"Okay, you can hop up on the bed and then hand me your leg," the imaging tech said to Leo.
As Leo did as instructed, the tech continued, "Your PET scan will take 45 minutes to an hour. You'll have to be still the entire time. If something is wrong, we can hear you in the control room, so just tell us. You aren't claustrophobic, are you?"
"Nope."
"Any metal on you? Piercings? Bone screws or plates?" the tech continued.
"No, no, and thank goodness no. Just the leg, which you now have."
"Right," the tech said. "Alrighty then, let's get you situated on the bed and then we'll start the scan."
Leo settled himself as best he could on the hard, narrow bed that would soon slide into the cylindrical hole in the PET scanner. From experience, he knew the room was kept cold to combat the heat produced by the machine.
"Can I have a blanket?" he asked the tech.
"Sure thing. I'll be right back with it."
The imaging tech quickly returned with a blanket and spread it over Leo.
"Anything else?" he asked.
"I'm good, thanks," Leo answered.
"Okay, see you in about an hour."
The tech closed the door to the room as he left. A moment later, Leo heard his voice over the intercom. "Still doing okay?"
"Yep," Leo answered. Always impatient, he added, "Let's get this thing going!"
"Alright, I'm going to slide you into the scanner now." Leo heard whirring and felt the bed under him move backward toward the opening in the scanner. When he was positioned inside the machine, the tech said, "Okay, the scan is starting now."
Leo closed his eyes as the scanner began its job. A PET scan really wasn't that bad, as scans go. Sure, he had to have an IV with radioactive contrast and be really still for an hour before the scan, but the actual scanning part was fine. The machine wasn't exactly quiet, but at least it didn't make obnoxious knocking noises like the MRI machine. Now that was an annoying scan. He couldn't get any good thinking done with all that knocking going on.
Now that he had an hour of uninterrupted time on his hands, he let his mind drift. He tried to drift toward thoughts about soccer, specifically why the new US coach didn't play the great Landon Donovan in the last World Cup, but his mind kept drifting back to three months ago and the last time he saw Emma. Had it really been three months since she left the hospital with her father and stabbed him in the heart with her icy farewell? "It was nice to meet you." It was nice to meet you? Yelling at him, cursing him, heck, saying nothing to him would have been kinder than it was nice to meet you.
From there Leo's mind wandered to what Emma was doing now. He knew that she was back at Ocean Park, getting the help and treatment she needed. Maybe this time it would work. Maybe this time she would be honest. Maybe this time she would let her facade of perfection fall and allow the true Emma, broken and frightened, to emerge. He hoped so. He really did.
Leo must have fallen asleep, because the next thing he knew the bed whirred out of the scanner and the tech said over the speaker, "Great job. You're all done. I'll be there in a second with your leg."
Leo knew the post-scan drill. He had to wait two or three days for an appointment with his local oncologist, who would give him the results of both the scan and his bloodwork. If the scan was clear and his numbers looked good, he was free to live his life for another three months, until the next round of scans and bloodwork. If something showed up on the scan or his counts were off, well, he'd rather not think about that. He had about five months of NED status behind him. NED - no evidence of disease. See, in the cancer world, you don't use the term "cancer-free." Oncologists prefer the term "NED," which basically means that you still could have cancer; they (the doctors) just can't find it. You can be sure you have cancer, but it's a lot harder to be sure that you don't have cancer. Comforting, right? And then after five or ten consecutive years of NED status, you can consider yourself cured. Five months really wasn't that much compared to a decade, but that was where he was, and he was grateful.
After two days of waiting for and worrying about the scan results, Leo felt like he was going crazy. He did his best to go about his everyday life, going to school, doing homework, and hanging with his sister, whom he had missed terribly during his long hospital stay. Yet he had trouble doing all of those things because he kept thinking about his scan results. This was unusual for Leo. Typically, when he had a scan, or a test, or some bloodwork, he was fine waiting for the results. Maybe it was because his precious NED state was on the line that he was so tortured with these particular results. He decided to seek his sister's advice.
Leo found her in the kitchen making a snack and immediately began voicing his concerns. "You know, by now the radiologist has read my scan and probably typed the report. Maybe he's even sent the report. Maybe Dr. Lin has read the report. I bet she has. If it were good news, she would call, right? I mean, there'd be no sense in me coming in and taking an appointment time to get good news, right?"
"Leo! Calm down. Dr. Lin has never called with results before. What makes you think she would start now? Besides, your appointment is tomorrow morning. You've waited two days. You can wait until tomorrow morning," Leo's sister said, trying to console him.
"Yes, you're right. Of course you're right." He paused. "I'm just - I'm just - I'm just worried. What if the cancer is back?" Leo's voice was small and scared, which threw his sister. Leo was never scared. This was the kid who reassured everyone else before his big surgery. This was the kid who insisted on cracking jokes while in the chemo room. Leo was a force of nature, and yet, here he was, anxious about a relapse. Of course, when his sister thought about it, it made sense. When you're in the thick of cancer, when you're neck-deep in treatments and surgeries and sickness, you do what you have to do to keep going. There isn't time or energy to waste on being scared. But here Leo was, almost five months NED and three months out of the hospital, with something to lose. He had just reclaimed his life. It wasn't fair for the cancer to reclaim him.
