All the Ways the World Can End Read online

  While Mom started scrolling through her phone for the lovely-fonted note, I tried to get some sense of what was going on with Dad. He kept thanking Julian and letting his eyelids droop.

  “Hey, Dad,” I said. “Before you float away, can I get an update on test results and stuff?”

  “Right,” he said. He pulled himself upright and looked at me squarely. “I actually had Ganesh write some notes this morning so I didn’t mix up any of the names. Sarge, can you hand me that pad of paper?”

  “Pad of paper—check,” said Mom. I watched her hand him the notepad and kiss his bald head. He fit perfectly into her armpit. I felt bad that I kept rolling my eyes when Mom talked and doubting her sanity. She was dealing with this with an extra dose of nuttiness, but I wasn’t exactly stable either. She curled over Dad like a protective wing, then whispered something into his neck and let go.

  “Okay, well there’s Varlilumab and Nivolumab, which is also called BMS-9365-something,” said Dad.

  “BMS-936558,” I said. “I’ve been reading up on both of them.”

  “Wow, look at you,” Dad said. I studied Dr. Ganesh’s scribbles. His handwriting was much messier than I’d thought. Everything slanted to the left a lot.

  “Okay, so you know both of those drugs are sounding very promising in terms of the liver and the lymph nodes,” Dad said. “The clincher is here.” He flipped to the next page on the notepad and showed me a diagram with lots of circles and arrows. Dad squinted at the drawing and hummed a little. As if he were analyzing some cubist retrospective at the Met. “I think those dark spots are the lesions. Let me get this right. And that’s the myelin wall. And I think this set of arrows down here is the blood-brain barrier. Is that right, Sarge?” He turned the paper on its side and narrowed his eyes for serious studying.

  “Wait, did you just say blood-brain barrier?” I asked. My teeth felt thick and hairy. The back of my throat filled up with saliva.

  “It’s okay,” Dad said.

  “No it’s not!” I squawked. Dad and Julian both instinctively reached out to hold one of my arms.

  Mom chimed in. “The good news is they’re small and easily zappable.”

  “Wait—they? How many lesions are there? How big? How long?” I asked.

  “Size doesn’t matter,” Julian said. Mom chuckled. Dad and Julian high-fived.

  “Are you serious?” I kicked Julian in the shin. He whimpered.

  Dad took my hands in his and said, “Look, this is not entirely unexpected. And to answer your question, there are between four and seven lesions that they will easily zap with gamma knife therapy. Which is very precise and doesn’t involve any surgery. Once we’ve done that, then we’ll start on the Varlyloola stuff.”

  “Varlilumab,” I corrected. “Why didn’t you tell me all this?”

  I was getting louder and whinier, but I couldn’t help it. I needed to prove this was all wrong and someone was at fault. Even though Dad was the last person I wanted to be accusing.

  “Sorry,” Dad said. “Dr. Ganesh just left about an hour ago.”

  “So sweet, that man,” said Mom. “And again, he asked for you, Ey-leah-nor.”

  That did unclench my stomach, at least a fraction of a knot. Dad peeled off the pieces of paper with Dr. Ganesh’s drawings and words and handed them to me, as if they were a peace offering. I buried my nose in the big muddled notes he’d written on the side. Lymph nodes, liver, brain, Lowenstein. They needed Lowenstein’s final approval, Dad went on. But Lowenstein was held up in Toronto for another thirty-six hours.

  “What does that mean, ‘held up’?” I growled.

  “Another person in high demand,” Mom said. “Speaking of, I just found the email from Chelsea Diamond. Just a little backstory: I told her how much of an inspiration she was to me and Dad and asked if she would come visit or speak at the hospital. Does anyone want to read it?”

  I groaned instead of answering and unwrapped more alcohol pads to clean off Dad’s night table. Mom decided to read the email aloud. It was only three lines to the effect of Sorry about your troubles. I don’t make house calls. Good luck.

  “That’s a form letter, Mom,” I scoffed.

  “No it’s not,” Mom shot back. Then she lost her bravado and said in a small voice, “Is it?”

  I didn’t care if I was the resident asshole. Nobody else was taking this seriously. I refused to make eye contact with anyone. Instead, I folded the papers from Dr. Ganesh together tighter and tighter until the wad was almost as small as a bottle cap.

