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Handle With Care

February 2005


My whole life, I've never been on a vacation. I've never even left New Hampshire, unless you count the time that we flew to Nebraska --- and even you have to admit that sitting in a hospital room for three days watching really old Tom and Jerry cartoons while you get your Pamidronate infusion is nothing like going to a beach or SeaWorld or the Grand Canyon. So you can imagine how excited I was when I found out that my family was planning to go to Disneyworld. We would go during February school vacation. We'd stay at a hotel that had a monorail running right through the middle of it.

Mom began to make a list of the rides we would go on. It's a Small World, and Dumbo's Flying Circus, Peter Pan's ride.

"Those are for babies," I complained.

"Those are the ones that are safe," she said.

"Space Mountain," I suggested.

"Pirates of the Caribbean," she answered.

"Great," I yelled. "I get to go on the first vacation of my life, and I won't even have any fun." Then I stormed off to our room, and even though I wasn't downstairs anymore, I could pretty much imagine what our parents were saying: There Amelia goes, being difficult again.

It's funny, when things like this happen (which is, like, always) Mom isn't the one who tries to iron out the mess. She's too busy making sure you're all right, so the task falls to Dad. Ah, see, there's something else that I'm jealous about: he's your real Dad, but he's only my stepfather. I don't even know my real dad; he and my mother split up before I was even born, and she swears that his absence is the best gift he could ever have given me. But Sean adopted me, and he acts like he loves me just as much as much as he loves you --- even though there's this black, jagged splinter in my mind that constantly reminds me this couldn't possibly be true.

Meel, he said, when he came into my room (he's the only one I'd ever let call me that in a million years; it makes me think of the worms that get into flour and ruin it, but not when Dad says it), "I know you're ready for the big rides. But we're trying to make sure that Willow has a good time too."

Because when Willow's having a good time, we're all having a good time.

He didn't have to say it, but I heard it all the same.

"We just want to be a family on vacation,"

he said.

I hesitated. "The teacup ride," I heard myself say.

Dad said he'd go to bat for me, and even though Mom was dead set against it --- what if you smacked up against the thick plaster wall of the teacup? --- he convinced her that we could whirl around in circles with you wedged between us, so that you wouldn't get hurt. Then he grinned at me, so proud of himself to have negotiated this deal that I didn't have the heart to tell him I really couldn't care less about the teacup ride.

The reason it had popped into my head was because a few years ago, I'd seen a certain commercial for Disneyworld on TV. It showed Tinkerbell floating like a mosquito through the Magic Kingdom over the heads of the insanely cheery visitors. There was one family that had two daughters, the same age as you and me, and they were on the Mad Hatter's teacup ride. I couldn't take my eyes off them --- the older daughter even had brown hair, like me; and if you squinted the father looked a lot like Dad. The family seemed so happy it made my stomach hurt to watch it. I knew that the people on the commercial probably weren't even a real family --- that the mom and dad were probably two single actors, that they had most likely met their fake daughters that very morning as they arrived on set to shoot the commercial --- but I wanted them to be one. I wanted to believe they were laughing, smiling, even as they were spinning out of control.

· · · · · ·

Pick ten strangers and stick them in a room, and ask them which one of us they feel sorrier for --- you or me --- and we all know who they'll choose. It's kind of hard to look past your casts and the funny twitch of your hips when you walk and that part of your right arm that's supposed to be straight curves in a half-circle. I'm not saying that you've had it easy. It's just that I have it worse, because every time I think my life sucks, I look at you and hate myself even more for thinking my life sucks in the first place.

Here's a snapshot of what it's like to be me:

Amelia, don't jump on the bed, you'll hurt Willa.

Amelia, how many times have I told you not to leave your socks on the floor, because Willa could trip over them?

Amelia, turn off the TV (although I've only watched a half hour, and you've been staring at it like a zombie for five hours straight).

I know how selfish this makes me sound, but then again, knowing something's true doesn't keep you from feeling it. And I may only be eleven, but believe me - that's long enough to know that our family isn't the same as other families; and never will be.

Case in point: what family packs a whole extra suitcase full of Ace bandages and waterproof casts, just in case? What mom spends days researching the hospitals in Orlando? It was the day we were leaving; and as Dad loaded up the car, you and I sat at the kitchen table, playing Rock Paper Scissors. "Shoot," I said, and we both threw scissors. I should have known better; you always threw scissors. "Shoot," I said again, and this time I threw rock. "Rock breaks scissors," I said, bumping my fist on top of your hand.

"Careful," Mom said, even though she was facing in the opposite direction.

"I win."

"You always win."

I laughed at you. "That's because you always throw scissors."

"Leonardo da Vinci invented the scissors,"

you said. You were, in general, full of information no one else knew or cared about, because you read all the time, or surfed the net, or listened to shows on the History Channel that put me to sleep. It freaked people out, to come across a four year old who knew that toilets flushed in the key of Eb, or that the oldest word in the English language is town, but Mom said that lots of kids with osteogenesis imperfecta were early readers with advanced verbal skills. I figured it was like a muscle: your brain got used more than the rest of your body, which was always breaking down; no wonder you sounded like a little Einstein.

"Do I have everything?" Mom asked, but she was talking to herself. For the bazillionth time she ran through a checklist. "The letter," she said, and then she turned to me. "Amelia, we need the doctor's note."

It was a letter from Dr. Rosenblad, saying the obvious: that you had OI, that you were treated by him at Children's Hospital. It was in the glove compartment of the van, next to the registration and the owner's manual from Toyota, plus a torn map of Massachusetts, a Jiffy Lube receipt, and a piece of gum that had lost its wrapper and grown furry. I'd done the inventory once when my mother was paying for gas.

