I have the top bunk overlooking the window of the train cabin. From the window, the trees and stony hills blur together from the rapid movement of the train. Below me, my younger sister, Anna, sleeps. Loud snores come up through my mattress. I take this as a good sign. With each snore, I picture my sister’s lungs strengthening.
The cabin room contains a single large window, and the bunk beds that are to be converted into a sofa during the day. We have asked to keep them as beds and for the train staff to leave us alone. I preferred to be in bed all day and I didn’t want my sister to be bothered by the comings and goings of strangers. There is a private toilet and a shower, which my sister can use to clean the incision on her chest. It is our first night on the train back home to Vancouver. The trip will take several days.
My sister has just had her third heart surgery. She had come from the hospital with my father, who needed to fly off immediately for business. I was to be her chaperone. I had arrived quite early in the morning to meet them at the Toronto Union Station to take charge of my sister. She could not travel by air—the pressure would be dangerous to her lungs, one of which had collapsed during the surgery.
My sister has two heart conditions: Wolff-Parkinson-White syndrome and supraventricular tachycardia. Her heart rate accelerates, called an “episode,” and won’t slow down. Extra electrical pathways in her heart are to blame. (Anna has several.) My father would tell me that Anna had holes in her heart whenever he tried to explain her condition, but they aren’t actually holes. She takes Sotalol twice a day, a beta-blocker prescribed for life-threatening cases.
During surgery, a catheter is used to ablate, or erode the pathways. Children's hearts are smaller, and it’s therefore more difficult to locate and ablate these holes successfully. Anna had waited until she was a bit older, seventeen now, her heart bigger, beating more solidly. Her surgeon threaded a catheter through a vein in her groin, up to her heart. Then: burn, burn, burn. She had to be awake for it, too. They pumped her with adrenaline to make her heart race in order to map her heart and find the holes. It was a difficult surgery. One of the holes was 6 millimeters away from her AV node, a good electrical pathway. It was terribly hard to ablate the bad pathway and not the one you needed to live without a pacemaker. But, the surgery had failed. Worse, a new physician had inserted the chest tube to reinflate her collapsed lung, which had been incredibly painful for Anna. She probably tried to smile through it all. Anna’s like that.
My sister is tall and has deep brown hair like our father. She likes to please people, and is generally more social and cheery than me. In fact, I wasn’t social or cheery at all. I wasn’t a particularly nice older sister either. I usually got Anna to fetch me things from downstairs, while forcing my other sister to watch me play video games. When Anna was about four, I tied her to a chair, made her face up like a clown with some lipstick we had bought for our dance competitions, and fed her dinner.
I stretch and kick off my blankets into a ball at the foot of the bed, before climbing down the ladder. I wake Anna up. Then, I leave to get a table for us for lunch.
The dining car is clean: white tablecloths, white coffee cups. We are the youngest ones in the dining car. Rows of older people, retired, with money for such a trip and who wanted to sit and see Canada that way, sit around us. (It’s supposed to be a luxury travel experience.) Windows run the length of the car. Each table sits four, with tables on either side of a long, central aisle. Most people are in pairs, so this system works quite well. We are to be seated with a new pair every meal, although I would prefer to eat alone. I do not like all this chatting. I like to focus on my meal.
Our table is one at the back. Our server shows us the scar on his head, like the outline of a scythe had been burned above his ear. “Brain cancer,” he says.
An older couple is seated across from us.
“What a lovely day it is out there,” the woman says.
“Yes,” I say, glancing outside. I liked comments about the weather. It signaled neutral, polite conversation territory: they wouldn’t be inquiring about anything personal from me or my sister.
Our server pours us coffee and hands us the menus: grilled salmon pasta with a lemon cream sauce and capers; tuna melt with a little salad and minestrone soup; falafel and pita. I order the tuna. The table has an assortment of individual food items: soda crackers, single-size containers of jam and smooth peanut butter (the kind with icing sugar), sugar cubes, creamers. I want to open them all. At home, I was used to meals of boiled chemically potatoes with melted margarine, freezer burnt pork, and microwaved broccoli that sat in a few centimeters of luke-warm water at the bottom of the casserole dish. The food arrives and I tear open a packet of soda crackers and crush it into my soup.
After a few bites, the woman speaks again.
“It’s good, isn’t it?” she says.
“It’s much better than what we get at home,” I say, reaching for another packet.
She laughs, glancing slightly at her husband.
“We’ve never had train food,” I continued.
“Either of you?” she asks, her husband examining the ingredients list on a packet of marmalade.
“Sorry,” I say. “That’s Anna, I’m Lorne. This is our first time on the train.”
“A graduation gift,” Anna says quickly. “From our dad.”
“How nice,” the woman says. “Your parents weren’t able to come along?”
I feel Anna stiffen slightly beside me.
“We wanted sister-bonding time,” Anna smiles.
I take a sip of coffee. “Yes,” I say. “We wanted to bond.”
