Didn’t the wish letter from JWC say she could spend it on anything she wanted? What could be more important than finding her birth mother? What could be more important than discovering if she had siblings with compatible bone marrow? Her very life could depend on finding these people. Sarah practically jumped up from the sofa. “I’ve got to go,” she said.
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Published by
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New York
Copyright © 1992 by Lurlene McDaniel
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eISBN: 978-0-307-77631-0
RL: 5, age 10 and up
Bantam Starfire edition July 1992
First Laurel-Leaf edition July 2003
v3.1
Contents
Cover
Other Books by This Author
Also Available in Dell Laurel-Leaf Books
Title Page
Copyright
Author’s Note
Chapter One
Chapter Two
Chapter Three
Chapter Four
Chapter Five
Chapter Six
Chapter Seven
Chapter Eight
Chapter Nine
Chapter Ten
Chapter Eleven
Chapter Twelve
Chapter Thirteen
Chapter Fourteen
Chapter Fifteen
Chapter Sixteen
Chapter Seventeen
Chapter Eighteen
Chapter Nineteen
Chapter Twenty
One
SARAH MCGREGGOR SAT cross-legged on the hospital bed, staring at the handful of light brown hair in the palm of her hand. “It’s starting all over again, isn’t it, Mom?” she asked.
Her mother, a short, plump woman with a sleek cap of black hair, nodded sympathetically. “I’m afraid so, honey. But we both know it’s temporary. Hair grows back.”
“Sure,” Sarah said miserably. “But it wasn’t supposed to happen to me again. Not after two years of being well.”
“Honey, I’d give anything to make it go away for you. Maybe this time the chemo will knock it out once and for all.”
Sarah knew her mother was trying to make her feel better, and give her a ray of hope, but holding the wad of hair—hair she’d lovingly groomed since the last time it fell out from chemotherapy—made hope seem like an illusion. Not since she’d been ten and learned she had leukemia had Sarah felt so hopeless.
She’d endured treatments for three years. At first, the medications had made her deathly ill. Some had felt like fire as they’d dripped into her veins. She’d been sick, had lost all her hair, and had gotten painfully thin, then puffy and fat when her drug protocol had been changed. Yet, her leukemia had responded, and when she’d been thirteen. Dr. Hernandez had taken her off all therapy. “If you continue in remission for five years, Sarah,” Dr. Hernandez had said at the time, “I’ll consider you cured.”
“And if I don’t?”
“Let’s not borrow trouble. Relapses can be tricky, because obtaining a second remission is much more difficult. For now, you’re fine, and we want you to stay that way. Come in for blood work every six months, and as for your everyday life, go have fun.”
For two years, she’d been happy and healthy. Then, three weeks ago, her routine blood work had shown abnormalities. Dr. Hernandez had sent her to the hospital and put her back on chemo.
“Dad says he’ll bring Tina and Richie when he comes to visit this weekend,” Sarah heard her mom say, and suddenly remembered that she was still in the room.
“Good. Don’t tell them, but I miss them a lot.”
Her mother smiled. “Richie is driving me crazy asking when you’re coming home, and Tina’s had her suitcase packed since Tuesday, according to your father.”
As if it weren’t bad enough being hospitalized. Sarah was also three hundred miles from home. The big Memphis hospital might be one of the foremost cancer treatment centers in the country, but for Sarah, it was too far away from all that was familiar back in Ringgold, Georgia. She looked out the window and saw puffy clouds in a bright blue April sky. She wondered about her friends. She pictured Cammie, Natalie, and JoEllen in the school’s cafeteria eating lunch without her.
Ninth grade was supposed to have been their year. All of them had made the JV cheerleading squad, which meant that they’d have a good chance of making the varsity squad when they entered high school in the fall. Now, all Sarah had to look forward to was three more weeks of intensive treatment in Memphis and then a new regime of medications and clinic visits for the next few years.
“Is Dad bringing my schoolwork?” Sarah asked. “I’m already behind, and I want to pass. Mom, I can’t stand the idea of being held back.”
“Don’t panic.” Her mother patted her arm reassuringly. “Your teachers all understand. What you don’t get done before the end of the year, you can finish up over the summer. You’re a good enough student that you’ll be able to stay with your class. You did before.”
“What a way to spend summer vacation,” Sarah grumbled. “Why did this have to happen to me? It’s not fair.”
“None of it’s fair, Sarah. But your dad and I never gave up hope of having you, so don’t you give up hope now.”
Sarah had heard the story a hundred times as she was growing up. Her parents had tried for years to have a baby, and just as they’d given up, Sarah had been born. Two years later, Tina had come along, and nine years after that, Richie. “Once we got the hang of it, there was no stopping us,” Dad had often joked.
Sarah rolled her wad of hair into a fuzzy ball. “Would you ask the nurses for some scissors, please,” she said. “I’d rather cut it off now than watch it fall out in clumps.” She looked at the hair sadly. Somehow, when she’d been ten, it hadn’t seemed as horrible. But now that she was fifteen, it felt as if she were losing her best friend.
