“Acute Promyelocytic Leukemia, Marrow Aspirate” by euthman

Like all colouring books, it was unfinished. Though looking at it, at the filigreed patterns of jungles and seascapes and rolling hills, I felt my pencils would somehow sully it. This was an adult colouring book, as Mum had stressed, entrusted to me at the age of fourteen, by which time I was an expert at colouring within the lines.

I would clear the bedroom of clutter, of distraction, find a purity of mind I could achieve only when I was alone, when Jilly was out of our room. Under the bunkbeds went all her things, followed by the no-man’s-land of books and toys that Dad had misguidedly gifted “to both of us.” Each one was a reminder of arguments past, and arguments present: Jilly and I still tussled over some of those old toys, even the ones we had both outgrown, items with no value to us now except the brute allure of ownership.

I would sit at our desk and arrange my pencils in a row, parallel and equidistant, select whichever colour sang to me, sharpen it to a fine point, and begin. It was a ritual, a kind of meditation, until one day I found the book half open, an orange squiggle breaking out of a flower petal and unzipping a placid sky.

Jilly said you could barely notice it, that it didn’t matter. She said it nonchalantly, as if blue were orange and petal were sky, the lines between any two things blurred. I told her that wasn’t the point, that the book was mine. As our voices rose, Mum and Dad came rushing in to calm us down. They were always vigilant, ready to keep the peace with hugs and I-love-yous that had a searching, desperate quality.

“She used it,” I protested, pointing to the book. “It’s not hers.”

“Abby,” Mum soothed, “we’ll get you both one.”

This solution infuriated me. It wasn’t just the book; the conflict was mine, too; to solve it was to take away one more of my things. So the words rose in me, and I didn’t stop them: “I saved your life,” I said to Jilly, who started crying before I’d finished the sentence, who felt it in her blood before I opened my mouth.

There was a silence, that moment of shock after a nasty fall, before you register the damage.

“You must never say that,” Dad said. The words came out awkwardly, as if he had drawn one breath too few.

I supposed he meant I must never use it, but I took him literally, never uttering it after that, not once. Locked it away like a family heirloom, too precious and fragile to be held against the light.


I was twelve when Jilly started going for tests. I had just started high school, peeking over the parapet of adolescence, too consumed by what was flying at me to pay much attention to my little sister. I remember the day of her diagnosis, though. Languishing in the waiting room of the hospital as time bent and slowed. Turning my back to the clock but measuring seconds by the faint tap of footsteps. Sitting in foam chairs under a cloud of sympathy.

Jilly emerged from her scanning and prodding looking tired and blood-sucked. Dad was conscientious, enfolding us both in his arms, dividing himself fastidiously between us.

The first night Jilly and I didn’t speak. She lay in the upper bunk, and I watched the gentle bulge of her body through the mattress above. We had shared a room since we were little. We used to talk ourselves to sleep, holding secretive Q&As, her asking me all the things she didn’t dare ask Mum and Dad. But now the mattress between us was impenetrable, soundproof. We lay awake in silence, her curled and still on her bunk, me wondering how it was possible to be at war with your own blood.


I was alarmed when the doctor sent Mum and Dad out of the room. The way they walked, slowly, reluctantly, leaving me with this stranger, his face lined and solemn and bristling with eyebrows. He told me that no one could force me to do anything and explained how it would work if I chose to do it: I’d be put to sleep, a needle would go into my hip, and the marrow sucked from my bones and suffused into Jilly’s blood. He used the word anaesthesia, a word cavernous enough to hide all manner of terrors in its dark corners. I imagined being smothered by a gloved hand, clamping my mouth, pinching my nose, jamming fingertips into my eyes. That a gap in consciousness was a hole down which anything could tumble.

When I came out of the doctor’s office, Mum was looking at me with a new expression. A kind of pleading, with just a hint of her usual sternness. Dad seemed lost, blinded, like the men I’d seen walking out of betting shops into scowling sunlight.

“I don’t want to do it,” I said.

Mum’s voice wobbled, as if balancing at a great height. “It’s best for both of you.”

“I don’t want to do it.”

I felt dizzy, rattled. I cried again, not at the thought of going unconscious this time but at the sight of Mum at my mercy, at the reversal of that polarity. Suddenly she was the child on the verge of a meltdown, on the verge of saying something she could never take back.


The conversation continued into the night. Picked-at dinners hardened on the table. Darkness stalked through the front room, and no one thought to turn on a light. Dad hugged Jilly a lot and stared at her as he might a crystal ball.

“You won’t feel anything, Abigail,” Mum said to me softly. “It will be very quick. And we’ll be so proud of you. We need you to be brave for Jilly, now, for everyone.”

I knewthis was unlike anything she had ever asked, that a new kind of gravity was acting upon me. But not cooperating with Mum was a familiar, almost comforting, pattern. It was too easy to fit into its grooves, so I resisted, wriggled away from the point of that big needle. “I think she’ll get better by herself,” I said. “The doctor said the transplant isn’t the only thing they can do.”

“It’s the best chance,” Dad said. “By far, by far the best chance. I would do it instead of you if I could.”

She will not just get better by herself,” Mum hissed. Some physical force was coming from those words; they made the muscles on the back of my neck tense up, radiating pain through my head.

“Tomorrow you’ll meet a woman who’ll talk to you about the situation,” Mum continued more calmly. “You must tell her you want to do it, to help your sister.”

“Amy…” Dad began. Mum’s first name, rarely heard amongst all the honeys and darlings, said limply, a failed reproof.


