The Gilgal Passage

by Bob Brown

  It was clear from their vantage point that Sydney was doing most of the talking. So Jason and Karen were left to wonder what was being discussed. Was it Kyle’s medical tests? Was it Sydney’s impending departure to Portugal? Or was it something altogether different?

  Only one way to know for sure.

  “Hey guys, what a gorgeous evening, huh?” Jason couldn’t believe the words actually came from his mouth. Pretty cheesy.

  Karen used a more direct approach. “So, you two look like you’re having a pretty serious conversation. Anything you want to share?” She smiled.

  Direct. With a smile chaser.

  Kyle and Sydney both looked over at their friends. They were still holding hands. Sydney was crying. Kyle spoke first.

  “Sydney just told me she’s leaving to go to Portugal for two years. She’s leaving in three weeks.” Then Kyle looked directly at Jason and asked the question Jason dreaded. “Did you know about this?”

  Jason wished he had been invisible. Or, at the very least, mute. As it was, he was stuck.

  “Kyle, I just learned about it this morning. Karen and I both felt it was up to Sydney to tell you. I’m sorry. But it wasn’t my place to let you know.”

  Karen had gone to Sydney’s side and had her arm around her friend. Sydney was still crying, her head buried in Karen’s shoulder.

  “It’s OK,” said Kyle. “I understand.” He reached out and pulled Sydney away from Karen, wrapping his arms around her waist and pulling her onto his lap on the seawall. Sydney kissed him briefly, then she buried her head against his neck.

  “We’ll figure it out,” said Kyle. Heck, I’ve always wanted to visit Portugal. Maybe they need a Honda dealership there.”

  This brought laughter from everyone, including Sydney. Kyle always seemed to know how to make things better.

  *****

  Ten minutes later, the girls were walking arm-in-arm ahead of Jason and Kyle as the four exited the boardwalk along the marina and passed through the lobby of the Marriott. They turned right on the sidewalk to Harbor Drive, retracing the steps of the carriage horses earlier that evening, heading back toward the Gaslamp and Petco Park.

  As Jason and Kyle fell a comfortable distance behind the girls, Jason asked, “So I take it from Sydney’s reaction that you two really are more than just friends.”

  “Looks that way,” Kyle replied.

  “So you’re OK with her going to Portugal?”

  “Not for me to decide.” And that’s all Kyle would say.

  As the four friends passed through the ticket gate at Petco Park and headed toward the concourse, Kyle turned to Jason and asked, “So where are our seats?”

  “Follow me,” Jason replied, grabbing Karen’s hand and leading the way down into the bowels of the stadium.

  When they finally emerged back into the daylight, Kyle was impressed. “You’ve got to be kidding me, field level, day-of-game tickets?” It was mostly an act, because both Jason and Kyle knew that game-day tickets for a Padre game were never hard to come by.

  “Oops, my mistake,” Jason replied playfully, as he led the group back into the belly of the beast. The next time they emerged, Kyle was speechless. This time he really was impressed.

  “First row, Section One, dugout seats, I believe,” said Jason as he guided his friends to their seats directly behind home plate. From where he sat, Jason was sure he could read the tag on the catcher’s underwear, if for some reason the catcher were to lose his pants during the game.

  “Jason, how did you get these tickets?” Karen asked. “They must have cost a fortune.”

  “Actually, they were free. I just called in a favor from a client of mine. It just so happens he had these seats for the game tonight and couldn’t use them. So he sent them over by courier this afternoon. Pretty cool, huh?”

  “Well, I’m impressed,” said Sydney. “And I don’t even like baseball.”

  Jason looked over at Kyle, who just gave him a shrug.

  “Oh, and did I mention that these seats come with drinks, dinner, dessert, and just about anything else you might want for the duration of the game, except maybe a massage.” Jason was clearly loving his role as host for the evening.

  “I think I could learn to like baseball,” Sydney offered, with a huge smile. All the tears were gone. Now it was just four friends enjoying an evening together.

