Emma Swan is fourteen years old, her older sister Lilly is 17. They live in a tiny town in Maine called Storybrooke with their parents and younger brother Neal. Emma hates her parents, but not because they make her wash the dishes, or don't let her see a boy she likes, she hates them because she is an allogeneic donor for Lilly who has leukemia. Emma is now being forced to give her sister part of her own body that could really impact her.
Chapter one.
BASED ON "MY SISTER'S KEEPER" BY JODIE PICOULT AS IT IS MY FAVOURITE BOOK. OBVIOUSLY, I AM NO EXPERT ON KIDNEY DONATIONS OR ANY OTHER TYPE OF MEDICAL TREATMENTS SO MOST WILL BE SIMILAR TO THE BOOK OR OFF GOOGLE- FEEL FREE TO FACT-CHECK ME.
Emma Swan Nolan lived a somewhat ordinary life. She lived in a modest home with her parents, David and Mary-Margaret, her older sister Lilly, and her younger brother Neal who is eight. She went to school every day and tried her hardest to be top of her class. She excelled in sports and English due to her love of stories, but she hated math and geography. She played basketball and hockey, both for fun and because it was never too early to think about colleges. Emma wanted to study to become a sports physiotherapist. There was just one spanner in the works for Emma.
Her name was Lilly.
Lilly was diagnosed with Acute Lymphoblastic Leukaemia when she was seven years old. Emma had been four when Lilly was diagnosed and since then, life as they knew it had stopped. Lilly Wyvern Nolan was supposed to die eight years previously but, miraculously, she was still alive. All thanks to Emma.
Emma had donated her blood to help Lilly when she was four because her mother had asked her to, then when Lilly needed Stem cells at nine, Emma was volunteered. The same thing happened when Lilly was thirteen and needed white blood cells, Emma was the one who gave them to her. Why?
Emma was a perfect sibling match, the perfect accident.
But leukemia wasn't Lilly's biggest problem right now. Right now, she needed a kidney. It wasn't due to leukemia that she needed a new kidney, it was down to the chemotherapy that Lilly had previously had to treat her leukemia, but that chemo had broken down her kidneys- an exceedingly rare side effect. So now, she was in kidney failure. Emma knew when Lilly wound up on the oncology ward of Storybrooke General Hospital, Emma nearly always wound up there too. Neal wasn't totally oblivious to what was going on with his older sisters, but he lived with his uncle James and his wife Belle during the week just to give him a bit of stability and normality. Emma and Lilly were absent from school so often when they were younger that eventually it was decided that the two would just be better off being home-educated.
The two sisters were closer than close, seeing each other at their most vulnerable would do that to anyone, but also because they had a lot in common. Lilly was obsessed with all things typically girly, makeup, cute bandanas to cover her head when she had chemo, bright colorful clothes, and reading fashion magazines. Emma was the tomboy, climbing trees and grazing her knees, wearing a band Tee under her blazer when she had gone to school, playing hockey and basketball, and living in baggy jeans, leggings, sweatpants, tank-tops, or band tees with her red and black flannel shirt over the top and her signature red leather jacket over the top. Emma had long curly blonde hair that she pretended to hate but secretly adored, but it was almost always swept off her face in a high ponytail that bounced when she walked. The girls swapped secrets, dreams, fears, and the mystery of life beyond the walls that had kept them trapped for so long.
It was Tuesday, Emma was just back from her hockey practice where she went three times a week as a goalie but when she walked into the kitchen, both her parents were waiting for her.
"Emma, we need to talk to you about something," said her mother, flicking her bobbed hair over her shoulder.
"okay, but I told Lilly that you would know it was her that used the credit card to buy herself nail varnish" Emma started but her dad stopped her.
"It's not about the credit card Em, it's about Lilly".
"Is she okay? What does Dr Pan say?" Emma asked urgently, feeling her heart jump into her throat.
"Lilly's okay at the moment. Do you know how sick she's been recently? Well, Dr. Pan says she needs a kidney transplant, but Lilly can't have a transplant from anyone… Dr. Pan is only recommending the transplant if the kidney comes from you." Mary explained, her green eyes hopeful.
"So you want me to give Lilly my kidney?" Emma clarified.
"Please, Emma? This could…" David started to say something, but Emma interrupted.
"This could save her life…again! her life. What about my life? My life is non-existent! I feel like all I do is wait for Lilly to get sick again, or to need white blood cells, or marrow, or granulocytes… is that all I am to you two? Just spare parts for my sister?" Emma shouted. Her mother used to say that Emma was beautiful when she was angry; her face flushed a pale pink, her eyes grew larger and flashed, and her perfect rosebud mouth seemed almost as though it was meant to spew those hurtful words.
"Emma Swan Nolan! You will not speak to your parents that way! Get to your bedroom at once!" David fumed.
Emma stomped up the stairs to her attic bedroom, it was small and was bitterly cold in the winter, but the views made Emma forget about everything. Her dad had even fixed her a small seat when she was six so that she could see the views that stretched all the way to the coast. If she tried hard enough and scrunched herself up small enough, she could still just about fit herself on that seat. The sight of the ocean calmed her a little bit, it always made her relax. She was so engrossed in her anger and frustration that she almost didn't hear the knock at her door.
"Come in unless you're my mom or dad" Emma called, and the door swung open. Lilly walked in and sat down on Emma's bed.
"Lil, you should be resting! Mom will do her nut if she catches you up here!" Emma exclaimed, throwing her older sister a fluffy rug to put around her shoulders.
