“Rita,” I whisper, but she’s swallowed by sleep.
The pain slips up into my head and cracks so tight in my eyes that I think I might be sick. I get up, feel in the dark for the door. Sweat sticks my T-shirt cold to my skin as I stumble into the bathroom.
I squeeze a washcloth through some water and put it wet on my forehead. Drips fall in my eyes, as I sit on the closed toilet seat. The burning in my ribs is so bad that it takes the rest of the room away. I feel for the comforting thud of my heart and try to steady the pain with its beats. But a knife is sawing through my ribs, scattering boiling splinters into my skin.
“Ma,” I say, but she’ll never hear me, and my words are squeezed and useless.
I get up and walk back to our room. The door rattles slightly as I open it, the light from the bathroom following me in.
“Rita?” It hurts to stand straight, to shake her awake.
“Lo?” she asks, half sitting up.
“My ribs hurt,” I say.
“Your ribs?” She pushes back the duvet. She’s heavy with sleep, and I wonder if I’m dreaming.
“My head hurts,” I say. And the tangled sleepiness of her hair makes me want to cry.
She puts her palm to my forehead and leads me back into the bathroom. I know what she’s looking for in the cupboard. I know she won’t find them.
The bile in my throat rises so quick that I have to push her out of the way. I hardly lift the toilet seat before I vomit the pain from deep inside me. Rita holds back my hair, but my head hurts too much and I pull away from her and start to cry.
“Did you eat anything strange when you were with Dean?” she asks as she flushes the toilet. I shake my head. “Did he make you take something?”
“No.”
“I think we should get you to a doctor,” she says. She’s filling the empty toothbrush mug with water and she holds it out for me. I’m so thirsty, but I don’t want to be sick again. “I’m going to get Ma.”
“No. Don’t wake her.”
“I’ve got painkillers under my pillow,” Rita says. “I’ll get them.” I grab onto her hand.
“It’ll help,” she says.
“I had them,” I say.
“Had what?”
“The acetaminophen.”
“And it didn’t make you better?” There’s worry in her eyes.
“I took them before.”
I pull my knees to my chest, but it hurts too much. I stretch my legs out, but the pain stabs so hard that I think I might be sick again.
“What do you mean ‘before’?” I can see in Rita’s eyes that she’s already working it out.
“Last night. I took some.”
She hesitates. “How many?”
“Twenty-one.”
“Jesus, Lo.” She crashes out of the front door. I hear her calling for Ma, for Dad. I lie on the floor and wait before Ma is here, in the doorway, in the bathroom.
“Did you take the pills?” she asks. I don’t want her to know. I don’t want any of them to know.
“When?” Dad is behind her, tying his shoes as he talks to me.
“Last night,” Rita says. Panic drifts off her in spikes.
Dad grabs my arm and pulls me up. “What were you thinking?” he asks. “That doing this would change my mind?” Change his mind? “About you seeing Dean.”
“Not now, Ray,” Ma shouts at him.
“Rita, stay with Gramps,” Dad says.
“I’m coming with you,” she replies.
“No. You’re staying here.” He’s half dragging me out of Terini, but it hurts so much to walk, my chest burning when my body is stretched straight.
“I want to come too,” I hear Rita say, and she starts to cry.
“She’ll be OK,” Ma answers. “Go into our bed and try to sleep. We’ll be back soon.”
Dad’s arms go under me and he lifts me up. The smell of him is close, and I wonder how I ever wanted to leave him.
“It’s not the pills,” I tell him. “That was too long ago.” It’s something else. I don’t know what it is, but it’s something very wrong.
Ma rests my head on her lap. The car smells too strong, and I want to be sick again. It moves so quickly, through the dark, street lights so bright that I have to close my eyes.
I want to see Dean. I want to see Spider.
The car stops, and they get out. Dad picks me up. We’re at a hospital.
