THE YOUNG PATIENT (last part)

“Hello Jen, I am sorry. I behaved like a jerk.”

“No kidding. What has gotten to you? Did you find religion?”

“I now know what if feels like to be sick and abandoned by your friend.”

“What are you talking about?”

“I was scared when you told me you were sick. I felt very uncomfortable with the idea.”

“I see.”

“I also broke my leg while playing football and I am at the hospital with a blood clot in the leg.”

“I am sorry to hear about your own illness. This can be a lonely feeling. People in good health have no clue what it is like to be sick. Young people especially regard sickness as a plague to flee from and they want to run away from anyone who is sick. Well, we all sooner or later will be sick, whether we like it or not. I can only hope you recover well and quickly. I have my own illness to contend with. I will see you around.”

“Does that mean you don’t want to hear from me? I admit I was a selfish being and I showed no compassion to you, but at least I now confess to it and I need your friendship. I want to reestablish what we started.”

“Well Rich, my priorities have changed over the past few weeks. I was crushed by your behavior, but I have gotten over it. You probably did not care much for me, and I was merely one more chick that a jock was having a fling with. Don’t expect me to look forward to being put in the same position again.”

“You are perfectly correct to feel this way. I guess I will have to prove otherwise to you. All the same I promise to keep in touch if you will let me.”

“Again, I will be busy taking care of my own issues. That is number one on the list. I suppose you can call and if and when I am not busy, we can talk but that is it.”

“Well, talking to you for now will be good enough.”

The call awakened some dormant feelings. Even though the infatuation was waning, or so she thought, the sound of his voice still brought butterflies to her chest and that stumped her.  She certainly was no longer as naïve as before, yet… She was thinking about this when the phone rang, it was Arlene. “So did it go well?”

“It was well worth it. I am so glad I went. I learned a lot from the other patients.”

“Good,” then Arlene continued “did you hear what happened to Rich? He was injured in a game. He broke his ankle at several places. He now has a blood clot in his leg and he is in the hospital.”

“He called me a few minutes ago from his bed at the hospital, apologizing and wanting to rekindle the friendship but I am not ready for this. He was just a creep.”

“So you know, right after the news broke that you were sick, he started going out with Megan. Word has it that they had a fight because she was double dating him; she had a relationship with another jock. They broke up one week before the injury. Just be careful with him. See you later.” Jennifer took the advice to heart and decided to place Rich on the back burner. At least that was her plan.

Welcome to girls’ talk where any news spreads real fast. The present and future looked brighter to Jennifer. Things were beginning to click together. She reached home and gathered everybody together at the kitchen. “I had a wonderful session with other patients, some of them are my age or thereabout, and there are several changes I need to make in my lifestyle. For one thing I need to eat more vegetables on a very regular basis. In fact, we all need to because mom will benefit, I will and all of us will also. Besides that, I need to start to exercise on a regular basis. It would be a good idea to walk as a group whenever possible. The last leg is the diet. I will have to cut back significantly on animal fats and sweets. The cancer cells feed off sugar and I have no intention of making life easy for them. So please mom, no more cheesecake or peach cobbler or ribs for that matter. It was fascinating to observe how much information I was able to get in just one session. The patients volunteer information freely and the atmosphere was pleasant and encouraged this kind of interchange. I am feeling really good about this whole thing. I need everyone’s understanding and help on this matter.”

As a result, the family decided to go along with the program: in for a healthy diet and routine of exercise; out for the consumption of a lot of saturated fats, animals or otherwise. Once the group decided to do it together, it made it that much easier. Jennifer felt that the pieces of the puzzle were fitting well. She retired to her room to do her schoolwork. Once she finished with it, she began to read the chemotherapy regimens. She saw that as a group they kill cells that divide rapidly; malignant cells behave as such. However innocent cells in the body like hair, skin, gut do the same and are susceptible to damage.  Being proactive made a lot of sense to her. Dealing with potentially lethal drugs mandated every precautionary measure.  She read all the literature provided to her by the doctor and was still ambivalent about radiotherapy. Her next step was to discuss it with her mom and see how she felt about radiotherapy. Except for this reservation, she felt very upbeat. The phone rang, it was Rich. She hesitated to answer it.

