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“Now, what do you know about leukemia?” asked Dr. Maxwell.
“It’s got something to do with Olivia’s blood,” I answered, purposely not using the word cancer.
“Good,” said Dr. Maxwell, and even though we were talking about a deadly disease that my best friend had, I felt glad to have gotten the answer right. “It does have to do with blood. Specifically, it’s a cancer of the blood.”
“Actually, I was trying to avoid the c word,” I explained.
Olivia laughed, and even Dr. Maxwell cracked a smile. “We use the c word a lot around here,” Dr. Maxwell assured me. “Now, there are different types of leukemia. Most children and teens get something called acute lymphoblastic leukemia, or ALL. Olivia has acute myeloid leukemia, or AML. It’s a cancer more commonly associated with males in their sixties.”
Livvie turned to me. “I have old-man cancer. Isn’t that so humiliating?”
“It is, actually. But I won’t tell anyone,” I promised.
Dr. Maxwell was shaking her head. I couldn’t tell if she was amused or irritated by the way we were talking. “In a healthy person,” she went on, “blood is formed inside the soft, spongy part of the big bones in your body, such as your femur. You know what your femur is?” I nodded. Our first year at NYBC, a girl in our class had had a skiing accident and broken her femur. I still remembered when one of the worst dancers in our class had pulled us aside to tell us about the accident. She may never dance again. Her face had been bright pink with the drama of the moment.
“Your femur’s here.” I hit my thigh as I said it.
“Correct,” Dr. Maxwell said. “So blood is born—formed—in the bone marrow. There, immature cells called blasts grow into mature blood cells: white blood cells, red blood cells, or platelets. Think of bone marrow as a school. Or a house. The kids grow up, learn a trade, then leave home and go to work at a job.
“But leukemia stops blood cells from doing that. In a person with AML, instead of making normal blasts, which grow into normal blood cells, the bone marrow starts making cancerous cells. They divide quickly and uncontrollably. They don’t do their jobs. And they fill up the bone marrow so that there’s no room for normal, healthy cells to be made or to grow. The immature cells are strong and hard to kill. They’re like child soldiers.”
Dr. Maxwell pointed behind her at the IV bag hanging on the pole beside Olivia’s bed. “The drugs we’re giving Olivia right now are drugs that target rapidly dividing cells, such as myeloblasts.”
“And hair,” Olivia said. Her voice was quieter than it had been. I patted her arm, not sure what else to do.
“And hair,” Dr. Maxwell said, and now I was grateful for how matter-of-fact she was about everything. “Because chemotherapy targets all rapidly dividing cells, it unfortunately doesn’t only get cancer cells.”
I’d always wondered why people with cancer lost their hair. “Why can’t they invent drugs that target rapidly dividing sick cells only?” I asked.
“Well, we’re working on it,” Dr. Maxwell said. She pushed her glasses up on the bridge of her nose. “I promise you. We’re all working on it.”
I couldn’t take Dr. Maxwell’s being so nice. It made me want to cry. Instead I asked, “Will she get sick? I mean, will she throw up?” Livvie made a face. She hated throwing up. Not that anyone likes it, but Livvie really really hated it.
“She may experience nausea and vomiting,” Dr. Maxwell said. “Chemotherapy triggers a chemical response in the brain that makes some people sick to their stomach. But the good news is we have a lot of drugs to make Olivia comfortable. Hopefully she’ll only have very mild side effects.”
“That’s kind of lame good news, Dr. Maxwell,” said Olivia.
“It is,” Dr. Maxwell agreed, and she stroked Olivia’s forehead gently. I’d never seen a doctor do something like that.
“When can she come home?” I asked. If she was home by Friday, I could spend the weekend at her house with her. We could watch distracting movies all day.
Dr. Maxwell’s voice was businesslike. “Three to four weeks.”
Three to four weeks? I tried to keep my voice neutral. “I thought … I thought maybe she’d be home this weekend.”