She put on her best no-nonsense face and said matter-of-factly, "If the cancer is back, you deal with it. Just like you did before. And you'll beat it, just like you did before." Leo's sister was trying to be reassuring, but he still looked scared. She tried a different tactic. "Hey, what's that funny word Dr. McAndrew used to describe being worried about scans?"
Leo looked up and smiled. "You mean 'scanxiety'?" he replied.
"That's it! Do you have scanxiety? Do you feel scanxious?" his sister teased.
Leo laughed. "Yes, I feel super scanxious," he said with more than a trace of sarcasm. "Hey, that would be a great name for a band: The Super Scanxious. It could be made up of musicians who have had cancer. They'd have to keep canceling tour dates because of scans, though. And at least one of them would have to be bald."
"And maybe their tour bus could have its own PET scanner!" his sister imagined. "And instead of roadies they could travel with oncologists and nurses!"
"Don't forget the radiologist!" Leo added, laughing.
"Oooh, they could play at hospitals and cancer centers around the country!"
Still laughing, Leo said, "Okay, that's enough. I'm going to my room to finish my homework. Thanks, sis. I feel better now."
Leo did have every intention of doing some homework, but when he got to his room, he once again couldn't concentrate. In less than 24 hours he'd know his test results. In less than 24 hours, his life could change. Again. He hated that he was so consumed with worry and fear. He hated that instead of living his life, he was focused on some stupid tests that he had no control over anyway. He hated that he couldn't be just a regular kid. And he never would be a regular kid. Even without a relapse, he was facing years of scans and tests and bloodwork. And, as he had learned from a friend he made during chemo, also ahead of him were years of worry about any unexpected pain or lump. He would never have a stomach ache without worrying that the cancer had spread to his abdomen. He would never have a cough without thinking that maybe the cancer had metastasized to his lungs. Sure, he figured the level of worry would decrease over time. But it would never completely go away. He wanted to flip a switch and have all this worry be over for good.
Flip a switch. That's how he used to think Emma worked. He thought she simply could flip a switch in her head and get better. Press a button in her mind and eat. Now he realized that he couldn't even quiet his mind of worry for three days. How could she be expected to fix her mind after years of disordered thinking?
Leo opened his desk drawer and took out a letter Emma had written him several weeks ago. He had yet to reply. He didn't know what to write. He didn't know if there was anything he could write that would help. So he wrote nothing. He reread a portion of the letter for the hundredth time.
I want you to know that I don't blame you for not understanding me, for not being the remedy for all my problems. When you said that people don't pity me, you were right. People don't pity me. They barely understand my disorder; they barely comprehend the mental, emotional, and physical toll it takes on me. What most people don't know about eating disorders is that they are very taxing. Tiring. Exhausting. In every way. Sometimes I envy you, Leo. You had cancer, which is terrible, but at least people know how to respond to cancer. They know how to react, what to do, what to say. I bet people made meals for your family, sent you magazines and flowers and tins of cookies, asked your family for updates on your condition. No one did any of those things when I was hospitalized. Your friends came to visit you. They called and sent you funny emails and cards. My friends no longer acknowledge my existence. My own mother barely acknowledges by existence. So maybe pity is a good thing, Leo. Pity is better than nothing.
How could he respond to something like that? Everything she said was right. And now, with his slight, small, tiny glimpse into the pattern of obsessive thinking, he thought that maybe, just maybe, he understood her more than he used to. Because of these three days of anxiety and fear and unrelenting thoughts of his test results, maybe he had a taste of what a mental disorder is like. And he didn't like it. It was tiring. It was exhausting. He hated it. But his obsessive thinking would end when he got his results. When would Emma's end? Would Emma's end?
He wanted to write her and tell her all these things. He wanted her to know that he understood a bit more what she was going through. He wanted her to know that he was still her friend, her ally. He wanted her to know that she was not alone.
As Leo tried to sleep that night, the night before finding out his test results, he tried to think of all the good things cancer had given him. It was corny, he knew, to think of cancer as a gift. But maybe listing some cancer positives would bring him peace - and sleep. First, cancer brought his family closer together. That was good. Cancer introduced him to some amazing people, people who would be his friends for the rest of his life. Cancer made him realize that life is finite and that he shouldn't wait to do things he really wanted to do. Sure, it made him grow up fast, but it also taught him maturity.
As he drifted off to sleep, he realized that he was okay with either outcome the next day. He would be okay either way. As a nurse once told him, "Everything will be all right in the end. If it's not all right, it's not the end." If the scan was clear, he would continue with his NED life, and that would be great. If there was a spot on the scan, well, he would get through it. It wasn't the outcome he wanted, but with some luck, he would survive it.
His last thought before falling into welcome unconsciousness was that whatever news Dr. Lin delivered tomorrow, he would contact Emma. Either he would write her or, he supposed, see her in person as a fellow patient at Ocean Park Hospital. Either way, he was ready.