Still Growing

March. Wednesday.

The washcloth caught on something new below Patrice’s left ear. A ridge, woody, the diameter of a pencil. Eva pressed gently and the ridge held. Not soft tissue. Not a vein. It had the resistance of a green branch, the kind you can bend but not break, and when Eva moved the cloth across it the texture underneath was bark.

She rinsed the washcloth in the basin. The water had gone the color of weak tea, same as every bath morning, because the growth shed — not cells, exactly, but a fine particulate that settled in the folds of the washcloth and smelled of turned earth after rain. She wrung it out. She made a note in the composition book she kept on the toilet tank: March 19. New growth behind left ear, lateral. Woody. Approx 3cm.

Patrice was looking at her. Her eyes were still her eyes — dark brown, the same as Eva’s, the same as their mother’s — and they tracked Eva’s hand as it moved the cloth down the jaw, under the chin, along the throat where the skin was still mostly skin. A thin filigree of something green laced the hollow of the throat. It looked like the veins in a leaf held up to light. Six weeks ago it hadn’t been there. Three weeks ago it was faint enough to miss.

“Cold,” Patrice said. Her voice came out strange now, breathy, as though her vocal cords had to work around something. Which they probably did.

Eva ran the hot tap until the pipes stopped clanging. The plumbing in this house had been temperamental since before their mother died, and the hot water heater was a Montgomery Ward unit from 1987 that the landlord had promised to replace four times. She wet the cloth again. Warmer.

“Better?”

Patrice didn’t answer. She had closed her eyes. A small tendril — pale green, no thicker than thread — had curled from her hairline during the bath. Eva watched it emerge the way you watch a plant growing in time-lapse, except this was real time, and the soil was her sister’s scalp.

She finished the bath. She dried Patrice with the good towels, the ones from Target, not the old ones that snagged on the rougher patches. She helped her into the oversized Garth Brooks T-shirt Patrice had been wearing since high school, working the sleeves carefully over the forearms where the growth was thickest, a dense matt of something between moss and lichen that had fused with the skin in a way that no longer suggested surface but structure.

Eva carried the basin to the bathroom and poured it out. The residue coated the tub in a thin greenish film she’d stopped trying to scrub away.

September. One year earlier.

The first thing was a rash on Patrice’s wrist. This was nothing. Patrice worked the register at Tractor Supply in Dalton and her hands were always dry, always cracked, always reacting to something — the anti-theft tags, the receipt paper, the hand sanitizer the company made them use every forty-five minutes as though retail workers were vectors. She bought hydrocortisone cream at the Dollar General and rubbed it in every night and the rash didn’t go away but it didn’t get worse and so it became part of the landscape of Patrice’s body the way a water stain on a ceiling becomes part of a room. You stop seeing it.

Eva was living twenty minutes away, in the apartment above Guillory’s Hardware on Route 9, working Tuesday through Saturday at the elementary school cafeteria. She saw Patrice on Sundays when she drove out to the house — their mother’s house, technically still, though their mother had been dead eleven months and the house was now just the house where Patrice lived alone with two cats and a back porch that was pulling away from the foundation. The rash was a footnote. Eva noticed it was greenish but Patrice said that was the cream, it oxidized or something.

It wasn’t the cream.

But neither of them knew that yet, and September was warm, and the leaves were just beginning to think about turning, and Patrice’s wrist was a small wrong thing in a world where wrong things were plentiful and mostly survivable.

June. Eight months later.

Dr. Keene at the walk-in clinic on Hargrave looked at Patrice’s arms and said nothing for eleven seconds. Eva counted. She was sitting in the plastic chair against the wall, the one with the cracked armrest, and she counted the seconds because counting was something she could do while the doctor’s face moved through expressions she had no name for.

