Fireflies (7 page)

David groped past a window toward the phone on the kitchen wall. Heart racing, he pressed the numbers for Matthew’s room. One ring. Two rings. Ten rings. No one answered.

He let it ring longer.
Still
no one answered.

Feeling suffocated, David set down the phone. He pressed his back against the wall and strained to keep his knees from collapsing. In his nightmare, the explanation for the lack of response on Matthew’s phone was that Donna had helped Matt get out of bed and walk into the ward so Matt could reach a bathtub in a room around a corner down the hall.

Again David floated.

He couldn’t ignore his terror. He felt so sure of what would happen next that he had to act as if it
would
happen.

If he was wrong, he’d be grateful beyond belief.

But what if he was right? He didn’t dare dismiss the possibility that he’d been granted the gift he’d prayed for in his nightmare.

To dial back. To retreat in time. To take the knowledge of the future into the past.

Based on what he’d dreamed, given what he’d learned from his experience with Matt in Intensive Care, from conversations with doctors who reconsidered the choices they’d made, from conclusions based on the autopsy report, he had a precious opportunity.

To save his son’s life.

The University of Iowa’s hospital administers to patients not just in Iowa City but throughout the state. There are other hospitals in the area, of course, but few are so well-equipped to deal with extreme diseases, especially those involving children’s cancer. A helicopter is available to fly emergency cases from hundreds of miles away. Other patients—chronically ill but not in imminent danger of death—sometimes spend hours being driven to the hospital for specialized treatment.

Two years before, when the demands of writing assignments had forced David to resign from being a professor of American literature at the university, he and his family had considered moving to another locale. Thanks to the famous character he’d created and the income he received from best-selling novels about other characters, he had the financial ability to live anywhere he wanted. After all, to work he needed only a word processor and a quiet room. He could set up those conditions anywhere. Los Angeles had been a likely place—because of the movie producers David sometimes worked for. New York City (or nearby in Connecticut) had also been an option—because he’d be close to his publishers.

But in the end, as a consequence of the many business trips he had to take, the palm trees he saw in California and the skyscrapers he saw in New York had begun to seem ordinary. Flying home, peering down at the rich black soil and rolling wooded hills of Iowa, he’d gradually decided that the Midwest was as exotic as any of the so-called glamorous sites he’d visited.

A friend had once laughed at David’s choice of word. “Exotic?”

“Well, attractive anyhow, and more important, innocent. The air’s clean. There aren’t any traffic jams. I’ve never had to worry about my children being mugged in the schoolyard. I can get anywhere in town in fifteen minutes. The people are friendly. I like the space, the big-sky feeling. I guess what it comes down to is, I feel at home. I’ve settled. Even on a practical level, the dental and medical care are magnificent.”

Medical care? Another irony, for David could never have guessed how desperate he soon would feel about the medical care he’d so praised or how fortuitous his choice to remain in Iowa City would be. Patients in the farthest reaches of the state had to travel hundreds of miles for their treatment. But David’s desperately ill son could be driven to one of the nation’s finest hospitals within five minutes; the family home was only ten blocks away.

The hospital is huge, much larger than most medical facilities even in major American cities. The complex stretches over blocks and blocks. New buildings are constantly being constructed. And some of the sophisticated diagnostic instruments (a magnetic resonance imager, for example) aren’t available in many areas.

Yes, David thought, if your son gets a rare form of cancer and the tumor lodges where it almost never does—in a rib instead of an arm or a leg … if your son might have the only case of its kind in the nation, it’s a damned wise choice you made in deciding to stay in Iowa City.

These thoughts occurred to him as he pushed away from the kitchen wall. With an unnerving sense of viewing everything from a distance, he staggered downstairs to shower, then stumbled upstairs to his bedroom, where he struggled to dress. Still dizzy, he knew he was risking a traffic accident by driving to the hospital, but the alternative, that of staying in bed till tomorrow as his nightmare had told him he otherwise would, was an unacceptable option.

He had to save Matt’s life.

