Chapter 98
The cancer’s spreading.
Those were the words Nick had dreaded hearing basically ever since
he had gone into remission back in August.
And now, it had finally happened.
Not quite a full year after his initial diagnosis, he had already
relapsed. He was out of remission; the
cancer was back.
Devastation quickly set in.
Questions spun out of control in his brain, and he finally found
his voice to speak. “C-can you treat
it?” he asked, looking at Dr. Kingsbury with desperation in his eyes.
“Yes,” she said firmly. “I
wanted you started on six-week course of radiation therapy.”
“Radiation therapy?” Nick repeated. He did not like the sound of that at all.
“Yes. Radiotherapy is the
use of high-energy rays that destroy cancer cells. If it works, it will shrink the tumor in your
leg.”
“If it works?” Nick questioned, his voice rising shrilly.
Dr. Kingsbury smiled patiently and patted his knee. “Most Ewing’s Sarcoma tumors are sensitive to
radiation. There’s a good chance the
treatment will help.”
“Well, what if it doesn’t?”
“Then we’ll cross that bridge when we come it,” she replied,
giving him her standard answer.
He nodded and hoped they would never have to cross that
bridge. “So,” he said, “what’s radiation
like? Is it… is it worse than
chemo?” He bit his lip, not sure he
wanted to hear the answer. The thought
of being so sick and losing all his hair again was almost too much to bear.
“Oh no, much better actually,” smiled Dr. Kingsbury. “Radiation’s very simple. You’ll need to come to the radiology
department here at the hospital five days a week for treatments…” His mouth dropped open in horror, and she
continued quickly, “… but the treatments don’t take long at all. Just a few minutes, really. And they’re painless. No worse than an x-ray.”
He let out a sigh of relief.
Although coming to the hospital once a day for this shit would suck, it
had to be better than being hooked up to a chemo pump for a whole week. “So what about side effects?” he asked. “Like will it make me sick? Will my hair fall out again?”
“No,” she replied, and he let out a sigh of relief. “There are a few minor side effects, but
nothing as bad as chemo. The biggest one
is fatigue – the treatments will make you tired. Since you’ll be receiving the radiation on
your shin, the hair there will either fall out or have to be shaved off, but
that’s it. Also, you might have some
redness or itching or burning on your shin, but other than that, it doesn’t
cause much discomfort. Most patients
I’ve had prefer radiation to chemo.”
He nodded. That didn’t
sound so bad. “So when will I start
this?”
“As soon as possible,” answered Dr. Kingsbury, looking at him
seriously. “This week, if you can.”
“Okay,” he said. “I guess I
should start this week then. The sooner
I get started, the sooner it’s over, right?”
He pasted a smile on his face.
“Right,” Dr. Kingsbury smiled back. “Okay then… on Monday, you’ll need to come in
for a planning session. You won’t
actually start the treatment that day, but you’ll meet your radiation
oncologist, who will take you through the procedure and show you how everything
works and get you ready to go for the next day, when you’ll receive your first
treatment.”
“Radiation oncologist? So
you won’t be my doctor?” asked Nick nervously.
He liked Dr. Kingsbury and had grown comfortable around her; he didn’t
want to be handed off to another specialist.
“Oh, I’ll still be your doctor,” Dr. Kingsbury assured him. “But you’ll go to a colleague of mine, Dr.
Marvin, for your radiation treatments.
I’ve already showed him your scans, which is why I took longer than
usual to come talk to you, and he thinks you should start with a six-week
course of treatment. He can talk to you
more about it when you meet him on Monday.
And I’m sure you’ll like him, Nick.
Vin’s an excellent doctor, star of the radiology department, and he’s a
very nice man as well. A little
eccentric, but very sweet. Anyway, I’ll
be in close contact with him to check on your progress, and at the end of the
six weeks, you’ll have a follow-up visit with me so we can see how things
look.”
Nick nodded.
“So… do you have any questions?”
Did he have any questions?
It seemed he should, but he was so overwhelmed with this sudden news, he
didn’t have the slightest clue what to ask.
Slowly, he shook his head. “No, I
guess not.”
