When the first clump falls out, I think at first that it is the residue from my sister’s shaver. But it is too thick and too plentiful. I run my hand through my hair, frowning. Then another clump falls out.
“Mom!” I scream.
My mother comes running, and when I see her ashen white face, I know that she is certain that I have collapsed or that I am bleeding terribly. When she sees that I am not convulsing on the floor, she clutches her chest, relieved.
“What’s wrong, Annika?” she asks.
In response, I hold up my hand, now covered in hair.

The hospital is a dark and foreboding place. When my mom first sees the bruises on my back, she takes me straight to that ominous building. I scream during the first few needle pricks. For the second battery of pricks and prods, I sit as still as possible, tears streaming down my face. When it’s finally over, my mom and I sit hunched in the plastic orange chairs in the pediatric ward, waiting for the results. Soon, a doctor heads towards us, a clipboard in hand. I have been drifting in and out of sleep as we wait for my test results, and now I pretend that I am sound asleep, so that I can hear what the doctor is here to say. Through my nearly closed eyes, I can see that he is wearing an impenetrable mask, his expression neutral and pleasant. Yet, beneath that mask, he is grimacing, and in his eyes, I can see sorrow.
He introduces himself to my mom and begins, “I’m very sorry.”
I feel my mom tense, every muscle in her body freezing. The doctor’s words wash over me. I catch snippets of the news he is bringing us. “Leukemic syndrome.” “White blood cell count.” And one word: “Cancer”.
“The prognosis is not the best,” he says at last, “The survival rate is 20-30%.”
I hear my mom suck in her breath. Around her, everything is collapsing. The world has been pulled out from under her feet. But his words don’t really register with me. Survival rate? What does this have to do with my bruises?
“What should we do?” my mom asks, recovering slightly, “We need to start treatment immediately.”
“For now, take her home and let her rest. We’ll schedule a meeting for tomorrow, and we can discuss her treatment plan.”
“Why should we wait any longer? Why delay when every second could be the difference between life and death?” my mom says, her voice quivering with disbelief and anger.
The doctor lowers his voice, and I tune out the rest of their discussion. The news is finally sinking in. I have leukemia, and I am going to die.
The doctor convinces my mom to go home, and she shakes me, believing that I am asleep and have not heard the fateful news. We leave the hospital, heading back out into the bright, sunny day. We get in the car and drive away, as if nothing has changed.
“Annika, you have an illness called leukemia,” my mom tells me, her voice about to break, “It’s going to take some time to get better.”
“Okay,” I say.
She is about to say something else, but she can’t put words to her inner tumult, and she stays silent.
I look out the window as a flock of birds flies through the sky. I want wings, I think. I want to fly.
“Wouldn’t it be wonderful to be a bird?” I say.
“What?” my mom says, shocked, “Honey, I can’t think clearly enough to drive right now. Please don’t distract me.”
I go back to gazing wistfully at the birds. They can fly wherever they want, whenever they want. Wouldn’t it be wonderful, I think, to trade places with a bird just for one day? They can fly all over the world. A world, I now know, that I won’t be around long enough to see.

My mom has to steel herself before she tells each neighbor, friend, and relative that she encounters over the next few weeks. The first night, after we get back from the hospital, I hear my parents talking softly, and I hear my mother crying. When I wake up the next morning, I wonder if it had all been a dream. It seems surreal that first day, but soon it becomes a fact of life. I have only been on this Earth for ten years, and according to my doctors, it’s quite likely that I’ll only be here for a year or two longer.
The hair starts to fall out, and everyone knows that I’m sick. It’s the telltale sign that makes strangers point, stare, and pity. My mom agonizes over whether or not to keep me in school, but ultimately she decides that I shouldn’t spend my time learning capital cities and long division, when I might not be around long enough to use that knowledge. She didn’t say it that way, but I know that’s what she meant.

