"The chemotherapy will be very strong," Dr. Collins tells me the next morning. Dad and Jane are here, too, drinking good cups of coffee in the seats by the window. It is Sunday. There is a mute morning light. This time yesterday I was still in Lancaster.
Dr. Collins has been explaining about the catheter that will be inserted into my body later in the day.
Allow me to be clear about one point now, because it almost certainly was not Dr. Collins who stood in my room on the morning of March 4th, 1990. She would come later. Her rotation as resident on 6 South East wouldn't start for another week or two, and would continue for what, maybe a month? Six weeks? Through the entire course of my several stays on the sixth floor, there would be half a dozen resident physicians. But she would become my primary physician; she would write the reference letter, later, to the Mayo Clinic when I finally made it back to Carleton in January of 1991.
For the sake of narrative clarity, I will only have one doctor throughout the majority of this story. We'll make an exception in July and August, when I'd like to think my family and I helped to improve the bedside manner of the young resident who was looking after me during that whole deal with the fevers and the eye infection and the several abscesses that had formed on my brain. But everything else will be the wise, calming, excellent Dr. Carolyn Collins.
"The chemotherapy will be strong," she says. "We'll assume it's chemotherapy for now, pending the results of another bone marrow aspirate tomorrow. Regardless, you'll be needing a Hickman catheter."
I'm barely half awake. Basic physics again. A body in motion continues, except that I've stopped moving now, and as much as I might want to put a brave face on it, leukemia really does wipe you out. Jet lagging, the emotional high of being home again, next to no healthy white blood cells remaining, a restless night in a strange bed with nurses waking me up every few hours; I'm spent. I know that this is important, that I should be awake enough to be able to ask questions about all the things that will be happening to my body. I will need to be my own best advocate. But it's a struggle just to keep my eyes open while Dr. Collins is talking to me.
"What is it?" I ask.
Or somebody else asks. Probably somebody else asks this question, one of my parents. I'm happy to just nod politely, agreeing with whatever Dr. Collins says.
"What's a Hickman anyway?" Jane asks.
"Pretty simple, really. Well, a little complex. But simple enough to understand: the chemotherapy will be strong. It would tear apart your veins if we ran it through your arm. To say nothing of the other supporting meds we might need to give you. So the Hickman catheter will act as an alternate line for us.
"You're very lucky, actually. Dr. Hickman works at the hospital here. He'll be putting yours in. It's a point of professional pride for him to put them in for anybody who needs them here. You'll be in very good hands."
"Sounds good," I say.
Dr. Collins stands next to my bed. She touches a spot on the right-hand side of my chest.
"The catheter itself is essentially a thin plastic tube that will go into your chest here. You won't need anything more than a local anesthetic. Dr. Hickman will make one small incision here, and another, here." She traces a line almost up to my collar bone. "He'll guide one end of the catheter into your subclavian artery. Big vein. A good, big vein for the chemo to enter your system. Other medication, too. We'll also start to do blood draws from one of the ports."
"Sounds good."
Of course, everything sounds good at this point. I don't know anything about anything, and I have placed immediate, absolute trust in the people caring for me. My doctors could recommend running naked through the hallways, waving pom-poms, shouting out, leukemia, out, geee-tttt OUT! and I would cheerfully agree, only asking if I needed to find the pom-poms on my own -- and what color? -- or if the hospital would provide them for me.
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