upwards.
‘I’ll paint them,’ Tippi says,
and takes the polish from the nurse
who won’t leave until every nail
is red.
‘Thank you,’ I tell Tippi,
who is blowing on my fingernails
as she always does,
and
I tell myself
that this makes perfect sense—
that the doctors should be playing it safe
to prevent any mistakes tomorrow.
But I can’t help thinking that
the red polish is telling the doctors
less about whose heart to look out for
and more about
the life they should relinquish
if it comes to it.
Before Bed
I unlatch the rabbit’s foot pendant from
around my neck
and put it on the nightstand
before turning out the light.
I don’t want it any more.
I don’t need it.
Luck is a lie.
All Night
All night Tippi and I lie with our arms
wrapped around each other
like rope.
I bury my face in her neck
and she wakes every now and then
to kiss the top of my head.
When the birds begin to sing
and the sky turns peachy,
we lie looking at each other,
our eyes too tired for tears.
Tippi rubs my nose with her own.
‘It’s all going to be OK,’ she says.
‘And even if it’s not OK. It really is.’
Separation Day
Mom is clutching our hands and Dad is holding her up.
‘We love you,
we love you,
we love you,’ they say
over and over
like an incantation.
A nurse drags them away
and the swing doors to the operating room gobble us up.
It seems like a thousand people are in the room
and when we enter they are silent.
Dr Derrick takes centre stage.
‘Ready?’ he asks.
We are nudged on to the operating table
like meat on to a chopping block.
‘As ready as we ever will be,’ Tippi says.
Dr Derrick leans down so only we can hear him.
‘I’ll do my best
to keep you together.
I’ll do my very, very best,’ he whispers.
I squeeze Tippi’s hand and she rolls her head to the side
to look at me squarely.
‘See you soon, sister,’ she says
and presses her lips against mine
like she did when we were little.
‘Soon,’ I say.
We rest our heads against each other
and suck in silence.
I Move My Head to Look for Tippi
She is not here.
Not beside me in the bed
nor in the room
at all.
It has happened.
I am alive and I am
alone
in a land of
so much
space.
It has happened.
Sick
Mom, Dad, and Grammie are squeezing different
parts of my body,
gripping on to me like I might
float away if they didn’t.
Dragon stands at the end of the bed.
Her eyes are red-rimmed,
her face wrung out.
Mom sobs.
Dad sniffs.
Grammie’s nostrils quiver.
Dragon is the only person who can talk.
‘Your body is doing well with the Heartware,’ she
tells me.
‘And they’ve put you on a list.
You’re on a list to get a heart, Grace.’
A twisted smile.
‘But Tippi is not doing so well.
She lost a lot of blood during the operation
and now
she has an infection.
She’s pretty sick.
Like,
she’s very sick.’
‘I want to see her,’ I say.
‘I want to be with her.’
Dragon nods.
‘We knew you’d say that.’
Holding On
Tippi is hooked up to as many wires and tubes as I
am.
She is lying in a quarantined room,
doctors darkly mumbling and skulking in a
corner,
a monitor persistently beeping
next to her.
The huge wound at my hip burns.
My stomach clenches.
Swallowing slices my throat.
‘Put me next to her,’ I say.
The doctors shake their heads and
the nurses bow because there’s no way they will
defy their superiors.
‘Let me lie next to her,’ I beg.
Dad grunts and without asking permission,
pushes my trolley bed as close to Tippi’s as he can.
‘Help me move your sister,’ he tells Dragon,
and suddenly the doctors dart across the room
and
I slide gently
on to Tippi’s bed
along with a bag
the size of a laptop
that is keeping me alive.
My body pounds and I scream out.
But still Tippi does not move.
Her breath is as delicate as lace,
her face is calm
like she never expected this to go any other way.
I put my arms around her.
Hold on.
Sinking
In the morning Tippi’s eyes are
narrow slits letting in hardly any light.
I use my fingertips to stroke her lips.
‘Hello,’ she says
in a barely-there voice
and again, ‘Hello.’
Against the pain, I press my chest into her,
try to make our bodies merge.
She winces and shakes her head.
‘I’m sinking,’ she says.
‘You’re not,’ I lie.
Tippi manages a little laugh,
all her skepticism wrapped up in it.
‘Remember your promise,’ she tells me.
What am I supposed to do?
I don’t know
so I say the words I would want to hear,
‘Go, if you have to.’
A corner of Tippi’s mouth lifts as
her eyes close.
Her eyes close
and they do not open.
‘Go,’ I repeat.
‘Go, go, go.’
Gone
Dr Derrick stands over me in a clean white coat,
his stethoscope dangling
like an ugly necklace.
Dad is next to him,
a greying beard grown in.
Mom is by the door
in shadow.
‘Can you hear me?’ Dr Derrick asks.
I can hear but
I do not move.
I blink and he speaks.
‘Tippi’s gone,’ he says.
‘All I can say is I’m sorry.
I’m so, so sorry,
but I know that’s not enough.’
‘Get out,’ I say,
turning away from everyone and
hating them all equally.
Tippi
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi? Tippi? Tippi? Tippi? Tippi? Tippi? Tippi?
Tippi.
I Ache
I howl and I scream.
I ache for my sister.
‘Tippi,’ I whisper into the darkness.
I ache for my sister.
‘Tippi!’ I beg from the darkness.
I howl and I scream.
I ache for my sister.
I howl and I scream.
I ache for my sister.
I ache for my sister in my blood and bones
in my limbs and my veins.
I ache for myself.
‘I love you,’ I tell her
and I ache.
‘I miss you,’ I tell her
and I ache.
And this aching,
this aching,
it will not
go away.
Her Heart
I want it in me.
I do not want them to throw it away.
I want it in me.
To save me.
To save it.
To save her.
