Sunday, March 25, 2012

Babies to the Rescue

A hoot owl from outside my window woke me before dawn this morning. I slipped downstairs, made some tea, and watched the sun come up. Shafts of light, brilliantly bringing forth the new day, shined upon the beauty of spring on its way to the gardens.

In 2007 two babies were born – unrelated, unknown to each other, and unknown to my family. As the babies left the hospital to begin their journeys, they each left something behind…their umbilical cords. Today the babies are five-year-olds, off playing somewhere with trucks or dolls. Neither knows the other exists. They still know nothing of us. They do not know they are about to be joined in life, or of the battle a part of each of them will fight. They have no idea they are about to save a man.

Tomorrow, Cecil…my husband of twenty-seven years…will begin a stem cell transplant. His medical team has decided to use cord blood cells to avoid some of the more deadly complications that come with transplants. Cord stem cells are less mature than their adult counterparts. The host patient’s body is not as apt to reject cord cells because the young cells haven’t developed features that the host recognizes as foreign. Likewise, since the donor cells are immature, they are less likely to attack the host’s body, a problem called Graft Versus Host Disease. It is cutting edge medical technology.

Cecil needs two donor cords for his transplant, two lifelines with a genetic blueprint remarkably similar to his own. With so few cords available, the odds of finding what we need have never been good. Cecil has been living from one transfusion to the next. Time has grown short.

The phone rang last week. They’d found two cords, two perfect matches. It was time to move. We jolted from ‘Someday’ mode to ‘Get ready to go…now.

Suddenly, he will be gone; I will be handling everything. He will be trying to stay alive; I will be trying to stay intact.

As we pass the mantle here at home, the cords of Cecil’s Babies, as we now call them, are on their way to the University of Virginia Medical Center, where they will, for the second time, foster life.

But first, the transplant team must kill what’s left of Cecil’s own immune system. To do that, they will nearly have to kill him. That means chemo-therapy straight from hell, and then more of the same. It means total body irradiation, and then more of that. He will lay limply in the bed, open sores festering everywhere. His hair will fall out. The color will drain from his face. The slightest thing could do him in. Three lines into his chest will try to keep him alive. Then, when there’s nothing left, when he is totally defenseless, the babies will enter the fray.

Cells from both babies will be introduced. They will incite each other. They will compete. The cells from one of the babies will eventually take over and engraft. As death hovers in the room, waiting for its chance, the dominant baby’s stem cells will bring Cecil back to life.

When it’s over, Cecil will have that baby’s blood type. He will have the baby’s immune system. He will need vaccinations and childhood shots again because his new cells will not have been immunized. His cheeks will be pink, like those of a baby. For him, as for a baby, life will start anew.

It will be a grueling process. With the best of outcomes, Cecil will nearly die before they’re done, and he will suffer so much from here to there that he will likely wish himself away several times. The odds that he will survive the ordeal are not something we can boast about. It’s strange that one would walk willingly down such a path, eager to bring himself around the dark corner that lies ahead…encrusted, as it will be, with webs and things that crawl, and every representation of death that one might conjure.

That he looks forward to what waits for him, and that he smiles now where he didn’t before, speaks to how wretched things have been. It measures, in the only way possible, the depth and the reach of the babies’ gift. Cecil sees only the sliver of life that has made its way back to him: the promise of more; the hope that it will not end sooner than he is ready to say goodbye.

Two beautiful babies. Their cords were cut, but not thrown away. Now they are saving us. The babies are coming to the rescue.

Sunday, March 18, 2012

Three Words

“I have cancer.”

Someone you love stands before you and delivers the blow. Your response is visceral. Though you will eventually have more questions than there are answers to give, at that moment no thoughts come to mind. Everything shuts down and you find yourself unable to speak or to move. The only sense that life still lingers is the shallow breathing that barely whispers from between your dry lips.

 I remember the day the words came at me. I was sitting in the kitchen. Cecil stood in front of me at the open window. Colors of spring lit him from behind, as the hand of death snaked in and encircled him like a swirl of smoke. In an instant my husband had been taken. Nothing would ever be the same again.

