Chapter 14: Diagnosis
"Alright, now just look up for me, niña." Dr. Alviso said as he held up a nasal scope to Leti's nose. "This won't hurt at all. It might even tickle a little, so don't sneeze on me, bueno?" Leti tilted her head back and grunted a little as the nasal prong gently slid into her nostril. The doctor peered into the little lens, checking the canal at every angle, and nodded. "Alright, now the other one."
When Dr. Alviso had heard that the Riveras had come bursting into the hospital in hysterics, he had just assumed they were there because of poor Mateo again. He was a sweet boy for sure but por Dios was he torpe! It was a shock, however, to see little Leticia bundled up in a blanket in her father's arms, dried blood smeared on her face and nightgown, while her mother was screaming at the poor receptionist for assistance. Thankfully it was a slow day today and there was no need to wait as the nurses whisked the little girl off on a gurney to the back room. In their haste her parents had forgotten to bring fresh clothes for Leti, so she was now donned in a hospital gown while her soiled nightgown was disposed of. Now they stood by nervously as they watched him look over their daughter.
Dr. Alviso put the nasal scope down and wrote his findings on a clipboard. "Well, there is minor trauma to the nostrils but nothing serious, just a little scrape. She must have just bumped her nose wrong in her sleep. Happens all the time, I do it myself."
"A little scrape?" Imelda asked incredulously. "But there was so much blood! It couldn't have come from a little scrape!"
"Si…" the doctor agreed as he stretched out Leti's arm to look at the numerous markings. "Leti, how did you get these bruises?"
"I don't know." Leti shrugged. "They just pop up. I don't even know when I get them."
"I see." He wrote that down as well, and then turned to her parents. "How is her appetite?"
"It's fine, I suppose." Imelda said. "She doesn't eat as much as I would like her to, and she rarely wants any snacks."
Again that was written down. "Leti, do you ever feel sore in your joints, like your elbows and knees?" At her nod he wrote that down. "Do you ever get really sweaty at night when you are in bed? And do you get any tummy aches?" She nodded again and he wrote the confirmation down.
"What are you writing?" Héctor asked nervously. "Do you know what's wrong?"
Dr. Alviso gave them a warm smile. "I can't say for sure, Senor Rivera. But don't worry, it might just be something minor. What I do want to do is take a few vials of Leti's blood to test, that way I can be absolutely positive." He scribbled something on a piece of paper and handed it to Héctor. "I'm writing you a prescription for penicillin for any infection Leti might have, but I would only advise taking it if she gets worse, better to be safe than sorry. She has a hundred degree fever, but I think she'll be more comfortable at home than here so I'm also prescribing you some aspirin to help lower it. It'll also take care of the soreness. And I suggest you ice her arms, legs and anywhere else she might be bruised."
"Alright, we will." Héctor nodded and. "Gracias, doctor."
"The nurse will be by in a few minutes to collect the blood. Feel better soon, Leticia!" Dr. Alviso waved at the little girl and left the room.
"How will they get blood?" Leti asked her parents. "Through my nose again?"
Imelda cringed and sighed sadly. "No, mija, they have to get it from a needle."
"What?!" Leti cried out, jumping off the high table and hiding behind Héctor. "No! I hate shots! Papá, please don't make them give me a shot!"
"Now, Leti…" Héctor said sternly. "You heard the doctor, it's the only way for them to see what's making you so sick." He felt her shake her head vigorously on his back, and he sighed before turning to pick her up. "Look at it this way, when we're done here we can go to the drugstore to get your medicine. And you know what that means…"
Leti perked up a little and smiled. "Helado!"
"Si, helado!" Héctor laughed as he put her back on the table. "What flavor do you want? Butterscotch, rum raisin, ooh maybe some maple flavored?
"Gross Papá, no!" Leti sneered in disgust. "Strawberry! Always strawberry! With nuts and whipped cream and chocolate sauce and cherries-"
"Ay Dios mio, it's not as if you haven't had cake every day for the last three days, now you want helado?" Imelda said with an amused smile.
"I tell you what, how about I go get your brother, sister, and uncles to come with us, as well as some clean clothes. You don't want to surprise Senor Chacón by waltzing into his store with your little butt sticking out the back of your shirt, do you?" Héctor laughed as Leti's face flushed red before kissing her forehead. He turned to Imelda. "Unless you'd rather go and I stay here?"
"No, you go, we'll be fine." Imelda said as she reached up and kissed his lips.
As Héctor made his goodbyes and left the room, his smile slowly faded as he walked down the hall. The doctor's words didn't calm him in the slightest. Children didn't just gush blood out of their nostrils and not have something wrong with them. A painful knot that he had never felt before was starting to form in his gut, and he feared it wouldn't fade away any time soon. But he had to power through it for his family, and especially for Leti.
