These are the things you think when you come home to find that your sister has starved herself to death and you have dropped to your knees to revive her:

1. My sister is flat like a board. There’s fat guys in the locker room with bigger boobs than she has.

2. When I scream my sister’s name into her face, I can hear my father’s voice in my own.

3. Where is it you’re supposed to press? In the middle, on the side? Left or right?

I choose middle. I put the heels of my hands, one on top of the other, on Karen’s chest. I can feel her ribs under the thick of her too-small sweater. When I press down, her head rocks a little, hanging huge on her neck. I feel nothing pulse against my hand. I count out, “One and two and three and four and five.” Something cracks under my palm and I yank my hands away, not because I broke her rib but because she did nothing. I broke her and she didn’t even flinch.

“COME ON!” I scream. I shove my fingers into her mouth and pull it open. Her teeth move against my fingers. I suck in a breath and push it out, into her. Her chest rises. Fake alive. She doesn’t return my breath.

“Karen?” I whisper.

The front door crashes open and whacks me in the shoulder, knocking me away. I land on my side, my elbow smacking against the tile of the front-hall floor. When I look up at the doorway, I see God. I sit up, the arm with the bruised elbow limp and tingling in my lap. God is huge; he stands in the doorway and blocks the winter sun from slanting into the hall. He’s holding a box of fishing tackle. It takes me a second to realize it’s not God. But it is Elvis. Elvis is back. He is an EMT with a harelip and acne, and he has come to save my sister.

I am in the center of his shadow, and when he steps into the house to drop his equipment at Karen’s side, the brightness of the sun surprises me, burning red-ringed white spots into my eyes before I can turn my face to where Elvis is pressing two fingers behind Karen’s jaw.

I crawl toward him, my hurt arm curled against my stomach. I watch his face, trying to read what he feels beneath his fingers. I am whispering, “Please please please please please.”

He moves his hand away from her neck and I choke on the air in my mouth.

“How old is she?” he asks, and I know it’s a question meant to keep me from being strangled by my own throat, it is supposed to get air into my lungs and back out again.

“Sixteen.” The word squeaks out and I am gulping air and I am saying too loudly, “She is sixteen and I am fourteen. I’m her brother.”

“Turn on the light,” Elvis says, still not looking at me.

I scramble up and switch on the front-hall light and press my back against the wall. Elvis sucks in his breath when the light hits my sister. I could gouge out his eyes for that. For looking at her and gasping. For making maybe the last thing she hears be some jerkoff gasping at the skin hanging loose off her bones.

I’ve seen dead things before. I know a dead thing looks smaller than when it was alive. My sister looks like she could fold inside a paper cup.

There is another EMT in the house now and she kneels next to Elvis so he can talk low into her ear. Behind them, in the kitchen, I can see the calendar that hangs by the phone. There is an empty square where today’s date should be. I know what was in that blank space, I know it was more than a number to show that today is February twenty-second. Months and months ago Karen and Amanda decorated that small square because today is the one-year anniversary of the day they met and became instant best friends. They had a whole celebration planned. Karen said, “Donnie, you have to play yourself in the historical reenactment of the first time I met Amanda.”

It’s not till Elvis says, “Let us work, son,” that I realize I am walking toward the kitchen, toward the memory of Karen and Amanda bending their heads over the calendar on the kitchen table. I’ve stepped onto the bright orange backboard the other EMT brought in with her. She lays her hand on my shin and pushes gently. I lean back up against the wall. “Let us work,” she says.

“Let us work” means “let us put our hands on her.” Let us open her eyes and let them slip shut again. Let us shine lights into her mouth and put our palms on her chest and press again and again and again until Elvis sits back on his heels and shakes his head and says, “Son of a bitch.”

I’m telling you this because you didn’t ask. I’ve got it all here, growing like a tumor in my throat. I’m telling you because if I don’t, I will choke on it. Everybody knows what happened, but nobody asks. And Elvis the EMT doesn’t count because when he asked, he didn’t even listen to me answer because he was listening to my sister’s heart not beat with his stethoscope. I want to tell. It’s mine to tell. Even if you didn’t ask, you have to hear it.

A car door slams, and when I look outside, I see Mom come screaming up the front steps gripping her brown leather purse by the top of its strap like a weapon swinging from her fisted hand. Karen’s on a gurney now and Elvis is pulling the sheet over her face when Mom runs past me and launches screaming into the air. I look away when she is midflight, flinging herself over Karen, collapsing the gurney with her weight. Mom’s left index finger gets smashed in the workings of the gurney, and later Elvis puts it in a splint while Mom lies on the couch, her eyes open and not blinking.

I am still standing by the light switch, and I am trying to remember when it was that Karen painted over that small square on the calendar.