To My Brother’s No-Nonsense Sister You were raised to think of your family as a choir in which singular voices did not ring out for individual recognition but were prized for their ability to harmonize and blend. Therefore, when your brother develops a disease that will ruin both of his kidneys, slowly and painfully, you volunteer, at age fifty-two, to donate one of yours for a transplant. You are not disturbed by the hospital donation coordinator who refuses to send you the consent form because “it might freak you out.” You do not linger over the years-long waiting list and those who die on it every day. You do not fuss or ruminate or wait to be asked. You have never used nitrous oxide for a dental procedure, acetaminophen for a mammogram, or even a pill for sleeping. So much wussy twaddle. Sadly, you are an alternative-reality sister and do not exist in corporeal form. And your brother—our brother—is still on the list. Waiting.
To My Brother’s Glass-Half-Full Sister Unlike No-Nonsense, you’ve combed the websites of transplant centers and kidney foundations. Glowing smiles accompany glowing stories. Donors and recipients reap mutual benefits. On forums, donors cite tidy incisions, quick recoveries, and profound personal rewards; they run in fundraiser marathons and become “donor ambassadors.” Amid this heroic assemblage of family members and friends, family and friends of friends, co-workers and co-workers’ relatives, church and temple goers, former classmates and even a kindergarten teacher who donated to a former student, how could you not donate to your own brother? Spare him the lonely, debilitating slog of dialysis? Improve—possibly, extend—his life? Help the next person on the list and inspire others to do same? You’ve never been a marathoner or a public speaker, but you could start now, couldn’t you? Become a greatly improved version of yourself?
To My Brother’s Glass-Half-Empty Sister You, too, have combed: One healthy donated kidney accidentally discarded; another contaminated by a ceiling drip; another placed in a misdiagnosed recipient; a donor’s aorta sliced during surgery. You’ve read studies about risk and even watched a nephrectomy video: the ligaments of the spleen divided with tiny scissors; the wet, squishy kidney “freed” within its webby white fasciae, the colon detached, veins cauterized, arteries clipped. If your body is your castle, you have sweat a knot of toads and dug yourself a treacherous moat.
To My Brother’s Sacrificial Sister Like No-Nonsense and Glass-Half-Full, you are compelled to donate. But unlike them, you see it as your calling, a chance to repay a debt you’ve incurred by breathing. How to go forth with two healthy kidneys when your brother has none? In the language of the King James Bible, your cup runneth over and the voice of your brother’s blood crieth unto you. In the language of a celebrated transplant surgeon, you were born with two, so you’d have one to donate. In your own language, you name one kidney Agatha Left and start telling her farewell.
To My Brother’s Sheepish Sister With clusters of rupturing cysts, your brother’s kidneys have swollen to the size of footballs, soaring his blood pressure and damaging other organs. When you tell him you’re worried about a nephrectomy’s consequences to your personal plumbing, he replies that lots of women become incontinent after menopause, so what’s the big deal? Your brother has a sense of humor; he also has a life-threatening condition. Maybe he’s joking. Maybe he’s not.
Immediately, the question around your father’s breakfast table is not whether you’ve considered an elective nephrectomy, but when you can be tested for compatibility.
“You’d better start right away,” says your father’s caregiver.
“I wish I could give him one of mine,” says your elderly father. “My lamp is on its way out. Your brother, he’s still young and sparkling.”
Your father mentions a distant step-relative who donated to a brother: “Both are just fine.”
You: “Were those two also adopted from different birthparents?”
“No.”
“Have you spoken to the donor in the last five years?”
“No.”
“Have you asked about any complications showing up later?”
“No.”
“Then how do you know the donor’s ‘just fine’?” “Well, I assume I’d have heard about it otherwise.”
To My Brother’s Raised-Eyebrow Sister Because your father often helps people and because he talks tirelessly about his son’s plight, several recipients of his generosity have offered a kidney. Two were neighbors in their seventies and two were caregivers needing car repair. None of the four got tested for compatibility. Or even filled out a form. With each offer, your father opens his heart and possibly his wallet. With each, he has hope and passes it along to your brother.
To My Brother’s Future Sister In five years, you will be diagnosed with malignant melanoma; you’ll have a second surgery before you’ve healed from the first. The cancer will find your brain. Nobody will know how long it has lurked in your body or how long it will stay or whether it will be fatal. In any case, you’ll be ineligible to donate, even posthumously.
To My Brother’s Only Corporeal Sister You and Sacrificial have long drifted. You and Future have not yet met. Unlike No-Nonsense and Glass-Half-Full, you’ve never healed quickly—from anything. Rather, you remain a mess of fear and shame about the removal of a major organ. Ultimately, your multiple selves don’t add up to the person you thought you were. And it is with this — its safety and its sorrow — that all of you must live.
Lisa K. Buchanan
Lisa K. Buchanan lives in San Francisco. Her writings can be found in Bending Genres, The Citron Review, and The Ekphrastic Review. Recent honors: Semi-finalist, Short CNF Contest, Cleaver, 2024; Notable, Best American Essays 2023. Current favorite book: Cain by Jose Saramago. Find her online at www.lisakbuchanan.com.
