Chapter 16

Charlie had been in the hospital for two weeks, and Don was no longer even trying to work. He had taken a leave of absence, so that he could stand and look at his brother through a window. Charlie wasn't allowed visitors anymore. Today, his father stood with him, rubbing his hand over his chin. Sometimes, when Charlie was awake, they could "talk" to each other in a new, sort of brotherly shorthand sign language that they were developing. Once, a nurse had helped Charlie over to the door, and he had held his hand up against the glass while Don held his on the other side, but that made Don feel too much like he was visiting Charlie in prison, and he didn't ask her to do that again.

Often Amita stood next to him, sometimes Megan, or David, even Colby had stood next to him. Don was so grateful for the people who stood next to him…but he probably didn't let them know that enough.

A third person joined them in the anteroom, and Don and Alan looked over to see Dr. Stevens looking through the window at a sleeping Charlie. In a few moments, he looked down at a chart in his hands, and said quietly, "It's time, now. Charlie's bone marrow is virtually destroyed. It's time to give him something to fight with."

Don brightened. "I'm ready," he said. "I'm already on a leave of absence. When can we do it?"

Dr. Stevens looked at him, then back to Charlie. "I know this is short notice," he began, "but one of my patients…well, I've had a cancellation. I can schedule you for the donor procedure at 10 a.m. Friday, but that's only one day…"

"That's enough," Don interrupted him. "I told you, I'm ready."

"Come with me to my office, then", said the doctor, placing an arm around both Don and Alan to herd them into the hallway. "I'll explain what we're going to do."

Once they were all seated in Dr. Stevens' office, he handed Don a diagram. "Marrow donation is considered a surgical procedure," he started. "We can use a general anesthesia, or a spinal block."

"I don't want to be fuzzy," Don said immediately, "no general. I'll want to get back to Charlie."

The doctor smiled. "I'm sure you will. Often, when we have more time, we have the donor deposit some of his own blood, and transfuse it back to him during the procedure."

This time Alan interrupted. "We're the same blood type," he said eagerly. "Can I give a unit for him?"

"That would be fine, Alan," the doctor answered. "We may not use it. Since Don has requested a spinal, he'll be alert during the procedure and can communicate with us how he is feeling. Of course, he'll also be receiving intravenous fluids. We'll have your unit of blood available, but we'll decide during the harvesting whether or not to use it. I'll set up a time for you to donate tomorrow, before Don's donation on Friday."

Alan smiled, happy to be able to do something, and Dr. Stevens turned back to Don.

"Now during the procedure," he said, we use special, hollow needles to withdraw up to 1 litre of liquid marrow from the back of your pelvic bones. This will immediately be processed and given to Charlie, through his central line. It will only take him a matter of minutes to receive it; for you, the whole thing will be over in a couple of hours."

"What about after?" Alan asked, looking anxiously at Don.

"He can expect to feel some soreness in his lower back for a few days," answered Dr. Stevens, "but most donors are back to normal routines in just a few days. As for the missing marrow, it's completely replaced within four to six weeks. Just try not to get a cold during that time," he smiled.

"And Charlie?" asked Don.

"Charlie will have regular post-transplant blood counts," answered the doctor. "When the bone marrow begins making its own white blood cells — usually within two or three weeks — we have a successful transplant."

Both Eppes men smiled, but the doctor held up his hand. "Now for the rest of the story," he said seriously, and Don and Alan felt the smiles slip from their faces. "Post-transplant infections are frequent," the doctor said. "Remember, he'll have no white blood cells to fight off anything for a few weeks. And no red blood cells at first, either," he continued, "so anemia is inevitable. He'll probably have to have several blood transfusions. The most serious complication we have to watch for is 'Graft versus Host Disease', or GvHD. This can be a major, life-threatening event." At the paling of Alan's face, he added, "Because Don is such a good match, I don't expect that."

Don cleared his throat. "When will we be able to see him?" he asked.

"I'm afraid you'll still be window-watching for the next two weeks," the doctor said, and he sensed their frustration and disappointment. "I'm sorry, but the isolation must be total for a while. Any post-transplant infection would be extremely difficult to treat."

The men were silent for a few moments. Finally, Don spoke. "I understand that." He glanced at his father. "We can appreciate that. It's just that we haven't been able to actually touch him for so long already…"

"I know," said Dr. Stevens quietly. "This is difficult for him, as well." After a few more moments, he added, "I'll be speaking with him this afternoon, telling him what I just told you."

Don understood the unspoken invitation, and turned pleading eyes to the doctor. "Can you give him a message from me?" he asked.

"Of course," the doctor answered.

"Tell him…tell him…" Don searched wildly for the words he wanted to say. "Tell him to hurry up," he finally finished lamely. "I need his help on a case."