In My Sister's
Footsteps

This is a story about true identity and the healing of the transgender mind

Blazing a new trail is difficult for a young burn victim, but he manages well enough with support from his mother, some unusual help from his sister, and a little luck.

Chapter 1: Saving My Sister
Chapter 2: Vital Signs
Chapter 3: Smoke Signals
Chapter 4: Options
Chapter 5: Honoring My Sister
Chapter 6: Skin Deep

In My Sister's Footsteps
by Terry Volkirch

Part 1 of 8

Chapter 1: Saving My Sister

Friday night and I was in bed by 11. Being 13, I didn't have many other options. It was too cold to do anything outside, and besides, the earlier I went to bed, the sooner I'd wake up and the more time I'd have for tomorrow's activities with my best friend, Gary. I drifted off to sleep while thinking about all the fun to be had with Gary after helping my sister with chores. Young teens had to get their fun when and where they could.

Imagine my surprise when I woke up while it was still dark. That never happened, unless I was sick, or it was the end of the world. I slept like a rock. I kept my heating vent closed to keep it cool in my room and hibernated under several layers of blankets. Nothing ever woke me up until I got my usual nine hours of sleep.

At first, I had to shake off a strange dream. My sister and I had been attached by the ankle, forcing us to do all the household chores like a three-legged race. If that wasn't strange enough, we'd finished the chores and I'd celebrated by roasting marshmallows over a camp fire. The really strange part was that the camp fire was in the middle of my bedroom. As I was lying in my bed, I thought about the smell of smoke that continually drifted my way in my dream, even as I shifted one way or the other to try to avoid it. The situation reminded me of a saying: Smoke follows beauty. That made me laugh. How stupid is that?

When I finally burrowed out from under all my blankets, I sniffed, wondering if I was still dreaming. I really did smell smoke, though it took several minutes before the importance of that fact forced its way into my groggy brain. The house was on fire!

I sprang from my bed and immediately started coughing. I forgot that you're supposed to stay low in a fire. Then I made a second mistake, taking hold of the door knob and throwing open my bedroom door.

A wall of fire blew in my face, singeing all my facial hair. Only young reflexes saved me. I jerked back and fell on my butt. I was on the floor where I should be. There should be a layer of breathable air near the floor.

It just started to register that the door knob had burned my hand and the pain actually helped. It made me think clearly. Everything snapped into sharp focus and I began thinking my way through the emergency.

My mother was away for the weekend at a seminar, leaving only my sister and me in the house. We lived in a one story house so I could easily escape through my window. But what about my sister? Beth was a very sound sleeper, like I was, and she might still be asleep, or worse!

As I thought about her, I got a bad feeling. I was sure that she was still in her bed, and she was in trouble. I don't know how I knew. I just did. My sister and I had always shared a special bond, like what a lot of identical twins claimed to have, even though we were fraternal twins.

Our mother always joked that we should've been identical twins. We looked very similar, and both of us had wavy, dark brown hair. We were also the same height and build, though puberty would soon change that. I was a boy, and I didn't appreciate my mom's sense of humor. When she said identical, she meant I should look like my sister and not the other way around.

Of course with the house on fire, it wasn't time for jokes, or reminiscing about them. I couldn't live with myself if I didn't make sure Beth was okay, and I'd gladly give my life to save her. I had to act.

I could try to go outside and go around to her bedroom window, though I doubted there'd be time to try knocking on the window to get Beth's attention. I'd have to break the window to get in ... except that wouldn't work well either. I didn't think there'd be time to get dressed and broken glass and bare feet didn't mix. Crap!

I heard sirens in the distance. That meant neighbors were probably outside, watching. What if someone tried to stop me? I couldn't let that happen. I had to brave the burning hallway, the fastest way to my sister. I grabbed my down comforter off my bed and wrapped it around me for some protection. Then I rushed into the flames.

The hallway was an inferno and my choice of protection was unfortunate, as was the fact that I didn't have an adjoining bathroom like my sister's bedroom. It would've helped to wet the comforter and myself. As it was, the comforter was old and worn, and the feathers in it caught fire. So did my pajamas.

I screamed in pain and quickly shrugged off the burning comforter as I staggered to my sister's bedroom door. The flames hadn't reached that far but it was clear it wouldn't be long before they did.

My instinct for self-preservation told me to go straight through the room and jump out the window. Saving my sister was a suicide mission, but my love for her overcame my fear of death. Besides, I couldn't live with myself if I didn't try. I'd rather die.

I fumbled with the door knob and rushed in, slamming the door behind me. Then I stayed low and crawled towards the bed while patting my smoldering pajamas.

Through the thick smoke that filled the room, I could just make out Beth's form, lying under her covers. Even with my coughing and the noise of the fire, she wasn't moving, and I started to panic.

