July 2003 Archives

Wherein my mother arrives in England; she and Gail travel to Lancaster; I try to lighten up the mood; memories overlap; they visit my room and meet some of my friends; are cared for by Colin's wife, Rosemary. Departure.

2/28/90
I got up at 4:30 to catch the 6:00 Speedlink from Gatwick to Heathrow. The driver got me to Heathrow ten minutes late and I worried that Jerri had already come through. Her plane -- the same that Steve and I had taken 6 days before -- had come in early. But she was walking through the crowd -- thin and exhausted -- wearing her black and white tweed coat, a pink turtleneck under a long thick sweater, jeans, leather tennis shoes, carrying a smallish leather bag. We hugged and immediately left the airport for the Picadilly Line.

She was all there, helping figure out which way to go and how to buy the Tube tickets at the automatic machine. The train was clean. I can't remember the other people -- I just listened to Jerri.

At Euston we got off and went to the rail office and each bought a ticket to Lancaster. Then we sat down and had sandwich en baguette with Coke and coffee. Weather snowed and rained, so the passing countryside didn't show up very well. We sat opposite the train table. I read her leukemia pamphlets and she talked and I talked and she cried and people looked at us.

No one was at the station as we got off. But in the upper lobby was the most curious welcome: a thin, little straight-haired woman in a neon green rain jacket asking if either of us was Mrs. Brown, hovering and apologizing that her husband had been delayed in picking us up and, unfortunately, her car was only a 2 seater and couldn't carry us both to the hospital. I suggested we get a taxi, but with her hovering, the last taxi was taken before our eyes. So I asked, and someone said just turn left and you will find more taxis. But the second left didn't look right, so we kept walking on the sidewalk. By this time I was beginning to find my role in the process... Soon a taxi drove by. We hailed it and we told Rosemary we would see her at the hospital.

Jerri wanted to talk to Dr. Lorigan before we went to see Robert. He rushed into the hallway and we agreed to meet him during his 2 to 5 clinic. The hospital was Victorian, ancient, the nurses called sisters. There, turning in from the hallway, was Robert in a small room across from the sister's office. Glass walled, a TV and VCR, a double-sash windo in stone blocks looking into the alley. We had to wash our hands before we went in. Felt good after the train. Just.

The first thing Jerri said was "you've grown chest hairs." They talked about bank accounts and things in his room and transfusions and platelets. They spin platelets out of the donor's blood and put them in packets, then they're injected into Robert's blood. He'd just had platelets, and was scheduled for a transfusion shortly. Robert said he did want some nice pajamas, since he'd be in the hosptal for a year. Neither of us corrected him, time enough later. The treatment-to-cure is about a year. 85% chance of that.

Robert told how he was playing snooker Thursday night and they were all being Dudley Moore silly, saying cancer of your cuetip, cancer face, cancer the ball, and a girl said "You shouldn't say that." That's funny, it was only last Thursday and now here I am and leukemia is a cancer, isn't it?

We left to go to the University office for insurance arrangements. Jerri called Buzz, Robert's father, and told him he might have to share a £6,200 transportation bill, although they were trying to get insurance to pay. The British Healthcare and Ambulance of St. John needed a guarantee of the £6,200, so Colin Lyas and Dr. Rogers faxed a University of Lancaster guarantee. The trip was to begin at midnight that night. An English Navy doctor would accompany Jerri and Robert back to London in the ambulance and then onto a British Airways jumbo jet to Seattle. That later changed to Pan Am -- leaving Thursday morning at 10 AM; the University of Washington already had a bed for Robert. Dr. Lorigan's job -- in addition to medical things -- was to coordinate all the ambulances, airfares, medical accompaniment and to browbeat/convince the insurance company that Robert really needed to be in Seattle for his treatment. Then Jerri and I went to Robert's room.

The University is only 30 years old and quite modern in architecture. We met a porter who had to tell us how awful she felt about poor Robert. She meant quite well but I was relieved when she finally left us alone in Robert's room, a sort of concrete bunker affair, but pleasant with shelves and wardrobes. More sobs, the first in hours. Jerri decided to leave the sweaters and coat, but took the Lynda Barry jean jacket, two journals, tapes, a sweatshirt. Then Simon came by, such a stricken young man. He wanted to know if he should give Robert's bank account money to Jerri or Robert. Jerri said Robert. He said he'd have to mail some, if that was all right, and Jerri said yes. We closed the door behind us, our arms full of Robert's few things, and walked back along the concrete hallway. We passed rooms and students and showers and loos and it was such a journey. The students knew us, I think.