A little bit of her.
‘Tippi’s heart wasn’t healthy enough
to use in any transplant,’ Dr Derrick’s
voice mutters.
‘And anyway, it’s too late.
It’s far too late for that
now.’
And I know it’s true.
But it is such a waste.
Tippi always had
a very strong
heart.
Healing
A nurse with wire-brush hair is by my side.
A latex glove presses on my arm.
My body burns from the
inside
out.
I feel banging in my bones,
thudding behind my ribs,
a stabbing like glass is being injected
all over my skin.
The pain is exhausting and endless.
It is
more than I ever imagined
I could feel.
I croak
and the latex tightens around my arm.
‘Are you hurting?’ the nurse asks.
‘Yes,’ I tell her.
She fiddles with a bag of clear solution
hanging by my bed
as though a morphine refill will fix me.
‘All better soon,’ she says.
But how can that be true?
How can anything she gives me
take away this pain?
Voices by My Bed
She needs
some fresh air.
She needs
more meds.
She needs
to get home.
She needs
our prayers.
She needs
her family here,
her friends close by.
She needs
a chance to grieve,
a chance to talk,
a chance to laugh.
She needs
water,
drugs,
silence,
time.
But I need
none
of these things.
What I need
is
Tippi.
Improvement
Today I have eaten half a cracker,
and the doctors are pleased.
Anorexie
Dragon is the first person I agree to see.
She sits on my right,
not trying to fill the void on my left,
and talks about the weather—
the snow which is three feet high
in Hoboken today.
And about Dad who has
moved back home
for weeks, as far as she can tell.
Dragon’s bones poke through her skin.
Her gaunt face is ghostly.
‘Are you anorexic?’ I ask,
suddenly sure she is and angry with myself
for not saying something sooner.
She nods. ‘Probably.’
‘That would have pissed Tippi off,’ I tell her.
‘We’ll have to do something about it.’
Dragon puts her head on my pillow
and squeaks out a cry.
‘I miss her, too,’ she says.
‘We all do.
So, so much.’
Recovery
I tell Mom not to postpone the funeral,
that I’ll be in the hospital many months
and I don’t want to make Tippi wait.
Instead I get Paul to record the service
—which he does—
then he leaves a slim silver DVD next to my bedside
so I can see how it happened.
When I am stronger, I will watch.
I will watch my
Aunty Anne singing about a bird with wide wings,
Yasmeen reading a poem about
carrying the dead’s heart in our hearts,
my father, uncles, and Jon carrying Tippi’s coffin
to a hole in the earth and
lowering her into it.
I will do all of this.
But for now I am in the hospital recovering,
letting the wounds heal
and waiting for the doctors to cut out my heart
and replace it with one that’s not broken.
‘Time is a healer,’ Dr Murphy tells me,
and though I don’t believe her,
I let time pass.
I let time pass
and
I live.
I live in hope
that soon,
very soon,
another human heart
will be stuffed
inside me.
I live in hope
that a dead person’s heart will
revive me.
Speaking
Caroline comes alone,
no Paul or Shane,
just her and a camera,
though she says it’s too soon.
Maybe she’s right but she
sets up at
the end of my bed and
starts rolling
anyway.
‘I want to talk,’ I say.
‘I want to speak it out.’
‘Fine,’ Caroline says.
I turn my head to the left
to let Tippi start,
forgetting that I am a singleton.
This will happen
for the rest of my life:
I will never remember that she has gone.
‘Go on,’ Caroline says.
And I do.
I go on.
My Story
This is my story.
It is mine alone because I am the one who needs
to tell it.
I am the one who is still here,
no longer stage right but
centre stage.
It is a single story,
not two tales tangled up in each other
like lovers’ limbs,
as you might expect.
And anyway, Tippi was
always pretty good at getting heard.
I have hidden from the world for a long time.
I have been a coward.
But here is my story.
The story of how it is to be Two.
The story of how it is to be One.
The Story of Us.
And it is an epitaph.
An epitaph to love.
Author's Note
Although this novel is a work of fiction, the lives of Tippi and Grace, their feelings about being conjoined, and many of the details about how the public treats them, are based on amalgamated stories of real-life conjoined twins,
both living and dead. Particularly helpful books have been Conjoined Twins: An Historical, Biological and Ethical Issues Encyclopedia, by Christine Quigley, and Very Special People, by Frederick Drimmer, as well as a score of documentaries on the subject, most notably BBC2’s ‘Horizon: Conjoined Twins’ and BBC3’s ‘Abby and Brittany: Joined for Life’.
The ethicist Alice Dreger’s writings on conjoined twins and people living with unusual anatomies have also profoundly informed my views on separation surgery. As all cases of conjoined twins are unique, the hypothetical medical situations in this novel are based on conversations with leading heart specialists from University College London, Great Ormond Street Hospital for Children, and particularly with Edward Kiely, one of the world’s leading surgeons for conjoined twins.
It might be astounding to a singleton, but conjoined twins do not see themselves or their lives as tragedies. Two such twins are Abby and Brittany Hensel, born in Minnesota in 1990, who have said they never wish to be parted. Abby and Brittany have appeared on many TV shows and in documentaries in the hope that by allowing the public into their lives, they will be left to live as normally as possible. They have completed college, travelled to Europe with their friends, and now work as elementary school teachers. They are a testament to the fact that separation, especially a separation which puts one particular twin at great risk, isn’t always the best option.
Many conjoined twins have lived full and happy lives, and several have married and had children. Arguably the most famous conjoined twins in history were Chang and Eng Bunker (originally from what was then called Siam, hence the term ‘Siamese twins’) whom I reference in this novel. They married a pair of American sisters, shared their time between two homes, and fathered twenty-one children. Their descendants continue to meet regularly and celebrate the legacy of these two men.