Driving carefully from the residential area, turning left toward the expansive towers of the hospital that it seemed he hadn’t seen in forty years, he entered a parking ramp, where he found a place to leave his Porsche 912 near the Plymouth Voyager his wife had driven to the hospital. For a moment he leaned against his car to establish his balance, then walked as steadily as he could from the ramp to one of the many entrances to the hospital.

His mind was playing tricks on him. He felt unfamiliar with an institution that he’d visited almost daily for the past six months, as if he hadn’t been here for half a lifetime instead of just this morning. Pushing open a door, he walked along a corridor that he’d gone down a thousand times and yet seemed barely to remember. He reached a large open area in which chairs surrounded a grand piano that doctors sometimes played during lunch hour. Plants hung from gleaming mirrored walls and a ceiling four stories high.

Turning right, he forced himself along another corridor, this too familiar but only as if through a mist. He reached an elevator marked G, and while it swiftly rose, he endured a powerful pressure behind his ears. With his hands cupped to his head to reduce the pressure, he heard an increasing hum within his brain.

What’s happening to me?

His arms and legs now tingled so severely it seemed as if electricity stung him. The band around his chest squeezed tighter. His forehead felt cold, yet sweaty.

At the third floor, the elevator door opened. He lurched out, turned left down another corridor, and compelled himself not to waver. He even managed to quicken his pace.

Passing patients’ rooms, he reached a nurses’ station whose design seemed primitive compared to the type he’d seen in his nightmare.

“Mr. Morrell, how good of you to come back.” A blond nurse smiled.

David remembered her, and yet it didn’t seem from recent conversations, instead from long ago. “Come back?”

“We were hoping you’d give us a visit. How’s Matt doing?”

“What do you mean? That’s what I’m here to find out.”

“But you know he isn’t here. He left a week ago. He’s up in Bone Marrow.”

Oh, my God, David thought. I reached the wrong floor. I went to where Matt always used to get his treatment: the Pediatrics Ward.

From a child’s room, he heard the distinctive sound of a nurse gently paddling her hands on the chest of a cystic fibrosis patient, clearing fluid, helping constricted lungs to breathe.

“Of course,” David said. “I must have … Bone Marrow. I made a mistake.”

“I know what you mean. Matt’s been on this ward so often, I can see how you’d come back by habit.”

Disoriented, David surveyed the rooms along the corridor. It seemed that Matthew had stayed in every one of them at various times. In the last six months (forty years ago?), this ward had become a second home.

In one room, he recognized (again as if through a haze) a ten-year-old girl bald from chemotherapy. When first diagnosed, she’d been riddled with tumors, but treatment had managed to cure her. Nonetheless, the patient’s mother, unable to control her revulsion, had disowned her daughter, never once visiting, eventually divorcing her husband.

In another room, David saw an eight-year-old boy whose parents had considered his cancer an inconvenience to their routine. Every three weeks, on a Friday, they drove him to the front door of the hospital, let him out, and left while he found his way up to the Pediatrics Ward for chemotherapy. He stayed for the weekend, vomiting, the fear and loneliness in his eyes enough to make David want to strangle the parents, who drove back to the hospital on Monday and waited while a nurse brought the boy in a wheelchair down to the hospital entrance, where she helped him into the car.

But not us, David thought. Not us! Donna, Sarie, and I stayed with Matthew always, never letting him give up hope, never allowing him to feel lonely or succumb to despair. Taking shifts, and sometimes all three staying with him at once, they’d bolstered his spirits and let him know how much he was loved. They were his companions at all hours for his six months of treatment. Donna and David had probably seen Matt more than most parents saw their children, in snatches, an hour in the morning, an hour at night, for a lifetime.

Early in Matthew’s treatment, a doctor had asked about David’s work. “How’s your fiction going? Any new books?”

Restraining his frustration, because the doctor was trying to be friendly, David had answered, “My work? Since Matt got sick, I’ve stopped writing. Right now, as long as it takes, my job is my son.”