It was several long days later before Héctor finally received the call they had been anticipating from the hospital. Leti's test results had come in and Dr. Alviso had requested that he and Imelda come as soon as they could so he could discuss it with them. They had been sitting in the doctor's office for about ten minutes alone until Imelda could take it no more.
"The man tells us to come as soon as possible and then he makes us wait?!" Imelda vented as she paced across the room. "Our daughter's health is at stake and he thinks now is a good time to have a cigarette break, or a snack, or just twiddle his thumbs for all we know!"
"Now Imelda," Héctor said soothingly, turning around in his seat to watch his agitated wife pace. "He's probably with other patients that need his help. You don't want to make a fuss like you did with the receptionist the other day, do you?"
Imelda glared at him with her hands on her hips. "Our daughter had blood pouring from her body Héctor, and that woman had the gall, the gall, to tell me to sit down and fill out some stupid papers?! Would they have made El Presidente fill out papers, no I don't think so!" At that moment the door opened up, startling Imelda as she smoothed out her hair and dress before turning sweetly towards the doctor. "Buenos tardes, Dr. Alviso."
"Buenos tardes, Senor y Senora Rivera. Sorry to have kept you both waiting." Dr. Alviso walked around to his desk with a thick folder as he slipped his reading glasses on and sat in his chair. As Imelda sat back down both she and Héctor noticed the deep frown on the doctor's face as he opened the folder, only increasing their fears. "Well, I wish I could tell you some good news, but the truth is it's very bad. We ran Leti's blood through all the tests, and she is showing a very high amount of abnormal white blood cells. This is what is known as leukemia, or more specifically acute myeloid leukemia. That's where these abnormal white blood cells form instead of healthy ones, which means there's less room for healthy blood cells and platelets to form-"
"I-I'm sorry," Héctor interrupted, waving his hand in confusion. "Leukemia, what is that, what does that mean?"
"Leukemia is a type of blood cancer, Senor Rivera." Dr. Alviso said sadly. "And a fatal one at that. I am very sorry."
Cancer. That was a word Héctor and Imelda understood. Cancer was a taboo word that only brought misery and despair to any family. That just didn't seem to mesh with their little girl. Leti was so full of life and laughter, the funniest and cleverest angelita. She loved to test out the tap shoes her Mamá had made by dancing to her Papá's new song alongside her sister. She thought all of her uncle's jokes were the funniest things in the world when they certainly weren't. And Matty. Sometimes you couldn't think of one of them without thinking of the other. They were inseparable, always getting in and out of trouble together, coming up with plans to outwit the school bully Sergio, and just being there for each other. To think that this sweet child was about to be torn away from them… No.
Imelda tried to clear her throat of the knot that had formed in it, but despite her stiff countenance her voice wavered. "Are you s-sure? There are no other tests you can perform?"
"Well, there are other tests, like a bone marrow test or a spinal test, but those are very painful procedures and we wouldn't want to put her through that." Dr. Alviso gestured to the documents on his desk. "Besides, these results are showing that Leti is in a very advanced stage, she might have had this for some time. Maybe months."
"What are you saying?" Imelda asked horrified. "Are you saying that we should have noticed this earlier? I mean I-… I did notice the bruises but I just thought she was just playing too hard! Oh, Dios!"
"No, Senora." the doctor said. "Symptoms of leukemia start out very vague, you wouldn't have known. No one could have, not until it gets this bad."
"Is there a cure?" Héctor whispered after finally finding his voice.
Dr. Alviso sighed, "Unfortunately no, Senor. This form of cancer has been around for centuries, but has only been named about eighty years ago, and then the different kinds named only thirty years ago. That's about all we know about it."
Imelda was livid. "This disease has been around for thousands of years and all you doctors have done about it is name it?! I don't believe it! There must be something you can do?!"
Dr. Alviso kept his cool. He was used to hysterical patients and parents. "Well, I myself can't help you from here on out, as I and my staff are ill equipped to treat this kind of disease. However," he flipped through the folder, pulled out a sheet and handed it to them. "There is a trial run of radiation treatments going on in Mexico City. It has shown some results, but I must warn you the cost is-"
"You know who we are, Tomas," Héctor growled, cutting off the doctor. "I am Héctor Rivera, the greatest songwriter in all of Mexico. She is Imelda Rivera, the most artistically talented, most revered shoemaker in Mexico. I don't say that with arrogance, those are just facts. We both make more money than we know what to do with so I'm pretty sure we can afford it. But even if we couldn't, I would sell every part of my body and soul if it meant I can let my daughter live for just one more day. So don't tell me about the cost, just tell me where it is and how soon can we leave."
