Dessert First Read online

  Drowningirl—

  Hope you’re finding some light, too. Are you okay? Friendhugs, Cipher.

  She always finished her emails to me with “Be well.” I finished mine to her the way I always do, with the prevention hotline numbers. 1-800-SUICIDE (784-2433) 1-800-273-TALK (8255).

  2

  UCSF is a fifteen-story hospital in San Francisco. Beep was just on their regular kids’ floor, not yet in their intensive care unit, called the PICU. (“Pee, I see you,” which Beep says makes sense, what with the bedpans.) He didn’t have to share his room with anyone, though. With his immune system on blood cancer vacation, they weren’t sticking another kid in there to cough on him.

  I stood at the door. Beep was watching TV, so he didn’t notice me. Beep looked even smaller than usual, propped up in the big hospital bed. He had short hair, and his ears and eyes were slightly too big, like he was still growing into them. He was pale underneath his spray of freckles, and the white bendy tube of a Broviac line stuck out of the gauze dressing on his chest, like he’d been harpooned with a giant drinking straw. A drip was going in through the Broviac, but it wasn’t chemo. The bag was dark red, blood products—because Beep’s cancer-mutated cells otherwise weren’t so good with the basics, like carrying oxygen and clotting. Weirdly, the visitor’s chair was empty—no Mom or Dad. Was Dad still at work?

  “Hey, Beepster.”

  “Oh, hey.” He flicked off the TV.

  “Brought your stuff from home. Where are the parent units?”

  “Dinner.” Beep frowned. “Dad just got here. I said I wanted to be alone.”

  That was probably code for having a sore neck from watching Mom bounce off walls. It didn’t apply to me. Anyway, I had Beep’s videogames. “Is Mom freaked?”

  “Naaah,” he stretched it out, deadpan, earning a smile from me. “But she tried to get them to move me because a kid was coughing—two doors down. And she made them refill the hand sanitizer, because it was more than half empty.”

  The hand sanitizer on the wall was full now. He probably wasn’t making that up. “No holes in the ceiling, though,” I said, glancing at it. “So Mom didn’t actually hit the roof.” I put my backpack in the visitor’s chair and hugged Beep, careful not to mash the tube in his chest, collecting a nice Beep hug back while he sat up in bed. He still had his regular-person Beep smell, the warm yeasty smell of person, not the faint chemo-sweat stink of hot metal. “I’m so sorry.”

  “Me too.” We hugged for ten seconds, then he let go. I kept my part of the hug going, rubbing his small back for another couple of seconds.

  I turned away and dabbed at my eyes where he couldn’t see. I cleared my throat. “Brought your Xbox.” Beep has gone so many times from the pediatric floor to the PICU to the step-down unit at UCSF, then to George Mark Children’s House, to home, to the emergency room, and back, bouncing between hospitals like a little bald Ping-Pong ball. So I’m the only girl in the universe who can set up an Xbox and have the controllers and headset working in sixty seconds.

  “How are you?” I got one question in before I pulled out the packet of game disks and he could disappear into videogame gunfire.

  “Okay. I was getting tired of having hair anyway.” He didn’t even pick up the Xbox controller. “Can you find out what’s wrong? Mom got weird. Something with the blood tests. It’s—” He frowned. “Bad. Cancer again but mutated or something—they didn’t explain well.”

  A hot pang of fear shot through me. “Sure.” I sat down on his oversized bed. What was to explain? He’d relapsed, which meant his ALL—acute lymphocytic leukemia—was back, and he’d spit and hurl his way through another treatment plan to get rid of it. Ninety-five percent of the time, the docs get kids with ALL into remission.

  “And Mom.” He shook his head. Mom’s freak-out meter is useless in signaling between Bad, Really Bad, and OMG.

  “Kat.” Mom’s voice came from the doorway behind me, and I jumped. “Have you eaten?”

  “Just some cardboard with Rachel.”

  “The cafeteria here is still safe,” Beep said. “They’re not recycling my barf. Yet.”

  Gross.

  “Can I talk to you, honey?” Mom used her forced cheerful voice. “Maybe get a bite?”

  I nodded. Beep raised his eyebrows. You’ll find out for me? I winked and picked up my backpack, which was lighter without Beep’s stuff.

