Fireflies: A Father's Classic Tale of Love and Loss

1

Fireflies swarmed. Power chords throbbed. David opened his eyes. Sunlight gleamed through a window. Through a swirl, he saw a cupboard above him, the edge of a sink, a stack of dishes. About to vomit, managing not to, he turned his aching head to the left and saw the blur of a kitchen table. His movement bumped an object and sent it rolling.

David strained to clear his vision. He recognized the rolling object, an empty glass that the turn of his head had sent clinking to a stop against a leg of the table.

His hair was soaked. He lay in a pool of water. But his body was drenched with more than water. Sweat. His bare legs, arms, and chest were slick with perspiration. His shorts clung sweat-soaked to his groin and hips. What was going on?

Through misty vision, he focused on the digital clock on the microwave to the left of the table: 12:55.

A calendar (the kind you tear a page off each day) showed…

It couldn’t be.

1987?

June?

Thursday?

The eighteenth?

Impossible! The last moment he’d known had been sometime in March. The delirium of morphine and the distracting pain of his mortal illness had made him unsure of the date. But without doubt he’d entered Intensive Care in March.

Forty years from now. So what was he doing on the floor of the kitchen of a house that he’d sold five years after Matthew’s death because he couldn’t bear the memories of…?

A year after Matthew’s death? Intensive Care forty years later?

With tingling feet and hands, David raised his head from the floor and peered at his body.

No wrinkles in his stomach. No cancerous gauntness in his chest. He was struggling through nausea to stare at the daily-exercised body of a man of forty-four. Despite his nausea, he felt in the middle-aged prime he’d known and then lost after Matthew had died.

After Matthew had died? June eighteenth? One day before Matthew had contracted the septic shock that eight days later had killed him?

Power chords kept throbbing. David squinted through a kitchen archway toward stereo cabinets against a wall in the living room. Lights glowed on a tape player. Stereo speakers thrummed. He still saw the fireflies, but now he realized that they were specks of lights inside his head.

His dizziness lessened. His memory cleared. He’d spent all night at the hospital, sleeping next to Matthew’s bed. Donna had taken her turn to sleep at home, then had come up to the Bone Marrow Ward to trade places with David, to give him a chance to go home, shower, and change his clothes. He’d arrived home at eleven and decided to exercise, to run as was his custom. Frustration had made him run faster than usual, to sweat out his tension. But excessive humidity had added to the ninety-degree temperature, making it the equivalent of one hundred and three. Perspiring worse than usual, he’d stumbled into the house, turned on the tape player, poured a glass of water, raised it to his lips, felt dizzy, seen fireflies, dropped the glass, and fainted on the kitchen floor.

David realized that none of the other things had happened. Matthew’s septic shock, his eight days in Intensive Care, his eventual death had only been a nightmare caused by unconsciousness due to overexertion and excessive loss of bodily fluid.

A nightmare.

Gaining more strength, David groped to his knees, crawled to the table, and tugged himself to his feet. For a moment he wavered. But with both hands on the table, he held himself steady. The fireflies dimmed.

Sure, a nightmare.

Then why had everything he’d dreamed appeared so real, as if the events of the nightmare had truly occurred and what he now saw was merely an illusion?

The power chords kept throbbing.

Why, if he’d merely fainted, was he so terrifyingly sure that on June twenty-seventh, nine days from now, his son would die from unexpected complications due to his cancer treatment?

The tingling in David’s arms and legs made him wobble. He strained not to faint again.

Something was horribly wrong. He recalled the fireflies in his bedroom and the dove in the mausoleum.

But none of those things had happened!

Yet he knew, as if remembering, every dismal instant he’d endure for the next forty years. His future was so clear and detailed that he could not believe those forty years, every wretched minute of them, could have been crammed into so brief an unconsciousness.

While unconscious had he imagined the possible course of his life?

He breathed deeper, faster, on the verge of hyperventilating.

Or was he remembering his life from the perspective of forty years later?

His chest felt tight. What in God’s name is happening?

In his dream, the next events in his life had been that, after he wakened from fainting, his dizziness had worsened. He’d been forced to stay in bed until the next day. When he felt well enough to return to the Bone Marrow Ward, his son had contracted septic shock.

But none of that had happened! At least not yet.

But would it?

His dizziness intensified. In a rush, he pulled a chair from the table and slumped into it. He propped his elbows on the table and clutched his head. His chest felt squeezed.

