A/N: Hi everyone! So sorry for this chapter taking so long. But this is kind of the crux for the next little bit of this story, so I needed to make sure I was getting every part of this correct. You'll also see that this chapter is pretty heavy for a lot of reasons, and it just took more time to process through and make it be exactly what I wanted. Thank you for your patience :)
"Isn't this a bit extreme, Emily?"
Alison asked from my guestroom door as Carter and I hovered over the queen-sized bed in the room.
"Shh…" I whispered behind me, before turning back, "A little to the right there, Carter."
Carter moved his camera flashlight to his right to shine a light on Jacob's back, "And the Benedryl will really keep him knocked out?"
"It should." I shrugged, lifting up his left arm and dropping it only to watch it fall back to the bed. "Just to explain what I'm doing for you both. Using these two fingers, I'm feeling up and down his spine to try and locate this first tumor. Because those assholes at Johns Hopkins said they 'needed a day' to gather his past scans, all I know is that somewhere along this medial throa – oh, there it is. Okay, so the tumor is located between the T7 and T8 vertebrae on his spine. For reference, these vertebrae effect nerve functionality in the gallbladder, diaphragm, intestines, liver, stomach, spleen, pancreas, appendix, kidneys – "
"So basically everything in his fucking torso?" Alison whispered, suddenly between the both of us at the edge of the bed.
"More like trachea to colon." I sighed, "I mean, good news is that it is pretty small, feels like a pea to my touch, and I do have to exert some pressure on his spine in order to feel in between there. Sharpie, please?" I asked behind me with my hand extended as Alison passed it my way. "So, now with my right hand, I'm going to keep track of the positioning while tracing the outline shape very carefully with my left. Carter, could you bring the light kind of parallel to my hand, but a little elevated from there?"
"Yeah, sure." He adjusted slowly, attempting to block the light directly from Jacob's eyes, "Do we all still think it was the best move to not tell him about this right away?"
"He's made it 6 months, Carter. He can make it another day or so." Alison mumbled.
"The way I see it, if the needles and everything freak him out, he doesn't need to know until right before going in. He was already terrified when we came into the waiting room to tell him we needed to come back tomorrow."
Alison reached to brush some hair falling into my eyes as she spoke, "He looked up at you with the saddest eyes as you told him, Emmy. I just want him to be healthy."
"We all do, Al." Carter looked over his shoulder, before facing me again.
"There we go. Can I get the ruler, please?" Alison passed it over my shoulder as I measured the length, width, and diameter of the tumor, calling out the measurements for Alison to jot down. "Okay, when you're done with that, if you could reach forward to place the ruler on his back so I can take the photo exactly 12" from his body."
"What does that do?" Carter asked.
"Well, if we're going to appropriately track these between his appointments so that J doesn't have to go in for a biopsy every 6 weeks, then we have to do the same thing every time. Control every variable. If we're actually going to see if to the naked eye the tumors are growing, we have to take these photos from the same distance each time. Using a standard ruler just helps us not fuck that up."
He cleared his throat, "Right, right. Medical professional versus a common citizen. I forget sometimes."
"I'm just so well-adjusted to everyday society, right babe?"
Alison laughed, "I wouldn't quite say that."
"Sorry for the joke. Photo is done." I passed the sharpie held between my fingers back to Alison. "Now the same thing but for the neck." I gulped, worrying about what I would find, as Alison noted that it was partially visible. As I lifted his hair, I could immediately spot it, a knot about the size of a gumball. "So they told you to not worry about this?" Alison nodded. "Alright. To compare, from sight alone this is a T2 tumor ranging in size between 2 to 5 centimeters. My best guess, without measuring, is about 2.8 centimeters or about an inch. That's close to the size of the two cancerous tumors found in his brain at age 3, but this one is next to his brain stem."
"That's bad news, I assume." Carter phrased it like a question, but we knew it was a statement that weighed heavy over us all.
I moved on to not get caught up in my own head, "To be specific, tumors in this area are called gliomas because instead of being made up of tissues found in the rest of the body, glial cells are specific to this area of the nervous system. From where this is located, it appears to be a focal brain stem glioma, which is good. They're slow growing and typically grow outside of the brain stem itself, making them easier to remove and treat. Doing observation is usually fine for these types of tumors, but not following up 6 months later with a biopsy still doesn't sit right with me. He's probably fine though, guys."
"Probably…" Alison whispered. I wanted nothing more than to grab her hand in that moment, but I was more focused on her son and ensuring he was okay.
"Would you recommend treatment?"
"I'd have to think about it. It's risky in general because of location. Ultimately, I think his doctors are making the right choice, with the exception of not doing the biopsy and claiming it was because a technician was unavailable." I paused, "Sharpie? Thanks for moving the light, Carter. Ideal medical assistant."
"Why, thank you."
"Ruler?" The room quieted down as I measured. "Ooh, 2.4 centimeters. I still got it –" I looked over my shoulder at Carter and Alison, "Sorry. That's probably insensitive."
"You're okay, Emmy."
"Just the photo's left and then we're all good. Here's the ruler, sweetheart." We all froze in place as I snapped the picture. "Now once we tell Jacob about everything going on, we'll no longer have to do this so intensively. But we should track the growth of these every 4 to 6 weeks, potentially more frequently depending on if any symptoms develop."
Carter switched off his flashlight, quickly pulling the comforter up Jacob's back as we settled in the hallway to finish talking. "What do you think though?"
"I wouldn't be very worried about the one on his back. It's very small and with the brain stem glioma not being cancerous in June, I would expect this one to not be either. The glioma is more important to track. But once again, the location on his brain stem is promising. If surgery was needed, survival rates would be good. Not great, but good. Because brain cancer studies for children are so new, they only really look 5 years out. Five year chance of survival is 90 percent with intervention."
Alison reached for my hand in the dark, "But didn't you just say that you might not recommend surgery?"
