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sound out of breath,” my father says. “How about we keep our voices calm?”

      This is an infuriating suggestion since he’s the one who’s not calm, but his observation is accurate; I’m having trouble catching my breath. I concentrate on forcing air in and out of my chest.

      I notice that we’re only talking about Julia’s heart, even though she’ll give me so much more—her liver, part of her large intestine, her kidneys, even her pancreas. It’s too depressing to keep mentioning all the pieces of both of us that aren’t working right, so my parents and I have begun using the heart as a stand-in for everything.

      I look up at him wearily. “Dad, why do we keep talking about it, anyway? You already decided.”

      “You decided too, Evan.”

      I sigh, and though I try to sound as angry as possible, he’s right. I did decide.

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      When the nurses show up to do tests, my father leaves. He doesn’t like to stick around for the nitty-gritty, which used to annoy me but now is a relief. If my father is present, he considers it an obligation to insert as many positive comments as possible into whatever uncomfortable hospital procedure is happening. It’s not ideal to have to make appreciative noises about the weather and baseball scores when a male nurse is putting a catheter into your penis, for example.

      With my father gone, I hardly have to say anything.

      Nurse: “Does that hurt?”

      Me: “A little.”

      Nurse: “Is this better?”

      Me: “A little.”

      Nurse: “Can you roll over onto your back now?”

      I don’t even have to answer that. I just have to do it.

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      Later, I’m left alone in my hospital room. This is the last day. It will happen in the morning. Julia and I have just barely made it to our fifteenth birthday. And now comes … whatever is next.

      I am not immune to daydreams. I imagine slipping on my clothes, walking out of the hospital, and asking my mother to bring me somewhere peaceful to die. My favorite fantasy locations are on a beach overlooking Lake Michigan, or on the moon base, while staring up at the small blue face of Earth.

      Yes, I know there isn’t any moon base, but I’m not sneaking out of the hospital either.

      The daydreams are tempting, but here’s the truth of it: death sucks more than life, almost no matter what. There. I’ve admitted it. I want to live. Blech. It feels wrong.

      I get off my hospital bed and go into the connecting room, Julia’s. My heart races as soon as I’m on my feet, but if I move slowly, I can keep it from getting out of hand. Julia’s room is kept nice and quiet and mostly dark, though it’s still daytime, so cloudy light comes in through the slatted blinds over the window. Her ventilator hisses and clicks. Her bed is surrounded by IV stands that are providing her food, her water, her drugs. Dripping, dripping, dripping away.

      “Hey,” I say, out of breath when I reach the edge of her bed.

      Hey, she says. Not out loud, of course. But I know she says it.

      Julia is gray and her cheeks are hollow, but she’s still beautiful. Her hair is red, like mine, but hers is much longer and it’s been fanned out across her pillow (by our mother, probably), as if she’s posing for an illustration in a book of fairy tales. Here is Snow White, awaiting the kiss of a prince to wake her. Here is Sleeping Beauty, for whom the rest of the world has been frozen. I slide myself onto the bed next to her and lie there as my heart and lungs slow down, listening to the sounds of the machine that is breathing for her.

      “Hey,” I say again.

      It’s so boring here, she tells me quite clearly, though, again, not out loud. The time when Julia can speak out loud is over.

      “I’ve realized that being a medical pioneer is mostly about surviving the boredom,” I tell her.

      Julia sighs, silently of course. Then she tells me, When the doctor calls us that, I imagine us in a covered wagon with one of those old-timey black doctor’s bags.

      “Why do people think being a pioneer is good?” I wonder aloud. “Isn’t it better to be waaay at the back of the line, after all the kinks have been worked out?”

      This is going to sound mean, Julia tells me, but I never even liked real pioneers. In those Little House books, I kept wondering why they didn’t stay in New York or Chicago, where all the fun stuff was happening.

      “You’re a snob,” I tell her. “They were brave.”

      Yeah, they probably were, she admits. Then: You’re going to be brave too, Evan.

      “Yuck. You sound like one of those greeting cards with the fancy cursive.”

      I got sappy there for a second. Sorry. It’s from being in the hospital. She changes the subject. Where have you been all afternoon?

      “Tests. Oh—this is exciting—they took a sample of my poop. New test. I guess it was to see what my large intestine is doing.”

       What were the results of this poop test?

      “It was poop. They confirmed that.”

      Well … that’s a huge load off my mind, she says.

      “After the test they plopped me back onto the bed.”

       I’m flushed with relief that everything’s okay.

      “It would have been so crappy otherwise.”

      We both laugh. Me out loud. Julia, you know, not out loud. Annoying puns are kind of our thing. I scoot over until my head is against hers.

      I forget what that’s like, she says.

      “What? Tests?”

       Moving.

      “Oh. Right.” Even though I’m here with her so much, sometimes I forget too.

      We’re both quiet for a while, but I know what Julia’s thinking about. She’s remembering that time when we were five years old, and she beat me twenty-four times in a row running down the street outside our house. I can feel her gloating.

      I tell her, “Look, you beat me that one time—”

       It was twenty-four times, Evan.

      This is an old argument.

      “Fine. You beat me on that one day. But I never let you beat me again,” I remind her.

      What neither of us says is that we didn’t have many races after that day when we were five. Running became too difficult for either of us, and the following year, it was apparent that very few of our organs were growing at the proper rate.

      Relax, Evan, she says. You’ve won forever now.

      I don’t answer her because that’s a horrible thing to say. If we were having one of our competitions to see who could say the most despicable thing, she would totally win.

       Oh shit, are you crying? I didn’t mean it. I was only joking!

      I put my hand over Julia’s heart, and then I put Julia’s cool, limp hand over mine. It’s possible that I am crying, but there’s no reason to dwell on it.

      In that calm way of hers, Julia tells me, We shared a womb, Evan, and a crib, and a room for the first six years of our lives. Now we’ll share more things. It will be okay.

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