Lexie

When my landline rings at 2:00 a.m. on a Thursday morning, I know who's at the other end of the line before I pick it up. Only one person in my life would call at that hour; the same person who wouldn't hesitate to ask for something after two years of silence, the same person who wouldn't give a single thought to the fact that I need to be at work by 8:00 a.m.

As I bring the handset to my ear, I brace myself for the one thing that contact with my little sister has brought me in recent years.

Chaos.

"Annie?"

"Lexie," Annie's voice breaks on a sob, "you have to help me — I think I'm dying."

I sit up and push my hair out of my face. My fiancé, Sam, had been asleep on the bed beside me, but he sits up, too. I glance at him and see sleepy confusion cross his face. As a physician, I periodically have late-night calls regarding patient emergencies, but never via the landline. I've moved houses twice since I last spoke to Annie, but I've always made sure the same number followed me, just in case she wanted or needed to reconnect.

Now, here she is — and just like I always feared, she's calling me because she's got an emergency on her hands.

"What's going on?" I ask.

"My head hurts so much and nothing helps the pain. I'm seeing double and my feet are swollen and ..."

They are troubling symptoms, but as Annie speaks I recognize the slur that indicates she is high. Frustration floods me, and I sigh impatiently.

You're thirty now, Annie. Are you ever going to grow up?

"Go to the hospital," I say. I feel Sam stiffen on the bed beside me at the hard edge of my tone. He's never heard me speak like that, and I turn toward him again, an apology in my gaze. It hurts me to be cold with Annie, it even hurts to recognize how only seconds into this phone call I'm already boiling up inside with impatience and frustration toward her. This is my baby sister. This is the same kid I shared a room with for our entire childhood, the same sweet nine-year-old who used to beg me to play "mommies and daddies" with her after our dad died.

But I've been dealing with her addiction for years, and even after a two-year break from the drama, the weariness returns as soon as she does. If this was a one-off, I'd probably panic and rush to her aid — but it's not. I have lost count of Annie's desperate 2:00 a.m. phone calls. I couldn't even tally the times she has gotten herself into a hopeless situation and called me to find her a solution.

"Lexie, I can't," Annie chokes now. I wait, expecting some long-winded story about not having health insurance or having a warrant out for her arrest or something simpler like not even having a car, or having woken up from a binge to find herself lost. When the silence stretches, I know I need to end the call. I try to push the phone call to it's inevitable conclusion as I prompt her, "Well?"

"Lexie, I'm pregnant. I can't go to the hospital. I just can't."

I've been a GP for several years — I thought my poker face was pretty good, but I'm not prepared for this. I gasp and feel Sam's gentle arm snake around my waist. He rests his chin on my shoulder, then presses a soft kiss against my cheek.

My first instinct is to assume Annie is lying. It wouldn't be the first time, although she generally lies only for some financial or pharmaceutical payoff. The last vestiges of sleep clear from my brain and I quickly consider the situation. There is something different about this scenario. Annie isn't asking me for money. She is asking for help.

"If you're pregnant then those symptoms are even more troubling. You need to get to a hospital."

Annie speaks again, her voice stronger and clearer. She is determined to make me understand, and there's no way I can ignore her plea.

"If I go to the hospital, I'll fail the drug test. I just can't."

I slide my legs over the edge of the bed, straighten my posture and take a deep breath. I'm immediately resigned to what this call is going to mean. Annie is back — this peaceful period of my life is over.

"Tell me where you are."

Sam tries to convince me that there are smarter ways to approach this situation than jumping in the car myself.

"Just think about it for a second," he says quietly. "This is the same sister who nearly got you fired two years ago, right?" I bristle at his pointed tone, and I'm scowling as I reply, "She needs me, Sam."

"She needs medical help. And even if we go there right now, the best we can probably do for her is to call an ambulance anyway. So why don't we just do that in the first place?"

"Because her situation is complicated and they won't understand. If I go to her, I can talk sense into her. I know I can."

There's a hint of impatience in his eyes as he scans my face in the semidarkness, but then he sighs and throws back the covers on the bed.

"What are you doing?" I frown at him, and he walks briskly toward the wardrobe as he mutters, "I'm not letting you go to some trailer park by yourself at three o'clock in the morning."

"But you have surgery all day tomorrow, Sam. This isn't your problem."

"Lexie, your problems are my problem now. I'll be fine, and if I'm not, I'll postpone the surgeries. If you're going, I'm going, so either call an ambulance and get back into bed or let's go."

So I let him come with me, but even as he drives across the city, I feel anxiety grinding in my gut. Sam knows only the basics about Annie's issues. He's been supportive and understanding, but at the end of the day, he's from one of those "old money" northeastern families; the biggest scandal in his entire lineage is his parents' somewhat amicable divorce. And now, four months after our engagement, here he is looking for an obscure trailer park in the middle of the night, to give medical care to my pregnant, drug-addicted sister.

He hasn't ever met Mom, and I'm not sure he ever will. I haven't seen her myself for almost two decades — not since the day of my sixteenth birthday, when I walked out of the strict religious sect she moved Annie and me into after Dad's death. We speak on the phone from time to time, despite that being against the rules of her community — since Annie and I turned our back on the sect, we're dead to them. I hate calling her because I usually hang up feeling lonely. A call to Mom back in Illinois is like telephoning another planet. She's so disconnected from my world, and I have completely rejected hers.

I try to keep an open mind as we drive. I don't want to think the worst of Annie, but it seems like her situation has gone from bad to worse over the past two years. I think of her every day — but in my thoughts, she has lived a much healthier life than the one I fear I'm about to see. It was the only way I'd been able to deal with throwing her out of my house two years ago. I imagined that she was working somewhere — maybe writing again — maybe she has a nice little apartment, like the one she had in Chicago after she graduated. I pictured her dating and going out with friends and shopping for clothes at little boutiques. Annie always had such a beautiful sense of style, back when she cared about how she looked.

It's well after 3:00 a.m. when we find the place. It's an older-style trailer, and even in the semidarkness of the trailer park, there is no denying that Annie is somewhere near...