Devil's Choice

by Graham Wilson

  Treatment

  The next three weeks passed in a blur. During the first week Amelie received the anti- cancer drugs, a course of treatment called induction therapy where they gave doses of the two chemotherapy drugs in combination, which was hoped to kill the cancer cells which had been evident in large numbers in both her blood and bone marrow. The doctors called her cancer, Acute Lymphoblastic Leukemia or ALL for short and told them it occurred most commonly in children aged between two and three.

  If this induction therapy went well and her blood count and bone marrow returned to normal over the next month, then they would give her one further dose of the treatment to mop up any surviving cancer cells, and provided the cancer cells did not come back after that the treatment would cease and they would just conduct regular checks to ensure it stayed that way.

  Amelie tolerated this first course of chemotherapy surprisingly well though she was restless and grumbled a lot. Her hair did not even start to fall out and she continued to eat well except for a couple days after the treatment ended and she only lost a small amount of weight. The worst thing was she was bored by being confined to bed and wanted to get out and start doing things again so it was hard to keep her entertained and keep her as still as the hospital required.

  However they all took turns at entertaining her, Lizzie and Gran Patsy told her stories and read her books. Catherine brought in paper for drawing and did pictures with her and Mathew got her to help him making little wooden toys and building houses out of blocks. As she got better it got even harder to contain her but everyone considered this was a good sign so it was a small price to pay.

  After three weeks all the abnormal cells were gone from her blood and bone marrow and there was evidence of new healthy red and white blood cells being produced. The X-Rays were also all clear of any signs of the cancer in her lungs and the lumps were gone from around her neck and under her arms.

  The doctors considered the treatment had gone as well as could possibly be expected and expressed their confidence in a favorable outcome from here. Catherine and Mathew, along with Lizzie and Patsy crossed their fingers and toes and hoped it was true.

  They expected the repeat treatment to go equally well a month later, now it was only Mathew and Catherine caring for their child as Lizzie, Robbie and family had returned to Broome so their own children could return to school. Gran helped out when needed but they felt they had their life under control and could mostly manage on their own.

  However Amelie got much sicker this time, she had vomiting and diarrhea for several days and lost a lot of weight. Then two weeks later all her hair began to fall out in great lumps, and soon there were only a few straggly bits left.

  Surprising, despite Amelie getting much sicker this time, she was a much better patient. She no longer grumbled about being confined to bed and would play happily by herself with just her dolls for hours without appearing to get bored. However after three weeks, except for a little round bald head, with a light fuzz of new hair and a thinner face and body, she appeared to be back to her normal self, eating ravenously, full of chatter and mischief.

  Once she was home she spent endless hours driving her red car around the apartment and on quiet mornings as they tidied the hotel, Mathew would carry the car downstairs so she could drive it over the smooth wooden floors of the hotels bars and corridors. They could follow her progress by the clatter of the wheels over the joints in the floorboards and her babbling happy voice.

  After another month it was as if this sickness was just a distant memory, they had their Amelie back, face was round again with a mischievous grin and she gave out a stream of endless chatter with the bar workers and patrons. She had also become incredibly loving, often cuddled between them in the night and saying her prayers. “God Bless Mummy, I love her the best, God Bless Daddy, I love him the best, God bless Gran Lizzie and Great Gran Patsy, God bless Ella, God bless Robbie who helped Daddy make my dolls house.”

  In those nights when they held her close then gently lifted her to her own bed so they could join their own bodies undisturbed, they had started to talk about having another baby, the idea of creating new life alongside that of their little girl seemed fitting now they had her back.

  A Month Gone - Hope

  It was now into April, the heat of the summer was easing. Business was booming again, better than ever. It had taken a bit of a hit for the first two months when they were spending half their lives at the Children’s Hospital but in the last month it had caught up and was now looking to be their best ever year.

  Balmain had started to be discovered by a richer set, people who loved the old houses so close to the city and bought in, bringing their own young families and money with them, often professional people who were making a business success of their lives, along with a more Bohemian artistic set. There were still lots of regular old timers, who brought their pension payments, but alongside them were the new sets of the upwardly mobile and artistic and they valued the good meals the hotel served along with the Sunday afternoon music.

  Amelie now had an inch of hair starting to reshape her head away from an Elfin look to a little girl look again. Ella had managed to tie a red bow into some of the longer strands, telling her it matched her red car and made her look like a racing driver. In the morning, before the car was banished to the upstairs it could be heard, wheels rattling, pedals clanking, along with Amelie making engine noises as it flew along the hotel passages, warning pedestrians to step aside.

  Each fortnight they would take her in to the hospital for a blood check and each month for a bone marrow check. They hated these reminders but Amelie accepted it all with good graces, at most giving a little whimper when they put the needles in. So far all was clear. Mathew and Catherine found they almost did not want to know the results, they dared to hope yet feared lest something would fracture this joy, it was easier to live each day at a time and not to think of a future, beyond the immediate events.