“Hello Rich, I can’t talk now, I am busy.”

After hanging the phone, she wondered if this was true remorse from him or crocodile tears. She was not in a hurry to find out. She went to sleep anticipating the next day’s procedure: the insertion of the special catheter. When she arrived at the hospital, she asked the surgeon to be ever so careful; she didn’t want to develop another infection behind a surgical procedure. The procedure went without a hitch and for the remainder of the time the catheter was inside her body, no complication ever arose.

She did everything by the book: she exercised regularly (walking and jogging), she curtailed her intake of sweets, animal fats and took her supplements as ordered. She had none of the dreaded complications like hair loss, diarrhea, numbness of the extremities or discoloration of the fingernails. However, she developed a nausea that was persistent. At times it was unrelenting and made her feel miserable. For a time, she was unable to eat or drink much and subsequently became dehydrated. She had to be hospitalized for it. In her room the second day, she received a bouquet of flowers from Rich. It gave her a  pinch in the heart. He was really trying, she thought, and it occurred to her that maybe she ought to give him a second chance. Just maybe. He also sent a card that said: “I can say I know what you are going through for I have been there myself. Yes, being sick is a lonely journey. I just want to be part of the inner circle that you can count on.”

This was nice, she thought. Being part of the inner circle was a different matter. It was not a God-given right but one that had to be earned. She was thinking about her past six weeks of life. She was a debonair teen and now she was dealing with a complication of treatment. She has tried as much as possible to prevent it but still she had one. She saw the silver lining as the fact that it could have been worse. Some patients have profound bone marrow failure and worse. She was determined not to shed a tear; it would be useless. It would not change anything. A covering physician for the oncologist came in and introduced herself. She didn’t stay long and did a cursory exam. Jennifer was nonplussed. She was accustomed to being properly examined and talked to by her treating physician. She was miffed.  A few hours later, she felt hot and had shaking chills. Her temperature climbed to 101.8 F. Blood tests were done. The next day when her regular doctor came in, “I am sorry to tell you the blood cell count has dropped to an alarming low level. I am afraid you have an infection.”

This was a disappointing news. Another complication. He did examine her and requested a chest X-ray because he heard some abnormal sounds over the lungs. “I want you to know that the covering physician stayed very briefly and didn’t examine me the way you normally do.” She emitted these words with quite a bit of bitterness. This was all the worse when the X-ray came back with a pneumonia, another complication. Then the sign of “Reverse Isolation” to protect her from others who are sick became affixed to her door. Anyone entering her room had to wear a mask and gloves. Suddenly, she veered from a young person with a healthy immune system to one with an abnormal one.  She couldn’t help but conclude she shared a special kinship with complications. All the positive core she had amassed to help her face the disease evaporated away instantly. She felt so vulnerable and needy. For the first time, she doubted whether the outcome would be to her liking. Her mind was drifting back and forth over her situation when her roving eyes stopped at the sight of the roses.

It was another fork, and she was wondering what she should do next, call him to thank him or let him come to visit or what. She was debating the point in her head when he suddenly appeared with a get-well balloon to boot.

“Hi Jen, I want to wish you a rapid recovery!” Rich was bubbling and his exuberance was infectious, festooned with a mask, gloves, and all.

“Thanks. That’s kind of you.” No support could have come at a more propitious timing. Jennifer felt a melting of the ice in a sense. Jennifer noticed that Rich’s body language was different in his approach; he was more attentive, and he appeared sincere.

“I owe you. I want to make amends.”

