Chapter 23

Anna was ten years younger than me. She had always tried to be like me in small ways—the way younger sisters do—though she was much smarter than I was. She was a gifted student. She played tennis in high school and had been a ranked junior in Indiana, though I'm not sure how much she ever loved it.

She had beautiful long legs—the kind that made you think she could have gone anywhere, done anything, if she wanted to.

She was creative—the kind of person who could spend hours making up characters for computer games, building entire worlds with their own logic and rules. She had a twisted sense of humor—same as mine.

She enrolled at Valparaiso University, not far from my parents. She left when she started having problems with trigeminal neuralgia

—severe facial pain. When Mom and Dad moved to Sedona, Anna moved with them.

That year, Sean, Anna, my parents, and my grandmother were all in Sedona for the holidays. I flew out after Christmas and spent five days with them.

One afternoon, Anna and I were in the car together. I don't

remember where we were going—just that we were driving. She was quiet for a long time, then suddenly started to cry.

"What's wrong?" I asked.

She told me she wasn't happy. That college hadn't worked out.

That she didn't feel like she fit in.

"There are other colleges," I said. "You know I left after my first year."

She shook her head. "Yeah, I know, but…" She hesitated. "Nobody liked me. Everybody liked you."

"That's not true," I said. "It really isn't."

She wanted to get along with everyone. She always had.

Like me.

Then she said, "You got out. You were able to leave. I can't get out."

I told her she could do anything she wanted. That she was smart. Talented. That she seemed to have found something she liked with computers. I told her it didn't matter if Mom and Dad didn't fully understand it—as long as she did.

She said the people she knew who worked with computers were older than she was. They'd already been through college.

"Well," I said, "then maybe they can help you figure out where to go next. Or I can help you. You can always call me. We don't have to talk only after I talk to Mom and Dad—we can talk separately."

She listened. She nodded. She stopped crying. She promised she would call me.

After the holidays, I went back to my life. Granny and Sean left too. But I wanted to do something for her.

I sent her my 500SL Mercedes—the one I'd had in LA. There was no point keeping it in New York. I didn't need a car.

A few weeks later, Anna called.

"I got the car!" she said. She was excited. "I'm getting a person-alized license plate. Beepr."

I laughed. "Perfect."

She told me she was on antidepressants now. They were helping.

She'd enrolled at Northern Arizona University. She was taking classes, working with computers—finding her path.

"You sound really good, Anna."

"I am," she said. "I'm feeling so much better."

THE CALL

Growing up, I had always believed I would die young. I never said it out loud. It wasn't fear or drama. It was just a quiet certainty that never moved.

I believed I would die at thirty-six.

After Valerie got divorced, we somehow reconnected. She came to visit me in New York, and we planned a girls' weekend—a show, a spa, the kinds of small indulgences that felt earned.

Anna called while Valerie was there. "What are you going to do?" she asked.

"Valerie wants to shop and see The Lion King," I said. "I'm so jealous," she said. "You get to go do things." "You can come visit me anytime," I told her.

She laughed.

"Can I come see a Madonna concert?" "Of course," I said.

She had gallbladder surgery scheduled, but it was routine.

Everything sounded fine. She sounded like herself.

Valerie and I went to the spa. For the first time in a long time, I turned my phone off.

When I turned it back on, it wouldn't stop ringing. Messages. Missed calls. People trying to reach me. Anna was in a coma.

They told me she had been overdosed with Dilaudid on the operating table.

Valerie was standing next to me. The room tilted. Then the story kept changing—she was stable, then improving, then trans-ferred to a step-down unit.

I spoke to Anna on the phone.

She reminded me about the Madonna tickets.

"Of course," I said. "But that means you'll have to come stay with me in New York."

She was happy.

A few hours later, the phone rang again.

My father had been with Anna. She was stable, so he went home to get his inhaler. My mother stayed. She and Anna were watching the Notre Dame game together. Anna said she was tired. She wanted to sleep.

My mother said that was okay.

Then my mother heard Anna gurgling. She realized Anna couldn't breathe. She screamed for a nurse. They called a code.