Dr. Maxwell shook her head. “The chemotherapy itself only lasts for about a week, but it destroys so many blood cells that a person is very vulnerable to infection. We keep her here until her blood counts go up.”
My head spun. How could Livvie be in the hospital for an entire month?
They were both staring at me. I had to say something, but my panic had parched my lips and my tongue felt glued to the roof of my mouth. “Well …” I cleared my throat, hoping to make my voice more normal. “And then … that’s it, right? She’s done?”
Livvie shook her head. “That’s just the first round. Then I have to do it three more times.”
“Three more times?” It came out like a wail, which I immediately regretted.
My response triggered something in Livvie, who suddenly looked distraught. “And I might not be able to go to school between treatments at all.”
“Wait, you’re going to miss months of school? I—” I bit my tongue. Literally. Because here’s what your best friend doesn’t need to hear you say when she’s just found out she has cancer: I can’t deal with that.
“This is a lot to take all at once, I know,” said Dr. Maxwell. She furrowed her forehead in a way that somehow managed to be concerned and not pitying. “And it’s not the last time you’ll be able to ask me questions.” Dr. Maxwell put her hand on Olivia’s shoulder. “I’ll see you tomorrow, but if something comes up during the night, they’ll page me.”
“Okay,” said Olivia. “Thanks, Dr. Maxwell.”
“Yes,” I said, trying to capture an optimistic tone. “Thanks for explaining all of this to me.”
She smiled at me. “Olivia is very lucky to have a friend like you.”
Dr. Maxwell said good-bye to everyone, and when the door had closed behind her, Mrs. Greco clapped her hands together once. “Now I’m sending everyone home. Our girl needs to get her rest.”
I was surprised that Olivia didn’t object, but when I looked at her face, she seemed tired, and I thought maybe she was relieved that everyone was leaving.
My mom came over and gave Olivia a long hug, then touched me lightly on the shoulder. “I’ll meet you outside.”
Calvin and Jake said good-bye. When Calvin was hugging Livvie, she gave me a little wink and a thumbs-up behind his back, and I actually laughed.
I got off the bed and stood over Olivia. Maybe it was a trick of the light, but she looked somehow frailer than she had when I’d first walked in, as if she’d gotten smaller over the past thirty minutes.
Not wanting her to read my thoughts, I bent down and hugged her. She squeezed me back. There was nothing frail about her hug, and the strength in her arms made me feel better.
“This is going to be okay,” I whispered into her shoulder. “You’re going to be okay.” She gave a tiny squeak, and I could tell from the way her body shook that she was crying. It was hard to believe that just a minute ago she’d given me the thumbs-up about Calvin Taylor’s hugging her.
Remembering how my getting upset earlier had made her get upset, I forced myself not to cry as I pulled away. “I’ll see you tomorrow, ’kay?”
“Thanks, Zoe,” she said. She wiped the tears off her cheeks, and no new ones fell. “I love you.”
“I love you too, Liv.”
The whole way home, my mom talked. She talked about how Mrs. Greco was going to arrange for Olivia to Skype her classes. She talked about how the doctors felt there was every reason to be optimistic. She talked about how Olivia was getting the best medical treatment there was. She told me she’d called my dad, who was on his way home. Every once in a while, she turned to me and patted me on the knee or stroked my hair.
“You okay, honey?” she asked about twenty times.
“I’m … yeah. I’m okay,” I said each time. I couldn’t find the words to describe the tight feeling that had disappeared for a little while when I was with Olivia but had come back again now that we were in the car. Months. She was going to be out of school for months. She had to go through round after round of chemotherapy. My mind danced from one detail to another, skittishly skimming the surface of the situation. I would picture Dr. Maxwell’s glasses, then the dark circles under Olivia’s eyes. I felt Olivia’s shoulders shaking as I hugged her. I lowered my window all the way, hoping the chilly night air would focus my thoughts, but it did nothing except make my face cold.
