I USED TO PRETEND that I was just passing through this family on my way to my real one. It isn’t too much ofa stretch, really—there’s Kate, the spitting image of my dad; and Jesse, the spitting image of my mom; andthen there’s me, a collection of recessive genes that came out of left field. In the hospital cafeteria, eatingrubberized French fries and red Jell-O, I’d glance around from table to table, thinking my bona fide parentsmight be just a tray away. They’d sob with sheer joy to find me, and whisk me off to our castle in Monaco orRomania and give me a maid that smelled like fresh sheets, and my own Bernese mountain dog, and a privatephone line. The thing is, the first person I’d have called to crow over my new fortune would be Kate.

Kate’s dialysis sessions run three times a week, for two hours at a time. She has a Mahhukar catheter, whichlooks just like her central line used to look and protrudes from the same spot on her chest. This gets hookedup to a machine that does the work her kidneys aren’t doing. Kate’s blood (well, it’s my blood if you want toget technical about it) leaves her body through one needle, gets cleaned, and then goes into her body againthrough a second needle. She says it doesn’t hurt. Mostly, it’s just boring. Kate usually brings a book or herCD player and headphones. Sometimes we play games. “Go out into the hall and tell me about the firstgorgeous guy you find,” Kate’ll instruct, or, “Sneak up on the janitor who surfs the Net and see whose nakedpictures he’s downloading.” When she is tied to the bed, I am her eyes and her ears.

Today, she is reading Allure magazine. I wonder if she even knows that every V-necked model she comesacross she touches at the breastbone, in the same place where she has a catheter and they don’t. “Well,” mymother announces out of the blue, “this is interesting.” She waves a pamphlet she’s taken from the bulletinboard outside Kate’s room: You and Your New Kidney. “Did you know that they don’t take out the oldkidney? They just transplant the new one into you and hook it up.”

“That creeps me out,” Kate says. “Imagine the coroner who cuts you open and sees you’ve got three insteadof two.”

“I think the point of a transplant is so that the coroner won’t be cutting you open anytime soon,” my motherreplies. This fictional kidney she’s discussing resides right now in my own body.

I’ve read that pamphlet, too.

Kidney donation is considered relatively safe surgery, but if you ask me, the writer must have beencomparing it to something like a heart-lung transplant, or some brain tumor removal. In my opinion, safesurgery is the kind where you go into the doctor’s office and you’re awake the whole time and the procedureis finished in five minutes—like when you have a wart removed or a cavity drilled. On the other hand, whenyou donate a kidney, you spend the night before the operation fasting and taking laxatives. You’re givenanesthesia, the risks of which can include stroke, heart attack, and lung problems. The four-hour surgery isn’ta walk in the park, either—you have a 1 in 3,000 chance of dying on the operating table. If you don’t, you arehospitalized for four to seven days, although it takes four to six weeks to fully recover. And that doesn’t eveninclude the long-term effects: an increased chance of high blood pressure, a risk of complications withpregnancy, a recommendation to refrain from activities where your lone remaining kidney might bedamaged.

Then again, when you get a wart removed or a cavity drilled, the only person who benefits in the long run isyourself.

There is a knock on the door, and a familiar face peeks in. Vern Stackhouse is a sheriff, and therefore amember of the same public servant community as my father. He used to come over to our house every nowand then to say hi or leave off Christmas presents for us; more recently, he’s saved Jesse’s butt by bringinghim home from a scrape, rather than letting the justice system deal with him. When you’re part of the familywith the dying daughter, people cut you slack.

Vern’s face is like a soufflé, caving in at the most unexpected places. He doesn’t seem to know whether it’sall right for him to enter the room. “Uh,” he says. “Hi, Sara.”

“Vern!” My mother gets to her feet. “What are you doing at the hospital? Everything all right?”

“Oh yeah, fine. I’m just here on business.”

“Serving papers, I suppose.”

“Um-hmm.” Vern shuffles his feet and stuffs his hand inside his jacket, like Napoleon. “I’m real sorry aboutthis, Sara,” he says, and then he holds out a document.

Just like Kate, all the blood leaves my body. I couldn’t move if I wanted to.

“What the…Vern, am I being sued?” My mother’s voice is far too quiet.

“Look, I don’t read them. I just serve them. And your name, it was right there on my list. If, uh, there’sanything I…” He doesn’t even finish his sentence. With his hat in his hands, he ducks back out the door.

“Mom?” Kate asks. “What’s going on?”

