She would have expected to start screaming out “no!” She would have pictured herself demanding that he run the tests again. Tears, at least.
Instead, she sat there numbly, staring at his face, wondering if that scar over his lip had happened in childhood, or if it had been recent. Had stitches been involved, or plastic surgery, or just a Band-aid?
Harry cleared his throat, shaking her out of her rambling thoughts. He was beside her now, taking her hand. It felt like ice, though she wasn’t sure if it was his or hers that needed warmth.
“Six positive lymph nodes,” she repeated. “What does that mean?”
“It just means that the cancer cells have spread. That we have to be a little more aggressive with treatment.”
Sarah moaned and covered her face, and Jeff took her hand.
“Let me see the report,” Harry said, and the doctor handed it to him.
“The cancer cells are also hormone receptor positive,” the doctor went on.
Sylvia’s mind groped awkwardly for the information she’d gathered. She had read about the hormone part of this, but for the life of her, she couldn’t remember it now. “What does that mean?”
Harry rubbed his eyes and handed the report back to Sam. “They look for a particle of protein on the surface of the cancer cell to see if it’s sensitive to estrogen,” he said. “If it is, the cell is triggered into growing and dividing when it’s stimulated by estrogen. Most women over fifty have that. Isn’t that right, Sam?”
“That’s right. That means that we’ll have to treat it with hormones after the chemotherapy.”
“For how long?” Sylvia asked.
“For at least five years, but possibly the rest of your life.”
She swallowed, wondering how long that would be.
The doctor explained, “The hormone therapy will keep the hormones from triggering the cells into growing.”
“What about the breast tissue?” Harry asked. “Can I see that report?”
The doctor flipped through the file and found the pathologist’s report on that. “He determined that her breast tissue is poorly differentiated. No surprise there. The tumor is three centimeters, as we thought.”
Harry took the report and studied it. His face was pale, and she felt his hand tightening over hers. He didn’t realize how strong he was. Often, when they prayed together, he would hold her hand so tight that it would go numb. He did that now.
“As we told you going in, Sylvia, your cancer cells are very aggressive,” Sam said. “That means that our chemo treatment is going to have to be aggressive, too. It’s not going to be a picnic.”
Sylvia thought of her hair falling out, her eyebrows bare…
Tears stung the backs of her eyes, but she told herself she would not cry in front of her children. She wasn’t finished teaching them lessons, even in early adulthood. They were learning from watching her. Everything she did, every expression, every word, would be forever etched in their memory.
So she rose to the occasion. “I’m up for it, Sam. Bring it on.”
He smiled weakly.
“What do we do next?” Harry asked. The paper in his hand trembled as he handed it back to Sam.
“I’m going to send Sylvia for scans of her head, chest, abdomen, and bones to determine if there’s cancer anywhere else in her body. That should give us a good indication of what we’re dealing with.”
“More tests,” Sylvia said. “How long does all this take?”
“We hope to get all the scans done today.”
She nodded and looked at her children. Sarah had tears running down her face. Jeff’s face was red and as serious as she’d ever seen it.
“When will I be able to start killing this cancer?”
“We can’t start chemo until a month from now. We’ve got to give your body time to heal from the mastectomy.”
She didn’t like that answer much. “I know the oncologist warned me of that, but it seems like we need to do it sooner. Those cells are dividing and growing.”
“It’s okay,” he said. “Even with aggressive cancer you have time to heal.”
She looked at her children again, saw the terror on Sarah’s face and the rock hardness on Jeff’s.
“All right,” she said, “I’m ready for those scans anytime you are.”
“We’ll schedule them for this afternoon.” He closed her file and got up. “My secretary is making you an appointment about two weeks from now with your oncologist, so that you’ve had a little time to heal and we’ve gotten all the results back.”
He patted Sylvia’s hand. “Don’t worry. We’re going to be walking alongside you in this. We wouldn’t mess up for anything, knowing Harry the way we do.” He chuckled, and Harry forced a smile.
He started to leave, but Sarah came to her feet. She looked like a child lost at the mall. “Doctor?”
He turned at the door.
“Is my mother going to be all right?”
“We’ll know more after the scans,” he said. Without offering any more in the way of commitment, he headed down the hall.
CHAPTER
Twenty-Four
By the time Sylvia had finished all her scans, the kids had gone home to give the baby a nap. Sylvia tried to sleep, but the pain in her chest and under her arm was so great that she couldn’t relax.
But it wasn’t the pain keeping her awake. It was the fear. She’d already had bad news once today. If the scans showed tumors in other organs…Well, she couldn’t even think past that.
Harry had gone to see the film and gather the reports. Once again, she thanked God that he had pull in this hospital, and that she didn’t have to wait through another long night.
When he finally came back into her room, his eyes were bright and dancing.
She caught her breath. “Good news?”
“Yes,” he said. “The cancer doesn’t seem to have spread to any other organs.”
“Oh, thank you, God.” She brought her hand to her forehead and gave in to the tears that had threatened her all day. “Thank you.”
Harry’s eyes were wet as he bent over her bed. “You’re going to be fine, sweetheart,” he said. “What the surgery didn’t get, the chemo will.”