My family pours in from all corners of the world: cousins, aunts, uncles, and other long-lost relatives we haven’t seen in years. Friends whom I haven’t spoken to in months suddenly shower me with condolences and well wishes. Acquaintances I never even considered friends appear in the living room, watching my younger brother while my parents take me to the hospital. My older brother comes home from college; my sixteen-year-old sister is forbidden from bringing friends home after school. I am the focus of everyone’s attention.
I am not afraid of dying, I try to tell people, especially the counselor the hospital assigns to prepare me, I assume, for the possibility of death. What they don’t understand is that I don’t need to be prepared. I already am.
One time, when I was little, I was in the park, watching a flock of birds fly over my house. Suddenly, one of the birds trembled and fell to the ground, a few feet away from me. I watched its body shiver and fall still. I could feel something happening. It was almost as if the bird’s spirit lifted out of its body and took off into the air, its wings flapping, flying into another realm. This is what will happen when I die. When I think of this, I am filled with excitement. I want to fly. When I die, I will grow wings and fly into the distance, away from this realm and into another.
I will never grow up. I will never drive, be in high school, or go on a date. I will never get married or have kids of my own. Yet, I will go on another journey. I will go on a journey to a beautiful, far-off land, where there is only happiness and harmony.
And yet, “You’re not going to die,” my mom tells me.
She makes the effort to look me straight in the eye, and repeats it, “You’re not going to die. I don’t want you to ever give up. There is a good chance that the treatment will work, and you’ll be cured. Do you hear me?”
I nod and run into my mother’s embrace. Yet, I have felt, since that first drive home from the hospital, almost a certainty that I will die. And I know that I would rather die at peace, eager for the journey ahead, than struggling for that last gasp of air, clinging to life, fighting a battle with the enemy that is trying to kill me, when that enemy is no one but my own body cells, and there is truly no one to fight.
My mom doesn’t see it that way. I go for treatment after treatment, from chemotherapy to radiation to a bone marrow transplant to experimental drug trials. Every treatment fills me with irrepressible emotions, from trepidation to unease to outright fear. Most of the time, I am only concerned with the immediate pain or discomfort. Needle pricks and injections, I have gotten used to, but every treatment brings with it a new, menacing pain. Every time, the nurse says it will not hurt, and every time, it does.
Why can’t I just die? Why do I have to undergo these constant pains or this overbearing uncertainty of not knowing what or when it will happen? Every time I am put to sleep for a treatment or my parents rush me to the emergency room with a fever or a new set of bruises, I wonder if this will be it. When they put the anesthetic mask on me, I feel a flurry in my stomach, wondering if this will be the last time I go to sleep. But each time I wake up, to see my mother sitting by my bedside, struggling to hold back tears.
Sometimes my body responds to the treatment, and I start to feel better, but other times it doesn’t make any difference at all. Every time there is even a hint of the possibility of remission, it is quickly eradicated by the reappearance of tumors, the cancer metastasizing, slowly claiming my body bit by bit. Yet, I hold on, day after day, climbing out of the throes of cancer only to slide back into relapse. My mother struggles to take each piece of bad news with equanimity, but her composure always seems as if it is about to break at any moment. My father, stony-faced, stands beside her and holds her hand. My siblings and friends bring me games to play and books to read and do everything to avoid speaking about the situation, or even acknowledging that it exists. Their company and comfort helps to soften the days I spend in a hospital bed. But when I am alone, I gaze out the window, and search the sky for birds.

A few weeks after my twelfth birthday, I call my mom, holding up a panty covered in blood. She freaks out, certain that this signals kidney failure or metastasis, and rushes me to the hospital. When we get there, the doctor smiles and says, “I know this is hard to believe, but she’s just gotten her period.”
My mom seems ready to collapse with relief and shock. We drive home, slowly this time, listening to the radio in silence. At home, she shows me how to put on a pad. She seems calm and steady, but I see her in the kitchen after dinner, standing by the sink, tears streaming down her face. They are tears of joy, I realize. She never thought I would live to see this day.

I’m getting worse, I know. My body doesn’t respond to new treatments as quickly as it used to. Organ failure, I hear the doctors tell my parents, could be imminent. Course after course of chemotherapy leave my immune system compromised and send me into isolation, yet barely hold the cancer at bay. There is a battle being fought inside my body, I am told. I am a living civil war. My side is losing, I know. Yet, in this battle, there is no malicious enemy; both sides just want to stay alive. In the end, either the cancer will die and I’ll survive, or I’ll die and take the cancer out with me. Like all wars, it is pointless and ultimately self-defeating.

One day, about two years after my initial diagnosis, I ask my mom for a bird.
“A bird?” my mom says, shocked.
I nod.
“Honey, I can’t pay all these medical bills, much less afford to take care of a bird,” she answers, softly.
Her eyes are full of sorrow, because she knows how much I want this, and how much joy and comfort it will bring me.
“I’m so sorry, Annika,” she says.
“I understand,” I answer, and I do. I suddenly can’t believe that I asked at all, that I didn’t already know the answer.

