Always and Forever (7 page)

“Rheumatic fever causes heart damage, doesn’t
it?” As soon as she voiced the question, the thought frightened her. “What causes it?”

“Untreated strep.”

Melissa swallowed against a scratchy throat. Could she have had strep throat and ignored it long enough to have caused rheumatic fever to develop?

The bone marrow aspiration was not so pleasant as the electrocardiogram. The nurse and technician were friendly, almost cheerful, making Melissa wary. They placed her on an examining table on her stomach, a pillow tucked under her pelvis. The nurse cleaned her hip area with iodine. The brown liquid felt cool and stained her creamy, white skin. Next she applied a cooling spray. “This is a local anesthetic, Melissa,” the woman explained. “It will numb the site so you won’t feel the needle going in. We’ll insert it into the spongy part of the bone where your marrow is manufactured, and it won’t take but a few seconds to withdraw the cells we need for lab analysis.”

Melissa clutched the metal edge of the table, determined to focus her attention on the white tiled wall in front of her and not on the syringe that looked a foot long. She gritted her teeth as pressure, then pain, overcame her. It felt as if a vacuum cleaner were sucking out some of her insides. When it was over, the nurse gave her a perfunctory pat. “There. Now that wasn’t so bad, was it?”

Yes, it was horrible
. “No problem,” she said as she blinked back tears.

“You’ll be tender in that spot for a little while, but you can get up and walk around once you get back to your floor.” The nurse settled Melissa in a wheelchair for the ride back to her room. “There’s a video game machine up there if you’re into Space Invaders.”

But Melissa didn’t want to socialize. She just
wanted to return to her room and study. Regardless of her hospital visit, she was determined to make a good showing in the Brain Bowl drill next week. Besides, studying let her escape from worrying about her mysterious illness.

Jory called at lunchtime. “Where are you?” Melissa asked.

“Drove over to McDonald’s for lunch. I’m at the pay phone next door at the Seven-Eleven.”

The familiar image of that corner, a hangout for Lincoln students, sprang so sharply into Melissas mind that a lump came to her throat. “What’d you have to eat?” she asked, clearing her throat.

“The usual—Big Mac and large fries. You know my weakness for grease. Hold on—I have someone here who wants to say hi.”

Sounds of the phone being fumbled and passed came through the receiver. “Hi, Melissa.”

“Hi, Brad.” Her voice went soft when she heard his.

“Jory tells me you’re skipping school for a few days.”

“Jory exaggerates. I’ll be home in another day. I thought I’d experience firsthand the life of a laboratory rat. So far, it’s not much fun, but it’s given me a whole new respect for people who march for animal rights.”

Brad chuckled. “Hey, did I ever tell you I’m glad you made the Brain Bowl team?”

“Yes, but not nearly in enough detail. I left school a bit suddenly the other day.” She allowed the sarcasm to bleed into her inflection. “But you did predict at the country club we’d both make it. Are you psychic?”

“Just confident. And besides, didn’t I say I wanted you on the team with me?”

Her pulse quickened. “Yes, you did.”

“So hurry up and get out of that hospital. I wouldn’t mind a few private study sessions between the two of us.”

“I’ll tell my doctor to put a rush on my case.”

The phone passed back to Jory. “Well, I’ve gotta run. Chemistry lab next period, you know. Ugh. I hate it.”

“Don’t blow anything up.”

“Ha-ha! I’ll stop by to see you tonight. Do—uh—do you want me to bring a visitor?” Jory asked the question in a conspiratorial whisper.

“Don’t you dare drag Brad up here, Jory Delaney! Do you hear me?”

“Just asking … ” Jory huffed in mock innocence. “It’s not every day you can legitimately have a guy ogle you while you’re lying around in your nightgown. It could be kind of sexy.”

“Forget it.”

“I could bring the red harem gown … ”

“Jorry!”

“Suit yourself. See ya later.”

Melissa hung up with an amused shake of her head. Jory was incorrigible. Maybe that’s why I like her so much, Melissa thought. Lucky, carefree, Jory. With nothing more serious on her mind than a chemistry lab.

