bad.â
âNausea?â
âA little.â
âDizziness?â
âOccasionally.â
âUnbutton your shirt. Let me check for any changes in the lumps.â
Stern felt along the inside of Gageâs collarbone, under his chin, and pressed hard into his armpits.
âWhereâs Faith today?â
âShe had a class to teach. I told her Iâd bring her back a sucker.â
Stern laughed. âSorry, Iâm fresh out.â Then she tilted her head toward two bone marrow biopsy syringes laying on the counter. âYou ready?â
âHave you been working out?â
âEvery day.â
âThen I guess Iâm ready.â
âI can give you a muscle relaxer. That may make it easier.â
Gage shook his head. âIâll pass. I need to be alert later. Iâm working on something.â
Stern pointed toward the end of the exam table.
âTake off your belt and unbutton your pants, then lean over and slide yourself up. I need good access to your lower back and hip.â
Gage did as instructed.
Stern pulled down Gageâs slacks just far enough to expose his hips, then rubbed alcohol over his right hipbone and injected a local anesthetic.
âIâm going after some of the liquid, then after the bone marrow itself.â
Stern poked at Gageâs anesthetized skin with the needle and asked, âCan you feel that?â
âOnly pressure, no pain.â
Gage then felt all of Sternâs hundred and thirty pounds lean into his hip and the corkscrew motion of the needle. He caught his breath as the hollow needle broke through the outer shell of the hipbone and drove into the marrow. She aspirated some of the liquid marrow, detached the plunger from the syringe, and set it on the counter. He then heard her attach another one.
âNow comes the hard part. Try to stay relaxed.â
Stern began rotating the needle, driving it harder, forcing a sliver of bone and marrow up into the needle.
âHang in there, Iâve almost got it.â
Then she released the pressure.
Gage breathed out and pain iced through him as she extracted the needle.
âJeez . . . I didnât expect that.â
âThatâs the one youâre supposed to get the sucker for. Too bad Iâmââ
âFresh out.â
Gage belted his pants, then took a few steps around the examining room, testing his right leg.
âI donât think youâre the squeamish type. You want to see what I took out?â
Stern held up a liquid-filled glass vial in which there stood an inch-and-a-half sliver of bone and marrow about the thickness of a small nail.
âDonât worry, itâll grow back.â
âIâm not worried.â Gage flashed a smile. âI didnât figure youâd break something you couldnât fix.â
âIâll have the results the day after tomorrow. Then Iâd like to bring in a few youngsters and put together a treatment plan.â
âA little show-and-tell?â
âWeâre a research and teaching hospital after all and we need the Graham Gages to keep the kids entertained.â
Gage eased down onto a chair next to Sternâs. âIâve been doing a little research myself. No one seems to know why normal cells mutate into cancer cells. It seems like an evolutionary misfire.â
âAll evolution, good and bad, is fundamentally a matter of mutation. Itâs just that this mutation makes a particular individual less able to survive in the environment.â
âI think thatâs what Charles Darwin called extinction.â
âIt would be, except he didnât know about chemotherapy.â
âBut why lymphoma? I canât find anyone who claims to have found what causes it.â
âThere is no known cause. Not pollution, smoking, diet. Itâs nothing you did to yourself.â
Gage smiled again. âSo itâs like a guilt-free
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