Hello? A woman comes on the line. Antonia—her conditioning kicking in at crisis moments—assumes the woman is a nurse since she is female. This is Dr. Kane, the woman introduces herself. She sounds too young to be in charge of anybody’s life. This must be her first gig out of medical school, the bottom-of-the-totem-pole, late-night-early-morning shift at the ER in a small hospital west of Boston.

Your sister is still alive, Dr. Kane answers Antonia’s first question. For a moment, Antonia feels such immense relief she spews out, Thank you, oh, thank you! From now on, Antonia will choose only young doctors as a good luck charm. Sam’s ER doctor, the kindly Dr. Wolcott, must have been pushing seventy-five.

The doctor is going through her checklist, as if she were being examined by a licensing board, all the things she has done to resuscitate her patient, IV, intubation, meds to stimulate heartbeat. All our efforts have failed, the doctor concludes, her voice almost a whisper. Your sister is being kept alive by mechanical means, which, if disconnected, would mean death within minutes.

Antonia’s relief has been so fleeting, it feels cruel to have summoned it at all. But you said she was still alive, she reminds the doctor in the same peevish tone as she used when her mother went back on a promise.

Who is her next of kin? the doctor asks after a heavy pause. Does your sister have a living will?

In another, less horrible moment, Antonia would burst out laughing. Dr. Kane, of course, can’t know that Izzy would be the last person to plan for such an eventuality. She couldn’t even say where she’d be on any given day.

I’ve gathered she does not have a husband or any children? the doctor pursues.

She has us, the sisterhood.

I didn’t catch that.

She has her sisters. And a ton of people who supposedly “love” her, Antonia adds. She already misses Izzy’s air quotes.

So, you, her sisters, will have to decide what to do.

What do you mean we decide what to do? You’re the doctor! Antonia is furious at the whole medical establishment. They let Izzy self-medicate. They let Sam die. Soon, they’ll let her die, too. Shame on them!

I’m so sorry. Dr. Kane sounds genuinely sorry. In a few years the young doctor will have been coached on not using any such litigiously loaded phrasing that might imply error, apology.

Isn’t there a chance she could recover? Antonia pleads with the woman. Come on, work with me on this one.

The damage to her brain is irreparable, the doctor says in a hushed voice, as if it is a secret they must all keep from Izzy.

But I’ll give her whatever she needs! Antonia offers desperately. An organ, a blood transfusion. Where on earth did Antonia learn science? Also at summer camp? Izzy needs a new brain, a new heart, a second life. We have the same blood type, you know? We were always mistaken for twins growing up. Same frizzy-kinky hair they both detested and ironed, same knobby knees, same bony build.

Dr. Kane keeps saying, I’m so sorry.

This woman is no help at all! Will you just put her on?

Dr. Kane hesitates. Her patient is in no condition to talk.

Of course, Izzy can’t talk! Antonia isn’t a total science dummy. She knows what is possible. Just hold the phone to her ear, Antonia sobs, her anger washed out of her, weapons tossed on the ground.

Antonia listens to the rattle of the respirator, the beeping of monitors, her sisters weeping in the background. Ay, Izzy, how could you? is all she can think of saying. But she doesn’t want her last words to her sister to be a scolding, raining on Izzy’s cortege as in the past on her parades. Still, Antonia can’t think of a single word to say. It’s finally come: the frightening moment she has fought so hard to prevent, when not just the world but the words fall apart, and the plunge goes on and on and on.

If you ever need a transfusion or an organ, Antonia once offered Izzy in the dark of their shared bedroom, overcome with love for her older sister, remember you can always come to me.

Are you kidding? Izzy scoffed. Why would I want your cooties?

Antonia had been glad for the darkness, so Izzy couldn’t see her tears. Here she was offering to risk her life for her sister and Izzy had turned her down. Why did Izzy detest her so? She wanted to ask, but she knew what her sister would say, Because you ask such stupid questions!

