Chapter One
“N o response,” I repeated, staring dumbly at the upside-down chart on the doctor’s desk. “None.”
“I am sorry,” Dr. Robeson said. “There is really no point in keeping you on the alemtuzumab any longer.”
“But you said that it’s the only thing that could help,” I protested. “It has to work.”
“Cora, I have your latest lab results right here.” She tapped the open folder. “Your lymphocytes are continuing to climb. Right now, the only thing the alemtuzumab is doing is decreasing your quality of life.”
I could see my name at the top of the chart: Cora Ann Shaw. There I was, summed up in black and white. My height—a little less than average. My date of birth. My weight, which had fallen from I’d-like-to-lose-10-pounds to terrifying double digits. And, of course, my diagnosis: T-cell prolymphocytic leukemia.
Cancer. To me, it had meant pink ribbons, surgical scars, and middle-aged women without hair. I hadn’t even heard of T-cell leukemia then. I hadn’t realized how the cancer could steal all my strength, burn through my fat and then consume even my muscle to feed itself as I wasted away.
“There must be other things to try,” I pushed. “Some other chemotherapy.”
“I’m very sorry,” the oncologist said again. “The older therapies were ineffective. That’s why their use has been discontinued. They simply don’t prolong life—in fact, on average, they shortened it. Alemtuzumab was our only realistic shot.”
I should get a second opinion, I thought. Except Dr. Robeson was my second opinion. I’m at Johns Hopkins, for godssake, I thought bleakly. Where else can I go?
“So,” I said. “Five months, then.”
“It could be that long,” Dr. Robeson said carefully.
I felt the tears burning my eyes, and I blinked them away. “You promised me seven months. That was nearly two months ago.”
Dr. Robeson had a bulletin board on her office wall. It was full of the happy pictures and notes from those she’d cured, and even a few grateful letters from those she hadn’t. Mine wasn’t going to go there. I wouldn’t know what to say. Thanks for trying, didn’t seem quite generous enough. Anything more would have been fake.
“Cora, cancer has a different rate of progression for everyone—”
“I know,” I said, cutting her off. I was being unfair. I knew it, and it made me squirm inside.
But I don’t want to be fair. Damn it, I just want to live!
“I’m turning twenty-two in two months,” I continued. “I’m graduating— supposed to be graduating—from the University of Maryland in six months. I’ve applied to grad school.”
“I know, Cora.” And there was genuine sympathy there, behind the professional wall that kept her insulated from all the people she couldn’t save.
I took a deep breath and pushed to my feet. My hips hurt from the institutional chair, my buttocks too thin now to cushion them. “Sorry. I was just hoping for better news.”
“So was I.” Dr. Robeson opened a drawer and pulled out a brochure. “This is an excellent hospice program. Your student insurance will cover all the costs beyond the deductible, and there are many people there who will be happy to help you.”
It took all my will to force myself to accept the shiny trifold of cardstock from her. I squeezed it a little too hard, and it creased in my hand. “Thank you,” I heard myself say.
“I can, of course, continue to treat you, addressing symptoms as they arise, infections and the like, making sure you’re as comfortable and healthy as possible for as long as possible. I’m happy to do so. But I can’t slow the progress of your leukemia.” The oncologist hesitated. “There is one other possibility. A chance in thousands. If it works....” She trailed off. “Anyway, here is his card. You can give him a hearing, at least.
“N o response,” I repeated, staring dumbly at the upside-down chart on the doctor’s desk. “None.”
“I am sorry,” Dr. Robeson said. “There is really no point in keeping you on the alemtuzumab any longer.”
“But you said that it’s the only thing that could help,” I protested. “It has to work.”
“Cora, I have your latest lab results right here.” She tapped the open folder. “Your lymphocytes are continuing to climb. Right now, the only thing the alemtuzumab is doing is decreasing your quality of life.”
I could see my name at the top of the chart: Cora Ann Shaw. There I was, summed up in black and white. My height—a little less than average. My date of birth. My weight, which had fallen from I’d-like-to-lose-10-pounds to terrifying double digits. And, of course, my diagnosis: T-cell prolymphocytic leukemia.
Cancer. To me, it had meant pink ribbons, surgical scars, and middle-aged women without hair. I hadn’t even heard of T-cell leukemia then. I hadn’t realized how the cancer could steal all my strength, burn through my fat and then consume even my muscle to feed itself as I wasted away.
“There must be other things to try,” I pushed. “Some other chemotherapy.”
“I’m very sorry,” the oncologist said again. “The older therapies were ineffective. That’s why their use has been discontinued. They simply don’t prolong life—in fact, on average, they shortened it. Alemtuzumab was our only realistic shot.”
I should get a second opinion, I thought. Except Dr. Robeson was my second opinion. I’m at Johns Hopkins, for godssake, I thought bleakly. Where else can I go?
“So,” I said. “Five months, then.”
“It could be that long,” Dr. Robeson said carefully.
I felt the tears burning my eyes, and I blinked them away. “You promised me seven months. That was nearly two months ago.”
Dr. Robeson had a bulletin board on her office wall. It was full of the happy pictures and notes from those she’d cured, and even a few grateful letters from those she hadn’t. Mine wasn’t going to go there. I wouldn’t know what to say. Thanks for trying, didn’t seem quite generous enough. Anything more would have been fake.
“Cora, cancer has a different rate of progression for everyone—”
“I know,” I said, cutting her off. I was being unfair. I knew it, and it made me squirm inside.
But I don’t want to be fair. Damn it, I just want to live!
“I’m turning twenty-two in two months,” I continued. “I’m graduating— supposed to be graduating—from the University of Maryland in six months. I’ve applied to grad school.”
“I know, Cora.” And there was genuine sympathy there, behind the professional wall that kept her insulated from all the people she couldn’t save.
I took a deep breath and pushed to my feet. My hips hurt from the institutional chair, my buttocks too thin now to cushion them. “Sorry. I was just hoping for better news.”
“So was I.” Dr. Robeson opened a drawer and pulled out a brochure. “This is an excellent hospice program. Your student insurance will cover all the costs beyond the deductible, and there are many people there who will be happy to help you.”
It took all my will to force myself to accept the shiny trifold of cardstock from her. I squeezed it a little too hard, and it creased in my hand. “Thank you,” I heard myself say.
“I can, of course, continue to treat you, addressing symptoms as they arise, infections and the like, making sure you’re as comfortable and healthy as possible for as long as possible. I’m happy to do so. But I can’t slow the progress of your leukemia.” The oncologist hesitated. “There is one other possibility. A chance in thousands. If it works....” She trailed off. “Anyway, here is his card. You can give him a hearing, at least.
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