Side Effects by Brenna Cameron

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Side Effects 

   “I shouldn’t even say this.” Mom looks at me, tears in her eyes. 
    We’ve alternated the entire weekend of who has tears in their eyes. Whose turn it is to cry. It’s her turn. 
    “Do you know what I’m going to say?” 
    I shake my head no. 
    She takes a sip of her wine. She’s the one who suggested we get a drink after we drove away from the hospital. A building tucked into suburbia. Off the highway where just minutes before there were only corn fields and oil rigs. It’s different than anywhere else my sister’s been before. A hospital not meant for patients with IVs or breathing tubes, but something more sinister, something you can’t always see. It’s a place where all the handles are smooth and patients’ bags are checked for metal-containing bras, drawstrings on pants and jackets.    “To keep everyone safe,” the nurse explained to us as we dropped a bag of my sister’s clothes off at the front door. 
    The bourbon burns my throat, taking away the sour taste in my stomach. 
    “Sometimes I question whether all of this was worth it,” Mom says now, taking a sip of her wine. “Should we be treating these kids if this is what they’re up against?” 
    I nod. “I think about it nearly every day.” That is, every day since Caitlin became sick again. 
    We were twelve when she was diagnosed with brain cancer. She survived, but just barely. It took her gallbladder and her adrenal gland. It destroyed her pituitary’s ability to make any hormones. It all seemed like acceptable trade-offs at first. The biggest worry she had were the scars the size of little fists on her chest and abdomen – she didn’t want to wear a bikini. And the lack of hormones meant she hadn’t gotten her period, which for my sister—the perpetual tomboy—was at first a relief, and then when everyone else had her period, something she asked the doctor if it wasn’t just something they could get going already. But more than that it made her brain slow so instead of taking fifteen minutes to study for the upcoming Spanish quiz, she took an hour. It made it so driving was nearly impossible—the process of deciding which lane to be in, checking the side mirror while also keeping the car straight, realizing that you needed to speed up to merge—too much for her to handle. And then there was her coordination, which was never quite the same afterwards. Instead of becoming the star soccer player of the high school team – which by all means she was slated to be when she was ten years old, a dribbling, athletic fiend – she barely made the freshman team. Her run was now awkward and tilted. Just a year later, she quit. “It’s not the same,” she admitted. “I’ll never be what I once was.” 
    We were the same age – triplets – and yet, it became clearer as we grew up that her development was forever arrested as a thirteen-year-old girl. When we graduated college, she moved back in with our Mom, while Pierce and I moved abroad – me to Thailand, and Pierce to Central America. I went to medical school. Pierce started a business. And Caitlin, she wanted so much for herself – to go back to school and get her master’s, to move out, to be independent – and for reasons that she couldn’t understand, these goals were not entirely obtainable. 
     And then, when we were twenty-eight years old, she became sick again. It was Thanksgiving. Her speech began to slur, and I – a third year medical student at the time – thought it was a stroke. Her neuro exam, though, was fine and so we waited a day to take her to the emergency room, where they did an MRI. There was a turkey in the oven at home because my mother, a perpetual holiday freak, wanted another full Thanksgiving dinner on Black Friday. The doctor came in, sitting down on a stool and as he said the words out loud – “There’s a lesion in your speech center” – it didn’t quite register that this would start her cycle of illness all over again. 
    For months she had tests and imaging, everyone too scared to go into her brain and take whatever it was out. To obtain a level of certainty. It was either cancer – a different kind this time – or demyelination—the nerves in her central nervous system being stripped of their protective sheathing. Either way, both would be from the radiation she received to cure her the first time. The diagnosis only became clear as she declined. She started falling more, tripping over herself and falling down the stairs. And then, over the course of a single weekend, she could suddenly no longer sit up on her own. She couldn’t dress herself or go to the bathroom. That was when the doctors could say with certainty that this was demyelination. A type of MS, they said, because they didn’t know how else to explain it.  
    At first, we all felt relief. It wasn’t cancer. But this was another type of torture. A slow death. It wouldn’t take her in a year but eventually, it would kill her. They placed a central line in her neck, the catheters taped to her skin so she could only sleep on one side. She got better in some ways – able to sit and stand and walk again. But there were small changes, her brain slowly being eaten away, little chunks of grey matter disappearing, so small that the MRI could barely pick it up – just little blips of flare. 
    They go into the emergency room on Friday for a sore throat, my mother calling me on my work break to inform me, but also to ask my opinion. Despite my mother being a nurse, we have now officially transitioned roles. I am the medical confidant. The advisor. The one who reads and interprets the MRI scans for everyone in the family. Who breaks down the treatments and the research. It’s a role I take on with trepidation. It’s odd still, to be the one who knows the most. I want to know less. 
    For reasons I can’t explain then, I have a terrible feeling. It’s just a sore throat, I tell myself. But an hour later, when my mom calls back to give me an update she whispers into the phone: “Brenna, she says she’s suicidal.” 
    It’s not entirely a surprise. She’s had these thoughts before. But when the psychiatrist sees her, Caitlin, unbeknownst to all of us, says she has a plan to kill herself. The psychiatrist recommends inpatient psych treatment. They take her clothes, giving her a pair of scrubs instead that I swear are made from a fine plastic, not even a thread of cotton holding them together. 
    “I know she wasn’t happy,” I tell my mother now, taking a sip of my wine. “But I didn’t realize just how unhappy she was. What she was willing to do.” 
“I don’t know that she would have done any of those things,” Mom says. She taps her finger against the wood grain of the table. 
I nod. Although I’m not so sure. I don’t know what to believe. 
    We talk about how anyone in Caitlin’s position would feel the way she does. Lost and alone. And stuck. Completely stuck. 
    “She’s thirty,” my mom says. “Thirty years old.” 
    “And she can’t drive. Can barely work. She lives with her mom.” 
    “She has no friends,” Mom adds. 
    I nod. Cancer has taken away so much. Her brain was never quite normal after all the radiation—when they did it, they had her face down on a table, a custom-made cage screwed over the back of her head, so they knew just where to aim the protons – but now her white matter is crumbling. And if her brain can’t fire well enough to keep her upright going down a set of stairs then it’s no wonder that it’s hard to convince herself to want to be alive. It’s no wonder that her brain is sick in more ways than one. 
    She is suffering a long, slow death and there is nothing I can do but love her. She is not alone. 
Childhood cancer forces toxic chemicals into a growing body. A growing brain. The rates of cure have increased astronomically – a child diagnosed with leukemia now has a 90% chance of survival. But these numbers fail to encompass everything that comes afterwards. The decade later where their brains begin to crumble, where second cancers set in, and it becomes glaringly obvious that they will never be a normal adult. It’s not everyone but it certainly isn’t just Caitlin. 
    “We’ll look back ten years from now and think how good we had it then,” Mom says, taking the final sip of wine. I shiver. Despite my jacket, I’m not used to the autumn chill. 
    “Ten years,” I repeat, unable to hide my surprise. My distaste. “In ten years, I hope—” I hesitate, fingering the stem of my wine glass. “In ten years, I hope she’s dead.” Now it’s my turn to cry. 
    “I don’t think she will be.” 
It’s the saddest thing I’ve heard all day. 


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Brenna Cameron is an emerging writer and a pediatrician living in Denver. Her fiction and poetry have previously been published in Please See Me, Vessel Arts Magazine, The Human Touch, and Cross Currents. In her free time you can find her playing in the Rocky Mountains with her dog Rowan.