Mothers' Day 2016

        Mothers' Day was easier than I expected. I experienced a lot of anticipatory grief in the week leading up to it, but the actual day was pleasant, including a luncheon at church and phone calls from my kids.
       Then yesterday in the shower I listen to WCRB. Cathy Fuller announces "The Moldau" by Smetana. This is one of my very favorites; I played it in the viola section of the New Hampshire Philharmonic back in the early 90s. As the piece begins with gentle flutes and soft pizzicato strings, my happy anticipation immediately turns into grief and hot tears. Music can do that to you.

       The first few weeks of May, two years ago, were some of the bleakest in the leukemia experience. I prefer short blog posts, but there was just too much going on to condense it into a short post. Please share the journey with me.


2 May 2014
Great news: the bone marrow biopsy shows signs of leukemia remission. He has so few bone marrow cells that another, confirming biopsy must be performed in about a week, but we are all hopeful that the process towards a bone marrow transplant can move forward.
3 May 2014
I take a Megabus from Boston down to Secaucus Junction, New Jersey, where my son, Matt, picks me up. He’s going to run a marathon along the Susquehanna River starting in Danville, Pennsylvania, literally the town I was born in (Geisinger Hospital, now a large regional medical center). I plan to walk a half-marathon.
May 3rd is a beautiful spring day and the brisk 13.1 mile walk along the river valley where I was born is a refreshing break from the stress of the past eight weeks. Matt finishes his 26.2 mile run in about 4 hours. I cover half that distance in about the same amount of time. Twice his age, half the distance: I’m proud of my accomplishment.
We drive to Perth Amboy, NJ, where Matt drops me off at my dad’s house. Matt will be in Bethesda with David a few days before me. Jim has taken the Friday night Megabus to visit David, who is in good spirits. Charlotte, Jim's mom, arrives in the afternoon. She comments that David is good at letting people know what he needs. David quips, “Well, yes, I’m the one who is the leukemia patient. I have the trump card.”
A detailed conversation with Dr. Mo clarifies that although attending physicians, fellows, residents, and nurses rotate with dizzying frequency, Dr. Mo is managing David’s case. He is in touch with a bone marrow transplant doctor at Massachusetts General Hospital and is making arrangements for a transfer there as soon as David achieves remission.

May 4, 2014
I go to 10 o’clock Mass with Dad at St. Mary’s Church in Perth Amboy. We have brunch at the Reo Diner in Woodbridge, then drive to Rahway Hospital to visit my brother Michael, who is being treated for a large kidney stone and subsequent infection. Michael is my only younger brother. (I have three older brothers and a younger sister.) He is severely intellectually disabled. As a child he was quite a talker and enjoyed special education classes in public school, but for all of his adult life he’s been unable to talk. He’s asleep when we arrive. I sit with him and my dad, half-watching a Discovery Channel piece on the “United States of Bacon”, in which a loud, obnoxious man goes to different restaurants all over the country, seeking the ultimate bacon delight. The first destination was Chicago, and I assume that place had won first place, but I soon realize the man only deals in superlatives. “You keep using that word. I do not think it means what you think it means.” [Princess Bride]. I love bacon, but this program is over the top in inanity. So I try to ignore the TV and sit next to Mike, gently and impotently rubbing his arm, his crewcut head, his hand. Looking at the PICC line and thinking about my other boy with plastic tubing. My other boy with the bald head, similar to Michael’s crewcut. Mind-numbing. When his lunch arrives, Michael eats voraciously, in contrast to David’s painfully slow hour-long meals with his esophageal pain.

May 5, 2014
I take my dad to a medical consult. He has minor surgery scheduled, but his lab work showed an elevated white blood cell count, so the surgeon insists he see a hematologist. Two months ago I didn’t even know what that was.
As we sit in the waiting room my cell phone rings. It’s Matt. David has a badly infected colon and will have emergency surgery to remove it. I feel torn between my two worlds: my 91-year-old widower-father and my leukemia-patient son. I explain to Matt that I can’t do anything at the moment but will take the next Amtrak train from Metropark, NJ to D.C. when we are done at this appointment.
       Meanwhile, the hematologist concludes that although my dad’s WBC is elevated, his unrelated surgery doesn’t need to be postponed.
When I get Dad home I make a reservation for the 129 Northeast Regional Amtrak train, leaving Metropark at 5:13 p.m. Arriving at the station, the 127 train, scheduled to leave at 4:36 p.m. is sitting on the tracks. I get on, call Amtrak on my cell phone, and change my reservation. Perfect. I didn’t stress myself by making a reservation for the earlier train, but I get on it.
I type in my journal: “David is in major abdominal surgery. His colon is swollen. They will remove his large intestine and hook his small intestine to a bag, which he will wear the rest of his life. Typing this threatens tears. I don’t want to think about it. I don’t want this to be happening. I want WiFi, which isn’t working on this train.”
Matt is with David. The anesthesiologist lets Matt hug David before the surgery.
6:24 p.m. The train passes through low country and across bodies of water. We’re in Maryland, north of Baltimore. The trees are soft and green. I get a little car sick with all the close trees and the swaying of the train. I open a Fresca. I type some more.
“I’m a bit numb. It’s all happening so fast. All of a sudden David’s life has changed again drastically. Removing the colon. Wearing a bag the rest of his life. On top of the chemo-induced sterility, which happened in Korea (and without patient consent, btw), the dangers of chemo, the dangers of killing all his bone marrow before a transplant, the dangers of the transplant, the long recovery. I’ve just got to stumble through this. Lots of people love me and our family and they are praying for us.
Sipping a Fresca. Keep breathing.”

5 May 2014
David's surgery to remove his large intestine lasted about three hours. The cause of the infection is c-diff (clostridium difficile). It’s a common microbe but between David’s low immunity and the competing species in his gut wiped out by antibiotics it has taken over his large intestines.
       Matt remains with David all day May 5, seeing David after the emergency surgery.

6 May 2014
The SICU (Surgical Intensive Care Unit)
I arrive by Amtrak and Metro Red Line around 8:15 p.m. It’s strangely comforting to be far away from home, and on a Red Line. I'm grateful that Matt had prepared me for the change in David. Looking into a brightly lit hospital room I see a pale, other-worldly face with impossibly smooth skin and prominent jaw. Matt had warned me not to come right into the room. In the hallway is a large plastic cabinet full of yellow paper gowns, grey gloves, and stiff blue face masks with thin metal strips to bend against the bridge of the nose.
       Although David stirs and even speaks during the evening, he’s incredulous the next morning when Matt tells him that I had visited.
Next day David is alert, with color in his cheeks. We have a constant stream of medical visitors at the SICU: the surgery team doing rounds, an oncology fellow, the GI team, the infectious disease team, a neurology resident, and nurses and students.

The gowns, gloves, and masks are protection for us and other patients: as David announces, “I’m a bio-hazard.” C-diff is a serious infection; everyone suits up to guard against catching it and spreading it. The foaming hand sanitizer, de rigueur on the 5 West hematology/oncology ward, isn’t effective against C-diff; thorough hand washing is the best defense, to wash away the spores.
David’s respiration rate is high, so he will spend a second night in the SICU, where they monitor him carefully and treat him with extra fluids easily.
Dr. Mo plans to do another bone marrow biopsy Wednesday or Thursday. If the results aren’t good, he will start more therapy immediately.