I’m having a heart attack!

But he didn’t feel a sharp pain down his left arm. And his heart-though it rushed-didn’t skip or feel stabbed.

Mouth parched, tongue swollen, he knew he shouldn’t move if this was a heart attack, but he took the risk and staggered toward the kitchen sink, where he turned on the tap, bent down, and gulped water. He shoved his head beneath the faucet and drenched his hair.

At once, he had the vertiginous sensation of floating over an old man in a hospital bed. The old man’s eyes were closed. Hooked to life-support systems, the old man was surrounded by nurses and doctors raising the foot of his bed, injecting medications, and turning dials on a respirator. An elderly woman slumped over the old man, sobbing.

My nightmare!

Drifting down a brilliant corridor, he hovered in a radiant doorway.

Fireflies.

Power chords.

Hunched over the kitchen sink, David almost threw up. Man, you’re in really bad shape. You’d better go to bed.

But that’s what happened in my nightmare! And the next day, the septic shock hit Matthew and…!

Septic shock? He suddenly realized he’d never heard those words before. Except in his nightmare. But he understood what septic shock meant. Or thought he did.

Floating from an old man’s body. Hovering in a radiant doorway. Searching for a firefly among splendrous millions.

You’d better get control.

David drank more water and turned off the tap. Grabbing a dish towel, he wiped his dripping hair.

Well, there’s an easy way to convince yourself it’s all in your head, David thought. In your nightmare, before you staggered to bed, you phoned Matt’s room at the hospital. You let it ring ten times, but no one answered.

David groped past a window toward the phone on the kitchen wall. Heart racing, he pressed the numbers for Matthew’s room. One ring. Two rings. Ten rings. No one answered.

He let it ring longer. Still no one answered.

Feeling suffocated, David set down the phone. He pressed his back against the wall and strained to keep his knees from collapsing. In his nightmare, the explanation for the lack of response on Matthew’s phone was that Donna had helped Matt get out of bed and walk into the ward so Matt could reach a bathtub in a room around a corner down the hall.

Again David floated.

He couldn’t ignore his terror. He felt so sure of what would happen next that he had to act as if it would happen.

If he was wrong, he’d be grateful beyond belief.

But what if he was right? He didn’t dare dismiss the possibility that he’d been granted the gift he’d prayed for in his nightmare.

To dial back. To retreat in time. To take the knowledge of the future into the past.

Based on what he’d dreamed, given what he’d learned from his experience with Matt in Intensive Care, from conversations with doctors who reconsidered the choices they’d made, from conclusions based on the autopsy report, he had a precious opportunity.

To save his son’s life.

2

The University of Iowa ’s hospital administers to patients not just in Iowa City but throughout the state. There are other hospitals in the area, of course, but few are so well-equipped to deal with extreme diseases, especially those involving children’s cancer. A helicopter is available to fly emergency cases from hundreds of miles away. Other patients-chronically ill but not in imminent danger of death-sometimes spend hours being driven to the hospital for specialized treatment.

Two years before, when the demands of writing assignments had forced David to resign from being a professor of American literature at the university, he and his family had considered moving to another locale. Thanks to the famous character he’d created and the income he received from best-selling novels about other characters, he had the financial ability to live anywhere he wanted. After all, to work he needed only a word processor and a quiet room. He could set up those conditions anywhere. Los Angeles had been a likely place-because of the movie producers David sometimes worked for. New York City (or nearby in Connecticut) had also been an option-because he’d be close to his publishers.

But in the end, as a consequence of the many business trips he had to take, the palm trees he saw in California and the skyscrapers he saw in New York had begun to seem ordinary. Flying home, peering down at the rich black soil and rolling wooded hills of Iowa, he’d gradually decided that the Midwest was as exotic as any of the so-called glamorous sites he’d visited.

A friend had once laughed at David’s choice of word. “Exotic?”

“Well, attractive anyhow, and more important, innocent. The air’s clean. There aren’t any traffic jams. I’ve never had to worry about my children being mugged in the schoolyard. I can get anywhere in town in fifteen minutes. The people are friendly. I like the space, the big-sky feeling. I guess what it comes down to is, I feel at home. I’ve settled. Even on a practical level, the dental and medical care are magnificent.”