“I’ll find you,” Ma says. “Go quickly.” And she’s driving off as Dad carries me inside. I press my head into his chest, hoping he’ll make the pain go away.
He stops running, and he’s shifting from foot to foot.
“I need to go in front,” I hear him say. And he’s forcing his way past someone, my legs brushing against people.
A little girl is crying.
“We’re first,” a woman says firmly. But my dad pushes through and leans me against a ledge.
“She’s taken an overdose,” he says. And now his voice cracks and I hold him tighter as his shame seeps into me.
He’s telling someone my name. That we’re travelers, so we don’t have an address.
“We don’t have time for this,” he growls.
“My head hurts,” I whisper into his shirt. I breathe him in, but the pain doesn’t go away.
“I’m not going to wait,” he shouts.
“Dad,” I say, but I don’t think he hears.
They tell him to sit on a chair, but he paces with me in his arms. His muscles, his back, must be burning, but he won’t let me go.
He paces and he paces and the thudding in my head is still here.
They call us into a room, and he sits down. I’m too big on his lap, but I’m a child again.
“So can you tell me a bit about what’s going on?” a woman’s voice asks.
“She’s taken an overdose,” my dad says sharply. “We need to see a proper doctor now.”
“I didn’t mean to,” I whisper. “Not really.”
“Laura.” The woman touches my arm and I look up. “Was it pills that you took?” I nod. “It’s very important that you try to tell me exactly what it was.”
“Twenty-one acetaminophen,” I say, and I feel Dad’s arms tighten around me.
“When?” she asks.
“I don’t know,” I say. She looks up at my dad.
“Last night, I think,” he says, his jaw clenched.
“A few hours ago?” the woman asks.
“The one before,” I say. There were pills in my hand and I put them in my mouth.
“And are you sure about how many you took?” she asks. I nod.
I think I am.
But why did I take them?
“Right,” she says. She puts her fingers on my wrist and we wait.
“My ribs hurt,” I tell her.
“Can you show me where?” she asks and I point to my right side. She nods, takes her fingers from my wrist and types something onto her computer.
“This is to test your blood pressure,” she says. She’s wrapping something around the top of my arm. “Have you ever had it done before?” I shake my head. “It will start to feel a bit tight and uncomfortable, but it won’t be for long.” She presses a button and the blue bandage on my arm swells.
“She needs to get the pills out of her,” Dad says. His chest heaves in and out. “You need to pump her stomach.”
There’s a beep and the squeezing on my arm starts to go.
“I’ll refer you through to the doctor as soon as I can. They’ll do blood tests, and the results of those will show us what we’re dealing with,” the nurse says. “Right, I need to take your temperature, Laura.” She’s holding a thermometer. It makes me want my mom, and I think I might cry again. “I’m just going to put it in your ear. It won’t hurt, OK?”
“She’s taken acetaminophen,” my dad says, his voice a solid wall. “We need to see a doctor, now.”
“I know you’re concerned.” The nurse tries to calm him, but I can feel his arms
ticking against me. “I’ll do this as quickly as I can.”
I think I’m going to be sick again and I have to breathe steady through my nose. I close and open my eyes. There’s a painting of a giraffe on the wall behind her. I try to count the spots on its body, but the sharp ache in my head clamps my mind tight.
She takes the thermometer from my ear.
“My head hurts,” I say.
“I know. It’s horrible for you. We’ll give you something to help as soon as we can. Now, if you can pop onto this chair, we can check your weight.”
Dad lifts me and places me on a cold, plastic seat.
“Great. We’re done,” the nurse says and she smiles at me before she looks at Dad. “If you could take Laura to the pediatric waiting room, it’s a bit nicer for you, less crowded. It’s just left outside of here and two doors down. Someone will come and get you as soon as possible.”
I rest my head into him. I feel him lift me, and I keep my eyes closed as he walks with me to a different room.
The pain is scooping me raw.
“Dad,” I cry and he holds me tighter.