All their shared childhood, Antonia was convinced Izzy hated her, until that time in summer camp when Antonia was thrown from her horse during the big horseshow on parents’ weekend. She lay in the dust, a trickle of blood coming from the back of her head, eyes closed, dead to the world. Izzy had jumped into the ring, wailing and pulling her hair and begging Antonia to come back to life. Please, please, oh, Toni, please don’t die!

You were like a banshee, screaming your head off, their mother recounted. (Where on earth had their mother picked up the word banshee, mispronounced “bang-she”?) Antonia has no memory of the actual fall, but she recalls coming to and hearing Izzy’s inconsolable weeping and delaying opening her eyes to savor this exquisite moment: Izzy loved her! A light came on in Antonia’s life.

And now Izzy has put it out.

The sequence is a blur. There is the drive back to Boston that morning, a stay of four, five days, or is it more? They have changed hotels, too creepy to stay in the old one, the rug will have to be shampooed, the green vomit leaving the faintest stains, the management very kind when the sisters offer to reimburse them. There are arrangements to be made, papers to be signed, bills to be paid—the expensive delicate ship . . . had somewhere to get to and sailed calmly on; lines that used to be lifesaving—mantras to keep confusion at bay, string in this labyrinth—fly off, untethered, disconnected, yadda yadda yaddas of past meaning. There’s a delay in getting Izzy cremated, as the coroner’s office has gotten involved, for although it is not a crime to be missing even unto death by one’s own hand, still, in one of those conundrums, law enforcement needs to know that the suicide was a suicide.

So it is that several weeks later, after Mona and Tilly have gone back to their respective homes, Antonia drives down again to pick up the ashes at the funeral home, returning the same day in the soft evening light, a tearjerker light if there ever was one, Izzy riding beside her in the passenger seat in a white box that weirdly reminds Antonia of Chinese takeout. Inside the satchel (Patterson & Sons: Celebrating Life, One Family at a Time), there is a card with a white dove flying in a gauzy sky from the Donor Center acknowledging receipt of Izzy’s organs. You have given the gift of life. Thank you.

You’re welcome. Don’t mention it. Yes, please don’t mention it. Antonia jokes to Izzy’s ashes beside her. All these niceties and euphemisms attached to the death of a person you love. Dr. Kane’s astonishing verb, harvest, when she asked Antonia, who seemed the least distraught of the sisters, which wasn’t saying much, What organs of your sister’s should we harvest? Antonia pictured a combine like the ones Sam had pointed out in his native Nebraska cutting swaths in the amber waves of grain on what was left of his family’s farm. Sam on his knees in his Vermont garden digging out his potatoes.

Take whatever you want! she had replied, her voice rising, a liberating cry. A strange hilarity had come over her. Antonia felt like a rebel throwing wide the gates of a barricaded city, the investments contained therein no longer privatized. She was sounding out of control, but why not splurge on the thrilling feeling of falling, falling, hitting a world at every turn—

Harvest away! Okay? OKAY? Antonia hollered even louder.

I’m so sorry. Dr. Kane said it again.

eleven

As if

There have been times when Antonia’s life seemed weirdly in sync with earthshaking events. She left her first husband on the very day of the nuclear meltdown at Three Mile Island. She and Sam married hours before the Tiananmen Square massacre, and the image of tanks plowing down young people, their outspread arms mirroring the embrace she was giving Sam, haunted her every year on their anniversary. The evening of the Haitian earthquake, while buildings tumbled, men, women, children crushed under rubble, her father died.

It was the opposite of that Auden poem about suffering, how it takes place while someone else is opening a window or eating a piece of pie. A boy tumbles from the sky just as an expensive delicate ship goes sailing by. Her life, on the other hand, seemed to be riding the coattails of the horror, the horror. And because each public event was so devastating, her individual drama seemed petty in comparison. It was a corrective: being aligned to a world larger than her own. It put her puny sorrows (and joys) in perspective.

Art reminds us that we’re all connected, the guy eating the piece of pie, the ice skater going through the ice. Her students all seemed intent on their note-taking, or maybe, as in the poem, their minds were elsewhere: texting a boyfriend, complaining to their moms about their English teacher going on and on.