Natural Killer

by Harriet Alida Lye

  Awful things happen to good people for no reason, and we don’t need to make logic of that. We are unable to make logic of that. But the opposite is also true. Look at the wildflowers blooming in the ditches, in the fallow fields. Spring blooms later the farther east you go, so as we headed to the Atlantic, Cal and I were following what felt like an eternally blooming spring as the baby inside of me grew from an orange to a cauliflower. I gathered armfuls of pink and purple lupins in the Maritimes.

  Now, as we go west, and the baby grows to a cantaloupe melon: cornflowers along the shores of Lake Superior, anemones on the Assiniboine, salmonberries in the Rockies.

  Reminders that the world indulges in beauty, too, for reasons that have nothing to do with us.

  Plans were moving forward with the bone marrow transplant, though it was taking much longer than we’d all anticipated. A match had still not been found. At the end of that fourth round of chemo, it was decided that a fifth round should be added for safekeeping, a new development in the protocol.

  My mum wrote on the forum on September 17:

  The plan is that Harriet will be undergoing a 5th round of chemotherapy starting as soon as this Friday. In the absence of a donor the Drs want to give Harriet this 5th round to really consolidate the treatment and give them a chance to find a donor. If they do not find a perfect match they will not do a transplant, weighing up the side effects of a not-perfect match vs the chance of recurrence.

  This next round has not been completed before by any patient at the hospital. The round will be 10 days and will be even stronger than the last. Harriet is barely recovered from the last one and we had hoped that she would get a rest but they want to test her bone marrow ASAP and proceed.

  My dad wrote:

  I don’t understand what takes so long to find a match, what with the speed of computers these days.

  It did seem strange, as though there was some kind of old-fashioned door-to-door campaigning going on in rural villages. But the speed of computers has tricked us into believing that there are always answers at our fingertips. We think we can type our questions or desired locations into a search bar and get a concrete answer instantaneously, because this is what usually happens.

  What’s the temperature outside?

  Will it rain today?

  How far to the moon?

  What is the etymology of cancer?

  What is a Natural Killer cell?

  Will this kill me?

  If not this, then what?

  I felt as though my life depended on the discovery of this person who had matching bone marrow to mine, somewhere in the world.

  I want this to be a book not about cancer, or even motherhood, but about becoming.

  We see Alcestis in the process of dying, and then we see her in the process of coming back to life: Heracles brings her back in this in-between state, saying she won’t be completely herself for three days.

  Unless we are dead, we are in a state of becoming. And even then, perhaps becoming is another way of saying surrendering.

  As I move away from one and towards the other, I am still the girl, and I am still death: both elements are, forever will be, within me.

  It’s November 16, 2017, and the point of today is receiving a Facebook message from Megan’s mother.

  Hi Harriet. I know this is totally random but my daughter was a patient at sick kids at the same time as you. We are here today for our follow up apt and I thought of you and thought I’d look you up. Glad to see you are doing well. My daughter Megan had leukemia too. She is in remission as well. I just wanted to say hi and let you know I was thinking of you, even tho you probably don’t remember me! Take care!

  I click on this woman’s profile, find Megan, and recognize her instantly. Her huge, spoon-like blue eyes and broad forehead. Her curly hair—it’s brown now, but the kind of brown where you can tell she’d been blonde as a baby.

  Hi! That’s crazy. I do remember you and actually tried to look up Megan on Facebook recently, but didn’t have any information to go on. There are a lot of Megans. I’m so glad to hear she’s doing well. She must be nearly 17 now right?

  How is it possible that even though I’m sitting on my sofa, a half-empty cup of cold coffee on the table, the dogs curled up and sleeping at my side, I’m also in the dark bedroom across the hall from mine, an eighteen-month-old baby holding herself up in a playpen, her forehead sticky with sweat gone cold?

  Megan is sixteen now, and posts memes about pot and selfies where she’s smoking bongs. Her mother says she doesn’t remember anything about being in the hospital, “which I guess might be a good thing.”

  She is in remission as well. Remission is a state of not-having-cancer. It is a tenuous state: “a temporary diminution of the severity of disease or pain.” Perhaps this is true of Megan’s state and my own. Perhaps it is the state of everyone not currently dying.

  Megan’s mother caught me up on her daughter’s life in shorthand, the kind of headlines that you’d give to an old family friend. Megan has epilepsy as a result of the chemotherapy. I wonder if that is a result of treating the tumours behind her eyes, since epilepsy was never raised with me as a possible side effect. Megan’s sister, nineteen years old now, has two children. “She’s a bit young for it, but they are a blessing either way.” Blessing. I wonder if she is religious, and how that would be possible.

  She says she split up from the girls’ father shortly after Megan left the hospital, and she implies the relationship didn’t end well. I feel a space open up for me to tell her about the conversation he had with me, and type it out in a rush, clicking send before a second thought.

  “Yeah. He’s not a very good person,” she writes back. “I’m sorry you had that experience with him.”