Medical care? Another irony, for David could never have guessed how desperate he soon would feel about the medical care he’d so praised or how fortuitous his choice to remain in Iowa City would be. Patients in the farthest reaches of the state had to travel hundreds of miles for their treatment. But David’s desperately ill son could be driven to one of the nation’s finest hospitals within five minutes; the family home was only ten blocks away.

The hospital is huge, much larger than most medical facilities even in major American cities. The complex stretches over blocks and blocks. New buildings are constantly being constructed. And some of the sophisticated diagnostic instruments (a magnetic resonance imager, for example) aren’t available in many areas.

Yes, David thought, if your son gets a rare form of cancer and the tumor lodges where it almost never does-in a rib instead of an arm or a leg… if your son might have the only case of its kind in the nation, it’s a damned wise choice you made in deciding to stay in Iowa City.

These thoughts occurred to him as he pushed away from the kitchen wall. With an unnerving sense of viewing everything from a distance, he staggered downstairs to shower, then stumbled upstairs to his bedroom, where he struggled to dress. Still dizzy, he knew he was risking a traffic accident by driving to the hospital, but the alternative, that of staying in bed till tomorrow as his nightmare had told him he otherwise would, was an unacceptable option.

He had to save Matt’s life.

Driving carefully from the residential area, turning left toward the expansive towers of the hospital that it seemed he hadn’t seen in forty years, he entered a parking ramp, where he found a place to leave his Porsche 912 near the Plymouth Voyager his wife had driven to the hospital. For a moment he leaned against his car to establish his balance, then walked as steadily as he could from the ramp to one of the many entrances to the hospital.

His mind was playing tricks on him. He felt unfamiliar with an institution that he’d visited almost daily for the past six months, as if he hadn’t been here for half a lifetime instead of just this morning. Pushing open a door, he walked along a corridor that he’d gone down a thousand times and yet seemed barely to remember. He reached a large open area in which chairs surrounded a grand piano that doctors sometimes played during lunch hour. Plants hung from gleaming mirrored walls and a ceiling four stories high.

Turning right, he forced himself along another corridor, this too familiar but only as if through a mist. He reached an elevator marked G, and while it swiftly rose, he endured a powerful pressure behind his ears. With his hands cupped to his head to reduce the pressure, he heard an increasing hum within his brain.

What’s happening to me?

His arms and legs now tingled so severely it seemed as if electricity stung him. The band around his chest squeezed tighter. His forehead felt cold, yet sweaty.

At the third floor, the elevator door opened. He lurched out, turned left down another corridor, and compelled himself not to waver. He even managed to quicken his pace.

Passing patients’ rooms, he reached a nurses’ station whose design seemed primitive compared to the type he’d seen in his nightmare.

“Mr. Morrell, how good of you to come back.” A blond nurse smiled.

David remembered her, and yet it didn’t seem from recent conversations, instead from long ago. “Come back?”

“We were hoping you’d give us a visit. How’s Matt doing?”

“What do you mean? That’s what I’m here to find out.”

“But you know he isn’t here. He left a week ago. He’s up in Bone Marrow.”

Oh, my God, David thought. I reached the wrong floor. I went to where Matt always used to get his treatment: the Pediatrics Ward.

From a child’s room, he heard the distinctive sound of a nurse gently paddling her hands on the chest of a cystic fibrosis patient, clearing fluid, helping constricted lungs to breathe.

“Of course,” David said. “I must have… Bone Marrow. I made a mistake.”

“I know what you mean. Matt’s been on this ward so often, I can see how you’d come back by habit.”

Disoriented, David surveyed the rooms along the corridor. It seemed that Matthew had stayed in every one of them at various times. In the last six months (forty years ago?), this ward had become a second home.

In one room, he recognized (again as if through a haze) a ten-year-old girl bald from chemotherapy. When first diagnosed, she’d been riddled with tumors, but treatment had managed to cure her. Nonetheless, the patient’s mother, unable to control her revulsion, had disowned her daughter, never once visiting, eventually divorcing her husband.

In another room, David saw an eight-year-old boy whose parents had considered his cancer an inconvenience to their routine. Every three weeks, on a Friday, they drove him to the front door of the hospital, let him out, and left while he found his way up to the Pediatrics Ward for chemotherapy. He stayed for the weekend, vomiting, the fear and loneliness in his eyes enough to make David want to strangle the parents, who drove back to the hospital on Monday and waited while a nurse brought the boy in a wheelchair down to the hospital entrance, where she helped him into the car.