  “What are we doing about this? Right now?” I demanded.

  “It’s okay,” Dad repeated softly. “Right now, we’re waiting for Lowenstein to schedule the gamma ray. Then they assess whether I qualify for the trial, and meanwhile we can start on radiation. I think two weeks after the brain mets are out.” I just huffed in response. “It’s okay,” he said for the hundredth time, proving that it meant nothing.

  I mashed my lips together so I wouldn’t say, No it’s not and you know it.

  “Now c’mon, this is boring,” Dad said to the room. “Tell me what’s going on in the real world. Julian, any letters for you from San Fran?”

  Julian kept looking at Dad’s feet as he mumbled, “Actually, yeah.”

  I wanted to roar, but I couldn’t find enough air in my lungs to start. It was National Punch-Lenny-in-the-Gut Day.

  “You got in!” Mom cheered. “I knew it!” She launched into singing some hippie song, If you’re going to San Francisco…,bouncing and gliding around like she was on an acid trip. Dad was singing now too. I was the only one just standing there, trying to obliterate the party with my storm-cloud face.

  Julian looked up at me and shrugged.

  “When did you find out?” I knew he couldn’t lie if I asked him directly. It was part of his AA pact of being accountable to the higher power of truth.

  “Just … last week I guess,” he said.

  “I have to pee,” I muttered, stomping out.

  I could’ve peed in Dad’s bathroom, but instead I walked all the way down to the one by the elevator. It smelled like hot ammonia and there was no lid on the toilet seat, but it would do fine for my purposes. I locked the door, balled my hands into tight fists, and pounded them into my head twenty-five times really fast while I counted out loud.

  I stopped for five breaths and took inventory. My knuckles burned. My head was full of static. But I knew I could get up to one hundred punches before things started looking really blurry.

  Pounding was my favorite obsession, or maybe it was a compulsion. All I knew for sure was that each blow to my head was sharp and clear and rocked me completely out of my circuit of anxiety. When I pummeled myself in the head, all I could think about was the darkness and pain. My pain that I gave to me.

  I’d started this lovely self-destructive activity two years before, when there was an outbreak of meningitis one town over from where I lived. Maybe “outbreak” was an exaggeration. There was a 14-year-old girl who died, though. She played intramural lacrosse and some of the girls in my grade had seen her a week before at the lacrosse meet. When she died, they made a dance video for her that our principal played during morning announcements. No one could figure out where she’d contracted the disease, and all my research pointed to contaminated tap water. I knew it was a rare incident, but it just shook everything inside me. I tried boiling all my water for a week, then switched to almond milk. Which, ironically, led to crushing headaches.

  Instead of taking two aspirin and calling someone in the morning, I kept trying to measure my agony. I couldn’t tell whether it was bad or bubonic. Two weeks after the outbreak-of-one, kind of on a whim, I went home, locked myself in my closet, and pulled my hands into two tight fists. I clobbered myself in the head. Hard.

  That first round of self-boxing was actually magical. It felt surprisingly cleansing, like I’d just knocked out all the cluttered voices and broken through to a pocket of fresh air. I pounded my head twenty-five times
that first day. Thirty the next. Then thirty-five. By the end of that week I’d raised the bar to one hundred, pulsing on my toes and grunting a little like Rocky in between sets of twenty-five. The sound effects were probably what tipped Dad off. It was a fall Saturday afternoon and I thought he was outside raking, but he must’ve come in and heard me. He knocked on my door and demanded to know what I was doing.

  “Hammering … stuff?” was not a genius answer by me. Dad had a lot of follow-up questions and I was feeling very tired and unsteady, and then he was inside my room and I couldn’t look him in the eye and come up with a new story.

  He sat me down and made me explain exactly what I liked about harming myself and how it gave me relief. Then he opened one of my notebooks and a pen and we wrote a list together of other things that could make me feel breathless, but in a good way.

  1. Swimming at Wahonsett Bay

  2. Bicycling up the hill at Pinebrook Boulevard

  3. Fajitas

  Dad threw a sweatshirt at me and told me to get my shoes on and meet him outside. He got our bikes out of the garage and spritzed them with lube, then took off for Pinebrook at record speed. I had no choice but to try to catch up to him. Both of us panting and gasping at the red leaves clogging the sewers.