"If it's in the van, why can't you just get it when we drive to the airport?"

"Because I'll forget," Mom said, as Dad walked in.

"We're locked and loaded," he said. "What do you say, Willow? Should we go visit Mickey?"

You gave him a big silly grin, as if Mickey Mouse was real and not just some teenage girl wearing a big plastic head for her summer job. "Mickey Mouse's birthday is November 18th," you announced, as he helped you crawl down from the chair.

Mom frowned over her list one last time. "Sean, did you pack the Motrin?"

"Two bottles."

"And the camera?"

"Shoot, I left it on the dresser upstairs --- " He turned to me. "Sweetie, can you grab it while I put Willow in the car?"

I nodded and ran upstairs. When I came down, camera in hand, my mother was standing alone in the kitchen turning in a slow circle, as if she didn't know what to do without Willow by her side. She turned off the lights and locked the front door, and I bounded over to the van. I handed the camera to Dad and buckled myself in beside your car seat, and let myself admit that as dorky as it was to be eleven years old and excited about Disneyworld, I was. I was thinking about sunshine and Disney songs and monorails and not at all about the letter from Dr. Rosenblad.

Which means, in the long run, that everything that happened was my fault.

· · · · · ·

We didn't even make it to the stupid teacups. We had just gotten through the front gates of the theme park and onto Main Street USA --- Cinderella's Castle in full view --- when the perfect storm happened. You said you were hungry and we turned into an old-time ice cream parlor. Dad stood in line holding your hand while Mom brought napkins over to the table where I was sitting. "Look," I said, pointing out Goofy, pumping the hand of a screaming toddler. At exactly the same moment that Mom let one napkin flutter to the ground and Dad let go of your hand to take out his wallet, you hurried to the window to see what I wanted to show you, and you slipped on the tiny paper square.

We all watched it in slow motion, the way your legs simply gave out from underneath you, so that you sat down hard on your bottom. You looked up at us, and the whites of your eyes flashed blue, the way they always do when you break.

· · · · · ·

It was almost like the people at Disneyworld had been expecting this to happen. No sooner had Mom told the man scooping ice cream that you'd broken your leg than two men from their medical facility came with a stretcher. With Mom giving orders, the way she always does around doctors, they managed to get you onto it. You weren't crying, but then, you hardly ever did when you broke something. Once, I had broken my pinky playing tetherball at school and I couldn't stop freaking out when it turned bright red and blew up like a balloon; but you didn't even cry the time you'd broken your arm right through the skin.

"Doesn't it hurt?" I whispered, as they lifted up the stretcher so that it suddenly grew wheels.

You were biting your lower lip, and you nodded.

It was Saturday night, and the people coming into the emergency room were much more interesting that the TV program that was playing. There were two kids who looked like they were the right age for college, both bleeding from the same spot on their foreheads and laughing every time they looked at each other. There was an old man wearing sequined pants and holding the right side of his stomach, and a girl who only spoke Spanish and was carrying screaming twin babies.

Suddenly, Mom burst out of the double doors to the right, with a nurse running after her, and another woman in a skinny pinstriped skirt and red high heels. "The letter," she cried. "Sean, what did you do with it?"

"What letter?" Dad asked, but I already knew what she was talking about.

"Mrs. O'Keefe," the woman said, "please. Let's do this somewhere more private."

She touched Mom's arm, and --- well, the only way I can really describe it is that Mom just folded in half. Dad wrapped himself around her, and the nurse led them to another empty room, a smaller one, with a tattered red couch and a little oval table and fake flowers in a vase. There was a picture on the wall of two pandas, and I stared at it while the woman in the skinny skirt --- her name was Donna Roman, and she was from the Department of Children and Families - talked to our parents. "Dr. Rice has some concerns about Willow," she said. "Apparently, this wasn't her first break?"

"Willow's got osteogenesis imperfecta," Dad said.

"I already told her," Mom answered. "She didn't listen."

"Without a physician's statement," the woman said, "we have to look into this further. It's just protocol, to protect children --- "

"I'd like to protect my child," Mom said, her voice sharp as a razor. "I'd like you to let me get back in there so I can do just that."

"From what I understand, Dr. Rice is trying to reach your daughter's physician. But since it's Saturday night, he's having trouble making contact. So in the meantime, I'd like to get you to sign releases that will allow us to do a full examination on Willow ---"

"Ms. Roman," Dad interrupted. "I'm a police officer. You can't really believe I'd lie to you?"

The woman just blinked at him. "I've already spoken to your wife, Mr. O'Keefe, and I'm going to want to speak to you too...but first I'd like to talk to Willow's sister."

My mouth opened and closed, but nothing came out of it. Mom was staring at me as if she was trying to do ESP. "You must be Amelia," the woman said. "Why don't we take a walk?" She took me to the candy machine at the far end of the emergency room hallway. "What would you like?" she asked. "Me, I'm a chocolate fiend, but maybe you're more of a potato chip girl?"

She was so much nicer to me when my parents weren't sitting there --- I immediately pointed to a Snickers bar. "I guess this isn't quite what you'd hoped your vacation would be, huh? Does this happen a lot?"

"Sure," I said. "Willow breaks bones all the time."

"Where does it usually happen?"

"At home, mostly."

"And who's home when it happens?"

"My parents," I said. It was a stupid question --- one of them was always with you.

"Who was with Willow this time?"

I thought back to the ice cream counter, to Dad, holding your hand. "My father."

"Was he upset?"

I remembered his tight face as we sped toward the hospital. His fists, balanced on his thighs as we waited for word about Willow's latest break. "I guess so."

"Do you think he did this because he was angry at Willow?"

Suddenly, I realized what she thought I'd meant. "My dad wasn't mad at Willow," I said. "It was an accident!"