But not us, David thought. Not us! Donna, Sarie, and I stayed with Matthew always, never letting him give up hope, never allowing him to feel lonely or succumb to despair. Taking shifts, and sometimes all three staying with him at once, they’d bolstered his spirits and let him know how much he was loved. They were his companions at all hours for his six months of treatment. Donna and David had probably seen Matt more than most parents saw their children, in snatches, an hour in the morning, an hour at night, for a lifetime.

Early in Matthew’s treatment, a doctor had asked about David’s work. “How’s your fiction going? Any new books?”

Restraining his frustration, because the doctor was trying to be friendly, David had answered, “My work? Since Matt got sick, I’ve stopped writing. Right now, as long as it takes, my job is my son.”

3

“Yes,” David said to the nurse. “I made a mistake. I’d better get up to the Bone Marrow Ward.”

“But you didn’t answer my question. How’s Matt doing? Is he okay?”

“The answer’s too complicated. It depends.”

“On…?”

“If you look forward or back.”

“What?”

“Right now, he’s doing well.”

“He’s one of our favorite patients, you know. He’s so brave. We love his sense of humor.”

“So do I. Believe me, so do I. For what it’s worth, I think you and the rest of the staff did a wonderful job.”

“Keep us posted.”

Yeah, David thought, but I hope the message isn’t the disaster of my nightmare.

“I’ll let you know. Right now I’d better get up to where I belong.”

To the Bone Marrow Ward.

Toward what David was becoming more convinced was a desperate chance for salvation.

4

The Bone Marrow Ward. Logical, simple, ingenious, and if your case isn’t in the right statistics, terrifying. You don’t go there to be treated unless there’s nowhere else to go.

Tumors are perversely fascinating in their capacity for evil. They may be the only organic substance that left unharmed and given nourishment lives forever. In laboratory conditions, they survive and survive. With Matt, the initial combination of chemical agents (each combination is called a protocol) proved ineffective. After several administrations of it, a second protocol was tried, and that too proved ineffective. Matt’s tumor became classified as resistant, an especially malignant life force. The third protocol showed results, however. The mass shrank 50 percent, and surgery (which would formerly have killed Matt, so large was the mass to start with) now became possible.

The surgeon explained that the operation would take eight hours. Matt would lose the diseased rib and maybe one rib to the top and bottom, depending on what the surgeon found. The principal risk was that the tumor had grown so close to the spine that in removing the tumor the surgeon might accidentally cut a nerve-or else the artery that supplies blood to the spinal cord-and Matt would be paralyzed.

“What are Matt’s chances of that happening?” Fear made the question a whisper.

“Chances?” the surgeon had responded. “I do my best. I can’t give odds. What happens to each patient happens to him one hundred percent.”

So Matt, with utter calmness, allowed himself to be prepared for surgery. The nurse who took his heartbeat and blood pressure readings was astonished by how relaxed Matt’s vital statistics made him seem. David, Donna, and Sarie walked beside Matt’s bed as he was wheeled toward the surgical area. Then the family was told to go to a waiting room.

5

The waiting room. A horror in itself. Plenty of televisions and magazines, but everyone stares at the floor.

An eight-hour operation, and the major risk is paralysis, but the surgeon is optimistic and says he’s going for total cure. So you know when three hours into the operation you get a message to meet with the surgeon, something’s horribly wrong-and when not one surgeon but three of them join you in a consultation room, you know that whatever’s wrong, it’s worse than you can imagine.

“We ran into troubles,” the first surgeon said.

“You don’t mean he’s paralyzed!” Donna said.

The second surgeon shook his head. “Not that at all.”

“Then…?”

The surgeons didn’t respond.

“For God’s sake, tell us.”

“The tumor may be inoperable.”

“What?”

“It metastasized,” the third surgeon said. “It’s not just on his rib.”

Metastasized. When David later repeated that word to friends and business associates, he was amazed by how many didn’t understand what metastasized meant. To spread. The tumor had sprouted seeds. Roots were growing throughout Matthew’s lung.

“No!”

“The metastases are so close to the spine I don’t think I can get them all,” the first surgeon said. “I’ll probably have to take several more ribs than I hoped.” The surgeon exhaled. “And all of his lung.”

David ached.

“The point is, if I don’t get every offshoot from the tumor, several other tumors will start to grow, and in areas where I can’t operate without killing him.”

