Eight Hundred And Seventeen

Harrington... Uniondale... Welburn... All names of otherwise pretty little settlements along the Maplewood Sideroad between Tavistock and London... And all places I would not miss if they happened to be totally wiped off the map. The countryside is beautiful year round, fresh new pale greens and yellows in spring, rich deeper greens in summer, vibrant with reds and oranges and the golden corn in fall, and stark, crisp, and white in winter. And all this beauty on this particular road brings to me is sadness, fear, melancholy, and despair.

The drive tonight started about 6:30 in the evening, fully dark, the air cool and damp, with cloudy skies. I had a passenger to accompany me on this drive, Alexander, now nine. I let him bring along his Nintendo DS, as drives like this leave me more contemplative than cheerful, and I did not want him bored for a whole hour.

A few minutes out of town I turned right on the Maplewood, and looked to the south. The familiar glow of Woodstock was directly to my left, and even though it was well over sixty kilometers away, ahead and to the left the glow over London was easy to see. The little blue Echo happily spun through the gears, seemingly eager to get us to our destination, and I settled into fifth at about a hundred clicks. All was dark, the moon obscured, the only lights from the occasional farms and houses we passed by.

The previous morning Rudi had been running a fever, so we had gone to the Kitchener Oncology Satellite clinic to have him checked out. Multiple sets of bloodwork from the port in his chest and his arm were taken, and a complete workup by the Pediatrician on staff. His white blood count was extremely low, and he had no neutrophils, so no ability to fight off any infection. He was started on saline, and soon after an IV broad spectrum antibiotic to keep any possible bacterial infection in check.  Other than looking grey and tired, the only other evidence of him being sick was a slight pain in his gut... The doctor was asking Rudi about how much or how little pain there was, and suggested that may be a concern. I replied that he had chosen a perfect time to get appendicitis!  Later that evening, after an ultrasound and  X-ray had revealed only a slightly inflamed appendix, Rudi and Katherine had been transported via ambulance to Emerge at Victoria Hospital in London for further assesment and possible treatment.

Through Harrington the road was wet with a light drizzle falling. I coasted through the chicane leading toward Adam's goat zoo and the microwave tower south of Belwood Lake, and passed a vehicle heading in the opposite direction. There had been virtually no other traffic on the road tonight, an apt parallel to our lives over the past two and half years. No matter what help, support, and love you receive, and we have received lots, as a parent you still drive this road completely and utterly alone.

Six Hundred Ninety Three

At the very front of Rudi's binder is a laminated page clearly marked "Paediatric Oncology Fever Card". It is basically a pass to move him to the front of the line at any hospital emergency department in the event he runs a fever. If that happens, no matter where we might be, we simply walk into an emergency room and present the card.  Absolutely everything going on there is then put on hold, and whatever staff resources are needed to begin Rudi's assessment and treatment are devoted to him... Cut your thumb dicing tomatoes, and you are fourth in line?  Sorry, you are now bumped to fifth!  Broke your arm falling off your bike and you are next to be seen?  That's a shame, you get to wait an extra twenty minutes!

So Rudi was not feeling well after dinner, and Katherine took his temperature, high thirty sevens.  According to protocol, a second reading in that range in a twenty four hour period and we would have to run him into Kitchener.  He went to lie down, so over the next few hours checked him a couple of times, once under, and once over the threshold. He appeared under the weather, and had a headache and the sniffles, more than likely suffering from the common cold.

An hour later, with a temperature in the thirty eights, we phoned London to reach the Oncologist on call, to let them know we would head in to Kitchener.  As Kitchener has an Oncology day clinic and a Paediatric unit, we wanted to know if we should go to Emerg, or bypass it straight to the Paediatric unit. After an hour of phone tag between us, two docs in London, and the Kitchener staff, who had a bed, didn't have one, and had one again, we were sent straight to the inpatient Paediatric unit, where we would be expected.