Since I’d gotten my permit, every time we got in the car I begged my mom to let me drive, but even if we hadn’t been driving in Manhattan (where out-of-state residents can’t drive until they’re eighteen), I was way too distracted to even contemplate operating a motor vehicle. I kept thinking about how on the way to school I’d been pissed because on B days after lunch I have history, then physics, and then math. And I’d thought, I hope Livvie’s in school, because if she’s not, this day is going to suck even worse than it will if she’s not in school, which is a lot.
If you’d asked me on my walk that morning to list ten things I was worried about, I would have started with a pop quiz in history, because I’d only kind of done the reading. If you’d asked me to come up with ten more things, chances are global warming might have made it onto the list. And if you’d asked me to list another ten, I might have added something about bioterrorism, because sometimes when it was late at night and I couldn’t sleep, I worried about how my parents and I would get out of New Jersey if there were a terrorist attack.
But no matter how many multiples of ten you’d added, I just don’t think I’m worried that Olivia has cancer would have made it onto one of my lists. Because there are some things you worry about. And then there are some things you don’t worry about.
You don’t worry about them because they’re too awful to contemplate worrying about.
We pulled up into the driveway. I followed my mom up the stairs to the front porch and waited while she fished for her keys. She opened the door and flipped on the light. From the kitchen came a whimper.
“Oh my God,” my mom whispered. “We forgot all about Flavia.”
She raced into the kitchen, and I followed her. Flavia was lying on the floor, his paw covering his face as if he were ashamed. A few feet away was a small puddle of pee.
It was my job to give Flavia his afternoon walk. I pictured him waiting for me to get home from school, imagined how confused he must have been when I raced into the house and then raced out again, taking my mom with me instead of him.
I went over and dropped to the floor. “I’m so sorry, Flavia,” I said, putting my arms around him. “I’m so sorry.” For a second he seemed to resist my hug, and then he gave a little sigh and rested his head on my lap as if to say, I understand. I forgive you.
“I just forgot. Livvie’s sick, and I just forgot.” Flavia blinked at me. The last time I’d walked him, I’d gone over to Olivia’s house after. She hadn’t been sick then. Except she had been. I pictured her bone marrow, full of terrifying child soldiers, the kind that were sometimes featured on the front page of the New York Times, with their dead eyes and their automatic weapons. They’d been hiding out inside her, their numbers growing for weeks. Months. Maybe years? We were driving in and out of Manhattan and dancing and planning our glamorous futures, and all that time, an enemy deep in Olivia’s DNA was plotting and waiting and getting ready to strike.
“She’s okay, Flavia,” I said. “She’s going to be okay. Really. She is. You don’t need to worry, Flavia. She’s going to be fine.” And then I wrapped my arms around his body and the tight feeling inside me burst and I cried and cried into his soft, warm fur.
7 (#ulink_c92c10b7-ebf9-5e41-b407-39732e6facb5)
I would have said that after Livvie’s diagnosis nothing could shock me, but the next morning, when I pushed open the door to Wamasset High School minutes before the first bell, still bleary-eyed from my night of tossing and turning, it turned out there was something for which I was completely unprepared.
No sooner had I entered the lobby than there was an ear-splitting scream, followed by the cry, “Oh my God, Zoe!”
It was as if I’d tripped some personalized burglar alarm. I stood, frozen, waiting to see where the voice had come from.
The lobby was wall-to-wall people, but the crowds parted as Stacy, Emma, and the Bailor twins flew toward me, hurled their bodies at mine, threw their arms around my shoulders, and—and here I am not exaggerating—began to sob.
“Zoe, it’s so awful!” Stacy dug her chin into my shoulder. Her ponytail slapped my face.
“It’s just so awful!” Emma echoed. She was clutching my arm and patting the side of my head.
Within seconds, the rest of the cheer squad had gathered around us, all of them damp-eyed, a few with tears running down their faces.
Stacy released me from the hug, then grabbed my hand. “Zoe, we just love you so much.”
The cheer squad loved me?