"I know but I don't care. I wanted to talk to you" said Lilly defiantly, shrugging the rug over her thin shoulders.
"What do you want to talk to me about?" Emma huffed, knowing exactly what Lilly would say.
"The kidney…" Lilly said
"Don't you start! I've just had an earful off our parents about it. I don't want to do it! It's not just the kidney Lilly, I… can't have another operation… I just can't!" Emma said, tears finally spilling out over her eyelashes.
"I wasn't going to ask you to give me your kidney. I was going to ask you to keep it to yourself. I don't want your kidney… I don't think I can survive another major surgery. It takes me days to recover from dialysis sessions! No Em, baby sis, you need to fight this fight for me… you need to keep your kidney!"
"How? I don't exactly get to consent to my parents forcing needles into my arms when you needed white blood cells to fight that raging infection you got when you were nine. Or they didn't ask my permission to draw out my bone marrow when I was four. It just never seems to end Lilly… one day one of us will die doing this… and I don't want it to be me" Emma said but she suddenly saw how selfish she was being but without another word, Lilly walked out of her room.
Nice going, Swan. Not only have you lost your best friend, but you've also just lost yourself your sister. Your mother will be delighted to hear that!
Emma thought to herself, knowing her mother would be less than thrilled to know that Lilly was actually on her side.
Mary-Margaret's Point of View
When you have a daughter who is seventeen, your main priorities are her grades in her exams, keeping her from seeing that boy you don't approve of, or picking out beautiful dresses for her prom or formal.
When your seventeen-year-old daughter has leukemia, all that goes out the window. I try to keep Lilly's iron count high in case she has a hemorrhage in the middle of the night again. I have to remind her to take the medications that she needs to prevent her body from rejecting bone marrow. I keep my home shining clean and spotless, totally sterile, so Lilly stands a better chance of not getting an infection that could kill her.
That morning when Lilly was seven, she was yawning a lot at breakfast. I just thought she hadn't had a good night's sleep, so tucked her in a half-hour early that night. When Lilly was getting ready for her bath with her sister, I pulled her t-shirt haphazardly over her collarbones, and there it was… trailing down her spine to her hips was a line of splotchy blue bruises, like sapphires on white silk.
Whipping my daughters down to the doctor's office, Dr. Stubbs ran through everything he could think of: anemia, mono, even just Lilly being clumsy… when I told him that she was always tired and picked around her food on her plate and was dropping weight, he ordered blood work. I thought nothing of it, sometimes kids have anaemia, and with Lilly being a picky eater, well, it was almost a guarantee that that was the answer.
"Mrs Nolan, Lilly's test results were problematic. Her white cell count is almost half of what it should be. I need to send her to get a more in-depth analysis done on her blood samples." He explained, handing me a card that said the name of a doctor: Mal Moors, and her MD cert and office number on the floor in the Haematology and oncology wards.
"Oncology? But isn't that cancer?" I ask, feeling my throat swell shut at the thought. I wait for him to tell me that it is a mere coincidence that the hematology and oncology wards simply share nothing more than a location.
He doesn't.
he doesn't tell me anything. Just waves me off with a sad smile.
There is a certain kind of camaraderie for parents of children who are sick. We all just… understand. When your child is shaking with a fever so high that nurses have to submerge her in cold water, or when she vomits from the effects of chemotherapy all down her favorite blanket, or even when she is clinging on to life by a thread after fighting an infection that you think will ultimately kill her… parents just understand. Sometimes they offer kind words about the nurses while your daughter's teeth are chattering, or they slip you the number of a tried-and-true dry cleaner who can get even the toughest stains out, or even just offer a sympathetic smile at your daughters comatose-like sleep… we all understand. Today it isn't my daughter, but tomorrow it could be.
Dr. Moors is a strict no-nonsense type of woman, whose greying hair is scraped back into a formidable, schoolteacher bun. It makes her look a lot older than her forty-something years and much more fearful. She comes into Lilly's room with her tray of torture supplies while I try to keep my two daughters occupied.
"Okay mom, you wanna hold her on your lap?" Dr. Moors asks and I nod mutely.
Picking up my daughter and her favorite picture book to keep her focus on as opposed to the needle that will shortly be embedded in her soft skin, I try to chat around the doctor putting on the tourniquet, and tapping for Lilly's small, spidery veins.
"just a little pinch sugar" Dr. Moors promises- exactly the wrong words to say as Lilly begins to scream and cry but there isn't any blood flowing into the sample tube.
"Sorry darling, I'm going to have to try again" Dr. Moors sighs and sticks my daughter all over again, but still no blood. A third time strikes lucky, and blood is filling the syringe slowly. Lilly has now gone limp and sucks her thumb with her other hand. I can't tell if I preferred her screaming.
"Mrs. Nolan, your daughter's results aren't what we expect to see in a healthy seven-year-old.
she's eight in three days I add inside my head while nodding lightly.
"Lilly is presenting with a low white blood cell count, around 2,200. This could be an autoimmune condition, but Lilly also presents with 8% promyelocytes and 9% blasts. This indicates a leukemic syndrome."
"Leukemic?" I repeat. The word is slimy and unfamiliar.
"Yes. Leukemia is a blood cancer. Now I know I'm moving quickly but I believe that Lilly has what is called Acute Lymphoblastic Leukaemia. She'll need another blood test and a bone marrow aspiration to confirm it." She gets up to leave but then hesitates.
"I'm sorry"
Some sympathy is thrown in for free.