We were buzzed in after arriving, and met by two nurses, and eventually the Doctor, and over the next hour Rudi had bloodwork taken, and a whole bunch of questions asked about how he was feeling, in addition to vitals done. Because the Paediatric unit in Kitchener is not an Oncology unit, and the Doctor not an Oncologist, his Doctor in Kitchener had to conference with the Oncologist in London to go through all the results and confirm treatment.

About five hours later, with bloodwork showing he was not neutropenic (still had some immune system left) and his fever falling, he was given two Tylenols and we were allowed to go home.  It was two-thirty in the morning, and he slept all the way back to Tavistock.

Five Hundred And Forty Three

I was handed the envelope by a gentleman who looked about my age, or perhaps just a few years older. He was greying a little, with a wider face and square jaw, classically handsome, but with hints of a tiredness in his appearance. He was dressed in faded jeans and a rust coloured cotton shirt, wearing black oxfords. The envelope was blank except for one word, one name rather, my own.  I opened it after the drive home, and read it while standing in the kitchen.

My name is Robert, and I am the father of Melissa, who is a long term childhood cancer survivor. Melissa was diagnosed with B-Cell Acute Lymphoblastic Leukemia about twelve years ago, and completed her chemotherapy treatment after a little over two and a half years. She is now seventeen years old, and is doing absolutely wonderfully now!  As a family, we have traveled a road that may be quite similar to the one you now face, and we would be happy to give you and your family whatever support you need.  Please feel free to call me anytime at 519-725-1234, or email me at robertsmith@yahoo.com"

I could feel it, the wave approaching, the lightness in my chest, and the foaming surge, but I fought hard, and pushed it back. The last time was about three months ago, at the cottage after watching Rudi fly out by Medevac helicopter to Ottawa with his mom, two days before his actual diagnosis.  For three months, we had mostly overcome our fear, and much of the emotional upheaval associated with your kid getting diagnosed with cancer. And now this, exactly what I needed, more than just about anything. Someone who has a very good idea where we are going, and is holding out their hand

But sadly, 'Robert' and 'Melissa' do not exist, and the letter does not exist, and that person holding out their hand and offering it that early on in our journey does not exist.  That is not to say we did not meet 'Robert' or 'Melissa', as we have, and many others, just that their names, and specific circumstances are different, but would it not be nice to get a letter as simple as that within the first month or two of your child's diagnosis?

Seventy Seven

It was an absolutely glorious day, the mid day Autumn sun still very strong and high in the sky, and it was easily warm enough for shorts and a tee shirt, even though it was well into September. I had just walked across the street from Ronald McDonald House to deposit a cheque and get some cash at the very conveniently located Bank of Montreal Branch. 

I arrived at the doors just before an older man in a dark blue suit, tall and solidly built, who nonetheless was clearly feeling the heat, beads of sweat on his temples, his reddish grey hair cropped closely, and he had a graying well groomed goatee. I opened the outer door, went in first and held it, then opened and held the second door and let him pass ahead. He thanked me, and as we got into a fairly long line of clients for the tellers, he told me to go ahead, as I had arrived at the building first.  I noticed the business deposit book in his hand, figured he may be pressed for time, and politely declined:

"You seem to be on business,"  I said, pointing to his deposit book. "I have been forced to stay for a while across the road, so have all the time in the world, really."

He looked across the road where I had pointed, and smiled.  His eyes, I noticed then, sparkled brilliant blue.

"Ahhh, it has been quite a while since I have been there... RMH correct?  Close to fifteen years actually now, but my wife and I spent the better part of a summer there."

"Oh! so you know it well then?" I replied, 

"It was much smaller when we were there, of course, They added the big addition on about five years ago or so... Our son had B Cell leukemia, got it just after he turned four."

"Oh wow.... Our son has leukemia also, T cell, He got sick in June, and was diagnosed early in July this year."

"So he is almost through consolidation now?  You should be able to go home soon then, then things will start to get better."

"That's the plan, and I hope so." I replied.  "And if you don't mind...ummm" I had no good idea how to be tactful asking about his son, but I had to know. He did not say whether his son had survived or not.