"It's just risky. I don't – "
"Baby, if it wasn't Jacob?"
But it was. She could ask me to take Jacob out of it a million times, and probably a million other times in my life, I had made an unbiased decision. But that was before his smile. That was before his laugh. His humor. His wonder. That was before. And Emily before Jacob was very different to Emily now. The Emily that now had to take a family into consideration. The Emily that now had to worry about Alison and Carter and Jacob and their families and my own. The Emily that now couldn't go back to who she was before.
"If it wasn't Jacob," I sighed, "I'd probably recommend surgery."
Her grip tightened, "Okay." She commented into the dark in hopes that her acknowledgment would send the fear away with it.
"Why is that?" Carter asked, worriedly.
"The risk." I gathered myself to keep speaking, not wanting to get emotional in front of both Carter and Alison. "If it did turn cancerous, the survival rate wouldn't be very good at all. It like –" I paused again, putting my hand on the back of my neck to try and hold myself together at the strings, "It drops – " I took a gasping breath as the tears starting to try and infiltrate, "It drops from about 90 percent to 10."
"10 percent?" Carter's eyes went wide.
"Yeah." I nodded, repeatedly.
"And surgery survival rate? You said it was good earlier, but didn't say the number."
"Between 60 and 80 percent depending on size and symptoms. From what I just saw, I'd say 75 percent without looking at a biopsy."
"So we're looking at 90 to 75 to 10 based on what we do. That's what you're telling me?"
"Yeah, Carter. That's what I'm telling you."
He turned around immediately, slapping his hands against his thighs, "Well, fuck me, then. We just can't catch a fucking break." He started pacing, "Um, I need to take a drive. Clear my head a bit?"
"That's fine, Car. Do whatever you need." She stood nearly catatonic next to me, digesting all of the information I had stated.
"Are you okay, Al? Is it okay if I go?" He asked over his shoulder halfway down the stairs. She nodded next to me before turning to walk into our bedroom.
I reassured him before following Alison into the room, "I've got her; it's okay. There's a key by the door that you can grab to lock up."
"Thanks, Emily. Really. Thanks for all of that."
But I had already entered into the bedroom where Alison had moved into the adjoining bathroom. She stood at the sink, splashing water on her face before mindlessly moving on to remove her make-up from the day. I didn't know how to proceed, so I walked to my sink to follow her lead. I glanced at her sideways repeatedly waiting for her face to show some feeling toward the changing news I had just revealed. But she stayed there stoically, putting on moisturizer as though the events of her day hadn't gone completely different than she had expected. Once finished with her nightly routine, she casually walked toward the closet. I followed her inside as item by item she unrobed. Not sexually, no intent behind it. But I could feel her starting to think. I could tell she was beginning to process through each part of the day. She was beginning to try and catch up. Each of us put on an oversized t-shirt and as she started heading back for the bathroom, I reached for her hand.
"What do you need?"
But she replied with a question, "How do I not think about it yet?"
"Maybe you need to?"
"And maybe I don't want to." She led me to the middle of our bedroom, to the open area of carpet between the door and the bed.
"That's okay. Um, what helps you not think, in general?"
"Being in your arms, Em." Alison's hand cupped my face as our eyes connected.
I turned away from her hand, "No, Alison. I'm not doing that again. We already talked about this, you can't keep using sex as a diversion from – "
She smirked, bringing my face back into her hand, "Not that. I'm not. I mean, neither of us are obviously in the mood. I meant that all I need is to be in your arms. I know it's been a few months but…" She leaned up toward my ear to whisper, "Emily, would you dance with me?"
"Dance with you?" A pout barely graced my lips at her adorable request.
"Nothing fancy. Just you. And me. Trying not to think." She silently wrapped her arms around my neck as I kissed her cheek, "Is that a yes?"
"I'd love to."
My hands started on her waist as she pulled herself into my chest, softly humming as we rocked back and forth. We fit into each other remarkably well. Her fingers worked their way into the bottom of my hair line, scratching the sides of my neck slowly as I closed my eyes next to her face. It was a lot more calming than I initially gave it credit for, slowly falling into a lull of comfort as time passed.
"You know, I lied to him yesterday." She eventually whispered into the darkness.
I leaned back to look up at her, "What's that, my love?"
"Being in your arms is actually the best part of my weeks. It's like there's a piece of my soul that doesn't find peace until next to yours. Like there is a wake within me that only quells under your touch. I said it was limited to just mine and your relationship, but I lied."
"It's the best part of my weeks too. You make all of this worthwhile."
She exhaled against me, "I'm really fucking happy we worked out our shit last weekend. You were right: standing on the same ground is more important than I gave it credit for. I think going into this week if we were still where we were, this would feel a lot harder for me. This would've made me feel more off-balance."
"I'm happy we worked our shit out too, Ali. As long as we keep talking, we'll be fine. If this is bad, Alison, and you know what I mean by that. If this is bad, you can't shut down on me. You need to ask me questions. You need to talk to me." Her body was still pressed against mine as we floated between our right and left feet gently turning in circles as we lamented our fears. "I need you to stay present with me. I'm not going to lose you to this. I'm not allowing you to lose someone who loves you, especially when it is me."
"Especially because it's you." She lifted her head at an angle to place a singular kiss against my jawline. "I'll have to talk to Carter. But if you recommend surgery, then I want him to have the surgery. I haven't fully processed it, but I trust you enough to know that if it's what you think is best, then it's what's best."
I lifted the side of her shirt with my thumb, tracing the side of her upper thigh, "Okay… there's a chance that if they can't get everything, or even if they do, that they would recommend radiation or chemotherapy as well."
"I understand that. Last time took nearly a full month to get him fully cleared from the hospital and that was for the side of his brain. So I can only imagine how long this might take."