Sometimes my sister would forget to take her heart medication, which could result in an episode. Her heart would beat over a hundred times a minute, which could result in her heart stopping altogether, which could result in death. Other people with mild cases could drink a glass of water or lay on the ground and put their legs above their head to stop an episode. This did not work for my sister. Anna had a bad case. Her heart would continue to thrash against her ribcage and she’d have to be taken to the hospital. One time an ambulance had to rescue her on a family trip. We were staying in a remote mountain location and the ambulance drove hours in a snowstorm and hours back to the hospital. With each switchback the ambulance took, I thought she would die. I sat up late listening to music and painting, my brain taking each switchback. The snow raged outside. Anna was only about nine.
For the last seven years, my grandma has called every morning at 8 to remind Anna to take her pill. If my dad was away on a trip, she would also call around dinner time. These scheduled calls allowed Anna to live a fairly normal life, episode free. Before my grandma’s calls, my sister had tried setting alarms on her wristwatch, but she never remembered to wear it. I’d often have to dig through the couch cushions or run all over the house to locate the beeping thing and turn off the alarm. And my sister never left her watch in the same location: in the drawers stuck with the old phone books or spare pencil crayons, in the bathroom beside the hair straightener, still on, or sometimes in the kitchen behind the fruit bowl.
There isn’t a lot to do on the train. After lunch, I sit in the car with the panorama dome, the glass windows continuing up to the ceiling, meeting in a curve towards the sky. I order some snacks, and watch the other guests reading or nodding off. Looking through the dome for too long is a little nauseating. The glass framed the atmosphere in motion, like a painting with nothing to focus the eye on. Anna has returned to our cabin to rest and will come find me later.
Classes start up again at the university in a week. I read as the Canadian landscape goes by. What I really wanted was to be in movement, like the train. One could not easily exercise their legs while onboard. It was impossible to walk up and down the cars for leisure. The hallway was narrow, only one person could walk through at a time, causing many guests to have to retreat back into their rooms, then peer back out to see if the way was clear. Peer, retreat, peer, walk, then quickly retreat again if someone rounded the corner unexpectedly. The staff seemed never to retreat, only to move forward to where they wanted to go. I wanted this forwardness.
This summer I had returned from working on a farm in Sweden. My days were full of drinking, smoking, and working the land. I wanted to get strong. Our mother had died in the spring from suicide and I was still in that phase where I was not sure what kind of effect it had on me. The farm gave me some routine. I’d wake early and have a breakfast of cheese, butter, Knäckebröd, and fresh coffee. Then we had the morning meeting to assign tasks. I didn’t have any skills and was usually sent out into the fields to weed with the other unskilled volunteers. I weeded every day. I hated it. I couldn’t tell the difference between a weed and a vegetable seedling and the farmer had to keep coming to my row to point out the cucumbers I had wrongly removed and I would try again, but they still all looked the same to me. There wasn’t a radio to listen to so I would talk to the other volunteers, but I also found this boring. There were a lot of Germans at the farm who seemed to work on their hours off and I got the sense that they found me lazy for not doing the same. Then, after more weeding, we would take a fika, a coffee break, and I sometimes got to eat a bit of cake from the cafe if it hadn’t been sold and was about to spoil.
My back ached after a day in the fields, squatting over the rows of vegetables in the hot sun, and it was hard to stand back up. I found a children’s toy to sit on in the fields, a plastic turtle, but soon abandoned it as it made no difference to the pain. I’d return to the sleeping cabins that I slept in with some of the other girls and would try to lay very flat to stretch out the muscles in my back in an effort to calm the pain down. There was no heat and the mattress was a thin piece of foam and I often went to sleep in a fleece sweater I had bought for the trip. We only had to work six hours a day and had two days off. On my days off, I took the bus into Stockholm or sometimes hitch-hiked and wandered around the city and drank and smoked. I began to have a pain in my lungs and I suspected it was from all the smoking. I stopped smoking, but the pain stayed. One afternoon, while returning to the farm from the city, I felt a cramp in my stomach that forced me to stop and lay down on the side of the road for half an hour until it passed. I’d only been home for a few weeks when I got back on another plane to go get Anna.
The train speeds up at night, which terrifies me. It was just the train hurtling through the wilderness, lit by the moon, my window opening up into the dark. I had never traveled overnight on a train before. It was also quite loud. I could hear the freight trains when I slept at home, but it was always in the distance, not the hard sound of the wheels against the tracks. Maybe there will be a derailment, I think. Could the train come off the tracks if a moose or a large branch were hit? I grow afraid that I will be tossed from my bunk. There is netting near my legs to prevent this, I know. I gently kick out at the net and feel my feet make contact. I try to switch my brain off of this thought, and instead begin to wonder why my mother didn’t try to go out this way, jumping in front of a train. I fall asleep thinking about her.
“Lorne.”
I turn around. Anna’s shirt was lifted.
“Does this look okay?” My eyes come to rest on an inch-long incision on the left side of her ribcage, directly below her bra. Bruising softly spread around the cut. At the hospital, a tube had been inserted into the lung, then stitched into place, to allow her lung to drain.
“I think so, but please don’t make me look closely at it.” I turn away. The fact that
the incision had gone straight into her lung, into her body… Something about its deepness unsettled me. I felt that it was something that should remain private, like the small incisions below her groin. Anna turns back to the mirror and continues to check her wound. My chest starts to ache.
