“How’d you score the closet and the portable cabinet?” I joke, trying to ease the tension.
Natalie smiles. “Our department is rather small, and mobile. I go from site to site.”
“Oh. You need some better chairs.” My butt bones ache already, the chairs are that hard.
She reviews our responses to the questionnaire silently, with zero expression. Next she draws out a family tree and asks a nauseating number of questions, most of which we answer with guesses. When this is done, she launches into information overload.
“My job is not to recommend your course of action, but to educate you about your options. We recommend women consider genetic testing ten years earlier than the youngest age of cancer diagnosis within the family. Since your mother was diagnosed at thirty, the guidelines would indicate considering testing at age twenty.”
“See? We don’t have to worry about this yet!” I announce, way too upbeat.
Saff glares at me. “Birthday present,” she reminds me. Drat.
“Here’s what I want you to consider. A blood test will take ten seconds. It will inform your decisions. I can have the nurse administer it today. The results take several weeks to come through, but then at least you’ll have information. In the absence of information, you both have to assume that you’re at high risk, and you can begin getting MRIs at age twenty for cancer prevention. But if we get some information back that takes you out of this high-risk category, then you can relax a little. Of course, I have to add that the BRCA gene mutation is only one contributor to cancer; certainly people who don’t have it can still get cancer.”
“See?” I say again. “Pointless. Even if we don’t have the gene mutation, it’s not like we’re in the clear. We can still get it. We’re basically all dying no matter what.”
“Lovely,” says Saff dryly.
It’s distinctly possible that I’m giving Natalie a headache. She pinches the bridge of her nose. “I know breast cancer is your focus, due to your mother’s experience, but I also want to stress this gene’s connection to the increased risk for ovarian cancer. This type of cancer is much harder to detect, and the timing for a salpingo-oophorectomy can put a deadline on your reproductive decisions.”
What a clinical way to say, If you want to have kids AND avoid being cannibalized by your own cells, start planning now!
“These are complicated decisions,” Natalie says, slowing down for emphasis, “and while you’re both adults, you’re both very young. I want to make sure you fully understand the risks and benefits of whatever you choose to do. Of course it’s up to you whether you involve your father or aunt in this discussion, but because your decision can have such an impact on your life, I encourage you to take your time with this.”
Saff has been very quiet this whole time. But as soon as Natalie pauses, she says, “We want to do it. We’ve been talking to our aunt about it for months—let’s just get it over with.”
“Speak for yourself,” I say. “I’m not sure I want to know right now.” I’m not sure I even want to think about it. I’d rather think about Natalie’s pinched nose. I wonder if that impacts her sense of smell. “Maybe I don’t ever want to know.”
“Cayenne,” Saff says softly. She places her hand on my arm and I forget about Natalie’s nose. “You made a promise to me. And to the girls. You owe it to all of us.”
Natalie clears her throat. “It’s entirely your right to decide you don’t want to be tested,” she says to me, with a pointed look at Saff. “I can tell you both have dramatically different personalities and perspectives on life. You each should approach this in the way that feels right for you. And you can certainly take some time to think about it.”
✱✱✱
I take Natalie up on that offer and go for a walk (aka crutch-hobble) around the medical building. I’m not one to flake on promised birthday presents, even one that involves blood loss. But to be fair, this is a big decision. Saffron’s always pushing personal choice—especially when it relates to anything about women and their bodies. Breastfeeding in public? Personal choice. Makeup? Personal choice. Hijab or no hijab? Personal choice. Appropriate pronoun? Personal choice. Casual sex, monogamous sex, or wait-for-marriage sex? Personal choice. While I give her a hard time whenever humanly possible, I totally agree with her on this front. So I’m not sure why she isn’t apply that philosophy to me. Genetic testing or no genetic testing? She doesn’t want me to have a choice. And if I’m positive for the mutation, I’m going to have to make many more personal choices that are even tougher. This is my body, right? I should be able to do whatever I want.