"It'll depend on if there are any complications. Um, please talk it over with Carter, but if this happens, you should move in with me." I spoke the words into the air, not knowing if they would be picked up or allowed to drop to the floor. "You and Jacob, while he's recovering." I paused again to see if Alison would say anything. "And you know, Carter the weeks he would usually be in town if that's something you'd – I don't know."
Her head stayed tucked against my chest as we both swayed, "You want me and a 7-year old to move into your home, even if it's just temporarily?"
"Yes…"
"And sometimes, depending on the week, your girlfriend's ex-husband? In your home? All together?"
"Look, it's not ideal, but I'm not going to let you stay in a hotel or rent a house or something like that when my perfectly good home is right here."
"I'll talk to Carter, but I'd love to."
"Really?" My hand stopped, gripping her side with my fingers in excitement.
"Of course. Your support every day is exactly what I need. Maybe when Carter comes to town, I can split his hotel room with him or something. Because you may be okay with him staying here for a week at time here or there, but we divorced for a reason."
I laughed, pushing aside her bangs to kiss her forehead, "Absolutely whatever you want. I just want to be here for you if you need me to be."
"I always need you, Emmy." She leaned back, meeting my head for the first time in a few dozen minutes.
"Okay then, live with me." I kissed the side of her cheek just above the corner of her lips, "I'll move the desk down to the living room so Jacob can have a space that's his. We can make it work, and then you're not having to travel back and forth or anything. Just for his recovery."
"We'll play it by ear based on the next few days, but I think it would help a lot for our stability." She rested her hand on my collarbone as we continued to dance, "Is this a good enough date for tonight?"
I gasped, "I completely forgot."
"Yeah, I didn't even cancel our reservation."
"You made a reservation?"
"You'd think it was so cute. I did research."
"Research?" I pulled away, sweetly, "You know I love when you do research."
"I know." She scrunched up her nose, "I'll call tomorrow to try and reschedule, I guess."
"I can do anytime next week while you're here. I'll move whatever I need to aside."
"But this is enough for tonight?"
"Ali, I could sit with you in an empty room, and it would be plenty. So dancing with you, in our home, with Jacob soundly sleeping nearby, surpasses my every expectation."
Her thumb reached up to brush my cheek as stared at each other innocently. We held the world between our stare. The good, the bad, the beautiful. It was all encompassing. And with the glow in her eyes, part of me felt ease for the first time since hearing the news. With her, I was spellbound.
"You know, Emmy? Part of me knew some bullshit like this was bound to occur."
"And why is that?"
"Things were too perfect. We were too happy, too content, too at ease. Too – "
"Good?"
She nodded, "When everything is up, the only way to go is down. First Nana, now this. It feels like a lot, but at the same time, I'm not surprised. I'm not freaking out."
"I've been surprised by you today. Part of you feels… calm?"
"I was an actual terror last time, Emily. Sometimes a swift departure is exactly what you need. Maybe this will work out better for all of us. Maybe I'll be able to feel like I kept a piece of myself by the end of this."
"Well, I told you that I think he's okay. The surgery is tricky because of location, but Johns Hopkins is one of the best in the nation." I paused, letting everything further sink in, "If you're able to talk to Carter early tomorrow morning, you all may want to give consent for surgery while in the biopsy?"
"What do you mean?"
My hand once on the side of her thigh maneuvered up underneath her shirt, until my hand perched on the bare skin of her stomach, soothing her as much as I was attempting to soothe myself. "I don't know if you were a part of the conversation six months ago or 4 years ago, but you could consent to an open biopsy, where part of his skull is removed."
"Removed?"
"Yes, for better access to the tumor. The bone is put back and re-fuses, but you could consent that regardless of the biopsy results, they should complete the surgery."
"Tomorrow?"
"No, consenting for the surgery would delay everything. You'd probably need a second opinion, consent from insurance, and all that is involved. But then you wouldn't have to put him under anesthesia twice."
"What's the con?"
"If somehow it is now cancerous, we wouldn't know until surgery. So if it is cancerous, it could spread or be spreading."
"Wouldn't that happen even if we did the biopsy tomorrow? Wouldn't we still have to wait?"
"Definitely. It's just do you want to know in advance that his cancer could be spreading or not? But you save him the anesthesia and the potential anxiety and stress."
"So doing two surgeries is better for us and our fears or anxiety, but doing one is better for Jacob."
"That's one way to put it, Ali."
She replied without pause, "Then we only do one surgery. We always do what's best for him, our fears be damned."
"Our fears be damned." My reply echoed into the night as both of our sighs were the only thing carrying us through.
"Our fears be damned? Alison, he's seven. We can't make this decision simply based off of what's easiest for him? What if it's already in bad shape and just continues to get worse?"
"That would still happen regardless, Car. If I'm staying back with Jacob today, I need you and Emily on the same page later today. Emily will do whatever we want, but she does recommend only putting him under anesthesia once."
"Can you explain that for me then, Emily?" He called from the kitchen table as I was packing up my work stuff in the living room moments from walking out the door.
I walked into the door way to not be shouting as we attempted to keep Jacob asleep as long as possible the next morning. "It's not going to lower his overall life expectancy or anything, but any extended amount of time under anesthesia can impact brain development. It's safe, but any amount of time over 3 hours is risky. The biopsy will already take close to that and a full surgery would definitely go over that time. To me, one 6-hour procedure gives me more confidence than two 3-hour ones."
"But that's your professional opinion?"
"Yes, Carter. My professional opinion."
He looked at me sincerely as he spoke, "What's your parental opinion then?"
"Carter – That – It's not my responsibility to make that – I'm not his parent." I stuttered, trying to find a secure place to fit my words despite them struggling to escape.
"If you're going to be at the hospital with me today making this decision, then you're wrong. If Alison trusts you to take her place so that he doesn't have to go back in today, then you're his parent. Sure, maybe your parental opinion isn't equivalent to ours right now. But if you're there today, your parental opinion means more than your professional one." He looked at Alison for approval as she nodded his way. He mouthed, 'It's okay,' before turning back to me.
