Labor Pains

In my March 25, 2012 post, Babies to the Rescue, I spoke of the two infants whose umbilical cord stem cells would be intravenously introduced into my husband’s body, with the hope they would engraft and produce a new immune system for him. Inasmuch as Cecil’s own defenses had been depleted by Non-Hodgkin's lymphoma and the treatments he underwent to put him in remission, the babies’ cells had become his last hope. 

April 3^rd was an exciting day. The Babies (as we had affectionately come to call them) were to be brought on-board. While friends and family followed through a Facebook group page, Baby #1 was brought into Cecil’s room and introduced. You could all but hear a cheer ring out from around the country. That afternoon, Baby #2 came on-board. Another cheer. It was Day Zero…of what would be a one-hundred day ordeal. The waiting began.

We learned the babies were both girls. One’s blood type was B+ and the other’s O+.  We called them Miss B Positive and Miss O Positive.

From then until now, Cecil’s liver has wavered. His appendix has come out. He’s suffered one fever of undetermined origin after another, each accompanied by a new round of diagnostics, each followed by more drugs being pumped into the lines that make entry through his juggler. His lungs have become compromised. His blood pressure has gone up and then down. His gut was infected. He was weak. He was nauseous. There was no appetite. It has been a rough ride.

Then, Day 13 came along. The babies’ stem cells had engrafted and begun to build an immune system. We had new life.

By Day 15 there was a rash, one that looked like something was eating him alive. It seemed the Babies were attacking Cecil. Flickers of hope and optimism extinguished as quickly as they had appeared. As it turns out, though, the rash indicates that the Babies’ cells are cleaning house and, as long as they don’t kill the Host in the process, he is on the road to recovery. Though the rest of us have been white-knuckling it through all of this, Cecil has shown grace and unyielding spirit. 

I'm sure it has been a difficult role reversal for him to be the patient. As labs come in, Cecil is in the bed, but then he is gathering his Johnny and pulling his IV pole over and crawling out to review test results, interpret indications…and to tell his team what doesn’t make sense. He banters back and forth with them in their own language and, at times, actually directs the course of things.

Cecil loves being a doctor. He has been fascinated by medicine since he was a boy. He grew up with three brothers and a sister on the family’s hundred-and-fifty acre ranch in Brownfield, Texas, best described as flat, dusty and barren land in the middle of nowhere. They had geese, pigs, sheep, chickens – you name the animal, it seems there was a family of them on this ranch. 

 

The kids moved irrigation pipe and picked cotton. The boys also branded cattle and, whenever they could get away with it, blew things up. It was a childhood to be remembered.

Cecil’s father was the only doctor for a hundred-sixty miles to the south and a good sixty miles to the north. He made house calls and frequently disappeared into the night to tend to one emergency or another. Cecil would hear the phone ring and he’d be waiting at the door to head out with his dad. One story in particular comes to mind this morning.

Cecil was about thirteen at the time. He went with his dad to the hospital and made himself available near the operating room, hoping this might be the time he’d get to go in and watch. His dad stopped to talk to another doctor, then walked by without looking in Cecil’s direction. The weight of disappointment came swiftly. But then, from just at the door to the forbidden suite, came the words Cecil had imagined for so long, the kind of words that transform a boy into a young man.

“Well, come on, son. Let’s go.” His dad pushed open the doors and walked through. Cecil caught his breath and followed his father in.

Inside the scrub room, his father stripped off his shirt. Cecil did likewise. Then came the pants and the socks and shoes. Cecil stood quietly in his underwear. The nurse disappeared and came back with green scrubs, shoes and booties. Finally, there was a hat and then a mask. Cecil felt like a doctor himself.

At the sink, he and his dad scrubbed. They kept scrubbing, and then they scrubbed some more. Cecil waited for his dad to say it was good enough; his skin was getting raw. They worked in silence, the father and the son. The son copied the father’s every move and he memorized every moment.

After they’d been draped in gowns, the nurse brought gloves. Cecil’s dad slid into his with laser accuracy. Cecil got three fingers into a single hole. A second pair was brought. He tried again. And then a third time. Finally, he got them on. “Don’t touch anything,” the scrub nurse warned him.

Cecil’s father led the way into the operating room. Lights were blazing over the patient, who was draped on the table. She was large. Cecil thought she was bloated, like his calf had been last year. He figured they were there to let out the gas.

As he approached the table next to his dad, who now seemed more like the doctor than his father, Cecil’s nose itched. He scratched it with his hand. Without looking up, his dad intervened. “You’ll have to go stand in the corner, son – away from the patient.” He kept working. Cecil was devastated, but there was no time for self-pity.

The O.R. nurse handed over an instrument. Cecil stood on his tiptoes to see. His view was blocked, but he could tell his dad had just cut the patient open. Cecil’s heart pounded. He wanted to see more. He stretched and leaned this way and that. Suddenly, the nurse walked over to him. “Hold out your arms.”

Puzzled, Cecil complied. The nurse laid a towel across his outstretched limbs. He didn’t say a word. Seconds later, at the table, his father passed something bloody to the nurse. She turned and crossed the distance to Cecil and laid the bloody thing into his arms, then returned to the operating table without speaking.

Cecil looked down into the face of an infant boy. The baby opened his eyes and looked up – an indescribable moment for each of them. One would never remember it; the other would never forget.

And now the stem cells of Little Miss Baby B+ or Little Miss Baby O+ are duking it out with bacteria and viruses, and who knows what else, to save Cecil’s life. One of them will carry the day and become Little Cecilia. She will have embarked on life, and then given it, without realizing the miracle of either event. Cecil, on the other hand, will never forget that he owes each breath to the gift of an infant, like the bloody bundle that opened his eyes and looked up all those years ago.

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.