I quickly scrabbled over to the window and choked from the smoke that billowed out of a nearby heating vent. I closed the vent but smoke still seeped in so I pulled the comforter off my sister's bed to cover it.

As I reached up from my low position to open the window, I wondered if the gas furnace started the fire and had to shake myself. I didn't have time for idle thoughts. I had to get Beth out as soon as possible. I sat on the floor and shouted as I pulled the rest of her covers off. "Beth! Wake up! We have to get out! Beth!!"

That was all the shouting I could manage. The smoke made it impossible to keep it up. It was just as well because my sister still hadn't moved. All I could do was cough and hope for the best.

I made a desperate lunge for Beth's body and managed to grab her arms and pull her off the bed without losing consciousness. I wasn't very strong but a short burst of adrenaline can work wonders.

With both of us sprawled on the floor, I looked up at the window and sighed. It was so high and I was so tired. I needed help. So did Beth.

The room sucked in cold fresh air through the open window. A draft blew over us, giving both of us goose bumps, but it brought some welcome relief from the smoke. I sat with my back against the wall and breathed deeply while I tried to summon the strength for one last attempt to get us both out.

As I sat there, I lightly grasped my sister's wrist and found that her pulse was erratic and weak. I also checked her breathing but couldn't feel anything. If she was breathing, it was very shallow.

I tried a little CPR -- I had to try something -- but I worked myself into a rage when it didn't seem to help. I couldn't live without my sister. I wouldn't!

I fumed along with the burning house and watched helplessly as smoke filled the room faster than it could escape out the window. In spite of the poor visibility, I could see the glow of flames on the far side of the room, and I could hear ominous creaking noises coming from above. It sounded like there wasn't much time before the ceiling collapsed.

I scooped my hands under my unconscious sister, and with a last burst of energy, I heaved her limp body up to the window sill and stuffed her outside before I slumped back to the floor.

I sat on the comforter over the heating vent with my back to the wall and looked down at myself. My pajama bottoms were burned off and I could see my legs, hairless and red with with blisters. Shock must have settled in because I no longer felt any pain. I watched passively as the fire quickly spread across the floor until it reached me. I didn't bother to try moving my legs back. I couldn't find the energy.

Flames licked at my lower body, leaving me with two thoughts before everything went black. I thought about how much I hated the smell of burning flesh, and I thought about my sister. I hoped she'd be okay.

Chapter 2: Vital Signs

An incessant beeping and the smell of antiseptic annoyed me enough to bring me back to some semblance of consciousness. Those sensations seemed normal enough, but I couldn't see or think clearly, and random flashes of light and bursts of heat gave everything a surreal tinge.

I found myself lying on my back so I tried to get up to get some answers, and immediately regretted it. Intense pain burned with a fire that reminded me of how I ended up in what I suddenly realized was a hospital bed.

The harsh memories of last night's disaster added to my distress, but I kept myself from hysterics by wondering and worrying about my sister. As long as I focused on her, I could distract myself from my own problems and endure virtually anything.

I relaxed and took deep, calming breaths while I listened to the rate of beeping slow back down to its original rate. I knew then that it was my heart monitor, and it sounded like beautiful music to my charred ears. It meant I was still alive. My pain and everything else I sensed proved I was alive.

Being alive might please my mother but I couldn't celebrate yet. I needed to find out about my sister. If she died, I didn't think I could face my mom or myself. Every time I saw my reflection in the mirror, I knew I'd always think of Beth and wonder if I could've done more to save her. Guilt would eat away at me until there was nothing left. My body would die and my spirit would drift away to join my sister, wherever death had taken her.

My eyelids fluttered but I saw only blackness. I occasionally heard people around me so I knew there must be light. I worried that I might be blind until I realized that gauze covered my eyes and virtually every other square inch of my body. I could feel the bandages along with a dull pain that throbbed with every heart beat. The pain spread throughout my body, from my head to my toes. Everything hurt, and it gave me a sudden feeling of dread, just before I sank back into the painless realm of deep, dreamless sleep.

***

Throughout the day, my head swam with images of smoke and fire. Lucidity came and went, and I began to doubt my conclusion that I was still alive until I heard a familiar voice. It was my mother. Her voice, along with my doctor, kept me from dwelling on my pain and fear, or at least they did until they started discussing my state of health.

"Are you sure there's nothing you can do?" asked my mom. I could tell she'd been crying. I knew from her tone of voice.

"He has third degree burns over more than 90 percent of his body," a man said. "I'm very sorry but he's not expected to live, not with injuries that severe."

"But there must be something." My mother refused to give up. Her voice rose in volume and pitch and she ended the sentence with a sob.

