The Four Degrees of Disease by McKenlee Heath

“It’s going to be okay,” my father whispers with a watery smile, clutching mother’s hands tightly between his, like he’ll die if he lets go.

“That’s what they all say,” she replies in the same tone, glancing down at their clasped hands.

I’m not supposed to be looking, but I am. Father’s shoulders start shaking with silent sobs. It hurts to watch, but turning away would be the same as ignoring it. And I can’t ignore it. We can’t ignore it.

Mother has cancer. She’d had it a few years after I was born, before she had Jacob. It had disappeared and she had been able to look after me like normal.  After she gave birth to Jacob, my brother, she got it again.

She’d got it worse the second time.

“Malignant,” the doctor had said.

He’d gone on about malignant tumors, and something called metastasis and other long words I hadn’t been able to take in.

She’s all I’ve ever been able to take in since that day. Her frail hands, her sunken eyes, her forced smile, her sallow cheeks.  Her body made up of skin and bone, her effort to hide the pain every time she walks.

It wasn’t so hard to live with when I was younger; at the time, I knew nothing. Father told me she was sick, but a cold was the only thing associated with sickness. This is a different kind of sickness.

This is a Disease.

In The Society, there are four kinds of Disease, or as I call them the four degrees of Disease.

There’s the slow, agonizingly painful, killing kind—like the one mother’s got.

“Don’t worry about me,” she says. “I’ll be fine, I promise.” She smiles. There’s always a smile. Smiling is one of the hardest things to do in this house.

Dying. That’s the second kind of Disease, except this kind is different. It’s like a prolonged sort of euthanasia. It’s given as a pill and once taken, life changes. You’re on a high. Life becomes the best it can be, filling with you with adrenaline and dopamine for a day. One day. One whole, perfect, wonderful day where you feel as though you’re on top of the world. Sounds fun, right?

“A sweet escape,” Jacob once said.

But it’s also a curse. Evade it you might, but it’ll come eventually. And once it does, the Third Disease follows.  The pill lets you live life to the full for one whole day, but the curse is that someone close to you dies.

Someone you love.

That’s where the next disease comes in. It is the silent kind. Grief. Also known as The Black Death, grief follows the Second Disease. When it becomes unbearable, one has no choice but to die.  And that is when the last one, the fourth one, comes for you like it does for everyone. Death.
I’ve always promised myself I won’t take it, because I can’t. It’s selfish, and I want to believe I’m strong enough to make it through.

“You’re stronger than this!” Jacob has said once; he had caught me smuggling money to buy a pill. “Don’t do this! Please. You can’t, you’ll leave me, and mother will leave, and then what will happen to me and father?”

The tears in his eyes, the way he’d clutched my hand, how could I say no?

I continue to watch Father sobbing against his and mothers intertwined fingers guiltily. What Jacob didn’t know was that I already have a pill upstairs, and the minute I break, I won’t be able to stop myself.

And that won’t be long.

Two weeks ago, we visited the doctor when mother had been at death’s door.

“How long has she got, Doctor? I asked.

He gave me a pitying look. The kind that makes your insides squirm.

“Not long,” he replied.

“How long is not long?” I demanded.

No matter how many times I asked, the most I could squeeze out of him was still “not long.” Looking back, I’m glad he hadn’t given me details. Details mean a time limit, and limits lead to all sorts of horrible things. But I know that however long ‘not long’ is, we’re almost coming to the end. That was very obvious last night, when I had a pillow over my head for about five hours to keep out the screams.

“She’ll be in a lot of pain,” the doctor had said.

I have been expecting pain, but not pain like this. Several times I’d walked up to the desk, taken out my box from underneath, opened it and stared at the pill.

It was so tempting.

Halfway through the night, Jacob had slipped into my room. In the dark, all I could see were his shining eyes and the glistening tear tracks on his cheek. Without a word, he slipped into my bed.
And somehow I knew that restless night, pierced with the occasional scream, had been our last.

Something tells me that today is the day.

The day you take the pill or the day your mother…

The absence of noise, of atmosphere, of everything remotely to do with life lurks like a stranger as I creep into my parents’ room. I can still hear Jacob’s soft snores coming from my bedroom, and as my fingers tremble on the handle of the bedroom door, I pray he stays asleep a few minutes more because I know that I will regret what I do next.

The door opens, and the sight slams into me before I even comprehend it.

The eyes.

The hands, the cheeks, the legs, the lip. But, my goodness, those eyes.

