Digging deeper into this haploidentical thing, I learned that “each sibling or half-sibling of a patient has a fifty percent chance of being haplo.” So as CJ’s half-sibling, my chance of being a haploidentical donor was just as good as Trey’s or Quinn’s. Shouldn’t I be tested as well?
There was a problem with that, of course. HLA genetic testing would reveal my true parentage, along with the fact that my three “cousins” were really my half-brothers. I decided not to tell Trey at this point, hoping that either he or Quinn would be a good match for CJ.
Chapter 28
T hree days later, I stopped to visit with CJ on my way home from law school. He was alone in their classic North End home, sitting in his favorite recliner in their spacious living room. I suspected he’d been sleeping when I showed up.
We engaged in small talk for a while. He told me Stacey and the boys were at parent-teacher conferences at their middle school, but he’d been too tired to go.
“I’m always tired,” he said. “I think that’s the worst part—the total lack of energy. I look and feel like an old man, with my bald head and a body I can barely drag around.” He gave me a half-smile. “Sorry. Afraid I sound like an old man, too. Always complaining. I need one of your pep talks.”
“Can I get you anything? Something to drink?”
“I think there’s apple juice in the fridge. Pour some for yourself, too.”
“Okay. Be right back.”
CJ was on his cell phone when I returned with juice glasses in hand. He ended the call as I placed his glass on the end table beside him.
“Sit down, Elise,” he said. “That was my doctor.”
I sat. “Bad news?”
“Yeah. My potential donors’ test results are in. Seems they are not a good match for me. He went into the technical details—way over my head—but neither my brothers nor my sons can be my stem cell donor.”
“I’m sorry. We were all hoping for positive news. What happens now?”
CJ took a few sips of juice before he replied. “My brothers and my sons are disqualified. Johnny and Jim are too old. My mother is dead. That pretty much wipes out the whole pool of related donors. They’ll start searching the transplant registries for a match, but that takes time and isn’t always successful.”
I knew that. According to my research, less than a third of patients on the waiting list receive an unrelated donor stem cell transplant. Less than a third! CJ could die before a good match was found. And even if it were, I also knew that related haploidentical donors were a better choice than matched unrelated donors. I have a fifty percent chance of being haplo, I thought. I can’t let CJ die when I have a good chance of saving him.
“What about me?” I asked. “Aren’t you forgetting me? I am your half-sister, you know.” I explained about the haploidentical thing and the fifty percent chance and how I wanted to be tested right away.
CJ shook his head. “Forget it.”
“What? Why?”
“You know why. HLA testing would clearly prove you are a half-sister to me, Quinn, and Trey. All four of our test results would be on file in Idaho, where incest between siblings is a crime, as you well know. I will not allow you to risk exposure this way.”
“I’m sure there’s very little risk,” I argued. “The test results are confidential, aren’t they? And even if they were disclosed, no one can prove that Trey and I have an incestuous relationship. There’s no law against brothers and sisters living together, right?”
CJ glanced at the ring on my finger. “How careful are the two of you? Have you ever hugged in public? Kissed? Even looked at each other the way lovers do? Be honest.”
I searched my memory. “I don’t think so. Well, maybe once or twice.”
“That’s what I thought. People notice things, and people talk. What about Quinn? How much does he know?”
“He knows Trey and I are intimate, but he thinks we’re cousins. I can’t trust him with the truth.”
“But you’re willing to trust a lab technician who might happen to spot you and Trey holding hands in the park?”
“How would they make the connection between Trey and me? How would they even know who we are?”
CJ sighed. “Don’t be naïve, Elise. Trey is well-known as an athlete and as Boise State’s youngest professor. He’s also Quinn Larson’s brother. Besides, you and Trey look like twins. You really think some smart person won’t make the connection? Come on.”
“A genetic counselor in Oregon knows, and nothing’s happened.”
“I doubt she knows you’re living together. And Oregon is not Idaho. You two are playing with fire in Idaho. If your secret gets out . . .”
