Authors: Lurlene McDaniel
They stuck a needle in my back today. I couldn’t see it, but I really felt it … like it was sucking out my insides. It hurt so bad. I tried not to cry. I squeezed the nurse’s hands so hard that she yelped and I felt bad even though she said it was okay. I wished I’d let Mom come with me for the test, but I didn’t want her any more upset. She looks like she’s going to cry all the time. Dad looks like he hasn’t slept in days. I hope whatever’s wrong with me isn’t bad. Please, God, don’t let it be bad
.
TO:
Ann
Subject:
Apology
I am so sorry you were inadvertently left off our e-mail news list. Please forgive us. Lenny and I have been distraught over Melinda and we’re not thinking clearly. The second I heard Jesse’s voice on our answering machine, I realized what had happened. Poor kid! He sounded upset. I had forgotten how long he and Melinda have been friends. Of course the news hit him hard. Melinda said she’d asked Bailey to get the word to him.
Well, you’re in the e-mail loop now and just as soon as we know something, we’ll send out the word. I hate the worried look on her doctor’s face. I know that whatever is wrong, it’s serious—much more than a case of severe anemia like they’d first suspected.
Tell Jesse that Melinda will be in touch, because they have computers here at the hospital and patients can use the Internet and e-mail. We just found this out today.
Elana
UNIVERSITY PATHOLOGY
CONSULTANTS
121 East 18th Street, Suite 318
Atlanta, GA 30020
Phone: (800) 555-4567 Fax: (800) 555-4568
BONE MARROW PATHOLOGY REPORT
Referring Physician:
Janet Powell, M.D.
Specimen Number:
JL01-99437
Hematology Associates
Emory University Hospital, Suite 2010
Atlanta, GA 30020
Date Collected: 7/11
Date Received: 7/11
Date Reported: 7/12
Diagnosis: Acute Lymphoblastic Leukemia
Gross Description
The specimen consists of 5 slides and 2 additional aliquots of 3 cc each, labeled “Bone Marrow Aspirate, Melinda Skye.”
Microscopic Description:
The bone marrow aspirate demonstrates extensive hypercellularity with normal bone marrow elements essentially replaced by infiltrating lymphoblasts. There are multiple mitotic figures seen. The lymphoblasts demonstrate a high nuclear/cytoplasm ratio and clumped nuclear chromatin. Some nuclei display a folded appearance. Scattered among the abnormal cells are small numbers of erythroid, myeloid, and megakaryocytic cells.
Flow cytometric immunophenotypic studies demonstrated a
population of beta lymphocytes, which expressed the CD19 and CD20 antigens, and were weakly positive for CD10 (CALLA) antigens.
Cytochemistry was positive for TdT, further corroborating a lymphoblastic process and poor prognosis.
The findings are consistent with acute lymphoblastic leukemia.
Stephen R. Jones, M.D. Pathologist
TO:
Jesse
Subject:
The Final Word
Hi.… I’m writing this from a hospital computer. My fingers are shaking and I’m crying. Dr. Powell gave us the results of my tests today. She told us what’s wrong with me. I have leukemia, Jesse. I have cancer.
Melinda