There was no time to process the words, or to imagine all they would siphon from our lives. Cecil was at stage 4B. Chemo and radiation began immediately. He lost every hair on his body. He crawled to the toilet. He lay on the stairs because he couldn’t make it up. The kids and I were helpless to do or change anything. We could only watch him suffer as he all but died from the poisons that were meant to save him.

Months passed, and years. There was remission, followed by relapse. The devastating treatments came again. Then, out of nowhere, a secondary anemia that was as bad as the lymphoma. With it came exhaustion and hemorrhages and a new threat. More tests, more treatments.   

There has been wishful thinking that it would all go away, but mostly there has been fear – never the peace of mind that allows you to travel along without watching every step. Peace of Mind is a cliché we toss about. When you don’t have it, you come to know what it means.

Cecil shouldered his pain with uncommon bravery. I tried to share it with him, but he would not let me. Eventually, I became convinced he didn’t appreciate what this was doing to the rest of us. I actually felt angry with him for being sick. I began to say my goodbyes, in small ways, creating a distance into which I could retreat from the thought of losing him. I think Cecil, on some level, began to resent that I wasn’t suffering the digging into my hip for marrow, the hours spent with my head in the toilet, the fear that all the suffering might end because it was no longer holding the killer at bay.

Illness is insidious. It can foster misguided emotions that tend to run amuck. We caught this happening and now stand vigilant against the intrusion. Still, its reach has been endless. I can’t think of a corner of our lives that has not been sullied.

It is ten years since those first three words. Despite the anguish, maybe because of it in some ways, we have had love and laughter and life together. We have even, on rare occasion, ignored the monster at the door who waits to claim his latest. For all of this, I am thankful. I never would have thought a moment without death upon us would be as good as it gets.

Cecil spends part of most every day at the hospital. Transfusions are keeping him alive. A stem cell transplant is his only hope. We just learned they have located perfectly matched donors. So, we are on countdown to Day One, when they, literally, will start killing him. Then, on to Day Eight, when they will try to rescue him with the new cells. On Day One Hundred, he will either be dead, or he will have wrestled and clawed and willed his way back to life. We are, at once, terrified and excited. It is a schizophrenic existence. Post Traumatic Stress Disorder… PTSD…I think I will have to look into that.

Right now, I am going to appreciate Cecil’s smile, his sweet voice, and the goodness within him. Perhaps most of all, I am going to remember how lucky I am to have known and loved a man who has felt like home.

Sunday, March 11, 2012

OMG We're Selling the House

I heard a lecturer discuss resiliency once. He said people who have a strong resiliency factor meet challenge head on, or go around it to the next thing. They don’t lie down in the road to get mowed over. Having been through some very difficult times and come out on the other side still standing, I figured we were good to go with the resiliency thing.

That was before we realized the house we’ve lived in for twenty years doesn’t work anymore. Maybe you can relate.

It is the most gorgeous place. We raised our children here. We’ve loved and laughed and done a whole lot of crying here. But, for lots of reasons, it’s time to let it go. After we chewed on that for a while, and finally came to grips, we agreed to sell the family home.  

The realtor came over and walked around with a notepad. When his eyes landed on the chipped paint in the living room, he made a note. We came to the torn wallpaper along the staircase, another note. The dripping faucet in the bathroom seemed to have picked up speed as we poked our heads in there. And, man, how many years had we been growing mildew in the shower?

Suddenly, the plaster was cracking everywhere. The floors were so scuffed it was sad. And the windows…it’s a wonder we could see outside. They looked like someone had thrown up all over them. Needless to say, we had some work to do.

First we started hauling stuff out of the attic to make room for the stuff we needed to haul up into the attic. It took a 28 foot truck to offload the small portion of our collection that we could bring ourselves to part with. We had a yard sale. I watched the years being snapped up by bargain hunters. When a woman tried to get my daughter’s bassinette for a buck-fifty instead of two dollars, I said no. It was the principle of the thing.

The six thousand pictures that had been excellent dust collectors all this time had to go, as did the several absolutely essential stacks of paper that covered my desk, and every counter. The closets were not the safe havens I’d imagined they would be. As it turns out, prospective buyers open everything and look in, so we couldn’t just shove it all in there.

