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I had thought it ironic last year, when I was being wheeled into surgery on the morning of my twentieth birthday. How interesting would it be to die on the day you were born?

Imagine if that was everyone’s destiny.

How would we spend each year, surviving a birthday? Would we make good on all our vows and promises to ourselves? Would that wish we made over those flickering candles hold more gravity?

My whole life had been about survival. It was my earliest and most tangible memory, and it had followed me into adulthood like a friend.

When my mother had handed me a cupcake—which I couldn’t eat—with an unlit candle—because of the no-open-flame rule—I had still made a wish.

I had wished to live.

I had wished to survive.

I had still wanted it so badly. And reflecting on it now, I wondered if that was because it had become more of a habit or if I wassupposedto want it. If I was supposed to want another person to die so I could live.

Tragedy had manifested in the universe.

It felt wrong to have a party. Yes, it was my birthday, and I had survived the dreaded one-year mark, but I knew I needed to be grateful, to be patient. Because this hadn’t just been my journey.

My parents had watched me die for years, day by day. They had watched the life drain from my eyes, the color fade from my cheeks, my limbs shrink as my body betrayed me again and again, like some cruel horror loop we were all forced to endure.

They had lived their lives on a held breath. And when the call finally came—when someone else’s tragedy became my salvation—that breath was released.

I didn’t know whose heart beat in my chest. The family that donated it wanted no contact. I had no idea who this heart once belonged to or who they left behind.

What did their one-year anniversary look like?

Did the people who lost their person wake up this morning the way I had? With dread curling through their bodies as they faced another day in a world that no longer felt right without them?

As my eyes roved around the room, they landed on my brother near the entryway, leaning against the staircase in his army greens, a beer in hand as he talked with my parents.

My breath caught in my throat.

I hadn’t known he’d be here.

Mom had told me he was still on deployment... somewhere.

To say my relationship with my brother was fraught would be an understatement.

He was my brother, but I didn’tknowhim.

I wanted to… I just didn’t know how.

I was consumed with guilt over all the attention I had taken from him as we grew up. He was two years older than me, and he likely felt as if he had lost our parents from the age of seven. After my first diagnosis.

Our childhoods had been vastly different. I had spent mine battling cancer, fighting off near-death experiences, and then chasing a heart transplant. His had been spent just existing in the background, a subplot to the lives of our parents, who poured everything into me.

It hadn’t taken a genius to understand why there was a canyon between us.

I just wasn’t sure how to bridge that gap, or whether he even wanted me to.

There had been a time of closeness after my first diagnosis. We had done everything together. He had become fiercely protective, especially after Mom explained what I was going through. He had wanted to help, to look after me. On days when I was too weak to leave the bed, he would stay with me, and we would watch movies or he would play Xbox beside me.

It was the second diagnosis that cracked us—or at least, in my eyes, that’s when things changed.

He started getting left behind. My parents forgot pick-up times. Hobbies fell by the wayside. Grandparents had to step in. Looking back on it now, as an adult, I could see why he had become reserved and aloof.

I could see why, the minute he turned eighteen, he signed up for the army and left.