The doctor tried to intubate her.

The tube was too big. Anna was overweight. It didn't fit. He tried again.

Still too big.

Too much time passed.

By the time they got it right, the damage was done. Anna was back in a coma.

The doctor said words that didn't soften with repetition: anoxic stroke. Lack of oxygen. Brain injury.

"You should come out here," he said.

I left Valerie asleep in my bedroom. I slept on the couch. I cried the entire night. I took the first flight I could to Sedona.

When I arrived at the hospital, my parents were there. Sean had flown in from Denver. Anna lay in the bed with tubes down her throat.

I sat with her for days.

I talked to her. I rotated her. I stretched her legs and her feet. At one point, I noticed the cuts on her ankles—thin lines, over and over.

Razor scars.

She was a cutter.

I knew what that meant. The doctors were blunt.

If she woke up, they said, she would be a vegetable.

I don't think any of us believed them. Or maybe we couldn't.

Don managed to get one of the best doctors in the world on the phone. He tried to transfer her to a top brain institute outside Phoenix.

When the doctor called back, I ran to the parking lot—terrified I would lose the cell connection.

"I'm so sorry you're going through this," he said first. Then he hesitated.

"They can't take her."

"What do you mean?" I asked.

"It's her insurance," he said. "She's on welfare."

"No," I said. "There must be a mistake. She has normal insurance."

"No, she doesn't, Lisa." My mind was reeling.

"She can't be," I said. "My parents wouldn't do that." There was a pause.

"It doesn't matter," I said. "I'll pay. Whatever it costs."

When the call ended, I sat in my car screaming and crying, begging God to take me instead of her.

On the fifth day, the doctor pulled us aside.

I was sitting next to my father in Anna's room. Sean and my mother were there. The doctor started explaining something, but all I saw was my father's shoulders collapse, as if he were holding some-thing impossibly heavy.

I kept saying, "What does that mean?" It meant brain death.

Anna was never coming back.

My parents couldn't take her off the machines. The coroner would need to examine her body. It was Friday.

I said we couldn't let that happen. Anna was afraid of the dark.

She'd had nightmares as a child about being trapped in small spaces, unable to get out. The thought of her body alone in a coro-ner's office for the entire weekend—I couldn't let that happen.

I asked the doctor if we could keep her on life support until Monday.

I know it was absurd. But I wasn't going to leave her there, alone, in the dark.

When the time came, my parents and my brother couldn't stay in the room.

I stayed.

After forty-five minutes, her body went still.

A man came in with a gurney and a body bag. He struggled to lift her.

"Do you need help?" I asked. He nodded.

I lifted Anna into the body bag with him. He zipped it closed.

I left the room where Anna had died and walked to where my mother, father, Sean, and Granny were waiting. They were with a nun.

My face was swollen from crying. I hadn't slept. I hadn't changed clothes in days.

Granny had flown in from Detroit. Her favorite grandchild.

When she arrived, I knew it was the end.

The nun stood there in her neat habit, rosary clutched in her hand. She walked toward me, reached for my arm, and began to say something about God.

I said, in a low, furious voice, "Don't you dare touch me. And don't you dare lecture me about God."

Anna wanted to be cremated. She used to joke that she didn't want worms crawling through her.

At the funeral home, there were decisions to make. What kind of casket would be used for the cremation. It was strange, picking things out.

My parents chose the cardboard box. Then they showed me the urns.

All of them were tacky. Then I saw one made of wood—simple, elegant.

"That one," I said.

They told me they didn't have it in stock. That I should choose something else.

"No," I said. "That's the one."

I was angry. Then why even show it to me?

"You don't seem to understand," I said. "I want that one. And come hell or high water, that is what I will get."

The woman looked at me, slightly frightened. "I'll make a few calls," she said.

I paid four hundred dollars to have it driven overnight directly to the funeral home.

There had been reports on the news—scandals about funeral homes selling bodies, harvesting parts. I didn't trust anyone. Not after everything that had already gone wrong.

Anna was dead, and I was not going to let anything else happen to her.

That's why I watched.

