by L. J. Smith
“All right, sweetheart,” she said briskly. “Dr. Franklin says come right in. I’m sorry, James, but I’m going to have to take Poppy away.”
“That’s okay. I can come back this afternoon.”
Poppy knew when she was defeated. She allowed her mother to tow her to the garage, ignoring James’s miming of someone receiving a large injection.
An hour later she was lying on Dr. Franklin’s examining table, eyes politely averted as his gentle fingers probed her abdomen. Dr. Franklin was tall, lean, and graying, with the air of a country doctor. Somebody you could trust absolutely.
“The pain is here?” he said.
“Yeah—but it sort of goes into my back. Or maybe I just pulled a muscle back there or something….”
The gentle, probing fingers moved, then stopped. Dr. Franklin’s face changed. And somehow, in that moment, Poppy knew it wasn’t a pulled muscle. It wasn’t an upset stomach; it wasn’t anything simple; and things were about to change forever.
All Dr. Franklin said was, “You know, I’d like to arrange for a test on this.”
His voice was dry and thoughtful, but panic curled through Poppy anyway. She couldn’t explain what was happening inside her—some sort of dreadful premonition, like a black pit opening in the ground in front of her.
“Why?” her mother was asking the doctor.
“Well.” Dr. Franklin smiled and pushed his glasses up. He tapped two fingers on the examining table. “Just as part of a process of elimination, really. Poppy says she’s been having pain in the upper abdomen, pain that radiates to her back, pain that’s worse at night. She’s lost her appetite recently, and she’s lost weight. And her gallbladder is palpable—that means I can feel that it’s enlarged. Now, those are symptoms of a lot of things, and a sonogram will help rule out some of them.”
Poppy calmed down. She couldn’t remember what a gallbladder did but she was pretty sure she didn’t need it. Anything involving an organ with such a silly name couldn’t be serious. Dr. Franklin was going on, talking about the pancreas and pancreatitis and palpable livers, and Poppy’s mother was nodding as if she understood. Poppy didn’t understand, but the panic was gone. It was as if a cover had been whisked neatly over the black pit, leaving no sign that it had ever been there.
“You can get the sonogram done at Children’s Hospital across the street,” Dr. Franklin was saying. “Come back here after it’s finished.”
Poppy’s mother was nodding, calm, serious, and efficient. Like Phil. Or Cliff. Okay, we’ll get this taken care of.
Poppy felt just slightly important. Nobody she knew had been to a hospital for tests.
Her mother ruffled her hair as they walked out of Dr. Franklin’s office. “Well, Poppet. What have you done to yourself now?”
Poppy smiled impishly. She was fully recovered from her earlier worry. “Maybe I’ll have to have an operation and I’ll have an interesting scar,” she said, to amuse her mother.
“Let’s hope not,” her mother said, unamused.
The Suzanne G. Monteforte Children’s Hospital was a handsome gray building with sinuous curves and giant picture windows. Poppy looked thoughtfully into the gift shop as they passed. It was clearly a kid’s gift shop, full of rainbow Slinkys and stuffed animals that a visiting adult could buy as a last-minute present.
A girl came out of the shop. She was a little older than Poppy, maybe seventeen or eighteen. She was pretty, with an expertly made-up face—and a cute bandanna which didn’t quite conceal the fact that she had no hair. She looked happy, round-cheeked, with earrings dangling jauntily beneath the bandanna—but Poppy felt a stab of sympathy.
Sympathy…and fear. That girl was really sick. Which was what hospitals were for, of course—for really sick people. Suddenly Poppy wanted to get her own tests over with and get out of here.
The sonogram wasn’t painful, but it was vaguely disturbing. A technician smeared some kind of jelly over Poppy’s middle, then ran a cold scanner over it, shooting sound waves into her, taking pictures of her insides. Poppy found her mind returning to the pretty girl with no hair.
To distract herself, she thought about James. And for some reason what came to mind was the first time she’d seen James, the day he came to kindergarten. He’d been a pale, slight boy with big gray eyes and something subtly weird about him that made the bigger boys start picking on him immediately. On the playground they ganged up on him like hounds around a fox—until Poppy saw what was happening.
