by Heather Gray
The teen beckoned her from the bed. “Come on in. Join the circus.” Mrs. Maskey hovered nearby, wringing her hands. A wound care specialist stood on one side of the bed examining the teen’s visible bruises. Depending on the type of cancer and the treatment, patients bruised easily, and simple bruises could quickly turn into DTI’s — deep tissue injuries. From the other side of the bed, another nurse stitched up a cut on Makayla’s forehead.
Rylie grimaced. “The forehead? You couldn’t fall somewhere with soft fatty tissue to cushion things?”
Makayla chuckled, and the nurse doing the stitching warned her to hold still.
“You mean I could have avoided all this fuss by falling on my butt? How bad is it?”
Rylie downplayed the knot on the teen’s forehead. “Not quite as bad as those old cartoons where someone would get hit in the head and a ten-inch bump would grow from the spot.”
“Mom’s kind of freaked out.”
The teen glanced over at her mother, who raised her arms in surrender. “Guilty as charged.”
Rylie shrugged. “Moms are allowed to freak out now and then. Freaking out is in the official mom handbook. They’re legally required to do it at least once per month, but they’re given leeway for up to once each day.”
Makayla rolled her eyes. “I’m fine, honest. I think Mom screamed, though, so some of the others might be worried. You should go make sure everyone else is okay.” The teen wasn’t saying the words, but the message was loud and clear. I don’t want to talk about it in front of Mom.
Rylie stepped toward the door. “I’ll do that, but don’t be surprised if kids pop in all evening to check on you.”
The teen made a brushing motion with her hands, and Rylie allowed herself to be swept out of the room.
The meeting was over, and exhaustion tugged at Rylie’s shoulders. She’d been asked to serve on a hospital committee whose purpose was to determine the necessity of different programs and services available to the pediatric patients. She hated it. Cutting the pediatric budget seemed to be the committee’s entire goal. Every meeting turned into a battle. Wait until one of those committee members had a kid in the hospital with a deadly illness. Then they’d understand. Until then…
Rylie sighed.
She wouldn’t wish a deadly illness on anybody — child or adult — but still. If those people got out of their offices and bothered to go down to the units they complained about, they’d appreciate how every penny was spent. They would realize how important it was for kids to have toys to play with and movies to watch. If they ever sat in with a family receiving a terminal diagnosis for one of its members, they’d understand the importance of having chaplains available. If they bothered to go to the MRI suite when a terrified and hysterical child was told to lay still for an hour-long MRI, they would see first-hand how vital Child Life was.
Those problems, unfortunately, would still be there tomorrow. They could wait. Makayla couldn’t.
The unit was quiet. Most of the parents had gone home for the night. Some of the kids were asleep. Others stared at the TVs in their rooms.
She made her way to the teen’s room. The lights were out, but the glow from the hallway caught the flash of her open eyes.
“Hey. Is it okay if I come in?”
Makayla gave her a tired smile. “Sure.”
Rylie slipped quietly into the room but didn’t turn on the lights. After a hit on the head, her eyes might be sensitive. Then again, maybe she didn’t want anybody to be able to read her face and thoughts.
“Want to talk?”
Makayla shrugged.
Rylie sat on the edge of the bed. “Do they know yet what happened?”
“Doc says I fainted. They’re running a million tests.” The teen’s voice was dejected.
“Tests are nothing new. Why so down this time?”
“Stupid doc opened his big mouth and said they were talking about releasing me but wouldn’t be able to now.”
Ouch. Having the prize within reach then seeing it snatched away… That was brutal.
“I thought the trial forced you to stay in the hospital for the duration.”
Makayla growled before answering. “The doc in charge of the whole trial made me go into the hospital because my white count was going wonky. That, and I kept getting fevers. He said he wanted more control over my environment. He’s in Chicago, but he let me pick a hospital close to home.”
None of these details were new to Rylie, but she let the teen talk.