"Oh Jonathan!" He laughed, heartily. "Just finished first year at University, two inches taller than me, and more of this... and much less of this!" He answered, in turn squeezing his bicep, and patting his gut. I could not help but laugh. "He plays hockey, does well in school, has a wonderful girlfriend, He is great!"

"Well, that is good"

"It is yes. But it wasn't back then, when we were at your stage.  You are following a road that very few are permitted to travel. But you will travel it, and eventually you will come to the end. And you'll be able to look back, and see how far you have come, even though it was extremely difficult."

"Well, I do hope so, That is what I have to believe."

"And years from now, you might even meet someone, walking into a bank perhaps, and let them know that they will also likely be successful as they travel the road themselves!" He smiled, "Take care, and good luck!"

He was at the head of the line now, and one of the three tellers had just become available.

"Thank you!"  I replied, "Very much."

He laughed again, "No need at all, I know you'll pass it along."

Four

It was about one o'clock in the morning, and the Paediatric ICU was nearly dark, save for some task lighting at nurses stations, and the countless LED monitors and LCD display screens giving the whole place an eerie, dim glow. It was my second night with Rudi at CHEO, and I did not need sleep, even though I had probably only had about twelve hours of it over the previous four days.  I could hear him breathing gently, muffled though, under his breathing mask. A hose and a couple of tubes led away from the breathing mask, an IV tube trailed away from his arm to a wheeled support rack, and a tube from his chest dropped off the bed to his 'zombie briefcase' which was still collecting the puke coloured liquid being drained from his collapsed lung.

I sat, and thought, as there was absolutely nothing else to do.  How did we get here? For what wrongdoing was I being punished? I mean, Rudi was not old enough to have done anything in his life to be punished for, so I was able to eliminate that as a possible cause. Was there a box I forgot to tick, the one that requested my preference for a cancer free child? Perhaps there was a God, and he just has a sick fucking sense of humour? Or perhaps the diagnosis could have been a lot worse, and this will be an easy path? I had no answers, I just knew I was completely, unequivocally afraid.

At least two hours passed, until I noticed a strong smell of shit. In his sleep Rudi had had diarrhea, and had completely messed his hospital gown and all of the bed sheets. I gently stripped off the bed sheets and his gown, and found a half dozen face towels, which I wet, to clean him and the bed up. After getting him out of bed, still not fully awake, to completely clean this legs and body, and he and the bed were cleaned and dry, and all the clothing tossed in a hamper, I made the bed, found him a gown and dressed him, and helped him lie down again, to continue sleeping.

One

"Mister Chiles?  If I could talk with you and Rudi's Mom for a few minutes, there is something of more concern than your son's collapsed lung."

Katherine and I looked at one another. She appeared concerned, but really not worried at all, the nurses probably did not have a great idea of what was going on, other than Rudi's collapsed lung, a rare but not completely unheard of occurrence in tall, healthy teen boys. We stepped together into a small room adjoining the emergency department, and the doctor pulled up Rudi's chest x-ray on the computer. You didn't need a medical degree to see just how bad things looked. His left lung was simply not there, and his trachea and esophegous were pushed well to the left side of his chest, running toward his stomach in a distorted and twisted question mark. Running vertically down the center of his chest, taking up well over one third the total width of his chest cavity was a brilliant white mass, which completely obstructed the image of his spine.

"As you can see, Rudi has a pleural anuerism, a collapsed left lung, clearly evident here, however the large mass in his chest is his lymphatic system, which is normally not this size. I have sent this image to the radiologists at CHEO, and they have returned with an initial assesment. I can't provide a diagnosis here, but he has to be transported to either CHEO or Sick Kids in Toronto immediately."

I looked again at Katherine. She appeared calm, but I could see the worry now, and confusion. It's not everyday that you go from a pretty damn healthy kid with what you think is seasonal allergies, to being told they have to go immediately to the nearest children's hospital.

