“Wu feng zhong,” someone calls out backstage. 5 minutes. 

       The warning signs are always the ones that you never see coming. Emi stares at her reflection in the illuminated mirror, her pale skin glassy against the vermillion paint on her lips.

       For as long as Emi has dreamed, she has pictured this moment over and over again. The height of her career— she’s racked up enough awards to keep her mother’s mouth shut about her decision to become a pianist rather than a surgeon— and finally, performing at Carnegie Hall Stern Auditorium, all two thousand and seven hundred ninety seats sold out.

       Through music, I heal, Emi decided. After all, it was through music that saved her from a lifetime of nightmares. Through music, I will heal others better than I would have as a surgeon, Emi tells herself this until she isn’t sure who she is convincing.

       “San feng zhong!” someone calls out again. 3 minutes. Emi stares at her pale reflection in the mirror one last time. The time ticks slowly, and Emi puts in her earphones, ignoring the coldness as they nestle into the crooks of her ears.

       Tick. Tock. Tick. Tock. After spending her formative years in Shanghai where she often snuck out of her mother’s one-room apartment to listen to renowned pianists perform and years of pressing her ear up against the door while she listened in on teachers instructing their students, Emi’s career has culminated to her first American and European tour. Those uncertain years, fighting for piano lessons that she could never afford, and practicing until her joints were sore were all worth it.

       The clock runs, but Emi thinks only of a metronome as her heart pounds against her chest, the beat conforming to the reliable strike of the metronome. 150 beats per minute, she decides as she cranks the metronome up.

       “Yi feng zhong!” One minute. Too many years have gone by for her to hope that her mother’s in the audience tonight. Emi knows better than to hope for such fickle things. What is love, what is family, what is anything before your career? As she turns to place the metronome back down, Emi realizes a second too late that her muscles suddenly give way, faltering suddenly, and the metronome slips out of her hand, shattering into a million pieces.

       In this moment, Emi stands utterly still, mouth dry as she stares at the floor. Inside her, millions of her neurons begin to stir.

~~~

       Emi, her mother had called out, arms outstretched as she crouched on her feet, bending her knees and leaning back. The Asian squat, Emi’s friends in America would later joke whenever Emi squatted the way her mother did. Beneath the blistering sun in Shanghai, Emi, barely three years old, had run straight into her mother’s arms with a lopsided smile. Emi, Emi, Emi. Shrieking with joy, Emi gasped for air as her mother scooped her up and swung her back and forth in the hot air. As the daughter of a seamstress, Emi often floated around the premises of the street flea market, kicking up dust that permeated the air that often elicited angry cries from nearby vendors.

       “Bang ma-ma feng yi fu ba,” her mother said, swinging her daughter back down. Help Ma-Ma with sewing the clothes. Hopping on the stool, Emi slid into her usual place beside her mother, handing her different threads and fabrics based on her mother’s gestures. On most market days, Emi’s mother barely took home any earnings —perhaps a few dozen yuan if it was a good day. But most of the time, it was always just the two of them— with Emi’s father perpetually overseas and no other siblings, Emi had started to understand where she fit into the world. A world where it was just them two against everyone else.

       Squinting her dark eyes under the sun, Emi’s breath hitched. Before them, a new stall parked its wooden frames and booth before them. Emi watched as they slowly assembled the table, filling it with tiny trinkets and musical toys. A glass flute, a mini keyboard, and a microphone. Straining her eyes, Emi could just barely make out the price tags.

       “Gei wo hong se, Emi!” Her mother instructed, gesturing to the thread. Pass me the red.

       Snapping out of her daze, Emi slid the red thread over to her mother. A passerby ran by, kicking up the copper dust, and Emi coughed, her vision fogging. When it finally refocused, she realized that someone had stopped in front of the musical booth. The stranger leaned over slowly. Then tapped the keyboard, hands moving intricately over the black and white keys. When the melody hit Emi’s ears, she stops breathing just momentarily before she’s flooded by the silvery music notes as the millions of neurons inside of her hold her breath.  Finally, the stranger left.

       But it was already too late — perhaps the red threads that connected Emi to music were sewn that afternoon, snipped and tied together forever. An endless tie, bound together for life. It would be another ten minutes before Emi could move again, and it would be only a few more days before Emi stole her first keyboard.