  “Hi, Kat,” Dad said, then “Hey—Xbox,” actually recognizing the controller appendage next to Beep. Dad set a bowl of quivering gelatin cubes for Beep on the bedside tray. “I’ll play you, Beepster.” That was great, because Beep would mop the screen with Dad, which would be good for Beep’s morale.

  I wandered off with Mom to complete my spy mission.

  On our way down, Mom sputtered about Rachel. “I’ve called her ten times in the last hour.” Impressive. “She’s not picking up. Something’s wrong.”

  Right. Only if neck hickeys are really wrong. I wouldn’t know. “I’m sure she’s fine.”

  “Something happened.”

  Like, she happened to be ignoring Mom. “Rachel turns her ringer off when she can’t deal. Can you think of any new reason she’s having trouble with that tonight?” I waved my arm around at the hospital cafeteria and vaguely up toward Beep’s room. “Send her a text.” I grabbed an orange tray and peered down the counter to find the least gross cafeteria choice. Hospitals serve cruddy food, like school lunch, but for dinner. If they make the food bad enough, they figure patients will get well to escape it. The little sign claimed mine was “beef bourguignon,” but it was just brown sludge with gray meat and mushy carrots. It almost made Rachel’s vegan pizza seem appealing. Almost.

  At the table, Mom texted Rachel some version of the Inquisition, then finally looked up. “Your Dad can give you a ride back to BART.”

  “Not all the way home?” It was already almost eight and dark. Mom was, no doubt, staying at the hospital overnight.

  “He’s going back to work.” She pressed her lips into a tight frown. “He has a filing tomorrow.” A filing means turning some long legal pleading paper in to the judge. Like lawyer homework, but I guess you can’t get an extension because of a little thing like your kid has a cancer relapse.

  “Great.” I stabbed a carrot with my fork, to underline how not great. “What’s with Beep?”

  Mom crinkled her mouth into a worried frown. “It’s terrible. He’s also got AML.”

  My stomach tensed. AML—acute myeloid leukemia—is bad, period, which I knew from the blood cancer Facebook page and from my online flirt-buddy Hunter Lange, who had it. It’s a different kind of blood cancer you can sometimes get as a side effect of the chemo and radiation. Survival odds were worse.

  “If they can’t get Beep into remission,” Mom said, “we might need you to donate bone marrow.”

  “Of course.” Rachel and I had both been tested after Beep’s prior relapse. Neither of us was a perfect match, but I was closer.

  Mom blew out a long breath. “They’re still figuring out how bad it is. So don’t tell Beep about the AML. I don’t want to worry him.”

  I gritted my teeth. Beep would worry way more if no one told him what was wrong.

  “Can I have the iPad?” Mom asked. “We should check for clinical trials.”

  Clinical trials test new things that are more effective than the standard treatment. Beep was in one in his first two go-arounds with the ALL to get him into remission, so we got all his expensive cancer drugs for free—a good thing, because Mom had joked that otherwise we would have had to sell our house to pay for them. I’m not sure it was a joke. I frowned at Mom. “If UCSF has clinical trials, they’ll tell you about it.”

  “What if it’s at a different hospital? Or they forgot?”

  She had me there. I passed her the iPad. Maybe I could get three bites of “beef bourguignon” in peace. But all I could manage was pushing around the gray lumps, while Mom pecked at the screen. “There’s nothing,” she said f
inally. “Except numbers about mortality rates.”

  I tugged it away from her and clicked back on the browser to Google. Her search terms included “mortality,” “morbidity,” and “risk of death.” Please don’t let insanity be hereditary. “No one uses words like ‘fatality’ to name a clinical trial. They don’t scare people away. Tonight, back home, I’ll look online.” I shoved my bowl away. Another bite of beef bourguignon would have killed my appetite anyway.

  Mom’s heels clicked on the corridor tiles while we marched back toward Beep’s room, under the too-bright fluorescent light, passing through the pine-disinfectant hospital hallway smell. Back in Beep’s room, Dad was still playing the videogame, running around onscreen in a spacesuit while Beep, smiling his little kid grin, blasted him with a laser rifle.

