About the Author
Jodi Picoult received an AB in creative writing from Princeton and a master’s degree in education from Harvard. The recipient of the 2003 New England Book Award for her entire body of work, she is the author of twenty-six novels, including the #1 New York Times bestsellers House Rules, Handle With Care, Change of Heart, and My Sister’s Keeper, for which she received the American Library Association’s Margaret Alexander Edwards Award. She lives in New Hampshire with her husband and three children. Visit her website at JodiPicoult.com.
Excerpt. © Reprinted by permission. All rights reserved.
Handle with Care PROLOGUE
February 14, 2002
Things break all the time. Glass, and dishes, and fingernails. Cars and contracts and potato chips. You can break a record, a horse, a dollar. You can break the ice. There are coffee breaks and lunch breaks and prison breaks. Day breaks, waves break, voices break. Chains can be broken. So can silence, and fever.
For the last two months of my pregnancy, I made lists of these things, in the hopes that it would make your birth easier.
On the night before you were born, I sat up in bed with something to add to my list. I rummaged in my nightstand for a pencil and paper, but Sean put his warm hand on my leg. Charlotte? he asked. Is everything okay?
Before I could answer, he pulled me into his arms, flush against him, and I fell asleep feeling safe, forgetting to write down what I had dreamed.
It wasn’t until weeks later, when you were here, that I remembered what had awakened me that night: fault lines. These are the places where the earth breaks apart. These are the spots where earthquakes originate, where volcanoes are born. Or in other words: the world is crumbling under us; it’s the solid ground beneath our feet that’s an illusion.
· · ·
You arrived during a storm that nobody had predicted. A nor’easter, the weathermen said later, a blizzard that was supposed to blow north into Canada instead of working its way into a frenzy and battering the coast of New England. The news broadcasts tossed aside their features on high school sweethearts who met up again in a nursing home and got remarried, on the celebrated history behind the candy heart, and instead began to run constant weather bulletins about the strength of the storm and the communities where ice had knocked out the power. Amelia was sitting at the kitchen table, cutting folded paper into valentines as I watched the snow blow in six-foot drifts against the glass slider. The television showed footage of cars sliding off the roads.
I squinted at the screen, at the flashing blues of the police cruiser that had pulled in behind the overturned vehicle, trying to see whether the officer in the driver’s seat was Sean.
A sharp rap on the slider made me jump. “Mommy!” Amelia cried, startled, too.
I turned just in time to see a volley of hail strike a second time, creating a crack in the plate glass no bigger than my fingernail. As we watched, it spread into a web of splintered glass as big as my fist. “Daddy will fix it later,” I said.
That was the moment when my water broke.
Amelia glanced down between my feet. “You had an accident.”
I waddled to the phone, and when Sean didn’t answer his cell, I called Dispatch. “This is Sean O’Keefe’s wife,” I said. “I’m in labor.” The dispatcher said that he could send out an ambulance, but that it would probably take a while—they were maxed out with motor vehicle accidents.
“That’s okay,” I said, remembering the long labor I’d had with your sister. “I’ve probably got a while.”
Suddenly I doubled over with a contraction so strong that the phone fell out of my hand. I saw Amelia watching, her eyes wide. “I’m fine,” I lied, smiling until my cheeks hurt. “The phone slipped.” I reached for the receiver, and this time I called Piper, whom I trusted more than anyone in the world to rescue me.
“You can’t be in labor,” she said, even though she knew better—she was not only my best friend but also my initial obstetrician. “The C-section’s scheduled for Monday.”
“I don’t think the baby got the memo,” I gasped, and I gritted my teeth against another contraction.
She didn’t say what we were both thinking: that I could not have you naturally. “Where’s Sean?”
“I . . . don’t . . . kno—oh, Piper!”
“Breathe,” Piper said automatically, and I started to pant, ha-ha-hee-hee, the way she’d taught me. “I’ll call Gianna and tell her we’re on our way.”
Gianna was Dr. Del Sol, the maternal-fetal-medicine OB who had stepped in just eight weeks ago at Piper’s request. “We?”
“Were you planning on driving yourself?”
Fifteen minutes later, I had bribed away your sister’s questions by settling her on the couch and turning on Blue’s Clues. I sat next to her, wearing your father’s winter coat, the only one that fit me now.
The first time I had gone into labor, I’d had a bag packed and waiting at the door. I’d had a birthing plan and a mix tape of music to play in the delivery room. I knew it would hurt, but the reward was this incredible prize: the child I’d waited months to meet. The first time I had gone into labor, I’d been so excited.
This time, I was petrified. You were safer inside me than you would be once you were out.