Then Colin again. He took us in his borrowed mini out to his 200 year-old house in a village called Hornby, a Danish name meaning Horn Place. Rosemary was there, no longer wearing her neon green jacket. She got out her best brandy. Colin says she hoards it -- he buys it duty-free on his many travels. The ceilings were at least 12 feet high and Rosemary had a good smelling coal fire going in the wall grate, 3 dishes of salted peanuts, and three glasses. She wasn't drinking because she would be driving Jerri back to Lancaster at ten that night for the ambulance journey. 2 glasses each in fairly quick order, sitting on a flowered rug, warm fire.

Rosemary brought a cookbook and wanted to know if she should make a paella for us -- she and Colin were going out to dinner. I said no, we'd fix our own, besides we weren't really hungry. She said Oh. I want to. So I let her. Jerri fell asleep by the fire. Alone, we ate the paella, surprised that we were so hungry, smoked a couple of their cigarettes, talked and cried and cried. Then Jerri went to take a shower and I slept. Jerri put her same clothes back on and she and Rosemary drove off in Rosemary's Fiat about 10:30. Colin and I sat by the fire philosophizing until Rosemary returned.

Rosemary died of lung cancer no more than six months later, before the summer had ended, before I was completely out of the woods myself.

One of my mother's oldest and dearest friends happened to be visiting her daughter in London at the same time I was getting poked and prodded and diagnosed in Lancaster. She shared two days from her journal (only two days!) with Mom. Recently, the photocopied, handwritten pages arrived at my house along with many other documents. It's good to see things from a different perspective. Outside looking in, instead of the other way around. Here's what Gail wrote:

2/27/90 - London

Jerri called and sobbed. The doctor says Robert probably has leukemia. What do you want me to do? Please go and hold him for me. So I called Dr. Lorigan at the Royal Lancaster Infirmary. He was very available once he ascertained that Jerri had already told me how ill Robert was. He said well, it's not certain, but if it's not leukemia then it's something just as bad.

I asked him how Robert was doing, and he said he's very stoic and also denying, but I don't know what's in the back of his head. So then I talked to Robert and he said I don't know how I managed to catch this blood disease, but it's left me wide open to catch anything that was going around the school, so I've got this bad cough.

I asked him if the antibiotics made him naseous and he said no, they're putting it through my veins very slowly so it doesn't tear them up.

So, I said, I'll probably be up tomorrow and he said you can stay in my school room. I'll tell you where I hide the key. Then we talked about his Christmas trip...

I thought a lot about it the next day -- sad and angry and disbelieving. The following morning I called Dr. Lorigan again and told hiim I had decided to wait a few hours to see if Jerri was coming to England or not because I thought she would probably need me at the airport, and the train to Lancaster, and would he please inform Robert I was still deciding. He said call back at half-one and our diagnosis will be certain.

It was leukemia for sure. I called Jerri -- she was leaving on the 708 TWA. Dr. Gorst the hematologist had arranged for someone to meet her at Heathrow but I asked her if I could meet [Jerri] there instead and go up with her. She said to just let Dr. Gorst know. So I will see [Jerri] in the morning. I feel very sad.

October 8th, 2000. The end of a clear, cool Twin Cities Marathon. It wasn't a blazing finish, but I wasn't expecting rocket speed. Ten years after everything, however, it was unbelievably satisfying. A great way to celebrate a milestone anniversay.

I'm on the left, Aaron on the right. The picture is taken in the staircase in Fourth Davis, October, 1991. It's the same shirt I wore at my 21st birthday, although I've managed to put on about twenty pounds since then.

At the old house in Renton, on or around my 21st birthday. Ian and I had been friends since I don't know, fourth, fifth, sixth grade, and it was a fortunate twist of fate (luck? chance? a plan between ian's parents and mine that nobody ever told me about?) that he was in town the day Mom and Paul were throwing a party for me.

I weigh 145 pounds. I've been out of the hospital for a week. It feels incredibly great to be out, even though it's hard work walking up and down the stairs, and I still get tired very easily.

Two of the few photos anybody took of me while I was in the hospital. These would have been March, or maybe April. I had to look cool. Sunglasses. Leather jacket. Not sick. Definitely looking cooler, healthier, hipper than tired, dragging, sick. We will not photograph the latter.