~~~

       Emi sits in the room, silent as the doctor enters and clicks the door shut.

       In the clinic, the only music that Emi can find is the ticking of the clock. It’s strangely comforting. The clinic feels sterile and tidy, but Emi imagines that she is sitting in a prison, surrounded by four white walls with no way out. Sealed completely. She tries to remind herself to breathe, but it’s no use. Today marks two months since her performance at Carnegie Hall. Two months of fear whenever her muscles began to falter spontaneously, when she couldn’t arch her right hand the way she used to, when her pinky refused to hit the C note in the final chord of Chopin’s Revolutionary Etude.

       Her ears are numb.

       “It’s ALS,” the doctor explains to her slowly, her voice soft as she takes a seat across from Emi.

       Emi tries to dig her nails into her palm, but her muscles refuse to obey.

       “Why?” Emi can barely make the words out. “Me?”

       “It’s sporadic,” the doctor says quietly, then turns back to her monitor. “I’ll print out a sheet of information for you to read up on.” Her voice is gentle as she continues. “Now, I understand that you may need time to process it. There’s no cure, but there are treatment options to slow the onset.”

       She pauses and looks at Emi with kind eyes. “Do you want to start bringing a family member with you for these visits? It might be helpful.”

       Emi hears nothing as she stares straight through the doctor. But what do you tell someone when their whole identity is built around music, around an instrument? When your entire life has been built around the one thing that you can no longer do, how do you cope? When you can no longer touch and grasp the keys and drum out the chords that have colored every surface, turning pinks into rose golds and brass into brilliant golds for your entire life?

       When the doctor finally leaves, Emi looks down at the counter and sees a nicely printed sheet, still warm from the printer. In tiny little letters, “ALS” is explained to be amyotrophic lateral sclerosis. Mutations in one gene are linked to the possibility of ALS’s cause.

       C9ORF72. SOD1. 

       Emi can only hear the ticking of the clock on the wall as the letters ring through her mind. C. 9. O. R. F. 7. 2.  S O D 1. The letters and number repeat in her mind to an invisible beat.

       This gene, that gene. But of course, there’s no concrete evidence, no “for sure’s”. It is not like music, where the music score tells you exactly what note is right and what to play in black and white. Emi stares at the sheet until it all blurs together in her mind. Emi’s not sure of much in life, but when she leaves that room, she’s sure of only one thing:  she will never be able to play again.

~~~

       Emi’s days are spent in the living room of her house where her piano sits by the window. Hands slightly arched over the piano, she tries again to master Chopin’s Revolutionary etude. Her finger slips once in the middle of the piece. Emi pauses, then moves on. It’s just sweat on her fingertips.

       At first, she simply does what she’s always been best at — playing the piano. Her right hand curves in a right arch, she hits the crescendos, and for a second, Emi thinks that perhaps that this is simply all a fluke. Of course— how could she have ever thought otherwise? Just a fluke, how silly of her to think anything otherwise. Mistakes happen all the time, even in diagnoses. Medicine is not perfect. It was just a hard few months, perhaps she overanalyzed every twitch, every convulsion. The paranoia must have gotten to her — after all, musicians are ultra-sensitive to their muscles. The relief that begins to flood her is imminent. There’s still time to restart her tour — she can squeeze in a few more dates after her American tour, hit up Tokyo and Seoul on her way to Shanghai. Perhaps then she’d finally pay the flea markets a visit with her mother and finally muster up the apologies that sit lodged in the back of her throat.

       Then her left hand clenches involuntarily in the final measure of Chopin’s Revolutionary Etude, her fingers flailing against the keys with a bang.

       Emi wants to scream but nothing comes out. Then, taking a deep breath, she places her hands on the keys and begins to play again, this time with more force. Even as her hands shake and it begins to become harder to swallow the lump in her throat, she realizes only one thing — as she plays, death continues to bloom inside of her, motor neurons tumbling down an endless cascade as they deteriorate to their death. Emi’s heart withers alongside her motor neurons.