I couldn't take it. I could handle the cold facts and figures, but when my mother got upset, I wanted to comfort her. I wanted to shout that I wasn't dead yet and spend whatever time I had left with her, and I tried. I tried so hard.

The heart monitor beeped out a faster and faster rhythm as I struggled to raise my head. I think I opened my mouth but no intelligible sounds came out. My tongue felt huge. My lips stretched tightly and throbbed with pain. I couldn't even say good-bye.

"Nurse!" I heard the doctor shout. "Get in here! Now!" He demanded some amount of a drug that soon had me swimming in images again. I lost myself in a sea of fire and wondered if there really was a hell. Then I lost consciousness for the umpteenth time that day. As long as I was out, I was safe.

***

The steady beeping was back, giving me a sense of the passage of time. I counted beeps for awhile and thought that the time between each one approximated one second fairly well. That meant I could estimate the minutes and hours if necessary. I had nothing better to do so I stubbornly counted.

Approximately nine minutes and 37 seconds went by before a nurse came into my room. She actually greeted me, but it didn't sound like she knew I was awake. It seemed more of a way for her to pass the time. She played the same sort of game I did except she counted patients instead of beeps.

The nurse talked to me for a short time and then spoke to someone else. That someone turned out to be my mother.

"I don't think he's in any pain," the nurse said.

"How could he be? He's asleep." My mother sounded a little angry. I don't think she appreciated the nurse's efforts to give her some comfort.

"I suppose he is now. It's hard to tell. But if he was awake, I think he'd moan if he was in pain."

"Didn't the doctor say he was kept sedated?"

"Well sure. Doctor Blake increased his medication after he woke up two days ago. It probably keeps him sedated most of the time but I think he's come around before. I visit quite often and I've see him move a little and heard him make sounds."

"Even if he did wake up, how could you tell?"

"You can sort of tell by his heart rate. It's only 55 beats a minute now so I'd guess he's asleep. But if it climbs much higher, like say 70, it's more likely he'd be awake."

"Thanks," my mom said, sounding much happier than she had a moment ago. "No one pointed that out before but it makes sense. I'd like to be able to talk to him when he's awake."

A moment of silence passed, marked by 48 beeps. I wished so much that I could speak, or move, or do something to show I could hear them. I couldn't though. I didn't have the energy, and I could tell my tongue was still swollen. It nearly filled my mouth completely.

"I know the prognosis is bad but please don't give up hope," the nurse suddenly said. "This hospital has some pretty good specialists. I've seen some pretty amazing recoveries here."

"Oh really?" My mother's voice suddenly turned bitter. "I know you mean well, but can your doctors fix partially cooked eyeballs? Can they heal my son's skin and replace his genitals? I'm guessing not."

"I'm sorry." The nurse spoke quickly. "I didn't mean to upset you."

Anger and sorrow permeated the room as thick as the smoke in my sister's bedroom the night of the fire. Some of it came from me after hearing how badly I'd been burned. It also choked me up to hear my mother respond in such a negative manner, and my mood must have shown. The heart monitor started beeping much more quickly.

"Oh! Look there. His heart rate shot up ... 70 ... 75 ... 80 beats a minute."

"You mean he heard us?" My mother sounded concerned. "Is he awake?"

I could hear the swishing of fabric, like someone was talking wildly with their hands and arms, and I counted another 23 beeps before the nurse responded. "Probably."

I tried to hum out something that sounded like, "Uh huh," but it came out more like two indistinct grunts.

"Mike? Honey? Can you hear me?" My mother's face hovered over mine.

"Remember that his throat was very badly burned," the nurse said. "It's not likely he'll be able to talk."

My mother backed away and cried out in frustration, but luckily, the nurse didn't give up on me.

"Mike? My name is Cindy. Grunt three times if you understand."

I managed to grunt three times.

"He did it! Did you hear that, Mrs. Wagner? He answered me."

The excited nurse got through to my mother, who was soon asking me all sorts of simple questions about how I felt. Was I in a lot of pain? One grunt for no. Did I feel a little pain? Three more grunts for yes. Did I want more pain medication? No. It would've been nice if I wasn't asked the same question in so many different ways.

I wished I could've said how good it felt to be able to answer. If only I was asked the right questions. What I really wanted was to find out about Beth, but that was impossible. My mother was understandably focused on me for the moment. She wouldn't ask me what I really wanted or volunteer the information I sought any time soon.

After only a dozen or so answers, the process got a bit tedious and I started getting tired. I faded out, but I was satisfied that I could finally communicate.

Chapter 3: Smoke Signals

I heard my heart monitor again, and mercifully, the antiseptic odor was masked by flowers so I was in a much better mood.