Two nights later, I wake with a start, my heart thumping. I am shivering, and I have broken out into a cold sweat. I stand up, testing my shaky legs, and walk down the hallway and into my parent’s bedroom.
“What’s wrong?” my mom says, her eyes widening with fear when she wakes up to see me standing over her.
“I think I have a fever,” I answer.
My parents jump out of bed immediately, running to get the car keys and shoes and to call the hospital. My dad goes to wake my younger brother as my mom practically carries me to the car.
“You’re burning up,” she says, feeling my forehead.
My dad speeds through the dark streets, driving maniacally, hardly stopping for traffic lights. At one point, my mom screams at him, “If we get into an accident, then we’ll all be dead!”
He slows down after that, but only slightly. We pull into the emergency room parking lot and rush out of the car and into the cold, ominous building. I can’t stop shaking as my mom rushes to call the doctor and I am guided into a hospital room.
My head is spinning. All around me, I hear machines beeping and frenzied voices. I close my eyes and black out.
I wake up to the slow, steady beeping of a heart monitor, and the familiar murmurs of doctors and nurses. This has happened before – the sudden midnight ailment, the rush to the hospital – but it has never been this bad. I remember the time I woke up convulsing with blood coming out of my nose and mouth; my dad had called 911 and the paramedics had rushed into my room, lifted me onto a stretcher, and took me to the hospital in an ambulance. But even that hadn’t been like this.
Now, I feel as if I can hardly breathe. There is something pressing down on my chest, and I am shivering. My head feels as if it weighs a ton, and the room is spinning. My body aches, and on my arm, I realize, is a morphine drip.
The door opens with a hiss and my parents are there, holding my hands. I look in their eyes, and suddenly I know that this is it. It is time.
“You have a fungal infection,” my dad whispers, “Your immune system can’t handle it, and it’s spread to your lungs. They’re trying everything they can.”
“Am I going to die?” I ask.
That’s all it takes for my mom to burst into tears. She covers her mouth with her hand and sobs.
“Yes,” my dad answers, his own eyes filling with tears.
“It’s okay,” I tell my parents, “I’m ready.”
My mom nods, squeezing my hand as tightly as possible.
“You’re going to a better place,” she tells me.
“I know.”
I do know, but despite all the years when I wasn’t afraid to die, my heart suddenly fills with fear. I will never see my parents again. I imagine my funeral. Who will come? What will they say? I think of everyone I will never see again and all the places I will never return to. Did I thank my favorite tutor the last time she helped me with schoolwork? Did I hug my friends good-bye? Did I tell my grandparents I loved them?
“Will it hurt?” I ask, my voice small, my eyes watering.
My dad shakes his head, “No, we won’t let it. It’ll just feel like falling asleep.”
I stare into my parents eyes for a few, long seconds. Then, my dad breaks away, walks over to the corner, and comes back carrying what looks like a large box, covered with a blanket.
“We were going to give you this as a present,” my mom says, her voice breaking.
My dad pulls away the blanket to reveal a beautiful, female canary. It chirps and its eyes focus on mine. My face breaks into a broad smile, and just like that, all my fear is gone.
“What her name?” I ask.
“It’s up to you,” my mom says.
“Annika,” I say, “So that when I’m gone, I’ll still be with you, in a way.”
My mom cries, kissing me on the forehead. Tears stream down my own cheek, but I feel at peace.
My sister and brothers come in shortly after that, and they kiss me and tell me how much they love me. I ask my family to make my funeral a joyous affair, where everyone will remember me with happiness, not with sorrow.
In the final hours, they give me more morphine for the pain, trying to keep it at bay. Annika is perched next to my bed, where I can see her, and she begins to sing. It is beautiful, and it fills my heart with joy. I remember the flocks of birds flying through the sky, their freedom, and I long to join them.
My parents hold my hands. My mom strokes my head. She tells me that she will see me again one day, and I believe her. I smile when she says good-bye and I love you for the last time. My last words, I make them beautiful ones.
“I love you.”
I know that to my family, my eyes are glossing over and I am about to flat line, accompanied by the dull, telltale tone that signals the end. But at the very moment when to them my eyes go still, unseeing, I feel as if my eyes are opening, and a whole new universe is appearing before my eyes. I feel as if I am growing lighter, lighter, as if my spirit were made of air. I feel free.
I feel myself grow wings, and I fly away.