  Before coasting back down, Dad pulled off to a patch of grass and got off his seat. He walked over to me and put his hands around my head.

  “Promise me you’ll do this instead. I love this beautiful, giant noggin.”

  I didn’t say anything because I was still gulping air spastically from the tough climb.

  “Promise,” he said again, holding out a pinky. Waiting until I hooked mine with his.

  I did take that oath seriously and I did stop the hitting. Until this moment, that is. I didn’t feel like Dad was holding up his end of the bargain either, though. He could have called me when Dr. Ganesh was there or said something to me besides “It’s okay.”

  Fifty-three, fifty-four, fifty-five. I was definitely out of practice. My hands felt more damaged than my head, no matter how hard I rapped. I wondered how forcefully I’d have to strike to crush one of my fingers or shatter a knuckle. I didn’t know why humans were created with these ridiculous digits and appendages that really served no purpose. I didn’t know why any of us were here if we were just going to perish.

  “Hello? Hello!” Someone was rattling the doorknob. “Are you okay?” It sounded like an older woman, who then started some diatribe about whether this was really a public restroom and who was in charge of maintenance.

  “Be right out!” I mustered. I was now up to seventy-two and had just hit my stride. I really didn’t want to stop before getting to a multiple of twenty-five, but I could tell Miss Maintenance wasn’t budging. I turned on the faucet and waved my hands in front of the automatic paper towel dispenser. It emitted a loud clucking sound but nothing came out.

  “Sorryforthewait,” I slurred as I opened the bathroom door. The hall light seemed blindingly bright now and the woman waiting had sprouts of gray mustache. As if I was in a place to judge.

  Walking back into Dad’s room, I did feel at least a shade victorious. Everything was just foggy enough to be less real. Mom was slapping down piles of playing cards on the tray table attached to Dad’s bed.

  “Want us to deal you in?” Dad asked. “Hearts.”

  I stood there for a good thirty seconds, watching the three people closest to me drift in and out of focus. I thought it would feel crumbier to betray my dad. I also wished he’d look at me deeply and know what I’d just done. But we were obviously on different planes. I took some cards from Mom and propped myself up on the window ledge. The numbers were skiing off my cards and everything in my head was ringing. I looked around again and broke into a stupid grin. No one else could hear it. No one knew what it felt like to be achy and tipsy and me.

  We played two rounds of hearts before Dad started squirming a lot and trying to reposition himself in bed.

  “Did you press the button?” Mom asked. Dad nodded, looking up at his morphine drip with glassy eyes. I hadn’t noticed he was still hooked up until that moment.

  “What’s happening?” I asked.

  Mom cut in before he could answer. “Do you guys mind clearing out? Lenny, I’ll be home just a little after you.”

  Dad told Julian again how great the acupressure felt and thanked him for coming in. Mom was about to change his pillow arrangement when Dad said, “Actually, let me talk to Lenny privately for a minute first.”

  She left without a word. Then Dad took both of my hands in between his, closed like a shut book. He used to tell me bedtime stories this way. Opening up our palms and tracing the lines in my skin with his once-upon-a-times.

  “Hey, do you know how much I love you?” he asked. I nodded, avoiding his eyes. “And do you know what a champ you are for getting me to the hospital when you did?” I shrugged. “Okay, how about this—why don’t you look up plane tickets to San Francisco and we’ll get you out there for a visit?”

  “With you?” I asked. It was like a knee-jerk reaction. It took Dad and me both off guard.

  “We’ll try,” he said, pulling me in for a hug. His skin smelled so sour I winced. “You’re my girl,” he whispered as I rushed out.

  Julian was waiting by the elevators. So was the mustachioed woman who’d ushered me out of the bathroom just a half hour ago.

  I smiled at her and said, “Hi again!” so gleefully that she got confused and looked behind her. Then I gave that same fake smile to Julian and asked loudly, “Were you going to tell me? Or just send a postcard from the Golden Gate Bridge?”

  “I just thought you had a lot going on,” he said.

  “Shut up,” I shot back. That scared the woman enough that she motioned for us to take the next open elevator by ourselves. I pressed the L button two times with each elbow and sucked in my breath defiantly.