I thought about how I could increase my heart rate to get someone's attention and tried imagining that I was running. It worked. Just thinking about exercise made my heart race and I soon had a nurse talking to me.

"Hello Mike," said a pleasant sounding woman. "Are you feeling okay?"

I grunted three times.

"Ah. That means yes. Good. Cindy told everyone about how you communicate, and your mother left a note just in case. She's sitting with your sister now."

I knew she didn't mean to do it but the nurse's careless comment agitated me and I started a long series of grunts. My sister was in the same hospital. That meant she could be in trouble.

"What is it? Was it something I said?" The nurse was clueless but I resolved to keep grunting until she asked the right question, or until I exhausted myself.

"Please. Stop. I'm sorry. Whatever I said, I'm sorry."

I kept grunting.

"Is it about your mother?"

I stopped a short time, grunted once for no, and then resumed my grunts.

"Okay. No, it's not about your mother. Is it about Cindy?"

I stopped and grunted once for no again. Then I tried to continue my series of grunts, but I got tired and sounded feeble.

"Oh, you poor thing. Please stop grunting. I have an idea. It will take some time but we can communicate better than this."

I stopped and waited for her to continue.

"You form a short simple sentence in your mind and then I'll run through the letters of the alphabet. I'll also add a space at the beginning of the list to separate words. When I get to the first letter of the first word, grunt once. I'll ask again to confirm the letter with another single grunt and then we can start over and do the same thing until we get all the letters and spaces between words. Okay?"

I grunted three times to show I agreed. I'd finally be able to ask about my sister.

It went slow but I kept my sentence simple. I simply asked, "Is sister okay." It wasn't good grammar and I couldn't add a question mark at the end, but the wording was plain enough for the nurse to understand.

"Oh dear. No one has told you yet? I better get your mother."

I heard the nurse's footsteps as she left me alone with my unpleasant thoughts. I feared for my sister's safety more than my own, but the worry took its toll and I couldn't stay awake. I'd used up all of my energy for the day. I listened to my heart rate slowing as I quietly slipped back to the land of Nod.

***

More beeping, more flowers, and something else this time. I smelled perfume. Was it my sister's? Did she even wear perfume? I didn't think she did but I allowed myself a wild hope and my heart rate increased.

"Mike? Are you awake?" my mother asked. The perfume I smelled must have been hers.

I grunted three times for yes.

"Oh Mike. I'm so sorry. I heard you asked about Beth."

I grunted three times again.

"She's not doing well, honey."

I made another sound, but it wasn't a grunt. It was more a horrible wail, so horrible it scared me and I managed to control myself and stop.

My mother sat on the edge of the bed and sniffled a little before she spoke. "I know. I'm quite upset too." Then she told me all about my sister and what happened the night of the fire.

It had already been a little over a week since the house caught fire. Our home was a total loss and my mother had been staying with my grandma, her mother, when she wasn't at the hospital. She let my grandmother deal with the insurance and everything else that had to be worked out, leaving her free to deal with my sister and me.

She told me I'd been a hero that night. The emergency crew figured out that I'd pushed Beth out the window at my own expense after seeing her condition. They thought she must have had help getting out. A fireman braved the flames then, and peeked in the open window where he found me, horribly burned but amazingly enough, still alive. He pulled me up and out and cradled me in his arms. Someone draped a blanket over my severely burned body and an ambulance took me away.

The story had us both sniffling, but the worst was yet to come. My mom finally told me about Beth.

My sister hadn't suffered any burns, but she'd been overcome by fumes as I feared. She'd breathed in so much smoke for so long that her brain had been starved for oxygen and stopped working. She was brain dead. The only things keeping her body alive were the respirator and feeding tube. She'd never wake up again.

"I'm so sorry, Mike. I know you tried your best to save her. Please don't feel guilty."

She knew me all too well. I did feel guilty. There must have been something I could've done better that night. I made too many mistakes, took too long to open the window and get her out. If only I'd gotten her out of bed right right away and pushed her outside sooner. If I tried harder, she might have been there, helping my mother keep watch over me instead of wasting away in a hospital bed.

I wailed again and my mother started calling for a nurse to sedate me. I didn't want that so I forced myself to breathe deep and calm down.

"Good boy," my mother soothed. "Take it easy. Please."

I listened as she continued to talk about Beth.

"I was hoping to keep her on life support until you could see her one last time. I know you'd like that."

I grunted three times.

"I don't think that's going to happen though. You're in pretty bad shape too. I'm sure you heard Dr. Blake and I discuss it earlier so I'll tell you again. You're not expected to live."

I grunted three times again. I accepted my fate. I felt it only fair. If my sister had to die, than I'd gladly follow her to keep her company. There was only one little problem.

My mother started crying and choking out words. "I don't want to lose both of you. Please. Try to hang on. For me? I know it's hard. But I don't know if I could go on without at least one of you."

