By Marietta Brill

When my sister’s doctor recommended that she get a mammogram, Karren called me. “Do you want me to make an appointment for you, too?” she asked, as though scheduling a pedicure. I immediately agreed. She rarely needed medical interventions, and this might be her way of asking for support. And I was way overdue. As busy New Yorkers—Karren, at the time, an advertising creative director and yoga teacher, me a freelance writer and Brooklyn mom of a teen—unpleasant procedures weren’t high on our to-do lists. I also knew that going with Karren might make it seem a little fun.

We arrived together. It was a rainy Thursday. Wearing sweaters and jeans, my sister and I looked more alike than usual. “You ladies,” the doctor said when he looked up from his chart, “you look a lot alike—you could be twins.” Tall, dark-haired, and olive-skinned, Karren and I were often mistaken for twins. I noticed that the doctor could be Matt Damon’s stunt double.

“Thank you!” we replied in unison.

“We’re just sixteen months apart,” Karren said.

Like Borscht belt comedians, we had our routine down over years of telling. I might describe how my husband once confused us. Karren would joke that our mother couldn’t tell us apart on the phone. “That’s because,” my sister, who’d once been an actress, would continue cheerfully, “we have the same voice box.” This expression always baffled me. I imagined tiny, identical gramophones in our throats. But lately I thought it was a great way to explain what made us alike—something indefinable, as intimate as breathing, which our voices expressed.

•••

Looking at the doctor’s immaculate mahogany-grain wood desk reminded me of a similar room at Sloan Kettering Neurology Unit two years earlier where Karren, my husband Peter, and I had waited for a good hour to look at my brain scan. I’d been having seizures that left me temporarily speechless and with auditory hallucinations. On the neurologist’s wall were framed nature prints and an eye chart.

Like many doctor’s offices, it had the fake cozy vibe of a Holiday Inn. Pre-diagnosis, it was a neutral purgatory, the zero-point baseline where nothing was yet decided. We would stay in this innocent safe zone until the doctors arrived—and then with a diagnosis I’d either leap above the line into my treasured normal life or drop into some ring of hell.

We had run out of conversation and our worry hung in the air with the buzz of the fluorescent lights. With a sharp tap on the door, the neurologist burst in with his entourage of five interns. Insanely, I felt like I was in the middle of a Marx Brother’s movie (the neurologist was a little short), and I half expected someone to honk a horn. He did the usual double-take and made a tepid joke about our similarity (“Which one’s the patient?”).

In front of this audience of family and doctors I was asked to perform tests. The doctor read a list of random words for me to keep in the back of my head and repeat later. Then he asked me to walk a straight line. The crowd watched as I minced, heel to toe, along blue paint-tape, like a DUI suspect or a trapeze artist. I was told to count backwards by sevens from one hundred, a task I couldn’t handle reliably in my most sober moments. “What’s the name of the Vice President?” he asked. I couldn’t remember and almost began to cry. When I couldn’t replay the random words from ten minutes ago, through a blur of tears, I saw Karren mouthing the answers. We all practically cheered when my knee jolted from the reflex tap.

Finally, the doctor tacked a film up on a light box and we gathered around the image. It looked like a Google satellite map of two shadowy divided galaxies, with a white dot on the left side, lighting up like a population center. I wanted him to zoom in, to give me the details, to orient me. “It’s an enhancing lesion in your parietal lobe,” he explained. None of us knew what it meant. Karren gasped and reached for my hand. My husband Peter squeezed my shoulders. I thought the word “enhancing” had a soothing, upbeat sound to it. I was wrong (again).

“If it shows up bright on the scan, it’s active.” This was at once not enough and too much information. I couldn’t think of anything to say. The critical, investigative part of me shut down. I looked down at my kitten-heeled Mary Janes. Those Aerosoles were so darling and comfy. They had gotten me through our mother’s funeral a year before, through our father’s funeral the year before that. They were not lucky shoes. But they were the perfect mid-life shoes, cushioning me from the hard bricks of life. Comfort is what I sought more than anything.

The neurologist said that the lesion was pressing up against the speech center in my brain. It explained why I’d suddenly lost my ability to speak and started talking like a caveman a few weeks ago. And the auditory hallucinations. In one type of hallucination, everyone had a French accent. Another expression was the echo of voices and sounds. Once I heard a stroller clanging down a stairwell for close to half an hour, as though the stairs were endless and haunted.

The centimeter-sized dot shining hard in my brain suddenly became the center of my universe. I kept thinking of the palindrome, “rats live on no evil star.” It wasn’t true, I thought; awful things could live anywhere.

The doctors agreed that the lesion was too dangerously close to my speech nerves to biopsy. No surgery. They would watch it with MRIs and give me anti-seizure drugs for the speech and hearing problems. Desperate for any good news, we almost cheered again.