  After Beep finished Dad off with the sizzling boom of an onscreen explosion, Dad scurried into the hallway with Mom for a mysterious parent conference before he bolted back to work. I used the break from hovering Mom zone to tell Beep about the AML.

  “How bad is that?” he asked.

  “Not great. Harder to get rid of, but probably easier in kids than in grownups. Mom didn’t want to tell you yet.”

  “How come?”

  “She’s insane.”

  He snorted. “You’re supposed to tell me the stuff I don’t know.”

  “Well, they’re figuring it out exactly with tests. She didn’t want you to worry.”

  “Right. I’m back in the hospital, with a relapse. But not, you know, worried. So. What’ll they do?”

  I sat on Beep’s bed next to him. “Well, they’ll start chemo, but maybe with different drugs.” I took his hand. “Tonight we’ll check for an even better, newer treatment program. And if the chemo doesn’t get you into remission, you might get a bone marrow transplant, to get rid of the cancer, forever.”

  “From who?”

  “Me.”

  “Cool,” Beep said. “About time someone else in the family got jabbed with a needle.”

  3

  On the BART ride back to the East Bay, I checked my phone. Sorry—at a movie, was the only text back from Calley Rose. Going to movies must be nice. But her family has a no-text rule after 10 P.M., and she actually follows rules, so there was no catching up with her.

  On Facebook, my online flirt-buddy Hunter had updated his Facebook status. Thinking of a great summer job—collecting on my life insurance. Profit$$$! And I don’t even have to show up!

  I usually enjoy Hunter’s sense of humor, which is seriously sick and totally irreverent. But tonight I wasn’t in the mood. Mostly, I entertained him. Tonight maybe he could help me. I sent him a Facebook private message. Hey, handsome shiny-headed guy with a sick sense of humor (even sicker than your blood)—know anything about AML clinical trials? Beep just got diagnosed with AML too. Rough day.

  Of course, it was already after 1 A.M. on the East Coast, where he was. So no quick reply.

  Evan had also texted me. Future indie-band-mate: How is Beep? Email or text me. Or call.

  It’s scary, I sent. Now he also has AML—a worse blood cancer. I promised Mom I’d look online for clinical trials.

  Whoa. So sorry. Can I help?

  It would help to have two people looking, because you phrase your searches differently and find different things. Sure. I’ll call you when I get home. Unless it’s too late.

  Call anytime. I dream of hanging out with you, even by phone.

  Was that an over-the-top flirt? Or was he being sarcastic? Evan was probably just trying to make me feel okay about imposing in the middle of the night. You have weird dreams, indie-boy, I finally sent. But I’ll call anyway.

  I sat there fantasizing about saving Beep, as darkness and lights flicked by and I passed Berkeley rooftops: If my bone marrow could fix Beep, somehow that might start fixing everything—my whole life. Instead of hating on each other, maybe Rachel and I could go back to getting along, like we did before Beep got sick. If Beep could survive cancer, maybe Mom could let go of worrying about every other little possibility. Or at least we could remind her that Beepster survived cancer, for perspective. Maybe Dad could stop stressing about money or how it felt to have a son with cancer or keeping our health insurance or whatever sent him running to work all the time.

  Maybe I could give up being angry long enough to stop jabbing at everyone with sarcasm. And have multiple friends again. And even get my schoolwork done.

  Or not. But, worst case, if not, I might still barely be okay: I could always say, “Sure, I had to repeat a high school grade—but I saved my brother’s life.”

  • • •

  For anyone who’s not a serious cancer sibling geek like me, it might be easy to miss what a horrible person those last thoughts make me.

  Because “It would be really cool to save Beep with my bone marrow” really translates to “Wouldn’t it be neat if Beep’s horrible chemo and radiation failed, so he needed my bone marrow?” Transplant is a last resort. It comes with a lifetime of immune system–whacking drugs to keep your body from fighting off sis’s bone marrow. Which shouldn’t be a big issue because it’s not like I often get rejected.

  I just hadn’t thought it through. What I did instead was check my Cipher email to see if Drowningirl had answered. Nope. Maybe Drowningirl had an actual life, full of friends and even a boyfriend. Although if she had lots of friends, it’s hard to see how she’d be that miserable. And if she was that miserable, maybe she had as much trouble as I do making new friends.