She sighed. "Accidents like that don't have to happen."

"You don't understand --- "

By now she was walking back toward the room where my parents were. "Mr. and Mrs. O'Keefe,"

Donna Roman said, "we're putting your children into protective custody."

Mom threw her arms around me. "Protective custody?"

With a firm hand --- and the help of the police officer --- Donna tried to peel her away from me. "We're just keeping the children safe,"

she said, "until we can get this all cleared up. Willow will be here overnight." She started to steer me out of the room, but I grabbed at the door frame.

"Mommy," I yelled.

"Where are you taking my daughter?"

"Come on, sweetheart," Donna Roman said, and she pulled at my hands until I had to let go, until I was being dragged out of the hospital kicking and screaming. I did this for five minutes, until I went totally numb. Until I understood why you didn't cry, even though it hurt: there were kinds of pain you couldn't speak out loud.

· · · · · ·

I'd heard the words foster home before, in books that I read and television programs I'd watched. I figured that they were for orphans and inner-city kids, kids whose parents were drug dealers -- not girls like me who lived in nice houses and got plenty of Christmas presents and never went to sleep hungry. As it turned out, though, Mrs. Ward, who ran this temporary foster home, could have been an ordinary mom. I guess she had been one, from the photos that plastered every surface, like wallpaper. She met us at the door wearing a red bathrobe and slippers that looked like pink pigs. "You must be Amelia,"

she said, and she opened the door a little wider.

I was expecting a posse of kids, but it turned out that I was the only one staying with Mrs. Ward. She took me into the kitchen, which smelled like dishwashing detergent and boiled noodles. She set a glass of milk and a stack of Oreo cookies in front of me. "You're probably starving," she said, and even though I was, I shook my head. I didn't want to take anything from her; it felt like giving in.

My bedroom had a dresser, a small bed, and a comforter with cherries printed all over it. There was a television, and a remote next to the bed. My parents would never let me have a television in my room; my mother said it was the Root of All Evil. I told Mrs. Ward that and she laughed. "Maybe so," she said, "but then again, sometimes The Simpsons are the best medicine." She opened a drawer and took out a clean towel and a nightgown that was a couple of sizes too big. I wondered where it had come from. I wondered how long the last girl who'd worn it had slept in this bed.

"I'm right down the hall if you need me," Mrs. Ward said. "Is there anything else I can get you?"

My mother.

My father.



"Are my parents...are they in a foster home too?"

She hesitated. "Something like that."

"I want to see Willow."

"First thing tomorrow," Mrs. Ward said.

I lay down, and tried to remember the useless bits of information you'd rattle off before we went to sleep, when I was always telling you to just shut up already: Frogs have to close their eyes to swallow. One pencil can draw a line thirty-five miles long. Cleveland, spelled backward, is DNA level C.

I was still hungry, or empty, I couldn't tell which. After Mrs. Ward had gone to her own bedroom I tiptoed out of bed. I turned the light on in the hallway and went down to the kitchen. There, I opened up the refrigerator and let the light and cold fall over my bare feet. I stared at lunch meat, sealed into plastic packages; at a jumble of apples and peaches in a bin; at cartons of orange juice and milk lined up like soldiers. When I thought I heard a creak upstairs, I grabbed whatever I could: a loaf of bread, a Tupperware of cooked spaghetti, a handful of those Oreos. I ran back to my room and closed the door, spread my treasure out on the sheets in front of me.

At first, it was just the Oreos. But then my stomach rumbled and I ate all the spaghetti --- with my fingers, because I had no fork. I had a piece of bread and another and then another and before I knew it only the plastic wrapper was left. What is wrong with you, I thought, catching my reflection in the mirror. Who eats a whole loaf of bread? The outside of me was disgusting enough --- boring brown hair that frizzed with crummy weather; eyes too far apart, that crooked front tooth, enough fat to muffin-top my jean shorts --- but the inside of me was even worse. I pictured it as a big black hole, like the kinds we learned about in science last year, that suck everything into their center. A vacuum of nothingness, my teacher had called it.

Everything that had ever been good and kind in me, everything people imagined me to be, had been poisoned by the part of me that had wished, in the darkest crack of the night, that I could have a different life. The real me was the kind of disgusting person who imagined a life where you had never been born. The real me had watched you being loaded into an ambulance and had let myself wish, for a half a second, that I could stay at the theme park. The real me was could eat a whole loaf of bread in ten minutes and still have room for more.

I hated myself.

I could not tell you what made me go into the bathroom that was attached to my room and stick my finger down my throat. Rats can't throw up, you'd told me once; it popped into my head now. With one hand holding up my hair, I vomited into the toilet, until I was flushed and sweating and empty and relieved to learn that, yes, I could do this one thing right, even if it made me feel even worse than I had before.

Weak and wobbly, I stumbled back to my borrowed bed and reached for the television remote. My eyes felt like sandpaper and my throat ached, but I flipped through the channels. Suddenly that old Disneyworld commercial came on. It felt like a punch in the gut: there was Tinkerbell, there were the happy people; there was the family that could have been us on the teacup ride.

What if my parents never came back?

What if you didn't get better?

What if I had to stay here forever?

When I started to sob, I stuffed the corner of the pillow deep into my mouth so Mrs. Ward wouldn't hear. I hit the mute button on the television, and I watched the family at Disneyworld going round in circles.


