2

“I’M FIRING CHRISTOPHER,” MY DAD SAYS.

“You’re not firing Christopher,” my mother replies.

I drift awake to my parents’ voices, but I’m still in that dreamy in-between state so I keep my eyelids closed and let the morning chatter wash over me.

I can usually hear their kitchen conversations pretty clearly through the heating vent in my bedroom, but this is way crisper than usual, almost like they’re in the room with me.

“If he hadn’t called in sick, I would have been there,” Dad says. “I should have been there.”

Huh. This is juicy stuff. My father took over the neighborhood hardware store my grandfather started and I would bet my winning mural commission no one’s been fired in the seventy-two-year history of the place.

Been there for what, though?

“None of this is Christopher’s fault and it isn’t yours either,” Mom says.

Something beeps over my left shoulder. What the— The alarm on my phone is a guitar strum and I don’t have anything else that would beep in my room. My mattress sinks low and I startle, my eyes flying open.

Not my bedroom.

Not remotely.

The ceiling above me has the same dropped panels as my school, and a silver stand holds an IV bag that dangles over my right shoulder.

“Lia! I’m so sorry, baby!” my mother says. She’s positioned next to my torso and holding a thin plastic tubing that she drops in order to grab my hand. Behind her is a long curtain acting as a partition. “I was trying to see where your IV line was pinched, so I could stop that blasted machine from going off. I didn’t mean to wake you.”

Her eyes drink me in like I’m some kind of mirage.

“Hey, Sunshine,” my dad chimes in, and I turn my head to find him in a chair on my other side, his expression soft with sympathy. He takes my free hand. “How ya feeling?”

How am I feeling?

I don’t know. How should I be feeling?

I’m feeling . . . disoriented. But it only takes another second for scenes to line up behind my eyes, flipping from one to the next as though I’m scrolling through them on my phone. The arena. The EMTs. The ambulance. The ER.

I remember the anesthesiologist leaning over to tell me I’d be put in a “twilight sleep” so I could have an operation and her waking me up immediately afterward, telling me I’d done beautifully.

I remember the blood.

Blood.

More blood.

I squeeze my eyes shut to banish the memory of it, but the smell is back in my nostrils. What if it never leaves?

The machine continues to emit a beep every few seconds and my mother strokes the back of my hand with her fingers. “It’s okay, sweetness. You’re safe. Everything’s gonna be fine.”

I peel my lids open again with effort. There are faint mascara tracks on Mom’s cheeks, and her normal “lawyers work on Saturdays” blouse and dress pants combo is all wrinkled. Dad, with his shaggy hair and habit of forgetting to shave, is the one who usually corners the market on the rumpled aesthetic. I love the guy, but most of the time he looks like a walking unmade bed. My mother, on the other hand, sleeps in her pearls.

I swallow over the worst sore throat I’ve ever had and try to wet my lips. “What—what happened?” I manage.

Mom’s gaze goes directly to my father and I catch the flare of unease in it. “You had a—” she begins, but is interrupted by a nurse poking his head around the curtain.

“Aha! I thought that beeping was coming from in here.” His eyes fall on me and light up. “Well hey there, sleepyhead. I’m Anthony. Do you remember me rolling you here to recovery?” When I reply with a tentative nod, he smiles. “Good.”

Anthony steps to the machine behind me and does something that makes the noise cease.

“That’s better. Do you feel up to trying some ice chips, Amelia? The doctor should be in to check on you—”

“Right about now,” a voice from the other side of the curtained partition calls, and my eyes widen as a familiar face rounds the corner.

“Hi, Amelia,” she greets me. “You had quite the eventful afternoon.” She turns to the nurse and asks, “Has she been up long?”

Anthony looks to my mother, who answers, “Just a couple minutes.”

Why is Dr. Wah here?

The doctor steps closer and presses a button on the side of my bed to raise me to a halfway-seated position, then drops into the chair Dad vacated. She scoots it next to my shoulder and rests a hand on the rail beside me.

“The sedative should be almost out of your system by now, but you lost a lot of blood, so I expect you might feel woozy for a little while longer. Does anything hurt?”

I swallow thickly and croak, “My throat.”

“That’s to be expected. The pain when you swallow should also recede in a couple of hours. I’m sure you have a lot of questions. Have your parents brought you up to speed?”

“We were just about to,” Mom answers.

