Sam pauses and takes in that statement. “So, you mean Joe is a goner?”
Jex kicks herself inside for referring to it like that, the memory of her father causing her to briefly forget Sam has a friend in a battle with his own sarcoma right now. “There are all kind of sarcoma and they are found at all different levels of severity.” Trying to sound hopeful, she adds, “Joe’s could be very different and have a lot more treatment options.” Her attempt at hopefulness does not seem very hopeful to Jex, and she wonders how it sounds to Sam. She makes a note in her head to think through that later. Communication matters, she thinks to herself. You have to remember that.
For the first time, one of the guys that is with Sam speaks. His voice is louder than Jex would have imagined, and is full of distress.
“Yeah, there are treatments, and those doctors explained them to us, but they only used these big words and they don’t make any sense to us. And they only give us like five minutes, and are all arrogant and everything.”
The third guy now speaks up, agreeing with the second. “They’re a bunch of asshats.”
Jex nods her head absently, having had many of her own experiences with doctors, some of whom certainly fall within the category described by the third guy. “What about Joe’s family? What are they saying about it?”
“We’re the only family he has,” Sam responds. “His dad disappeared on him before he was born. His mom died a few years ago. It’s just us metalheads trying to figure all this bullshit out. We’re family.”
Both of the other guys nod in agreement. “True dat,” one says.
Sam gets to the point. “Look, we know it’s not your problem, but with all that medical stuff you have, maybe you could come to the hospital and meet Joe, see what’s up with him?”
Jex can’t help but laugh just a little out loud. “Dudes, I’m sixteen with a high school degree and no more. I read a lot of books, but I can’t cure cancer. Trust me, the doctors at Cedars-Sinai are giving Joe the best treatment he can get. They can be asshats, but they are the best asshats out there.”
Sam shakes his head in mild frustration. “We know you’re not a doctor. We know you can’t fix him. But, you know, we could really use, like, a translator. If you talk to the doctors and look at all these papers they give us, maybe you could help us understand what all this is about. Maybe you could even offer up something that the doctors didn’t think of.”
“Trust me, Sam. I can’t think of anything the doctors didn’t already think up.”
“Maybe not,” the third guy chimes in. “But like Sam said, maybe you could translate for us. Help us understand.”
“Come on, Jex, maybe you could just meet Joe,” Q interjects suddenly, hopefully; the story clearly touching her. “It couldn’t hurt.”
Jex shrugs. “Maybe it won’t hurt, and I don’t mean to be brutal, but it probably won’t help either.”
“But maybe it will,” the third guy retorts. “We’re just living on chances right now, even if they’re small ones.”
Jex rubs her face and through her hair in frustration. She pauses and then asks, “What’s Joe’s’ doctor’s name? Is there one that is more involved than others?”
All three guys nod in unison and say, “Dr. Cohen.”
Jex gags involuntarily in response. “Dr. Benjamin Cohen?”
“Yeah” the three guys respond, again together.
“Do you know him,” Sam asks.
“Yeah,” Jex nods, reluctantly. “I know Dr. Cohen. He was my father’s doctor.” The three note Jex’s reluctance and she senses the instant worry in their eyes. She clarifies. “An amazing doctor, don’t worry. He just … ,” she shrugs, struggling for the right words. “He just fits very neatly into the asshat category you describe.”
* * *
The next day just before ten a.m. at Cedars-Sinai, Jex is outside the hospital, sitting cross-legged in the parking lot on the hood of her car. She is smoking a Camel Crush and sipping a plastic cup of McDonald’s coffee. She woke up feeling bad this morning, but the sun feels good on her face as she peers through her cheap sunglasses, neon green frames, out over the parked ambulances and Mercedes Benz. She runs her hands through her hair. She squints, trying not to think. All the things running through her head, ghosts and echoes of yesterdays, she tries to ignore them. She tries to focus on science, or medicine, or some graffiti tag she might break out over in West Hollywood later this week. Tagging gives her an escape, and she quietly thinks to herself that she could use an escape at the moment. She tries to focus on anything but the things that are piercing into her brain.