Somehow, we were starving after the appointment and found a coffee shop called, amazingly, The Silver Star. Karren and Peter sat across from me in the booth. I was the focus of their searching, gentle looks. They were waiting to follow my lead. “Well, at least I don’t have to get my head drilled,” I said.

They laughed a little. Peter put his hand on mine.

Karren looked at me, intently and kindly, and said, “I know you are going to be five hundred percent!”—a mantra she would repeat in the months to come. I didn’t want to argue. I wanted to believe that she saw something inside me that I couldn’t, some other force that could outshine and blot out the enhancing dot.

The waiter came. Pete ordered a western omelette. Karren said, “I’ll have two eggs over easy with whole wheat toast, and a slice of tomato.”

I said, “I’ll have exactly the same thing.”

Karren promised she would be with me at every appointment. And she was. We ate a lot of eggs over the next year until the dot faded, and we had no more use for the Silver Star.

•••

Ever since we used to eat TV dinners in front of Patty Duke Show reruns in our suburban split-level house, Karren and I have been charmed by the idea of being twins. Back then we looked nothing alike. She was petite and I was tall; she tanned and I burned. She had big brown eyes, and mine were hazel. But the closeness of our age and our dark hair gave our mother enough reason to push the likeness. She ordered matching haircuts—pixies as toddlers and Beatle cuts as tweens. She duplicated our smocked Peter Pan–collared dresses, mine red and Karren’s yellow.

I did not appreciate my little sister then. I saw her as an interloper. I resented having to watch her in the playground, help with her homework, slow down for her when we were riding bikes. Once, when she was two and I was four, I aimed a rock at her head and surprised myself by hitting her dead on. My satisfaction wilted within minutes. It was my first experience of guilt, and to this day, I can see her lying there in bed with a cold pack inches from her Bambi eyes.

I continued to resent and ignore her until I was about thirteen when I realized that not only was she very sweet and loved me, she was wise and hilarious. As we got older, we got closer and looked more alike. We became the sworn keepers of each other’s secrets, protecting our nervous mother from my pack-a-day habit and her relationship with an older man.

Sometimes our similarity almost got us into trouble. When I was nineteen, I went out with an acquaintance of hers who called me “Karren” all night long, but I was too embarrassed to correct him as he introduced me to his sophisticated friends. He was mad when he finally figured it out. Another time, Peter and I had been on just a few dates before he went on vacation; when he returned, Karren was standing at the top of the steps of our walkup apartment. Pete loves recalling how he saw the red-lipsticked smile and dark hair and thought it was me—but eerily different. He was ready to go with it until I stepped onto the landing beside her. “Hi!” we said, doppelgangers in stereo.

For the next two decades Karren and I moved in lockstep through life, sometimes criss-crossing and sometimes following the same paths, reflections of the other in an imperfect mirror. Karren moved to New York City after college, and I did too. She led me to my first writing job in advertising, and I led Karren to hers. I introduced her to her husband and to yoga. We lived together in a sky-lit Chelsea apartment where we threw great dance parties. More importantly, Karren and I had a strong spiritual curiosity that drew us beyond our Jewish background. Over the years, she inquired into Kabbalah and Kundalini yoga. I was suddenly the tag-along.

•••

Throughout the yearlong ordeal of trying to diagnose and treat my brain tumor, Karren kept her promise. She saw me through seven spinal taps and countless CT scans, brain scans, and MRIs. She was by my side during day-long infusions and anxious waits for lab results. Once, in a panic, I felt my eyes swimming in my head: the dizziness that forewarned of a seizure. Karren held my face in her hands and said, “Look at me, and breathe.” I stared into her sweet brown eyes and followed the slow count of her breathing, inhale and exhale, until I felt that her air was mine and, sufficiently infused, relaxed.

When the panic attacks recurred, I visualized her eyes, tuned my voice and breath to her frequency to guide me back to balance.

In Dr. Matt Damon’s waiting room while Karren was inside, I couldn’t believe how nervous I felt. Praying she would be okay gave me a sense of how she’d felt all of those months when my fate was in question. After it was over the doctor admitted, laughing, that he still wasn’t sure who had which appointment. It didn’t matter. The doctor read the results, giving us both a clean bill of health.

As we went our separate ways, Karren said goodbye one more time and I heard my own voice echoing back, leaving a doctor’s office with one less worry. I realized that I turned to Karren to connect with an essential part of myself that went deeper than illness. Hearing her voice, so similar to my own, had nourished my vitality. She helped keep my brain scan serenely unlit.

•••

MARIETTA BRILL lives in Brooklyn, NY, with her husband and teenaged son. She writes poetry, essays, and articles about books, art, health, food, and parenting. Her work has appeared in Brain, Child, The Brooklyn Rail, Hyperallergic.com, Parenting Magazine, and The Daily Forward. She blogs about cooking at swinginginthekitchen.blogspot.com.