On the left side of the photo with all of my various antibiotics (the larger yellow bag is actually food/nutrients, since I couldn't eat anything for awhile) you can see some adhesive tape strips attached to my chest. That's where my Hickman catheter ran into my body -- the main entry point, the highway, Route 66 for any chemicals or medicines that needed to get inside.

An old, not particularly flattering picture, probably taken during the last month or two of 1989, or the first month or two of 1990. I'm sure this was after a Beck's or two or five.

I've included it for a couple of reasons: first, I need a haircut in the worst way. Second, it's probably the last picture on record where I've got any kind of acne. It's not like my face was ever cratered, but a zit or two, here or there, were one of those steady facial accessories of my teen years (and even into my twenties).

Sometime during the summer I realized that my face had never been smoother. Chemotherapy and complete hair loss (no shaving!) had something to do with that. A few months of antibiotics, though, meant no more pimples, either. Excellent.

You won't find me recommending chemotherapy and antibiotics as a form of acne treatment, but at the same time, I'm not about to complain about a little silver lining.

My hospital stay in London is as good a place as any for a rapidly-edited montage. No words necessary (saving the cost of paying actors and actresses for speaking lines in what, ultimately, will be a cameo appearance). The previous scene focuses on the hands. Maybe the camera blurs, or maybe it's a slow fade to black. We could probably kick the soundtrack in again at this point, another song inexorably linked to my months in Lancaster, This Corrosion by The Sisters of Mercy.

We may have to work on a special, shortened re-mix, because the whole point of the montage in the first place is that while there is activity in that London hospital -- doctors doctoring, nurses nursing, mothers mothering -- it is neither a beginning nor an end, a simple two day transition between where I was and where I needed to be. We've stopped moving. For the first time in about a week, there is nothing to do except wait until Saturday, when the next flight -- Pan Am this time -- will send us across the Atlantic.

Stop-motion photography, almost, meant to compare and contrast the sudden lack of inertia with the ongoing hustle and bustle both inside and outside my body. There is a camera on a boom where the ceiling would be in this tiny room. I will be motionless, for the most part, tossing and turning occasionally in the bed. Time passes. People enter and exit. Strips of sunlight crawl up the far wall, then disappear, overpowered by flourescents. Food is brought to me, consumed, discarded. You can catch the backbeat, the steady bass, and it almost feels like a dance. The camera has been moving steadily closer to my chest. The lighting appears to change again, daylight, maybe, grey and muted. The camera is close enough, now, that everything happening around me is nameless, faceless, a blur of hands with thermometers and blood pressure cuffs and tiny paper cups filled with medicine, needles and vials, blankets and pillows. The slow, steady drip of clear liquid from a bag above my head, down a plastic tube, winding into my arm. The camera follows the tube, loses focus, then shoots into my body.

Here we take a cinematic tour of my bloodstream. I don't know that we need to show good blood versus bad blood, or what that would even look like. What the budget would look like for the necessary special effects. But we've got music, and a steady beat, and we already know that we've lost enough time to unexpected delays. We can let the camera linger somewhat. It is quiet here. Blood is pumping. Things are working, even if they're not.

The chorus repeats itself in the background: hey, now, hey now now, sing this corrosion to me. Over and over, like a hymn.

And once, maybe twice, as both music and images fade, four words that resonate above the others, a reflection of the optimism that still managed to prevail as we prepared ourselves to fly west over the Atlantic, the beginning of our journey, really, although in many ways it would feel like the end:

Like a healing hand.

It doesn't get much simpler than this: your body is very resilient. If you can get your bone marrow to actually stop producing the immature, leukemic blood cells, it will (fingers crossed) be able to recover, firing up the production lines again. A hard reboot, if you will. Slam it shut, any way you can, and in strange and mysterious ways, it will resume normal production sometime later.

The tricky part, then, is "turning off" the bone marrow. This is where chemotherapy comes in. Chemical therapy. Basically, pump a controlled amount of extremely high-dose chemicals into your body so that it can knock your marrow senseless. Kick the complete and utter crap out of it. Pummel it. Pound it relentlessly and trust that your body is strong enough to get back up off the mat when all is said and done.

Think you're tough now, Leukemia? Why don't you try a little daunorubicin on for size?

Let's see how tough you are after we throw in some Ara-C for good measure.

