Reaching around, so her child was still wrapped in her arms, Alice used the sleeve of her thermal, wiped at her eyes. Oliver was poised, ready with a slender stick of cheese wrapped in plastic.
“As I said, we really don’t know why leukemia appears in most patients.” Eisenstatt’s face was pink with health and closely shaven, but also had a shadow, stubble coming in. “This says you don’t have any brothers and sisters?”
“Correct.” She lightly rocked Doe. “I’m an only child.”
A pager in the room was vibrating on someone’s belt loop. Someone was laughing and walking down the hall outside the door.
A doctorish thought formed across the doctor’s face. Eisenstatt digested whatever he was thinking. When he said, “Okay,” his tone was more authoritative, the okay acting as a switch. Oliver withdrew a spiral school notebook from their bag. The doctor blinked and swallowed, tics that Alice would come to recognize as indicators he was preparing to speak at length.
“You’re on top of your treatments, that’s impressive. It’ll be helpful down the road. If you have any questions, make sure to ask. If I’m telling you things you know, I apologize, but I’d rather we’re all on the same page.”
Medical personnel, doctors and nurses alike, talked in this clipped manner: short sentences, quick back-and-forth exchanges. It was the same way in the design world, or dealing with magazine people, anyone who seemed to straddle the lines between corporate and creative worlds. Time was at a premium. Unless someone was above you on the hierarchical ladder, you didn’t have a moment to spare, merely enough time to explain what you needed, or wanted, or had to get across—then you waited for the person to catch up, nod that they understood, or stare at you looking glazed. Once the supervisor left, it was up to whomever to sink or swim. In the medical realm, at least, in Alice’s experiences there—all of which encompassed her pregnancy and these six weeks of insanity—doctors pretended it mattered if the patient understood, before continuing to the next thing.
“You have acute myeloid leukemia, or AML,” began Eisenstatt. “What this means: inside your bones there is marrow, a spongy red tissue responsible for producing your blood cells. AML is a mutation, or disruption, inside that marrow. Instead of producing a normal blood cell, your marrow produces purplish cells called myeloblasts.”
He checked to make sure she was with him, saw an eager student.
“Your red blood cell counts, your whites, your platelets—myeloblasts are what is produced instead, and when they replace your healthy blood cells, this causes a major disruption. Among what’s disrupted is the production of neutrophils—the part of the immune system that helps fight infections. We think this is what happened with your pneumonia. It’s why it was key for you to get diagnosed as quickly as you did.”
The sounds of Oliver scribbling. The conspicuous scratch of Bhakti’s nail file, now pausing. Alice gave Doe her forefinger. The baby’s cheeks imploded, her brow furrowed, her sucking rhythmic, fervent.
“With you, Doctor,” she said.
“Based on the genetic makeup of myeloblasts, AML has three possible courses of treatment. First: simple. The genetic makeup of the AML cells is, for lack of a better term, the most straightforward. Treatment: straight systematic chemotherapy. With simple AML we have a good—”
“You can spare us,” Oliver said. “We know we have the complicated kind.”
Eisenstatt nodded. “So you already know we’re looking at a stem cell transplant. And you know this is a serious procedure. We have to find a bone marrow donor with a genetic match of your DNA. There are ten categories that have to match. The more we can line up, the better we are.” He waited a count. “Since siblings have DNA from both parents, they often give us a chance at the best match. You’re an only child,
“As I said, we really don’t know why leukemia appears in most patients.” Eisenstatt’s face was pink with health and closely shaven, but also had a shadow, stubble coming in. “This says you don’t have any brothers and sisters?”
“Correct.” She lightly rocked Doe. “I’m an only child.”
A pager in the room was vibrating on someone’s belt loop. Someone was laughing and walking down the hall outside the door.
A doctorish thought formed across the doctor’s face. Eisenstatt digested whatever he was thinking. When he said, “Okay,” his tone was more authoritative, the okay acting as a switch. Oliver withdrew a spiral school notebook from their bag. The doctor blinked and swallowed, tics that Alice would come to recognize as indicators he was preparing to speak at length.
“You’re on top of your treatments, that’s impressive. It’ll be helpful down the road. If you have any questions, make sure to ask. If I’m telling you things you know, I apologize, but I’d rather we’re all on the same page.”
Medical personnel, doctors and nurses alike, talked in this clipped manner: short sentences, quick back-and-forth exchanges. It was the same way in the design world, or dealing with magazine people, anyone who seemed to straddle the lines between corporate and creative worlds. Time was at a premium. Unless someone was above you on the hierarchical ladder, you didn’t have a moment to spare, merely enough time to explain what you needed, or wanted, or had to get across—then you waited for the person to catch up, nod that they understood, or stare at you looking glazed. Once the supervisor left, it was up to whomever to sink or swim. In the medical realm, at least, in Alice’s experiences there—all of which encompassed her pregnancy and these six weeks of insanity—doctors pretended it mattered if the patient understood, before continuing to the next thing.
“You have acute myeloid leukemia, or AML,” began Eisenstatt. “What this means: inside your bones there is marrow, a spongy red tissue responsible for producing your blood cells. AML is a mutation, or disruption, inside that marrow. Instead of producing a normal blood cell, your marrow produces purplish cells called myeloblasts.”
He checked to make sure she was with him, saw an eager student.
“Your red blood cell counts, your whites, your platelets—myeloblasts are what is produced instead, and when they replace your healthy blood cells, this causes a major disruption. Among what’s disrupted is the production of neutrophils—the part of the immune system that helps fight infections. We think this is what happened with your pneumonia. It’s why it was key for you to get diagnosed as quickly as you did.”
The sounds of Oliver scribbling. The conspicuous scratch of Bhakti’s nail file, now pausing. Alice gave Doe her forefinger. The baby’s cheeks imploded, her brow furrowed, her sucking rhythmic, fervent.
“With you, Doctor,” she said.
“Based on the genetic makeup of myeloblasts, AML has three possible courses of treatment. First: simple. The genetic makeup of the AML cells is, for lack of a better term, the most straightforward. Treatment: straight systematic chemotherapy. With simple AML we have a good—”
“You can spare us,” Oliver said. “We know we have the complicated kind.”
Eisenstatt nodded. “So you already know we’re looking at a stem cell transplant. And you know this is a serious procedure. We have to find a bone marrow donor with a genetic match of your DNA. There are ten categories that have to match. The more we can line up, the better we are.” He waited a count. “Since siblings have DNA from both parents, they often give us a chance at the best match. You’re an only child,
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