“Apparently I’ve been so stinking stable lately that he was talking to the oncologists here about letting me go home for Christmas. Nobody told me in case it fell through. Until that jerk opened his mouth tonight.”
The doctor wasn’t a jerk, and mentioning Christmas was a mistake he would never make again. Makayla didn’t need to hear that, though. She would figure it out for herself in time. She might even feel guilty for calling the guy a name.
The teen spoke into the darkness. “Maybe I was right.”
“About what?”
Makayla sighed. “This is going to be my last Christmas, isn’t it?”
Rylie scooted closer and pulled the teen into her arms. Tears soon soaked the short sleeve of her top, but she didn’t say anything, at least not to Makayla. That didn’t, however, stop her from talking to God.
It’s not fair. She’s spent most of her life in the hospital, and she deserves to go home to be with her family. Give me the words, Lord. Help me know what to say.
No words came, but peace settled across Rylie’s heart. She stayed in place and held Makayla as the torrent of tears continued.
“Are you up yet, hon?”
The voice reached through Rylie’s fitful slumber and tugged at the edges of her attention.
“Come on, sleepyhead. You told me to wake you.”
Rylie rolled over on the couch and stared up at her mom through a cascade of sleep-mussed black hair. The lights of the Christmas tree twinkled to her left as the sun, visible through the living room window to her right, worked its way up into the sky. “Is it morning so soon?” As if the sunlight didn’t give it away.
Her mom held out a cup to her, and the smell of coffee tickled her nose and tempted her stomach. Rylie pulled herself up and tucked her feet beneath her on the couch.
Spending Christmas Eve night at her mom’s had been a tradition ever since she’d gotten her first job after college and moved out. She reached for the cup and sniffed the air again. Cinnamon, brown sugar, and yeast. Ahhh. Monkey bread, another family tradition.
“Merry Christmas, sweetheart. What time do you need to go?”
Rylie rubbed a hand over her eyes and fought to focus. She hadn’t slept well since Makayla’s collapse, and the whole waking-up nonsense got harder with each passing morning.
With a familiar shake of the head, her mom slipped from the room. The sound of the oven door being opened reached Rylie. The time had come to get moving. She set her coffee on the couch’s side table and trudged to the bathroom.
Fifteen minutes later, Rylie returned to the living room. Her face was washed, her teeth brushed, her hair combed, and she was dressed. As for being awake? She needed to drink more coffee first.
Her mug, however, was no longer where she’d left it. Mom at work, no doubt.
Rylie reached the kitchen and the small two-person table tucked away in a corner. The missing coffee sat next to the platter of monkey bread with her mom’s cup of hot tea on the other side.
Once she took her seat, Mom grasped her hands and prayed. “Dear Lord, thank You forever for the precious gift of Your Son. We ask You to bless us today, and to help us keep our focus on Christ’s birth and, ultimately, on His sacrificial death. Encourage us at every turn, Lord. Lift our hearts and challenge us to wholly seek You. Be with Makayla today as she gets this news. Comfort her heart, be with her family, give them strength, show them Your Love. Hold them tenderly and please, please, please… Please let the test results be good.”
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br /> Rylie echoed the soft Amen and opened her eyes to be greeted by her mom’s watery smile. Mom had taught her from a young age not merely to act compassionate toward others, but rather to make compassion a part of her existence in the same way that eating, sleeping, and breathing were. The tears were expected. Anything less, and it wouldn’t have been her mom there with her.
“So did they give you any indication of the results?”
Rylie shook her head in answer. “They usually do, though.”
“And that has you worried?” Mom nudged the platter of monkey bread closer to Rylie’s side of the table.
“I don’t understand the timing. They wouldn’t deliver bad news on Christmas, would they?”
She’d received a text late the night before. Makayla and her family would be getting the test results this morning.
Oncology rarely saw surprises. Cancer was, after all, usually a slow disease. Most procedures and tests were scheduled during normal business hours. For that reason, only one Child Life Specialist worked the unit — her. When a situation developed outside her schedule, the nurses took care of it and either texted her about it or informed her the next time she came in.