The growth covered both forearms from wrist to elbow. It was no longer possible to call it a rash. The surface was textured like the bark of a young birch — pale, layered, with horizontal lines that resembled lenticels. Underneath, or within, or growing through — the language kept failing — a network of green ran in patterns that followed Patrice’s veins but were not her veins. The green had its own architecture. It branched.

“How long,” Dr. Keene said.

“Since September,” Patrice said. “But it was small. It was just my wrist.”

Dr. Keene touched it with a gloved finger. He pressed. The growth didn’t yield. He pressed harder and Patrice winced.

“You can feel that?”

“It’s part of me,” Patrice said, as though this were obvious, as though she were explaining to a child that your arm is attached to your shoulder.

He referred them to a dermatologist in Pittsburgh, which was two and a half hours each way. The dermatologist referred them to a specialist at UPMC who took three biopsies and said he’d never seen anything like it. The biopsies grew back in four days. Not the skin — the biopsied tissue itself regenerated, and what grew in the biopsy sites was not skin but more of the bark-like material, denser now, as though the body had interpreted the biopsy as damage and rushed to defend the territory with reinforcements.

The specialist’s report said anomalous integumentary presentation, etiology unknown, recommend monitoring. Recommend monitoring. As though there were an apparatus for this.

January. The photographs.

Eva found them in the closet in the back bedroom, in a shoebox that had once held a pair of their mother’s church shoes. Photographs from before digital, the kind with dates stamped in orange along the bottom edge. She wasn’t looking for evidence. She was looking for the heating pad, because there were nights — bad nights, nights when the growth pushed against the joints and Patrice said it felt like her bones were being braided — when she needed the heating pad fast.

The photographs were from a Fourth of July, date-stamped 2020. Six years ago. Patrice at a picnic table in the backyard. Hot dogs, paper plates, the American flag bunting their mother put up every year and left up until September because she couldn’t reach the nails. Patrice was wearing a tank top and grinning at whoever held the camera. Her arms were bare.

Eva held the photograph under the light. There, on Patrice’s left forearm, below the elbow. A discoloration. Greenish. The size of a quarter.

Six years. Everyone had seen it and no one had looked.

Eva put the photograph back in the shoebox. She found the heating pad. She brought it to Patrice, who was awake, who was always awake now because the growth did something at night — expanded, maybe, or deepened its hold — and sleeping through it was like sleeping through someone slowly tightening a belt around your whole body. Eva plugged in the heating pad and placed it against Patrice’s lower back, one of the last areas that was still mostly clear.

“Better?” she said.

“No,” Patrice said. But she closed her eyes, which was her version of yes.

April. The flowering.

It started on a Tuesday. A small bud, pale yellow, emerging from the lichen on Patrice’s left shoulder. By Thursday there were four more, clustered along the collarbone, and by Sunday the first one had opened into a flower that Eva did not recognize from any garden or field guide — five petals, waxy, yellow fading to a deep arterial red at the center, with a scent like jasmine cut with something mineral and wrong.

Eva stood in the doorway of Patrice’s room and looked at her sister in the morning light and felt something move through her that she identified, with a sick precision, as admiration. Against the dark bark-like skin, the yellow blooms looked arranged, intentional. Patrice’s shoulder was a ruin overgrown.

Eva went to the kitchen and put both hands flat on the counter and breathed through her nose until the feeling passed. Then she went back and started the bath.

She did not write beautiful in the composition book. She wrote: April 7. Flowering onset, left shoulder/clavicle. Five buds, one open. Yellow. Unidentified species. No apparent distress to patient.

Patient. She’d started writing patient instead of Patrice three weeks ago and hadn’t decided whether that was clinical distance or surrender.

November. Six months after the rash.

Patrice quit her job at Tractor Supply because she couldn’t work the register anymore. The growth on her forearms made it difficult to flex her wrists, and the customers stared, and the manager — a man named Dill Haggerty who wore clip-on sunglasses and talked about Jesus in the break room — told her she needed to wear long sleeves, which was corporate policy, which was also impossible because the fabric caught on the bark and pulled and once, when she’d tried, the sleeve came away with a patch of the growth attached and underneath was not skin but a raw wet pink surface that bled something that was almost sap.