“Maybe it’ll grow some over the summer. I don’t want to start high school looking like a freak,” Sarah said.
“Honey, you’re beautiful with or without hair.”
Sarah sniffed. How could her mother think that would comfort her? “Mom, most guys like their girls with all their body parts—including hair.”
“If it’s going to make such a difference to them, then they can’t be worth your time in the first place. Goodness, I hope Richie doesn’t grow up to be that shallow.”
Sarah bit back a retort. Arguing with her mother wasn’t going to make her feel better, and it certainly wasn’t going to keep he
r hair from falling out. “Just ask the nurse for some scissors, all right? And let’s get it over with.”
Her mother left the room, and Sarah shoved the clump of hair into a paper sack and flung it across the floor.
“You sure got a big room, Sarah.” Four-year-old Richie crawled up on Sarah’s bed and gave her a wet, sloppy kiss.
Sarah hugged him tightly. “I’d rather be in my room back home. Are you guarding it for me?”
Richie nodded. His fly-away hair was the color of dark chocolate, and his big brown eyes looked solemn. “I put a Keep Out sign on it. I made it myself.” He glanced toward Tina, who was touring the room and reading the names on every bouquet of flowers Sarah had been sent. “Tina tried to borrow your green sweater, but I told Dad, and he made her put it back.”
Richie’s self-satisfied grin made Sarah smile. She remembered when he’d been born. She’d been eleven and had just completed her first year of cancer treatment. Richie had brightened her days. He’d been so adorable, so tiny and sweet with his little button nose and bow-shaped mouth. She and Tina used to fight over who would push him in his stroller.
“You sure got a lot of flowers,” Tina remarked, ambling over to the bed.
Sarah didn’t like her tone. Did Tina think Sarah had purposely relapsed so that she could collect flower arrangements? “They cheer up the place,” Sarah replied.
“Doesn’t look too awful to me,” Tina countered, peering around. “Private room, your own TV, all this new stuff to read …” Tina flipped through a pile of the latest teen magazines their mother had bought. Her parents had gone down to the hospital coffee shop, so the three of them were alone in Sarah’s room.
“The days are pretty long and boring,” Sarah said. “Not to mention the chemo treatments.” She knew Tina didn’t understand. Sarah was never sure why she and her sister didn’t get along too well. Maybe it was because they were only two years apart, but she always felt as if she and Tina were in some kind of competition.
“I know.” Tina shrugged. “I didn’t mean to make it sound like you were on vacation. I know this is a real drag.”
Sarah felt her attitude toward her sister soften. Tina did have her moments. “How’re my friends?”
“People call every night to ask about you. I give them a full report. JoEllen says that she’s writing you a long letter with all the latest news.” Tina flopped on the bed. “And this is from Scott.” Tina handed Sarah an envelope. “He says to tell you that he’s hurting in track this year because you’re not there to time his workouts.”
Sarah smiled as she took the envelope. Scott Michaels had lived next door to her all her life. They’d been friends since their sandbox days and had announced their “engagement” when they’d been three. Of course, then they’d been children, and now Scott dated other girls, but Sarah still felt a deep affection for him. “Tell him I’ll write,” Sarah said.
“When are you coming home, Sarah?” Richie asked. “I miss you.”
“I miss you, too. But I can’t come home until they give me a bunch of medicine.”
“I don’t like it when you’re not home.”
“I don’t like it much, either.”
Richie reached up and toyed with the scarf she’d tied around her head to hide her baldness. “Why are you wearing that?”
Tina caught her eye and gave a knowing nod. Of course. Dad would have told Tina. “I have a new haircut,” she explained.
“Can I see?”
“It’s real different.”
“I want to see.”
Sarah slowly untied the scarf and let it slide to her shoulders. Richie’s eyes grew wide, and his mouth dropped open. “Where’s your hair?”
“The medicine I take makes it fall out.”
Richie stared at her head from different angles. “I think I like your old haircut better.”
Sarah laughed. “I do, too.”
Tina looked self-consciously down at the floor. Sarah realized that Tina felt embarrassed and uncomfortable. It irked Sarah. How could Tina act so childish? Did she think Sarah enjoyed showing off her slick, shorn head?
Richie’s face broke out in a sudden grin. “I know!” he exclaimed. “You can be on Star Trek. They like bald ladies.”
Sarah laughed and hugged him. Tina laughed, too. Richie looked puzzled, trying to figure out what was so funny about his suggestion.
Sarah retied the scarf, glad they were all laughing. It beat crying.
Two
“DON’T BE NERVOUS. This is only a meeting to discuss our options,” Dr. Hernandez began.