Michael popped his head around her door frame. “Up for some company?”

Delighted to see him, she lifted her arms for a hug. “I thought you were working this afternoon.”

“I’m between jobs. Also, I have class tonight, and I didn’t want to go an entire day without seeing you. Mom says she’ll be up this evening. How are they treating you?” The lightness left his voice.

She rubbed her hip gingerly. “I’ve had better times in my life. But the sooner I get all this testing done, the sooner I can get back to a normal life.”

He tugged affectionately on a hank of her hair. “You look pale.”

“Michael, there is something I want to talk to you about.”

“Name it.”

Melissa fidgeted with her covers. “The money for all these tests. How’s Mom gonna pay for all this? It isn’t exactly built into our budget.”

She saw his blue eyes, so like her own, take on a look of concern. “Mom has a good insurance policy. It’ll pay for most of this.”

“But we’re talking about major bills. Even the balance after insurance pays its share will be hard to afford.”

Michael tipped his head and smiled. “Why don’t you read these fashion magazines Jory brought and stop worrying your pretty head about hospital bills?”

“Look, Michael, if I’m going to get that National Merit Scholarship I can’t numb my brain with fluff about designer labels and the latest hairstyles.”

“And you can’t afford designer labels either,” Michael teased.

“You’re making fun of me,” she snapped.

Michael hugged her and kissed, her forehead. “Not at all, Melissa. I think you’re beautiful. And brave, too. I’d kick somebody’s face in if he tried to stick needles in
my
bones.”

The blatant admiration in his voice made her own voice stick in her throat. “Don’t be such a baby,” she said, attempting to hide her embarrassment.

He laughed and kissed her goodbye.

Later that night, after her visitors had left, she
caught a glimpse of the boy Ric walking past her room. She quickly averted her eyes and held her breath, hoping he wouldn’t follow through on his promise to visit her a second time. She didn’t like him and she didn’t want to know him. Luckily, he passed by without even glancing inside. She sighed and scooted down under her covers, wearied by the rounds of testing and the gaiety she felt compelled to show her visitors.

She hated to have her mother worry. Melissa was worried enough herself. She wanted out, wanted to go home and resume her regular schedule. They’d have some of the test results back by the morning, according to Dr. Pace. Until then, there was nothing for her to do but wait.

Two doctors came midmorning, while she was engrossed in her history book—Dr. Pace and Dr. Rowan, a bear-size man with bushy brown hair and large, strong hands. Behind them stood her mother and Michael. Melissa’s surprise at seeing her family gave way to apprehension immediately. Her mother’s face was pasty white.

“So many of you?” She gave a nervous twitter of a laugh. “Will it take two of you to hold me down for today’s tests?”

Dr. Rowan said, “No more tests, Melissa.”

“Mom? Why aren’t you at work?”

“I wanted to be here when they talked to you, so I took the day off.”

Fear tasted metallic in Melissa’s dry mouth. She dipped her head, struggling to catch Michael’s eyes, but he refused to meet hers. “Okay. So it’s more than anemia.” Why was her voice so high-pitched?

“Melissa, it isn’t a common anemia. Or mono.”
Dr. Rowan grasped her small hands, and she could feel the strength of his.

“Or rheumatic fever,” she pronounced insightfully. Her gaze fastened onto the front of his lab coat, spotlessly white except for a faint brown stain on the pocket. She wondered if he knew that the pristine whiteness was marred by that single spot. “All right. I give up,” she said, a bit too brightly. “What do I have?”

Dr. Rowan’s unswerving gaze trapped hers and held it. “The diagnosis is lymphocytic leukemia, Melissa.” His voice sounded clinical and very far away. “It’s a form of cancer.”

Melissa laughed. Dr. Rowan sounded absurd, and her family, hovering around her bed with stricken expressions, reminded Melissa of a silent movie. She quickly sobered and said, “I don’t believe you. You must have made some mistake. I’m sixteen years old. How can I possibly have leukemia?”