She filed for disability. The paperwork took three months. During those three months she lived on what was left of their mother’s savings, which was $4,200 in a checking account at the credit union that also held $11,000 in credit card debt their mother had never mentioned.

Eva drove out every day after her shift at the cafeteria. She cooked. She did the laundry, separating the towels and sheets that had been in contact with the growth from the rest because the greenish residue didn’t fully come out in the wash and she didn’t want it on her own clothes, and then she felt guilty about not wanting it on her own clothes, and then she felt angry at the guilt because the guilt was one more thing she had to carry and nobody was carrying anything for her.

She called Reggie — their brother, in Spokane. He worked for a company that installed commercial irrigation systems and had a wife named Britt and twin boys and a mortgage and a life that was organized around the assumption that someone else would handle the things back home.

“How bad is it,” Reggie said.

“It’s past her elbows.”

“Both arms?”

“Both arms.”

A pause that contained everything Reggie was not going to offer. “Should she see someone?”

“She’s seen three doctors. The dermatologist wants to do more biopsies. The specialist wrote a paper about her. Nobody knows what it is. Nobody can do anything.”

“Is she eating?”

“She’s eating.”

“Well,” Reggie said. “That’s good.”

Eva hung up. She drove to Patrice’s house. She made tuna casserole from a recipe their mother had made every Thursday for thirty years, not because it was good — it wasn’t good, it had never been good, the cream of mushroom soup was sodium and the noodles went to paste — but because it was Thursday.

February. The recognition.

She was changing the sheets — a process that now took forty minutes because Patrice had to be moved carefully, the growth on her back having developed a root system that extended from the base of her spine into the mattress, thin white tendrils that worked into the fabric the way morning glory vines work into a chain-link fence, and extracting them without pain required a patience Eva did not naturally possess but had manufactured through repetition.

She was on her knees beside the bed, working a tendril free from the fitted sheet, when Patrice laughed.

Not the sound she’d been making lately, which was closer to a creak, the noise of wood under pressure. An actual laugh. Short, nasal, exactly the laugh Eva had grown up hearing — the laugh that came out when Patrice found something genuinely funny, not politely funny, not socially funny, but the kind of funny that ambushed you.

Eva looked up. Patrice was looking at her, and for a span of time Eva would later try to measure and fail — three seconds, five, some duration that had no unit — Patrice was entirely Patrice. The eyes were her sister’s eyes. The expression was her sister’s expression, the one that said we both know this is absurd. Through the bark and the moss and the thin branches that had begun to emerge from her temples like the first tines of a crown, through all of it, the person inside was looking out with full recognition.

“Your face,” Patrice said. Her voice was her voice, not the breathy rasp. Her voice. “You should see your face right now. Kneeling there with a — what is it — a root — in your hand like it’s —”

She didn’t finish the sentence. The clarity left her eyes the way a window fogs from the inside. She was still looking at Eva but she was no longer seeing her, or she was seeing her from a distance that had nothing to do with the three feet between them. She made a sound that might have been the end of the sentence or might have been the growth settling deeper into whatever was left of her throat.

Eva finished extracting the tendril. She put on the clean sheet. She tucked the corners the way their mother had taught them, hospital corners, tight enough to bounce a quarter. She went to the kitchen and sat at the table and put her forehead on the Formica and stayed there until the light changed.

July. The territory.

The growth had reached her torso. It spread across her stomach in concentric whorls like the cross-section of a tree, dark and light alternating, the bark thickening at the center where her navel had been. Had been. The navel was gone. Not covered — incorporated.