“He’s going to die?”

The second surgeon nodded. “I’m sorry. You have to be prepared for that possibility.”

“But isn’t there anything we can do?”

The surgeons glanced at each other.

“The tumor’s been resistant to chemotherapy,” the third surgeon said. “The only thing I can think of is to really give it a dose, I mean a humongous dose, of chemicals. To go for a bone marrow transplant.”

David vaguely recalled having heard the term before, but he had no idea what it meant.

“It’ll take too long to explain right now,” the second surgeon said. “The treatment’s severe, much worse than the chemotherapy your son’s already received. It’s risky, but in many cases, especially leukemia patients, it’s been known to work.”

“But you’ve got to make a decision,” the first surgeon said. “As soon as I opened Matt and saw what I was dealing with, I put him on hold. Don’t worry about him for now. The respirator and the other machines are keeping him alive. But I can’t leave him like that very long. You’ve got a decision to make.”

What’s the worst thing that ever happened to you? How about the worst question you ever faced?

“The options are this,” the first surgeon said. “I can leave the tumor as it is. I can close Matt up. The tumor will continue to grow. But Matt will be able to have a more or less tolerable summer, provided he gets enough pain medication. He will be dead by the fall.”

Donna’s face streamed with tears.

“And the alternative?” David breathed.

“I can go ahead with the surgery, take several more ribs than I hoped, probably all of his lung, leave the parts of the tumor I can’t get at, close him up, and hope that chemotherapy combined with a bone marrow transplant kills the rest.”

“But remember, the tumor’s especially resistant,” the second surgeon said. “The bone marrow treatment might not work.”

“And the treatment’s extremely severe, worse than anything he’s already been through. He could die from it,” the third surgeon said. “He might not even have the tolerable summer he’d have if we took the first option and stopped the operation right now.”

“I can’t keep Matt on hold up there forever,” the first surgeon said. “I’ve either got to stop the procedure or get on with it. Soon.”

“How soon are you talking about?”

“You’ve got fifteen minutes to make up your mind. And this is a one-time-only decision. You can’t change your mind tomorrow or next week. Matt couldn’t survive another exploratory operation of this scope. And if the tumor gets any bigger, I’d have to leave much more of it inside him, which means the bone marrow treatment would have a great deal less chance of being effective.”

“Fifteen minutes?” David’s voice rasped as if his throat were packed with broken glass. “If you just sew him up right now, he’ll die for sure?”

“Sometime in the fall.”

“And if you take out what you can and go for the bone marrow transplant…?”

“He still might die, and you’d be denying him a tolerable summer. With the transplant, his summer would be a distress, to put it mildly.”

Donna kept weeping. Sarie seemed about to faint.

“Fifteen minutes?”

“Less than that now,” the first surgeon said.

“And a one-time-only decision?”

“Correct.”

“Tell me what to do!”

“I can’t. That’s why I came down here to speak with you. The situation’s too complicated. It’s up to you to make the choice.”

“I can’t”-David gasped for breath-“face Matt when he wakes up and tell him we did nothing. I couldn’t bear the look in his eyes. I couldn’t bear telling him that he doesn’t have a chance-that he’s going to die.”

David looked for agreement from Donna and Sarie. Cheeks raw with tears, they nodded.

“Go ahead and cut the sucker out,” David said. “Get as much as you can. We won’t give up. Matthew’s strong. He’s proved it before. He’ll prove it again.”

“Just so we understand each other,” the second surgeon said. “Whatever happens, it’s extremely important to your mental health that you never second-guess this decision. You made it in good faith. Never reconsider it.”

“Cut!” David said. “Get as much of that bastard tumor as you can!”

6

Another waiting room, this one outside Intensive Care. Matt’s operation, as predicted, took eight hours. The chief of the surgical team came into the crowded room and found a place to sit across from David, Donna, and Sarie. His eyes were red with exhaustion. He was scheduled to perform another operation within an hour.

“How bad?” David asked.

There must have been forty people in the room, all afraid for their own friends or relatives. Eavesdropping unabashedly, they waited for the surgeon’s answer. There are no secrets-privacy is impossible-in the waiting room for Intensive Care.

“Actually it went better than I expected.” The surgeon rubbed his raw eyes.

David straightened.

“I only had to take four of his ribs and a third of his lung.”