  *****

  Later, as the game crept along, Jason noticed Kyle and Sydney cuddling in the early night chill, talking quietly, scarcely aware of the activity around them.

  “Cute couple,” Jason said to Karen, as he leaned in and kissed her cheek. “I guess I should never have doubted your match-making ability.” He smiled broadly.

  “What? You doubted me?” She smiled back. Then she returned to the game program and her studies of the players, stats, and standings.

  ‘Like a bookie handicapping horse races,’ Jason thought, remembering his early days with Karen when he had first learned of her fondness for sports information.

  If he were doing his own handicapping of things based on what he now knew, Jason figured the odds were probably better than even on Kyle and Sydney’s relationship and on the results from Kyle’s lab tests.

  As to his chances for a successful resolution to his job problems, Jason figured those odds were a lot worse.

  Chapter 48

  It took just over a week for the lab results to come in and another couple of days to schedule the follow-on appointment with Dr. Neumann.

  As Jason and Kyle waited in the same examination room they had occupied before, it was clear that things were not the same as they had been during the previous visit. This time there were no jokes. There was no idle chit-chat. Jason and Kyle were silent, each lost in his own thoughts.

  “Hello, Kyle,” said Dr. Neumann as she entered the room, closing the door softly behind her. In her hand she carried the same lime green folder as before. This time she also had an oversized envelope Jason assumed contained the results of Kyle’s x-rays.

  “Hi, doc,” replied Kyle. “You remember Jason?”

  “Of course. Nice to see you again, Jason.”

  “You, too.” Jason wasn’t sure he meant it. He’d know in a minute.

  There was an awkward silence. Dr. Neumann opened the green folder and looked inside. Then she abruptly closed it and looked directly at Kyle.

  “Kyle, there’s no easy way to say this, so I’m just going to say it.”

  She tapped the oversized folder and the green folder in her lap. “Although all of your other lab tests were fine, the blood tests confirm that you have apparently gone active for the same disorder your mother had. We’ll of course do some follow-up tests just to be sure, but I have no reason to think that the results will be any different.”

  Jason was numb. He wasn’t sure exactly what it all meant. But there was one thing he knew for sure. Kyle’s mom had died.

  Kyle spoke first, his voice calm.

  “Any idea why this is happening now?”

  “Well, you may recall, the disease results from a breakdown in the genetic code for a specific enzyme in the blood. “As to what initiates the breakdown, we just don’t know for sure, because the condition is so rare. We think there’s a trigger. Some event, condition, or illness. Something like an infection, cancer, or pregnancy. Or a medical procedure, like surgery, chemotherapy, or a bone marrow transplant. Or it might be from a serious injury of some kind.”

  Dr. Neumann looked at Kyle. “I remember you telling me that you have never been sick. So I assume you’ve never been hospitalized, or had surgery. Is there anything you can think of that might have acted as a trigger? Anything at all?”

  Kyle thought for a moment. “Not that I can think of.”

  “What about your knee?” Jason asked.

  “Knee? What about the knee?” asked Dr. Neumann.

  “It wasn’t that big a deal,” replied Kyle. “I tore a
ligament in my knee playing football in college. I spent a month or so on crutches. But it didn’t even require surgery. Heck, that was eight years ago.”

  Dr. Neumann made some notes in the folder. “That could well be it. You see, even though you may not have required surgery, your body’s immune system kicked in to repair the tear and prevent infection and further damage. Somehow during this process a gene mutation might have occurred in the blood enzymes.”

  “But that was eight years ago,” repeated Kyle.

  “We don’t understand why the triggers act like they do to initiate the genetic mutation or why the process takes longer in some patients than in others. We simply don’t have the answers.”

  “So what exactly happens when the enzymes get screwed up?” asked Jason.

  “Again, the disease is rare, so we don’t have a lot of data. But what we do know is that the affected enzyme can cause the blood to clot abnormally, impacting oxygen exchange and leading to other problems in the body, like heart attack, stroke, seizure, and organ failure. Sometimes a multi-enzyme reaction can occur, resulting in a breakdown in the structure of blood vessels and causing internal bleeding.