Then there were those windows. As much as we rationalized, they had to be done. It was snowing that day, but we’d run out of time. As an aside, let me mention that Windex all but eats the skin off your hands if you use enough of it, and no amount of lotion will bring it back. You just have to grow a new batch.

The windows took days, as did the floors and the bathrooms and the zillion crevices into which every kind of filth had made its way. My God, we’d been living like a bunch of pigs.

Next we started painting: hallways and doors and walls that went on forever. There was no place to stop. How could you leave that dingy mess there right next to this fresh coat here?

Slowly we got things cleaned up, but then came the ordeal of living that way until the house sold. You make your damn bed up behind you as you’re crawling out in the morning, no questions asked. Not so much as a spoon gets left on the kitchen counter and you should expect a much deserved tongue lashing should you ever leave your toothbrush out on the sink. Shoes go in the closet. I found it easier to just step in with them on, then pull my feet out and shut the door. That way, I don’t have to bend over.

We dust two times a week and feel guilty it’s not happening on a daily basis. We haul the vacuum out of the neatly arranged coat closet each night before we call it quits, and even that’s not enough. When we flush the toilet now, we just grab the brush and give it a swirl right then and there.

Should someone drop by and toss his coat on a chair, we stare at it and wonder how long before the friend will leave. There will be no overnight guests anymore because the spare room has been staged and they will mess it up. And we don’t even think of cooking. It took several hours to clean the stove and I’m not about to do it again.

It’s a frightening existence and we were getting the tiniest bit snippy with each other. So, we went looking for a positive spin. Suddenly, there it was, dancing before us on layers of the life we had laid down. Beneath the debris were memories, rich and textured. We’d almost forgotten them. The clutter of time passing had begun to cover over the beauty of time spent.

When we cleaned the house, we scraped away the dullness of spirit that can sometimes gather. All the focus on where we’ve been has led us to where we want to go next. We are, at last, looking forward.

That being said, I am fairly certain we will never stage a house for sale again. Ever. We’ll just give the next one away, as is.

Sunday, March 4, 2012

Searching for a Pain Doc: Part 2

You might remember when Oxycontin came out. It became the drug of choice in treating pain patients because it didn’t destroy the liver and other organs like some pain medications did. Unfortunately, it didn’t take long for a few people to figure out they could defeat the drug’s unique time release mechanism by crushing and snorting the pills. And then it didn’t take long for people to start dying from overdoses. And then it didn’t take long for the feds to get involved.

Headlines about ‘Hillbilly Heroin’ started popping up around the country. What could the government do to stop it? The DEA formed a task force. Next thing you know, they were going after doctors. The prescription pad was the source of Oxycontin, so that’s where they would dry it up. If they took a few docs down…hard…other docs would be afraid to prescribe narcotics for fear of being next. Everyone could save for another day the question of how legitimate pain patients might find relief. It was a simple plan.

It might seem they would have worked with the docs to solve the problem, but there’s the whole culture thing: prosecutors like to prosecute. They’re what you might call a breed unto themselves. I used to buy the notion they were do-gooders trying to rid society of its shadier types. Then I interned in the U.S. Attorney’s office during my third year in law school and saw a rather scary mentality lurking about, just off in the corner where everyone could tap into it on a regular basis. It was kind of a ‘Let’s get ‘em cuz we can’ combined with a ‘How dare they resist; now they’re really asking for it’ type thing.

So, the Task Force edict went out. They started looking for targets. My husband, Cecil, made a good one. What legitimate doctor wears holey jeans and keeps his office like Bubba’s fraternity house?

They came after him like he was some kind of Mafioso. And when he didn’t like having feds raid his office and his home with guns and battering rams, when he didn’t care for them hauling out his patients’ charts by the truck load, they ramped things up and kept coming, and kept coming some more. There were seven indictments before they were done.

So, first thousands of patients found the pain doc they’d been searching for. Then the feds found him and took him down… hard. People looked on, largely aghast. But that didn’t stop the show.

To be fair, if I really stretched my imagination, I could say the prosecutors and their agents and the experts they brought in probably thought they were doing the right thing, on some level. There’s room to rationalize it. And we might all appreciate having Big Brother out there hovering over our lives, except, last time any of us checked, not that many cops or prosecutors had gone to medical school.