Just then the door burst open and Piper filled all the space with her assured voice and her bright pink parka. Her husband, Rob, trailed behind, carrying Emma, who was carrying a snowball. “Blue’s Clues?” he said, settling down next to your sister. “You know, that’s my absolute favorite show . . . after Jerry Springer.”
Amelia. I hadn’t even thought about who would watch her while I was at the hospital having you.
“How far apart?” Piper asked.
My contractions were coming every seven minutes. As another one rolled over me like a riptide, I grabbed the arm of the couch and counted to twenty. I focused on that crack in the glass door.
Trails of frost spiraled outward from its point of origin. It was beautiful and terrifying all at once.
Piper sat down beside me and held my hand. “Charlotte, it’s going to be okay,” she promised, and because I was a fool, I believed her.
· · ·
The emergency room was thick with people who’d been injured in motor vehicle accidents during the storm. Young men held bloody towels to their scalps; children mewed on stretchers. I was whisked past them all by Piper, up to the birthing center, where Dr. Del Sol was already pacing the corridor. Within ten minutes, I was being given an epidural and wheeled to the operating room for a C-section.
I played games with myself: if there are an even number of fluorescent lights on the ceiling of this corridor, then Sean will arrive in time. If there are more men than women in the elevator, everything the doctors told me will turn out to be a mistake. Without me even having to ask, Piper had put on scrubs, so that she could fill in for Sean as my labor coach. “He’ll be here,” she said, looking down at me.
The operating room was clinical, metallic. A nurse with green eyes—that was all I could see above her mask and below her cap—lifted my gown and swabbed my belly with Betadine. I started to panic as they hung the sterile drape in place. What if I didn’t have enough anesthesia running through the lower half of my body and I felt the scalpel slicing me? What if, in spite of all I’d hoped for, you were born and did not survive?
Suddenly the door flew open. Sean blew into the room on a cold streak of winter, holding a mask up to his face, his scrub shirt haphazardly tucked in. “Wait,” he cried. He came to the head of the stretcher and touched my cheek. “Baby,” he said. “I’m sorry. I came as soon as I heard—”
Piper patted Sean on the arm. “Three’s a crowd,” she said, backing away from me, but not before she squeezed my hand one last time.
And then, Sean was beside me, the heat of his palms on my shoulders, the hymn of his voice distracting me as Dr. Del Sol lifted the scalpel. “You scared the hell out of me,” he said. “What were you and Piper thinking, driving yourselves?”
“That we didn’t want to have the baby on the kitchen floor?”
Sean shook his head. “Something awful could have happened.”
I felt a tug below the white drape and sucked in my breath, turning my head to the side. That was when I saw it: the enlarged twenty-seven-week sonogram with your seven broken bones, your fiddlehead limbs bowed inward. Something awful already has happened, I thought.
And then you were crying, even though they lifted you as if you were made out of spun sugar. You were crying, but not the hitched, simple cry of a newborn. You were screaming as if you’d been torn apart. “Easy,” Dr. Del Sol said to the OR nurse. “You need to support the whole—”
There was a pop, like a burst bubble, and although I had not thought it possible, you screamed even louder. “Oh, God,” the nurse said, her voice a cone of hysteria. “Was that a break? Did I do that?” I tried to see you, but I could only make out a slash of a mouth, the ruby furor of your cheeks.
The team of doctors and nurses gathered around you couldn’t stop your sobbing. I think, until the moment I heard you cry, a part of me had believed that all the sonograms and tests and doctors had been wrong. Until the moment I heard you cry, I had been worried that I wouldn’t know how to love you.
Sean peered over their shoulders. “She’s perfect,” he said, turning to me, but the words curled up at the end like a puppy’s tail, looking for approval.
Perfect babies didn’t sob so hard that you could feel your own heart tearing down the center. Perfect babies looked that way on the outside, and were that way on the inside.
“Don’t lift her arm,” a nurse murmured.
And another: “How am I supposed to swaddle her if I can’t touch her?”
And through it all you screamed, a note I’d never heard before.
Willow, I whispered, the name that your father and I had agreed on. I had had to convince him. I won’t call her that, he said. They weep. But I wanted to give you a prophecy to carry with you, the name of a tree that bends instead of breaking.
Willow, I whispered again, and somehow through the cacophony of the medical staff and the whir of machinery and the fever pitch of your pain, you heard me.
Willow, I said out loud, and you turned toward the sound as if the word was my arms around you. Willow, I said, and just like that, you stopped crying.