Her legs were still mostly clear below the knee, but the tops of her thighs had begun to show the familiar greenish tint, and when Eva bathed her she could feel, under the skin, the first filaments pushing outward. They felt like guitar strings tuned too tight. Patrice didn’t flinch when Eva touched them, which meant either they didn’t hurt or the nerves in those areas had been replaced by something that didn’t register pain in any way Eva could recognize.

Patrice no longer spoke in sentences. She spoke in words, sometimes two or three strung together with long silences between them, and the words were not always words. Some of them sounded like words from a language Eva didn’t know. Some of them sounded like the noise wind makes moving through a stand of poplars — sibilant, layered, not quite random.

Eva had moved into the house in May. She’d given up the apartment over Guillory’s Hardware, given notice at the cafeteria, applied for family medical leave, been denied because Patrice was a sister and not a spouse or parent, quit, and started driving for DoorDash three nights a week while Patrice slept — or did whatever she did at night, which was not exactly sleep but a stillness so complete that Eva sometimes put her hand over Patrice’s mouth to check for breath and felt instead a faint warm exhalation that smelled of chlorophyll.

The house was deteriorating around them. The back porch had separated another two inches from the foundation. The kitchen faucet dripped. A window in the upstairs bathroom had cracked during a freeze and Eva had taped it with packing tape and the tape had yellowed and curled. She did not call the landlord because the landlord would want to come inside and she could not let anyone inside.

Not because of shame. Because of the bedroom.

The growth had reached the walls. Thin tendrils extending from Patrice’s back, from the root system in the mattress, across the headboard and into the plaster. They ran along the ceiling like cracks, except they were green and they were alive and when Eva lay in the next room at night she could hear them growing. A sound below hearing, almost. A creak and a push. The patience of a root breaking concrete.

December. Four months after the rash.

Patrice came to Eva’s apartment for Thanksgiving leftovers and they sat on the couch and watched a movie — something with Sandra Bullock, Eva couldn’t remember later which one — and Patrice wore a long-sleeved flannel and kept her wrists in her lap and the only sign was the way she held her fork, carefully, turning it so the bark on her inner wrist didn’t scrape the plate. It was still small then. It was still a thing that could be hidden.

“Does it itch?” Eva asked.

“Not exactly.”

“What does it feel like?”

Patrice considered this with the same furrowed attention she gave to math problems, to tax forms, to the instructions on the back of a frozen dinner. She was not a careless person. She was a person who read directions.

“You know when a tooth is coming in,” she said. “When you’re a kid and the new tooth is pushing through the gum. It doesn’t hurt, not really, but you can feel it happening. You can feel the pressure of the new thing arriving. It feels like that. Everywhere it is.”

They watched the rest of the movie. Eva drove home.

August. Almost a year after the rash.

Reggie came. He flew from Spokane to Pittsburgh and rented a car and drove two and a half hours and stood in the doorway of Patrice’s bedroom and did not come in.

Eva watched him from the hallway. She watched his face do what Dr. Keene’s face had done, what her own face must have done at some point, though she’d been too close and too gradual to catch it — the recalibration. The understanding that the world contained this now.

Patrice was in bed. The growth covered everything above the waist. Her face was still partially visible — the left eye, the mouth, the chin — but the right side had been claimed, the bark advancing across her forehead in a slow front that Eva tracked in the composition book in millimeters. Her hair had been replaced by something that grew in fine green filaments, each one terminating in a tiny leaf the size of a fingernail. In the light from the window she looked like something from a church wall, half-human, half-forest.

“Jesus Christ,” Reggie said.

“You could come in,” Eva said.

He did not come in. He stood in the doorway and his hands hung at his sides and he looked at what his sister had become and the hallway smelled like a greenhouse, loamy and sweet.

“How do you — what do you —”

“I take care of her,” Eva said. “I bathe her and I feed her when she’ll eat and I keep the room warm and I write it down.”

“Write what down?”

“The changes.”