“Okay. Well, if you think
of anything over the weekend, don’t hesitate to call my office, and I’ll answer
what I can. And Nick,” she said, causing
him to look up, “this isn’t the end of the world. It’s a setback, sure, but things are still
looking positive. Your chest x-ray
looked fine, and your bone marrow should be clean. The tumor’s growing again, but as long as it
stays in your leg, your chances of recovery are high.”
“H-how high, exactly?” Nick asked, licking his dry lips.
“For people with Ewing’s that hasn’t metastasized… spread, that
is… the five-year survival rate is fifty-five to seventy percent.”
Nick blinked, his stomach lurching. Fifty-five to seventy percent? Then that meant that thirty to forty-five
percent died within five years. He
didn’t think that was very high chance of recovery at all; those were terrible
odds! Okay, so it could be worse… but
fifty-five/forty-five? That was almost
fifty/fifty! Nothing more than the flip
of a coin. Heads or tails.
“Concentrate on the seventy percent,” Dr. Kingsbury said, reading
his mind (or maybe the expression on his face).
“You can beat this, Nick.”
He nodded numbly, wishing he could feel as confident as she
sounded. “So… so can I go now?” he
murmured, not quite sure his legs would even support him when he slid off the
table.
“Yes. But first let me call
radiology and set up Monday’s appointment.
Any specific time of day you’d prefer to come? If it were me, I’d do it early, get it over
with. Then you still have the rest of
the day. But it’s up to you.”
“Okay… yeah, make it in the morning, I guess.”
She nodded. “All
right. I’ll call right now and get it
set up for you.” She stood up, crossed
the room, and picked up a phone that was mounted on one of the walls. She punched in a few numbers and waited a
moment, then said, “Hi, this is Barb Kingsbury from Oncology. I’d like to schedule an appointment with Dr.
Marvin for Monday morning for one of my patients. I’ve already spoken to him. Yes… Nickolas Carter. N-I-C-K-O-L-A-S. Yes.
Nine o’clock? Okay, thank
you.” She hung up and turned to Nick. “Nine o’clock on Monday morning, Nick. Don’t come here; go to the radiology
department, where you go for you x-rays and CT scans. Got it?”
“Yup,” he replied dully.
“Good. Then go ahead and
get dressed, and you can go. Good luck
with your appointment on Monday, and feel free to call me if you need
anything.” She rested her hand on his
shoulder, like she had done so many times before, and gave it a reassuring
squeeze. “I’ll see you in six weeks, if
not before.”
“Thanks, Dr. K.”
She left, and he got up slowly.
His legs felt like rubber, and his left shin throbbed as soon as he put
weight on it. Now he knew why. It had been the tumor all along, and he’d
been either too stupid to realize it or too much in denial to accept it. But there was no denying it now.
His cancer was back.
***
In a way, Sunday night came far too soon, but in another way, it
couldn’t come soon enough. Nick was
dreading radiation the following morning, but the weekend had been pure
hell. He had been unable to escape the
recurring nightmare that was his cancer, unable to forget about his
relapse. The rest of Saturday and all
day Sunday was spent just plain freaking out, worrying about the upcoming
radiation treatments and whether or not they would work.
He had briefly considered calling Brian on Saturday to tell him
the bad news, then decided against it.
Dr. Kingsbury had said the radiation treatments would only last six
weeks. What would come after that, he
did not know, but he decided to wait until the treatments were done and
see. If the tumor had cleared up by
then, there would be no need to call the guys.
Why worry them for no reason?
So he worried all by himself instead.
One thing he could not forget was the odds… seventy/thirty at
best, fifty-five/forty-five at worst.
They were not completely horrible… yet they didn’t do much for his
confidence. Now eighty or ninety
percent… that would have been a lot better.
But fifty-five?
At one point, he recalled a conversation he’d had with Claire before her bone marrow
transplant.
“Well… it’s too big a risk, I guess. That’s why they try chemo and everything
first. This treatment is just sort of a
last ditch effort…” She went quiet, her
voice trailing off into nothing, and he felt a tremor of fear ripple down his
spine.
“What kind of a risk?” he asked.