Too much chemotherapy and you're down for the count. Too little and you've got to get back in the ring again, already more than a little punchy from the first round. The chemo needs to be carefully measured and monitored. You cross your fingers, hoping that it comes back. With a dwindling supply of healthy blood cells, and no way, post-chemo, of producing any kind of blood cells, healthy or otherwise, you just hope that it comes back soon.

The alternatives? Well, we won't go there, because there really aren't any.

Under normal circumstances, your body produces a steady flow of healthy blood cells. We'll keep it extremely high-level and say that you've got your white blood cells and your red blood cells. There are a few more than that, but all we're concerned about is ability to fight infection (white) and ability to clot (red).

It's your bone marrow, actually, that does the production. Through some process far beyond my understanding, healthy bone marrow produces a healthy string of different types of blood cells, as appropriate.

Somewhere along the line -- whether it's genetic, or environmental, or some combination of the two -- the bone marrow of a patient with leukemia will begin producing immature blood cells. They're not nearly as effective as the stronger, healthier cells. Certain subtypes of AML will tend to see certain symptoms, based on which production line gets thrown most off-kilter. All will share some common symptoms, mostly related to the growing number of white blood cells in the body that aren't able to do their jobs: fatigue, lingering sicknesses, a general feeling of malaise.

The subtype that I had (M3, now classified as APL, or Acute Promyelocytic Leukemia) is also generally recognized for a very low number of healthy platelets (a kind of red blood cell) which helps blood to clot around wounds. With these patients, you will see a great deal of bruising and bleeding.

Left unchecked, the bone marrow will continue to fill the blood stream with larger and larger quantities of malformed blood cells -- "blasts," to borrow a bit of medical terminology. There's probably some kind of accelerated curve, the greater the percentage of blasts, the more quickly they begin to crowd out the remaining few healthy blood cells.

Eventually (again, left unchecked) the patient will die from some infection that the body isn't able to respond to, or from some internal or external wound that simply doesn't stop bleeding. There's nothing left. You can't stop it. Your defenses are gone.

Leukemia is a passive-aggressive killer. It doesn't do anything by itself, other than undermine a body's ability to stave off something else. Deadly? Not me, Leukemia says. It was that other guy. The brain infection. Not my fault.

Sneaky, quiet, back-stabbing mother-effing disease.

They've given me a thin white blanket, at least, standard hospital issue, after they've wheeled me into the busy emergency room. Brick walls, linoleum floors. Activity all around. Surprisingly (thankfully) the stabbing pain in my stomach has already started to subside. It's manageable. Most of the discomfort, now, comes from the fact that I haven't moved too far from the doors, and cold air continues to blast into the room.

Correction: I'm not exactly in the emergency room. See, there's all sorts of sick people in emergency rooms. Coughing, sneezing, wiping their hands on door handles or couch cushions or whatever. When your immune system isn't doing much of anything in the way of fighting infections on it's own, it is not a good idea to place yourself into the middle of that environment.

In many ways, we would learn later, a hospital is the absolute worst place to be when you've got leukemia, thanks to all the other patients sharing their infections with you. But a hospital is also the absolute best place to be. Leukemia is pretty messed up that way.

So we're up against a far wall in this kind of a wide passageway, probably closer to the curb outside than the front desk inside, with thick brick walls and sliding glass doors on either side of my gurney.

The RAF nurse remains nearby (I'll need to remember her name, later, because she was so helpful early on. She sent me a card a month or so into my treatments that I've saved with many others in two thick manila envelopes upstairs. For now, she'll need to be, simply, the RAF nurse. But before this is done, I at least owe it to her to remember her name, if for no other reason than the comfort she gave in that frozen effing London hospital).

Somebody had had my mother paged at the airport as soon as we'd arrived at the hospital. The nurse sat in a chair next to me. She told me that mom would be coming soon. Not to worry.

"They can't move you yet," she explained, "because we've already told them that you've got to have an isolated room."

"Don't they have any temporary rooms? Someplace warmer, maybe?"

"Do you want me to see if I can get another blanket for you? Are you cold?"

"No," I told her. "I mean, yes. If they have one. Can you ask them how much longer it will be?"

She got up to find somebody. "You're not exactly a run-of-the-mill patient, now are you? We've got to make sure they can set aside a room for you, a clean one, disinfected. But I'll ask. I'll be right back with the blanket."