  Easter came in early April, it was a time to take joy in life. They went to the Royal Easter Show and spend the day walking amongst the animal stalls, Amelie stroked the rabbits and guinea pigs and watched the cows and horses with a little person’s awe of other creatures so large. They watched the events in the main arena and the wood chopping, all shared ice creams and hot dogs and tried the rides which were suitable for a two year old, the merry go round and dodgem cars. Finally, in the mid afternoon, when the heat of the day was making them all tired, they came home and all fell asleep together on the big bed of their apartment.

  The next day was Easter Sunday and together they all went to church, alongside Gran Patsy, to the big church on the hilltop where they were married, giving thanks for their lives together and the returned health of their daughter.

  They refused to look over the horizon but were grateful for the precious life they had.

  Failure

  The last week in April was the two month checkup, two months since the end of the second chemo treatment. Amelie was still in fine form but in the last week had lost a little of her sparkle. It was not something clear, but just as if her buoyant ebullience had faded at little. Perhaps it was just that after her sickness and sudden wellness, life was back to a steady state again.

  Yet, as Mathew and Catherine together brought her to the hospital, they felt an edge of anxiety, but perhaps it was always thus with these moments of truth and they had allowed themselves to forget over the last month. Still they found themselves holding each other’s hand a little tighter and hugging the daughter a little more closely.

  The day proceeded with the banal tedium of normality, nothing to report, lots of waiting but still nothing to report as all the samples were collected and tests run. It would be tomorrow before the results were in, and the doctors scheduled an appointment with Mathew and Catherine for two pm. By then everything would be available, blood count and smear, bone marrow results and X-Rays of key body areas. There was no need for Amelie to come back on that date and Gran
Patsy had offered to mind her now that Lizzie had returned to the Broome.

  Both Catherine and Mathew slept badly that night, Mathew’s bad dreams had returned and Catherine could not shake a prickling anxiety as they waited for this moment of truth. They were in the hospital and waiting twenty minutes before their appointment was due, but there was no sign of either the specialist pediatrician, Dr McPherson, or oncologist Dr Ryan, who together were now managing the case. Finally, five minutes after the due meeting time they saw both hurry by together and go into the meeting room. They glimpsed Dr Roberts waiting inside as well. A further ten minutes went by with still no call for them to come in.

  Finally the oncologist opened the door and invited them in. One look at his face and Catherine knew that all was not well.

  Suddenly she did not want to know, to end their idyll in the sun. She felt an overpowering urge to take Mathew’s hand and walk out the door untold. It was as if a part of her had this impossible hope that if the story was not told then it could not come true, to pick up her daughter and pack up their car and drive over the horizon, perhaps to return to the desert where an aboriginal medicine man could try and cast out the evil spirit that lurked inside her daughter.

  But despite this will to run away her feet were glued to the floor, heavy lead boots restrained her from fleeing, instead she felt her insides turn to jelly as Mathew stood and took her reluctant hand to help her inside.

  The three doctors were arranged in a semicircle and spread out on the desk in front of them were the sheets of paper and X-Ray films which together constituted her daughter’s future, a life writ on plastic and paper. Catherine forced her panicked brain to quieten its inner noise. She realized that one of the doctors had begun speaking and she made her mind listen.

  She replayed the last two sentences stored in her memory banks. “I wish we could tell you that all is fine and there are no signs that the cancer has returned. Unfortunately that is not the case.”

  Mathew spoke, “What are you saying, Doctor?”

  “I am afraid we can see cells that look like cancer cells, abnormal lymphocytes with rapid division, in your daughter’s bone marrow. They should not be there. And there are also some suspicious shadows on the chest X-Rays that look like tumors are beginning to regrow in her lungs.”

  Mathew turned to the doctors and said, “I have been reading that Vietnam Veterans’ children have an increased risk of cancer. What do you know about that?

  Mathew continued, “They say it is from the dioxin which contaminated the Agent Orange they sprayed us all with, that it damages our DNA, and not only increases the risk of cancers in ourselves but the damage can be passed on to our children and cause cancer in them. Could this be the cause of what has happened to my daughter, that she got the cancer from me?

  The oncologist shook his head, “I don’t know and can’t say for sure, but it seems unlikely. However I have not read into this area, so others would be better qualified to answer than I am. But when these things happen there is no point trying to find something or someone to blame. That helps no one. It is not your daughter’s fault, it is not your wife’s fault, it is not your fault. The best thing you can do is focus on your daughter and staying positive. That is what works best.

  Mathew replied, with something like an angry growl resonating through his voice. “I am not blaming my daughter, I am not blaming my wife, I am not really blaming myself though some of my mates told me is was best not to get married and have children.

  “I am blaming the government of Australia who sent us there without protection and most of all I blame those American bastards who dropped spray all over the country to poison the trees and did not give a damn if they poisoned all the people and animals who lived there as well.”