Dr. Wah nods, keeping her eyes on me. “I know it probably felt quite chaotic when you first arrived, so you may not have processed all of what was going on. Would you like me to walk you through what happened when you reached the ER?”

“Okay,” I rasp, but my brain is stuck on the same question: Why is Dr. Wah here?

I’m still so unfocused, I’m having a hard time maintaining eye contact. Both of my parents jumped from their seats when Dr. Wah arrived, and now Dad stands awkwardly in the corner and Mom perches on the very edge of my mattress, next to my toes. Anthony’s disappeared, and I can make out his deep voice teasing a patient on the other side of the curtain.

“You had an upper GI bleed that was caused by ruptured esophageal varices,” Dr. Wah says, her voice soft and steady. “I’m sure it was incredibly scary to see that much blood coming out of you.”

My nostrils flare at the memory, but I can’t bring myself to do more than nod. She gestures at a bandage on my arm. “We gave you fluids and blood to make up for what you lost, and some medicine to decrease the flow to your intestines.”

I fight to process her words through the fuzz that is my brain at the moment, but she’s already continuing. “Then we did a procedure called a band ligation, where we use small rings of elastic—basically like baby rubber bands—to tie off the bleeding portion of the vein. We’ll have to scope you to check them periodically going forward, but the hope is they’ll keep this from happening again.”

Of all the words she throws at me, only the last line really penetrates, and when it does, I exhale.

Okay then. I don’t know exactly what scoping is, and it doesn’t sound like a picnic, but at least they fixed the problem. Thank god.

A thought intrudes. “Does this mean—I can still do roller derby, can’t I?”

Dr. Wah laughs. “Maybe we can revisit the question in a couple of weeks, but I think you should be able to return to it before too long.”

Phew. Her laughing. Her saying I can go back to derby. They all send a reassuring message to my gradually clearing brain, and my shoulders soften as the tension leaves them. It’s going to be fine. I’m going to be fine.

“This is a lot to take in at once. Do you have questions for me on anything I’ve told you so far?” Dr. Wah asks.

I shake my head gingerly. “Not really. I just don’t understand how a hit I don’t even remember taking could cause so much damage.”

“A hit?” The doctor’s eyes narrow and my shoulders stiffen again in response to the lines that appear in her forehead. She glances at my mother, who squeezes my foot, and my father’s sigh travels the length of the room.

Dread forms hard and cold in my belly.

“Lia,” Mom whispers before regaining her voice to tell me, “this—this didn’t happen because of any rough contact at your bout.”

I blink slowly, and Mom continues, “It happened because of your biliary atresia.”

Wait, what?

But as soon as she says it, the inconsistencies begin to click into place. Why Dr. Wah, a hepatologist, is here. Why the EMTs nodded when Coach handed them my emergency contact form. Why I can’t remember any traumatic blocks happening during the jams.

The fact that my brain took this long to connect the dots is partly a result of the sedative, but it also speaks to how little the liver disease I was born with has affected my life. Most of the time I can go months without even thinking about it, and when I do it’s usually only because the faded scar on my stomach happens to catch the light in my bathroom in a way that makes me notice it, or because someone offers me something alcoholic at a party, or because it’s time for my annual checkup at Dr. Wah’s regular office, where they take some blood, pat me on the back, and cheerfully say, “See you next year!”

It’s a minor inconvenience, if even that.

BA is a pretty rare disease that basically means my bile ducts didn’t work properly when I was born. I had to have an operation when I was six weeks old to fix the flow from my liver (where the bile was backing up) into my intestine. The procedure they did was only a temporary fix, but for some people temporary can mean a month and for others it can be well into adulthood. I’m one of the lucky ones. Bile ducts of a rock star, that’s me.

Fingertips creep up my spine as a realization begins to seep in. Is this my luck running out?

“We ran some bloodwork to check for excess bilirubin and enzymes that could indicate liver damage,” Dr. Wah says. “I’d like to get some imaging to give me a clearer picture, but I’m sorry, Amelia, the preliminary tests all point to decompensated cirrhosis.”

I stare at her. I vaguely know these terms, but my brain still isn’t functioning properly. I wish she’d just speak English.

As if I’ve said the words aloud, she clarifies. “It means your liver has a good deal of scar tissue that’s hardened and is keeping things from functioning properly.”

My mother coughs to cover a tiny yelp and my eyes slide to her.

“Sorry,” she whispers.