“Yo, Jex!” The yelp breaks Jex out of her thoughts at one of those times she doesn’t mind being interrupting in her thinking. She turns and sees Sam and his two buddies walking towards her, a big smile on Sam’s face; reluctant, hopeful looks on the faces of his friends. She waves to them weakly as they approach, but doesn’t try to smile.
“What’s up, Doctor Jex,” Sam inquires. “You look deep in thought.”
“I’m not a doctor,” Jex reminds Sam. “I’m just some punk kid.”
“Yeah, yeah, yeah,” Sam responds off-handedly. “You’re sure the smartest punk kid I ever met. And the kindest, by the way. Thanks very much for meeting us. We are super stoked you agreed to see Joe.”
Jex shrugs testily. “Yeah, I had nothing to do, so I thought I’d say hi and shut you guys up. But, like I told you last night, just because I know how to do some ear exams doesn’t mean I can treat or diagnose or even understand cancer. If your friend wants someone else to talk with, I’m happy to talk to him, but if you’ve got expectations that I can do anything to help him, your hopes are already too high.”
Sam’s two friends respond somewhere between shocked glum and I-told-you-so frustration. Sam doesn’t flinch a bit. He is, perhaps in his heart, somewhat of a salesman. “Understood, understood. Every word completely understood. Like I said last night, we are just looking for a translator for a minute, to try and comprehend some of this medical crap, and maybe a quick brain storm session. I know it will cheer Joe up, and what the hell, never say never as far as ingenious ideas, right?”
“No,” Jex retorts, just as testily. “Sometimes you can say never.”
Showing an eternal optimism that may have surprised his two friends if they were asked, Sam says, “OK. We’ll see.”
“Ugh,” says Jex, as she begins the walk to the hospital. Sam and his two friends follow close behind. Sam manages to scurry to the front of the small group just in time to open the door and walk into the room. Jex scans the room. It is just like every other hospital room she has ever seen. Well, to be precise, it is Cedars-Sinai, which is a nice goddamn hospital. Jex privately wondered to herself how this straggly crew of waxheads got their buddy admitted here. Freshly painted walls. Flowers everywhere. Nice framed paintings. Hardwood trimmings. Shiny linoleum floor.
Still, it is the same as any other hospital, sterile and clean; somehow empty in its cleanliness. Despite the moneyed fever inherent in its hallways. Despite the brilliant minds carried around by all these middle-aged pudgy bodies in white coats. Despite the storied history and famed patients, with their household names and overflowing bank accounts. Instant visions of healing people flood Jex’s mind, thinking there is a better way. Through all her negativity, these thoughts always make her smile, even if it is not apparent on her face. For a moment, she is lost in her thoughts.
“Jex, this is Joe. Joe, this is Jex.”
The introduction breaks Jex out of her momentary daydream. She looks down and sees Joe. He is bald and has no facial hair; no eyebrows, eyelashes. His face is thin, and the thinness of his body is apparent even under the blanket. His blue eyes are drooped and red but he is smiling.
“Hey there, Joseph Foster. Nice to meet you,” he says in a quiet voice with a manner that is genuine and instantly disarming.
Jex smiles for the first time since she left her car. “Hello, Joseph Foster. It is nice to meet you, too.�
�
“So, you’re the girl everyone is talking about. Dr. Jex.”
“It’s just Jex,” Jex corrects him through her easy smile. “I’m just a kid. Not a doctor.”
Joe smiles easily at her. “Sam tells me you can like save lives and shit.”
“Not even close,” Jex replies, still smiling. Her smile is worth noting for its calm nature. It’s one of those things that is natural, not artificial or forced. You either have it or you don’t.
“Well, don’t bother trying to save mine,” Joseph Foster says, still smiling. “It’s already gone.” There is a slight, tired slur in his tone, but it is otherwise clear and concise. His demeanor is pleasant to the ear, more pleasant than one would expect under the circumstances.
“Dude,” Sam exclaims. “Don’t say that. Negativity is terrible for you – you heard the doctors.”