“Yes,” David said to the nurse. “I made a mistake. I’d better get up to the Bone Marrow Ward.”

“But you didn’t answer my question. How’s Matt doing? Is he okay?”

“The answer’s too complicated. It depends.”

“On …?”

“If you look forward or back.”

“What?”

“Right now, he’s doing well.”

“He’s one of our favorite patients, you know. He’s so brave. We love his sense of humor.”

“So do I. Believe me, so do I. For what it’s worth, I think you and the rest of the staff did a wonderful job.”

“Keep us posted.”

Yeah, David thought, but I hope the message isn’t the disaster of my nightmare.

“I’ll let you know. Right now I’d better get up to where I belong.”

To the Bone Marrow Ward.

Toward what David was becoming more convinced was a desperate chance for salvation.

The Bone Marrow Ward. Logical, simple, ingenious, and if your case isn’t in the right statistics, terrifying. You don’t go there to be treated unless there’s nowhere else to go.

Tumors are perversely fascinating in their capacity for evil. They may be the only organic substance that left unharmed and given nourishment lives forever. In laboratory conditions, they survive and survive. With Matt, the initial combination of chemical agents (each combination is called a protocol) proved ineffective. After several administrations of it, a second protocol was tried, and that too proved ineffective. Matt’s tumor became classified as resistant, an especially malignant life force. The third protocol showed results, however. The mass shrank 50 percent, and surgery (which would formerly have killed Matt, so large was the mass to start with) now became possible.

The surgeon explained that the operation would take eight hours. Matt would lose the diseased rib and maybe one rib to the top and bottom, depending on what the surgeon found. The principal risk was that the tumor had grown so close to the spine that in removing the tumor the surgeon might accidentally cut a nerve—or else the artery that supplies blood to the spinal cord—and Matt would be paralyzed.

“What are Matt’s chances of that happening?” Fear made the question a whisper.

“Chances?” the surgeon had responded. “I do my best. I can’t give odds. What happens to each patient happens to him one hundred percent.”

So Matt, with utter calmness, allowed himself to be prepared for surgery. The nurse who took his heartbeat and blood pressure readings was astonished by how relaxed Matt’s vital statistics made him seem. David, Donna, and Sarie walked beside Matt’s bed as he was wheeled toward the surgical area. Then the family was told to go to a waiting room.

The waiting room. A horror in itself. Plenty of televisions and magazines, but everyone stares at the floor.

An eight-hour operation, and the major risk is paralysis, but the surgeon is optimistic and says he’s going for total cure. So you know when three hours into the operation you get a message to meet with the surgeon, something’s horribly wrong—and when not one surgeon but three of them join you in a consultation room, you know that whatever’s wrong, it’s worse than you can imagine.

“We ran into troubles,” the first surgeon said.

“You don’t mean he’s paralyzed!” Donna said.

The second surgeon shook his head. “Not that at all.”

“Then …?”

The surgeons didn’t respond.

“For God’s sake, tell us.”

“The tumor may be inoperable.”

“
What?
”

“It metastasized,” the third surgeon said. “It’s not just on his rib.”

Metastasized. When David later repeated that word to friends and business associates, he was amazed by how many didn’t understand what
metastasized
meant. To spread. The tumor had sprouted seeds. Roots were growing throughout Matthew’s lung.

“No!”

“The metastases are so close to the spine I don’t think I can get them all,” the first surgeon said. “I’ll probably have to take several more ribs than I hoped.” The surgeon exhaled. “And all of his lung.”

David ached.

“The point is, if I don’t get every offshoot from the tumor, several other tumors will start to grow, and in areas where I can’t operate without killing him.”

“He’s going to die?”

The second surgeon nodded. “I’m sorry. You have to be prepared for that possibility.”

“But isn’t there
anything
we can do?”

The surgeons glanced at each other.

“The tumor’s been resistant to chemotherapy,” the third surgeon said. “The only thing I can think of is to
really
give it a dose, I mean a humongous dose, of chemicals. To go for a bone marrow transplant.”