  My parents don’t remember that conversation—maybe I never told them—and the acknowledgement feels better than the apology.

  In the drama program at my high school, all of the students from all four grades went on a three-day retreat every September to a camp property on a lake a few hours north. There were talent shows and group cuddles, campfires and midnight hikes. No makeup or hair products were allowed, in an attempt to bring everyone onto a more equal plane. The girls not being allowed to wear concealer and mascara was no more dramatic, in the early 2000s, than the boys not being allowed to gel their hair.

  That September I was technically in grade ten, but I hadn’t actually entered school or done any work. The retreat fell in between my fourth and fifth rounds of chemo, and I was well enough to leave the hospital, so my dad took me up to the camp for an afternoon.

  The first picture is of my friends all around, but not touching me, as I get out of the car. My teacher from Alcestis the year before is standing slightly farther back, taking a photograph. (I overheard him remind people that I needed my space, and to try to act normal around me.)

  I’m wearing flared jeans, Adidas shoes with pink stripes, and a gauzy mauve shirt with a turquoise flower on the front. I’m carrying a black purse over my shoulder in which I keep Purell and lip balm. My limbs so rangy I’m positioned like a classroom skeleton. My wig, I think, looks pretty natural. In one photo, I’ve even put my sunglasses over it, like when you just slide up your glasses over your forehead when the sun goes behind a cloud and the world darkens—though in my case, that action would have been anything but second-nature: it would have involved delicate placement and rearranging, worrying whether I’d shifted the wig.

  The photos from that day show a large group of us, fifteen or so, sitting on the dock; then eating popsicles on a dirt path; then standing by the point on the cliff overlooking the pines and the bashed-pewter lake. In every photo, young Heracles is standing just behind me, like a bodyguard. The last photo is dusky, the grain pixelated. Most of the people are laughing, pushing each other, arms tangled up, but I’m sitting slightly off to the side, smiling so hugely,
hands to myself and dark circles under my eyes. With my eyelashes and eyebrows disappearing, the darkness stands out more dramatically. In contrast with the rest of these people, healthy, normal people who’d spent a summer in the sunshine, my pallor—especially in the twilight—is truly luminous.

  Weeks before my due date, my mother starts preparing and freezing meals for Cal and me to eat in the early days of new parenthood. She bakes dozens of muffins and scones, makes giant batches of curry and chili and soup. We have to tell her to stop when our freezer can’t fit any more Tupperware.

  My dad builds a mobile out of things from the hardware store. On the bottom of the wooden structure he inserts a hidden pocket between two slats of plywood where he places a note: “When the mobile is no longer needed, all parts can be re-used as originally intended.”

  My parents’ love of nourishing me is renewed, knowing that I am nourishing another.

  After receiving the letter from Cancer Care Ontario about my cervical cells, I called my hippie family doctor to ask what to do. He didn’t use the word cancer, but told me to get a follow-up test in Paris, where I was living, to see if the cells had disappeared, stayed the same, or developed.

  I obeyed.

  When I received the news that they’d developed, I was alone in my apartment. It was too early to call any of my doctors back home, so I Googled “cancer care help-line.” My screen was blurry through tears so I clicked the first one I saw. It just happened to be in Ireland.

  The woman who answered was so kind and patient that it made me cry even harder. I explained my situation through sobs, and she listened intently. After a minute, she said, in her lovely lilting accent, “Let me just get this straight. Are you Irish?”

  “No,” I wailed.

  “And do you live in Ireland?” she said, still the pinnacle of kindness.

  “No!”

  “Right, well, I’m not sure what it’s like in France,” she said, “but this is what I would tell you if you lived in Ireland…”

  Of all the people I spoke with before and after the procedure to remove the lesions, she was the most helpful. We even corresponded via email for a few days afterwards. The condition is a fairly common one; they removed the lesions successfully, and though I’ll have to monitor it, there’s no reason to believe further treatment will be necessary.

  But the most difficult thing to wrap my mind around was the fact that I had been wrong: lightning is indiscriminate. Lightning will strike however many times it likes.

  My dad’s handwriting:

  Tings and Bianca trying to figure out how to do a new special sample extraction from the back of the throat, via a nasal tube (?!) and negotiation led to a WOW bead for this.

  My mum’s handwriting:

  Delicious casserole from Christine for our dinner.

  The “WOW” bead I received in exchange for this procedure was a large, plastic, patterned bead to go on my string of “Bravery Beads,” a program run by volunteers at the hospital. Consider them more like “Event beads,” in which a red bead is given for every blood transfusion, a star for each X-ray or CT scan, a teddy bear for being in isolation. I had almost a hundred red beads, for example. Kids would generally hang them from their IV poles, and as we all trundled around the ward, we could visualize each other’s timelines: the longer you’d been there, the longer your string.

  I never talked to my parents about what they believed in, but recently I asked my dad about God. He thought about it for a while, and then said: “I think God can be a useful concept for children.”