"My parental opinion is – It's the same. If he were my son, I'd want the least stress put upon him as possible, no matter the stress it put on me. I would carry the weight of the world for him to not ever feel an ounce of the pressure. He's already anxious about all of this. It's not – It's not fair to put more anxiety on him for our own sakes."
He stared at me seriously before cracking a smile, "Good answer." Carter pointed at me, while looking at Alison, "Where'd you find this one again?"
Alison slapped his upper arm, "Shut the fuck up." She started standing while walking toward me, my arms extending for her waist as she approached, "Carter and I talked this morning before you woke up, babe. He wanted to make sure you would be able to go into today's meeting with Dr. Ramirez and Dr. King with the ability to see the procedure from both sides. I told him that I had no doubts, but he felt like playing a game a little bit."
I raised my eyebrow at him, "Ah, so that was my pop quiz?"
"And you passed with flying colors." He stood up, walking toward me as well, "We're gonna do great in the meeting today, Emily." His left hand rested on my forearm, "Thanks for offering them a place to stay, too. You just keep coming through."
As he settled in to the living room, Alison kissed me softly, "Sorry about the quiz; it wasn't my idea."
"I passed, didn't I? It would only be an issue if I miserably failed."
"I knew you wouldn't." She kissed my cheek as her hands continued lightly groping my abdomen.
"So he's okay with you two staying here?"
"He's the one who actually brought it up this morning over coffee. He asked if I could ask you." She laughed, "He specifically asked if you would let us stay here if we helped you pay your mortgage. But I told him about our conversation and how I offered to help pay for half of his hotel rooms whenever he wants to come down for his time. So we evened it out."
I kissed her forehead before letting go of her waist and turning for the door, "See you at two, Carter?"
"For sure." He settled into the furniture relatively uncomfortably, still unsure about his place in my home. "And we're all still on the same page of talking to Jacob tonight?"
Alison leaned against the doorway into the dining room, her eyes telling more of a story than her words let on, "As soon as we know the news, he knows the news. Text me this afternoon if you have any questions, Em."
The smile I left them with dropped the moment I stepped out the front door. Anything but calmness and understanding in front of Alison would only add to the tension building inside of her. I had noticed it for the first time last night. That when we went to bed, her body draped over mine felt effortless to contain. She relaxed against my chest easily, her arm lackadaisically extended across my torso as her lips lightly moved against my chest as we spoke. But as I woke up throughout the night, Alison began getting more tense. Her arm drifted from the sheets to cupping my side to clinging to it. Her face content while we spoke turned into a grimace as the hours turned into a full night's rest. As pleasant as she appeared to be on the outside, the calm she projected faded in her dreams.
It's not that she was still hiding from the rest of the world though. No, to me, it felt like she was hiding from herself.
I threw myself into work knowing that I held the weekend in my grasp. That these few hellacious weeks could be put on pause around 2 pm Saturday. But at the same time, I floated around the lab with a different air. Emmanuel had already left for paternity leave as Dominique was due any day now. And above the fray, with no one else to question my choices or decisions as lead, I found myself losing my place, forgetting steps, retracing previous samples to ensure I had completed them correctly. My body was present, but my mind was with Jacob.
My brain swarmed around the potential unknown. My heart cascaded through ebbs and flows of emotion that soared into my dreams for him and plummeted into my deepest concerns. In him were my biggest hopes for humanity and in him were my biggest fears of the future. Because if something truly did go wrong with Jacob, a piece would malfunction in us all. Inevitably. Though memories and moments and thoughts and feelings tied all of us together too, the strongest strand containing the three of us was Jacob. He made our bond and our connection worthwhile. And though Alison and I had much more tied between us, I knew parts of that tie would crumble in the face of tragedy.
Sweat beaded down my forehead as I drove over to the Children's Oncology building parking lot at the end of my day. Carter was already in the waiting room pacing back and forth as I walked inside. His eyes dropped the moment we made eye contact as his hands settled into his pockets before giving me an all-knowing shrug with his shoulders. Both of us knowing that this upcoming conversation would be nothing if not unpleasant.
"How'd your day go?" He asked as we both turned to face the door the doctor would come out of to call us.
"It was shit. You?"
"Same." A pause lingered between us, "I don't know what I would do if Alison wasn't his mother. Jacob's the best thing in my life, but he'd be nothing without her."
I shifted my eyes toward his face full of worry. Wrapping my hand around his inner forearm to cling to him, I replied, "She did alright today?"
"More than alright. She gave him a great last day of thinking he's not sick, Emily. She runs laps around the two of us suckers." He chuckled.
"I think I'm okay if I pale in comparison to her. Next to her, I think I'm okay with second best."
He sighed as we stood there motionless, a deep understanding radiating through us that on the other side of those doors held a more difficult future. That our last moments of innocence for the disease plaguing their family were contained between the two of us: an ex-husband and partner of two months. Alison trusted us deeply and that trust held us together more than anything else.
"Mr. Schoen? Dr. Fields? Please take a seat." Dr. King pointed us to the opposite side of a conference room table across from three other medical officials. "Thank you for taking the time to meet with us today."
Carter muttered next to me as I rested my hand on his, "The pleasure is ours. We're looking forward to figuring out these next steps together and how to prevent the errors prevalent yesterday from occurring again."
"I wouldn't say that yesterday was an err – "
I held up my hand, "But we do. Your patient's family believes it was, and therefore, you all should treat it that way regardless of what 'you would say', Dr. Ramirez."
"Yes, of course." Dr. King reassured, "We understand that not following through with a biopsy on the glioma was an oversight. I'm sure that Dr. Ramirez mentioned yesterday that our usual technician was not in office."
Carter looked up for the first time, "She did, but from what Emily has told both Alison and me, every single one of you in this room has been trained in biopsy procedure as a part of obtaining your medical license. Is that not correct?"