Dr. Alviso paused for a moment and then nodded. "Alright, Héctor. I have a colleague who works at the General Hospital. I'll contact him to let him know that you're on your way." Then he smiled sadly. "I wish you all the best."
Two days later Héctor, Imelda and Leti were all packed and ready to go to Mexico City to start Leti's treatment. When they had sat down with the family for a meeting to discuss the situation, Coco had burst into tears and hugged her sister tight. Oscar and Felipe looked like they had aged ten years right then and there as they also came over to hug their niece. Matty, however, was stricken with fear. He had read books about cancer in the past and knew that it was nothing short of a death sentence. Despite his parents' reassurance that Leti was going to be getting the best treatment possible, he still slept with his sister in the same bed in a tight embrace, fearful that she would just disappear on him. Even now at the train station, he was terrified of letting his sister leave without him.
"Please Papá!" Matty begged with unshed tears in his eyes. "Let me go too! We've never been apart for that long before! I'll help her with anything she needs! Please, Papá!"
"Mijo," Héctor sighed as he hugged his distraught son closely. "Leti will be just fine. It will just be three months and then we'll be home in time for Los Posadas. And it will fly by, I guarantee. Besides you need to stay here and go to school, as well as make sure that Coco does her homework." He teased.
"What if something bad happens to her before then?" Matty whispered.
"Trust me mijo, everything will be fine. Just promise me you'll be a good boy while we're gone, alright?" Feeling his son nod on his chest he kissed his head and hugged him tighter.
Meanwhile Imelda was giving instructions to her brothers about the shop. "Make sure that Abril takes her lunch break when the others do. I don't care that she's watching her figure for her novio, I will not have her collapsing in the workshop again. Now, what am I forgetting?... Ah, si! You know about the bookkeeping?"
Oscar nodded. "Every Monday so the supplies will get here by Thursday."
"And payday is on Friday for the workers, with bonuses for the ones who pick up the extra delivery shifts." Felipe finished.
"Bueno." Imelda nodded before she hugged them both and kissed them. "I'm trusting you two with not just the shop but with my children as well. Make me proud."
"When have we ever not?" they asked in unison.
Coco wove a lace ribbon over and around the top of Leti's long braided ponytail before tying it up in a perfect bow. "Ta-dah! Now you're all set!"
Leti felt the top of her hair and smiled as she fingered the lace. "Your favorite ribbon! Gracias, Coco! But why? You said if I ever take your ribbons you'd cut my hair off to get them back."
Coco shrugged. "I just wanted you to have something of mine for good luck. And because I love you, even if I don't show it enough. I'm really going to miss bossing you around, though." Leti laughed and hugged her sister, not seeing Coco's smile fade as she held onto her.
The train gave a piercing whistle, startling the Riveras and setting them in motion. "Alright, we've all said our goodbyes. Our suitcases are already on the train, now we must get on as well." Imelda said as she took Leti by the hand. "We'll call once we get settled in at Ernesto's."
"Adios, mi familia!" Héctor said as he took Leti's other hand, and the three of them walked towards the door of the train.
"WAIT! I almost forgot!" Matty's yell made Héctor and Imelda pause long enough for him to race up to Leti, where he stood on his toes to give her a kiss on the forehead. "Feel better, Leti." As his sister stared at him with wide eyes, Matty lowered his to the ground and blushed. "It always made me feel better when you did it for me, I just thought-"
"Gracias, Matty!" Leti smiled and pulled him in for a long hug. "I feel better already!" The family was content to stay there for a minute to make the hug last longer, before another train whistle blew and Héctor was forced to pull the twins apart. More goodbyes were made, tickets were taken, and as the three of them settled in for the long ride to Mexico City, Héctor and Imelda watched sadly as the twins waved at each other in the window, with Matty racing and failing to catch up with the train, only to be lost in the billowing clouds of steam.
Ernesto opened the door to his mansion to greet his guests with a solemn smile. "Welcome back, my friends. How was the train ride?"
"A little taxing I'm afraid, amigo." Héctor said as he carried in his drowsy daughter on his back. Twelve hours on a train was uncomfortable enough even with first class compartments, but a little while after they had left Leti had started to feel dizzy and nauseous to the point where she suddenly vomited her breakfast onto the floor. This required a new seating arrangement for the three of them and Leti had slept the rest of the way there, weakly waving off any meals from the lunch trolley.
"Well, I'll have the staff carry up your things. Right now you must be famished." Ernesto said as he gestured to his goddaughter. "I didn't know if there were any dietary restrictions for dear Leti, but I've had a light supper prepared just in case."