This was Makayla, though.
And it was Christmas Day.
No Child Life Specialists were due at the hospital. All the units were quiet. Every child who could be discharged had been, and nothing of import was scheduled. That’s why the text from last night was such a mystery. The oncologist on call for the holiday had texted to inform her he expected the last of Makayla’s tests back by early morning and planned to meet with the family between nine and ten.
Rylie couldn’t let the Maskeys go through this without support. Granted, everyone on the nursing staff loved them and would do whatever they could to help. But again — it was Makayla, a girl who statistically shouldn’t have lived to see her tenth birthday because of her first cancer and who had nonetheless survived two recurrences since. A girl who, at age sixteen, put on a positive face for her parents not to escape their hovering, but rather to give them good memories of her. A girl who… a girl who had stolen Rylie’s heart six years earlier when they’d first met and whose every stay in the hospital since had been an exercise in joy and torment.
She had to go. She wasn’t sure she’d be able to forgive herself if Makayla needed her and she wasn’t there.
“Are you going to take even a single bite?”
Rylie peered from her still-empty plate to her mom’s sad eyes. “I want to throw up.”
A nod met her words. “I had to try. You go. Be there for that girl, and love her and her family the best way you know how. I’ll still be here when you’re done.”
“I don’t want to ruin your Christmas.”
Mom began fitting plastic wrap over the untouched monkey bread. “We all have good days and bad, Ryles. It’s nobody’s fault if a bad one falls on a holiday. The only thing that will ruin my Christmas is if you don’t come back here and share your day — whatever it turns out to be — with me.”
Rylie headed for the front door and put her jacket on. Winter had finally shown itself with the fury of a wild beast in Northern Virginia, so she reached for her scarf, too. A quick jog back into the kitchen brought her to her mom’s place at the sink where she was washing out their cups. “Love you, Mom.” She gave the woman a tight hug before heading back to the door.
“Love you more, my pretty.”
The words floated behind her. The my pretty was an inside joke so old neither she nor her mom remembered how it had started, but still, it was comfortable and familiar, and on a day like today, those things mattered.
What would Makayla be facing? Bad news had become far too familiar in her short life, but it would never be comfortable.
“I can’t begin until…” The oncologist’s words trailed off as Rylie entered the room.
Were they waiting for her? She wasn’t that important.
The oncologist gave Rylie a grateful look. “I was explaining to the Maskey family that we need one more person, then we can get started.”
Makayla offered a wan smile before her eyes shifted to the door and dread filled them.
“Ah, Doctor Pratt, it’s good to see you.” Relief flowed through the oncologist’s voice like water through the crack in a dam — natural and forced at the same time.
Rylie took in the new addition. Dr. Pratt. She’d never met him. He was the head researcher for the drug trial. He had been to visit Makayla twice — once before she started the drug trial and then again when he made the choice to hospitalize her for the duration of the treatment.
His presence sent Rylie’s stomach on a roller coaster ride hurtling through the darkness.
Doctors didn’t travel across the country on Christmas Day to deliver good news. Then again, decent human beings didn’t travel across the country on Christmas Day to deliver bad news.
By the look on the faces of Makayla and her parents, they agreed.
Doctor Pratt strode into the room, grabbed a chair from its resting place against a nearby wall, flipped it around backward, and straddled it. He folded his arms across the top of the backrest. “My natural mode of communication is science. I want to explain what’s going on with your treatment, but if I get too sciency, feel free to jump in, okay?”
Not a hello, or a how’ve-you-been. Straight to business. Being a research doctor must void the need for a bedside manner.
The visiting doctor’s entire focus was on Makayla, and as soon as she nodded, he began. “I was in the midst of studying the cellular response to various chemo drugs when I noticed a correlation between mitochondrial reactions, the replication of certain amino acids, and the behavior of human t-cells…”
Makayla cut him off. “The science stuff is interesting and all, but are you here to give me good news or bad?”