From Dr. Wah’s comment earlier, I know she’s filled them in on all of this already, although I guess it’s not any easier to hear a second time. Dad’s hands fold over Mom’s shoulders.

I tear my gaze from them and return it to my doctor. “But how come I didn’t notice? Why haven’t I had any symptoms?”

Aside from turning a derby track into the set of a slasher film, that is.

I flutter my hands. “I mean . . . other than what happened today.”

“Upper GI bleeds like yours commonly hit without warning. Any other indicators could have been mild or even nonexistent. Have you noticed yourself getting fatigued more easily?”

I shake my head. I was just skating my ass off and feeling strong as ever.

“Any yellow tinge to your skin or the whites of your eyeballs, to indicate jaundice? Have you been really itchy?”

Again I shake my head.

“Bruising?”

I picture the two unexplained splotches of purple on my torso, the ones I’d been so proud of I’d referred to them as battle wounds. Dr. Wah notices my eyes widen and nods. “You can probably expect to see more of those. You’ve been among a small percentage of my patients who’ve managed to stay symptom-free all this time—but this was always how we expected your BA to progress at some point.”

At some point, maybe, but not now! I’m powerful and fit and firing on all cylinders. I’m about to graduate and take on the world, I want to scream at her.

She takes my hand, and the compassion on her face sends foreboding prickling under my skin. “You knew that, right?” she asks.

Wrong. I mean, yes, right. Sort of. I just—

My mother answers for me. “We talked to her about all this as soon as she was old enough, but she didn’t want to dwell on it and we figured it was okay to just . . . stick to the basics until the time came.” She sounds somewhere between apologetic and defensive. “We make sure she takes care of herself and stays up to date on all her immunizations, and we’ve lectured her about what alcohol or drugs could do to her liver, but we were treating it like, well . . . you know how some people who might be carriers of the breast cancer gene or the Alzheimer’s one get tested right away and others choose not to find out because they would feel like they were a ticking time bomb?”

My father, his hands still encasing my mother’s shoulders, interjects before Dr. Wah can answer. “Amelia, she—she’s full of energy and passion, and she’s just got this ‘in the moment’ personality, and we didn’t want to squash that. We never wanted her to feel like she had a shadow chasing her.”

Dr. Wah’s understanding smile is enough to keep him from continuing. “It sounds like exactly how I would have recommended handling it.”

But the flash of warmth in my chest at hearing my father’s description of me chills to icy tendrils when I finally grasp what this conversation is circling.

“You—you’re saying I need a liver transplant, aren’t you?” I whisper.

Mom rubs my leg and Dr. Wah presses her lips together briefly before answering, “I am.”

For the space of several heartbeats, my world shrinks to a pinprick of light on the ceiling as the words bounce against the edges of my brain. I feel them rather than hear them. They are hot and pulsing and prickly.

Dr. Wah lassos me back by saying, “I know this is a lot to take in, Amelia. Especially when you’re still recovering from the shock of the GI bleed and coming off the anesthesia. If you want, I can leave you to process this, and we can discuss further steps at your next appointment, which I’d like to have happen in a couple days’ time, okay?”

I’m shaking my head before she even finishes. I may not be completely coherent, but information is power and I need to cling to any control I can get right now. I’m not as naive as Mom and Dad might be making me out to be here. Of course I paid attention when they sat me down in third grade and told me I would likely need a new liver at some point in my life. And I haven’t been burying my head in the sand since then either—I check in on organ transplant advances every so often. Just a couple months ago I read an article online about two women in Silicon Valley who are working on a way to create organs using a 3D printer.

Reading things like that, though, it was easy to let myself believe that by the time my existing liver became an issue, a transplant might be some outpatient procedure I could schedule on my way home from saving the environment or solving world hunger or whatever it is I might be doing with my time ten or twenty years from now. So why waste mental energy on worrying in the present, when it could be a completely different landscape by the time I actually needed to confront things, right?

“When?” I ask. “I mean . . . how urgently?” I would rather have the blood back in my mouth than taste these words on my tongue, but I need to know the answer.

Dr. Wah sighs. “I can’t tell you that. It depends on how the scarring progresses from here and how your liver function holds up. For some people it can take a year for the transplant need to be critical.”

“And longer for others?” my dad asks, hope giving inflection to the word longer.

Dr. Wah’s eyes stay trained on me, though. “For others, a bit less.”