It's funny, isn't it, how you can be one hundred percent sure of your opinion on something until it happens to you. Like arresting someone --- people who aren't in law enforcement think it's appalling to know that even with probable cause, mistakes are made. If that's the case, you unarrest the person, and tell him you were just doing what you had to. Better that than take the risk of letting a criminal walk free, I've always said, and to hell with civil libertarians who wouldn't know a perp if one spit in their faces. This was what I believed, heart and soul, until about an hour ago when I was carted down to the Lake Buena Vista PD on suspicion of child abuse. One look at your x-rays, at the dozens of healing fractures, and the doctors went ballistic and called DCF. Dr. Rosenblad had given us a note years ago that should have served as a Get Out Of Jail Free card --- and as far as I know, Charlotte's always carried it around in the minivan, just in case. But today, with everything we had to remember to pack for the trip, the letter was forgotten, and what we got instead was a police interrogation.

"This is bullshit," I yelled. I'd been alternating between playing good cop and bad cop, but as it turned out, neither worked when you were up against another officer from an unfamiliar jurisdiction. I hadn't seen Charlotte since they'd brought us to the station to be questioned --- in cases like this, we'd separate the parents so that they had less of a chance to fabricate a story. The problem was, even the truth sounded crazy. A kid slips on a napkin and winds up with compound fractures in both femurs? You don't need nineteen years on the force, like me, to be suspicious of that one.

"Mr. O'Keefe," the detective said. "Let's go through this again."

"I want to see my wife."

"That's not possible right now."

"I want to make a phone call."

"You're not under arrest," the detective said.

I laughed. "Yeah, right."

He gestured toward the phone in the middle of the desk. "Dial nine for an outside line," he said, and he leaned back in his chair and folded his arms, as if to make it clear that he wasn't giving me any privacy.

"You know the number for the hospital where my daughter's being kept?"

"You can't call her."

"Why not? I'm not under arrest," I repeated.

"It's late. No good parent would want to wake his kid up. But then you're not a good parent, are you, Sean?"

"No good parent would leave his kid alone at a hospital when she's scared and hurt," I countered. "I'm not saying another word until I talk to her. Give me that number and I'll tell you what really happened today."

He stared at me for a minute, then picked up the phone and dialed. He asked for your room, and talked quietly to a nurse who answered. Then he handed the receiver to me. "You have one minute," he said.

You were groggy, shaken awake by that nurse. Your voice sounded small enough for me to carry around in my back pocket. "Willow," I said. "It's Daddy."

"Where are you?"

"We're coming back for you, honey. We're going to see you tomorrow, first thing." I cleared my throat. "Tell me something I don't know, baby."

It was a game between us. Honestly, I'd never seen a kid absorb information like you. Your body might betray you at every turn, but your brain picked up the slack.

"A nurse told me that a giraffe's heart weighs twenty-five pounds," you said. "That's huge," I replied. How heavy was my own? "Now, Wills, I want you to

lie down and get a good night's rest, so that you're wide awake when I come get you in the morning."

"You promise?"

I swallowed. "You bet, baby. Sleep tight, okay?" I handed the phone back to the detective.

"How touching," he said flatly, hanging it up. "All right, I'm listening."

I rested my elbows on the table between us. "We had just gotten into the park, and there was an ice cream place close to the entry. Willow was hungry, so we decided we'd stop off there. My wife went to get napkins, Amelia sat down at a table, and Willow and I were waiting in line. Her sister saw something through the window, and Willow ran to go look at it, and she fell down and broke her femurs. These three breaks would be her twenty-fifth, twenty-sixth, and twenty-seventh. She's got a disease called osteogenesis imperfecta, which means her bones are extremely brittle. One in twenty thousand kids are born with it. What the fuck else do you want to know?"

"That's exactly the statement you gave an hour ago." The detective threw down his pen. "I thought you were going to tell me what happened."

"I did," I said. "I just didn't tell you what you wanted to hear."

The detective stood up. "Sean O'Keefe," he said, "You're under arrest."

· · · · · ·

By seven AM on Sunday morning, I was pacing in the waiting room of the police station, a free man, waiting for Charlotte to be released. The desk sergeant who let me out of the lockup shuffled beside me, uncomfortable. "I'm sure you understand," he said. "Given the circumstances, we were only doing our job."

My jaw tightened. "Where's my older daughter?"

"DCF is on their way here with her."

Suddenly a door opened, and I could see Charlotte --- dazed, pale, her brown curls tumbling out of her ponytail elastic. She was blistering the officer escorting her: "If Amelia isn't back here before I count to ten, I swear I'll --- "

God, I love your mother. She and I think exactly alike, when it counts.

Then she noticed me, and broke off. "Sean!"

she cried, and ran into my arms.

She smelled like apples and suntan lotion. She'd made us all put it on before we even left the Orlando airport. To be safe, she'd said.

There was cry from the doorway, and we both looked up in time to see Amelia barreling toward us. "I forgot," she sobbed. "Mom, I forgot to take the doctor's note. I'm sorry. I'm so sorry."

"It's not anyone's fault," I said, pointedly looking at the desk sergeant. "Let's get out of here."

The desk sergeant had offered to drive us to the hospital in a cruiser, but I asked him to call us a cab instead. "To the hospital," I told the driver, and I closed my eyes and leaned my head back against the padded seat.

"Thank God," your mother said. "Thank God that's over."

I didn't even open my eyes. "It's not over," I said. "Someone is going to pay."


Suffice it to say that the trip home wasn't a pleasant one. You had been put into a spica cast --- surely one of the biggest torture devices ever created by doctors. It was a half shell of plaster that covered you from knee to ribs. You were in a semi-reclined position, because that's what your bones needed to knit together. The cast kept your legs splayed wide so that the femurs would set correctly. Here's what we were told:

You would wear this cast for several months. Then it would be sliced in half, and you would spend weeks sitting in it like an oyster on the half shell, trying to rebuild your stomach muscles so that you could sit upright again.

