“Hi, Sam,” Karen said without enthusiasm. The vestibule opened onto three hallways, each colored a bright, happy color, and threeyear-old Karen Heller headed down the purple hallway without being told.
“Good morning, Sam,” Crystal said, apologizing for her daughter.
“It’s okay, honey, we’re old friends, Karen and I.” Sam smiled, and her eyes seemed to twinkle, unaware how sad it was for a threeyear-old to be old friends with a pediatric oncology nurse. “Dr. Ryan is running a little late, so just follow your little angel.”
Crystal found Karen slumped in a plastic purple chair, her arms folded across her chest, her mittens and hat discarded on the floor in front of her, and her face screwed up into a scowl. They were surrounded by that damnable color. Everything around them was purple — the carpet, the walls, the toys. Karen hated purple because purple meant pain.
“Honey, do you want to take off your jacket?” Crystal asked. Karen got up, stripped off her coat and dropped it to the floor, then slumped back into that horrible plastic purple chair with palpable resignation. “I brought your coloring books,” said Crystal, trying to entice her daughter out of her sullen mood. Karen brightened and reached for the crayons and books and then stretched out on the floor.
As Crystal watched her daughter silently color mermaids and giants, she cursed God and prayed to him at the same time. Karen was dying of acute lymphocytic leukemia, or ALL, as it was known. She had been diagnosed more than half her life ago and all she had ever known were hospitals, blood draws, and bone marrow exams. She had already survived two crises, but the odds were very long that she would survive a third. Crystal began to pray again, the words running through her mind with all the emotional energy she could muster, which wasn’t much. She had long ago lost any hope that God would personally intervene and save her little girl, but still she prayed, because if she stopped, there was only one thing left to do: accept the inevitable.
She was pregnant again, but she hadn’t yet told her husband, Ron. At very best, she was six weeks along, and if they did an early C-section at thirty-four weeks, they may be able to get some cord blood, with its lifesaving potential — if the baby and Karen were a match, if she carried this baby to term, and if Karen could last the twenty-eight weeks. Crystal was overwhelmed by the “ifs,” and her eyes swelled with tears. It all seemed so hopeless, so futile. She turned away from her daughter, pretending to look out the window.
“Look, Mommy, I drew Aladdin and I stayed inside the lines,” said Karen, tugging at Crystal’s sleeve.
Crystal dried her eyes and gushed over her daughter’s latest masterpiece.
Karen scratched at the feeding tube that was taped to her nose. For weeks, it had been the only way they could get nutrition and fluid into her, except lately, she had done an aboutface. She had been eating reasonably normally for the last several days and had actually begun to complain about being hungry. Her energy level seemed to be better as well. On most clinic visits, Karen had been too weak to walk down the hall, forcing Crystal or her dad to carry her. Today, however, there had been no question about her walking to the car or stomping down the long purple hallway by herself.
“Mrs. Heller, Dr. Ryan is ready for Karen now.” Crystal and Karen both looked up at an unfamiliar nurse. Karen’s heart dropped, and Crystal’s raced. He was going to give them the latest blood counts today. Her cell phone suddenly started to cluck, and Karen stopped mid-stride to cluck along with it.
“It’s Daddy,” she sung out.
“Yes, honey, it is. Now go sit down for a moment.” Crystal made the nurse wait; she had earned the indulgence. “Hi. We’re about to go in now. I guess he was running late. I’ll call you as soon as I know something.” She listened to her husband’s response and then said, “I’m trying to be. Love you.” She closed the flip phone and fought back another set of tears. “Okay, baby, let’s go.” She reached for her daughter’s tiny hand and followed the nurse down another ridiculously purple hallway.
The nurse walked them past the three exam rooms that Dr. Patrick Ryan normally used and led them to his private office.
“There has to be a mistake. We always see Dr. Ryan in an exam room,” Crystal said, panic filling her voice.
“He wants to see you in his office today. Is your husband with you?”
It was happening too fast, and suddenly Crystal couldn’t breathe. The corridor began to narrow, and the nurse took her arm. “Please just have a seat in there. Dr. Ryan will be here in just a moment.”
Crystal lowered herself into one of the sofa chairs. Everyone knew the routine. Good news was given in the exam rooms, bad news in the office. She couldn’t stop the tears now, and she turned away from her fidgeting daughter. She stared at a wall filled with pictures of smiling children, most of whom had lost their hair from various treatments, and to her horror, she recognized that many of the children whose pictures hung on the wall had already died. She wanted to throw up, and it had nothing to do with pregnancy.
Patrick Ryan walked in through his side door. Rail-thin and six feet four inches tall, he looked more like a beardless Abe Lincoln than a pediatric oncologist. His lab coat was rumpled, and his tie was crooked and stained. Dark black circles under his eyes told the world that he needed a good night’s sleep. He sat in his chair flipping through the pages of a chart, barely acknowledging their presence. Crystal waited, dreading but needing to hear what he had to say. He rustled through the chart one last time, confirming what he had seen earlier, and then finally closed the file. The name Karen Heller was stamped across the bottom tab. Dr. Ryan looked up at Crystal and was surprised by the anguish written across her face.
“Crystal, are you all right?” he asked with genuine concern.
“No, I’m not all right. Why are we in here instead of one of the exam rooms?” She began to cry uncontrollably, but didn’t break the lock with Ryan’s eyes.
“We’ll be going to an exam room in a few minutes, but before that I need to talk with you. How are things at home?”
“At home?” Crystal practically screamed. “How are things here?” She reached over and grabbed her daughter’s chart.
“I think you have the wrong idea, Crystal. You’re not here because I have bad news. I brought you in here so I could understand how Karen’s blood counts have normalized.”
“Normalized? What does that mean? She’s not having another crisis, is she?” Crystal’s eyes grew as big as saucers as confusion and fear entangled in her mind.
“Absolutely not. In fact, and I find this hard to believe, I can’t find any sign of leukemia in Karen’s blood smear.” He leaned forward. “I want you to understand what I’m saying. I don’t see any evidence of any abnormality.” He spoke slowly and emphasized each individual word. “Either past or present. It is inconceivable, unbelievable. I had the lab repeat the tests, but we got exactly the same results. I checked the blood myself, and the machines were correct. Karen doesn’t have a single malignant cell in her system. It goes beyond even that. Her liver and kidney functions have both normalized, and her nutritional state is exactly what we would want for a threeyear-old. By every objective measure, Karen is a healthy little girl.”
Crystal listened to Dr. Ryan, but the words made no sense. “How?” was all she could manage.
“I don’t know, but Karen is not the only one. She’s had the most miraculous turn-around, but there are two other children who seemingly out of the blue have erased their cancer. Have you or Ron had the flu this year?”