· · ·
When I was five months pregnant, I got a call from the restaurant where I used to work. The pastry chef’s mother had broken her hip, and they had a food critic coming in that night from the Boston Globe, and even though it was incredibly presumptuous and surely not a good time for me, could I possibly come in and just whip up my chocolate mille-feuille, the one with the spiced chocolate ice cream, avocado, and bananas brûlée?
I admit, I was being selfish. I felt logy and fat, and I wanted to remind myself that I had once been good for something other than playing Go Fish with your sister and separating the laundry into whites and darks. I left Amelia with a teenage sitter and drove to Capers.
The kitchen hadn’t changed in the years since I’d been there, although the new head chef had moved around the items in the pantries. I immediately cleared off my work space and set about making my phyllo. Somewhere in the middle of it all, I dropped a stick of butter, and I reached down to pick it up before someone slipped and fell. But this time, when I bent forward, I was acutely aware of the fact that I could not jackknife at the waist anymore. I felt you steal my breath, as I stole yours. “Sorry, baby,” I said out loud, and I straightened up again.
Now I wonder: Is that when those seven breaks happened? When I kept someone else from getting hurt, did I hurt you?
· · ·
I gave birth shortly after three, but I didn’t see you again until it was eight p.m. Every half hour, Sean left to get an update: She’s being X-rayed. They’re drawing blood. They think her ankle might be broken, too. And then, at six o’clock, he brought the best news of all: Type III, he said. She’s got seven healing fractures and four new ones, but she’s breathing fine. I lay in the hospital bed, smiling uncontrollably, certain that I was the only mother in the birthing center who had ever been delighted with news like this.
For two months now, we had known that you’d be born with OI—osteogenesis imperfecta, two letters of the alphabet that would become second nature. It was a collagen defect that caused bones so brittle they might break with a stumble, a twist, a sneeze. There were several types—but only two presented with fractures in utero, like we’d seen on my ultrasound. And yet the radiologist could still not conclusively say whether you had Type II, which was fatal at birth, or Type III, which was severe and progressively deforming. Now I knew that you might have hundreds more breaks over the years, but it hardly mattered: you would have a lifetime in which to sustain them.
When the storm let up, Sean went home to get your sister, so that she could meet you. I watched the Doppler weather scan track the blizzard as it moved south, turning into an icy rain that would paralyze the Washington, D.C., airports for three days. There was a knock at my door, and I struggled to sit up a bit, even though doing so sent fire through my new stitches. “Hey,” Piper said, coming into the room and sitting on the edge of my bed. “I heard the news.”
“I know,” I said. “We’re so lucky.”
There was only the tiniest hesitation before she smiled and nodded. “She’s on her way down now,” Piper said, and just then, a nurse pushed a bassinet into the room.
“Here’s Mommy,” she trilled.
You were fast asleep on your back, on the undulating foam egg crate with which they had lined the little plastic bed. There were bandages wrapped around your tiny arms and legs, your left ankle.
As you got older, it would be easier to tell that you had OI—people who knew what to look for would see it in the bowing of your arms and legs, in the triangular peak of your face and the fact that you would never grow much beyond three feet tall—but right then, even with your bandages, you looked flawless. Your skin was the color of the palest peach, your mouth a tiny raspberry. Your hair was flyaway, golden, your eyelashes as long as my pinkie fingernail. I reached out to touch you and—remembering—drew my hand away.
I had been so busy wishing for your survival that I hadn’t given much thought to the challenges it would present. I had a beautiful baby girl, who was as fragile as a soap bubble. As your mother, I was supposed to protect you. But what if I tried and only wound up doing harm?
Piper and the nurse exchanged a glance. “You want to hold her, don’t you?” she said, and she slid her arm as a brace beneath the foam liner while the nurse raised the edges into parabolic wings that would support your arms. Slowly, they placed the foam into the crook of my elbow.
Hey, I whispered, cradling you closer. My hand, trapped beneath you, felt the rough edge of the foam pad. I wondered how long it would be before I could carry the damp weight of you, feel your skin against mine. I thought of all the times Amelia had cried as a newborn; how I’d nurse her in bed and fall asleep with her in my embrace, always worried that I might roll over and hurt her. But with you, even lifting you out of the crib could be a danger. Even rubbing your back.
I looked up at Piper. “Maybe you should take her . . .”
She sank down beside me and traced a finger over the rising moon of your scalp. “Charlotte,” Piper said, “she won’t break.”
We both knew that was a lie, but before I could call her on it, Amelia streaked into the room, snow on her mittens and woolen hat. “She’s here, she’s here,” your sister sang. The day I had told her you were coming, she asked if it could be in time for lunch. When I told her she’d have to wait about five months, she decided...
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