The rest of my family waited outside.

Anna was placed in the cardboard box. She was wearing jeans and a sweatshirt she'd stolen from me.

The box was placed on a short conveyor belt and slid into the crematorium.

I watched the door close.

It was October 4th. My mother's birthday.

The next day, Anna's ashes were in the wooden box I had chosen.

Back at the house, my mother was already boxing Anna's belongings for Goodwill.

Already.

As if to erase her.

I found my sweatshirts in Anna's drawer. The pearls I'd brought her from China. Some drawings. Her mixed CDs.

A vodka bottle, hidden in the back of her closet. I threw it away without saying anything.

We sat in silence. My mother left.

My father sat alone in Anna's room. Sean sat at the table.

I sat with my grandmother. "Dad," I said. "Come sit here."

Two days later, I flew back to New York.

As I said goodbye at the front door, the mailman arrived. He handed my mother a package.

Anna's custom license plate. BEEPR.

When I got home, Don and Marion were there. So was Simba. They had taken Valerie out to lunch and dinner while I was gone.

I went to bed and thought: She is still here. She is not gone.

She's just in Sedona. Life continued.

I didn't die at thirty-six. But something did.

And it happened there—in that hospital room—with Anna.

RECKONING

After Anna died, I didn't collapse.

That surprised people.

I went back to New York. I went back to work. I returned calls. I showed up. From the outside, it looked like resilience. Like strength. Like survival.

Inside, something had shifted permanently.

I had always believed my life followed a series of hard turns—tennis, leaving home, learning to survive inside systems that rewarded performance but withheld support. I framed it as disci-pline. Independence. A kind of earned toughness.

Anna's death broke that story open.

Because once I stepped back far enough to see it, I couldn't unsee the pattern.

It wasn't just tennis. It wasn't just me.

When I was a teenager, doors opened—scholarships, sponsors, attention. What was missing were the things that actually move a career forward: tournament fees, travel, the unglamorous expenses that turn talent into trajectory. Those weren't paid. I was told to support myself. That there was no legal obligation anymore.

Later, when I struggled, Donald offered to pay for treatment—if my father paid half.

"There are public institutions for that," my father said. Donald paid in full.

Anna struggled too.

She went back to my parents' house. She was depressed. She was on antidepressants. She seemed to be getting better. She had gallbladder surgery—a routine procedure.

And she was on Medicaid.

I didn't know that until it was too late.

The words came casually, almost bureaucratically: It's her insur-ance. She's on welfare.

My father was a doctor.

He understood what that meant—the limits, the differences in care, the risks.

And yet even Anna—his favorite—was uninsured.

The hospital Anna was in had so many complaints that the State of Arizona wanted to shut it down. It stayed open "for the community."

That's where Medicaid patients go.

When Anna couldn't breathe, they tried to intubate her. The doctor used a tube that was too big. He tried again. Still too big. Too much time passed while she was dying.

My father was a doctor. He knew what that meant.

If the child he favored couldn't get health insurance from him, then this was never about deserving or not deserving. It wasn't about me being difficult. Or tennis being frivolous. Or resources being scarce.

It was about withholding.

Not dramatic withholding. Not cruel in obvious ways. Quiet withholding, wrapped in reasonableness.

There are public institutions for that. You're an adult now.

Support yourself.

Language that sounds neutral—until you follow its conse-quences.

Anna didn't die because she was depressed. She didn't die because she had surgery.

She died in a system where corners were cut, monitoring was thinner, and mistakes compounded—because that was the level of care available to her.

I don't know if better insurance would have saved her life.

But I know it would have changed the conditions under which she lost it.

That knowledge doesn't resolve into forgiveness or rage. It settles somewhere else.

I survived the same pattern she didn't.

That doesn't make me stronger. It makes me responsible—to tell the truth about what survival sometimes costs, and what it some-times requires.

For years, I thought my story was about blocked opportunity. Now I understand it's about something else entirely.

It's about what happens when the people who are supposed to protect you decide—quietly—that there are cheaper ways to care.

And what it means to live on, knowing someone you loved didn't.

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