Read Online My Sister's Keeper by Jodi Picoult - Free Book Online Page B

smooth, cool voice falls into my ear. “Sara. It's
been a while.”
    She is the person I ran to when I got my period; the one who helped me knit
back together my first broken heart; the hand I would reach for in the middle
of the night when I could no longer remember which side our father parted his
hair on, or what it sounded like when our mother laughed. No matter what she is
now, before all that, she was my built-in best friend. “Zanne?” I
say. “How are you?”
    Thirty-six hours after Kate is officially diagnosed with APL, Brian and I
are given an opportunity to ask questions. Kate messes with glitter glue with a
child-life specialist while we meet with a team of doctors, nurses, and
psychiatrists. The nurses, I have already learned, are the ones who give us the
answers we're desperate for. Unlike the doctors, who fidget like they need to
be somewhere else, the nurses patiently answer us as if we are the first set of
parents to ever have this kind of meeting with them, instead of the thousandth.
“The thing about leukemia,” one nurse explains, “is that we
haven't even inserted a needle for the first treatment when we're already thinking
three treatments down the line. This particular illness carries a pretty poor
prognosis, so we need to be thinking ahead to what happens next. What makes APL
a little trickier is that it's a chemoresistant disease.”
    “What's that?” Brian asks.
    “Normally, with myelogenous leukemias, as long as the organs hold up,
you can potentially reinduce the patient into remission every time there's a
relapse. You're exhausting their body, but you know it will respond to
treatment over and over. However, with APL, once you've offered a given
therapy, you usually can't rely upon it again. And to date, there's only so
much we can do.”
    “Are you saying,” Brian swallows. “Are you saying she's going
to die?”
    “I'm saying there are no guarantees.”
    “So what do you do?”
    A different nurse answers. “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.”
    At this, a tiny cry escapes from me. This is such a small thing, and yet
it's the banner that will let others know what's wrong with Kate. Only six
months ago, she had her first haircut; the gold ringlets curled like coins on
the floor of the SuperCuts.
    “She may develop diarrhea. There's a very good chance that, with her
own immune system laid low, she will get an infection that will require
hospitalization. Chemo may cause developmental delays, as well. She'll have a
course of consolidation chemotherapy about two weeks after that, and then a few
courses of maintenance therapy. The exact number will depend on the results we
get from periodic bone marrow aspirations.”
    “Then what?” Brian asks.
    “Then we watch her,” Dr. Chance replies. “With APL, you'll
want to be vigilant for signs of relapse. She'll have to come into the ER if
she has any hemorrhaging, fever, cough, or infection. And as far as further
treatment, she'll have some options. The idea is to get Kate's body producing
healthy bone marrow. In the unlikely event that we achieve molecular remission
with chemo, we can retrieve Kate's own cells and reinstill them-an autologous
harvest. If she relapses, we may try to transplant someone else's marrow into
Kate to produce blood cells. Does Kate have any siblings?”
    “A brother,” I say A thought dawns, a horrible one. “Could he
have this, too?”
    “It's very unlikely. But he may wind up being a match allogeneic
transplant. If not, we'll put Kate on the national registry for MUD—a matched,
unrelated donor. However, getting a Transplant from a stranger who's a match is
much more dangerous than getting one from a relative-the risk of mortality
greatly increases.”
    The information is endless, a series of darts