  When the doors opened again, Julian said, “I thought you stopped doing that.”

  I blew all my stored-up air and rage in his face. “What do you know about me?! You don’t know anything! And I don’t need you to know anything! I don’t need you at all!”

  Storming through the tropical paradise of Lobby, I stopped at every hand sanitizer I could find and rubbed in the foamy elixir until my skin was screaming as loud as my anger. Then I hurled myself through the nonromantic revolving doors into the chilly night.

  “Listen,” said Julian. “I’m not leaving for another few months. Can we just have fun and not act like this is the end of the world?”

  “Ha!” I threw my head back to add exquisitely vulnerable drama. I almost hoped people were watching. “You’re so full of yourself. As if you could end the world. Goodbye, Julian.”

  I slung on my backpack indignantly and started strutting away. I hadn’t planned on breaking up with my best friend. I just wanted him and everything he had been to me to be gone.

  “Oh … kay,” Julian said. It was probably the first time I’d actually shocked him. Or maybe he was just confused about logistics. “But do you want a ride home first?” he asked.

  Damnit.

  Carbon Monoxide

  Yosef Schlockitsky1 got on his motorcycle to go into town but never arrived. He was found on the side of the road, sleeping. He slept for six days without waking. When he did get up, he had an erection that lasted a month.

  The culprit?

  A Soviet-era uranium mine that is leaking high levels of carbon monoxide, poisoning the villagers of Kalachi in Kazakhstan.

  Sounds like a joke, but not when you’re Yosef with the boner.

  Or any of the other 160 people in Kalachi who’ve fallen asleep for days at a time, or suffered headaches, hallucinations, and bladder problems.

  Carbon monoxide is odorless, colorless, and all around us. We have sensors for carbon monoxide levels in our house, but I don’t trust them anymore.

  Chapter 11

  PEOPLE WHO NEED PEOPLE

  It was always cool in Dad’s
toolshed, and smelled a little like cow dung, which is why no one went in there except for me. It was just about ten feet by ten feet of space, cut into the stone foundation on the side of our house. It had a dirt floor, one toaster-size window, and a door with a metal latch that only locked from the inside.

  Dad hadn’t actually used his tools or tried to fix anything besides the occasional leaky pipe in years. But he had the shed well stocked. Five huge bags of mulch, a few pairs of gardening shears, a circular saw, a power drill, and my favorite: the manual pencil sharpener that he’d drilled into the one wooden beam.

  This is where I was making my secret end-of-the-world bunker.

  I was pretty proud of how minimalist but efficient I’d set it up to be. It took a lot of research not only for the best quality but also I could only buy stuff once a month because of limited funding. Mom had given me an emergency credit card the first day of high school and I’d figured out how to keep the balance pretty steady by making deposits from my bat mitzvah/babysitting money. (That is, if I kept sponsoring Asian elephants to a minimum.) She never checked the statements she got as long as the bottom line continued to add up.

  I had just a few pieces of card tables from random garage sales and a small cooler of nonperishable foods. A bag of walnuts because if we were caught down here I didn’t want to spend the end of our lives hearing Mom talk about how those things could’ve saved us. The first-aid kit was the hardest piece to put together. I’d read so many different versions of what was essential and I didn’t want to make any mistakes but I also couldn’t afford a lot of the top surgical equipment. So far I’d collected painkillers, anti-inflammatory meds, bandages, antiseptic cream, a sterilized needle and strong thread, cough medicine, cotton wool, iodine, and a roll of string (for emergency amputations—those were my least favorite instructional videos to watch).

  On top of the mulch I had a dozen space blankets I’d gotten online. Four for our family and some extras because they folded up very compactly and I really did like most of our neighbors. I had to look into new insulation to help with extreme cold and protection against airborne gasses or poisoned runoff being absorbed by the soil. And I wanted to replace all the canned foods because I’d just finished this article about the difference between BPA-free and non-BPA. Whoever said that knowledge equaled power didn’t have the Internet as a source for info. Or my brain scrambling all the pieces of knowledge and power into a kaleidoscope of despondency. Looking around now, I felt dizzy from all the stuff I knew and could never unknow.