"We were just catching up on our gun magazine reading. We don't get the NRA magazine at home and it is fascinating. Did you know there is an ejector you can buy the propels birds into the air so you can shot them? Kindof like a trampoline for your pheasant." The doctor sits as I rattle on.
I am babbling and nervous. Take a breath.
I pause, take a breath, and let him say hello.
Dr. Varpas looks across at me, "You reading a gun magazine makes me nervous given what happened last week at Hopkins."
I look at George, "What happened last week at Hopkins?"
"A patient shot his doctor when he gave him bad news."
Oh shit, I knew it!
I look over at Dr. Varpas, put my hand over his on the desk, and ask him, "Are you going to tell me bad news?"
"Well, we walked down to radiology and looked at the scan results. It looks as though there are several hot spots in your mediastinal area near your vena cava, some near your spleen, a few next to your heart, and some along the central line."
I reach over and grab George's hand and hold tight.
"I am fairly certain this is recurrent Hodgkins."
Focus, ask questions.
"Do we go in and do a biopsy?"
"They are not in a good spot for that. They would have to open up your whole belly and they are such small spots it is very unlikely that they would be able to identify which ones to take. But there are choices. There are several clinical trials that look promising and that some of them have created full remissions. The first one is B*****m. It is an immune therapy drug."
I reach down for my purse, "Should I be taking notes?"
Dr. Varpas reaches for a paper from the printer over the desk. "No, I will write these down for you."
"What is an immune therapy drug?"
Will I lose my hair? It is growing back so beautiful!
You are so silly, hair is not the end of the world.
"Does it have the same side effects as chemotherapy?"
"Oh no, the side effects are very benign. You won't lose your hair or anything. Unlike chemotherapy that goes in and messes with your DNA, immune therapy target biological markers on the specific tumor type."
Why didn't we start with that one?
Hush, that doesn't help us now.
"There is one that I just heard about 6 months ago that is happening right down the road in Detroit." Dr. Varpas adds another name to his growing list as he thinks. "This one you have to have the CD25 marker on your B cells in order to qualify. Let me see." He trawls through my pathology reports on the screen.
I look over at George. His face is tight.
"And of course, there is always the allogenic transplant. Do you have any siblings?"
NO FUCKING WAY!
Hold on, you aren't there yet. These are just the options.
"I have a sister."
"Have you ever done a screen to see if she would be a match for you?"
"No. But my blood type is A and she is an O."
I don't want someone else's bone marrow! I like being me!
Hold on, we aren't there yet. That is only one option.
"Blood type does not make any different, did you have a chance to talk to Dr. Jarvis about allogenic tranplants? What their rate of success is with someone like you? Because if the rate of success is only 10%, than you might as well not even..."
"Not even bother, right."
Thank god, he agrees with me.
"So there are also other chemotherapy drugs that you could do..." His list grows longer.
"Are these pills? infusions?"
"Most of them are outpatient, some of them are pills, some of them are infusions."
"Do you take them once a month, once a week, three times a week for a year, five years? How long will I be on these?"
"Well, each one of these is different."
"Are all of them just a lead-in for an allogenic transplant?"
"Well, that is a great question. It depends on how things go. If you are able to have a complete remission with one of them than you are all done. If not, well, let us see how things go. I am going to call the center in Detroit and see whether or not you would qualify for that trail."
"So that is what you are leaning towards at the moment. The first clinical trial option?"
"Yes, because it does not disqualify you from doing anything else. If you start with the allogenic transplant, you take the other options off the table."
I look over at George and turn back to Dr. Varpas. "So George is in his last year of residency and we are in the process of signing a contract with a group north of New York City. Can we start something here and have it continued there?"
"Oh yes, you shouldn't change your plans for this. We can work something out."
I want to ask him how this happened? Why this is happening? What my chances are! What this means for me long term!
He doesn't know, he is doing the best he can.
"So while you make those phone calls what can we do?"
"Nothing, just wait to hear from me." Dr. Varpas stands and reaches out with his arms.
I stand and reach down for him.
This hugging business, such a double-edged sword.
(The names I use are the same pseudonyms I used in my book, I Dreamt of Sausage. Thank you for reading this as I continue to flush through all that is happening to me.)