I stood up. “I don’t care, CJ. I won’t risk your life for the sake of my secret.”
“Talk to Trey,” he replied. “I’m betting he’ll care.”
CJ was right. Trey did care. He loved CJ and naturally wanted him to live, but he also loved me and our relationship. I’d broken up with him for nine miserable months due to my fear of disclosure, and the risk would increase if I had the HLA testing. Would this break us apart again, when we were finally together and happy?
We lay in bed that night, wide awake but not touching. We’d discussed and argued back and forth for hours, searching for a way to help CJ without risking exposure of our relationship.
I stared into the darkness of our bedroom for quite a while before I spoke. “We both know there’s only one right answer,” I said. “I must be tested. Saving CJ’s life is more important than our relationship. If I do nothing and he dies, we will never be happy.”
Trey reached over and clasped my hand in his. “I know. Take the test.”
No sooner had we fallen asleep than we were awakened by someone pounding on our front door, yelling obscenities. I knew only one man who could make that much noise. Quinn. He almost knocked Trey down when he tripped over the doormat and lurched inside, reeking of alcohol.
Trey was not happy to see him. “What the hell are you doing here at three in the morning?”
“Don’t start in on me, bro. I’m here ‘cause The Grove kicked me out. Some uptight asshole complained ‘cause my party got too loud for his tender ears. Can you believe that shit?”
I could. Tower Suites at The Grove were not cheap, and Quinn’s parties were never quiet. I silently sympathized with the man while Quinn rattled on about his grievances with the hotel management.
“They threatened to call the cops if I didn’t leave. Somethin’ ‘bout damages. Hell! I paid ‘em thousands of bucks for that room, an’ now . . .”
He staggered from the living room to the kitchen and vomited into the sink. “Sorry,” he mumbled, grabbing a towel from my hand. “’Fraid I made a mess.”
“Go wash your face in the bathroom,” I ordered, “while I make up the sofa for you.” Our sofa wasn’t long enough for Quinn, but I didn’t care. My brothers certainly have a knack for disrupting my life, I thought.
Trey finished cleaning the sink as Quinn collapsed on the sofa, his long legs hanging over the side. He was snoring loudly when I covered him up.
“I want him gone in the morning,” Trey muttered when we crawled back into bed. “I’ve had enough of Quinn’s antics. It’s a wonder he didn’t wreck that Porsche on the way over here. What on earth is wrong with him?”
“He’s unhappy. The drinking and parties are just an escape.”
“What’s he got to be unhappy about? He’s rich, famous, sexy as hell . . .”
“You’ve said it yourself, Trey. He needs someone special in his life. He needs love.”
I skipped my morning class and tended to Quinn and his hangover. Thanks to my time with Ben, I had some experience with a hungover man. Ibuprofen came first, followed by Alka-Seltzer in ice-cold water. Fruit juice was next, and when that stayed down I fixed a cup of herbal tea.
“Tea?” he groaned from his spot on the sofa. “I need coffee!”
“No coffee. Caffeine will dehydrate you, which is
the last thing you need right now.”
“How the hell do you know what I need?”
“Trust me. I just know. Drink the tea and take a shower. You’ll feel better.”
“Can’t shower. Too dizzy. Take this damn tea and leave me alone. Let me sleep.”
“Fine. Sleep for an hour. But I don’t have all day to nurse you, Quinn. I have a class this afternoon.” Not that he cared about that.
I managed to get him up and into the bathroom an hour later, where he showered while I fixed him a meal of scrambled eggs, sliced banana, whole-grain toast and a sports drink, which had usually worked for Ben.
Quinn looked and smelled better as he sat on a stool at the kitchen divider, eating and drinking in silence. I sat across from him, just watching this enormously talented but inwardly troubled man. I thought of Johnny, and how his drinking had led to tragedy and years of suffering. I hoped Quinn would not go down the same path as his father.