He stayed for two days. He slept on the couch. He did not go into the bedroom again. On the second morning he sat at the kitchen table with a cup of coffee and told Eva she should call someone. A hospital. The CDC. Someone with resources, with equipment, with the authority to take this out of a house with bad plumbing and a cracked window and a sister who was doing this alone.

“And what happens to her?” Eva said.

“They help her.”

“They study her. They put her in a room and they study her and she dies in the room or she doesn’t die and they keep studying her and either way she’s alone and she doesn’t know where she is. She barely knows where she is now. But she knows me. She still knows my hands.” She picked up her coffee. It was cold. She drank it anyway.

Reggie left that afternoon. He said he’d send money. He sent $500 in October and nothing after that.

May. The ceiling.

The tendrils had reached the hallway. Eva found them one morning, three thin green lines extending from under Patrice’s door across the ceiling of the hall toward the bathroom. She stood on a chair and touched one. It was warm. It pulsed, faintly, with a rhythm that was not quite a heartbeat but was not random either.

She did not cut them. She had tried cutting them once, in July, the ones on the bedroom wall, and the scream that came from Patrice was not a human sound and not an animal sound but something in between that Eva heard in her sleep for weeks afterward. The tendrils were her. They were her sister’s nervous system extended into the architecture of the house. To cut them was to cut Patrice.

So Eva walked under them, the way you walk under a low branch on a familiar path. She added it to the list: the smell, the sound, the green film on the bathtub, the petals that dropped on the bedroom floor.

She ate dinner at the kitchen table under a ceiling that was developing a fine crack where something was pushing through from above. She did not look up.

March. Wednesday. Later.

After the bath, after the note about the new ridge behind the ear, Eva dried her hands and went to the kitchen and heated soup — canned, tomato, the kind that comes condensed and you add water and it’s never as good as the picture on the label but it fills you. She ate standing at the counter because the kitchen chair closest to the window had a tendril wrapped around one leg and she’d stopped fighting it.

The electricity bill was fourteen days overdue. The DoorDash money covered food and the minimum payments on three credit cards — two of them their mother’s, still — and the gas for the pickup and the supplies: towels, washcloths, the unscented soap that was the only kind that didn’t react with the growth, the composition books from the Dollar General, two so far filled front and back. The disability payments had started in February, finally, deposited into the account Eva had opened in Patrice’s name because Patrice could no longer sign her name because Patrice’s hands were two knotted structures of bark and root that no longer resembled hands.

She washed the bowl. She set it in the rack. She went back to the bedroom.

Patrice was where she always was. The growth had advanced past the new ridge behind her ear during the time Eva had been in the kitchen — forty minutes, maybe less — and a small branch, thinner than a pencil, had emerged from the ridge and was extending horizontally toward the wall. It would reach the wall by tomorrow. It would join the other tendrils. The house would become a little more Patrice and Patrice would become a little more the house and Eva would note it in the composition book and adjust.

She sat in the chair beside the bed. The chair had been their mother’s recliner, relocated from the living room, and the upholstery still smelled of cigarettes. The left armrest had a tendril growing along it, fine as thread, which Eva had let stay because removing it would mean moving the chair and moving the chair would mean leaving the room and she spent enough time out of the room.

She picked up the composition book. She wrote the date. She wrote: New branch from retroauricular ridge, lateral extension toward east wall. Approx growth rate 2cm/hr. Flowers on clavicle cluster have dropped petals — second bloom cycle? Check tomorrow. Patient calm. Fed at 7:30am (applesauce, accepted; broth, refused). Bath completed.

She looked at what she’d written. She crossed out Patient and wrote Patrice.

Then she crossed out Patrice and wrote Patient again, because what was in the bed was both and was neither.

Outside, it was raining. March rain, cold, the kind that finds the crack in the bathroom window and the gap where the porch was pulling away. Something in the walls crept and grew.

She closed the composition book. She set it on the tank. She picked up the washcloth, because in an hour she would need it again.