One

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? br />
  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 howl and I scream.

  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

  and hasn’t had a drink

  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.