  Before the fifth round, my mum took me to a strip mall in Markham to get acupuncture, but I refused to have any more needles. Seeing even these ones, wispy, almost decorative, made me feel faint. So the man performed “acupressure,” using his thumb and index finger to press certain points on my body. He wore grey sweatpants. He squeezed either side of my upper right knee.

  “This part”—he looked at me, then at my leg—“when I put pressure right here, it makes the cancer cells disappear.”

  “Right,” I said, hating him. Did he know he was lying, or did he really believe what he was saying? If what he said was true, I thought bitterly, wishing myself out of that windowless room, he wouldn’t be working out of a strip mall in Markham and I wouldn’t have been through this many months of chemotherapy.

  A little while later, I saw a book called something like The Spiritual Root of All Illnesses in the waiting room of a massage clinic. I flicked through it to find “Cancer: Leukemia,” which was said to be caused by self-hatred as a result of feeling rejected or misunderstood by one’s mother.

  I wish I’d thrown the book out and left the clinic, but all I did was put it back at the bottom of the pile and continue waiting.

  We are driving west through the prairies when I ask Cal whether he thinks we should freeze the baby’s stem cell–rich umbilical cord blood in a private or public bank—that is, whether we should keep it for ourselves, to use for our own child later, or donate it to the public system to be used whenever, and for whomever, it might be required. There are crayon-yellow canola flowers on either side of us, on every side of us. People talk about how shocking it is to be in such flatness, but I am surprised by how comfortable, how at home, it makes me feel. If you live in a place where you’re always able to see where you came from and where you’re going, would that change things?

  “Does our child have a higher chance of getting leukemia?” Cal asks.

  He asks this as though he hadn’t considered the question before, as though its significance is irrelevant, and I love him for this: it implies that we are doing this no matter what, that there’s no sense worrying about tragedy before any sign of it appears, and that if it comes to that, then we will get through it together.

  “No,” I say, “I asked my doctors, and it isn’t hereditary.”

  The sun is behind a curtain of cloud, and the dogs are sleeping in the back of the van. The landscape makes me feel comfortable, but I should also mention that there are treacherous winds and tornado warnings; eight tornadoes have already touched down near the southern border, so we have checked the map and are on a more northerly road.

  I scan the horizon and see no threats.

  “Then let’s go public?” he suggests.

  I agree.

  One of my primary doctors, Dr. L, was both extremely mild-mannered and extremely slender. The combination of her meek temperament and long, narrow bones gave the impression she might dematerialize. I was one of her first patients, and she understood that I was curious and involved. One day, when I was feeling well enough, she allowed me to look through a microscope at my own cells, the dark maze of my DNA. She brought me into a small room I’d never noticed before—right next to the room where I was anaesthetized for bone marrow aspirates and lumbar punctures—and had my blood ready between two clear plastic plates. There’s a photo of me in profile at a desk, looking into the black monocular tube; my eyes are wide open, my eyelashes almost gone. I almost expected to feel some kind of possessiveness, a recognition, in seeing my own cells. I didn’t, though. I looked at them with the reverence I feel for all science, all truth, all mysteries I don’t understand. I thought: there is something powerful there that I am so close to, and yet will still never know.

  A paper about my case was published in 2005. One of my primary doctors recently sent it to me. There are pictures of my chromosomes and magnifications of my cancer cells. It starts:

  “A 15-year old female presented with subconjunctival bleeding associated with cough. She related a history of fatigue, weight loss, and malaise over the preceding several months. Physical examination demonstrated pallor, bilateral subconjunctival hemorrhages, splenomegaly, and generalized lymphadenopathy.”

  Symptoms: the bleeding under my eyes, the swollen spleen and liver that had caused me to pee the bed, swollen lymph nodes. Funny to think of malaise as a medic
al term.

  “Blasts were positive for the myeloid markers CD33 (97%), HLA-DR (99%), and CD11b (66%). Blasts were also positive for CD4 (99%) and CD56 (99%), which are markers associated with monocytic and natural killer leukemias…Immunophenotyping by flow cytometry showed that the blasts had a unique immunophenotype, which was not typical of any recognized entity of leukemia.”

  Seeing myself in the abstract, written in the cool third-person neutral of a medical journal, feels more like looking in a mirror than I’d have anticipated. This is the recognition I was looking for.

  The same doctor who told me that in his religion people get sick as a punishment told my mother that the reason I was still alive was due to love. Though I don’t remember him being there, he told me that he was one of the doctors who first saw me in the emergency room, blood in my eyes and bruises on my face. He said that he hadn’t thought I’d make it.

  “Only 50 per cent of your daughter’s survival can be attributed to the medical profession,” he told my mother, “and the rest of her survival is due to your family, your love and positivity.”

  I can forgive him this, knowing that my mother considered his words a rare gift, but his comments cause me physical pain. All of the patients I met were loved.