"Just because we're trained doesn't mean we're available to complete the procedure."
"But then you notify the family ahead of time that a part of the medical plan you were going to complete that day cannot be completed. You give them the option of returning on a different day; you don't neglect to complete it and then pass it off as if all is well." I exhaled in frustration, "It doesn't matter though. We've moved past that."
I looked at Carter as he fumbled with the notecard in his pocket, before reading it off, "Our family has elected to request an incisional biopsy along with a surgical resection of Jacob's dorsal exophytic glioma to take place during the same surgery. We would also consent to an endoscopic third ventriculostomy should any brain swelling be present." He glanced my way to receive a reassured nod from me.
The doctors looked at each other back and forth across the table, before Dr. King spoke up, "You can't just elect for a surgery to take place."
"But Jacob's father can suggest that based on medically-reliable information, surgery would be best for his son." I spoke, candidly, "We all know that brainstem gliomas are dangerous, as are the procedures that surround it. I assume that a partial needle biopsy took place in June but those results are limited as it was not incisional or excisional. The only way to get a full picture of Jacob's glioma is surgery. You know that, you all have to know that." I could feel my blood pressure rising that discussing things I was passionate about led to me feeling overwhelmed.
"We do."
"Then all Carter – sorry, Mr. Schoen – is doing is requesting that while his son is already on the operating room table that you attempt to remove the tumor in its entirety."
"The contradicting point, Dr. Fields, is that there is no indicating information that an incisional biopsy is needed. His blood work came back – "
" – Please do not start a discussion of the meaning of blood work in accordance with cancer cells with me. It will not have the effect you want it to have." I could tell I was moments from exploding, that the fears and my passion were accelerating. Moments away from colliding with the inability to be contained.
"Enlighten us then, Dr. Fields."
I relaxed my shoulders, understanding that their pressing of me was a strange battle between who was right and who was wrong, instead of being about Jacob. This wasn't a competition for me. This was a fight for Jacob and Jacob alone. So, I sat quietly. I didn't respond; I refused to give in to whatever role they expected me to play.
"Dr. Fields?"
Inhaling deeply, I smiled, "Before disagreeing with me, you agreed that the only way to get a full picture of Jacob's glioma is surgery. You said that, and that verbal agreement is enough for the biopsy to be put in the books."
"I wouldn't – "
"No, you can't disagree with that point. It is a medically-indicated test as made apparent by your earlier confirmation in front of this room of people. It is a surgery and test that would produce usable information. The reasoning could be justified for insurance purposes as well. I'm sure that I don't have to sit here and explain why an incisional biopsy for a 7-year old with previous cancer history can be deemed medically necessary to literally any doctor in this hospital. There shouldn't be a discussion needed here."
"But we cannot guarantee – "
"Sure, you can't guarantee the need for resection of the glioma. I get that…"
"You do?" Carter leaned toward me, "I thought that last night you said the stuff about those percentages?"
"I know I did." I gulped, "But until they get in there, they can't know for certain if the resection it's medically necessary."
Carter's hand started shaking as he turned back to face the table, "I'm here for my son's survival. Not for his potentiality to survive. Not for a chance at him surviving this. I'm here in order for him to survive and for us to never have to step foot into these doors one day longer than medically necessary. That's the only medically necessary that I care about frankly. When the hell can my family and I get out of here? Correct me if I'm wrong, but if everything stays the same, Jacob has a 90 percent chance of survival, which allots for 10 percent chance of brain swelling or something else getting him first."
"Potentially, yes."
"Okay, good. And if his tumor is currently cancerous or becomes cancerous at some point during his life because you all want to keep it there, then his chance of survival drops to 10 percent. So in that instance, Alison, Emily, and I would literally be praying for brain swelling instead."
"It would depend on the severity of the cancer."
"Is my statement completely incorrect though?" Dr. Ramirez shook her head, "Okay, then. And going through with the surgery, regardless if Jacob's tumor is cancerous or not would drop his chances of overall survival to 60 percent or more?"
"We would need to look closer at his x-rays from yesterday, but 60 percent is a good guess."
"Then I'm so sorry for any medical opinion you have, but frankly I'm going to go with the solution that currently has my son's survival at six times the amount of the alternative. And if somehow that doesn't make logical sense, then I have no qualms of calling my father-in-law to explain the scenario to him. I'm sure it will make sense to him as well."
"I doubt that would be necessary."
Carter leaned forward over the table, pointing his finger at the four doctors across from him, "So then tell me why the inclusion of a man with money but no medical degree makes you all shake in your boots more than one of the leading professionals on cancer research sitting in this room and telling you the same damn thing?"
I stood, resting my hand on his shoulder, "Carter, sit down for me. It's okay if they don't want to admit fault. They don't have to admit fault here."
"I don't need them to admit fault, Emily. I need them to do right by our son."
He said our. I couldn't be certain that he meant him, Alison, and me, but he said it in a room of strangers. A room of people that would assume he meant the two of us. That he meant in this room, we were a united front. That next to me, he knew I wanted exactly the same thing.
Leaving the hospital that afternoon, Carter and I were depleted. After reviewing and consulting with all six of us over the x-rays, they had agreed to start the paperwork to be approved for the incisional biopsy, but at what cost? At what point had Carter and I lost something in the fight? Because walking out of there, neither of us felt victorious. As an employee, I had to park around the side of the building while Carter had the opportunity to park directly out front, so we casually waved while heading to our cars, knowing we would see each other shortly at my house.
And despite remaining strong and holding us together as best as I could, the moment my back hit the seat, I collapsed into tears. The weight and pressure of doing the right thing on the behalf of the welfare of someone outside of yourself was strenuous and taxing. And every moment caused anxiety. As if one choice may impact the future more than another. As if within that conversation, Carter and I had already determined Jacob's fate before even the next step had been taken.