“I mean… how dangerous is this thing?”
Her eyes locked with his, no trace of the usual twinkle of
amusement alighting them. Instead, all
he saw when he gazed into their light blue depths was fear. And he realized the truth… as hard as she was
trying to hide it, as upbeat as she was trying to be, this was totally freaking
her out.
She was scared to death.
“Claire?” he asked softly, not tearing his eyes from hers.
“Fifty-fifty,” she whispered, looking away.
His stomach lurched.
Fifty-fifty. It was a coin
toss. Heads, she won. Tails, she lost. And this was not just any game, but a battle
of life and death. If she lost, she’d be
losing her life…
Things had looked pretty grim for awhile for Claire. But she had made it through with worse odds
than him. He felt a bit better. If Claire could do it, so could he.
He only wished she could be there with him. He remembered all the times she had sat with
him in the waiting room and how she’d held his hand during his bone marrow
aspiration that time. And all the
conversations they’d had, some deep, others just silly. He would have given anything to tell her the
bad news. She would understand, and up
until recently, she would have been there for him in a heartbeat, he was sure
of it. Only now he was not so sure. He had pissed her the night before, and
though he was still not sure exactly where he had gone wrong, he wasn’t about
to call her now. His pride was too
great. He had come crawling back to her,
and look where it had gotten him. He
wasn’t going to do it again. It was her
turn; she could come crawling to him this time.
As he lay in bed, his stomach clenched with anxiety as he thought
of the frightening new journey he would set out on all alone the following
morning, he just hoped she would.
It’s been a long, long time since I’ve looked
Into the mirror
I guess that I was blind
Now my reflection’s getting clearer
Now that you’re gone things will never be
The same again
There’s not a minute that goes by every
Hour of every day
You’re such a part of me
But I just pulled away
Well, I’m not the same [guy]
You used to know
I wish I said the words I never showed
I know you had to go away
I died just a little, and I feel it now
You’re the one I need
I believe that I would cry just a little
Just to have you back now
Here with me
Here with me
You know that silence is loud when all
You hear is your heart
And I wanted so badly just to be a part of
Something strong and true
But I was scared and left it all behind
I know you had to go away
I died just a little, and I feel it now
You’re the one I need
I believe that I would cry just a little
Just to have you back now
Here with me
Here with me
And I’m asking
And I’m wanting you to come back to me
Please?
I will never forget that look upon
Your face
How you turned away and left
Without a trace…
- “Here With Me” by Michelle Branch
***
Promptly at nine a.m. the next day, Nick sat in the waiting room
of the radiology department. It was the
first time he’d had to wait there; although he’d been to radiology many times
for his x-rays and bone scans, he’d always been shuttled in and out rather
quickly. He hated having to sit there
and wait because his nervousness only increased with every passing minute.
“Mr. Carter, there’s juice there on the table; help yourself,”
called the receptionist from her desk, pointing to a large bowl filled with ice
and juice boxes that sat atop the coffee table in the middle of the room.
Nick nodded in acknowledgement, but didn’t take one of the juice
boxes, feeling as if anything he ate or drank would just come right back up
again. He was about ready to throw up as
it was, his nerves wreaking havoc on his stomach.
Luckily, he didn’t have to wait long before his name was
called. Standing up on wobbly legs, he
crossed the room to the nurse that stood waiting for him in the doorway. She smiled cheerfully, said hello, and led
him down a hall and around a corner, stopping in front of a closed door. The door had a frosted glass window on which
the name S. Vincent Marvin, M.D. was
printed. The nurse knocked once, and a
man from within called, “Come on in!”
The nurse opened the door and poked her head in. “Mr. Carter’s here, Dr. Marvin.” To Nick, she said, “Go on in, hon.” She stepped back so that he could enter and
then left. He found himself in a small
office. In the center, there was a large
desk behind which a man in a white coat sat, arms crossed on the wooden surface
in front of him, looking up expectantly at Nick.
“Good morning, Mr. Carter,” he greeted pleasantly and stretched
his hand out across the desk. “I’m Dr.
Vin Marvin, good to meet you.”