Saff must be getting nervous because she calls me twenty-three times during my hour-long walk/hobble. I ignore the buzzing in my pocket. I’m just circling the building, taking frequent rests because the crutches hurt my armpits and the pressure impacts my vulnerable ribs. If she peeks outside, she’ll see me.
It’s like planning a jump, I tell myself. Like scouting out the terrain ahead of time, picking the spot that works best, checking what time the sun will set. That’s all this is. Gathering information. It’s not actually jumping off the cliff.
I make my decision within thirty minutes, but I do a few more laps, partly so I can decide exactly what to say, and partly because it’s just a tiny bit satisfying to know that I’m making my sister sweat.
In the waiting room, I walk straight up to Saff and square off. “Listen,” I tell her. “I’m taking this test, and I’m doing it as a gift for you, but I’m not doing it because you told me to, I’m doing it because I want to. Got it?” Which is not entirely true. I’m doing it because I think it’s the right thing to do, not because I actually want to. Close enough.
“Thank you,” Saff says quietly. “Happy birthday to me. Now hopefully I don’t faint.”
Saff has had a fear of needles since age three. Probably since our mom died. When Mom got sick, she was pricked for IVs way too often.
The lab tech ties a stretchy band around her upper arm, hands her a squeezy ball, and tells her to pump it with her palm. I watch the color leave her cheeks. Saff can’t look. It’s not the pain of the prick, it’s the idea of her blood being drained from her body.
“Here. Look at my gorgeous face.” I arrange myself in front of her.
Saff can’t even laugh at that. She does manage to give me feedback on my mascara. “Your eyelashes look like spiders.”
“You’re just jealous of my technique.”
“Not jealous. Terrified. I keep thinking your lashes are going to crawl off your face and onto my arm.” Saff’s upper lip quivers, but she keeps her head toward me and away from the blood draw.
“We need a second opinion,” I say. “Let’s get our phlebotomist to weigh in.”
Saff’s voice hikes up three octaves. “No! She needs to focus on that needle.”
The lab tech pulls away from Saff’s arm, wrapping a stretchy bandage around a cotton ball. “Done. Now I can cast my vote.”
“You’re done?” Saff’s voice is still shrill.
The lab tech holds a cotton ball on Saff’s arm and wraps a stretchy bandage over it. “You two are a riot. You must have a ton of fun together.”
I glance at Saff. “Sometimes.” I hold my arm out for my turn.
“You won’t get the results back for a couple weeks,” the nurse tells us as she finds my vein. “Our genetic counselor will be calling you to discuss.”
“Joy.”
Saff rubs her arm and opens and clenches her fist. “There should be some mathematical way to figure out what the odds are of us both being negative. Or both being positive. Or one of each. I mean, we know that we each individually have a fifty-something percent risk, but what are our risks combined?”
“That would require that I pay attention in math.” I have a vague memory of flipping coins and charting it. Statistically each coin flip has a fifty percent chance of being heads. But if you flip two coins at once, what is the chance of them both being heads?
; I feel the needle pierce my skin. I don’t like to look at the needle either.
Chapter 27
The blood test must’ve wiped Saff out, because she falls asleep early tonight. The test did the opposite for me—my mind is catapulting in a million directions and I can’t settle down. I’ve actually been intending to pop by and talk to her, pay my dues toward some sisterly bonding, but when I nudge her door open, she’s fallen asleep on the journal. I hobble forward and slide it out from under her arms. One of her sticky notes flaps down a bit, and I see that there’s writing underneath it. On the back.
Huh.
Back in my room, I carefully comb through the journal. Saff has continued her entries on the back of nearly every sticky note. How did I miss that? I ease myself onto my bed and settle in to read.
Little known facts about me
Continued . . . .
Sometimes I think I love Cayenne more
Than she loves me.
I’m pretty sure Cayenne’s gonna die young.
I don’t think she cares.
But I do.
She’s like a runaway train.