My breath evaporates, leaving my lungs an empty cavern. I rip my gaze from hers and settle it on the ceiling, willing the echo of her words to fade in my ears. They’re all I can hear, though—if my parents have their own reaction, I don’t even register it. If Dr. Wah says anything next, I don’t hear her. I’m underwater, kicking for the surface.

Breathe, I order myself.

Again, I instruct.

Okay, focus, Amelia. This is an obstacle, and what do you do with obstacles? You slay them, that’s what.

I inhale deeply once more as I curl my fingernails into my palms and let the pain of their digging chase off my panic. I exhale. “So how do I buy myself enough time to reach the top of the transplant list?”

Dr. Wah tilts her head and grins at me. “Grit like that will help.” Then her smile fades and she speaks more seriously. “But really it’s less about the amount of time you’ve spent waiting and more about how urgent your need for a liver becomes. Someone could present for the first time today and move immediately to the top of the list, if they’re sick enough.”

“Are you saying we actually want Amelia to get sicker, so she can get a liver faster?” my mother asks.

Dr. Wah shakes her head. “Not necessarily, no. It’s a bit of a catch-22; the sicker you are, the closer you move to the top, but there’s also a point of no return where your body becomes too weak to receive a new organ, and that’s a tightrope I’d rather we didn’t have to walk.”

“Would—would you be able to—to give us any odds right now? If you had to guess Amelia’s chances?” Dad asks, avoiding my eyes.

Even more than the gut punch the question itself delivers, it kills me to hear my father’s voice crack. He’s usually such a giant goof—he’s never met a cheesy line or an awful pun he could resist. I’m convinced he is the actual man responsible for the expression “Dad jokes.”

Lately he’s been on a corny “Have you ever wondered?” kick. Have you ever wondered why sheep don’t shrink when it rains? Have you ever wondered who named grapefruits when we already had grapes and they’re a fruit? Have you ever wondered why Tarzan doesn’t have a beard?

But, Have you ever wondered what my daughter’s odds of survival are? Not words I expected to hear leave my father’s mouth. I bite my lip, waiting for the reply, but also desperately not wanting to hear it.

Dr. Wah sighs again. “I understand why you’re asking the question, but I’ll give you the same answer I give everyone. If I wanted to be an oddsmaker, I’d have skipped medical school and bought a horse track. I’m not trying to be glib; it’s just that there are too many unknown variables to take into consideration. I wouldn’t even be able to offer an educated guess, other than to say that I’m always optimistic, and I think you should be too—let’s leave it at that for now, okay?”

A rush of love for my doctor and her finesse courses through me. Her response was exactly what I needed.

My parents nod and Dr. Wah offers a tight smile. “Look, I know it’s frustrating to have your fate in the hands of a computer algorithm. But the list is set up in a way that prevents anyone from ‘gaming’ it—there’s no priority given to the rich or to celebrities and no prejudices based on religion or occupation or political affiliation. The only factors taken into account are biological and geographical. Who needs the recovered organ the most, who’s the best physical match for it, and who can be on an operating table in time to receive the transplant. You can make yourself dizzy trying to guess when the call will come, but please don’t do that. Honestly? Here’s the advice I give all my patients. You ready?”

She’s staring straight at me as she asks, and I nod.

“You’re going to recover from the GI bleed very quickly. In fact, you’ll be released shortly and once your sore throat wears off, you should feel just like your regular self, possibly for some time to come. So you go about your life as normally as possible and you do what you need to do to stay strong, mentally. There’s a lot we don’t understand about the mind-body connection, but I’ve seen enough to believe in the healing power of a positive attitude.”

I grasp at the lifeline she offers. The worst thing I can imagine being is powerless, and her words are lightness and hope. Resume normal life? Stay strong? I can follow that action plan. Coach’s favorite call and response—the one I’m in charge of leading at the end of every jam—plays in my head:

What’s the boss of us?

Courage!

What’s never the boss of us?

Fear!

The perfect mantra for this. The words are metal rods burrowing into my spine, straightening it, shoving up against the spaces where panic had invaded and serving notice. I can hack this waiting game thing.

No. I won’t just hack it . . . I’ll find a way to own it.

My lungs fill with air again.

“Now, beyond the mental game, let’s cover some other considerations to keep you healthy.” Dr. Wah’s words snap me back to the recovery room. “Your mom mentioned you being up to date on all your immunizations, but we’re going to confirm that. Your liver plays an important function in fighting off infections, so if it’s not running at full capacity, neither is your immune system. I’m talking double the hand washing, got it?”