“You know what Rich, I don’t care for pity. This time I do have something catchy; it is called pneumonia. Feel free to run away from me as far and as fast as you wanna.” She said the opposite of what she was hoping for. She ever so subtly planted a bait and wanted to see what his reaction would be. Years later, she would wonder how she came up with this clever trick.

Instead of running, Rich took her hand and kissed it. “I did run once before, and I lived to regret it. I felt lonely on that hospital bed. The shoe was in the other foot. I want to treat you the way I would have like to have been treated when I was sick.”

She instinctively withdrew her hand after the kiss. She wanted, but was still fighting the tendency, to engage in mushy stuff with Rich. “Not so fast. He had to court you this time and earn his way,” an inner cerebral voice was telling her. “This is the type of balm you need,” her heart was telling her.

“I want to be honest with you and tell you the truth, the whole truth and nothing but the truth. I always did like you. After we had gone on the date and you told me about your condition, it just freaked me out. I couldn’t conceive of the notion of illness. When I met you in the hallway in school, I felt uncomfortable; your cold shoulder did not help matters. Instead of trying to patch things up, I compounded it by looking for pleasure and turning my back. Well, Megan was not loyal; she was also dating another football player and when I discovered it we had an argument and she laughed at me. When I became sick and was hospitalized, she sure did not come to visit. This was a wake-up call for me.  Being a strong jock doesn’t protect one from being sick. I look at illness now from a different angle. The episode also made me see how selfish my behavior was toward you. If for no other reason than to make amends, I am here today to confess my sinning. I want you back. I care about you, and this is the truth. In fact, I want you to get better so we can go to the Prom together.”

Prom? That was a real catnip, she thought. She could come up with all the reasons in the world to reject this offer. All the same she also appreciated the flattery in all its pith, the type of antidote her soul needed in this dire moment. She was too vulnerable and emotionally drained not to accept. She was recently romantically rebuffed too bluntly not to be careful.  It was obvious that as a jock who has his share of girls to go out with, she wondered how long his interest in her would last. She figured the best  way was to stall and buy time while at the same time wanting to say, “Yes!”

“Well, Rich, I have no way of knowing which Rich I am talking to now. Is this the result of a spurned ego by Megan or a contrite Rich full of remorse? Only you know. I do know this: I have come to terms with the fact I have this illness.”

He put the balloon on the windowsill. Rich pulled a chair so he could sit closer to Jennifer.  He gently reached out and held her hand. This time, she didn’t withdraw it. The warmth of his palm against hers did indeed bring a fillip.  “I am sorry. I was inconsiderate.” They remained in this position for a while. He kept gently rubbing her forearm with his left hand while holding her hand with his right palm. This unbidden companionship on this very day had a calming effect. So much that she took a quick nap.  When she awoke, a bit of embarrassment about napping in his presence slipped in, “Not so fast. Let me think about this.” Never mind that during the nap, images of her in a gown and Rich in a tux in a limo on the way to the Prom had given her a most welcome exhilaration.

“Well, my dear, take as long as you want. I do not want to rush it. I want you to feel comfortable with the choice you make.” He kissed her hand again. “I will come back tomorrow,” and he left. Rich’s visit did bring some respite that lasted till the evening when she fell asleep. Unfortunately, and in keeping with the trend, the respite was a short-lasting lull.

Jennifer had a stormy night; she coughed violently and had a fever of 102.4 F. Her oncologist requested a lung specialist to come and evaluate her. The specialist came in the evening. He was asked to see her ASAP due to her  history of complications and recent chemotherapy. He did a very thorough examination and asked a lot of questions. He changed the antibiotic regimen she was getting, gave more oxygen and ordered some agent to break up the mucous she was producing and also ordered some agent to open the airways. She gradually began to feel better.