And so we waited. The extra blanket, when she returned, helped, but not much. I was getting sleepy. I rolled onto my side, curled up again. Knees. Chest. Whenever the door behind me would swoosh open, I braced myself for the fresh blast of cold air. I would lift my head to see if Mom was coming through them.

We waited and waited and waited until I eventually woke up in a new bed in a narrow room, Mom sitting next to me, edged forward on a folding chair. My right hand dangled off the edge of the bed, wrapped up within both of hers.

It's cold. Still pretty early in the morning, either the final dwindling days of February or very early March. I've kind of lost track. I'm not dressed for it either way. My shirt's off so the doctors can run lines, take temperatures, do whatever it is that doctors do for patients in the back of ambulances tearing through London. There's no heat. Not that it matters. My knees are huddled up to my chest.

I don't know anything about anything. There hasn't been time to research leukemia. Well, I guess there really was plenty of time, but I didn't know what was going on inside my body then. Didn't want to know. So it's mostly the not knowing that's the scariest part of the whole deal. Not knowing if this is what it's going to be like every day, or if it's just a one time thing. We haven't even started treatment yet. So if not treatment feels this absolutely unbelievably awful, what happens when we really get started?

I'm all turned around. The plan was Lancaster to Heathrow to Seattle. University Hospital to Airport to Airport to University Hospital. Very simple. But now we're somewhere in London, driving someplace that wasn't part of the plan, missing an airplane that was. I can't figure out where we're going. This is troubling. Uncomfortable.

I'm lost.

Who's going to tell Mom that I'm not on the plane? How will she find me?

When in the hell are we getting to this hospital?

It was early yet.
We hadn't even made it out of England.
Mother was running through Heathrow,
passports in hand,
exhausted, I'm sure, from the late
and sleepless nights.
I was in the United Airlines infirmary.
An airline doctor, apparently,
was to arrive shortly, to verify
that I was "fit to fly."

The rash was barely noticeable at first.
It started on the back of my hand.
It rushed up my arm,
wrapped around my neck,
crawled down my back.
My face flushed, my breathing labored.
What's happening? What...
My doctor said a reaction, quickly plunging a drug
into my veins. There, he said, there.
I had been receiving blood all night.
(replenishing lost fluids, i had joked with mother)
There, he said. It was just a reaction to the blood.

And then my stomach cramped.
Knives in my abdomen.
They helped me to a bed,
drew thin white curtains around me.
The doctor was there,
holding my hand,
saying there, there.
And I was trying to breathe,
and the rash was burning my skin,
and I thought
oh god oh god
this hurts this hurts
please don't let it hurt like this.

Our plane was leaving in two hours.
My doctor called an ambulance.
We've got to get you to a hospital, he said.
You can't fly now. We can't fly you out now.
They lowered me onto a stretcher.
The nurse wiped my forehead,
whispered hush.
And a brief thought,
between the stabbing pain:
now i've done it.
now i've gone and done it again.

I can't say for certain exactly when we got started again. A sleepy foot-dragging transfer between vehicles, two new drivers. As far as I'm aware, I'm the only one who'd been getting any sleep. Mom hates being late. She hates flying and she hates to be late, and we'd lost our comfortable cushion for getting into London. I'd still need to be examined by airline physicians; she'd need to get everything checked in, Customs, passports, and because of the way we would be flying back (six seats just for me), I'd also need to be on the plane before any of the other passengers.

My vitals needed to monitored every hour or so. There needed to be plenty of information about my condition to provide to the airline. An empty bag hanging above me would need to be replaced with a new bag, cold and dark, retrieved from a small blue cooler on the floor.

So many details to keep track of.

And another: instead of avoiding London rush hour entirely, we ran straight into it. We did not have time for this. I was starting to get a little nervous, although I figured that they couldn't just take off without us. I'd already waited long enough before going to the hospital in the first place. My limited understanding of the situation was that time, truly, was a precious commodity. We couldn't afford to wait however many days between this flight and the next non-stop flight to Seattle (assuming it had enough seats, was prepared to assume the risk of having me on board, etc.).

I don't remember if one of us mentioned something to the drivers, or if the growing sense of unease from the back was enough, but they turned on the lights, and the siren, and they drove.

"Hold on," they said.