Sarah and her parents were sitting in one of the hospital’s small consultation rooms with Dr. Hernandez and Dr. Gill, another oncologist. Her father had brought her down from her room in a wheelchair, and despite both doctors’ reassuring smiles, Sarah was nervous. She glanced at her parents, who looked worried and uncomfortable, too.
“Sarah, you’re almost finished with the induction phase of your treatment,” Dr. Hernandez said, her brown eyes serious and compassionate. “Before we put you onto a maintenance protocol and send you home. Dr. Gill and I want to discuss some other possibilities with you.”
Sarah had been given a chemo treatment that morning, and she was feeling queasy. Sores had formed in her mouth, and her gums throbbed, but she listened attentively.
“You know, Sarah, forty years ago, most kids with cancer died. Today, we have sixty percent surviving five years and more,” Dr. Gill said. “The main reason we don’t have a one-hundred-percent cure rate, especially with leukemia, is that no matter what kinds of chemo we throw at a malignancy, some cancerous cells survive. The cancer may stay dormant for years, but eventually it recurs, and even though we might obtain a second and third remission, the time between remissions shortens.”
“That doesn’t sound hopeful,” Sarah’s mother declared. “Isn’t this therapy going to help Sarah?”
Dr. Hernandez held up her hand. “Please, Mrs. McGreggor. We don’t want to alarm you. Yes, she will obtain another remission, but the best way to fight Sarah’s type of leukemia is with a bone marrow transplant. Have you ever heard of this?”
Sarah’s father said, “Of course, but isn’t that risky?”
“It can be, but let me explain.” Dr. Hernandez drew shapes on a yellow pad and turned it toward Sarah. “Once transplanted marrow takes a foothold in a leukemia patient, it has a good chance of knocking out leukemic cells and curing the disease. A much better chance than chemo or radiation alone.”
“Then why don’t I get one of these transplants?” Sarah was eager to learn about anything that might destroy her cancer forever.
“What are the risks?” her father asked.
“We get noncancerous marrow from donors,” Dr. Hernandez explained, “and there’s very little risk to them. The donor is given a general anesthesia, then we insert a special syringe into the pelvic bone and draw out a cup or so of marrow. Since the donor’s healthy, new marrow is manufactured, and except for some achiness in the hips, the donor’s up and around in no time.”
“But what about me?” Sarah asked.
“The marrow is hung in a bag and dripped into the recipient’s veins just like chemo. It migrates to the bone cavities and begins reproducing healthy blood cells.”
Sarah pondered the idea while studying the drawings. “So, what’s the catch? What’s the bad news?”
Both doctors laughed. “You’re right, Sarah—that’s the good news, a best-case scenario. The bad news is that before the recipient can receive the donor marrow, she has to have all her marrow destroyed. We do that with chemo and radiation.”
“Sounds creepy,” Sarah said.
“Isn’t it dangerous?” Sarah’s mother asked.
“The threat of infection is very real and very life-threatening, but we take every precaution. We isolate the potential recipient in a germ-free environment before and after the process and until the new marrow starts growing. We put her on immunosuppressant drugs, which are eventu
ally dispensed with as the healthy marrow takes hold.”
“What about rejection?” Sarah’s father asked. “I’ve heard about transplants that don’t take because they’re rejected by the body.”
Dr. Hernandez nodded. “Graft versus host disease is medicine’s biggest problem in the area of transplantation.”
Sarah thought it was a big problem for her, too. How could they promise something so wonderful as a cure, then snatch it away with a series of medical enigmas? “So, are you going to transplant my bone marrow or not?” she asked. There was a sour taste in her mouth, and the sores were starting to sting. Her mother poured her a glass of water, and Sarah sipped it slowly.
Dr. Gill thumped on the tabletop with a pencil. “Frankly, we believe that a transplant is necessary for you. We think it’s your best chance of winning this battle.”
The words hit Sarah hard. This was no scrimmage with a nagging illness she was fighting. This was all-out war, and in order to win, she needed a bone marrow transplant. “How do I get one of these transplants? Can we do it while I’m here now?”
Dr. Hernandez leaned back in her chair and folded her arms. “First, we need to find a suitable donor.”
“What we look for in matching donor and recipient is HLA compatibility.” Dr. Gill drew busily on the legal pad. “Remember that rejection factor?” Sarah nodded. “Well, we’ve discovered that if six proteins found on the surface of white blood cells match the proteins of your cells, we have an optimum, six-antigen match. Identical twins have identical HLA.”
“But I’m not a twin.”
“True, but you have siblings, which increases your chances of an antigen match.”
“I could use my sister’s or brother’s marrow?” Sarah asked.
“What about my wife’s or mine?” Sarah’s father blurted out, startling Sarah. He looked disturbed. Her mother looked pale.
“You are long shots,” Dr. Gill explained. “You see, each of your children received chromosomes from both of you. That gives them a higher probability of matching Sarah. We can screen them with a simple blood test. I assure you, it only means drawing out a vial of blood from each for testing.”
Mother, Help Me Live Page 1