Even at five she’d had a great right hook. She’d burst into the group, slapping faces and kicking shins until the big boys went running. Then she’d turned to James.
“Wanna be friends?”
After a brief hesitation he’d nodded shyly. There had been something oddly sweet in his smile.
But Poppy had soon found that her new friend was strange in small ways. When the class lizard died, he’d picked up the corpse without revulsion and asked Poppy if she wanted to hold it. The teacher had been horrified.
He knew where to find dead animals, too—he’d shown her a vacant lot where several rabbit carcasses lay in the tall brown grass. He was matter-of-fact about it.
When he got older, the big kids stopped picking on him. He grew up to be as tall as any of them, and surprisingly strong and quick—and he developed a reputation for being tough and dangerous. When he got angry, something almost frightening shone in his gray eyes.
He never got angry with Poppy, though. They’d remained best friends all these years. When they’d reached junior high, he’d started having girlfriends—all the girls at school wanted him—but he never kept any of them long. And he never confided in them; to them he was a mysterious, secretive bad boy. Only Poppy saw the other side of him, the vulnerable, caring side.
“Okay,” the technician said, bringing Poppy back to the present with a jerk. “You’re done; let’s wipe this jelly off you.”
“So what did it show?” Poppy asked, glancing up at the monitor.
“Oh, your own doctor will tell you that. The radiologist will read the results and call them over to your doctor’s office.” The technician’s voice was absolutely neutral—so neutral that Poppy looked at her sharply.
Back in Dr. Franklin’s office, Poppy fidgeted while her mother paged through out-of-date magazines. When the nurse said “Mrs. Hilgard,” they both stood up.
“Uh—no,” the nurse said, looking flustered. “Mrs. Hilgard, the doctor just wants to see you for a minute—alone.”
Poppy and her mother looked at each other. Then, slowly, Poppy’s mother put down her People magazine and followed the nurse.
Poppy stared after her.
Now, what on earth…Dr. Franklin had never done that before.
Poppy realized that her heart was beating hard. Not fast, just hard. Bang…bang…bang, in the middle of her chest, shaking her insides. Making her feel unreal and giddy.
Don’t think about it. It’s probably nothing. Read a magazine.
But her fingers didn’t seem to work properly. When she finally got the magazine open, her eyes ran over the words without delivering them to her brain.
What are they talking about in there? What’s going on? It’s been so long….
It kept getting longer. As Poppy waited, she found herself vacillating between two modes of thought. 1) Nothing serious was wrong with her and her mother was going to come out and laugh at her for even imagining there was, and 2) Something awful was wrong with her and she was going to have to go through some dreadful treatment to get well. The covered pit and the open pit. When the pit was covered, it seemed laughable, and she felt embarrassed for having such melodramatic thoughts. But when it was open, she felt as if all her life before this had been a dream, and now she was hitting hard reality at last.
I wish I could call James, she thought.
At last the nurse said, “Poppy? Come on in.”
Dr. Franklin’s office was wood-paneled, with certificates and diplomas hanging on the walls. Poppy sat down in a
leather chair and tried not to be too obvious about scanning her mother’s face.
Her mother looked…too calm. Calm with strain underneath. She was smiling, but it was an odd, slightly unsteady smile.
Oh, God, Poppy thought. Something is going on.
“Now, there’s no cause for alarm,” the doctor said, and immediately Poppy became more alarmed. Her palms stuck to the leather of the chair arms.
“Something showed up in your sonogram that’s a little unusual, and I’d like to do a couple of other tests,” Dr. Franklin said, his voice slow and measured, soothing. “One of the tests requires that you fast from midnight the day before you take it. But your mom says you didn’t eat breakfast today.”
Poppy said mechanically, “I ate one Frosted Flake.”
“One Frosted Flake? Well, I think we can count that as fasting. We’ll do the tests today, and I think it’s best to admit you to the hospital for them. Now, the tests are called a CAT scan and an ERCP—that’s short for something even I can’t pronounce.” He smiled. Poppy just stared at him.