It was remarkable.The kind of thing that -- if you're a twenty-year old guy, regardless of your condition -- you find yourself enjoying more than you probably should. The guy who'd been riding shotgun spent most of the next hour with at least half his body outside the ambulance, either yelling at people to get the hell out of the way or identifying gaps in the crowded lanes ahead.

Our driver made lanes. He used the shoulder when necessary. He sliced his way through what seemed, looking backward through the windows, to be nothing more than a four-lane parking lot. Laying on the horn, squeezing past confused morning drivers, threading the needle all the way to Heathrow.

We didn't get there with anything approaching the buffer we'd been expecting when we left Lancaster, but at least we didn't show up after our plane had already departed. Time enough for one last switch of an empty bag of blood for a full one, followed by hugs and kisses for Mom as she dashed into the airport alone, a promise to meet us onboard in half an hour or so.

We left the hospital pretty much on time. Brief introductions, all around, between the ambulance drivers, the doctor and the nurse traveling with us, Mom, myself. The four of us piled into the back. I was groggy. Mom had pushed me through the hallways in a wheelchair, taking extra care with me, and there was a kind of a cot inside the back of the ambulance for me to lay down on.

Along with the much-needed blood dripping into my body was a steady diet of antibiotics. I rubbed my eyes with my knuckles. Gave up trying to find a way to make the cot as comfortable as the bed I'd just left. It was strange at first, laying flat on my back in a moving vehicle. No sense of direction, no idea where we were going except for what I could see of the night sky outside the narrow windows, turns and bumps that seemed all backwards and spun around.

Streetlights passed by slowly, steadily picking up speed, spapping past until my eyes stopped trying to chase them. Deep, shallow breaths. A light, tentative sleep.

I'm sure it was the absence of movement, the absence of noise, that woke me less than an hour later. The bright wash of lights, as if we were in a covered parking lot. A sleepy, fuzzy brain, trying to make sense of the situation. It didn't seem like we'd been on the road long enough to be in London already.

"Whuzziza?" I asked nobody in particular.

"Hush," Mom said. "Go back to sleep."

Propped up on elbows, now, blinking through the harsh lights. "Hurr," I said, more exhale than an "Hurrwethur?"

"No," she said. "We've stopped. There was a problem. Something with the transmission, I think. Whatever: we've stopped. They've called it in, and we're waiting for another ambulance to take us the rest of the way. Shouldn't be much more than another hour."

"Timeizzit" I asked. Head back down. Eyes closed. Deep, shallow breaths.

"Late," Mom said. "Very late."

The ambulance was to arrive around midnight to take the four of us -- Mom, myself, and both the nurse and the doctor from the Royal Air Force Medical Corps (my escorts for the commercial flight to Seattle) -- to Heathrow. Although it wouldn't take us nearly that long to get to London in the middle of the night, it would allow us to miss rush hour traffic completely, arriving hours before our flight.

Along the way, I would finally be receiving a blood transfusion. I'd lost so much blood over the course of a few days -- either through my urine, my gums, or stupid, senseless thrashing around in my sleep -- that a few pints of liquid refreshment. A new, steady drip to be enjoyed while I slept on the ride down, replaced with fresh blood, periodically, by one of my travel companions.

My hospital room was a smallish rectangle. My bed rested pretty much in the middle of the room, lengthwise. A window stretched out across most of the wall to my right. It looked into the hospital wing, the more crowded beds slightly down the hall. The door was just past the window, so when the visitors started to trickle in, they tended to congregate at the foot of my bed.

I figure I must have called David, or Simon, or somebody. I know that I didn't grab enough stuff from my room -- before I knew that I'd be leaving Lancaster, I was still determined to finish some of my homework. It's not like I ever locked my door, so I probably called one of the boys late that first night, when it became clear that I'd be spending at least a couple of days in the hospital. No big deal, I must have said. I just figure it might get a bit boring laying around in bed all day, so if you wouldn't mind grabbing some books from the corner of my desk, maybe some more tapes, whatever.

There would have been laughter. They would have given me endless amounts of grief for being a stupid git, missing the chance to play pool that night, no chance to try besting my high score on the motorbike game. Of course, we'd dance quietly around the fact that they all had to wear surgical masks before they could enter my room, and there would be sideways glances towards the IV running into my arm, but these things are to be expected.

I'm sure that I called them after the test results came in. There was still some hesitation about whether or not my treatment would be in London, or, more likely, Seattle. Not a problem, I'm certain I told Wayne, or maybe Chris. Jim? The doctors had told me, I'd told them, that survival rates are exceptional. Nothing to worry about. It's just that well, bollocks and all, I'd definitely be leaving the campus. Quickly. At most, a matter of days.