“Got it,” I tell her.

“We’ll buy stock in Purell,” Dad says.

“I also want you to start taking an antacid daily. Tums. Rolaids. Any kind is fine.”

I’m tempted to answer, “I have a serious disease and you’re prescribing Tums?” but instead I simply say, “Okay, that’s easy.”

“Other than that, if you start having the other symptoms I described—itching, fatigue, yellowing—or any pain, I want you to check with me before taking any over-the-counter drugs because your liver is going to have a hard time processing them. In fact, check with me on anything you want. I’m going to be seeing you for bloodwork every couple of weeks, but if you need me between appointments, you call my office. Someone tells you about a homeopathic treatment they’re heard of and you’re curious about it, you call me to discuss whether it’s something we should explore. You have any questions, you call. Sound good?”

What would sound better is going back to yesterday, when none of this was remotely on my radar.

“Sounds good.”

“Okay then,” she says, standing. “I’m going to take care of things on my end to get you placed on the transplant waiting list. We’ll cover all this in more detail in future appointments, but as far as basics go, you’re going to want to keep your phone close to your body and your body in easy driving distance to the hospital. Recovered livers are only viable for eight to twelve hours, so time is always of the essence.”

So much for the march in DC with Sibby at the end of the month. I know that should be minor in light of everything else, but the pinch of disappointment is real.

Dr. Wah puts her hand on my knee. “You’re strong, Amelia. I have a good feeling about your ability to handle this. You have me to lean on anytime you need it. And your parents too, of course.”

She turns to acknowledge them and both share closed-lipped smiles with her, but I notice the tightness in the corners of my dad’s eyes, and my mother seems to be having a hard time swallowing. I have to look away to tamp down the tickle behind my eyelids.

Fear is not the boss of me; courage is.

I will not let this disease ruin my life.

Dr. Wah’s shoes click out of hearing range and a heavy silence descends.

There is both everything to say . . . and nothing to add.

After a few seconds Dad clears his throat and pulls his cell from his pocket, pointing it to the hallway. “I, um—I should fill Alex in while we wait for them to discharge you.”

My older brother is a sophomore at college in Maryland. We’re close, but not super tight or anything, and I wonder how much he’s been looped in already and how he’s reacting.

Mom’s sigh is soft. “Tell him I’ll call him later too.”

Dad slips from the room and my mother reaches under my bed to haul her purse into her lap. “Speaking of calling, I have your phone in here. Sibby’s been texting every five seconds, so you might want to let her know you’re up. When Dad and I got to the ER she was simultaneously manning a phone tree to update your teammates and badgering the woman at the registration desk for information on you. I had to promise her we’d call as soon as you were awake to keep her from staging a mutiny.”

I smile at the image, then flash back on how panicked Sibby was at the arena, having to watch me spray blood everywhere.

Mom jams her hand inside her purse, feeling around. “Do you want some privacy to talk to her?” she asks. “I could find Dad out there and we could grab a coffee from the cafeteria or something.”

My mother’s giant bag is the one place she surrenders to disorder and chaos, and the sight of her rummaging through it in search of some elusive item it’s eaten is such a normal sight, while everything else about this scene is so surreal. I can’t make myself reconcile the two.

“Why can I never find anything in here!” Mom glares death rays at the purse before she dumps it upside down and begins shaking items loose onto the blanket covering me.

“Mom!” I yelp, when crumbs from a half-eaten PowerBar scatter onto the floor.

She huffs but lets the bag fall from her fingers. “Sorry.” She lowers her chin and shakes her head. “I’m sorry,” she repeats, sounding defeated.

“It’s fine. It’s in there somewhere and in the meantime, I can call Sibby from yours—this is nothing worth getting worked up about.”

She half snorts, half chokes, her eyes still on the floor. We both know her being upset has nothing to with my phone, but neither of us is willing to go there. Despite all my resolve to stay strong following Dr. Wah’s pep talk, I have to fight the urge to turn on my side and draw my knees tight to my chest.

Mom exhales slowly and her expression turns rueful. “Bet you didn’t picture your day ending here when you woke up this morning.”

Truer words have never been spoken.

Not my day, or my year . . . or even my decade, if I’m being honest.

I’ve always known my BA could catch up with me . . . someday. I just never expected someday could be today.