I'm having a hard time remembering things. Not the obvious stuff: my name, family members, today's date, the name of the current president, all that. It's not amnesia. I'm sleeping so much. I'm sleeping all the time, waking up, sleeping again. Sometimes I can't tell. Conversations are lost, stuff from yesterday, last week. Mornings and afternoons and evenings are repetitive. My days bleed together.
I don't know for sure if Dr. Collins ever explained that we'd need to be doing this thing, but she probably did.
We already know that I've got leukemia. We know that it is a specific type: Acute Mylegenous Leukemia. What we don't know (but that I'm sure we suspect) is the exact sub-type. It makes a difference. Protocols might change, depending on how much more accurately we're able to hone in on the type of leukemia with which we're dealing. There are eight sub-types of AML, all with different symptoms and treatments, different methods of identification.
And so, Dr. Collins patiently explains, we get to the purpose behind this latest test: based on my textbook symptoms, we suspect a particular subtype. There is one way to confirm this with absolute certainty. There will be no doubts after this test, where we will look to my DNA for answers.
I don't have any idea what my doctors needed to extract to get the results of this latest one, or what the process was to get to the desired results. Probably just more blood work. Much more complicated, detailed blood work than anything I've had up to this point. The word "cytogenics" is used several times. I don't pretend to know much about genetics beyond some rough high-school science class memory of Gregor Mendel, and peas, pea pods, combinations that can and can't be based on what your parents have. I don't even know what my DNA would look like. Links in a chain, I suppose. A double helix. It's all very comic-book like when I imagine the labs and the glowing vials and the swirling camera angles, mad scientists in crisp white coats and Thomas Dolby electric hair cuts, cackling over my DNA.
One of the things they're looking for -- one of the things they knew to look for -- they've found. My links are in the wrong order. Two pieces of the genetic chain are not where they're supposed to be. They're unique enough, and have clear enough markers, that it becomes obvious when the right people look for the right things. Two chromosomes, fifteen and seventeen, have switched places.
Now we know: AML M3. The symptoms had supported this, and now, too, my genetic markers.
For me this is just one more in a long line of diagnostics, a nice-to-know, but no different than the countless other test results that confirmed what we'd already suspected.
For my mother, it is something else entirely. This test makes my leukemia appear to be less then random ; it is no longer a lightning-bolt of bad news from the sky, an out-of-control city bus as I'm walking across the intersection. Suddenly there is a feeling of responsibility: where does my DNA come from if not my parents?
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