“It’s true,” Emma asserted, though I hadn’t spoken my doubts out loud. She dropped her head onto my shoulder. “Have you seen Jake this morning?”
“Listen,” Stacy continued, “last night we were talking about doing a fund-raiser for the Leukemia and Lymphoma Society. And I just know that I speak for everyone at Wamasset when I say that we will all participate as we work to find a cure for this deadly disease.”
“Are you … planning a speech or something?” I asked.
She nodded. “To Principal Handleman. I’m going to propose we do a car wash and blood drive. Do you think Olivia would like that?”
They stared at me, waiting for an answer.
Do not be a total bitch. Do not be a total bitch.
“Um, yeah, that’s really nice of you guys. I’m sure something like that would mean a lot to her,” I said. My phone buzzed, and I checked the screen. OLIVIA.
“I have to go,” I said. I would have been relieved to hear from her anyway, but given my situation, her phone call was doubly welcome.
“Oh my God,” wailed Hailey. “Is that Olivia?”
“Yeah,” I admitted, “it is, actually.” I am not exaggerating when I say a reverent hush fell over the girls surrounding me, as if I had just told a group of nuns that Jesus Christ himself was on the line.
“Hi,” I said into the phone, ducking my head slightly so I wasn’t looking into all those eager faces. “Um, I’m standing here with the cheerleaders.”
There was a pause. Then Livvie said, “Seriously? But you hate those guys.”
I glanced up. Everyone was still staring at me. “Olivia says hi.”
“Hi, Olivia!” they shouted. “Tell her we love her!” a couple of voices added.
“They say they love you,” I repeated.
“Oh,” said Olivia. “Thanks.”
“She says thanks,” I said. Then I made a gesture to indicate I was having trouble hearing what was being said at the other end of the phone and began sliding toward my locker.
“Bye, Livvie!” cried Stacy. She began to wave, and the other cheerleaders followed suit, as if I were a cruise ship pulling slowly away from the dock.
“Zoe, you have to help us plan the car wash!” added Emma. I nodded and nodded and made the same I-need-to-go-somewhere-I-can-hear gesture and then I was blissfully out of the lobby and on my way down the two hundreds corridor.
“Jesus Christ,” I said. “This is really weird. They want to do a car wash.”
“I know,” said Olivia. “Stacy sent me a text last night. And this morning I got an email. She signed me up to receive daily inspirational messages. Today’s was all about the goodness within me.”
“Holy shit! Did you puke immediately?”
Olivia gave a tired laugh. “Already did that.”
“Oh, honey.” I leaned against my locker. “Are you okay?”
“I don’t know. Yeah. I mean, I’m okay.” She had this brave but tired voice that I’d never heard her use before. It made me want to crawl through the phone and curl up next to her on the hospital bed. The warning bell rang.
“I heard that,” said Olivia. “You’ve gotta go.”
“I don’t care,” I said. “Whatever. I’ll be late.”
“Actually, I’m kinda cooked,” she admitted. “I just wanted to say hi.”
“Right,” I said fast. “Of course. I’m sorry. You get some rest. I’ll call you later.”
After we hung up, I opened my locker, but I didn’t take anything out or put anything in. My hands were shaking, and I leaned the side of my head against the cool of the metal shelf. On my locker door was the picture she had taken the first day of school. We were tan. Our smiles were wide, and I realized Livvie’s dress was blue and white and so was my shirt, almost as if we were wearing some kind of uniform. You two look like salt and pepper shakers. That’s what my mom used to say when we both had long hair. You’re a couple of salt and pepper shakers. And now here I was, just a stupid, lonely pepper shaker. What was the point of a pepper shaker without a salt shaker? I didn’t even like pepper.
“Hey, Zoe.” It was a boy’s voice. I figured it was Jake, but when I turned around what I saw was Calvin Taylor, who, apparently, had decided to acknowledge my existence.
“Oh,” I said. “Hey.” I was still thinking about Olivia’s voice. It had been so frail.