Another night of silence. Now Jilly’s shape in the bunk above didn’t seem remote, it seemed heavier, lower, even though I knew she’d lost weight. I watched that imprint for hours, listening to the midnight sounds of scrabbling cats and distant revving engines beyond my bedroom window. It was inconceivable to me that the imprint would disappear, that the mattress would flatten, become featureless.

Inwardly I prayed Jilly would break her silence, if only to curse or cry. I knew she wouldn’t cry shrewd little sister tears anymore, that they would have darkened into something else, but anything was better than listening to Mum and Dad through the wall, to Dad’s low rumbling, Mum’s fraught whispers. I couldn’t make out any words, but the sounds had the icy cadence of an argument, a late-night duel full of quiet cutting.


Finally, Jilly broke her silence. Or rather her leukaemia did, emerging from her in the middle of the night in the form of moans and wheezes. The sounds invaded my sleep, leaving me with waking images of her sickened body, frail and trembling.

I stood on my bed and looked over the top bunk. As Jilly breathed, I could see her translucent skin sucking down on her ribcage. Her stomach was scattershot with fiery red marks, her sheets gummy with sweat.

“Are you ok, Jilly?”

She shifted position and took my hand, placed it under her cheek. I felt her breath kiss my palm. I felt fires being fought in her head. I stood there cupping her face until my hand went numb and my arm ached at the elbow. I don’t know how long I balanced precariously on the edge of our bunks, fearing I might fall but unable to pull away, as if her head might plunge through the mattress without my hand to support her.

The next thing I remember is waking up in her bunk. How my pyjamas were drenched with both our sweat, and the feeling of Dad gently peeling them off to put them in the wash.


Mum spoke to me in short little sentences, as if I were in trouble, though her tone was lacking any anger or purpose. She took several weeks off work, which she mostly spent in her room. I saw her through a crack in the door, hunched over on her bed and bathed in darkness. Dad made visits to her and Jilly both, moving furtively between them, bearing neatly cut sandwiches and glasses of water.

Meanwhile I was plagued by images of a blue spectre, face a crease of white cloth, pulling out my bones in a single thread like a chain of sausages. Splitting them open, the marrow sluicing out into a jar. I pictured them hooking me up to Jilly with a rubber tube, a kind of umbilical cord, sucking and pulsing at my insides.

I made a promise to myself: For each one of my nightmares I would study some of Jilly’s reality. Pushing food around her plate as if rearranging it would make it more palatable. Rushing to the bathroom and begging me to play music to cover the sounds she made, emerging in a fragile marionette-walk. After a few days of this I couldn’t bear it any longer, seeing her struggle so vividly, the unflinching colour of it.

I slipped into Mum and Dad’s room in the middle of the night, crawled between them, pulled at Mum’s arm. It was a warm, dead weight; I held it close.

“I want to do it,” I whispered into the tangle of her hair.

She shifted, her face raw and glistening, the moonlight illuminating an expression I could not decipher.


Before the transplant, Mum and Dad held me close, one on each side with me squeezed between them. Jilly took my hand, her grip loose, clammy, slipping. I was wheeled into the operating theatre and the blue spectres appeared around me, but beneath their masks I heard mumbles and chitchat, human sounds. As one of them looked down at me, two hazel eyes peering over a panel of white, I thought I could see the outline of a smile behind the mask, and it reminded me of Jilly’s shape impressed on her mattress.

The masked face told me to count to ten. One, two, three… and I sank into dreamlessness.

I awoke with a corkscrew jammed in my lower back, my head a ponderous raincloud. The drugs were still wearing off, so I don’t remember crying, or asking Mum and Dad to tell Jilly I was sorry.

“I don’t know why you said that,” Dad told me afterwards. “It must have been the drugs. You did the most wonderful thing.”

But I said it nevertheless, over and over.


I made the sky a deep cerulean blue with murmurs of white cloud. I pencilled over Jilly’s squiggle carefully, sinking the orange under layers of new colour, reinstating the line between petal and sky. I went into a kind of trance, my face so still and perched a string of drool almost slipped from my mouth. The scratch of pencil on paper was the only sound, the scene unfolding before me all-consuming.

When I was finished, I had a feeling I find hard to describe. As if the two years that had passed since Jilly’s treatment had disappeared. Something in me became uncentred, spinning and plummeting, knocking the breath out of me. I opened the bedroom door, clawed our things out from under the bunks. I called for Mum and Dad, and they appeared a moment later, grey-eyed and pale. For the first time I had a sense of how Jilly and I consumed them, how they were always there even when they weren’t, ready to rush out of their lives and into ours.

“I’ll never say it again,” I promised Dad.

He took me in his arms. “Say what, sweetheart?”

“That I saved her life. I’ll never say it.”

And it wasn’t just because it was unfair to Jilly, who was entitled to some colouring of her own. It was because I knew its hidden meaning, that it was really a confession. I knew I saved your life was big sister for I almost killed you, that it might reveal how I had dreams of killing her even now. Instead I should have told her how proud I was, though perhaps that’s what I was saying, albeit mistranslated by sibling scorn. So much easier, with sisters, to be guilty than proud. But I was proud, grateful even, for what we shared, for the needle in my side, for the pain afterwards, for my marrow to become her blood, so that if her skin so much as broke it would cut me to the bone.

About Adam Slavny

Adam Slavny is an Associate Professor at the University of Warwick, with interests in law and philosophy. His first book is forthcoming with Oxford University Press. His stories have been published in Storgy, Welkin, Silver Blade and others. You can find out more at

Adam Slavny is an Associate Professor at the University of Warwick, with interests in law and philosophy. His first book is forthcoming with Oxford University Press. His stories have been published in Storgy, Welkin, Silver Blade and others. You can find out more at

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