She broke down and leaned against me, soaking my bandages with her tears. The pressure on my skin hurt but I didn't care. She needed the cry, and I needed the contact. It was nice in spite of the pain.

Chapter 4: Options

My constant companion, the heart monitor, greeted me. I'd live to see another day, but I was steadily getting worse. Most of my skin wasn't healing and I had a strong chance of getting a fatal infection. The doctors were getting desperate, along with my mother.

I grunted to save some time and show that I was awake. Then my mother called in a group of doctors to tell us about a radical new therapy that had a good chance of saving me. It sounded crazy though because they said it would involve my sister.

Barring a miracle recovery, the doctors said I had no chance of surviving without some new body parts, especially skin. Then they reiterated that my sister had no burns, but no hope of recovery. They thought the solution was clear.

"You want to give my son a skin transplant using my daughter as a donor?" my mother asked, figuring out what the doctors had in mind easily enough. "Is that possible?"

"In essence, that is correct, and we think it is possible. We'll want to transplant all the skin though, as well as some other organs. It would work out much better that way. It helps that the donor and recipient are siblings and are virtually the same size."

"But even the face? Does that mean ... will my son have Beth's face? Will he look like Beth?"

The doctors ignored my mother's questions for the moment. They wanted to cover all aspects of the treatment before they discussed the implications. I just took it all in, not believing a word of it. It sounded impossible.

"With a new gene therapy, we have a way to eliminate tissue rejection. The therapy could be discontinued after a relatively short period of two or three months. The transplant would take hold and your son could live a normal life, with no further need of drugs or therapy."

"That's wonderful!" My mother shouted, hurting my ears. She seemed to forget her earlier questions for the moment. They still haunted me however.

"We wanted to make sure you understood that there was more to the treatment than just the skin transplant, Mrs. Wagner. We believe it would be the best and perhaps only course of action to transplant everything damaged by the fire. There's a much greater chance of tissue rejection otherwise."

"Well that sounds fine," my mother said, not thinking things through. She only saw the bottom line: I'd be alive.

"That means we'd include the eyes and larynx." The doctors continued.

"Of course," my mother said and then hesitated for several beeps of my heart monitor. "Wait a minute. Does that mean he'd not only look like Beth, but sound like her?"

"Yes," Dr. Blake admitted. "But there's still more to it than that."

My mother's train of thought finally caught up to mine and she gave a nervous little laugh. If I could, I would've joined her.

"His genitals were destroyed," she said quietly. "You can't possibly mean to transplant Beth's ovaries."

"It would be in the best interest of the patient if we transplanted all of your daughter's reproductive organs, Mrs. Wagner. That way, your son wouldn't need any hormone replacement therapy. It's really the only way the gene therapy will work anyway."

"So you're telling me, my son has to become a girl to live?"

"Yes, Mrs. Wagner. Your son would be a girl, with no chance of transitioning back to a male. We're not sure how testosterone would affect the gene therapy but we're pretty sure it would cause severe complications. Your son would have to remain female for the rest of his, make that her, life."

I felt my mother slump heavily on my bed. She must have been in shock, as was I. It was crazy, but it looked like the only option I had for life.

I thought I heard someone talking to me then, extolling the virtues of sedatives and pain medication, but I wasn't sure. All the excitement wore me out and I slowly slid back into slumber. The heart monitor sounded miles away as it registered my slowing heart beat, making me think one of the doctors had upped my medication. I'm sure everyone decided it was in my best interest to sleep on the idea of being remade in my sister's image.

***

I felt a presence near me. I could hear the person breathing over the sound of the heart monitor. It sounded like a woman, probably my mother. My hearing was really getting better, or maybe it was just my ability to listen. I'd heard that if you lost your sight, the remaining senses would get more sensitive to make up for the loss. It was true.

I gasped as I fought my way back to full consciousness. The pain had increased, even though I was sure the dosage of pain medication had been increased as well. I really was getting worse. I needed to seriously consider becoming my sister. I hadn't forgotten what the crazy doctors had said.

I didn't catch the attention of who I was sure was my mom, sitting in a chair next to my bed. She needed prodding so I imagined I was running through a corn field to speed up my heart. Between the increased beeping and a few grunts, I roused her.

"Mike? Are you awake?" She sounded groggy, like she'd been asleep for a long time in that chair. It must have been uncomfortable.

I responded with the usual three grunts. Then I imagined being chastised for being so unladylike, and I had to suppress a laugh. It hurt when I laughed.

"Are you okay?"

I gave her another three grunts. I suppose she misunderstood my stifled laughter.

Another 72 beeps sounded before she spoke again.

"So do you remember what the doctors said ... about the transplants?"