“Good, I think.”
“Good for me, or good for future generations?”
“Both, I believe.”
Makayla sucked in an audible lungful of air, a stunned look on her face. She smiled at her parents, who had been still as statues since Dr. Pratt’s entrance. They’d stood there holding hands as if their lives — or their daughter’s life — depended on it. They both started to rush toward the bed then stopped themselves. They retreated and sank onto the room’s wide window seat instead.
Rylie could only guess at what they were going through. Good news, after all, was relative. Did good news mean a cure? Or one more year? Both were good, but they were very different types of good.
Dr. Pratt’s eyes wandered the room until he met Rylie’s gaze. “Child Life?”
“Rylie.” She held out her hand with a nod.
He shook it. “I’m not good at the people stuff, and I know it. I visit a different hospital almost every week as part of this drug trial, and I can’t tell you how grateful I am for all the Child Life Specialists who spend their days making up for the shortcomings of doctors such as myself.” Then he winced. “I mean, relationship shortcomings, not medical.”
Rylie couldn’t help but chuckle. “You don’t say.” She waved her hand toward the hospital bed. “I think you can get back to your sciency stuff now.”
Dr. Pratt swung back to Makayla and gave her a wide smile. “Shall I continue, or do you want me to fast forward?”
Her eyes sparkling, the teen told him to pick up where he’d left off.
A thirty-minute lecture about the cellular effects of cancer drugs commenced. Dr. Pratt explained why his drug was different and how he hoped it would revolutionize pediatric cancer treatment in America. If it proved itself in this trial, he believed the methodology would be applicable to other cancers as well.
By the time he took a breath, Rylie was ready to sign up for his drug trial, and she didn’t even have cancer, let alone the specific one he was going after. Nor was she anywhere near his targeted age group.
“Is the drug actually doing what you designed it to?” The question came from Mr. Maskey.
> Dr. Pratt pulled off a nod-shrug that gave nothing away until he spoke. “Of those who have finished the treatment, we’ve seen an eighty percent remission rate. We don’t know yet how long the remission will last, but early signs indicate a positive outcome for patients.”
Eighty percent… Wow. Eighty percent was unheard of with Makayla’s cancer.
“Am I… Am I in remission?” The teen’s breathless question, wrought with hope, pulled on every single one of Rylie’s heartstrings.
Dr. Pratt nodded. “We need to finish out the treatment, but as of your last scans and blood draw, you appear to be cancer free.”
“Why did she collapse?” Mrs. Maskey’s voice cut through the room, a razor-sharp blade that demanded attention and allowed no celebration. They’d had remissions before, and they’d lost them.
The doctor hung his head for a moment before answering. “Every drug comes with side effects. This one appears to impact the pancreas in about fifteen percent of participants. The pancreas produces the insulin that…”
“Has the pancreatic side effect been fatal to anyone?” Mr. Maskey ignored the brief glare from his wife.
Dr. Pratt nodded, reluctance etched into the lines around his mouth. “Twice. I take responsibility for not stressing more thoroughly the importance of frequent blood sugar checks. Had more diligence been exercised in checking and documenting their levels, we might have caught the problem sooner and been able to get proper treatment for them both.”
He’d taken the blame rather than saying it was the kids’ fault for not checking their sugar levels more often. In a world where malpractice seemed to lurk behind every corner and medical professionals had gotten so used to avoiding blame that excuses were more common than platitudes, his approach was refreshing.
Still, Rylie wanted to read those two files. She’d ask him later. Now wasn’t the time. After all, it was Christmas.
Rylie stepped into the hallway and collected the balloons she’d left there out of sight. She brought the enormous bouquet of red and green balloons into the room. Every crevice, crook, and cranny of her car had been crammed, trunk included. Stepping close to the bed after depositing the gift, she grabbed Makayla’s hand. “Do you need anything?”