The Book of Why by Nicholas Montemarano Page B

returned to her breathing. She was good at living in the present even if it was unpleasant.
    It was August, hot and humid. A sweaty young man, too skinny, hair in a ponytail, paced the ER, his shoulder bleeding through his white shirt. He had large, frightened eyes and the long, delicate fingers of a pianist. A short, overweight woman sat across from us, moaning. Her legs and arms were stubby, but her face was beautiful. She took off her shoes and socks, as if this might help. Her feet were dry and calloused, her toenails painted pink. A nurse had to call the woman three times before she looked up; it was as if she’d forgotten her own name. She took her shoes with her, but left the socks behind.
    When a nurse called Cary’s name—we had been waiting two hours—she turned to me and said, “My sister was pregnant when she died.”
    I didn’t know how to respond; it was the last thing I expected her to say.
    â€œWhen I told you the story, I left that part out.”
    â€œIt’s not your fault,” I said.
    â€œI just wanted to tell you,” she said, and together we went to see the doctor.
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    It was one of the first stories she told me about herself when we were dating. She bought her father flying lessons as a retirement gift; he had retired early, in his late fifties. After he earned his license, he planned a day to take Cary, her sister, Parker, and their mother for a flight over the Berkshires. But Cary woke that morning with the flu and couldn’t get out of bed. She hadn’t been that sick in years—not since the chickenpox in sixth grade. Her father said they could reschedule, but Cary said they should go without her; there was always next time.
    Even had anyone remembered that she’d bought the flying lessons, that it had been her idea, no one would have blamed her.
    At the funeral, Parker’s husband—widower, rather—leaned over to Cary and said, “She was pregnant. She told me a few days before.”
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    â€œMaybe we’re not supposed to have children,” she said. “Maybe it’s something we have to accept.”
    We were making a salad. I was peeling carrots, Cary was chopping lettuce. The knife against the cutting board, the pile of carrot peels in the sink, the whir and suck of the garbage disposal—we both had strong déjà vu. It was as if the conversation we were about to have had already happened, as if we were reading a script. I knew all my lines. I even knew that I was about to say something foolish, that I was about to make a mistake.
    â€œYou accept things too easily,” I said.
    â€œLife’s easier that way.”
    â€œYour life, maybe. But this is our life.”
    â€œIt’s my body.”
    â€œI don’t think you should give in so easily.”
    â€œYou heard the doctor.”
    â€œDoctors don’t know everything.”
    â€œThings happen for a reason,” she said.
    â€œBut we’ve talked about having children,” I said. “They have names.”
    â€œThat wasn’t a good idea.”
    â€œI saw them,” I said. “They were real.”
    â€œThey were never real,” she said.
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    I couldn’t bring myself to tell her what I really believed: that her guilt about her sister—about her entire family, but especially about her pregnant sister—was causing her endometriosis. Her guilt, unless she changed her thoughts, would never allow her body to become pregnant.
    The doctor was recommending that her ovaries—each covered with a grapefruit-sized cyst—come out immediately, before the cysts could rupture. Her bladder, bowels, and uterus were covered with scar tissue.
    We went to see a fertility specialist, who gave us an option other than hysterectomy: surgery to remove the cysts and scrape away the scar tissue, followed as soon as possible—whenever Cary recovered—with fertility drugs and hormone injections.
    Cary