My head fell against the steering wheel as I allowed my weakness to overtake me. To allow for a breakdown before needing to put it all back together again. I got why Alison couldn't do it. Why she had always stayed in the waiting room. Why she chose to ignore it. Because acknowledging it felt like the entire world around you was crumbling. Because acknowledging it meant that your reality was different than the dreams you built.
"Um, Emily?" I heard quietly echoing behind me, "Emily?"
I turned to the left to see Carter standing sheepishly in the parking spot next to mine as my mascara ran down my face. He held out a package of Kleenex and motioned for me to step out of the car with his other hand.
Not wanting to comply, I opened the door begrudgingly to reply, "I'm fine. I'm going to be fine."
He walked closer to the car as he spoke, "I remember my first meeting without Alison next to me. And how you don't know how you're going to tell her without destroying her. How you finally understand why it's so hard for her because she walks through life feeling alone, but you only feel alone without her by your side. I remember, Emily. So, I just wanted to bring you these and remind you that I'm here. That we did a good job. That we're a good team."
With that, he momentarily held out his hand to pass the Kleenex before I collapsed crying into his arms. Carter caught me around my waist as my knees fell toward the concrete below us. Remnants of snow fall from the days before hung at our feet as Carter lowered both of us to the ground, placing his hand behind my head for me tuck into his shoulder.
Gasping for breath I asked, "Please tell me this gets easier."
"It never gets easier… you just get stronger."
"And if I don't get stronger?"
"Then this will rip your world apart, Emily."
Getting stronger. It was a laughable thought to me because before meeting Alison, I would've sworn that I was as strong as I was ever going to get. That all of my past had prepared me for my present. But that wasn't the case. It turned out that once your heart was tied to someone else, your strength was tied as well.
"Emlee? What you finking?" Jacob asked with his hand on my cheek as I snapped back to reality.
I smiled as sincerely as I could force, "What do you mean, J? We're playing – " I paused to take in my surroundings and figure out how I had fully gone into my thoughts while in the parking lot with Carter and now was back home with Jacob and no one else around. " – cars. Cars, right?"
He nodded, looking around with me, "But you were crying? I wipe a tear wif my hand?"
"I was?" I leaned back to bring my hands to my face, collecting a few tears on the edge of my finger. "I guess I was, J. Today was a big day."
"Yeah, Daddy said we talk bout it waiter."
"Right. Right. And where did they go?"
"Dere on duh porch, E. Are you okay?"
"I'm alright, Jacob." I brushed my hand over his hair, placing a kiss on the top of his head. "How are you doing today though?"
"I'm pwetty good. Mommy and I did lots of fun tings today." His voice trailed as he went back to his cars, "E, if I ask you a kestion, will you telled me a twoof?"
"The truth? Yeah, I'll do the best I can. Why?"
"Is somefing wong wif me again? Daddy came in wooking sad and had to talk to Mommy wight away. And now you wook sad, and you never wook sad when you're wif me."
He knew. He could sense it. He had lived this before whereas the stillness in the air was new to me. The distinct feeling of a shift was palpable to me, so I could only assume he could feel it too. That he could feel the heartache. He could feel the pain before he heard it.
"Nothing's… wrong." I sighed.
"But somefing's changing?"
I put my hand over his at his heart breaking in front of mine, "Yeah, J. Something's changing."
"Okay." He whispered before looking back at his cars, barely moving them forward. "You still be hewe, wight?"
"Yeah, Jacob. No one's going anywhere, okay?" I looked around the room once more trying to find something else to cling to than Jacob's sullen words, "Not if I can help it."
"But E told me nufing was wong?" He looked up at me on the couch as if I had betrayed him. Alison sat to his left, nurturing him into her side as she consoled him as a way to console herself. Carter sat to my left diagonal from the two of them with his hand on Jacob's knee to tell him the scoop.
"Well, Bug. We don't know if anything is wrong. Honestly, nothing could be wrong. We could be making this decision for you, and you're perfectly healthy." Carter attempted to make it easy to understand. But no part of having critical surgery without full cause was understandable to a 7-year old.
"Den why do it, Mommy?" He tucked his head further into Alison's side, adjusting the way she was sitting in his attempts to pry an answer from her.
She sighed, looking up at me with tears brimming the bottom of her lids, "Jake, we don't want anything to happen to you. And right now, you might be okay, but if somehow this has cancer in it…" Alison paused, glancing at me and shaking her head to tell me to take over.
"J, if the glioma on your neck becomes cancerous, you might not survive it. Right now, it isn't that serious, but it could easily become very serious."
He shook his head furiously before we all watched him fall apart. His hands desperately hanging at his side turned into closed fists. And my mouth stood agape as Jacob wound backward and started hitting Alison's thigh as hard as he could. Over and over and over again.
"IT ISN'T FAIR! I DON'T WANT SURGERY! I DON'T WANT TO BE HURT! I DON'T WANT TO! DON'T MAKE ME!" He wailed as Carter pulled him away from the couch, his hands and legs flailed while Carter held him around the waist from behind. "DADDY! DON'T MAKE ME SICK! I DON'T WANT TO BE SICK AGAIN! PUT ME DOWN! PUT ME DOWWWWN!"
Carter held him firmly, completing a balancing act in the middle of the living room as Jacob threw his body weight back and forth. "Jacob, we know this is the last news you wanted to hear, but we need you to calm down. Calm down, buddy. We can be upset. We can cry, but we can't kick and punch."
"I HATE THIS. PUT ME DOWN! I DON'T WANT TO BE HURT ANYMORE! I HATE MY LIFE! I HATE IT HERE! LET ME GET DOWN! I HATE YOU, DADDY! PUT ME DOWN!" He grappled with the air relentlessly, appearing to attempt and reach behind him for Carter's hair and face as he screamed. But as he kept screaming, as he kept reaching, I realized what he was doing. "GET IT OFF! PUT ME DOWN! GET OFF OF ME!"