  “The more immediate affects of the disease are things which you have already experienced, Kyle. Changes in the composition of the blood affect the blood’s ability to remove carbon dioxide and deliver oxygen to the organs of the body. So you tire more easily. You also experience a faster heart rate and shortness of breath when you exert yourself.”

  “OK, so where’s the part where you tell us how we’re going to make it all better?” Jason had heard enough about what was wrong. Time to talk about the big fix.

  “I understand your concern, and I can assure you that we’ll discuss all options and give Kyle the best treatment possible.”

  “So what are some of the options we should be looking at?” asked Kyle.

  “As much as you don’t want to hear this, let me make one thing perfectly clear. There is no cure for this disease.”

  “Right,” said Kyle. Jason knew he was remembering his mother.

  Doctor Neumann continued. “The first thing you might think of is a bone marrow transplant, since the marrow is where blood cells are manufactured in the body. But that’s not an option. That procedure is only used to treat certain cancers and requires extensive, dangerous chemotherapy prior to the transplant. As I said before, this disease is frequently a byproduct of chemotherapy and bone marrow transplants. So in this case, the cure would be the cause of the disease.

  “What we can do is what’s known as a plasma exchange. Plasma is the pale-colored, liquid component of your blood which is used to transport blood cells, hormones, enzymes, and nutrients to your body. During a plasma exchange, we’ll remove your blood, pump it through a cell separator to extract the plasma, then re-infuse new fluid into your body. The whole process typically takes a couple of hours.”

  “Sounds pretty straight-forward,” said Kyle. “I thought you said there was no cure. So does this actually work or not?”

  “Not long-term. There are similar enzyme-related blood diseases for which plasma therapy seems to work reasonably well if the disease is caught early. However, your disease is extremely rare in that the gene mutations which cause the enzyme anomaly actually compound when new plasma is introduced into the blood supply. In effect, the enzymes not only become resistant to plasma replacement, they actually use the new plasma as a catalyst to accelerate enzyme mutations.”

  Dr. Neumann was clearly having a difficult time trying to maintain any optimism. “Unfortunately, we haven’t made much progress with this disease since your mother died.”

  “So how many shots at this plasma exchange therapy do I get?” asked Kyle.

  “I’m afraid just the one,” replied Dr. Neumann. “Additional treatments would most certainly increase the rate of decline.”

  “OK, but surely there are other treatments available,” Jason stated, hoping that just saying it would make it true. “There must be drugs. Even cancer patients have some hope.”

  “There have been some preliminary tests done with glucocorticoids, and I recently read about a proposal using immunosuppressants. Unfortunately, these studies are too new to have progressed to the clinical trial stage. So, no, there is no specific drug therapy available for this disease.”

  Dr. Neumann paused, waiting for additional questions. When there were none, she added, “We need to get you set up for the plasma therapy as soon as possible. I’d like to schedule it for sometime next week.”

  “That’s fine,” said Kyle. “Whatever you can arrange.” Kyle looked both physically and emotionally exhausted.

  Silence. It was likely only a few seconds, but to Jason it seemed like hours.

  “How long do I have?” asked Kyle.

  “Nine months. Possibly less. Certainly no more.”

  Chapter 49

  As Jason and Kyle exited the parking lot from Dr. Neumann’s office building, Kyle asked, “Jason, do you have anywhere you have to be?”

  “Just with you.”

  “You ever been to La Jolla cove, down below the Cabrillo lighthouse?” asked Kyle.

  “Never have.”

  “Then let’s go.”

  “Are you sure you’re up to it? Wouldn’t you rather I take you home so you can rest.”

  “I’m fine. I want to do this.”