The small square cut out of the plaster at your belly would allow your stomach to expand while you ate. The open gash between your legs was left so you could go to the bathroom.

Here's what we were not told:

You wouldn't be able to sit completely upright, or lie completely down.

You couldn't fly back to New Hampshire.

You couldn't even lie down in the back of a normal car.

You wouldn't be able to sit in your wheelchair.

Your clothes wouldn't fit over the cast.

Because of all these things, we did not leave Florida immediately. We rented a Suburban, with three full bench seats, and settled Amelia in the middle. You had the whole rear bench, and we padded this with blankets we'd bought at Wal*Mart. There we'd also bought men's t-shirts and boxer shorts --- the elastic waists could stretch over the cast and be belted with a hair scrunchie if you pulled the extra fabric to the side, and if you didn't look too closely, they almost passed for shorts. They were not fashionable, but they covered up your crotch, which was left wide open by the position of the cast.

Then we started the long drive home.

You slept; the painkillers they'd given you at the hospital were still swimming through your blood. Amelia alternated between doing word search puzzles and asking if we were almost home yet. We ate at drive-through restaurants, because you couldn't sit up at a table. Seven hours into our drive, Amelia shifted in the back seat.

"You know how Mrs. Grey always makes us write a short story about the stuff we did over vacation? I'm going to write about you guys trying to figure out how to get Willow onto the toilet to pee."

"Don't you dare," I said.

"Well, if I don't, my short story's going to be really short."

"We could make the rest of the trip fun," I suggested at one point. "Stop off at Graceland...or Washington D.C ..."

"Or we could just drive straight through and be done with it," Sean said.

I glanced at him. In the dark, a green band of light from the dashboard reflected like a mask around his eyes.

"Could we go to the White House?" Amelia asked, perking up.

I imagined the hothouse of humidity that Washington would be; I pictured us lugging Willow around on our hips as we climbed the steps to the Air and Space Museum. Out the window, the black road was a ribbon that kept unraveling in front of us. "Your father's right," I said.

· · · · · ·

People ask all the time how I'm doing; but the truth is, they don't really want to know. They look at your casts --- camouflage or hot pink or neon orange. They watch me unload the car and set up your walker, with its tennis-ball feet, so that we can slowly creep across the sidewalk while behind us, their children swing from monkey bars and play dodge-ball and all the other ordinary things that would cause you to break. They smile at me, because they want to be polite or politically correct; but the whole time they are thinking, Thank God. Thank God it was her, instead of me.

Your father says that I'm not being fair, when I say things like this. That some people, when they ask, really do want to lend a hand. I tell him that if they really wanted to lend a hand, they wouldn't bring macaroni casseroles --- instead they'd offer to take Amelia apple-picking or ice-skating so that she can get out of the house when you can't; or they'd rake the gutters of the house that are always clogging up after a storm. And if they truly wanted to be saviors, they'd call the insurance company and spend four hours on the phone, so I wouldn't have to. But Sean says I'm being a martyr.

Sean doesn't realize that most people who offer their help do it to make themselves feel better, not us. To be honest, I don't blame them. It's superstition: if you offer assistance to the family in need...if you throw salt over your shoulder...if you don't step on the cracks...then maybe you'll be immune. Maybe you'll be able to convince yourself that this could never happen to you.

I suppose I used to think that too, but then I'd look at you, sleeping semi-upright in this spica cast, or stifling the urge to scratch the itch underneath the plaster. The last time you broke your leg, you were just as brave. I remember you inched one foot in front of the other, your teeth caught your lower lip in concentration. You forced yourself to learn to walk again after each fall. How could I ask any less of myself?

· · · · · ·


On my first day back at work, I came into the department to find a doctored WANTED poster on my locker. Written across the photo of my face, in bright red Sharpie marker, was the word APPREHENDED. "Very funny," I muttered, and I ripped down the flyer and crumpled it int a ball.

"Sean O'Keefe!" said one of the guys, pretending to hold a microphone in his hand as he held it up to another cop. "You've just won the Super Bowl. What are you going to do next?"

Two fists, pumped in the air. "I'm going to Disneyworld!"

The rest of the guys cracked up. "Hey, your travel agent called," one said. "She's booked your tickets to Gitmo for your next vacation."

My captain hushed them all up and came to stand in front of me. "Seriously, Sean, you know we're just pulling your chain. How's Willow doing?"

"Okay," I said. "She's okay."

"Well, if there's anything we can do,"

the captain said, and he let the rest of his sentence fade like smoke.

I swallowed, pretending that this didn't bother me; that I was in on the joke, instead of being the laughingstock. "Don't you guys have something constructive to do? What do you think this is, the Lake Buena Vista PD?"

At that, everyone howled with laughter and dribbled out of the locker room, leaving me alone to dress in my uniform. I smacked my fist into the metal frame of my locker, and it jumped open. A piece of paper fluttered out --- my face again, with Mickey Mouse ears superimposed on my head. And on the bottom: It's a Small World After All.

My ears were hot, my collar too tight. I pulled at it as I navigated the hallways of the department to the dispatch office and yanked a telephone book from a stack kept on a shelf. I looked for the ad until I found the name I was looking for; the one I'd seen on countless late night television commercials: Robert Ramirez, Plaintiff's Attorney: Because you deserve the best. I do, I thought. And so does my family. So I dialed the number. "Yes," I said. "I'd like to make an appointment."

· · · · · ·

I was the designated night watchman. After you girls were fast asleep and Charlotte was showered and climbing into bed, it was my job to turn off the lights, lock the doors, do one last pass through the house. With you in your cast, your makeshift bed was the living room couch. I almost turned off the kitchen nightlight before I remembered, and then I came closer and pulled the blanket up to your chin and kissed your forehead.