There is nothing I can do to stop her,
And I will be lost without her.
My heart folds in half. Clearly Saff wouldn’t want me to see this. It’s one thing to read about her liking raw carrots, but a whole different thing for her to say she loves me more than I love her. Is that true? And if it is, is that somehow a statement about my ability to love? Is she more capable of love? Because I love her more than I love anyone else in the world.
I force myself to reread her entry. I visualize myself on the train tracks, tempting destiny. Lusting after my next high, pushing any thought of Saffron out of my head. The selfishness of it strikes me fully for the first time.
I let Lorelei ensnare me in her ridiculous game of cat and mouse, thinking that the adrenaline highs were what it felt like to be truly alive. But really, they’re a distraction from real life. Real life is the now. It’s the mundane moments, it’s the human connections, it’s the things you build over time. It’s not contrived risks, rushes that last thirty seconds at most and then fizzle.
I want to stomp Lorelei to tiny bits, crush her like grapes, and flush her down the toilet. How did I fall for that trick? Never again, I promise myself. I’m done with her.
I flip through the other journal entries—Mom’s thoughts and Saff’s responses. I gingerly lift up each of the half-page sticky notes to view their underbellies. And yes, there is more that I didn’t know about my sister.
Things nobody tells you when you lose a mom
Continued . . .
I’m not tough like Cayenne.
She acts as if she’s covered herself in bubble wrap:
Her ears, her heart, her soul.
She thinks she can do anything,
Say anything.
Try anything.
Tempt fate—
No matter the consequences.
For me it’s the opposite.
I see every jagged edge,
Bacteria lurking on the countertops,
Moles ready to turn into cancerous carnivores.
Never knowing what tornado’s going to slam into my path
Makes it hard to let go enough
To live.
Something lodges in my throat. She’s . . . not wrong.
That blood test today kind of freaked me out. I think for most of my life, I’ve chosen not to see danger unless I can control it, unless I know I can conquer it—unless I can get in its face, give it the middle finger, and then walk away from it. I’ve chosen to ignore the risks that I can’t engineer myself. As long as I can orchestrate it, I feel safe, but today’s blood test has shattered that illusion. It makes it hard to ignore those risks. Saff and I are both pennies, flipped high in the air, free-falling. This feeling of absolute vulnerability is awful. Maybe this is how Saff feels all the time.
Fletch
Continued . . .
I like to kiss him. I like the way he smells.
And how we can fall asleep in bed
Without me feeling scrunched.
I kind of thought love would be
More of a rollercoaster ride. A thrill. A rush.
It sure seems to be for Cayenne.
I worry that I love Fletch because I love him,
And not because I’m in love with him.
But what’s the definition of love?
Is my kind of love less real because it’s less exciting?
Will I wake up twenty years from now,
Bored out of my mind?
Or will Fletch be my favorite pair of jeans,
Better and better with age?
For the first time, I get the itch to write my own entry. What would I say about Axel? He’s a rush—a rollercoaster ride—just like Saff says. But sometimes I wonder if all that adrenaline covers up something empty underneath.
When I was a kid, I used to think there were cookies in Alicia’s decorative cookie jars. She’s got like twenty, all lined up in her living room. I spent months imagining which types of cookies were in each jar—maybe snickerdoodle, oatmeal raisin, white chocolate or macadamia nut—just waiting for her to offer me one. She never did. And when I finally got the nerve to ask for a cookie, my heart beating like crazy and my mouth watering up a storm, she laughed. “Oh, sweetie. Those are just for show.” She pulled one off the shelf and tipped it over for me to see. Just dusty porcelain. She offered me a granola bar, but it couldn’t compare.
So is Axel a fancy cookie jar? Do I love him for his beauty and for the excitement he sparks in me, without knowing what’s inside?
The Big NEWS
Continued . . .
I wish I could tell Cayenne how I feel.