Only? When it comes to your son, and you were told he’d probably have a quarter of his body cut away, you actually feel a bizarre relief when you learn it was only a fifth.

“Then the roots of the tumor hadn’t spread as far as…”

“Not as extensively as I feared,” the surgeon said.

“Then”-David took a breath, afraid to ask-“you actually got it all?”

The surgeon bit his lip. “No. There’s a growth-it isn’t big, the size of the tip of my little finger-that I had to leave against his spine. It wasn’t just a matter of risking paralysis if I took it. I’d have killed him.”

The other people waiting apprehensively to hear about their friends or relatives listened more intently.

“Oh…” David’s voice dropped. He’d been warned not to hope, and yet he had hoped, and now he suffered the despairing consequences.

“As I told you, no matter how well the procedure went, I knew I wouldn’t get what I wanted: total surgical cure.”

“Then we go to bone marrow,” David said.

7

Matthew was strong. David had promised the surgeons that, and the degree of Matt’s strength was about to be proven. Matt’s surgery had been so severe-“The most painful there is to recover from,” the surgeon explained-that Matt had been scheduled for two days of intensive care instead of the usual one.

Nonetheless, twenty-four hours later, Matt’s tortured body had so responded to postoperative treatment that he could be moved back to his room on the Pediatrics Ward.

“You were right. You son’s constitution is remarkable,” the surgeon said. Then turning to Matt, who was conscious though groggy from pain medication, he added, “But Matt, I’m afraid I’m going to have to keep being tough on you. I can’t let you rest. I can’t let fluids accumulate in your system. You’re going to have to stand as soon as possible. You’re going to have to make your bladder work.”

Matt groaned. “Stand?”

“As soon as you’re able. The important thing is you have to pee. I don’t want to have to put a catheter back into your penis.”

Matt groaned again.

The surgeon’s pager made a beeping sound. From the small black box on his hip, a voice announced a telephone number for him to call.

“I’ll be right back,” the surgeon said.

Donna, Sarie, and a nurse followed the surgeon out, leaving David and Matthew alone.

David hesitated. “How are you doing, son?”

“I hurt.”

“I bet.”

Another pause.

“Well, let’s get it over with,” Matt murmured.

“What?”

“If I have to stand”-Matt groaned-“and pee, let’s do it now so I can sleep.”

God’s honest truth. That’s what he said. And don’t be surprised that he could talk, much less be able to move. Maybe in the movies, patients are unconscious for days after serious surgery, while the actors have meaningful conversations at the bedside. But in real life, the physicians want you alert as soon as possible. In Intensive Care, Matt had been conscious enough and alert enough to write notes (his mouth had been blocked by a tube driving oxygen into his lungs) two hours out of surgery.

“The pain’ll just keep on,” Matt murmured. “He told me to stand. Let’s do it. Help me.”

Somehow, despite the oxygen prongs attached to Matt’s nostrils… and the IV tube leading into his arm… and the tubes draining blood from an incision that curved from Matt’s right shoulder blade down to his waist, then around his waist and up to his right nipple… somehow David and Matthew got Matthew out of bed.

Matt gingerly placed his bare feet on the floor. He gasped and wavered, while David held him up and at the same time held the IV stand.

David groped for a plastic urine bottle and supported it under Matt’s penis.

David waited, it seemed forever.

Matt’s knees began to buckle. David gripped his left shoulder more firmly.

“Hurry, Matt.”

“I’m trying!” The force in Matt’s voice must have been agonizing to him. “It doesn’t want to come!”

“Then we’ll try another time.”

“No!” Matt almost sobbed. “I don’t want another catheter! I don’t want any more pain!”

Dribble.

The sound, so commonplace, made David’s heart break.

Dribble.

David felt the warmth of the urine through the plastic bottle he held. That warmth was the most intimate sensation he’d ever known.

Dribble.

Thank God!

The dribbles stopped.

No!

Matthew’s face contorted with strain. “That’s it. Can’t… make myself go anymore… tired… have to… get back in bed.”

“Twenty-four hours out of major surgery and you’re standing, peeing? You’re the strongest, bravest person I’ve ever known. I’m proud of you.”

“Have to get back in…”

“Bed? I know, son. Just a minute, and you can rest.”

David set the urine bottle on the floor, eased Matt toward the bed, and that’s when they discovered the huge mistake they’d made.

