brian and two male residents; he screams down the hospital. I stand back, and cross my arms, and inadvertently think of Kate, who stopped crying over procedures two days ago.

At the first trash receptacle I find, I dump the plant and all its desiccated soil.

"It's a tumor. The cancer's metastasized."