“Have you been to Ontario during this visit?” I asked.
He drained the last of the sports drink, crushing the plastic bottle and tossing it on the counter. “No. Why would I? Nothing fun about Johnny’s lectures and his damn rules.”
“Johnny loves you.”
“You think? Johnny resents me because I’m living the life he wanted: the NFL, money, sports cars, women. It’s not my fault he blew it all to hell and spent years in prison.”
“He knows that. He doesn’t blame you. And what about Grandma? You should spend time with her—the woman who raised you and Trey with years of endless love. She’s ninety years old and won’t live forever. At least visit Grandma before you leave.”
“Can’t. I called my PR guy and told him to deal with that little problem at the hotel. He’s sending a jet to pick me up tonight.”
“Where to this time?”
“Vegas. Sin City. Where the ladies are hot, the Blackjack tables are easy, and the hotels aren’t full of uptight assholes. I’ve had my fill of Boise.”
“Do you care about anything at all, Quinn? Besides yourself?”
He looked at me. “Sure, Elise. I care about you and Trey. I’m glad you’re happy together. I hope CJ gets well. I care about Grandma, too. I’ll call her before I leave and promise to see her next time I come around.”
He got up, came around the divider and pulled me into a breath-stealing hug. “Thanks for putting up with me, little cousin. I’ll be gone when you get back from class.”
And so he was. On the kitchen counter was a note. “Don’t worry about me. Take care of CJ. Stay happy with Trey. If you ever need me, just call. Quinn.”
The media made no mention of Quinn’s “little problem” with the hotel, so I figured his PR guy took care of it. I didn’t envy the man his job.
Chapter 29
T elling no one but Trey, I submitted to a blood draw for HLA testing on March 20th. I waited for the results with mixed feelings; one part of me hoped I could save CJ’s life, while another part feared what might happen if my true parentage was disclosed somehow.
But when CJ’s oncologist called with the good news that I was “haplo,” my fear melted away as full realization dawned. CJ’s cancerous cells would be destroyed and then replaced by my stem cells to create healthy bone marrow. If all went well, he would live a long and happy life. My little worries seemed like nothing compared to the enormity of that blessing.
I knew little about the actual donation process, but I soon learned it was far from simple. My education began two days later, when I attended a ninety-minute session about PBSC (peripheral blood stem cell) donation. I then completed a health questionnaire, signed a consent form, had a physical exam and gave more blood samples. A few days later, I was officially approved to be a donor for CJ. He needed to be told, and I felt I should be the one to tell him. His oncologist agreed.
I drove to CJ’s home on a blustery afternoon in late March. Stacey was there, but I asked to speak with CJ alone. Though obviously curious, she took me upstairs to their bedroom, closed the door and went back downstairs.
Even in sleep, he looked so very tired. So ill. I hated to disturb him, but I reached over and touched his hand. His eyes slowly opened and focused on me.
“Elise,” he said. “What’s up?”
“I have some news. Good news.”
“Yeah?”
“Yeah.” I squeezed his hand. “You are looking at your stem cell donor. I’m officially approved.”
He scowled. “I told you not to be tested.”
“I know. But I had to do the right thing. For you. For me. For our whole family. How could I possibly let you die, knowing I had a chance to save you?”
“But the risk . . .”
“There’s no risk. The test results are confidential. I’m not worried about disclosure.”
“I’ll bet my oncologist knows.”
“Of course. He’s seen the results. He’s bound by the privacy laws like all doctors. Stop worrying about me. This is going to work, CJ. You’ll see. We’ll get through this together, and when it’s all over, your bone marrow will be full of happy, healthy stem cells. You’ll live to be a very old man.”
“You sure?”
“Absolutely. Positively. This will be a piece of cake.”