When Matthew’s gurney had been wheeled down from Intensive Care, the nurses in the Pediatrics Ward had raised the bed in his room, gripped the sheet beneath him, and gently pulled him across from the gurney onto the bed. That bed, from which David had helped Matt to stand, had not yet been lowered. The mattress was as high as David’s chest and Matthew’s shoulders. Matt couldn’t set his hips on the bed and lean back to rest.

Matt wavered, close to falling. David clutched Matt’s left shoulder, released the IV stand, and reached for a button to summon a nurse.

But the button was too far away, David couldn’t reach the button unless he let go of Matt. The IV stand started wobbling. David grabbed for it. Matt wavered so fiercely that David couldn’t possibly expect him to try to edge toward the button that would summon a nurse.

The oxygen prongs fell out of Matt’s nostrils. The tube that drained blood from Matt’s huge incision stretched taught as Matt wobbled.

“Matt, I don’t have the strength to hold your IV stand with one hand and use my other hand to lift you onto the bed.”

“I can’t stand any longer.”

Why did I let myself listen to him? Twenty-four hours out of major surgery, and he’s out of bed, clutching me, the two of us wavering like two drunks trying to dance. How could I have been so stupid?

“Dad, that chair.”

“I don’t understand.”

“Can you reach the chair?”

“But why?”

“Do it.” Matthew wheezed. “Pull it over here. I think if I can stand on it…”

That’s when David knew he wasn’t as smart as his son.

“Yes!”

David frantically released his hold on the IV stand. He grabbed the chair, jerked it toward him, and desperately regrabbed the IV stand just before it toppled, all the while using his left hand to hold up Matt.

“Do you really think you…?”

“Just keep holding me, Dad.”

Matt strained. Gasping, he raised a foot to the chair. David eased him up.

With a greater gasp, Matthew raised his other foot to the chair. David eased him higher.

Matt’s hips were now level with the bed. He sat, clutched David’s shoulders, and with the most terrible groan David had ever heard, lay back in bed.

David quickly reattached the oxygen prongs to Matthew’s nostrils.

“So cold,” Matthew said.

At that moment, as David pulled a sheet and blanket over his shivering son, the door to the room swung open. The surgeon stepped in, followed by Donna, Sarie, and a nurse.

“The call I had to return wasn’t important,” the surgeon said. “But your mother and sister and I had a good chance to talk. As I was saying, Matt, I hate to do this. Nonetheless, I need to keep being tough on you. As soon as you’re able, in a day or so, you’ve got to get out of bed. More important, you’ve got to make your bladder work.”

Through his pain, Matt grinned. “It’s already taken care of.”

“What?”

“Here,” David said. He stooped and handed the surgeon the plastic bottle of urine.

The surgeon looked baffled. “But how did you…?”

“Well”-David glanced with love toward Matthew-“you might say we went dancing. I think the bed could be a little lower.”

“Wait a second. You don’t mean…?”

“You wanted him on his feet as soon as possible.” David directed another loving glance toward Matthew, who kept grinning through his pain. “I promised you. My son’s as tough as any patient you ever had.”

8

Tough doesn’t describe it. What do you say to a fifteen-year-old boy, who stood only five-feet tall and weighed only a hundred pounds and was totally hairless, whose cancer and chemotherapy had made his skin translucent… what do you say when he recovers from his mind-disorienting sedation after major surgery and realizes the extent of what’s been done to him?

“Four ribs? A third of my lung?” Matt’s eyes became panicked. His next question, though, so avoided the crucial issue that David’s breath escaped him, pushed out by pity.

“Then I won’t be able to play the guitar again?” Matt’s voice broke. “I won’t be able to keep up my-”

“Music?” David said. “The surgeon took some muscle tissue from your back and grafted in onto your chest where your ribs used to be. With some physical therapy, you ought to be able to have the strength to hold your guitar. Later, when you’ve stopped growing”-if, David thought, if you get the chance to be old enough to stop growing-“you’ll have another operation, not as serious, to put a support brace into your chest, to replace the ribs you lost. You won’t have a gap there. No deformity. You’ll stand straight. As far as your lung’s concerned, if you’d lost it completely, you wouldn’t be able to breathe sufficiently to play on stage with a band. But you only lost a third of your lung. You won’t run any hundred-yard dashes. You won’t charge up a dozen flights of stairs. But you’ll be able to walk as easily, with as little effort, as you did before. If you don’t try to be Bruce Springsteen and sprint around the stage, you still have a chance to be a musician.”

