Bayside Café Chap 12
Too young! II
A/N: Before we go any further, I need to offer some words of explanation. Ellen, our heroine, will be diagnosed with IBC (inflammatory breast cancer). Breast cancer as a whole is a very complex medical condition. IBC is arguably the most complex of all types. Now this is fanfiction, not the NEW ENGLAND JOURNAL OF MEDICINE (NEJM). So, this author will simplify things. A lack of accuracy – from a medical point of view – will be tolerated. If that frustrates you – I apologize in advance. Not that I am trying to make outright mistakes. I am not. Relax, sit back and enjoy this story arc. It's tough reading, I know.
88888888
Waiting for the path report
Waiting can be the hardest part of life:
At the grocery store; Is that little old lady pulling out her checkbook? Really?
At the DMV; Surely they aren't going to let that child on the road? He should pass grade school first!
At the post office; How many Christmas cards does she have? OMG – I just saw the box on the floor at her feet!
At the drive-up teller; That old man just dropped his deposit on the ground! Now he wants me to back up? Doesn't he see the line behind me? I have nowhere to go!
At Starbucks; How many people is that yuppie ordering for? Just give her 10 Grande coffees, better yet a carrier – and get her outta my way! Does what's his name know about the service in his stores?
At home, awaiting your pathology report; can't the pathologist work overtime? I can! I do! WTH.
888888
Ellen is going crazy. Time seems glacial. Maybe stuck in molasses. Finally – day 4 – THE phone call.
It was supposed to be 2-3 days! Relax, dear. What do you mean, you can see me tomorrow at 4 PM? Give me the report NOW! It's me on the phone – see, ME! You can't give this kind of report over the phone? Why not? Regulations? Whose regulations? The State? SHIT! Princess phone slams down. We're gonna need a new princess if they keep this up!
8888888
4 PM NEXT DAY
DR. WELLS' OFFICE
When Ellen, Michael and Abby walk in they see Albert Brust already there. He stands to greet them. "May I join you, and hear the report?" He asks.
Ellen and Michael look at each other. Ellen nods, Michael doesn't object. Abby can't stand it! Let's get going, folks!
Shortly, they are shown to a conference room and are seated. Dr. Gwendolyn Wells joins them and goes over the path report; and the findings at surgery.
Ellen has "inflammatory breast cancer". This type accounts for 1-6% of breast cancer cases in the USA*. At surgery no discrete 'lump' was found; therefore a 'lumpectomy' could not be performed, per se. The surgeons did excise a significant portion of breast tissue, where the disease seemed to be centered. They did not have Ellen's consent for a full mastectomy. Gwen told Ellen that her prognosis was likely not affected by not doing a mastectomy. The 3 lymph nodes that were removed all had cancer cells. The breast tissue, and lymph nodes were all tested for hormonal responsiveness. NONE showed any positive effect to hormone therapy. Gwen paused, awaiting questions.
AB: So, there are already metastases?
GW: Correct, to three nodes. At least.
ED: What are my treatment options?
GW: Given the characteristics of the tumor, and the known metastases – I do not recommend further surgery.
ED: None?
GW: Well, if a complication arises that is easily addressed by minimal surgery – I would offer you that option. So, I recommend that you see an oncologist – and discuss chemotherapy and symptom control.
AB: Hospice?
GW: Probably, eventually.
Gwen gives Ellen the business card of an oncologist whom she trusts and recommends.
8888888
FAMILY, FRIENDS, TREATMENT
The three of them have a very substantive discussion with the recommended oncologist. After much family talk and prayer – Ellen decides to give chemo a chance. She agrees to 4 sessions; followed by an assessment of where she stands.
Albert and Elizabeth Brust have pledged their total support. Dr. Brust has made arrangements for Ellen to have a private room reserved for her use during each chemo infusion; after the chemo, she may stay up to 24 hours to allow her body to equilibrate. And for side effects to be managed, preparing herself to go home.
Michael thinks that is a little much. Ellen understands – as will be seen below.
The outpouring of love and support for Ellen Dixon was unprecedented. Nursing colleagues – past and present – volunteered to assist with her care during chemo and through the following 24 hours. The oncology unit's head nurse coordinated all that – on her own time.
Ellen's parents obtained a short-term, 3-bed rental where they and Michael's mother moved into for the duration. There was room for Abby and Michael as needed.
NYU – Dean of Students Office
"Dean Ashton, I have a request, please."
"Abigail, nice to see you. You look rather down, my dear.
What can we do for you?"
Abby tells the story, sparing nothing. "Is it possible for me to take this semester off; so I can support my mom and dad? And not lose my scholarship?"
She sits with head down, trying very hard not to cry.
Mrs. Ashton is near tears herself. She pulls herself together and replies. "Abby, I am relatively certain that we can do that. I will need that request in writing; and will present it myself to the scholarship committee. That group meets next Thursday. So, can you have this form filled out (she hands Abby a form) and to me by Monday? Along with an accompanying letter of explanation?"