“There’s nothing frightening about either of these tests,” he said gently. “The CAT scan is like an X ray. The ERCP involves passing a tube down the throat, through the stomach, and into the pancreas. Then we inject into the tube a liquid that will show up on X rays…”
His mouth kept moving, but Poppy had stopped hearing the words. She was more frightened than she could remember being in a long time.
I was just joking about the interesting scar, she thought. I don’t want a real disease. I don’t want to go to the hospital, and I don’t want any tubes down my throat.
She looked at her mother in mute appeal. Her mother took her hand.
“It’s no big deal, sweetheart. We’ll just go home and pack a few things for you; then we’ll come back.”
“I have to go into the hospital today?”
“I think that would be best,” Dr. Franklin said.
Poppy’s hand tightened on her mother’s. Her mind was a humming blank.
When they left the office, her mother said, “Thank you, Owen.” Poppy had never heard her call Dr. Franklin by his first name before.
Poppy didn’t ask why. She didn’t say anything as they walked out of the building and got in the car. As they drove home, her mother began to chat about ordinary things in a light, calm voice, and Poppy made herself answer. Pretending that everything was normal, while all the time the terrible sick feeling raged inside her.
It was only when they were in her bedroom, packing mystery books and cotton pajamas into a small suitcase, that she asked almost casually, “So what exactly does he think is wrong with me?”
Her mother didn’t answer immediately. She was looking down at the suitcase. Finally she said, “Well, he’s not sure anything is wrong.”
“But what does he think? He must think something. And he was talking about my pancreas—I mean, it sounds like he thinks there’s something wrong with my pancreas. I thought he was looking at my gallbladder or whatever. I didn’t even know that my pancreas was involved in this….”
“Sweetheart.” Her mother took her by the shoulders, and Poppy realized she was getting a little overwrought. She took a deep breath.
“I just want to know the truth, okay? I just want to have some idea of what’s going on. It’s my body, and I’ve got a right to know what they’re looking for—don’t I?”
It was a brave speech, and she didn’t mean any of it. What she really wanted was reassurance, a promise that Dr. Franklin was looking for something trivial. That the worst that could happen wouldn’t be so bad. She didn’t get it.
“Yes, you do have a right to know.” Her mother let a long breath out, then spoke slowly. “Poppy, Dr. Franklin was concerned about your pancreas all along. Apparently things can happen in the pancreas that cause changes in other organs, like the gallbladder and liver. When Dr. Franklin felt those changes, he decided to check things out with a sonogram.”
Poppy swallowed. “And he said the sonogram was—unusual. How unusual?”
“Poppy, this is all preliminary….” Her mother saw her face and sighed. She went on reluctantly. “The sonogram showed that there might be something in your pancreas. Something that shouldn’t be there. That’s why Dr. Franklin wants the other tests; they’ll tell us for sure. But—”
“Something that shouldn’t be there? You mean…like a tumor? Like…cancer?” Strange, it was hard to say the words.
Her mother nodded once. “Yes. Like cancer.”
CHAPTER 3
All Poppy could think of was the pretty bald girl in the gift shop.
Cancer.
“But—but they can do something about it, can’t they?” she said, and even to her own ears her voice sounded very young. “I mean—if they had to, they could take my pancreas out….”
“Oh, sweetheart, of course.” Poppy’s mother took Poppy in her arms. “I promise you; if there’s something wrong, we’ll do anything and everything to fix it. I’d go to the ends of the earth to make you well. You know that. And at this point we aren’t even sure that there is something wrong. Dr. Franklin said that it’s extremely rare for teenagers to get a tumor in the pancreas. Extremely rare. So let’s not worry about things until we have to.”
Poppy felt herself relax; the pit was covered again. But somewhere near her core she still felt cold.
“I have to call James.”
Her mother nodded. “Just make it quick.”
Poppy kept her fingers crossed as she dialed James’s apartment. Please be there, please be there, she thought. And for once, he was. He answered laconically, but as soon as he heard her voice, he said, “What’s wrong?”