She reached up and framed his face with her hands. “Oh, Harry. Are they sure?”
“They’re sure and I’m sure.”
She sat up, slid her feet off the bed. Wiping her eyes, she said, “Okay, then that means I can get on with this. I need to go home, Harry. I need to shop for a prosthesis to wear under my clothes. I need to look for a wig for when my hair falls out. I need to start physical therapy so I can move my arm again. I need to spend time with my grandbaby. I need to get on with things.”
“I already talked to Sam about releasing you. He told me you can go home tomorrow.”
She got up and pulled Harry into a one-armed hug, and melted against him. “You’re going to be all right, sweetie,” he whispered again. “You’re going to be all right.”
But the good news didn’t outweigh the bad, and that night, as she tried to sleep one more night in the hospital room, with the bright night-light over her head and nurses coming in and out to take her blood pressure and temperature, she thought about those cancer cells that had already gotten past the filters of her lymph nodes. Where had they gone, and where were they headed? Would they take up residence somewhere in her body before the chemo could nuke them out?
Once again, she kicked herself for thinking this way. There was so much to be grateful for. How could she overlook the blessings of the normal scans and only concentrate on the negative?
But as hard as she tried to banish them, the thoughts wouldn’t go away. She almost wished she hadn’t insisted that Harry go home tonight. He was exhausted from sleeping on the sofa next to the window, and with Sarah’s family and Jeff in the house, he needed to be home.
Besides, she was a big girl, and the uncertainty had passed. She knew where she stood now, what to expect, what would c
ome next. It could be so much worse. People recovered from breast cancer all the time. It was treatable, and she had the best doctors anyone could want.
Yes, she told herself. She had much to be grateful for.
She reached for the Bible that Harry had left on her bed table, and turned to the Psalms. There would be comfort there, she knew. There always was.
She turned to Psalm 42 and began to read. When she reached verse five, she knew the Lord was speaking to her.
Why are you downcast, O my soul?
Why so disturbed within me?
Put your hope in God,
for I will yet praise him,
my Savior and my God.
My soul is downcast within me;
therefore I will remember you
from the land of the Jordan,
the heights of Hermon—from Mount Mizar.
Deep calls to deep
in the roar of your waterfalls;
all your waves and your breakers
have swept over me.
By day the LORD directs his love,
at night his song is with me—
a prayer to the God of my life.
She hung on the last words of that passage…His song would be with her tonight…
Yes, she thought. She should sing that song. She should praise him, even from her despair.
Softly, tentatively, she began to sing about entering his courts with thanksgiving in her heart…
She sang it slowly at first, haltingly, in a quiet voice that belied the words of the song. But then her heart lifted, and she sang in a faster rhythm…over and over…until joy did fill her heart like a prayer.
When she finished the song, she smiled and snuggled under her bedcovers. Yes, that was what she needed, she thought. The words of Psalm 104:33 whispered from her lips. “I will sing to the LORD all my life; I will sing praise to my God as long as I live.”
Sweet sleep wrought from the Lord’s presence fell over her, and in spite of the light and the cold and the pain and the intrusions, Sylvia slept better than she had in days.
CHAPTER
Twenty-Five
Sylvia was home two weeks when she decided to lead a Bible study of the book of James for the ladies of Cedar Circle. Tory couldn’t have been happier. Since Hannah’s birth, she’d spent so much time obsessing over the child that she hadn’t taken enough time for Bible study.
The late August heat hung heavy over Breezewood, so they met in Sylvia’s cool air-conditioned living room.
Tory sat at Sylvia’s feet as her friend taught her about “considering it all joy” when you encounter trials. Sylvia was still weak from the surgery, and Tory could see the pain on her face when she moved a certain way. But she seemed to be doing well.
As she taught from James, Tory realized that the choice of books was as much for Sylvia as for them. They had all gone through trials of one kind or another, but Sylvia’s was one of the worst of all. Tory couldn’t imagine how she had the energy to concentrate when so much uncertainty hung over her.
But the study gave Tory comfort, and she could see that it was helpful to Cathy and Brenda, too. When they ended with prayer, Tory sighed. “You know, the more I learn about the Bible, the more I realize I don’t know.”
Brenda laughed. “Isn’t that the truth? I feel the same way.”
Cathy, curled up with her stocking feet beneath her on Sylvia’s couch, waved them off. “You guys are way ahead of me. I came into this Christian thing too late.”
“Don’t be ridiculous,” Sylvia said. “It’s never too late.”
“But I don’t know half of this stuff.”
“Well, you will. We’re going to work through it together. It’ll keep me going.”
“Yeah,” Cathy said. “Every time you get discouraged and don’t want to teach us, you’ll realize what heathens we are and decide that you’ve got to keep going.”
Sylvia laughed. “That wasn’t what I meant.”
Cathy moaned and dropped her feet. “But it’s true. I feel like a downright pagan when I start studying. All these things start coming up that I’ve never even heard.”
Tory laughed. “And the worst part is that you’re accountable for the things you know. So in a way, ignorance is bliss, right? If you don’t know it, you’re not accountable?”