"Can't I just go to bed?" Leti whispered against Héctor's shoulder.
"Mija, you haven't eaten since early this morning," Imelda said, not adding that whatever she had eaten had been thrown up anyway. "You have to eat and keep your strength up." Leti sighed deeply but nodded, and Imelda smiled. "That's my girl."
Supper consisted of a nice fava bean soup, grilled lime chicken and leafy greens, with the adults drinking white wine and Leti drinking milk. Imelda had even let her daughter take a sip of wine, and her over-exaggerated grimace of disgust as she gulped it down brought laughter to everyone at the table. For a moment Leti was her goofy self again. But all too soon Leti began to wind down as she slumped over to her side after only eating half a bowl of soup and two bites of chicken, moaning slightly in pain.
"Alright Leti, that's enough. You did good, mija." Imelda walked to the other side of the table and collected her daughter into her arms. "Forgive us Ernesto, but I think we'll call it a night."
"Of course, Imelda." Ernesto nodded to one of the waiting maids. "Fernanda, please escort Senora Rivera to her room and draw a nice hot bath for Leti, por favor." The maid nodded and as she walked off with Imelda and Leti in tow, Ernesto turned to Héctor. "How are you doing, hermanito?" He watched as Héctor didn't answer, but instead chug his fourth glass of wine down to the last drop. "That bad, huh?"
Héctor sighed. "I keep waiting to wake up and find out that this has been just a bad dream. That Leti will be out in the courtyard, doing cartwheels and screaming at the top of her lungs like she did when she was a baby. Healthy, you know?' Then he scoffed. "Healthy… Just one week ago I thought she was just that, when instead she has been slowly dying right in front of me and I didn't even see it! What kind of a parent does that make me, Ernesto?!"
"Well, you're asking the wrong person about that, Héctor, because I don't know a thing about parenting. But I know a good parent when I see one. And that's what you and Imelda are." He patted Héctor on the shoulder. "Have faith. Leti will beat this."
"Dios, I hope so… I can't imagine what I'd do if-" Héctor shuddered and buried his face into his hands, slightly trembling.
Ernesto sighed. "Look, if you need me to stay here, just say the word Héctor. I can postpone the production of the movie-"
"No." Héctor said as he sat up with a sniff. "No, those people are depending on you for work. We'll be fine while you're gone. You letting us stay here is helpful enough. I wanted Leti to have a comfortable environment while she was getting her treatment and you provided it. Gracias for that."
"Well, you know that I would move Heaven and Earth for you, Héctor." Ernesto said, and then smiled mischievously as he refilled Héctor's glass. "You look tired as well. I suggest you get some sleep, I've seen what happens when you don't and it isn't pretty."
That earned the first real smile from Héctor. "Please, I still think you made all that stuff up." He huffed a laugh into his glass as he sipped. "Santa Anna…"
But even after a full bottle of wine by himself, sleep did not come easy for Héctor. He lay there in bed with Imelda asleep by his side, feeling a little queasy and too many thoughts racing through his head. What if this radiation trial didn't work? What if Leti got worse and this really was the end for her? How was he going to plan for the funeral? Would he even be able to do it? He was so lost in thought that he almost didn't hear the bedroom door creak open.
"Mamá, Papá?" a little voice whispered from the darkness.
Héctor immediately sat up, swaying a little in his tipsy state, and vaguely saw the dark outline of his daughter. "Mija, what's wrong?"
Leti sniffled and said in a watery voice. "It happened again…"
Imelda was awake by now and hurried over to her daughter. "Nose or gums?"
"Gums." Leti said as she started to cry. "I tasted it in my sleep and I tried to wipe it away, but it was too late and now it's on Tio Nesto's prized silk pillowcase from Egypt! I'm sorry!" Then she weakly broke out into a sob as red spittle drooled out of her mouth and Imelda wiped it away.
"Don't you worry about that, mija!" Héctor soothed as he came over to her. "Ernesto doesn't care about that. He probably has hundreds of those pillowcases locked away in a drawer collecting dust somewhere! So don't let a little thing like that upset you."
Leti sniffled and her eyes glistened in the dark as she looked up at Héctor. "Can I sleep in here with you two? It's scary by myself."
"Of course you can." Héctor said warmly while mentally kicking himself. This was the first night she had ever spent without her brother sleeping in the bed next to hers, of course she would be scared in that large room with nothing but eerie shadows. They all settled back into the bed, with Leti in between them, and as she quickly fell back into a deep sleep Héctor and Imelda looked over her head at each other, with fear and uncertainty in their eyes.