“You too,” replied Nick, perching himself in one of the two chairs
positioned in front of the doctor’s desk and shaking hands.
The Hispanic doctor looked younger than Nick had expected; he was
possibly in his early thirties, no older.
He had a casual air to him, and his office matched this. It was rather untidy, cluttered with several
cardboard boxes containing God-knows-what.
Amid university and medical school diplomas, random pictures hung on the
walls, from a painting of a grassy green pasture in which several goats grazed,
to an old poster from the Broadway play “The Miracle Worker”. The bookshelves in one corner were filled
with thick medical volumes, framed pictures, and all sorts of peculiar odds and
ends… a figurine of a chicken, a small taxi cab, a model train, things like
that. His desk was cluttered with papers
and more pictures and… a bat?
The doctor noticed Nick looking at the small, beady-eyed plastic
bat lying upside down on one corner of the desk and laughed. “Look at this, isn’t this cool?” he
exclaimed, picking up the bat. When he
flipped a tiny switch on the bat’s underside, the toy sprang to life, its eyes
flickering bright red, while an obnoxious, high-pitched humming noise
sounded. Dr. Marvin laughed again,
slapping his desk with the palm of his hand.
“Ahh, that’s great, isn’t it?” he remarked mostly to himself, turning
the bat off and setting it down again.
“Perfect for Halloween, eh?”
Nick wanted to ask why he had Halloween stuff out in the middle of
February, but kept his mouth closed, just nodding and smiling weakly. He now knew what Dr. Kingsbury had meant when
she called her colleague “eccentric.”
The guy was a freaking weirdo!
Nick just hoped he was as good a doctor as Dr. Kingsbury had said. He didn’t want some quack shooting
radioactive waves into his body.
“Well…” The doctor clapped
his hands together and said, his voice sobering, “Shall we get started?”
“Yeah, sure,” replied Nick, desperately wishing Dr. Kingsbury
could be in charge of the radiation instead of this lunatic.
But as they got started, Dr. Marvin quickly turned more
professional and not so freaky. “First,
let me just tell you what’s going to happen today. I’ll take you down to one of the radiation
rooms, where you’ll be getting the treatment done every day. There, some of my technicians will take some
measurements and do some calculations and then mark you up for treatment. What they’ll do is give you “tattoos,” as we
call them – tiny dots on your skin that will show us how to line up the machine
each time you come. That way, we know
for sure that the radiation will hit the tumor and not another part of your
body.”
“’Tattoos’?” Nick repeated.
“Those dots… they come off, don’t they?”
“No, I’m afraid the dots are permanent, but they will fade over
time, and they’ll be so small that no one will notice them. Once the dots are there, the technicians will
sort of play Connect The Dots with a pen and draw lines on your skin. These lines are for the same purpose – to
help us line up the machines – but, of course, they wash off. You’ll have to try to avoid using soap on
that area when you shower, but the technicians will redraw those lines as they
fade.”
Nick nodded. Well, so much
for wearing shorts out in public. He’d
look like freak with lines and dots all over the bottom half of his leg. And yay, he’d have the dots forever as a nice
little souvenir of this pleasant experience.
If he’d known he was going to have to get another tattoo, he would have
picked something a bit more interesting than a bunch of lame dots.
“So is that it?” Nick asked.
“Pretty much. It should
take around an hour, and if all goes well, you can start the actual treatments
tomorrow. They only take a few minutes,
so once you’re done today, the worst is over.”
He grinned, and Nick managed a slight smile back. “So,” said Dr. Marvin, standing up, “why
don’t you come with me? I’ll take you
down to one of the rooms.”
Nick nodded and followed him out of his office, back up the hall
and around the corner. They stopped at a
heavy door, which Dr. Marvin yanked open and held for Nick to pass
through. He found himself in large room
with a bedlike table in the center.
Positioned over the table was a gigantic machine with a cone-shaped
device that pointed down.
“This is the machine we’ll be using,” said Dr. Marvin, running his
hand over the smooth metal of the contraption.
“You’ll lie here on the bed, and the technicians will position this over
your leg so that it shoots the waves right at your tumor.”