And when my friends visited again, later, a gentle, steady, ever-expanding wave of smiling, worried faces from the University, we were still able to laugh together. They brought gifts and get-well cards. I was tired, and nervous, and at the same time that I wanted to rest for the eventual trip back to Seattle, I didn't want to say goodbye. It felt strange -- as the details of my departure were arranged behind the scenes, conversations I was not privy to -- as the waves subsided. I felt stationary, like I wasn't going anywhere. I think maybe I got out of bed, but maybe I didn't. Everything moved around me. Everybody said goodbye to me, then walked away, smiles and waves trailing along the window and past my field of vision.

It felt like I wasn't the one leaving Lancaster, but that my friends were leaving me.

Unrelated, but this is what happens.

I met Anthony David Moore in September of 1992. We spent ten weeks together on Orcas Island -- two of the four male counselors -- teaching outdoor environmental education to fifth and sixth grade students. Experiential education. Learn about the dynamics of the forest by walking between old growth and new, high forest canopies giving way to a new stand of birch trees where fire had gutted part of the woods decades earlier. Learn about marine life by spending time along the beach. Up at the farm, seriously, illustrate that supermarket food comes from these animals, here, and that fruits and vegetables can grow in gardens like these. The ropes course, mostly just for fun, but also an amazing opportunity for kids to challenge themselves.

You spend a lot of time with your co-workers in that kind of environment. You live in the same house, eating meals together, working different elements on the ropes course, walking into Eastsound for some free time at either of the two bars in town (The Upper, on the hill overlooking the water, or The Lower, well, down the hill).

Some people you gravitate to more than others. With some people -- Anthony was one of them -- I found myself sharing more of my story, and the impact that I'd thought it had had on my life, barely two years removed from my last hospital stay.

We talked about where we were going in our lives, what we wanted to do. Big picture. As much as I loved the San Juans, working on Orcas was an escape from hellish summer temp jobs after graduation, an attempt to get my bearings before moving on. For Anthony, it was a natural step in the right direction. It was exactly where he wanted to be.

Anthony died in 1994.

He died in a plane crash. A small, commuter plane. There was ice, wings, a loss of control. Everything ended up in pieces, scattered across a soybean field in Indiana. No survivors.

Nancy called me that night, I think, or early the next morning. I remember watching the news, thinking that she must have made a mistake because Anthony and I had played pool together in downtown Kirkland just a week or two prior, laughing, drinking beer, Jimi Hendrix in the jukebox. And besides that, there wasn't anything on any news channels about a crash. Not a word.

The words would come later. His face was on page 3 of the Seattle P-I. The front page of the Bellevue paper, The Journal American.

Anthony Moore, his co-workers said, seemed made for the work he was doing, reaching out to teenagers, involving them at the Eastside YMCA, trying to teach them values that would serve them as they struggled toward adulthood.

At 26, he was just getting started.

Moore was among 68 passengers killed Monday in the crash of a commuter flight from Indiana to Chicago.

I haven't thought about this in years.

Damn.

Part of the mourning process, then, was to compare and contrast. I didn't understand it, how their candles were extinguished while mine, somehow, managed to continue. It wasn't survivor's guilt; I didn't think that it should have been me instead. It was more like I couldn't understand how I could have been so consistently, repeatedly lucky -- finding a way through one close call after another, more complications, especially into August, than I could have ever imagined possible -- while Anthony and Laurena, for everything else that was good and wonderful in their lives, were singularly unlucky, and that's all it took.

Not that it should have been me, but that it could have been me. Easily. I had so many more opportunities to die than they did. If it had happened, anytime during the summer, it would not have been unexpected. Not at all.

My mom has always been afraid to fly. Some combination of claustrophobia and being out of control kept her out of airplanes and elevators. There were almost always staircases, and in the rare cases that there weren't, the tense, nerve-wracking ride was at least mercifully short.

But there were places she wanted to get to that couldn't be reached by road. After years of avoiding the issue, 1984 or 1985, she took a series of classes to help with her fear of flying. Graduation was a short trip: Seattle to Portland and back. Even though she'd learned the principles behind lift -- how something much heavier than air could remain suspended thousands of feet above ground -- and she knew the different sounds one could expect during a flight, she still drove to SeaTac with a pale, sunken face. Her entire body so tense, my sister and sat quietly in the backseat, thinking that maybe even one word -- one breath -- and she'd immediately turn the car around and drive back home.