I have to read the front of this sticky note again, to see what else she wrote, what she wished she could share with me. I flip it over. Oh, yeah. She’d been writing about Ryan/Dad being our father, and how royally pissed she was. I wish she could tell me how she feels too. I wonder if there’s anything I can do to help her talk to me. Maybe all my joking makes her feel like I can’t hear her.
What’s in a life?
Continued . . .
When I found Fletch
I had so few people of substance.
No Mom. Clearly.
No Dad.
And I’ve been losing Cayenne for as long as I can remember.
I did have her once.
As a soulmate. As a supporter. As a friend. As a sister.
After Mom died, we clung closer at first.
And then slowly, our connection began unraveling.
I’ve been holding on by a thread.
I may not be able to hold on much longer.
Shit.
I don’t want to read any more. Clearly, as a sister, I’ve scored an F. She doesn’t think I’m there for her, she can’t talk to me, she thinks I don’t value my own life or the impact I have on others . . .
And all a sudden I’m pissed. What—does she think she deserved an angel for a sister? Like somehow I’ve lost my right to have my own reactions to life? As if it’s worse for me to make a joke than to shatter to pieces? It’s not like she’s the only one who’s been impacted by Mom’s death. I lost my mom too! I’m nearly a year older than her, but that’s nothing in the scheme of things. Must be nice to be so freaking perfect. Must be nice to think she can pass judgment on me.
I return the journal to her room, and it takes all my self-control to not slam it on her dresser. I’d love to see her jerk awake. But I don’t. I force myself to totter back to my bed.
It takes me forever to fall asleep, and when I do, I sleep fitfully, tossing and turning, plagued by terrible, taunting dreams. Lorelei is strangely MIA, but even in her absence she mocks me. In every single dream, I let Saff down.
✱✱✱
My eyes are crusted shut when I wake. I’m pretty sure I didn’t cry before I fell asleep—I hardly ever do—but my dreams were full of body-wrac
king sobs. I pick at the crusties until I can blink easily.
I limp into the bathroom to brush my teeth, but I crash straight into Saffron. Because of my bum ankle, and the crutches, I can’t even catch myself properly. I tip right over on my ass. I feel the impact reverberate through my ribs.
Saff rushes forward. “Oh, I’m so sorry. I didn’t see you.” She boosts me up.
I’m still sort of shocked. And maybe traumatized by last night’s dreams. “I’m sorry too, Saff. I wasn’t thinking.” And I don’t just mean for slamming into her. I mean for everything. For taking needless risks. For not being someone she can talk to. Basically, for our whole lives.
Saff sort of laughs. She places both hands on my shoulders to straighten me out and steers me toward the bathroom counter. She stands behind me, and we both examine our reflections in the mirror. “I forgive you, Cayenne. You’re only human, right?”
She can’t possibly know what I’m thinking, but I feel like she’s talking about more than just bumping into me. And just like that, some heavy weight in my chest lifts.
“I like to think that I’m superhuman . . .” I start to joke, watching her reflection in the mirror. Is this a time when she’ll be irritated by my humor or amused by it?
She slings her arm over my shoulder and grins at our reflection. “Yeah, not with that morning breath. You’re definitely human.”
Chapter 28
“You feel like fro-yo?” Saff asks me that night.
“When do I ever not?” To be honest, I’ve been going through fro-yo withdrawal. Something about not being able to drive makes me feel like a little kid.
“Fletch and Vanessa are treating me—one last birthday hurrah. Come with us!”
I message Axel to invite him, but he says he’s cleaning Churro—which feels like a sorry excuse. He’s probably just afraid to face my sister.
I actually don’t mind that he doesn’t join us. Fletch and Vanessa have their own banter with Saff, but they’re good about including me in the conversation. Remembering Saff’s journal entry about them, I can’t help wondering if my life would be different with a tight group of friends, instead of a loose collection of acquaintances and the single focal point of Axel. Though I guess the tail end of my senior year of high school is a little late to try forming new bonds.
How to Live on the Edge Page 16