Chapter 22
This was what I knew so far: Cara’s graft had failed.
Last week she’d finished her single round of high-dose chemotherapy, and two days after was the transplant.
Apparently, she’d won the lottery of transplant failures, because autologous transplants were almost always a success.
It meant Cara’s own stem cells hadn’t reestablished in her bone marrow.
“Rocket,” Drew said, putting a hand my shoulder. “Don’t put a hole in the floor. They’ll be done soon.”
But I couldn’t stop fidgeting. For the past half an hour, I’d been pacing the hall of the pediatric floor.
We were waiting for Cara’s head doctor, Lisa Mitchell, and my parents to finish a meeting about different options moving forward.
I hadn’t even been able to see Cara since arriving, and the whole situation was driving me crazy.
To add to my frustration, I didn’t really understand the graft failure. Before the treatment took place, Dr. Mitchell told us it would work. Now I wanted someone to explain what went wrong and then give me a solution—the “how” to saving my sister.
“Don’t touch me,” I said and shrugged off his hand.
“Hey, don’t get mad at me,” Drew said, glaring in my direction. “This isn’t my fault.”
There were circles under his eyes and his shirt was rumbled, and the realization that he’d probably stayed here overnight made me sigh. I slumped down on the bench outside Cara’s room.
“I know,” I said in a quiet voice. Drew was right—this wasn’t his fault and I shouldn’t take it out on him. I looked down at my hands, knowing there was only one person I could blame. This one was all on me…
The flight from Los Angeles to Minnesota had messed me up good. Buckled in at an altitude of thirty-five thousand feet above the ground, I didn’t have much to do but sit and think. And think. And think. And it wasn’t long until I was pulled down by that rip current, drowning in my own thoughts.
Why did I leave in the first place? Why couldn’t I have trusted that horrible gut feeling I got after Paul first called me?
The one that terrified me. From the start, I knew that leaving was a bad idea, but I’d convinced myself that there was only one way to face my fear—to go on some stupid quest of self-discovery by touring with the Heartbreakers.
I’d been so consumed by my fears and my problems that all I was thinking about was me, me, me.
That was exactly what had happened when Cara got sick the first time.
There were signs that something was wrong—her lack of energy and usual enthusiasm—but I was too busy living in my own little world to notice, and then bam!
I was hit with the world’s largest reality check.
Yet somehow, impossibly, I’d managed to forget that and here I was.
I’d left Cara again even when I should’ve known better.
There was a sound of a door opening and closing, and I looked up to see a woman wearing a white lab coat. She was probably somewhere in her midfifties, and her long, gray hair was pulled back into a simple ponytail—Dr. Mitchell at last.
“Stella,” she said in acknowledgment when she saw me. “You got here quickly.”
From there, Dr. Mitchell wasted no time in explaining Cara’s situation.
There were only a few causes for autologous graft failure.
The first was extensive bone marrow fibrosis.
I wasn’t sure what that meant, but Dr. Mitchell assured us that this wasn’t why Cara’s transplant was unsuccessful.
The second potential cause was viral illness, but Cara wasn’t sick, at least not like that.
The final possibility was failure due to certain types of chemo drugs, none of which had been used to treat Cara.
“Then why the hell didn’t it work?” I demanded after she finished.
“Stella,” my dad said, his voice a gentle warning.
I ignored him, not really caring that I was being rude. Both my parents had already heard what Dr. Mitchell was saying, and I just wanted her to get on with it. Instead, she was taking time to explain details she’d normally skip over.
“Sometimes,” Dr. Mitchell said, “the reason for failure is unknown.”
My vision started to cloud as I stared at Cara’s doctor. How was that an answer? I wanted to punch her in the face, because really? What total bullshit. How could she not know why the treatment that was supposed to save Cara’s life didn’t work?
“That’s it?” I snapped. “What’s that supposed to mean?”
Dr. Mitchell looked down at the clipboard before her eyes flickered back up to me. “It means things don’t look good,” she said.
I gritted my teeth together for a painful moment, trying to contain my anger. It didn’t work. “So she’s just going to die because the shitty treatment you suggested didn’t work for some unknown reason?”
