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 heldher 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
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 heldher 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
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