Nick blanched. Dr. Marvin
talked about it so casually, as if they were just playing a game of
“Asteroids”. Only the cute little
two-dimensional blipping spaceship was this very real, very intimidating piece
of machinery. And instead of being
threatened by asteroids, he had to fight off an even worse foe – cancer. And the idea of a tumor deep in his shin bone
was a lot scarier than a few little white outlines hurting across a black
screen (although, as a child, bouncing around like a spaz in front of the Atari
Asteroids console at the local Pizza Hut with his tongue sticking out in
concentration and a handful of quarters jangling in his pocket, he might have
disagreed).
“So,” said Dr. Marvin, bringing Nick out of the black and white
reaches of space and back to the radiation room, “if you’re ready, we can go
ahead and get started with the calculation and marking.”
Nick felt he’d never quite be ready, but, like a puppet, his head
bobbed up and down once in a nod, and he heard himself reply, “I’m ready.”
***
As Dr. Marvin had predicted, it took almost an hour for the
technicians to do their calculations and “mark him up,” as they called it. When he left the hospital, his left shin was
covered in a pattern of blue lines, intermixed with tiny dots – the “tattoos”
Dr. Marvin had described. They were tiny
indeed, only about the size of a freckle, but they were still noticeable, at
least in Nick’s eyes. Seriously, who has
bright blue freckles? He only hoped they
really would fade the way the doctor had told him they would.
Bright and early Tuesday morning, he was on his way back to the
hospital for his first actual radiation treatment. And he was nervous as hell. Dr. Kingsbury and Dr. Marvin had both told
him the treatment was both short and painless, but he couldn’t help but feel
uneasy.
When he was called from the waiting room, a nurse took him to a
small room and gave him a hospital gown to change into. Grudgingly, he did, and when he was finished,
he was escorted into one of the radiation rooms, not the same one he had been
in the day before, but identical to it.
He was positioned carefully on the table, his left leg immobilized so
that he could not move it during the treatment.
A technician then moved the large radiation machine, adjusting it so
that the cone-shaped end was aimed at the markings on his left leg.
“Okay, Mr. Carter,” he said finally, “we’re going to start the
treatment now. You’ll be alone here in
the room, but I’ll be in the ‘control panel’ right through that window.” He pointed to a large window in one of the
walls. Beyond the window, Nick could see
a small room with all sorts of equipment and computers inside. “I’ll be able to see you from there, and
there’s an intercom, so if you need anything, just holler, and I’ll be able to
hear you too. Okay?”
Nick nodded.
“You’ll hear a whirring sound when I turn on the machine, but you
won’t feel a thing. It will only take a
few minutes, and then I’ll come back to readjust the machine so we can shoot
from a different angle.”
He suddenly sounded like a photographer at a photo shoot. And though he normally despised photo shoots,
Nick would have given anything to be at one of them now instead of here. No such luck though. The technician left the room, and as
promised, there was a buzzing sound. It
lasted just over a minute, and when it was over, the technician returned and
set to repositioning the radiation machine.
Some of Nick’s nerves left him; everyone had been right in saying that
the treatment would be painless. He
hadn’t felt anything. When the
technician left again, the buzzing started back up, as another dose of
radiation was shot into Nick’s leg from the second angle.
“That’s it. You’re done,”
the technician announced cheerfully when he returned, helping Nick up from the
table. “Same time tomorrow?”
“Yup,” Nick said, slightly shaky, but overall relieved at how
truly easy the radiation had been.
“You look a little pale,” commented the technician, studying
Nick’s face. “Probably just nerves,
right?” Nick nodded, smiling a
little. “That’s okay. Well, why don’t you grab a thing of juice on
the way out, get your blood sugar up a bit before you drive home.”
“Okay.” The technician led
Nick back out to the waiting room, where he grabbed a juice box from the bowl
on the table, downing it in just two swallows.
Flattening the small cardboard container, he tossed it in the trash.
“See you tomorrow,” he called to the receptionist and then left,
thinking of how annoying it was going to be to have to come here five mornings
out of the week for the next six weeks.
Still, if it got rid of his tumor, it was worth it. Anything was worth that.
***