I grunted three times.

"Are you okay with that?"

I mostly heard concern in her voice, but I also heard hope. This sensitive hearing really came in handy. She had to hope that I'd agree to the procedure. She already told me she couldn't stand to lose both of her children.

If I accepted the transplants, it wouldn't exactly be like she was getting a new child. To me, it seemed more like she was getting her son back along with some of Beth thrown in as a bonus. It would certainly be better than having me die, and assuming I live, it might even seem like a better choice to her than having a son with horrible burn scars over virtually all of his body. At least I wouldn't blame her if she thought that way. Still, it wasn't a decision to be made lightly.

I wanted to think about it a little more. I hadn't had much time so far. I'd been drugged too much and hadn't been able to think clearly. So instead of grunting yes or no, I threw her a curve by grunting only twice.

"Two grunts? What does that mean? Does it mean maybe?"

Good guess I thought, as I grunted three times again.

Chapter 5: Honoring My Sister

I was pretty much left alone to think about my fate. My mother occasionally asked how I felt and asked me whether I'd made a decision yet, but thankfully, no one pressured me. At least no one did until an unidentified man came to visit.

The man came in to talk soon after my mother went off to sit with Beth, and I guessed he made sure my mom didn't see him.

"I know you're awake," he said by way of introduction. "I heard you grunting with your mother."

His shoes squeaked noisily until he'd moved next to my bed where my mother had been sitting moments ago. I felt his eyes on me, and I counted over a hundred beeps of the heart monitor before he spoke again.

"Are you through feeling sorry for yourself?" he asked. His deep, emotionless voice projected with the ease of someone who did a lot of public speaking. I disliked him immediately. His horrible bedside manner made it easy.

"Why don't you just agree to the treatment? Do you like making your mother suffer?"

The man was a prick. He completely misread me. I wished I could've told him to leave but unfortunately, I was a captive audience. I committed his voice to memory and made a mental note to make sure I let him know how I felt about our conversation if I ever met up with him again.

Then he startled me when he spoke again. He'd moved his face a couple inches above mine and spoke much more quietly.

"I've read your profile, Mikey. You're a sweet, sensitive kid. You loved helping your sister and you almost burned yourself to death trying to save her life. Now she can help you. Take the treatment."

I could smell stale coffee on his breath. That was another strike against him. I hated coffee. I hated it almost as much as I hated being manipulated.

"You're too much of a wimp to ever be a man, but you'd make a great girl. Do everyone a favor and be a girl. I'm *sure* you'd like it."

I didn't like the way he emphasized the word "sure". I didn't like anything about the man, and I'd had enough. Though my balls had been burned off, my body still had enough traces of testosterone to fuel my anger. I imagined beating my tormentor with a baseball bat until my heart rate went through the roof and the monitor pinged an alarm.

I heard the man hurry out just before a stampede of nurses came in to attend to me. They broke out the happy drugs and my brain soon fogged. I lost consciousness with my imaginary baseball bat still held tightly in both hands.

***

The faithful heart monitor and my mother's perfume greeted me for another waking period. I wish I could say I was happy about still being alive, but every part of me ached. Even my teeth hurt. I was tired of the pain, tired of lying in a hospital bed, all wrapped up and nowhere to go.

I didn't want my mom to know I was awake yet so I stayed relaxed and kept quiet. I still had some thinking to do.

I'd pretty much decided to accept the treatment before my unwelcome visitor showed up. I didn't like the idea of living with my failure to save Beth, and I have to confess I wasn't crazy about being a girl. My instinct for self-preservation was still strong however, as was my love for my mother. If she wanted her son to live as a girl, I'd be a girl. I'd do it for her, and I'd do it to honor Beth. I imagined seeing my sister's face every time I looked in the mirror. That would certainly keep her memory alive.

I thought about letting my mother know my decision as soon as she came back, but then that prick of a man showed up. He really shook me up, but he actually did help reinforce my decision in his own way. He gave me motivation. I hoped to live so that I eventually would meet up with him and put him in his place.

Just thinking about him elevated my heart rate again. It increased enough that my mother didn't wait for me to signal her.

"Mike? Are you awake?"

I gave her the usual three grunts and yearned to be able to speak again.

"Have you made a decision?" My mother's voice overflowed with hope and love and my heart melted.

I grunted three times and I heard a sharp intake of breath. Then a hard, slow swallow.

"Will you accept the treatment?"

I loudly grunted three times to make sure there was no mistake. I decided to choose life, even though it would never completely be my own. I'd never be Mike again.

My mother responded in predictable fashion. She laid her head on my chest and cried, soaking my bandages with her tears as she had once before. The weight of her head caused excruciating pain but I bore it well. I was going to live.