Dr. Rowan gave her hands a slight squeeze. “The bone marrow aspiration confirmed it, Melissa. Leukemia is a blood disorder. It occurs when young white blood cells formed in the bone marrow reproduce abnormally and crowd out the normal ones. They take up the space of the red blood cells and the platelets. Platelets cause your blood to clot normally, and because your supply is low you’ve been bruising easily. Without enough red blood cells to carry oxygen, you become anemic. That’s why you’ve been so tired all the time, and why you look pale.”

Melissa only half heard him. She didn’t care how many facts he produced to back up his diagnosis. She didn’t believe him. “Maybe the tests were wrong.” She withdrew her hands from his and folded them primly in her lap. “Tests can be wrong, can’t they?”

“Sometimes. But not in your case.”

Melissa glanced around him to her mother’s face, where she saw the truth. “Oh Mom … ”

Her mother wrapped her in her arms and held
her tightly. “Well fight it, Melissa. You’ve got the best medical help available. And we’ll fight it.”

Dr. Rowan cleared his throat. “Medicine has made great advancements over the past few years in the treatment of different kinds of leukemia. Although we have no cure for the disease, we do have very sophisticated ways of dealing with it. The important thing now is to begin treatment as soon as possible.”

“What kind of treatment?” Melissa’s voice quavered as she asked the question.

“Traditional treatments include chemotherapy. That’s when we bombard the leukemic cells with large doses of powerful cancer-fighting chemicals … ”

“I know what chemo is,” she snapped. “I read. I’m not stupid.”

Dr. Rowan continued patiently. “Once we initiate chemo, we’ll expect an improvement. It will take several days to establish the right combination of drugs, but our goal is to get you into remission as quickly as possible. Remission is a decrease, sometimes a reversal, of your symptoms. After we achieve remission, you’ll go on to maintenance.”

“Maintenance?”

“Yes. Once initial treatments do their job and healthy blood-forming tissue begins to regrow, you’ll take oral medication. You’ll only have to come to the clinic every few weeks for testing and possible further IV chemotherapy. The longer you remain in remission, the better your chances for a complete recovery.”

“And if there is no complete recovery?” Melissa’s mind was spinning, but the question popped out. Somehow, his words sounded ominous.

Dr. Rowan’s expression grew somber, and he touched her arm; his eyes were filled with deep compassion. “I believe in being honest with my patients,
Melissa. I believe in being truthful because it’s necessary for them to actively participate in the treatment of their disease. I’m not going to lie to you, but I won’t leave you without hope either. People
do
survive leukemia. If you remain in a continuous first remission for five years, we consider you cured.”

“And if I don’t?”

“We try for a second remission. We also consider a bone marrow transplant. That’s the grafting of healthy marrow from a biologically compatible donor into your marrow.”

Suddenly, Melissa felt overwhelmed by too much information that threatened to split her head open. She couldn’t stand to hear any more that Dr. Rowan had to say.

Mercifully, her mother interrupted. “What are you going to be doing for Melissa right now?”

“Today we’ll do a lumbar puncture. We’ll take fluid from around Melissa’s spinal cord and examine it to determine if the leukemic cells have invaded your central nervous system. That test will also help us decide on the best combination of drugs to begin fighting your leukemia.”

Melissa understood that suddenly her body had become a war zone. Her internal defenses no longer controlled what was happening inside of her. “When will you start the drugs?”

“Tomorrow.”

“So soon?”

“Clinically, the disease progresses rapidly. We must begin treatment immediately.” The pressure of his large, warm hand on her arm made her nod almost imperceptibly.

“Do it,” she said, gazing toward her mother and Michael. “Hurry and get started. I want to go home.”

*  *  *

Melissa lay curled in a fetal position on her hospital bed. She felt empty. How long had she cried? An hour? Two? After the lumbar procedure, she’d been returned to her room. Someone brought a supper tray, but it sat untouched on her bedstand.

“You should eat, Melissa. You have to keep your strength up.” Her mother’s voice caused her to stiffen.