Upstairs, I checked in on Amelia and then went into our room. Charlotte was standing in the bathroom with a towel wrapped around herself, brushing her teeth. In the mirror, our eyes met. I've always wondered whether she sees what I do, when I look at her. Or for that matter, whether she notices the fact that my hair's gotten thinner on the top. "What do you want," she said. "How do you know I want something?"

"Because I've been married to you for nine years?"

I followed her into the bedroom. "I need you and Willow to come somewhere with me tomorrow," I said. "A lawyer's office."

Charlotte sank onto the mattress. "For what?"

"The way we were treated," I said. "The arrest. These things, you can't just let them get away with it. Because then it could happen to someone else."

She stared at me. "I thought you were the one who wanted to just get home and get on with our lives."

I sat down beside Charlotte, hesitating. "They took my family away. I was in that cell, thinking about you and Amelia and Willow, and all I wanted to do was hurt someone. All I wanted to do was turn into the person they already thought I was."

Charlotte lifted her gaze to mine. "Who's they?"

I threaded my fingers through hers. "Well," I said, "that's what I hope the lawyer will tell us."

· · · · · ·

The walls of the law offices of Robert Ramirez were papered in the cancelled settlement checks that he'd won for former clients. I paced with my hands clasped behind my back, leaning in to read a few. Pay to the Order of. $350,000. $1.2 million. $890,000. Amelia was hovering over the coffee machine, a nifty little thing that let you put in a single cup and push a button to get the flavor you wanted. "Mom," she asked, "can I have some?"

"No," Charlotte said. She was sitting next to you on the couch, trying to keep your cast from sliding off the stiff leather.

"But they have tea. And cocoa."

"No means no, Amelia!"

The secretary stood up behind her desk. "Mr. Ramirez is ready to see you now."

I pulled you onto my hip and we all followed the secretary down the hall to a conference room enclosed by walls of frosted glass. I kept my eyes on Ramirez; I wanted to see his reaction when he saw you. "Mr. O'Keefe," he said, and he held out a hand.

I shook it. "This is my wife, Charlotte. And my girls, Amelia and Willow."

"Ladies," Ramirez said, and then he turned to his secretary. "Briony, why don't you get the crayons and a couple of coloring books?"

From behind me I heard Amelia snort --- I knew she was thinking that this guy didn't have a clue; that coloring books were for little kids, not ones who were already wearing training bras.

Ramirez gestured toward a woman standing nearby. "I'd like to introduce you to Marin Gates...she's an associate here."

She looked the part. With black hair pulled back in a clip and a navy suit, she could have been pretty, but there was something off about her. Her mouth, I decided. She looked like she'd just spit out something that tasted awful.

"I've invited Marin to sit in on this meeting," Ramirez said. "Please, take a seat."

Before we could, though, the secretary reappeared with the coloring books. She handed them to Charlotte, black and white pamphlets that said Robert Ramirez, Esquire across the top in block letters. "Oh look," your mother said, shooting a withering glance in my direction. "Who knew they made up personal injury coloring books?"

Ramirez grinned. "The Internet is a wondrous place," he said. "How can we help you, Mr. O'Keefe?"

"It's Officer O'Keefe, actually," I corrected. And I told them. About your OI, and Disneyworld, and the ice cream, and how you fell. I told her about the men in black suits who led us out of the theme park and arranged for the ambulance, as if the sooner they got rid of us the better. I told her about the woman who'd taken Amelia away; about the interrogations that went on for hours at the police station; about the way no one believed me. I told her about the jokes that had been made about me at my own station.

"I want names," I said. "I want to sue, and I want to do it fast. I want to go after someone at Disneyworld, someone at the hospital, and someone at DCF. I want people's jobs, and I want money out of this to make up for the hell we went through."

Robert Ramirez nodded. "The type of case you're suggesting is very expensive, Officer O'Keefe. I can tell you right away that even though you're seeking a money judgment, you're not going to get one."

I blinked at him. "Those checks in the waiting room..."

"...were for cases where the plaintiff had a valid complaint. From what you've described to us, the people who worked at Disneyworld and the hospital and DCF were just doing their jobs. Doctors have a legal obligation to report suspicions of child abuse. Without the letter from your hometown doctor, the police had probable cause to make the arrest in the state of Florida. DCF has an obligation to protect children, particularly when the child in question is too young to give a detailed account of her own health issues. As an officer of the law, I'm sure if you step back and remove the emotion from the facts here, you'll see that once the health care information was received from New Hampshire, your kids were turned over to you; you and your wife were released...sure, it made you feel awful --- but embarrassment isn't a just cause of action."

"What about emotional damages?" I blustered. "Do you have any idea what that was like for me? For my kids?"

"I'm sure they were nothing compared to the emotional burden of living day in and day out with a child who has these particular health problems," Ramirez said, and beside me, Charlotte lifted her gaze to his. The lawyer smiled sympathetically at her. "I mean, it must be quite challenging." He leaned forward, frowning a little. "I don't know much about --- what's it called? Osteo..."

"Osteogenesis imperfecta," Charlotte said softly.

"How many breaks has Willow had?"

"Twenty-seven, including the new ones," I replied.

"How was Willow conceived?"

"Ugh," Amelia said --- until then, I'd forgotten she was with us --- "that's totally gross." I shook my head at her, a warning.

"We tried in vitro," Charlotte said. "Three cycles. But it didn't take. And we'd pretty much given up when I found out I was pregnant."

"Grosser," Amelia said.

"Amelia!" I passed you over to your mother, and pulled your sister up by the hand. "You can hang out in the waiting room," I said under my breath.

When I entered the conference room again, Charlotte was still talking. "...but I was thirty-nine years old," she said. "You know what they write on your charts, when you're thirty-nine? Geriatric pregnancy. I was worried about having a Down syndrome child --- I never had even heard of OI."