“Not long now,” he says, and he starts to rock me. A man arrives and they put me in a wheelchair.
Ma is here, walking beside us. I let her take my hand.
In a room, Dad lifts me onto the bed, and Ma strokes my hair.
“My ribs hurt,” I tell her.
“They’ll give you something soon, Lo,” Dad says. The door opens and it’s a different woman.
“Hello, I’m Nurse Collins,” she says. She’s talking to none of us and all of us. “I’ll be looking after you for a while.” She smiles at me, but it makes my head hurt more. “You must be Laura.” I try to nod. “I’m going to take a bit of blood for tests. Is that OK?” But already she’s putting a tight band at the top of my arm.
Dad holds my other hand. His breathing is too quick.
“This will only hurt for a second.” The nurse is speaking to me. “A little scratch.” She puts the needle in my arm, and my dad holds my head so that I look away. A fish sinks his teeth in and sucks my blood.
“This is for basic liver function tests. The results won’t take long, and they’ll be able to show us the extent of any liver injury. And we’ll be looking at something called your creatinine levels, to check how your kidneys are doing.”
“Has she taken enough to do proper damage?” Dad asks, his arms going tense around me. I want him to squeeze away the pain in my head.
“The kidneys, less likely,” the nurse says. “It’s the liver we’re more worried about. This might hurt a wee bit more, Laura.” She’s holding my wrist, the tight band lower down on my arm. I try to pull away from her, but she holds me firm. “Laura, this is a really important one. We need to know if your liver is all right. And when we’ve done all the tests, we can give you something for the pain.”
“Hold still,” my mom says, and she bends down and kisses my forehead.
Another woman comes in, and I relax slightly as there’s no fish by her ankles, but then one bites me on the wrist and I scream.
“I’m sorry, sweetheart,” the nurse says. “This one does hurt. But we need to check your acid levels.”
They’re burning my blood.
“Try to keep her steady.” It’s the other woman talking.
“Hello, Laura. I’m Dr. Sangha,” I hear her say. I look up at her, as the wave of pain begins to pass, but I can’t speak. My words are caught in the net. “And are you her parents?” Ma and Dad look at her as though she’s a creature they’ve never seen before. She focuses back on me. “I’ve read from your notes that you’ve taken some pills, Laura.” I nod, as the nurse takes my arm again.
“Another small scratch,” she says, and I start to cry. My head hurts and my chest hurts and no one is listening to me. I’m drowning in this strange dream. “It’s all right, sweetheart. All done,” and she’s putting my blood away.
“Can you remember how many pills you took, Laura?” the doctor asks.
Dad’s hands are clumsy as he strokes my hair, spreading smoldering coal through my skull.
How many? I pushed them into my hand, one after the other.
“Sometimes more than one,” I reply.
“Do you remember how many in all?” the doctor asks gently.
“I don’t know,” I say.
“Twenty-one,” Dad says. “She took twenty-one.”
“And they were all acetaminophen?” she asks and I nod. “And it wasn’t this night, but the night before?”
“I think so.”
“And yesterday, did you feel anything? Did you have any symptoms?”
I shake my head. I don’t think so. I don’t know.
Yesterday. I want to wake up now with Dean in our starling field. Maybe he left me there and I’m waiting for him.
The nurse injects something through the tube stuck into my arm.
“This will help with the pain,” the doctor says.
“She needs something to get rid of the acetaminophen,” Dad says.
“I know this must be difficult for you,” she answers calmly. “We have to administer something called acetylcysteine. If it’s able to, it can neutralize the effects of the acetaminophen. There’s always a chance that Laura is confused about how many pills she took and when she took them.” The doctor looks at us. She pauses before she speaks again. “But I’m afraid that I have to warn you, the chances of the acetylcysteine working are very slight.” Ma’s grip tightens on my arm. “By the time it’s through, we should have the blood test results, and then we can make a plan.”