CRAPS - Eight The Hard Way

I was standing in the middle of a long stretch of straight, nearly flat road. It had probably been a nice highway when it was last paved, with asphalt that was smooth, tight and virtually black, wide shoulders, and freshly painted lines, but that was at least a decade ago;  the pavement now had a very light grey pitted appearance, with numerous expansion cracks forming chains of small octagons that crisscrossed the road; there were small weeds growing from cracks in the shoulder, and the road markings were now faded and worn.

I was looking south, across a stark, dry landscape of short grass prairie, all golden yellow and tawny sand, the sun high in the sky and a little to my right. A series of low, smooth, rounded hills rose in the distance, beginning directly south of me, and trending to the west. The sky was an expanse of pale blue, with scattered cumulus clouds drifting slowly to the east.  It was a place I had only been once before, but for some reason I was familiar with it... I knew it well enough.

In the distance, through the shimmering midday heat, I watched as a figure walked toward me, his form wiggling erratically in the haze.  He came slowly, with no sense of urgency, picking what seemed to be a random path as he walked north toward the road.  Over the next ten minutes I watched as he came closer and became more clear: He was overdressed for the heat, wearing dark pants with a long dark grey great cloak, and a low, wide brimmed hat.

"Son... of... a... bitch", I thought to myself purposefully, yet at the same time quietly hissing the words out loud. "What the hell is he doing here?"

A few minutes later he was picking his way through the low wide depression that served as a ditch, and walking up the shoulder of the road.

"Good afternoon, son" the cloaked man said, quite calmly, with no hint of emotion, no flair.

"Why are you here? We don't normally meet like this" I replied. My acknowledgment of him was tacitly understood.

He looked me in the eye, and turned his head slightly. His skin was well tanned, lined with wrinkles, and his stubble was at least a week old, or more. "We have business, you and I, son... Well, something of that fashion, at least."

He knelt down, squatting on his haunches, cupped both hands together and shook them quickly, then just as quickly pushed them forward and separated them, and two dice tumbled to the asphalt. They hopped around for a moment, rolled toward me, and then stopped. Each showed six black dots.

"Boxcars!" He exclaimed, hinting at surprise.

The old man reached forward, picked up the dice, then slowly rose to face me, and handed them to me.

"Hold on to these son, your turn to roll will come soon."

At that moment, I heard the unmistakable blast from the air horn of a semi trailer, and I snapped my head quickly to look to my left. About a hundred yards away I saw the chrome polished grill and diagonal slash of a Volvo tractor-trailer bearing down on me at full speed.  I watched, helpless, and completely unable to move, as the massive rig raced directly toward me, too dumbfounded to even think about screaming as the truck closed the distance to  me, and then hit me full force.

Darkness.

Silence.

Cold.

For what seemed an endless time...

And then out of nothing, all of the tiniest molecules of my being began to find one another, to reassemble, faster, and faster, coalescing again into a form, the same form they had taken seemingly ages ago.

Then, within only an instant, there was light, dazzling in its multi coloured brilliance, and sound, a cacophony of horns, strings and other instruments, and heat, soothing, penetrating warmth.

I was standing again on the road facing the old man, the horn of the semi trailer still blasting full strength, it's pitch now taking a more muted, minor tone. I glanced to the right, and saw the back end of the trailer now racing away from me. No time at all had passed.

I looked at the old man, he was still standing in front of me, not particularly surprised, or distressed.

"Looks like its your turn now" he said.

"Wait, that bastard, shouldn't he have stopped?" I replied, interestingly far more incredulous that the semi driver had failed to stop after hitting me, rather than my entire form being vapourized, then virtually instantly reassembled out of ether.  I looked at the man, he was waiting, patiently, I knew what to do. Getting down on one knee, I shook the dice in two hands briefly, then tossed them forward. The tumbled near to his boots, and stopped.

"A pair of fours" the old man announced, solemnly "That's an eighter from Decatur"

"What the fuck is that supposed to mean?" I asked

"It's a roll of eight the hard way, just one of a number of random outcomes when you roll two dice, son... It has more meaning than that now... It looks like he might just get lucky."