"Calm down for me, Bug, and I can."
"LET ME GET OFF! STOP, DADDY! PUT ME DOWN!
"Ali –" I urgently whispered to my left, "He's trying to grab his neck."
Her already distraught face. Her already downtrodden and tear-filled eyes flashed back and forth between me and him before I realized she was paralyzed with anguish. Before I realized that I was the one that had to take action and quickly because Carter was beginning to listen to Jacob's commands.
"Carter!" I shouted from behind him as I stood, causing him to jump, "Don't put him down."
"What are you talking about?" Carter asked, picking him back up just inches from the ground. Jacob started screaming again, instantly.
"He's not reaching for your face. He's reaching for the tumor." I spoke urgently as I walked toward them, forcing my hands onto Jacob's upper arms as I slammed his arms into his side, "J, listen to me. You cannot take the tumor off. You cannot touch it forcefully. Look at me, sweetheart. Make eye contact with me please."
His eyes were moving chaotically. His pupils completely shot as adrenaline pumped through his veins. Carter stared at me wide-eyed, gripping his son even tighter at my revelation.
"Jacob? Respond to me. Nod your head or tell me you're listening, please."
"I heaw, E." He was out of breath as he gasped urgently, still flitting his eyes back and forth despite attempting to make eye contact.
I tightened my grip on his arms as I spoke "The worst thing you could do right now is grab for your tumor. Do you understand me? Any severe amount of pressure would be very bad. Very, very bad, J." He nodded. "I get that you think no one in this room understands what's happening to you right now. And you're right, we don't get it exactly. We don't know what this exact emotion feels like. But at some point in our lives, we've all wanted to grab an issue by the throat because we think it's what's best. We've all wanted to be taken off the rollercoaster. No one wants to be hurt or feel hurt. It's human, Jacob. But I can't let you hurt yourself. Okay?"
"You felt wike your insides wewe scweaming afor?"
"Definitely. Multiple times."
"When?" He tilted his head, earnestly asking.
My head told me to not start speaking. It told me that telling Jacob about my pain was not worthwhile in the slightest. That my pain was futile to a boy who barely understood the love he could feel for someone outside of his parents. My head told me to not start speaking.
But my heart got to my lips first.
"You know before your mom met me, she loved your dad, right? Well, I have loved people before your mom, too." I glanced over my shoulder to smile at Alison, who was still stoically sitting, unable to process the view in front of her. "And one of those people, women, one of those women that I loved, I wanted to marry. I wanted to marry her very badly."
"You got diborsed too?"
I giggled, looking up at Carter, who was just as puzzled as his ex-wife at my speech to their son, "No. I just wanted to marry her. I bought a ring and everything. Well, one day I woke up and everything in the house we lived in was gone. All of her stuff just taken."
"Why would someone stealed your stuff?"
"Not just someone, my girlfriend at the time." He gasped in his dad's arms, "She left me with nothing weeks before I wanted to give her the ring I bought. And I remember the feeling you're having right now. My heart was racing, so fast that part of me thought it would jump out of my chest. It hurt really badly too. Like more than a stomach ache or something, my heart felt sick. My throat got really tight like I couldn't start crying or I would never stop. And, J, all I wanted was for that to stop. I wanted to go talk to her and figure it out immediately, but she wouldn't talk to me. She left and wanted it to stay that way. I had to wait until she was ready, too. But I was like you, I wanted everything to stop so quickly because I didn't see another way of stopping what was happening unless I took action. But I had to trust the process. I had to trust that even though she hurt me, that she maybe knew what was better for me than I knew myself."
I paused, inhaling before continuing, "So yes, Jacob, I don't fully understand what you're going through. But I do understand this feeling. I understand you wanting to hit the back of your head to make the feeling you're having stop. But I also need you to understand that we all made this decision together so that you hopefully are never sick again. None of us want you to have surgery, okay? And we all would've done anything to make that not happen. But we also have to keep you safe. We have to make sure that we do what is best for you. Not what you think is best. Not what you want to happen instead. We have to actually make sure we do what's best. You have to trust us, J. You have to trust your parents who love you. You have to trust me as a doctor. You have to trust all of the work I do in that lab every day. You have to trust that you mean the most to all of us out of anyone in the world. So please, Jacob, please trust me when I say to not put pressure on your tumor if your dad lets you down. Do you trust me?"
He nodded again, as I felt his arms quit fighting against my grasp.
"And you trust that we made this choice because we love you, and we want you to stay safe?"
"I twust you."
"And you're not going to hit your head?"
"I won't."
I let my arms go before standing up to look at Carter, "Where should he go?"
As Carter leaned forward to set Jacob down, he spoke, "You need to go apologize to your mom, first. Then we can talk more or go take a bath, we leave first thing in the morning." Jacob's feet touched ground moments later, his eyes falling toward his feet as soon as he felt back on solid land.
Snapping her direction to look up, Alison shook her head out as Jacob stood in front of her, "What was that?" She asked sincerely, not rationalizing our conversation yet, though to Jacob it signaled that he wasn't talking loudly enough.
"I said I was sorry fow being mad, Mommy."
She opened her arms gracefully, "Of course, baby. It's okay to be upset, but you can't scare us like that." She rubbed her hands up and down his upper arm while talking to him, "Talk tonight or in the morning about all of this?"
"I fink morning." He yawned, "I tired."
Carter laughed, swinging his arms to pick up Jacob once more, "Probably from thrashing in my arms for incredibly too long. Come on, Bug. Let's get you a bath."
As the boys climbed the stairs, Alison extended her hands out to meet mine, "So that was…"
"A lot." I shirked, pursing my lips together in frustration. "And you are…"
"Confused." She rubbed her thigh absentmindedly, "I think I blacked out there for a second?"
"More than a second, Ali. We were over here talking Jacob off the ledge, and you were catatonic?" I hesitated over my words as I lifted her from the couch. "But he's okay. He's traumatized by the whole thing."
