Monday, February 7, 2022

For Katie, on her 40th.


Today is my baby sister’s 40th birthday. But she’s not here. Katie died  in 1984

after a 2.5 year fight with a liver disease with the complicated name of, biliary atresia, that I could

pronounce with clarity as a kindergartner. 


It’s amazing that baby girl ever learned to walk, because so many pictures and memories involve her

plopped in a lap. Nana’s lap, Aunt Carol’s lap, our mother’s lap . . . or being toted about by a bigger

cousin. But walk she did. She ran and she sang and she was a part of us. 


After her death we clung to her possessions like talismans. Even now a set of tiny booties sits in a box

of  mementos in my bedroom next to a rock I found in middle school and some snapshots of my

parents in their 20s. A battered teddy bear waits in a spare room at our mother’s home even though

Katie never got a chance to live there. 


If you were still here Katie what would your laugh sound like? Would you be the fun aunt sending our

kids ridiculous memes making fun of your Gen-X siblings in their decrepitude?  Would you be the only

organized sibling, or would you be as much of a hot mess as the rest of us? You didn’t live long enough

for hobbies, or a prom dress or a favorite Ramona Quimby book. You did live long enough to touch the

hearts of everyone who knew you. 


While thinking about writing this I, in true librarian fashion, did a deep dive in the archives of our

hometown newspaper. There I unearthed dozens of articles featuring or mentioning my sister. While I

knew there had been a huge community backing for funding Katie’s medical expenses I had no idea

how widespread it truly was. Events large and small raised an astounding amount of money in just a

few months. There were beautiful baby contests and antique car shows. Students at my elementary

school collected soup labels. There were oldies nights, and dance marathons, and rock-a-thons. Charity

runs, and hospital auxiliary donations raised thousands, and of course there was that classic central

Pennsylvanian pork & sauerkraut dinner. This fundraising push began not just because of a community

wellspring of goodwill, but because Katie’s father had lost his job, and consequently her health insurance

coverage, and while he’d begun a new business her precarious health made her uninsurable. 


There were so many articles about Katie that I finally stopped printing them when I’d refilled the paper

twice and started to run out of ink. There were well meant editorials lionizing her fight that have not aged

very well, and there are a surprising number of newspaper references to Katie in the years that followed

it. After her death remaining funds were given to other children awaiting a transplant.  While Katie’s

health care needs were eventually funded by the state, one can’t help but see startling parallels between

her situation more than 35 years ago and the constant presence of “Go Fund Me” campaigns for the sick

that dot our social media feeds today. Access to healthcare is a human right, and should be funded as

such here in the United States, as it is in virtually every other industrialized nation in the world.


The glaring omission I'm surprised to notice while poring over these documents is that we don’t exist.

Katie exists, our mother and Katie’s father are there, but the only reference to her siblings is her obituary,

where we are incorrectly listed as “step-siblings.” Technically we’re half-siblings, but I don’t count my

family members in fractions as a general rule.  I can only assume this was a deliberate editorial decision

by the newspaper staff to sanitize a blended family, but perhaps that’s an unfair assumption. Our older

sister and I have only ever referred to Katie as “our sister” and we generally don’t let her father’s name

pass our lips without hissing. Katie’s father and my mother divorced within 2 years or so of her death,

none of us have seen hide nor hair of him in over 30 years. He married the kindergarten teacher whose

class I attended the year Katie was most ill, but that’s a story for another time. Oddly I’m not sure I’ve

ever even heard our brother utter her name. Families are strange and complicated as often as they

are wonderful I guess. 



I remember my sister’s voice clearly, but I know that memory is likely only my recollection of a fuzzy 

VHS recording we watched over and over in which Katie, aged 2 years, plays with a set of plastic keys,

and her melodic toddler voice chants out “red one, yellow one, blue one.” Would she like to read like me,

or binge watch romance television like our big sister? Would she have a wild haircut as a teenager, and

sneak a first kiss at a high school football game? Would she hunt and fish and still live in small town PA,

or would she have gotten the heck out of there and live somewhere exotic like I don’t know

. . . anywhere else?


I have to wonder how much of my own hesitation to emerge back into the land of other people’s germs

these past 2 years has been due to intrinsic knowledge of what it means to live with an

immune-suppressed family member? How much has been because I remember the terror and shame of

being the healthy sibling who accidentally exposed a floor of transplant kids to the chickenpox? How

much has been because I know what it looks like when a parent sits in a hospital room with their child for

months and then eventually comes home empty handed? For what it’s worth the reaction of our older

siblings to the pandemic has been a lot closer to YOLO than mine,, so maybe it’s personality and not life

experiences, but who knows?



But I have other questions too. How many people did Katie’s life and death convince to become organ

donors? How many lives did that save? How many parents held their kids a little tighter? Part of why we

rarely speak of her is that we don’t need to. That loss may not be something we say out loud, or even

think about every day, but it is painted onto our identities as surely as our curly hair or dimples. I

remember years on end where we’d periodically wonder “how old is Katie now?” What we meant was

“does a soul age in heaven?” Has she grown with us and laughed at our foibles from above, or is she

frozen forever that patient toddler who now sits on the laps of all the relatives who finally grew old and

joined her? 


What does she remember? What do *you* remember from when you were 2? What about the year you

were 6 (the age I was at Katie’s death), how about 13 or 15 (the ages of our older siblings)? I don’t

remember much, but here's some of what I do.  I remember boldly stepping up the concrete steps of a

reclusive neighbor’s porch with my older sister, so we could report that our baby had arrived, on our

mother’s birthday, and her name was Kathryn Anne. I remember wheelchair races down hospital halls,

and arranging “little people” on worn wooden floors, and I remember that we loved you. I remember the

Christmas Santa brought  a Fisher-Price train, and the carnival that was held as a celebration of you,

and I remember that we loved you. I remember the jealousy I felt at the nonstop and much deserved

attention you received, and feeling displaced and left out, and I remember that we loved you.  I

remember the day we took a picture in the tulips growing outside the hospital, and I remember

daydreaming about you coming back long after you left us, and I remember that we loved you.

Wherever you are Katie, I have to believe you are bathed in love and light. Happy birthday. 


As a transplant recipient Katie was the 99th child to receive a liver (and then 2 more) in the groundbreaking liver transplant program at Children's Hospital of Pittsburgh. For more information about the gift of organ donation please visit:


UNOS