"Did you have amnio?"


I remembered it vividly --- Piper had wanted Charlotte to have the test so that she could put her mind to rest about Down syndrome. I thought it was an unnecessary risk, since there was a slight chance of miscarriage. The way I saw it, no matter what, we were going to have that baby and love that baby. So what could the amnio results tell us that would make any difference at all?

"OI can't be flagged with amnio," Charlotte said.

"So you didn't know Willow would be born with OI?" Ramirez asked.

"Not until the second ultrasound showed a bunch of broken bones. Look, are we about done here? If you don't want this case, I'm sure I can find --- "

"Well, there was that one weird thing," Charlotte interrupted. "During the 18 week ultrasound, the tech had to keep repeating the scan, because the picture she was getting of the brain looked too clear."

"There's no such thing as too clear," I said.

Ramirez and his associate exchanged a glance. "And what did your OB say?"

"Nothing." Charlotte shrugged. "No one even mentioned OI until we did another ultrasound at twenty-six weeks, and saw all the fractures."

Ramirez turned to Marin Gates. "See if it's ever diagnosed in utero that early," he ordered, and then he turned to Charlotte. "Would you be willing to release your medical records to us? We'll have to do some research on whether or not you have a cause of action --- "

I reached for you, leaving your mother's hands free. "I thought you said we didn't have a lawsuit."

"You might, Officer O'Keefe," Robert Ramirez said, looking at you as if he was memorizing your features. "Just not the one you thought."


As soon as we finished showing the O'Keefes out of the law office, I rounded on my boss. "There is no way I'm doing this," I said.

"Well," Bob agreed, "that's entirely possible. Or, alternately, we might wind up with the biggest wrongful birth payout in New Hampshire. Depends on what her medical records turn up."

A wrongful birth lawsuit implies that if the mother had known during her pregnancy that her child was going to be significantly impaired, she would have chosen to abort the fetus. It places the onus of responsibility for the child's subsequent disability on the OB/GYN. From a plaintiff's standpoint, it's a medical malpractice suit. For the defense, it becomes a morality question: who has the right to decide what kind of life is too limited to be worth living?

Many states had banned wrongful birth suits. New Hampshire wasn't one of them. There had been several settlements for the parents of children who'd been born with spina bifida or cystic fibrosis, or in one case, a boy who was profoundly retarded and wheelchair-bound due to a genetic abnormality --- even though the illness had never been diagnosed before, much less noticed in utero. In New Hampshire, a parent was responsible for the care of a disabled child their whole life --- not just till age eighteen --- which was as good a reason as any to seek damages. There was no question Willow O'Keefe was a sad story, with her enormous body cast, but she'd smiled and answered questions when the father left the room and Bob chatted her up. To put it bluntly: she was cute and bright and articulate --- and therefore a much tougher hardship case to sell to a jury.

"If Charlotte O'Keefe's provider didn't meet the standard of care," Bob said, shrugging, "then she should be held liable, so this doesn't happen again."

I rolled my eyes. "You can't play the conscience card when you stand to make a few million from the lawsuit, Bob. And it's a slippery slope --- if an OB decides a kid with brittle bones shouldn't be born, what's next? A prenatal test for low IQ, so you can scrap the fetus that won't grow up and get into Harvard?"

He clapped me on the back. "You know, it's nice to see someone so passionate. Personally, whenever people start talking about curing too many things with science, I'm always glad bioethics wasn't an issue during the time polio, TB, and yellow fever were running rampant." We were walking toward our individual offices, but he suddenly stopped and turned to me. "Are you a neo-Nazi?"


"I didn't think so. But if we were asked to defend a client who was a neo-Nazi in a criminal suit, could you do your job --- even if you found his beliefs disgusting?"

"Of course," I said immediately. "But this is totally different."

Bob shook his head. "That's the thing, Marin," he replied. "It really isn't."


"You look like hell," I said to Charlotte, as I came into the house. "When was the last time you slept?"

"Gee, Piper, it's really great to see you too," she answered tartly. "Is Amelia ready?"

"For what?"


She smacked her forehead. "I totally forgot. Amelia!" she yelled, and then to me: "We just got home from the lawyer's."

"And did they tell Sean he's nuts?"

Your mother was my best friend in the world, but your father could drive me crazy. He got an idea in his head, and that was the end of that --- you couldn't budge him. The world was utterly black and white for Sean, and I guess I've always been the kind of person who prefers a splash of color. "I suppose if you forgot about skating, you forgot about the bake sale too...? Charlotte winced. "What did you make?"

"Brownies. In the shape of skates. From scratch. The rest of the moms already blacklisted me because I missed the spring show for a medical conference. I'm trying to atone."

"So you whipped these up when? While you were stitching an episiotomy? After being on call for thirty-six hours?" Charlotte said, as she opened her pantry and rummaged through the shelves, finally grabbing a package of Chips Ahoy and spilling them onto a serving platter. "Honestly, Piper, do you always have to be so damn perfect?"

With a fork, she was attacking the edges of the cookies. "Whoa --- who peed in your Cheerios?"

"Well, what do you expect? You waltz in here and tell me I look like crap, and then you make me feel completely inadequate --- "

"You're a pastry chef, Charlotte. You could bake circles around --- what on earth are you doing?"

"Making them look homemade," Charlotte said. "Because I'm not a pastry chef, not anymore. Not for a long time. I'm just the skating club's resident dysfunctional mom."

I moved the platter away. "Charlotte. Are you okay?"

"Let's see. I was arrested last weekend; my daughter's in a full cast; I don't even have time to take a shower --- yup, I'm just fantastic." She turned to the doorway, and the staircase upstairs. "Amelia! Let's go!"