“I have no idea.” She unfolds the papers. I’m close enough to read them over her shoulder. THE STATE OFRHODE ISLAND AND PROVIDENCE PLANTATIONS, it says right across the top, official as can be.

FAMILY COURT FOR PROVIDENCE COUNTY. IN RE: ANNA FITZGERALD, A.K.A. JANE DOE.

PETITION FOR MEDICAL EMANCIPATION.

Oh shit, I think. My cheeks are on fire; my heart starts to pound. I feel like I did the time the principal senthome a disciplinary notice because I drew a sketch of Mrs. Toohey and her colossal butt in the margin of mymath textbook. No, actually, scratch that—it’s a million times worse.

That she gets to make all future medical decisions.

That she not be forced to submit to medical treatment which is not in her best interests or for her benefit.

That she not be required to undergo any more treatment for the benefit of her sister, Kate.

My mother lifts her face to mine. “Anna,” she whispers, “what the hell is this?”

It feels like a fist in my gut, now that it’s here and happening. I shake my head. What can I possibly tell her?

“Anna!” She takes a step toward me.

Behind her, Kate cries out. “Mom, ow, Mom…something hurts, get the nurse!”

My mother turns halfway. Kate is curled onto her side, her hair spilling over her face. I think that through thefall of it, she’s looking at me, but I cannot be sure. “Mommy,” she moans, “please.”

For a moment, my mother is caught between us, a soap bubble. She looks from Kate to me and back again.

My sister’s in pain, and I’m relieved. What does that say about me?

The last thing I see as I run out of the room is my mother pushing the nurse’s call button over and over, as ifit’s the trigger to a bomb.

I can’t hide in the cafeteria, or the lobby, or anywhere else that they will expect me to go. So I take the stairsto the sixth floor, the maternity ward. In the lounge, there is only one phone, and it is being used. “Six poundseleven ounces,” the man says, smiling so hard I think his face might splinter. “She’s perfect.”

Did my parents do this when I came along? Did my father send out smoke signals; did he count my fingersand toes, sure he’d come up with the finest number in the universe? Did my mother kiss the top of my headand refuse to let the nurse take me away to be cleaned up? Or did they simply hand me away, since the realprize had been clamped between my belly and the placenta?

The new father finally hangs up the phone, laughing at absolutely nothing. “Congratulations,” I say, whenwhat I really want to tell him is to pick up that baby of his and hold her tight, to set the moon on the edge ofher crib and to hang her name up in stars so that she never, ever does to him what I have done to my parents.

I call Jesse collect. Twenty minutes later, he pulls up to the front entrance. By now, Deputy Stackhouse hasbeen notified that I’ve gone missing; he’s waiting at the door when I exit. “Anna, your mom’s awfullyworried about you. She’s paged your dad. He’s got the whole hospital being turned inside out.”

I take a deep breath. “Then you better go tell her I’m okay,” I say, and I jump into the passenger door thatJesse’s opened for me.

He peels away from the curb and lights a Merit, although I know for a fact he told my mother he stoppedsmoking. He cranks up his music, hitting the flat of his hand on the edge of the steering wheel. It isn’t untilhe pulls off the highway at the exit for Upper Darby that he shuts the radio off and slows down. “So. Did sheblow a gasket?”

“She paged Dad away from work.”

In our family, it is a cardinal sin to page my father away. Since his job is emergencies, what crisis could wepossibly have that compares? “Last time she paged Dad,” Jesse informs me, “Kate was getting diagnosed.”

“Great.” I cross my arms. “That makes me feel infinitely better.”

Jesse just smiles. He blows a smoke ring. “Sis,” he says, “welcome to the Dark Side.”

They come in like a hurricane. Kate barely manages to look at me before my father sends her upstairs to ourroom. My mother whacks her purse down, then her car keys, and then advances on me. “All right,” she says,her voice so tight it might snap. “What’s going on?”

I clear my throat. “I got a lawyer.”

“Evidently.” My mother grabs the portable phone and hands it to me. “Now get rid of him.”

It takes enormous effort, but I manage to shake my head and drop the phone into the cushions of the couch.

“Anna, so help me—”

“Sara.” My father’s voice is an ax. It comes between us, and sends us both spinning. “I think we need to giveAnna a chance to explain. We agreed to give her a chance to explain, right?”

I duck my head. “I don’t want to do it anymore.”

That ignites my mother. “Well, you know Anna, neither ............