Joseph Foster shakes his head. “Man, I can hear these doctors all day long but I can’t understand a goddamn thing they say. But I heard what those test results were and I know I’m a goner. So be it. I’m not scared of death. Shit,” he continues, speaking to Sam but also turning his words to Jex, almost defensively. “We’ve been singing about it for ten years, it would be pretty lame if I fought against it now.”
“Yeah, but still,” Sam objected. “That’s why Jex came, man. So she can look at your shit and, shit I don’t know. Make some sense of it for us before we hold hands and jump into bed with Satan. I mean, you know, any more than we already are.” Sam turns to Jex, chuckling. Jex roundly ignores him.
“Sam asked me to come and say hi to you, which I’m happy to do. But you’re at the best hospital for cancer, probably in the world, Joseph Foster, I can assure you of that.” Jex spoke firmly but with a comforting manner, so her words, though stark, still held a comforting air in them. “There’s nothing I can tell you that they haven’t already, I am quite sure of that.”
“Yeah,” Joseph Foster nods. “I’m super appreciative for you to come here. It’s OK. I’ve never been scared to die. I’m not scared now.” Joseph Foster looks over at his band. “That’s not a negative thing.”
Jex nods. “It’s OK to be scared. It’s OK not to be scared, too.”
Joseph Foster smiles in a lazy way. “Thanks, Dr. Jex.”
Jex nods firmly, repeating her early words. “It’s just Jex. Maybe the best way to just shut our friend Old Sammy up is for me to have a look at your charts. Would you mind that?”
Joseph Foster shrugs. “It doesn’t matter to me. Doesn’t say much about me that I’m ashamed of. I caught herpes when I was fifteen, but oh well, I got past being embarrassed about anything a long time ago. Full transparency.”
Jex smiles her smile, with its comforting waves. “Thank you very much, Joseph Foster. Unlike your friend Sam here, you are a gentleman.”
The two other guys in the band laugh their Beavis and Butthead laugh. Sam kind of raises his eyebrows and leans back in a what-the-hell kind of way, throwing devil signs with both hands. Joseph Foster scrunches his face and bangs his head, in an in-your-face kind of way. These guys have chemistry with one another, Jex thinks to herself as she grabs the file next to the bed.
The seconds pass. And then the minutes. Jex reads page after page, her forehead scrunched up. Jex melts away into the pages, as though medical notes, good news or bad, are her only real solace. Lab reports and x-rays and clinical notes. Page after page. The minutes continue to pass. Sam studies his sneaker.
The two other guys just stand there with their hands in their pockets. Joseph Foster picks at his thumbnail, somehow appearing to be the calmest one in the room. A nurse walks in, drops some towels off into the bathroom and walks out. She doesn’t say a word. The silence gets louder.
It’s easy to see that Sam is the kind of guy who doesn’t have a lot of patience. He’s the kind of guy that jumps right out of his clothes at the slightest obstacle. He is kicking lightly at the side of the wall, his eyes darting from Jex to Joseph Foster and finally outside the doorway, into the hall of a hospital. A woman in an electric wheelchair speeds by the room, eyes Sam briefly but pays him little mind. Sam closes his eyes and breathes slowly. He’s the kind that doesn’t wait around, but here he is, waiting around to hear what Jex has to say.
An eternity passes.
After that eternity, Jex turns to Joseph Foster. “Ok, Joe, you want it straight?”
He doesn’t even pause. “Of course.”
“Ok. Well, what it says here is you went to County Hospital downtown with stomach pains. They sent you out for tests and took an image of your belly. They found a tumor in your abdomen, right?” She is talking straight to Joe, staring him in the eyes. She doesn’t refer to any notes.
“Right,” Joe confirms.
“Right,” Jex agrees. “So they took a biopsy of the tumor. That was your first surgery. They diagnosed you as having a sarcoma, right? Soft tissue sarcoma.”
“Yeah,” Joe confirms again. “That’s what they call it.”
“OK, and a really rare sub-type. It’s called a Ewing’s Sarcoma/Primitive Neuroectodermal Tumor. They abbreviate it as PNET. They told you that, right?”
“Yeah, like winning the lottery they said.”
Jex nods slowly. “Quite a victory,” she says, the sarcasm dripping from her lips.
“Yeah,” Sam interjects. “That’s how I felt.”