“Nothing—well, everything. Maybe.” Poppy heard herself give a wild sort of laugh. It wasn’t exactly a laugh.
“What happened?” James said sharply. “Did you have a fight with Cliff?”
“No. Cliff’s at the office. And I’m going into the hospital.”
“Why?”
“They think I might have cancer.”
It was a tremendous relief to say it, a sort of emotional release. Poppy laughed again.
Silence on the other end of the line.
“Hello?”
“I’m here,” James said. Then he said, “I’m coming over.”
“No, there’s no point. I’ve got to leave in a minute.” She waited for him to say that he’d come and see her in the hospital, but he didn’t.
“James, would you do something for me? Would you find out whatever you can about cancer in the pancreas? Just in case.”
“Is that what they think you have?”
“They don’t know for sure. They’re giving me some tests. I just hope they don’t have to use any needles.” Another laugh, but inside she was reeling. She wished James would say something comforting.
“I’ll see what I can find on the Net.” His voice was unemotional, almost expressionless.
“And then you can tell me later—they’ll probably let you call me at the hospital.”
“Yeah.”
“Okay, I have to go. My mom’s waiting.”
“Take care of yourself.”
Poppy hung up, feeling empty. Her mother was standing in the doorway.
“Come on, Poppet. Let’s go.”
James sat very still, looking at the phone without seeing it.
She was scared, and he couldn’t help her. He’d never been very good at inspirational small talk. It wasn’t, he thought grimly, in his nature.
To give comfort you had to have a comfortable view of the world. And James had seen too much of the world to have any illusions.
He could deal with cold facts, though. Pushing aside a pile of assorted clutter, he turned on his laptop and dialed up the Internet.
Within minutes he was using Gopher to search the National Cancer Institute’s CancerNet. The first file he found was listed as “Pancreatic cancer___Patient.” He scanned it. Stuff about what the pancreas did, stages of the d
isease, treatments. Nothing too gruesome.
Then he went into “Pancreatic cancer___Physician”—a file meant for doctors. The first line held him paralyzed.
Cancer of the exocrine pancreas is rarely curable.
His eyes skimmed down the lines. Overall survival rate…metastasis…poor response to chemotherapy, radiation therapy and surgery…pain...
Pain. Poppy was brave, but facing constant pain would crush anyone. Especially when the outlook for the future was so bleak.
He looked at the top of the article again. Overall survival rate less than three percent. If the cancer had spread, less than one percent.
There must be more information. James went searching again and came up with several articles from newspapers and medical journals. They were even worse than the NCI file.
The overwhelming majority of patients will die, and die swiftly, experts say.…Pancreatic cancer is usually inoperable, rapid, and debilitatingly painful.…The average survival if the cancer has spread can be three weeks to three months.…
Three weeks to three months.
James stared at the laptop’s screen. His chest and throat felt tight; his vision was blurry. He tried to control it, telling himself that nothing was certain yet. Poppy was being tested; that didn’t mean she had cancer.
But the words rang hollow in his mind. He had known for some time that something was wrong with Poppy. Something was—disturbed—inside her. He’d sensed that the rhythms of her body were slightly off; he could tell she was losing sleep. And the pain—he always knew when the pain was there. He just hadn’t realized how serious it was.
Poppy knows, too, he thought. Deep down, she knows that something very bad is going on, or she wouldn’t have asked me to find this out. But what does she expect me to do, walk in and tell her she’s going to die in a few months?
And am I supposed to stand around and watch it?
His lips pulled back from his teeth slightly. Not a nice smile, more of a savage grimace. He’d seen a lot of death in seventeen years. He knew the stages of dying, knew the difference between the moment breathing stopped and the moment the brain turned off; knew the unmistakable ghostlike pallor of a fresh corpse. The way the eyeballs flattened out about five minutes after expiration. Now, that was a detail most people weren’t familiar with. Five minutes after you die, your eyes go flat and filmy gray. And then your body starts to shrink. You actually get smaller.