Dating back to the night of her admission to Dartmouth-Hitchcock, continuing all the way through the morning of her release, Alice had tracked her blood cell counts; she’d made it her business to memorize the names of the nurses, personalize herself to the nursing assistants. Here at Whitman, for the umpteenth time, she was more than capable of verifying that, upon her admittance to DHMC, she’d been given two drugs, Zithromax and ceftazidime, for her pneumonia. (“Lower left lobe,” Alice remembered. “I’m fairly sure that’s what they told me about the pneumonia.”) She had no problem naming which antibiotics she’d been given upon her admission (acyclovir, and also some sort of azole antifungal), or “cytarabine,” the first of her induction chemotherapy drugs, or following up with “the other one. The red drip. Dana Rubenson.”
“Daunorubicin,” the cancer fellow corrected.
“Dana Rubenson makes it easy to remember,” Alice said.
She was counting the days until all this was over and Tilda and a bunch of other girlfriends formed a shopping mob with Alice and made it their personal mission to liberate every sexy pair of boots being held in the clutches of SoHo’s boutiques. Accepting a paper cup—“Thank you, Dantelle”—Alice let herself soak in the relief of sipping lukewarm tap water. She allowed herself to enjoy watching visiting fellow Bhakti retreat back into her little corner.
The moment she answered the next question, Alice knew letting her guard down had been a mistake; she’d confused desonide — the ointment for the facial rash she’d gotten as a side effect of a platelet infusion — with triamcinolone — the ointment she’d been given for her postchemo chest rash.
By then Dr. Bhakti was alert, the nurse-practitioner was having her say, Eisenstatt, too — everyone correcting her.
“It can get confusing sometimes,” Dantelle said.
“You’re doing great”—Bhakti’s voice dripped with honey—“remembering all this.”
Alice half-expected a lollipop. Her own fault. “You are kind,” she said.
Then the vancomycin she’d been given for that nasty blister and skin infection following her IV infiltration. The catheter-port contraption that had required minor surgery to install in her jugular, so they could run the IVs. The heparin drip into the catheter-port thing for the blood clot in the infiltrated arm. The transition from heparin drip to Lovenox pills, which had changed to Coumadin shots, after it turned out her insurance would not cover the Lovenox. Plus her platelet transfusions. And how long it had been since she last had a fever, her ordeal distilled into a connect-the-dots trail of pharmaceuticals and procedures. As if she were speaking about the intricacies and design specs of a blouse collar that she had been struggling with, Alice was as specific as possible about how many minutes after eating two spoonfuls of wheat flakes with sliced bananas she’d felt the cramping along the side of her stomach. She pointed to the right side of her abdomen, explained the shifting, cramps becoming something else, a rush both sudden and desperate, the consistency of her stool becoming watery.
Howard Eisenstatt and the nurse-practitioner shared a look. Eisenstatt speed-read a note from off her chart reporting that, after her induction chemo, traces of a stomach virus had been present in cultures taken from high inside her nose and deep in her throat. “Normally the virus goes away with time and antibiotics,” he said. “I imagine that’s been the case here.” He ordered the nurse-practitioner to take more cultures. “If the virus has reappeared,” Eisenstatt continued, “we need to make sure it just stayed in your stomach. I don’t want you to worry. If it comes to that, we have a drug that eliminates the bug. You can take it through an IV.”
“Even if the bug did get in your bloodstream,” Dr. Bhakti said, stepping up. “There’s an experimental form of the drug that’s been testing to encouraging results.” She crinkled her nose. “Only one potential problem. A number of patients have had some side effects.” Realizing what she was saying, “The, ah, most problematic…being”—her voice slowed—“well…diarrhea.” She waited. Then, for emphasis, added, “Dangerously explosive diarrhea.”
Oliver snorted, looked at her as if she was crazy. “You’re going to cure my wife’s diarrhea with a drug that causes dangerously explosive diarrhea? If it comes to that?”
Almost as a reflex, he checked with Alice, meeting her eyes, anticipating unhappiness with his flippancy.
“We’re not letting them do that to you,” he said.
She emanated gratefulness, relief.
“We’ll try with what we have,” Eisenstatt answered, “if it comes to that.” The doctor leveled a gaze at Bhakti, his irritation obvious. “And you’re still taking the Coumadin shots every day?”
“Mmm. Oliver — my husband — gives them to me.”
“Cancer in your family history?”
Alice’s hands joined and webbed; she flexed them in her lap, pursed her lips. “My father died from pancreatic cancer when I was eleven.” Be calm. Release. “And his mother as well — she was older by then, and two packs a day her whole life, a fiend. So I’m not sure how that affects the family tree, if you include…”
Closing her eyes, keeping them shut, she did a short breathing thing, unlocking her hands, putting them back on her knees, feeling the pointed jags beneath the denim. “Doctor, this whole day, being back in this…it’s already — I feel very…”
“Take your time.”
She held off her emotions. “I’m sorry. I’ll do better. Keep going.”
“There’s no solid reason why people get leukemia. I wish I had something more definitive to tell you.”
“What about heredity?” She jerked forward. “It’s not genetic?”
“Very few cases of acute myeloid leukemia are passed down,” Eisenstatt said. “If I had to guess — and it would only be a guess — I’d say chances are rare.”
Alice grimaced, snorted, gasped for air, “She’s safe?” Her chin crumpled. “My baby’s going to be all right? She can’t get this?”
The nurse-practitioner was at her side with tissues. Alice blew her nose, became aware of a disturbance. Her daughter’s eyes, huge white saucers; Doe’s little face uncertain, turning flush, light orange, now a deep crimson. Infant features scrunched around the meeting point of her nose; her mouth widened. That juncture, intimately familiar to a parent, right before the screaming starts. Horrible as your child’s misery might be, when you’d been through it enough, the building process toward eruption could actually be endearing. Through her tears Alice made eye contact with an equally entertained Oliver. She motioned for him to bring over Doe.
The baby was inches from her mother’s bosom when the inevitable finally took place, those tonsorial sirens blaring, their noise resonant, inclusive, the royal and imperial we: We are all going to plummet to the depths of my unhappiness.
Alice bounced Doe, made placating noises, grimaced.
Next to her, Dr. Eisenstatt pinched the bridge of his nose with his right hand. Bereft of a wedding band, an adult single childless male doctor, with how many patients waiting for him, he looked as if he’d gotten a wedgie in his ears.
“It runs in the family,” Alice said. “We’re criers.”
She smiled at her girl, made more cuddly sounds. The nurse-practitioner came over and added a soft “It’s all right.”