"Traumatized…" It was like a past memory returning into her eyes, "His screaming. And did he?" She glanced down to her pants. "Did he hit me?"
"Many times, love. Why don't you go let the boys know we're headed to bed, and then you can come up and let me take care of your leg?"
"Do you think it's bad?" She laced our hands together, assuredly.
"I mean, he really wailed on it, but it can't be too terrible." I loudly exhaled looking down at her, allowing the stress from my last conversation to escape through my untensing shoulders, "You're back with us now?"
"Yeah, yeah." Alison smiled, kissing me gently, "I'm not sure what that was."
"It's the second time it's happened. You did it last night too. It's like you go blank."
She shook out her shoulders, "On the outside too?" I nodded, pulling her into my chest, "Cause it's like I stop thinking inside. But I thought I was still maybe outwardly taking action?"
"No, sweetheart, you don't move at all."
She pushed off of my chest, "Okay. Well, that's another issue for another time, Emmy. I don't know what that is, and I'd rather not find out mid-repeating traumatic scenario in my family. But don't worry, I'm still calm about all of this. I'm okay; I'm here." Alison smirked as she pulled me in for one more kiss, "I love you; I'll see you upstairs."
It's okay if Alison didn't know what it was. It's okay if she didn't want to find out right now either. But as all of her behavior flashes through my head, I knew that I some point she would need to know what I did. She would need to know what I had recognized from the first time she had the panic attack over FaceTime. But Alison believed she was doing well. She believed that her peace during my time of distress brought me comfort. I knew she believed that. But I also knew that at some point in time, she would need to know that her being calm in the face of her son thrashing in the middle of my living room. That her inability to act. That her tranquility among all this chaos was actually the scariest part of my entire day.
Seeing me knelt on the floor near her sink as she walked into the bathroom, Alison quickly removed her pants before sitting on the counter. One small bruise sat in the middle of still red marks on her right thigh. She winced at the sight knowing that her son felt angry enough to cause her pain.
"Better than I thought it'd be, actually." I smiled up at her before tenderly pressing my lips against her leg repeatedly, "Still absolutely beautiful."
"You're such a fucking cheeseball."
Ripping open an alcohol wipe, I glided it over her skin as she stared for a response, "I love you, too." I paused, kissing her knee as I reached beside my leg for pain relief. "This is called Arnica. It's an herb that's going to work on this bruising and potential inflammation. After this, you'll be all set."
It was a small act completed to remind her that I was there. An act to reiterate that she didn't need to be strong for me or calm for me. That together we were here to face absolutely anything at all. That next to her, with both of us ready to take on the world, we were unstoppable.
As I laid down that night, Alison crawled in behind me in attempts to be the big spoon. It was a rarity for us due to being several inches taller than her, but my arm instinctively reached behind me to pull her closer. She clung to my shirt as her lips barely touched my neck before tucking her head into my back.
"You've had a rough day today, Emmy." She kissed the base of my neck. "You've carried a lot."
My hand covered hers, lacing them together as I spoke, "He told you, didn't he?"
"We've all had a breakdown in that parking lot. It only makes sense that it was your turn." Alison whispered, tucking her left foot between mine. "You pulled it together to be there for Jake tonight though."
"Yeah, of course. We have to pull it together for him."
"You're right." She sighed again, feeling the weight of the day on her shoulders, "You wanted to know if it gets easier?"
"That's all I want, Ali. I want hearing news about him to get easier, to be easier."
"It's only easy when the news is good."
"So a lot of times it feels like you've been shot? Like your breath is escaping rapidly with no ability to inhale? Like you personally caused his future pain?"
"Yes, Emmy. That's what being a parent feels like most of the time. Constant anxiety. Ours is just magnified by the cancer of it all."
"Then why again am I supposed to want a child in the future?" I asked the question facetiously, but also hoping for as truthful of an answer as she was willing to admit.
"For every other moment. When they're sad or upset, yes, it's the worst feeling in the world. But their successes are your masterpieces. Their triumphs are your legacy. Their happiness means everything to yours. They are the only world that matters when it's good. And when it's bad, they are all you want in your world. It goes hand in hand, regardless."
"I'm sure it's worth it. But a few days like this makes you reconsider the dozens of great days that proceeded it."
Alison's right arm still wrapped behind my head, moved to adjust my hair, "You know, Emily, I'm sorry for bringing you into this."
"Into what?"
"I knew that this could happen again, and I just let you become a part of all of this without considering what something like this would do to you. We thought about you hurting us, but we didn't even consider us hurting you."
"You might not have, but I did. You didn't bring me into anything I didn't want to be a part of."
Her lips hovered over my shoulder blade, "You sure?"
"I'm positive, Alison. Even in all of this, I don't second guess us."
"All of this? Fuck, I knew you trying to juggle all of these changes would be too much."
I sighed, rotating to face her, "That's not what I meant."
"Then what did you mean?" Her hand cupped my face ever so slightly.
"Wherever you are, you are exactly where I'm supposed to be."
A/N: Alright, everyone. I wrote this over multiple weeks, so I'm sure that was a lot for you. We are moving right along though while heading into the holiday season (both in the story and in real life). I hope you all are enjoy the story so far, and I hope this tides you all over.
Also, I Posted this on the lAst chapTer as well, but I Recently startEd an exclusive, Original coNtent platform where all profits will go toward medical bills I have accrued over the past year due to an autoimmune disorder. Shoutout to my current top-tier supporter, SquishyAnon! Thank you so much for the support! If you so desire, please join, the first chapter of a new and exclusive story will be posted during the first week of the year. (That story will forever only be available through the platform, though I will continue posting chapters here as well!). If interested, you can find me on the site indicated by capital letters in the first sentence of this paragraph under this same username.
Hope you all have an excellent holiday season, and see you next time!
- secretpen28