The momentary feeling of shock hits me. My gasp contains all the words I want to say, all the anger I want to scream, but I can’t.  No matter how hard I’d tried to prepare for this moment, I’d subconsciously been trying to evade the fact that there was nothing I could actually do.

Still rooted to the spot by the blow, my eyes glass over. Even as the tears fill them and spill over, no amount of time can erase the image of her lifeless eyes branded into the back of my brain.

“Mother!” The word ripped from my lips, raw. As my feet regain the ability to move, I approach her bed and grab hold of her hands.

My heart rips into shreds as I collapse to my knees, my hands wrapped around hers in a vise-like grip. If I let go, if I were able to, I don’t know what I’d do next.

A shudder shoots down my spine, followed by a sob that wracks my shoulders.

“ Mother!” I whisper again, a tear falling onto her hand. The hands that are so cold and so still, they could chill water. The hands that braided my hair when I was too young to do so; the hands that caressed my head and that rubbed my back whenever I cried; the hands that so carefully tended to my wounds, inside and out. The hands that now lay limp in my own.


I’m so far gone, overwhelmed by emotion, that I barely hear the footsteps behind me. When I turn my head, I see Jacob. Except he doesn’t look like Jacob. Not the Jacob I know.

He opens his mouth, and I brace myself for his scream, but nothing comes out. I want to comfort him, but I won’t let go of mother’s hand.  Though I know I’m going to have to eventually.
I’d expected Jacob to rage, to scream and pound the doors like he does when he has a tantrum. I’d expected him to yell and cry and shake. But he doesn’t. He doesn’t do anything. He just backs out of the room.  I know where he’s going.

I turn to mother, her frozen hands and her flat eyes.

Where have you gone, Mother?

I want to go after Jacob, but how can I leave mother like this? If I stay, the Society will find out and reprimand me for not reporting her death.

It hurts to let her go, but if Jacob finds the pill…

Dropping her hand is like dropping a stone, but leaving the room is like dropping the burden of loss, bringing short-lived relief, followed by a terror that Jacob could get to the pill before me.
And when I burst into the room I see him kneeling by my desk, the box clutched in his hands. His hand snaps in my direction, and suddenly hugs the box close, just like I’d done with mothers’ hands.

“Jacob, please,” I whisper. “You’re stronger than this. We’re stronger than this,” I beg, trying to remind him of the time I’d nearly succumbed to taking it.

Don’t do this! Please. You can’t, you’ll leave me, and Mother will leave, and then what’ll happen to me and Father?”

But Mother’s already left.

He jumps up and backs into the wall, shaking his head. “No.”

“Jacob…” I trail off. “Jacob, please. You don’t need it! I promise you, it won’t be that hard. I’ll be with you every step of the way.” My eyes plead with him to drop the box. But he opens it.

I dive for him, but he grabs the thing that falls out before I do. A pearl my mother gave me. It’s not the pill, I sigh with relief.

“Where is it?” he asks.


Realization dawns on his face, settles in his eyes. “You took it, didn’t you?”

I didn’t take it. Jacob didn’t take it.

“Where’s Father?” I ask. For some reason, I don’t think he went to alert The Society about mother.

“Answer the question!” Jacob’s lips tremble. “Did you take it?”


Our eyes lock, my watery gaze with his icy one. In those few seconds, the pieces click and we suddenly understand the true reason behind our father’s untimely absence.

He’s taken the pill.

He’s standing outside staring at the pale twilight sky when we find him. He stands just feet away from the cliff. And he’s not dead. Not yet. But the look on Jacob’s face as he charges towards him tells me that he could be soon.

My eyes widen as Jacob pushes Father toward the cliff edge, and before I can warn him, before the scream even reaches my lips, he disappears. Gone.

I think back to when we found out that my mother had cancer again. Jacob’s words echo inside my head, You’re stronger than this. If I could go back, I would take the pill out of the box and crush it between my fingers. I would watch the crumbling remains of the pill float out of the window because I still believe I am stronger.


* McKenlee Heath (MC) is a 15-yearl-old writer who has been enamored with the spoken word for years. Having grown up in a society saturated with dystopian writings, she chooses to use this genre in a very subtle way in her writings. Miss Heath is no stranger to personal angst, which is also reflected in her works. Writing has become like a personal therapist for her, and she hopes to use this creative outlet as a way to cope with being a teenager. “The Four Degrees of Disease” is an introduction to a series she plans to continue.