The deal is that Dr. Collins is only supposed to bring good news. That's the way it works. I do what all my doctors and nurses tell me to do -- do everything with a smile on my face if I have to, gritting my teeth if necessary, no complaints -- and the good news is supposed to flow like wine. We have certain expectations, understand, and they are not being met with this announcement.
There are, of course, explanations. It's not backpedaling. I know she's not backpedaling. And I know that what she's telling me are things that don't make sense to explain to me at the beginning. We're optimistic on Day One. We're so completely ready to beat this thing. Day one is not the time to hear Dr. Collins patiently explaining to her patient, hands open, palms up, apologetic, that on average, "it takes 1.3 weeks of chemotherapy to induce remission."
Induce is always the word we use when we talk about remission. Induction. Induction-duction, what's your function?
And because my protocol calls for 7 solid days of chemo, the statistic Dr. Collins shares with us really means that more patients make it to remission after only one round than don't. More get it right the first time, so it's not really backpedaling at all. The odds had been in my favor.
I should yell. I should yell at the top of my stupid lungs that this is complete and utter bullshit. I should rage. What the hell kind of hospital is this? What the hell kind of protocol am I on that I'm not already cured after a week of chemo? A tantrum would be good. Knocking over hospital equipment. A big show. I can't rip the Hickman from my chest, but I could make sure I'm not hooked into anything when I stand up and shout I am SO out of here. I could slam the door and walk barefoot all the way down to the lobby where I could stew. I don't have a car, or money for a taxi, or anywhere to go, really, or anything, but I could march right down to that lobby and... and...
I should be pissed, but I'm not. I'm not even sad. I remember writing ominious notes to myself, knowing full well that my words were a scary foreshadowing of something bad just over the horizon. I should have been walking up the Spine at Lancaster to visit a doctor. Instead, I sat on my ass for a week, too afraid to do anything except make excuses. This is my responsibility. If the leukemia has had an extra week to build up strength, and that extra strength means the first week of chemo didn't work, well, crap. It's on my shoulders. Yelling at Dr. Collins won't get me into remission any sooner.
"What does this mean?" I ask. "What's next?"
I think I already know. My sister had a blood test weeks ago. It's a specific test that measures six specific factors to determine whether or not her bone marrow and my bone marrow are identical. Siblings sometimes are. They're the best bet for a bone marrow transplant. Except -- much to Laura's chagrin, apologies after apologies -- she didn't match. We're still searching the registry for a any match, just in case. But for now, I'm pretty sure I know that we've only got one option with which to work.
"Same protocol as before," Dr. Collins says, "with one small difference: we're going to reverse the order. We want to hit the leukemia hard while it's on the run. We'll start both the Daunorubicin and Ara-C at the same time, the stronger combination at the beginning instead of the end. Three-and-seven this time, instead of seven-and-three. "
"One more week, then?"
"One more week."
"When do we start?"
"Now. Right now. Immediately."
Mom's hand is squeezing mine. Tight. I might be squeezing back just as hard. Can't be certain. I look to my right and all I can think to do is smile weakly at mom, kind of shrug my shoulders as if to say whaddya gonna do?, almost as if I'm asking for permission.
She pats my hand. Yes, yes.
Here we go again.