A few of her friends met us at the terminal. They were able to joke with her, offer words of encouragement. When it came time to board, she looked back at us, her face so hollow. One of the few times that I'd ever seen my mom truly, visibly afraid. When she came back the next day, she was still visibly stressed, but also clearly relieved. We still didn't take too many family vacations that required air travel, but at least she'd managed to conquer her fears.

And now: in a matter of days, she's learned that her only son has leukemia; has managed to get a new passport, somehow, in less than 24 hours; will be flying to England for the first time in her life; will take a several hour train trip from London to Lancaster; later that same night, she'll accompany her son in an ambulance back to London, where she will likely spend a couple of hours sorting out travel arrangements, again, for the return flight to Seattle.

It's safe to say that I'm expecting she'll be a complete wreck when she arrives.

Like I'm one to talk.

That night, that first night, music wrapped around my ears and a needle in my wrist and water at the edges of my eyes, I let my imagination carry me back home. I wore pajamas provided by the hospital. I had to lay flat on my back, resting on a book in the small of my back to keep pressure on the site of the bone marrow aspirate. One of the sisters would come in periodically and replace the bloody bandage, check my temperature, ask if I needed anything.

"No, no," I would shake my head. "No, thank you."

Fingers pressed against closed eyes -- thumb to the right, forefinger to the left. Push out, then back in, pinching the bridge of my nose. Slide down. Wipe the moisture on the bed sheets. Lower the volume on my Walkman.

What did I have?

It was a simple matter. It was practical. I didn't know what I didn't know -- hell, my first comic-book inspired vision of what a bone marrow transplant might look like involved a full skeletal replacement, and I was halfway hoping they had some adamantium lying around.

So when the doctors and the sisters and the visitors had left and it was just me and my blood and a handful of tapes I'd been listening to for six months, I got to thinking about what I had. My mix tapes -- with sides titled A-Mazing! and Bee-Yootiful! -- had songs that had been mapped out for consistency and style and transitions between artists, tempo, variety, well, I wouldn't want them to just get tossed in the trash after I died.

Would my sister appreciate them most? Or Aaron? Brady? It would probably be best if I decided on a fair balance, some tapes for each.

But then what about my books? Nintendo? My leather jacket? My Lynda Barry jacket, autographed at a writer's conference from my senior year in high school, tattered and faded but still important?

Or is it best, when making out a will in your head, to first identify the people you want to give things to, and then the stuff? I'd never done this before. I didn't want to figure out what to do what little crap I'd managed to accumulate over twenty years, but I couldn't stop. Sometimes I would try to stop, covering my face with both hands.

But then thinking of somebody else's face brought more memories, and every piece of crap I imagined in my bedroom back in Renton, or my dorm room up the hill did the same.

I don't know when I finally fell asleep that night, but the will never left my head. It never became permanent. I never wrote it down, black ink, white paper. By the time morning rolled around -- Mom arriving sometime later in the afternoon after an unbelievably hurried flight across the ocean -- it didn't seem like something I needed to worry about anymore. I didn't know what was going to happen, didn't know what to expect. Without giving it another thought, I think I knew that a will was looking backwards (an attempt to itemize my past) when what I needed more than anything was to focus on the future.

I was introduced to Kate Bush while spending countless hours in the Pendle College JCR. During winter break, while traveling solo from Lancaster to Mycenae and back again, she kept me company. It's hard to describe what her music meant to me, 20 years old, winding my way south through Europe, more truly alone than I'd ever been in my life.

Although the true meaning behind the song applies to something completely different, when I was first diagnosed with leukemia, knowing, even then, that I'd write about it someday, I carefully transcribed the lyrics to This Woman's Work inside my journal.

I know you have a little life in you yet.
I know you have a lot of strength left.
I know you have a little life in you yet.
I know you have a lot of strength left.

I should be crying, but I just can't let it show.
I should be hoping, but I can't stop thinking

Of all the things I should've said,
That I never said.
All the things we should've done,
That we never did.
All the things I should've given,
But I didn't.

Oh, darling, make it go,
Make it go away.

Give me these moments back.
Give them back to me.
Give me that little kiss.
Give me your hand.