***

The group of doctors returned and went over the treatment with my mother and me once again, and they were more thorough. They wanted to make sure we understood what to expect.

I'd be getting a full skin transplant, including all hair and my sister's face. I'd also get my sister's eyes, larynx and all of her female parts. I'd even be having some work done to feminize my pelvis and I'd be getting Beth's floating ribs. My mother asked if that was necessary but the doctors brushed her off, saying it would save me some embarrassing questions whenever I had x-rays for a physical examination.

They also covered the gene therapy treatments but that part went right over my head. The only part I understood was that I'd have to stay at the hospital and be closely monitored until my body completely accepted Beth's body parts.

My mother signed a bunch of paperwork right there in my hospital room. I could hear the pen scratch across the surface of the paper.
Then I was wheeled away to be prepped for the long surgical adventure ahead of me. I'd be out for three days, and when I awoke, I'd be living in my sister's skin and literally walking in her footsteps for the rest of my life.

I stopped moving and soon heard the snipping of scissors as someone cut away my bandages. A woman with a German accent stood off to the side and made a few comments to the doctors who prepped me. She mentioned starting the anesthesia. It wouldn't be long before my new life started.

It was ironic that I could've saved myself from the burning house and ended up with roughly the same result. I would've lived and my sister would've died, but that wasn't acceptable. I would've felt much worse, wondering if I could've saved her. It was worth it to trade my gender for the certainty that I at least tried to save her.

My badly burned skin stretched too tightly on my face for a proper smile, but I imagined smiling. I knew it wouldn't be much longer before I'd be smiling again and I was anxious to get started.

Chapter 6: Skin Deep

I thought I knew pain before, with my third degree burns, but that was nothing compared to what I felt when I woke up that day. To be fair, my new body gave me a different kind of pain. My burns had given me a dull, throbbing ache that was easy to get used to and filter out as it became familiar, as long as I didn't move. After my operations, I felt sharp, prickly hot spots flaring up all over as nerves introduced themselves to my new skin. Dozens of hot spots hit hard and fast, and left just as quickly, giving me no chance to acclimate. Medication was my friend.

Once I struggled past the pain, I found my vision blocked by bandages. At least I was used to that. I reached out with my ears, listening for any sign of a warm, friendly body to either distract me from the pain or increase my medication.

I couldn't hear anything, not even my friend the heart monitor, nor could I smell anything but that oppressive, harsh odor of antiseptic that hung in the air of hospitals everywhere. I found out later that exposure to perfume or flower scents might have interfered with my treatment. The doctors took no chances.

It seemed I was alone so I sighed ... and made a pleasant discovery. Though my throat hurt, I made a sound other than a grunt. I tested my new voice by groaning. That's when I found out I wasn't alone.

"Stop that!" a woman suddenly hissed.

Her command startled me. I flinched and searing pain erupted all over my body. The woman didn't have to worry about me obeying her. I was too busy gritting my teeth to be any trouble.

After the pain abated, the woman realized what had happened and apologized. I wasn't supposed to use my vocal cords until they had more time to heal. She only shouted because I surprised her. She didn't notice that I'd woken up.

The woman identified herself as Sarah, a physiotherapist assigned to help me through my coming ordeal. She jokingly used the word "ordeal" but with all the pain I'd felt so far, I reserved judgment. The doctors had discussed all of the possible side effects so at least I knew what I was getting into. The pain didn't scare me. In fact, I embraced it. I'd accept a lot of pain and suffering for the chance to speak and see and live again.

Bandages no longer covered every square inch of my body. Only my eyes needed protection while they healed. The rest of the surgery had been performed while I was skinned to eliminate the need for incisions. I was free of scars. Not even the skin transplant itself required any cuts. The doctors stretched Beth's flesh over me using a natural opening and some drugs to increase elasticity of the skin. I didn't want to think about it.

Except for my temporary lack of vision, I felt free, and I reveled in the feel of cool air on my face. It amazed me that I could feel anything so quickly after my surgery. Sarah explained that the gene therapy included something to help regenerate nerve tissue. The pain would be more intense from the rapid nerve growth, but it wouldn't last long. I hoped she was right.

My physiotherapist was very nice but also very demanding of me, as I soon found out. Right after she introduced herself and told me the agenda for the day, she ran me through a series of light exercises to help keep my new skin from forming adhesions. Normally, massage would be used, but for the time being, my skin was too sensitive to be rubbed.

I started by making different facial expressions. They were easy. As I did one, the pain immediately sent me to another. I slid from smile to frown to scowl without thinking. Sarah couldn't help but notice my discomfort and adjusted accordingly.

She worked my fingers and feet next. She focused on them for two reasons. Getting patients back on their feet was always a high priority, and being able to use my hands was important for me. I needed some way to communicate. With my vocal cords still sore from surgery, I wasn't even supposed to grunt.