  Catherine felt herself cringe inside at her husband’s anger. Her whole world of false hopes was collapsing around her; she wanted him to help her and Amelie and not fight with and blame the world. Perhaps he was right in some small way but what point was there to it all, as the doctor said their priority needed to be to help Amelie get better.

  She took Mathew’s hand, “Please can we just go home now, tomorrow we can talk to the doctors about what to do. I just want to hold my little girl and feel your arms around me too.”

  Something in the desperation of her voice must have got through to him, he stood up and brought her home with his arm around her shoulders and that night the three of them slept together, wrapped in a joint embrace, and if by holding on to each other they could hold away the next day.

  Fading Hope

  In the morning Catherine rang and told her mother of the test results, trying to keep the devastation out of her voice. It was hard to tell her Gran last night, saying it again to her mother was like a double body blow.

  She finished by saying, “Mum, I am so scared, and Mathew is taking it really bad as well, he is blaming himself from being sprayed with chemicals in Vietnam.”

  Lizzie cut through this at once. “Oh my, Cathy, I am so sorry. I will book the first flight I can to Sydney to come and help you. Robbie can mind the business here and the other children while we find a way through this.

  That day she and Mathew discussed what to do, both together and with the doctors. Mathew was opposed to further treatment. He kept saying that putting yet another poison into Amelie, trying to kill the cancer cells with yet more poison, when it was first caused by a poison, was crazy. He said he wanted nothing further to do with it, this chemotherapy thing, he knew it would only make Amelie really sick again like last time.

  However he had no other solution about what could be done and agreed that the cancer could not just be allowed to spread through her body unchecked. So together they talked to their doctors and then got second opinions from other specialists.

  At last Mathew agreed to a treatment plan which involved using radiation, which had not been used before, along with a moderate dose of chemotherapy that might in combination give a fair chance of controlling the cancer on the second go. They knew the odds of success were now below 50%. But by the end of all the talk they could not just abandon all hope for their daughter to this disease. However even when the decision was made Mathew said he still hated what they were subjecting Amelie to. Catherine could not disagree with him, but she refused to give up hope that this time it would work fully and cure her.

  By the time they had reached agreement Lizzie had arrived. She tried to give them support in their decision saying it was an awful choice but if it had been up to her she would have done the same thing too.

  When the day it came to take Amelie back to hospital and start the new treatment, Mathew asked Lizzie and Cathy to take her, he was morose and clearly did not want to have to face yet another round of medical meetings and waiting. He hugged Amelie tightly and promised to come and see her the next day.

  The treatment ran over another two weeks then there was a two week period for Amelie to recover before they retested her to see how it had worked. Amelie was really sick over the second and third weeks, she lost a lot of weight, she was five pounds lighter than when it started, her hair was all gone again and her face and arms were pitifully thin.

  In the fourth week she started to eat properly again and put some weight back, but now she had developed a persistent low grade cough, and sure enough when the time came the X-Rays showed that the lumps in her lungs had not fully gone away and she also had a low grade pneumonia that required ongoing treatment with antibiotics before it started to settle down.

  But she was a wonderful patient, so sweet and patient, barely grumbling when they gave her needles and always happy to see the nurses and doctors and with happy things to say to the other patients.

  Sometimes Catherine just desperately wanted her cross and crotchety daughter back, for there to be more fight in her soul to rage against this disease that was consuming her body. But she and everyone else had also fallen in love with delightful little girl who suffered it all so bravely.

  At first M
athew came to the hospital every day to visit her, but after a week as she got sicker he started missing visits, it was obviously tearing him up inside each time he saw that he started to take refuge in not coming and just giving the others presents to bring to her, drawings and little toys he made.

  Amelie seemed not to mind, she accepted all his gifts with joy. Each time asked Cathy and Lizzie to give him a hug and kiss specially from her.

  Finally at the end of the third week Amelie was well enough to return home and for a short time their life returned to something like normality.

  They all knew that Amelie was not better, the cancer cells were still growing away in her bone marrow and the tumors remained in her lungs.

  But for a month she seemed to have improved. The doctors gave instructions to feed her up, give her lots of attention and try and get her as strong as could be before they considered new treatment options.

  Madness

  As if she did not have enough to worry about with Amelie, Catherine had a new worry.

  Mathew had begun to have lots of bad dreams almost again. She remembered they had begun around the time she had the miscarriage in the second half of last year; but with so much else since it was hard to remember exactly when.

  Her memory was that since then they had ebbed and flowed, at times stopping for a week or two and then returning for two or three nights.

  But since Amelie had got sick they had occurred more and more. Now they were happening more nights than not and she found, in her own exhausted state, both emotional and physical, it was harder to give Mathew the level of attention she thought he needed.

  Now, more and more, she found herself resenting this additional disruption to her life. On some nights when she woke up to his tossing and turning she had started to go out to the lounge room, closing the door to the bedroom to cut off the noise of his muttering and the disturbance of his restless sleep.