The biopsy was completed the very next morning, and everything that Dan had been told in advance by the doctor ended up coming true. Yes, it was a quick, simple procedure, and yes it hurt like anything, and yes it was cancer.
Ewing's sarcoma, to be exact. What had likely happened was that the tumor had started in bone (as this type often does), and in Dan's case this bone was a rib. That explained the terrible pain and fevers he'd been having for almost two months. The cancer had probably been there for considerably longer than that, but since Dan didn't start having the symptoms until later, there had been nothing to clue them in to its presence.
At some point down the line, the cancer had spread to Dan's lung—a common occurrence, albeit an undesirable one. This was what had been causing the terrible cough, and ultimately the hemothorax that had brought Dan into A&E just two nights ago—two nights that felt like years.
So now that the healthcare team had an idea of what they were looking at, the next step was forming a plan to eradicate it. Since the only place the cancer had spread thus far was the lung, Dan had a decent chance of survival—thirty per cent, they were told, or maybe even better. But the key would be starting chemo and radiation as soon as possible before the cancer spread anywhere else, severely diminishing Dan's already-questionable chances. They would attempt chemotherapy for several months, and then re-evaluate and go in for surgery if feasible.
So that's exactly what they did. Dan went back to the ICU after his biopsy and spent one more night there to recover completely from the anesthesia, and the next morning his chest tube was taken out, he was completely off of his oxygen cannula, and he was sent to the cancer unit to begin his therapy.
The cancer unit was much different to the ICU. The rooms were smaller, the beds were more comfortable, and Dan no longer needed to be hooked up to constant heart monitoring, nor did he have his blood pressure taken every hour on the hour—every four hours at most, he was told. He no longer had the chest tube, the oxygen, or the multiple IVs to tie him down either, so he was given the freedom to get out of bed by himself and wander the hospital as he pleased.
Phil could see that Dan was much happier now that he could be relatively independent again. He had traded in his hospital gown for his favorite Christmas jumper and pajama pants, so he was looking a bit more like himself as well. He was even permitted to get in the shower—a huge improvement over standing at the sink with a damp cloth and the supervision of a nursing aide, which had been the closest thing to a shower that Dan had had in days.
When Dan emerged from the bathroom after his shower, dressed in his own comfy clothes and his hair all spiky and wet, Phil couldn't help but smile. It had been a rough few days, and it would continue to be a difficult journey from here on out, but in this particular moment Dan looked like himself again.
Dan's first couple of doses of chemotherapy went very well indeed. His nurse would come in early in the morning to hang a bag of the drug du jour, as Dan jokingly called it. This would take a couple of hours to infuse, during which time Dan's vitals would be closely monitored, but then in the afternoon he was pretty much free. It didn't take long until both Dan and Phil knew the hospital like the backs of their hands.
Dan started out feeling pretty well—the pain from his chest tube and biopsy was quickly resolving, and the pain from the mass on his rib was kept under control by his scheduled meds—although he didn't even really need those terribly often, either.
Phil had started venturing away from the hospital more and more while Dan was sleeping or contentedly browsing tumbler in the lazy afternoons. Phil was no longer afraid of leaving his friend alone and coming back to find him in a bad way. Things were looking up.
However, as the chemo drugs built up in Dan's system over the next couple of days, they started wreaking the havoc for which they're famous.
Phil first noticed it (perhaps before Dan even noticed it himself) as Dan was lying in bed with his laptop, his morning chemo nearly finished. He was strangely fidgety, which was unusual for him once he'd assumed his "browsing position." He had only about a half hour left in his chemo infusion, and after that the two had planned on moseying up to the cafeteria for a late lunch.
But Dan's stomach had other plans. As soon as Phil had picked up on Dan's discomfort, all he could manage to do was worry. He didn't dare mention it, though—for the moment Dan seemed sufficiently distracted by the internet, and maybe if neither of them brought it up the feeling would pass.
It appeared as though Dan was following the same train of thought. As he grew more and more restless, his face took on a sickly pallor and a thin layer of sweat broke out across his forehead. He kicked the blankets off and scooted himself up in the bed. Then he pulled the blankets back up to his chin and curled up, balancing his computer on his knees. And not a minute later the blankets were back off again and he was lying flat on his back. It was obvious that he was feeling poorly and trying very hard to deny it.