  It took about twenty minutes. After exiting the downtown area, Jason followed Harbor Drive northward, past the airport, to where it ended near the Fleet Training Center and the charter fishing fleet docks. Then he continued through the residential neighborhoods of Point Loma and up the peninsula to the Cabrillo National Monument. After stopping to pay the park entrance fee, Jason followed the winding black top down the hillside to the small parking lot directly below the lighthouse.

  Jason parked the car, and he and Kyle started the short walk along the dusty trail toward the cliffs.

  “You know, my dad used to bring me here when I was just a kid,” Kyle said as they walked slowly along. “My mom never came. Just me and my dad. It was our special time together. We’d spend half a day here just watching the waves splash against the rocks, talking about the fun things we’d do as I was growing up. If we came at the right time and the tide was out, we’d look for starfish, crab, and shrimp in the tidal pools.”

  They had reached the top of the cliffs, some twenty feet above the ocean. Jason looked out toward the horizon.

  Kyle continued. “Every once in awhile we’d find a small fish caught in one of the shallow pools. We’d sit and watch that fish dart about, looking for someplace to hide or some way to escape the tiny depression that imprisoned him. But there was no where to go, no where to hide.

  “Right now I feel like that little fish.”

  “Tell me what I can do to help,” said Jason.

  “It’s OK,” replied Kyle. “I was just thinking out loud. I miss my dad. I miss the times we had when I was growing up.”

  Kyle led Jason along the cliff, back toward the lighthouse. Then he climbed carefully down into the tidal basin. Jason followed silently.

  The tide was out, the jagged rocks exposed in the early-afternoon sunshine. It was just as Kyle had described: Little pools of seawater trapped in shallow depressions in the stone.

  Kyle turned quiet, and Jason sensed he was reliving those long-ago memories of his childhood. It occurred to Jason that those were joys Kyle would never share with his own son, and he gave his friend the space and time he needed to deal with his thoughts in his own way.

  Kyle found a weathered rock platform against the cliff and pulled himself up to where he could sit and watch the waves crashing in the distance. He motioned for Jason to join him.

  “Jason, nine months isn’t a lot of time. I’ve got a lot of things I’ll need to take care of. Things at the dealership. Things for the Foundation. Other personal stuff. I’m not sure how I’ll be feeling in the months to
come. I may need your help along the way.”

  “You know I’m here for you, Kyle. Always will be. Whatever you want or need, just ask.”

  Jason’s heart was breaking. His thoughts drifted back through the years he and Kyle had shared together, to classes, and games, and places, and happy times that now seemed like someone else’s lifetime. He found himself remembering the weekend trip to the A-frame on the lake. He thought of the beauty, the friendship, and the gentle manner in which Kyle had encouraged him to change his life forever.

  In that moment, there on the cliff looking out to sea, Jason suddenly realized that God was once again going to let him down. He hadn’t had time to think about it before, because his focus had been on Kyle. But with his best friend now sitting silently, introspectively next to him, Jason’s thoughts returned to the sad reality, and he found the anger rising in him.

  “Jason.”

  “Yea, buddy. What’s up?”

  “I’ve got something that’s really weighing on me that I need to get off my chest.”

  “What is it?”

  “This is important to me. Probably the most important thing I want to resolve before I die. So I need you to listen closely to what I have to say.”

  “You know I will.”

  “Jason, I need you to fix your relationship with God.”

  “What?”

  “You heard me. For over a year now, ever since the death of your parents, you’ve been mad at God. Mad that your parents died. Mad that my dad died. Mad that your job didn’t work out the way you hoped it would. When I die, I suspect you’ll be mad at God about that, too.”

  It was like Kyle had read his mind.

  “You don’t understand…,” Jason began. But Kyle cut him off.

  “Please. Let me finish. As sad as I am about what I learned today, I actually feel a deep joy and excitement. It’s the end of the earthly journey for all Christians, and the fulfillment of a lifetime of believing. So even though I’m sad to be leaving my friends, my hopes, and my dreams, I realize that my life has always been in God’s hands. In His wisdom, He’s decided it’s time for me to leave.