  • • •

  By the time I bicycled home through darkness from the El Cerrito BART station to our empty house, it was 11:45. Skippy greeted me with four hours of pent-up enthusiasm. I petted his little belly and scratched his ears, which he loved, for so long that I realized I was doing it partly to put off the call to Evan. So after I gave Skippy his time in the back yard, I carried him upstairs to my room for moral support. I turned on my computer and sat at my desk. Don’t cross the line into flirting. I took a deep breath and called Evan. Maybe it was so late he’d gone to bed.

  He picked up on the first ring. “Hi Kat. Thanks for calling.” His voice was quiet, like he was trying not to wake his parents up.

  “Thanks, uh, for helping.” My pauses between words were so long it sounded like I was translating French.

  “I’ve missed talking to you so much,” he said.

  Which was like a stab in my chest. I almost gasped at the quick razor-cut-through-my-heart sharpness of it, because of how I’ve missed Evan. “I was really mad at you,” I said. “You wouldn’t have enjoyed talking to me.”

  “I’m enjoying it now,” Evan said. “So maybe that means you’re not as mad anymore?”

  Long pause, on my end. “If you help me find a clinical trial for Beep, we might be able to work things out.”

  “Enough to write songs together again?”

  “Don’t press it,” I said, and I had to clamp my teeth together to keep from calling him Skinnyboy, which is what I call him when I’m in my secret online identity of Cipher, who no one knew was me. It had been a long day, and I was almost dizzy. Talking to Evan felt like walking on a high wire. “Maybe if we find a complete cure for Beep’s cancer.”

  “Well, then,” he said, “let’s find this cancer cure.”

  I laughed, a nervous bark of scared, and we were off. I explained we were looking for phase III clinical trials for pediatric AML and then Evan pounded away on Google, while I searched the different blood cancer sites. We shot links back and forth by email about leads we were turning up.

  The official Monroe house rule, instituted because of Rachel, is no calls after 11 P.M. But Mom was at the hospital, Dad was back at work, Rachel was off fogging car windows, and we were fighting cancer. Forget the rules.

  Evan found it first: www.clinicaltrials.gov, the searchable trial database of the National Institutes of Health.

  Then it was a slog. The descriptions were in medical jargon about as readable as medieval Fre
nch. In the middle of our search, Rachel came home and at one point banged on the wall, because I was talking so excitedly with Evan. I ignored her. After we turned up a bunch of random phase I trials, I finally stumbled on “Bortezomib and Sorafenib Tosylate in Treating Patients with Newly Diagnosed Acute Myeloid Leukemia,” a promising phase III trial accepting patients at 140 different hospitals, including UCSF Benioff Children’s, where Beep was.

  The chemicals were supposed to generally stomp little misshapen leukocyte butt, seven different ways. The trial was limited to patients with “High Allelic Ratio FLT3/ITD.” I had no idea what that meant, even as a serious cancer sibling geek, but for once I hoped it described my brother. Unless it was bad.

  “Wow,” I said when we were done. It had taken almost two hours, and by then we were giddy, having won the online scavenger hunt, making unpronounceable cancer drug name jokes. It was after 2 A.M., and I was sitting in the dark in my room, lit only by the computer screen. The door thudded closed downstairs, from Dad finally getting home from work, after Skippy’s quick who-woke-me-up bark. “Evan, you’re my hero, and officially great.”

  “Whew. You finally noticed.”

  I don’t know what he meant by that, but I had to hang up. “Dad just got in. I’m not supposed to be on the phone after eleven.”

  “It’ll be our secret. Good-night. Sweet dreams.”

  “Uh, you too. See you tomorrow.”

  “You mean today.”

  I laughed. “Right. ’Bye. See you today.”

  I sat back in my chair in the darkness and smiled at the glowing blue computer screen. I’d done exactly zero homework, which put me one day behind, but it was still early, not like the deep, undone homework crater at the end of last year. Plenty of time to dig out. Yes. We would help Beep stomp cancer. I emailed Mom, put in the links about the trial, and told her Evan and I had found it. I sent Evan a bcc, to make sure he knew I was giving him full credit. I even copied Dad’s work email, which I figured Dad would check again before bed because it was only 2 A.M. I hit send. It felt great.