"I will. Thank you so much." Abby brushes away tears, stands and shakes hands & leaves.
Abby does her part; Dean Ashton does her part; Abs gets the semester off so she can support mom and dad.
888888
Stony Brook Med Ctr – Oncology unit
It is the afternoon of Ellen's second chemo treatment. There is no noticeable benefit from the chemo, yet. (Except the bald head). Ellen has decided to do 2 more infusions as they had agreed, then evaluate her status.
She is resting quietly, having suffered a little nausea an hour ago. Some IV Zofran had promptly chased that away. A visitor slipped quietly into the room, taking a seat at the bedside – the non-IV side. Her surgeon had placed an access port in her left forearm. Elizabeth Brust slipped her hand into Ellen's and spoke softly.
"Ellen, my dear. You need not talk. I have some things that I need to tell you; and I have a gift for you, after a bit."
"OK," Ellen whispered – she gently squeezed Elizabeth's hand and smiled. Keeping her eyes closed all the while.
Elizabeth spoke softly; "You know my Albert has been a doctor a good long while. It was starting to really wear him down. I could see it – as most any wife could. So much suffering; too much loss. (She caught herself – she was about to say dying). The late hours on-call, and more."
She paused for a couple of minutes. When she restarted, her voice was shaky. "But it wasn't just the doctoring that weighed on him. When we were celebrating our 2nd wedding anniversary, we connected in that very special way – you know what I'm talking about." Both Elizabeth and Ellen smiled.
She goes on, "9 months later Elaine was born. A beautiful little girl. Daddy's girl as it turned out. At her 4th birthday, daddy got her a little nurse's uniform. She was so cute – it brought tears to my eyes. You can guess what daddy had in mind for his little girl!
"Then tragedy struck . . . Laney was stricken with aggressive leukemia." Elizabeth's voice chokes. She catches herself, and chokes out the words:
"5 weeks, diagnosis to death." Death in-utero.
"Ashes spread on the Atlantic." PACIFIC.
"Grieving parents." Grieving parents.
"We leaned on each other." So did we.
"Life goes on." Yes, it does.
88888888
"Let me give you my gift, then I'll continue my story."
Elizabeth reaches for what looks like a hat box. She turns and motions for a nurse to come. She whispers a request; the nurse nods, turns and leaves.
"Ellen, please close your eyes. Don't worry, just please close your eyes. I will tell you when you may open them."
Ellen does as asked. The nurse returns with a large hand mirror. Elizabeth pulls a beautiful brunette wig from the box. The nurse gasps – this is no cheap costume wig!
Liz places it on Ellen's head, adjusts it, holds up the mirror and says, "Open, sesame."
Ellen opens her eyes and looks in the mirror. "How . . . when . . . oh my god. It's beautiful Elizabeth. I can't-
"You can, my dear. Please allow Albert and me to help you."
Ellen slowly turns her head from side to side. "It's my hair!"
"No dear . . . it's as close as they could come, though."
"They?"
"A certain wig shop." Liz smirks.
"Tell me?"
"No, you don't need to know." (Michael had gotten hair samples from Ellen's hair brush when large patches were coming out; and given them to Elizabeth. She took them to a very high-end wig shop. The result was stunning – and expensive).
"As I said – allow Albert and me to help you. You are very precious to us. And now the rest of my story."
"Can I take it?" Ellen smiles.
"Yes …you can. I will never forget the day my Albert came home from work-
"Your Albert?"
"Yes, my Albert. As I've told you, his cardiology practice was wearing him down."
Ellen nods, "I could see it. I didn't know what to do to help him."
"But you acted. Albert came home one day – his smile was a mile wide! I could tell that he was back."
"I acted? What did-
"You, a nurse touring the cardiac step-down unit, heard CODE BLUE called and immediately flew into action. You did what the doctor wanted (My Albert, by the way) before he even called for them!"
"It's not that hard-
"He was blown away. He came home that evening shouting 'I found her! I found my Laney!'"
"Oh Elizabeth, I-
"No, my dear . . . not our physical Laney. But a well-trained nurse who can anticipate his every need and move. My Albert was back!"
Elizabeth Brust raised Ellen's hand to her lips, and kissed the back of it. "Thank you, my dear. That was the most precious gift I have ever received."
"You are very welcome. Working with your Albert has been a joy I can hardly describe."
"JOY! I am so glad you used that word. That is exactly how he described the feeling that you infused into his life that day."
They embraced and Elizabeth took 2 pictures of Ellen; then a nurse took 2 pictures of the 2 of them. Elizabeth promised copies for the family, and then she left.
Liz had a happy heart – even though she knew that time was short.
888888888
TBC
Albert does his part, and the family says good-bye.
Per Wikipedia.