Chapter 6

Three straight-back chairs formed a semi-circle facing a large wooden desk. The desk was cluttered wih various medical textbooks, and models of human body parts. Don was finding it difficult to look at anything but faces, and he didn't like what he saw there. The doctor's face was carefully sympathetic, sort-of interested and detached at the same time. Don understood. He used that face himself a lot, in his own work.

His father's face was older. Infinitely older than it had been just a few days ago — and sad.

His brother's face was pale, but his eyes were bright, and fixed on the doctor.

Don didn't want to think about his own face, but he had seen it in the rear-view mirror on the drive over here. It was chiseled, determined, angry. It looked like it did when a particularly clever perp was avoiding his grasp.

"We begin with remission induction therapy," Dr. Stevens was saying. "This is a course of chemotheraphy that lasts between four and eight weeks; we begin testing your blood every week at the fourth week, to determine when you enter remission. And we are fairly certain that you will — over 90 percent of our patients enter a remission under this combination of drugs."

"Is it an outpatient procedure?" Charlie asked.

"It starts that way," answered the doctor. "It depends on how you react. At first, you will have someone drive you to the hospital daily, for three-hour intraveneous sessions. Your chemotherapy will include anti-nausea drugs, and you will always be given sort-of a "compazine booster shot" before you go back home. But I have to be honest with you. Your body is already in a weakened state, and chemotheraphy can be very difficult. If you have too much nausea, loose too much weight, develop a secondary infection like the one you have right now — you'll be hospitalized."

Alan suddenly found his voice. "Okay," he said, leaning forward, "let's say it's been four weeks and your tests show that he is in remission. Does that mean it's over?"

Dr. Stevens smiled to make the news easier. "Well no, Mr. Eppes. I'm afraid that means it's just beginning. Once in remission, we'll give Charlie a one-or-two week break from the chemo, just to give his body a rest. Then we start maintenance therapy — more chemotherapy, perhaps some radiation — to guard against loosing the remission. During both of these stages we are also conducting CNS, or Central Nervous System Sanctuary Therapy."

"I read about that," Charlie said, and Don wondered when, since he had kept all the papers and brochures with him. Don found himself almost smiling when he thought, "Charlie must be surfing the 'net again."

"It's basically just adding some drugs to our chemo cocktail," Dr. Stevens was saying, "maybe some radiation. In Acute Lymphocytic Leukemia, bad cells sometimes hit the road, and hide themselves in places traditional chemotheraphy doesn't reach, like the brain, or the spinal cord. CNS Sanctuary Therapy is a way to prevent those cells from forming secondary cancers, like tumours…"

"All right!" Charlie's voice was loud enough to make Don jump. Louder then he had heard it in days. "I told you, I've read about this. What else? What about…"

Don placed a hand on Charlie's arm, and looked at his face. For the first time since this all started, he saw anger there. Don thought he understood. Tell Charlie he has a cancer that may kill him, he'll shut down on you. But tell him one of those cancer cells might migrate to his brain, where it will steal his numbers…well, that's something else altogether. "Charlie," he said softly, squeezing his arm. Charlie abruptly stopped talking and lowered his gaze to the floor for a moment before looking back up, first at Don, then to Dr. Stevens.

"I'm sorry to interrupt," he said, his voice much more under control.

Dr. Stevens waved a hand, and smiled. "Quite all right," he said. "I've had people throw things at me. Anyway, back to your maintenance therapy. I feel that you have the best chance of a complete recovery — not just a remission — if we conduct a high dose systemic chemo with a bone marrow stem cell transplant during this time. This will require quite a hospital stay. You'll be in isolation for two to four weeks during the high dose chemo, which is designed to kill virtually everything but you. Imagine that you are a blackboard, Dr. Eppes — I'm sure you can do that!" he smiled. "The high dose chemo will erase all the chalk, but the board will still be there, to receive new chalk — or, in this case, donated bone marrow. The transplant itself only takes a few minutes, but you must stay in the hospital, isolated, until your new bone marrow begins to make its own blood cells; probably another two or three weeks."

This time Alan spoke. "Donated bone marrow?" he asked. "From where? Who?"

"Well, there's the National Marrow Donor Program," began the doctor, but then Don leaned forward to look past Charlie at his father.

"From me," he said. He looked at the doctor again. "I've read that siblings are often a good match."

He felt Charlie staring at him as Dr. Stevens responded. "Yes, that's true; and if you're a willing donor, we'll certainly test you for compatibility." He shifted in his chair and looked back at the chart he was holding. "But all that's a bit down the road. Let's get the first round of chemo done first, and get Charlie in remission." He read in silence for awhile, then checked the calendar in front of him. Finally he continued. "Ordinarily, I would be aggressive and start as soon as Monday, he said, "but since you are already being treated for an infection. I want to give those antibiotics a week to do their job. I'll have my scheduling secretary set up your chemo to begin a week from Monday." He glanced back up and took his time to meet each set of eyes individually, ending with Charlie. "Use this time wisely," he advised softly. "Figure out your personal plan of attack, the logistics of taking time off your job, arranging transportation, food, all of that. And get a lot of rest, let your body recover from this infection so that we don't have to delay even more." Dr. Stevens stood, leaned over his desk and shook hands with each of the men before he began to walk toward a door at the rear of his office. "Please, take your time," he said kindly. "I know this is a lot to absorb. See my scheduling secretary on the way out."

Don, Alan and Charlie sat silently for a moment before Charlie shifted slightly to look at his brother in the eye. "Don…" was all he got out before Don answered, "Charlie. You're my brother. What else would I do?"

Charlie stood slowly, and Alan also rose to help steady his son. Charlie had a headache, and rubbed at his temple with one hand. "It's not that," he said, as the three men walked toward the future. He stopped and waited for Don to take another step and catch up to him.

"Then what is it, Buddy?" he asked, concern shining in his eyes.

Charlie sighed, dropping his hand to his side. "I was just wondering," he said, looking at Don, "if I have your bone marrow, does that mean I'll develop a talent for baseball?"