My Two Siblings' Enduring Legacy

Cystic fibrosis took the lives of my sister and brother. I use every opportunity to share their stories and help keep their memories alive.

March 27, 2018 | 5 min read
April Zimmerman

Previously published on

Cystic fibrosis. Two words rarely raised in conversation among our family, but the memories and absences they left still nest in the deep, daily parts of our lives.

When I slid from elementary into middle school, I left behind an awkward childhood and unfortunate fifth grade yearbook photo for an even more awkward puberty. My friendships seemed to shift rapidly and I drifted off into average while my former besties roamed with the coolest kids and the widest bellbottom jeans and the prettiest soccer players. Sixth through eighth grade delivered a weird, formative, sometimes-painful rehearsal before the hormones of high school drama unfolded.

When my sister, Karen, passed away from CF at the age of 29, I was a weird Maryland sixth grader who didn't know real, close, scarring loss. I don't remember the day she died. Not at all. I couldn't tell you the day of the week or whether it rained or who told me or how hard I cried.

My brother, Michael, died two years later from CF. I remember. I remember coming down the stairs of our two-story duplex. I remember seeing my little brother, Joey, and my mom huddled on our blue carpet in front of the recliner. Joey cried. Mom cried. Mom told me. I sobbed. I hated CF. I was 13 going on high school and my beloved Mike was gone and I hated CF.

Left to right, my brother, Michael, in his senior photo and my sister Karen with her horse.

Growing up, the hum and vibration of Karen and Mike's at-home ACTs (airway clearance techniques) and their yearly hospital stays alerted my childhood to illness. My other siblings and I would play around them while they huffed and coughed and their therapy vests inflated and deflated. I sat on the edge of Mike's hospital bed while a nurse performed rapid -- seemingly violent to my newish eyes -- percussion over his body to loosen mucus. My other older sister, Rachel, could be found wherever Karen was -- cuddled beside Karen in her favorite recliner, or out at the horse farm learning to ride on Karen's palomino, Jesse James. Sometimes I tagged along. Karen loved animals and always had a menagerie of little paws around the house. She paved her love for the little creatures firm and smooth in Rachel's heart -- so much that Rachel later attended Virginia Tech for vet school, now owns a veterinary practice, and loves on her own drooly, whiskered tribe at home.

Mike was my buddy. I think he must've known from the get-go that our spirits favored each other. I drove my parents up the walls and through the ceilings with my wild heart and my smart mouth. Mike never seemed overawed by my defiance. I helped myself to his lap space. I marched into his bedroom to hang out whenever I pleased. I showed up at his softball games and tried to set him up with the occasionally present lady friend. He laughed off my annoying little sister business, probably because he reveled in antics of his own -- like honking the horn of his blue Toyota all the way through the Harbor Tunnel just to piss off the other drivers.

When we lost Karen and Mike, the gravity of their illness hadn't yet reached my bang-clad-and-hairbrush-toting foresight. The last year of their lives was spent in the hospital more than at home. Still, it never fully registered that their lungs were failing and their bodies followed. I think our parents shielded us, understandably, from the truth of those last years.

Today, I'm a 32-year-old writer living on a quiet, Atlantic-adjacent island in Charleston, South Carolina. I light a candle and eat a cupcake every year on Karen's and Mike's birthdays. Cupcakes because Mike preferred them to a full-size cake.

I miss them both. I frequently wonder what high school and college and first boyfriends and turning 21 and first careers and first heartbreaks and second careers and turning 30 would've been with my siblings riding alongside and offering life-map routes.

American writer Frederick Buechner wrote, "You can kiss your family and friends goodbye and put miles between you, but at the same time you carry them with you in your heart, your mind, your stomach, because you do not just live in a world but a world lives in you."

Karen and Michael nurture and breathe into my enlarging world daily. And so I tell about them. When people ask how many siblings I have, I tell about them. When someone points to the tattoo on my left wrist, I tell about them. When a friend rides along in my car and notices the faded gold chain with a Miami Dolphins helmet pendant -- a necklace that Mike wore every day that I ever saw him -- swinging from my rearview mirror, I tell about them.

My brother and sister lived loud and brave and with abundant grace. By sharing their stories, I hope it lifts their voices far and high, and illuminates the lives of those currently living with CF and the lives of the people who love them.

This site contains general information about cystic fibrosis, as well as personal insight from the CF community. Opinions and experiences shared by members of our community, including but not limited to people with CF and their families, belong solely to the blog post author and do not represent those of the Cystic Fibrosis Foundation, unless explicitly stated. In addition, the site is not intended as a substitute for treatment advice from a medical professional. Consult your doctor before making any changes to your treatment.

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In Memoriam

April Zimmerman is a Maryland-born freelance writer, content writer, and blogger currently residing in Charleston, S.C. Recently she was a finalist in the Cystic Fibrosis Foundation's Charleston's Finest Class of 2018. You can read her blog at and follow her on Instagram and Twitter, at @ape_zim, for all of the daily things. 

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