I was wrong. It wasn’t a piece of cake for either of us. CJ had to undergo a barrage of physical and psychological exams to make sure he was strong enough for the transplant process and its potential side effects. He was hospitalized in a room with special air filters to reduce the risk of infection. A central venous catheter was surgically inserted in his chest to facilitate the induction of high-dose chemo for two weeks—a “conditioning” treatment to destroy any remaining cancer cells and make room in the bone marrow for the transplanted stem cells.
CJ was very sick during this time. He was unable to eat due to nausea, vomiting, and the terrible mouth sores that required strong pain medications. He also developed breathing problems. I ached for this once powerful man who physically shrank before our eyes. Our family visited in shifts once again, sitting beside him in our masks and long white gowns. He seldom spoke—the mouth sores were too painful—but he knew we were there.
During the last five days of CJ’s chemo, I was given a daily injection of filgrastim, which caused my bone marrow to make and release a lot of stem cells into my bloodstream in preparation for collection. Though my misery was nothing compared to CJ’s, filgrastim gave me headaches, bone pain, nausea, insomnia and a mild fever. I had trouble concentrating on my legal studies but did the best I could, telling myself it would soon be over.
Trey took me to the hospital on April 15th, where I was given a final dose of filgrastim and prepped for the actual stem cell donation. I lay on a bed while a catheter was put in each arm—one to take out blood and another to return it—for a process called apheresis. Trey stayed with me for eight long hours while blood was removed from my vein and cycled through a machine to separate stem cells from the other blood cells before the rest of the blood was returned to me.
It wasn’t fun. I had chills, muscle cramps, and tingling around my mouth, fingers and toes caused by the blood thinner used in the procedure. They slowed down the process long enough to give me a calcium replacement, which helped somewhat. But I got through it, knowing CJ was counting on me.
He received my donated stem cells the next day, via his central venous catheter. He was awake during the infusion process, and his oncologist reported that everything went well. He said CJ’s fever, low blood pressure, coughing and chest pain were common side effects that should go away in a few days, but naturally we were worried.
Stacey and Johnny stayed with him that night, but Trey took me home for some badly needed sleep. I was exhausted.
The following weeks were challenging for CJ as we waited for the stem cells to “engraft,” after which they would start to multiply and make new blood cells. CJ remained in the hospital, receiving IV antibiotics to fight infections from having too few white blood cells. Des
pite these drugs, he developed a high fever and required even stronger antibiotics, along with transfusions of red blood cells and platelets. He continued to suffer from mouth sores, throat pain, and shortness of breath.
We resumed our rotating shifts at his bedside, briefly conferring in the hallway before donning our white masks and gowns to enter his room. We tried to cheer each other up, but it was hard. He can’t die, I told myself in a repetitive litany. Not now. Not after all we’ve been through. I sat by his bedside, held his hand and prayed. To God. To Jesus. Even to Elise, CJ’s dead mother, whom Johnny believed was watching over us from heaven. If she had any power to help her son, this was the time to use it.
As was the case when my mother had her stroke, Daddy’s home became our family’s base of operations, where Grandma and Daddy provided nutritious meals and comfortable beds as we rotated in and out. Trey continued with his teaching and slept in the downstairs bedroom, but I slept in my old room upstairs. We were not comfortable sleeping together with our whole family around us.
Quinn called me a couple of times to ask about CJ, but I was short with him. He was still in Vegas, drinking and partying, while his brother was fighting to live. I resented Quinn’s sense of entitlement more than ever.
The days and nights blurred together as I shuffled between my law school classes, the hospital, and Daddy’s house for a few hours of sleep. I was nowhere near ready for my spring semester final exams, which were scheduled to start on April 29th. Flunking out of law school began to seem like a real possibility.
My family knew I was CJ’s donor. I saw no reason to keep it a secret from them. They expressed their gratitude in various and heartfelt ways—all except Johnny, who scarcely spoke to me as the days wore on. So I was surprised to find him waiting for me in Daddy’s living room one afternoon in late April. The house was very quiet; I assumed Grandma was taking her usual afternoon nap upstairs.
Forbidden- Our Secret Love Page 17