"Emma's gone selectively deaf, too," I said. "I swear she ignores me on purpose. Yesterday, I asked her eight times to clear the kitchen counter --- " "You know what," Charlotte said wearily. "I really don't care about the problems you're having with your daughter." No sooner had my jaw dropped --- I had always been Charlotte's confidante, not her punching bag --- she shook her head and apologized. "I'm sorry. I don't know what's wrong with me. I shouldn't be taking this out on you."

"I didn't even notice," I lied. Just then the older girls clattered down the stairs. "Don't forget your skates," Charlotte called, as they skidded past us in a flurry of whispers and giggles. I put my hand on Charlotte's arm. "You're not dysfunctional," I said firmly. "You're the most devoted mother I've ever met. You've given up your whole life to take care of Willow."

She ducked her head and nodded before looking up at me. "Do you remember her first ultrasound?"

I thought for a second, and then I grinned. "We saw her sucking her thumb. I didn't even have to point it out to you and Sean; it was clear as day."

"Right," your mother repeated. "Clear as day."


What if it was someone's fault?

The idea was just the germ of a seed, carried home in the hollow beneath my breastbone when we left the law offices. Even when I was lying awake next to Sean, I heard it as a drumbeat in my blood: what if, what if, what if. For four years now I had loved you, hovered over you, held you when you had a break. I had gotten exactly what I so desperately wished for: a beautiful baby. So how could I admit to anyone --- much less myself --- that you were not only the most wonderful thing that had ever happened to were also the most exhausting, the most overwhelming?

Three weeks after we first went to Robert Ramirez's law offices, they called to set up another appointment. They wanted to just run something by us. This time, Amelia was in school, but we still had to bring you. And this time, they were ready: beside the coffee machine were juice packs; next to the glossy architectural magazines were a small stack of picture books. When the secretary brought us back to meet the lawyers, we were not led to the conference room. Instead she opened the door to an office that was a hundred different shades of white: from the pickled wood floor to the creamy wall paneling to the pair of pale leather sofas. You craned your neck, taking this all in. Was it supposed to look like Heaven? And if so, what did that make Robert Ramirez?

The lawyer shook Sean's hand, and mine. "I thought the couch might be more comfortable for Willow," he said smoothly. "I'm sure you're wondering why we asked you to come associate's been doing a great deal of work these past two weeks. Does the name Marcus Cavendish ring a bell?"

Sean and I looked at each other and shook our heads.

"Dr. Cavendish is Scottish. He's one of the foremost experts on osteogenesis imperfecta in the world. And according to him, it appears that you have a good cause of action of medical malpractice against your obstetrician. You remembered your eighteen-week ultrasound being too clear, isn't that right, Mrs. O'Keefe? That's significant evidence that your obstetrician missed. She should have been able to recognize that your baby was suffering from osteogenesis imperfecta back then, long before the next ultrasound, where the broken bones were visible."

My head was spinning; and Sean looked utterly confused. "Wait a second," he said. "What kind of lawsuit is this?"

"It's called wrongful birth," Ramirez said.

"And what the hell does that mean?"

"A wrongful birth lawsuit entitles the parents to sue for damages incurred from the birth and care of a severely disabled child. The implication is that if your provider had told you earlier on that your baby was going to be impaired, you would have had choices and options as to whether or not to continue with the pregnancy."

I remembered snapping at Piper: Do you always have to be so damn perfect?

What if the one time she hadn't been perfect was when it came to you?

I was as rooted to my seat as you were; I couldn't move; couldn't breathe. Sean spoke for me:

"You're saying my baby never should have been born?" he accused. "That she was a mistake?"

As he stood up, so did Robert Ramirez. "Officer O'Keefe, I know how unpalatable it sounds. But the term 'wrongful birth' is just a legal one. We don't wish your child wasn't born --- she's absolutely beautiful. We just think that when a doctor doesn't meet the standard of care a patient deserves, someone ought to be held responsible." He took a step forward. "It's medical malpractice. Think of all the time and money that's gone into taking care of Willow --- and will go into taking care of her in the future. Why should you pay for someone else's mistake?"

Sean towered over the lawyer, and for a second, I thought he might swat Ramirez out of his way. But instead he jabbed one finger into the lawyer's chest. "I love my daughter," Sean said, his voice thick. "I love her."

At this, you lifted your face. "Well, Daddy," you said, so simply, "I love you too."

He pulled you into his arms, but too fast --- the grape juice box you were holding tumbled onto the leather and then the floor, a rapidly spreading puddle as dark as blood. "Oh," I cried, digging in my purse for a tissue to blot the stain. That gorgeous, creamy leather; it would be ruined.

"It's all right, Mrs. O'Keefe,"

Marin murmured, kneeling beside me. "Don't worry about it."

"No, no --- we made the mess --- "

"Charlotte," Sean said, "let's get the hell out of here."

He was already striding down the hall, volcanic, as I mopped up the juice. I realized that both lawyers were staring at me, and I rocked back on my heels. "Um, thank you...for all the time you spent with us," I faltered.

"Charlotte!" Sean's voice rang from the waiting room.

"I'm really sorry that we bothered you..." Slowly, I stood and crossed my arms. "I just...there's one thing..." I looked up at the lawyers and took a deep breath. "What happens if we win?"

Excerpted from HANDLE WITH CARE © Copyright 2011 by Jodi Picoult. Reprinted with permission by Atria Books. All rights reserved.

Handle With Care
by by Jodi Picoult

  • Genres: Fiction
  • hardcover: 496 pages
  • Publisher: Atria
  • ISBN-10: 0743296419
  • ISBN-13: 9780743296410