Dad breathes out heavily, as though he’s been holding his breath all his life.
“We’ll do everything we can,” the doctor says. And then she leaves us. We all stare at the door, until I curl on my side, away from my mom and dad.
When I blink, my eyelashes brush the pillow. It’s the sound of angels’ footsteps. If they’re in here, hidden in this room, they can save me.
Dean. I close my eyes and the angels walk away. Dean. I let my mom stroke my hair as I cry.
The nurse comes back in, and I turn to lie on my back.
“This is the acetylcysteine,” she says, as she hangs a see- through bag filled with liquid onto a straight pole by the bed. If I was small, I could walk up it with Rita and balance on the top together. “It will work through your system quickly and we’ll know soon whether it’s had any effect.” I watch as she straightens the thin tube running from it and clicks it onto the one sticking into my arm. “Hopefully you won’t get any side effects, but there’s a small possibility that it will make you feel a little sick and you might develop a bit of a rash. And if you’re worried at all about your breathing, just let us know.”
I fill my lungs with air. Each small breath keeps me alive. I hold my hands out, palm side up, and look at the lines that creep across my skin. They’re my lines, my handprint, my fingerprints that no one else has.
Rita and I have left footprints everywhere we’ve been. Tucked behind rubbish bins in the town with the shrieking child, hidden in the grass in the park where the fair kept us awake all night.
“Lo?” It’s Ma, looking close at me.
“Yes.”
But she doesn’t say anything else. She just puts my hand onto her cheek and waits for angels to come and work their magic.
★ ★ ★
The doctor looks different when she walks back in. She closes the curtain behind her and Dad holds tight to my hand.
“I’m afraid I don’t have good news,” she says. I watch her mouth as she speaks. The pause is filled with strange words.
“Laura, your blood results indicate severe liver damage.”
“The drip didn’t work?” Ma says.
“No. I’m afraid it was fighting against too much. It takes very few pills to do a lot of damage.” She pauses, as though we should speak. When we don’t, she sits down on the end of the bed. It makes the mattress tip, so we might capsize. “Laura, unfortun
ately any medicine we give you here can’t help. We’re suggesting transferring you to the liver unit at Kings Hospital in London.” She looks at my mom. “They’re in the best position to do further assessments and think about the next level of treatment.”
“What sort of treatment?” Dad asks.
“It’s difficult to say at this stage. They might discuss the possible option of a liver transplant,” the doctor says.
“A liver transplant?” Ma falters.
“Laura?” It’s the doctor’s voice. She’s looking at me slowly, the heavy blink of her eyes, the weight of her lashes. “Do you have any questions?”
She wants me to ask something, but I shake my head.
“Can she survive without a liver?” my dad asks, his voice an echo of his own.
“No, I’m afraid not,” the doctor says.
My dad begins to slowly shatter, like a piece of china. First a few small lines appear, legs of a spider, before they spread out and his eyes, his nose, his mouth fall through the cracks.
“There must be something else you can do,” I hear Ma say. Her words float like bubbles, and I pop them one by one. “Something you can give her to make her better.”
“I wish there was,” the doctor says. “But acetaminophen causes acute liver failure and the damage is often irreversible.”
I know I should say something, but the words get lost in the thudding in my head.
“You’ll have a transplant, Lo,” Dad says, his voice steel. “There’ll be a liver.”
I’ll get someone else’s liver.
“Do you have any other questions?” the doctor asks.
“How long will her liver last without a transplant?” Ma asks. The doctor pauses for a heartbeat that stretches too far around the room.
“Two or three days,” she says.
I see her mouth move. I know there are words and I reach for one.
“Days?” I look at her to change it, because days are short, days are too soon.
“I’m sorry. I wish that I could say something different.”
“When do we go to the liver hospital?” Dad asks.
“I’m going to arrange it now.”
The doctor doesn’t look me in the eye, as she flattens out the sheet on the bed and stands up.
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