“You need to lower your voice right now,” my mom said, no nonsense. She reached out and grabbed my arm. “Just listen.”
I knew this wasn’t really Dr. Mitchell’s fault, but I wanted to hear solutions, not bad news. I pulled away from my mom as hot tears streamed down my face. “How can you be so calm when she’s just giving up on Cara?”
“I’m not giving up on your sister. There is still something we can do for her,” Dr. Mitchell told me sternly. She glanced at my parents before continuing. “Since there was no determining factor for the transplant failure, I think Cara’s best option is to have another.”
She stared me straight in the eye as she made her announcement, almost as if it held some type of hidden meaning.
“How?” I asked.
“Stella,” she told me slowly, “you’d be the perfect donor for your sister.”
***
I knew what my decision was in an instant.
There was no way I wouldn’t donate for Cara, so making that choice was as easy as flipping on a light switch.
Dr. Mitchell called the transplant “syngeneic” or “syngepic” or something that started with an s and was along those lines.
Basically, it was a procedure in which a cancer patient, Cara, received stem cells donated by an identical twin, me.
Even though my mind was already made up, I told everyone I wanted some time to think things through, and I disappeared to the patient communication center where I could use a computer. There were some loose ends that needed attention before I could go through with the operation.
From the start, Cara’s odds were never anything spectacular, but even if the world is ending, some people refuse to be beaten down.
Not every cancer patient had the same optimism as my sister though, because while Cara’s survival was unclear, some people were beaten from the start—Stage IV and terminal.
I’d seen a few kids like that and, while some chose to chug along like my sister, most decided to get their things in order, to prepare for the irrevocable.
And that’s what I was doing now, because the fantasy I had about becoming an actual photographer, someone like Bianca Bridge, was as terminal as it could get. Once I accepted the irrevocable, I could focus my attention on Cara.
There wasn’t too much for me to do: I’d throw out my SVA acceptance letter and call Paul to decline his new job offer, but that wasn’t the hard part.
What I was dreading most was shutting down my website, especially after all the hard work I’d put in, but it had to be done.
If I didn’t, there would always be something left for me to regret.
I logged in to one of the hospital computers, pulled up the Internet, and typed in the address.
My neck was stiff, and I rolled my shoulders as I waited for the page to load.
When it did, I noticed a small, red number one next to my inbox, notifying me of a new message.
I figured there was no harm in reading whatever it said before I deleted everything, so I clicked on the icon.
As per the hospital’s usual crappy Wi-Fi, the page took a few seconds to load, but then I saw this:
Dear Ms. Samuel,
My name is Bethany Colt, and while we don’t have much in common (I’m a forty-two-year-old housewife from New Jersey), we do share one connection—the terrible knowledge of how it feels to watch someone you love suffer.
Like your sister, my daughter Stephanie has cancer.
She was diagnosed with acute lymphocytic leukemia last year at the age of twelve.
Like most thirteen-year-old girls, Stephanie is crazy about the Heartbreakers.
The walls of her room are plastered with their posters (much to my horror), and she’s particularly fond of the blog you run called the Heartbreak Chronicles, as she enjoys keeping up with what’s happening in the boys’ lives.
It was through the blog that I discovered your photography website.
I’m writing you this letter to express how truly moved I was by your gallery, especially the pictures you posted of your sister.
The past few months have been very difficult for me.
As Stephanie grows weaker, I feel like her cancer is claiming parts of me as well, and they’re all the important pieces I need, like my heart and faith and bravery.
But seeing your pictures has helped me take those pieces back.
Not only does your work reflect your sister’s inner strength, but it shows how loving someone so deeply is a source of courage.
Courage to hope and courage to fight. Thank you for giving me my fight back.
By sharing your experience, you helped make someone else’s more bearable.
Sincerely,
Beth
I read her message again and again. I kept thinking that if I studied the words long enough, if I read them just one more time, then maybe their meaning would finally click inside my head and I would understand.
How could my pictures bring back what she’d lost, especially something as intangible as faith or strength? Was that really possible?