My physiotherapy progressed quickly and well. Within minutes, I could tap different fingers to say yes or no, and before the end of my first session, I could write short messages on a notepad. The first message I wrote was to ask about my mother. I knew I had a lot of work to do but I missed my mother.

"She isn't allowed to see you yet."

"Why not?" I quickly scribbled on the notepad.

"We don't think that's a good idea just yet."

"Who's we?" I wrote. Sarah's comment made me nervous for some strange reason. Something sounded fishy to me.

"Uh ... I meant the doctors of course."

Good save, I thought, but I was still suspicious.

"I want my mom," I wrote.

"I'm sorry but that's not possible."

"Why?"

"I ... I'm not sure how to explain it."

"Please try." I'm sure my handwriting was a mess. I ran the pen off the edge of the paper in my haste. Sarah got the message though.

"Doctor Franklin thinks your mother might hinder your ... progress."

"Who's Doctor Franklin?"

"She's the psychologist in charge of your mental therapy. She was afraid you might have trouble adjusting after your accident."

I stopped and tried to give that some thought, but Sarah wouldn't let me. She didn't want to stop my therapy session so she pressed on, and I obeyed. We ran through a few leg and arm exercises before I could take no more. I was exhausted.

"Mercy!" I wrote on my notepad.

Sarah laughed, but she saw how tired I was and relented.

"You did very well," she told me. "We've spent nearly four hours already today."

"Wow!" I wrote.

"Wow indeed. Someone will bring you some juice in a moment and I think you'll even get to try some yogurt and a banana. I know it's been a long time since you've had solid food so I want you to take it easy."

"What's food?"

Sarah read my message and laughed again.

"You've got a good sense of humor," she said. "I think we'll get along fine."

Before she left, she told me I'd probably need a nap after my lunch. She'd be back later in the afternoon though and see about resuming my physiotherapy if I was up to it. I had a long way to go and she was anxious to push me as hard as she could.

***

A nurse named Carrie arrived to serve me lunch. She'd been briefed about my finger tapping and notepad so things went very smoothly. She raised my bed very slowly and helped me drink and eat for the first time in ... I don't know how long.

"How long since the fire?" I wrote after I finished my lunch.

"I'm sorry. I don't know anything about what happened to you. They said it was best that way."

"They?" I wrote. I was getting very concerned about the lack of names and titles.

"Oh. I don't know. Bureaucrats and military doctors I guess. This place is full of 'em." She left it at that but I wasn't satisfied.

Carrie cleaned up and left me alone with my thoughts, and I found that I still had a lot of company. I wondered about how well my surgery went, worried about the hospital I was in, and I missed my mother. I couldn't believe she wouldn't insist on seeing me as soon as I woke up.

My thoughts and concerns wound me up a little, but as Sarah predicted, I did soon fall asleep. I needed the rest.

***

I must have stirred as I woke up because Sarah spoke up immediately.

"Hello sleepy head. How do you feel? Ready to start again?"

I tapped my pinky finger to mean no. Was she insane?

"Okay. You did just wake up, but I still recommend a little stretching. It'll help get the blood flowing and wake you up more. Would you like to try some stretching?"

I hesitated for a minute or so, but eventually she got the answer she wanted and the physiotherapy session officially began.

***

Only two more hours went by before I called it quits for the day. Sarah congratulated me on my progress but I could tell she wanted more out of me. I could hear the disappointment in her voice. At least she truly seemed to care, I mused, and she was much better to talk to than Carrie was.

That reminded me. I still wanted an answer to the question I'd asked Carrie.

"How long ago was the fire?" I wrote.

"I'm sorry. I don't know anything about a fire. All I know is that you've been bedridden for about two weeks. That's why we're taking it slow."

"Slow? Are you kidding?" I wrote.

She laughed, and the sound made me smile, even though it caused a little pain. I loved the sound of her laugh. There was no malice or deceit in it at all. I was sure I had nothing to fear from her, but I still felt uneasy.

I might have shrugged off my growing suspicion, but it didn't help when a different nurse checked my vital signs and served me my evening meal that day. I never heard from Carrie again. My inner paranoid self whispered that she was removed because she was careless about what she said. Shadowy figures don't like people to be careless with words.

I fell asleep that night thinking about my mother. I hoped I could see her soon. She'd make everything okay.

*** to be continued ***

 © 2009 by Terry Volkirch. This work may not be replicated in whole or in part by any means electronic or otherwise without the express consent of the Author (copyright holder). All Rights Reserved. This is a work of Fiction. All the characters and events portrayed in this book are fictional and any resemblance to real people or incidents past, present or future is purely coincidental.