Jennifer experienced first-hand the benefit of emotional support from a caring companion to counter a physical illness. The following day when Rich came, she was too sick to engage in much of a conversation. His hand-holding and gentle touch of the forehead and forearm did wonders to her soul. Rich supplemented the ineluctable motherly devotion with the unique deftness to rosin the violin bow that only a warm-hearted companion can provide.  The following night, she had fewer coughing spells and was able to sleep. Her condition improved on a daily basis till she left the hospital. While an inpatient, she meticulously checked the type of intravenous fluid she was getting, always declining D5W. Rich, on the other hand, visited every day, always making sure he kissed the hand. He accomplished by deeds what words alone wouldn’t suffice to convince and in so doing left a lasting good impression on Jennifer’s mom and her best friend Arlene. By the time she left the hospital, she and Rich had resumed their relationship.

Jennifer’s life was now moving in a direction she felt comfortable with; she had her boyfriend back, the chemo was on hold because of this most recent hitch. She will resume it once the pneumonia cleared completely and her condition warranted it. She no longer asked, “Why me?” but instead “How can I prevent the next complication?” At the first support group meeting. she discussed her experience with the pneumonia and wondered if anything was available to help the immune system. Someone came up with the idea of Epicor; the person stated that she noticed that adding it to the regimen did make a difference in reducing the incidence of upper respiratory tract infections. She decided to do some research about it and what she did find was indeed interesting. It was a readily found product, inexpensive, that had the property of boosting the immune system. She imagined that every little bit helped, and she decided to add it to the daily regimen; she couldn’t be too cautious.

As her condition improved, she resumed going out with Rich. At the same time, she had to make some changes in their culinary consumption. A pizza place to hang out at replaced the ice cream parlor. Avoidance of sweets remained a fixture in her mind. Water replaced soft drinks. Rich had to adjust to it. There would still be a crowd of high school teens at the new venue, sure to spread the news about Rich and Jen going together again.  She and Rich became close, and they called each other every day now. He became the shoulder on which she could now rest her head literally and figuratively. She became a loyal woman with whom he felt comfortable with. High school sweethearts they were.

A routine milestone in the life of teenagers held the importance of a capstone of her recent life ordeal. She couldn’t any longer assume that she would be healthy and ready to reach the altar called the “Prom.” Lately she has had a cascade of life-altering events: riveting but fleeting joy, wiped out, filled by melancholy, returning hope stunted by unexpected complications. The chemo treatment amounted to her personal cliffhanger. Would she be a warble singing the praises of her success or the siren cooing the blues? The dénouement of this dispiriting calvary kept weighing on her. She wanted to harness all the energy needed and the allure of participation in this celebration increased as time passed. She wanted to cackle so much with elation and not brood in commiseration and acting like a nervous Nellie. “No need to harrumph,” she kept reminding herself, “there is plenty of necessity to prepare for the worst and hope for the best.” That maxim became a sign-post affixed to the wall above her bed, her North Star as it were.

The remainder of the chemo went without any more complications. She also received radiotherapy. Her life has returned as close to normal as could have been expected. As school was progressing and the Prom celebration was becoming a closer reality, efforts toward its success multiplied. As has become the norm among teens, Prom doubles as epicurean both in cosmetic as well as cosmic proportions. This burst out of the seams of a cocoon known as adolescence carried this type of momentum.

No longer a virgin and now using a diaphragm and a condom as contraception with Rich respectively, she wanted to be part of such a hedonistic weekend. She teamed with Arlene and her boo and both couples rented a chalet for a weekend. Expenses were split, starting with the limo. Of course, Jennifer and Arlene encouraged each other to purchase the slimmest thongs and most risqué negligees to add spice to the excitement, jettisoning any leftover prudery. Of course, all this was under close wrap. Just in case if any of it was discovered by her inquisitive mother, she was ready to provide the riposte of the playful, “Why not me?” instead of the oft-expressed rueful jeremiad of “Why me?”

 

Reynald Altéma, MD

I published this short story in series.
This is the last part, however you can read the entire story by
clicking here

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