Phil watched from his perch on the cushioned bench against the wall as Dan put his laptop to the side and sat himself up. Dan glanced over in Phil's direction, but quickly turned away once more when he realized that Phil was watching him.
Dan was now seated cross-legged on the bed, hunched over with his elbows resting on his knees. Phil could see the rise and fall of his back as he took a few slow, deep breaths.
"Phil, I don't feel so well," Dan said after a moment.
Damn you, Phil thought. You weren't supposed to say it out loud! But the words that actually came out of his mouth were more along the lines of, "Should I call the nurse? I'm sure she could give you something for it."
Dan shook his head. "It'll pass. I just need to focus."
Phil chewed his lip nervously. He really didn't handle vomit well at all, but if Dan was actually telling the truth, it hopefully wouldn't come to that. However, as Dan's slow deep breaths grew quick and ragged, Phil started to panic. His own stomach began to turn as he watched Dan's misery, and he had to turn away and shut his eyes. "Please let me call the nurse," Phil pleaded.
"Don't want to bother her," Dan whispered. "Anyway, I'm fine." The way he pursed his lips and panted through his nose, however, suggested otherwise.
Don't freak out, Phil willed himself as he scoured his mind for an excuse to get up and leave the room. He was just in the process of standing up when Dan's breath hitched audibly in his throat. Crap.
"Where's the sick bag?" Dan asked in a small, tight voice.
Phil scanned the room, frantically searching for the little blue plastic bag that the nurse had given Dan at the start of the infusion. Dan had tossed it aside, sure he wouldn't need it, but now Phil wished he knew where it was.
Dan gagged once, searching for any empty vessel he could find. He was tethered by his IV line so he couldn't make it to the toilet, but he didn't have any other option nearby. He gagged again and clapped his hand over his lips.
And suddenly, like a miracle, Phil found the sick bag at the end of the bed under the blankets. He thrust it under Dan's chin just as Dan's meager attempt to hold back the vomit gave way.
There Phil was, a self-proclaimed emetophobe, holding this little blue bag in his bare hands while his best friend retched violently into it. Nothing about this situation was okay with Phil, and he found himself gagging right along with Dan.
"Hold this," Phil commanded, picking up Dan's hand mid-vomit and thrusting the bag into it. Dan didn't look up from his present task; he just clutched the bag closer to his face, freeing Phil to flee the scene.
It was already too late, though, for as soon as Phil's hands were free he found himself holding them over his own mouth as he made a mad dash for the bathroom, shutting the door behind him in the hope that nobody would hear as his breakfast made an unsavory reappearance.
Once Phil had caught his breath again, he flushed the toilet and slumped against the wall, breathing heavily, his heart pounding in his chest and his hands shaking. He was frustrated with himself for acting so foolishly—how could his stomach betray him like that?
In the moments that followed, Phil noted that Dan was no longer retching. Instead, Phil picked up on a rather unexpected sound—Dan was laughing hysterically. Phil felt a fiery blush rise up his neck, coloring his face a deep shade of red. He was embarrassed, but that wasn't about to stop him from giving Dan a piece of his mind for laughing.
When Phil emerged from the bathroom, he was even more mortified to find that Dan was not the only one laughing—the nurse's face was painted with a smirk as well as she injected some nausea medication into Dan's IV.
"Phil," Dan cried, hardly able to speak. His face was as red as a beet as well, but from laughing so hard. "Phil, what on earth was that about?" He retched again, holding up a fresh new sick bag as he somehow managed to laugh and vomit at the same time.
Phil almost turned right back around for the toilet again, but somehow he found himself laughing too. This was quite possibly the most ridiculous situation he'd ever witnessed. He was still mortified, but Dan laughing maniacally whilst being sick was quite the sight to see.
"Dan, you're an ass," Phil declared, crossing his arms in front of him and trying very hard to look angry. He failed, a smile fighting its way across his face.
"You can't call someone with cancer an ass," Dan argued, still laughing but apparently done being sick for the moment.
"I'm not talking to cancer-Dan," Phil shot back. "I'm talking to asshole-Dan."
"Fair enough," Dan conceded, still chuckling quietly to himself as he leaned back against the mountain of pillows behind him.
Phil resumed his rightful position on the bench by the bed, still nursing his internal wounds of mortification, but also thrilled to see Dan laughing again for the first time in a while.