“Done,” Anna says. She finishes in the bathroom, turns off the light, and we leave for breakfast.
Every morning, the doctors wanted to check if Anna’s lung had reinflated. Instead of waking her, a nurse would wheel her to the x-ray room, still fast asleep. She would come to wheeling through a hallway, not knowing where she was or what was happening. Before each x-ray, Anna was asked if she was pregnant. “What do you think I’m doing in this hospital?” Anna said to the technician. “I’ve just had heart surgery. I have a collapsed lung!”
Shortly after an early breakfast, we step off the train and into Winnipeg. There was an exhibit I had researched beforehand and we ask one of the train attendants how to get to the art gallery. We walk north through the windy, cold streets and enter into the Winnipeg walkway, a system of under and above ground covered walkways that snake through the city. We exit right at the gallery, but it is closed. I walk to the entrance to check the sign: it wouldn’t open for another hour. We decide to wait.
I take some photos outside of the installation art: rows of lightbulbs that looked like Chinese cupping glasses were mounted to a mirrored ceiling. I look up, staring at myself in the art. I have on a little beret, a thin sweater, and some green stockings. The camera blocks my face. I take a few photos of Anna. She lies down on a concrete bench, her long brown hair flowing behind her, and I get down on the ground to take photos of the both of us in the installation. My hands start to turn blue and I notice Anna shivering, her body humming. We hadn’t packed for the chill of the middle provinces where the season turned earlier than ours. Anna only has on a flimsy long-sleeve shirt, a small jacket, and some sneakers. The morning prairie winds pick up, hitting our chests. I worry about Anna and her collapsed lung with the cold air and her heart that still has a hole in it. I make the decision that we should walk back to the train.
Back in our bunks, under the covers, we warm ourselves up. Anna texts her friends and listens to audiobooks. An hour later, the train starts off again. I flick through the photos in bed. Anna looks small and tired. I turn the camera off and close my eyes, pulling the blankets over my head. I stay like that for a while.
In the afternoon, Anna meets me in the activity car. I shuffle two decks of cards and make two piles of twenty for us to play Spite and Malice, stacking the rest in the middle. It’s a sort of two player solitaire, but absolutely ruthless. We each flip over the top card on our piles to see who goes first. Anna reveals a three. I get a queen. Anna draws five cards from the middle deck.
“Tell me again,” I say, “about that medication.”
“Adenosine restarts your heart,” Anna says, playing an ace, two, three, before discarding. “When it stops your heart, it triggers this smell. There’s a really strong smell, but no one else can smell it,” Anna explains. “Doctors and nurses always asked me what it smelt like.”
I draw and then place a jack in my discard pile.
“But there’s no way to describe it,” Anna says. “I was shocked that no one else in the room could smell it.”
The smell came from inside of her, I thought to myself.
“All of your bodily sensations are turned on at once. It feels like someone is sitting on your chest and you can’t breathe. You can’t move any of your limbs. You feel like puking, and then your heart restarts.”
“What you’re describing is a heart attack,” I say.
Anna is quiet. “Yes, you’re probably right. Like a heart attack.”
Anna had built up a tolerance to Adenosine. It would stop her heart, just not the episode. The second time I thought Anna was going to die, I had come home and found her near the stairs with her legs above her head, looking scared. She had forgotten to take her pill and I immediately drove her to the local hospital. Once there, I told the triage nurse my sister could die any second, listing her diagnoses, and quickly doctors and nurses descended upon her, hooking her up to monitors and tubes. Someone prepared the defibrillator in case she coded. I watched as the doctors tried to restart her heart with Adenosine. Anna kept telling them to give her Procainamide, not Adenosine, but they weren’t listening to her. They gave her Adenosine three times. I started to cry. Anna was attached to all these wires and machines and my sister was trying to be brave even though she could die at any moment. Finally, Anna was given Procainamide and she began to stabilize. I stood slightly beyond the curtain, totally drained.
My chest starts to ache again. It bothered me that illness could induce such strange, new experiences in the body that no else could ever understand or feel. It reminded me of our mother. Anna flips over the final card on her pile, an ace. I start to gather up the cards, the game over, when a train announcement comes over the speakers: we are behind schedule due to an earlier passenger delay and will be pulling over into Saskatchewan for a brief twenty minute stop, to allow guests to stretch their legs. The train slows down and Anna and I move towards the train doors, stepping out into an empty field. Several hundred meters away are some trees. Then, nothing. We stand, then sit down on the ground. It is already so much warmer than Winnipeg, just one province over. I look over at my sister, enjoying the late summer heat. I touch her shoulder.
“Maybe the next surgery will work,” I say.
“Yes, maybe,” says Anna.
The last day we eat our meals late so we can be seated alone. There is only one other person in the dining car. It is quiet. The other guests pack and the porters prepare for the guests to unload. I have the pancake breakfast. Anna has the continental: strawberry yogurt, cold cereal, and a piece of whole wheat toast. The train pulls into Vancouver. We take a taxi to our house with no one home.