“Hey, you’re accountable, all right.” Sylvia held her Bible up. “Everything you need to know is right here. You’re accountable because all that information is available to you. There’s no excuse for having it and not reading it.”
“Ouch,” Tory said. “You can be so brutal.”
Sylvia’s laughter lilted through Tory’s heart. It was music.
Sylvia led them into her kitchen where she’d baked a cake earlier that day. They cut it and took their saucers to the table. “So, Tory, what have you decided about the job?”
Tory shrugged. “I haven’t decided yet. But I do need to let Mary Ann know by the end of the week. She’s got to hire someone else if I don’t take it.” Never one to eat much of anything with calories, Tory picked at her cake. “I just feel like I need to stay at home with Hannah. I don’t like the idea of putting her in a nursery.”
“But it’s not just any nursery,” Sylvia said. “It’s a nursery that challenges her and helps her grow. She needs that, Tory. I wouldn’t feel guilty about it at all.”
Cathy dug into her cake with gusto. “And think of the benefits to you, getting to work with the older kids. You’ll have so much hope about what Hannah is going to do eventually. I think Mary Ann sounds like a genius. You were the perfect choice for that.”
Tory cut the icing off and took a small bite of cake. “The truth is, I’d really like to do it. And Barry wants me to.”
“Then what are you waiting for?” Brenda’s question sounded so reasonable. “I don’t even know what’s making you hesitate.”
Tory smiled. “Do you really think I should?”
“Of course I do,” Brenda said. “What’s the downside?”
“Well, I wouldn’t have as much time for Bible study with you guys. If I have Hannah in the nursery in the morning, I don’t want to leave her again at night.”
Sylvia wasn’t satisfied. “You’ll only be working Tuesdays and Thursdays. This is Monday. It’s doable, Tory.”
Tory considered the passion on Sylvia’s face. She needed this study to get her mind focused for her upcoming chemo, and Tory needed it to have the strength to go on with her mothering of Hannah. “I’ll probably take the job,” she said. “And I’ll try to keep up with the study. But the homework you’re giving us is pretty substantial, and I’m not sure how much time I’ll have to do it. There are some pretty complicated concepts in James.”
“Well, you can’t let the complicated concepts make you forget that the salvation message is very simple,” Sylvia said. “‘Believe in the Lord Jesus Christ and you will be saved.’ That’s all there is to it.”
“But there’s so much more,” Tory said. “We know that works can’t save you. Only faith can. But then James says that faith without works is dead. So there’s more than just ‘believe on the Lord.’”
“There’s not more to salvation,” Sylvia said. “Just to growth and sanctification.”
“Holiness,” Cathy said, pointing her fork at Tory. “Now that’s the hard part.”
“It is hard,” Sylvia said, “but when we stay in the Word we can figure out how to be holy. And the great thing is that it’s not our holiness that we need, but Christ working in us.”
“Amen,” Tory agreed.
That night, with her decision made and the Bible still fresh in her heart, Tory snuggled up to Barry.
“I think Sylvia’s going to be all right,” she said. “She’s already back to herself. She’s visiting the oncologist tomorrow but she doesn’t even seem to dread it.”
“I think she’ll be all right, too,” Barry said.
“And I’m looking forward to my job. I guess I’ll start Tuesday.”
/> He kissed her. “I’m excited for you. I think it will be good for you to think about someone other than Hannah for a change.”
CHAPTER
Twenty-Six
Harry went with Sylvia to her first post-surgery visit with the oncologist the next day. They sat across his desk, a stack of books and articles on the table next to them.
“What’s her chance of recurrence?” Harry asked.
Martin Thibodeaux, the oncologist, drew in a deep breath and thought for a moment. “I’d say fifty percent.”
Sylvia gasped. “Fifty percent? I thought my chances were better than that!”
He shook his head. “We’ll fight the recurrences if and when they come, Sylvia. But the number of lymph nodes involved raises the stakes.”
She felt herself wilting in her chair. Harry’s hand closed over hers.
“I’m recommending six months of chemo,” the doctor said, “with treatments every three weeks.”
“Which chemo?” Harry asked.
The doctor told him the name of the drugs they’d be using.
Sylvia saw by the look on Harry’s face that the choice didn’t please him. “What is it?” she asked.
“It’s a really harsh chemo.” The lines of his face deepened. He looked as if he’d aged ten years in the last few days, despite his attempt to keep her positive.
“We need to be harsh,” the doctor told her. “Like you’ve already been told, it’s a very aggressive cancer.”
Sylvia closed her eyes. “I don’t even feel sick. I feel like I’ve had surgery, but I don’t feel like I have cancer. Not the kind that needs the big guns.”
“Just keep in mind that we’re only doing it for six months. And then because we had six positive lymph nodes, I recommend radiation to begin six weeks after the chemo has ended and the hormone therapy has begun.”
Sylvia felt as if facts flew around her head like debris in a tornado, threatening to crash her skull if she didn’t duck at the right time. “Harry, I’ll never remember all this,” she said. “I hope you’re getting it.”
“I am.” She realized that Harry’s knowledge of what she was about to embark on made it even more stressful for him than her. Maybe it was good that she didn’t know all the horror stories that he knew.
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