“And you were classified T3 N1 M1b,” Jex says to Joe, ignoring the interjection. “But you know that, right?”
The room is deathly silent. “Yeah,” Joe says, almost in a whisper. “I remember the doctor saying that.”
She looks at him closely. “Do you know what that means?”
Joe pauses for a minute and just kind of stares in Jex’s eyes. After that pause, the reluctance in his voice is apparent as he slowly shrugs and admits, “not really.”
“No worries,” Jex says in that tone. “Each of the letter stands for something. So, the T stands for how big the tumor is, and yours is pretty big. It’s 3 out 3, which is the highest. So…”
“Kinda serious,” Joe offers.
“Yes,” Jex says frankly. “It is. And so you have the N, which is all about how far the cancer spread. So, cancer originates in an organ, in you it was the abdomen. A cancer spreads by, like, hitching a ride from one organ to the next, kind of piggybacking, you know. Not quite piggy-backing or hitching, but you get the picture.”
“Yeah,” Joe replies. “That makes sense.” Other than that, the room overflows with silence.
“The further a cancer spreads, the less likely it is you will be able to beat it back.”
“Makes sense.”
“Yeah. So, that’s the N1 part.”
“Is that a lot?”
Jex doesn’t pause and her voice is calm and steady. “It means it has hitched a ride to other organs; that it has spread to other organs. It’s a very serious classification.”
A flicker of despair pokes up from Joe’s eyes, and disappears just as quickly. “Yeah,” he says with a quiet choke. “I guess I knew that. It just didn’t really make sense until now.”
Jex pauses for a moment, but just for a moment. Silence hangs like violence in the room. “M just tells you whether the lymph node was able to transport the cancer to other organs. You’re M1b, so that means it did, like it made the lymph node ride to another organ. Metastasis it’s called.”
“Yeah,” Joe says, his voice finding its courage again.
Jex takes a deep breath. “You OK, Joe,” she asks.
“Yeah,” Joe confirms. “I got it.”
Jex pauses and recognizes the other three guys in the room, all of who stand in stunned silence. “You guys OK,” she says, in a whisper that has a tenderness in it completely absent from her earlier communications. They all nod slowly, saying nothing. Jex nods back quietly and returns her gaze to Joe.
“So, after that great news, you went through a treatment, right?”
“Yeah,” he agrees. “The night before that treatm
ent we had an awesome gig. Over at Canter’s in the back room. We fucking nailed it. You remember that, Sammy?”
Sam looks like he’s about to tear up, but he just nods in agreement, his face red, silence speaking all the volumes of the American canon. Joe looks over at the other two guys, who are both ashen, the reality of Joe’s condition suddenly seeming to sink in for the first time. Joe doesn’t say anything to them, but returns instead to his conversation with Jex. He pauses on his words, almost clawing them back, before he continues. “That was our last gig.”
Jex clinches her lips in response to that and says nothing for a moment, judging to herself whether Joe wanted to continue. After another second, he senses it and speaks. “Go ahead, let’s talk about the treatment.”
“Well, it’s tough with soft tissue sarcoma, because what this tumor does, these malignant cells, is they invade tissue nearby, neighboring tissue, you know, get into blood vessels. And so it spreads really quickly, through the lymph node. What they tried to do with you was pretty typical, and included what they call neoadjuvant therapy, ok?”
“Yeah, that sounds familiar.”
“So all that means, Joe, is that they assessed it and categorized it using computer imaging. That’s it.” She gestures to the flip chart, but doesn’t have to look at it. It is all already in her head. She only ever has to ready anything once.
“First you had your a dose of chemo, right? To try and shrink the area that needs to be treated. Then, you had your surgery, to try and get rid of the tumor in the abdomen. It’s called local excision, but basically it just means they cut it out.”
The two other guys turn from ashen to green. Jex continues. “After that, you recovered for a bit. Then they did radiation treatment. The idea of that is make sure that anything around the excision that is cancerous is killed off.” She pauses for a moment. “That must have sucked balls. I’m sorry you had to go through that.”
Joe just shrugs.
Jex Blackwell Saves the World Page 4