“Still have a chance?” Matthew sensed the implication. He mustered the courage to ask the all-important question. “Still have a…? How’s my case doing?”

David, Donna, Sarie, and Matt’s physicians had made a bargain with him from the day of his diagnosis. No one would ever lie to him.

“Dad? My case?”

“Not so good. The surgeon couldn’t get it all.” David held back tears.

Matthew knew that his tumor was resistant to chemotherapy, that only once had any combination of chemicals caused a response, and even then only a partial one. To the best of his information, surgery had been his final hope.

“Then I’m… going to die?” Matt asked the question as if he didn’t understand the meaning of the words, as if they were gibberish or a foreign language. But all at once he did understand, and tears leaked from his eyes. “I’m going to die?”

A physician, who saw Matthew seldom and thus hadn’t established rapport with him, responded. “You have to face up to it. There’s a strong risk you might not survive.”

At the time, David thought the doctor’s response was so cruelly matter-of-fact that David wanted to grab the man, shake him, and curse him for his insensitivity.

But the physician, it turned out, had been forced to answer that ultimate question so many times in his career that he’d finally concluded that the only adequate response was to be direct and objective. An unemotional statement of the facts.

And the fact was that Matthew did have to be prepared. His chances of survival were narrowing. There was a likely possibility he would die.

“But”-Matthew sobbed-“I don’t want to die.”

“No one wants to die,” the physician said. “Everyone eventually does, though.”

“When they’re old, when they’ve lived their lives.”

“It doesn’t always happen that way.”

Matthew sobbed harder. “I’m just a kid.”

No pain, no catastrophe that David had ever endured compared with the heartbreak Matthew’s next sobbing statement caused.

“No one will remember me.”

David wanted to scream.

Instead he held Matthew’s hand and tried not to let him panic.

“If the worst does happen, I promise, son. You won’t be alone. And you will be remembered. But no one’s giving up. I told you, we’ve still got a chance.” David looked with hope toward the physician. “A bone marrow transplant.”

“Yes,” the physician said. “Provided your son meets the requirements.”

“Requirements?”

9

The start of another nightmare. During Matt’s operation, when the surgeons had explained the unforeseen complications of his tumor, when a decision had to be made within fifteen minutes, there hadn’t been time for the surgeons to discuss the conditions required for a bone marrow transplant.

There were four.

First, the bone marrow transplant unit wouldn’t put Matthew through the extreme procedure unless there was a reasonable expectation that the treatment would succeed. To determine whether Matthew was a suitable candidate, the physicians had to know…

Second, whether the remnant of the tumor that the surgeon had been compelled to leave against Matt’s spine was as small as the surgeon had described.

Third, whether the tumor was growing on any other parts of Matthew’s body, on his legs and arms, for example, where Ewing ’s sarcoma customarily struck.

Fourth, whether his bone marrow was free of any microscopic evidence of tumor spores.

If any or all of these latter three conditions gave cause for pessimism, “all bets are off,” the physician said.

Time was crucial. The sooner the answers were determined (provided they were encouraging), the sooner Matt could be given a bone marrow transplant. That quarter of an inch of tumor that for sure was still in his body, against his spine, would keep growing, and if it got much bigger, it might resist even the massive doses of chemotherapy with which the physicians would attempt to kill it.

Mentally, psychologically, emotionally, and physically, Matt had almost reached the limit of what a human being can suffer and withstand.

10

But the suffering persisted. Within forty-eight hours of Matt’s surgery, he was wheeled from floor to floor, from ward to ward. Each bump made him cringe in pain. Each time he was transferred from his bed to various examination tables, he groaned and sweated. But he never screamed. He never panicked. He had chest X rays, skeletal X rays, CAT scans, magnetic resonance images. Some of these procedures required him to remain immobile, stifling his agony, for an hour.

Then his bone marrow had to be tested. Lying on his good side, fighting the excruciating stress on his bad side, he gripped David’s hand with the force of a wrestler and endured the threaded point of a needle being screwed through each buttock and into each hip bone. The needle probed to the very center of each bone and extracted marrow.

David had no idea what marrow looked like. He imagined it resembled bone. But as the needle was unscrewed from each hip and its contents pushed onto a microscope slide, he saw that bone marrow looked like blood, the thickest, the darkest he’d ever seen.

The tests were completed. The waiting began.

Three days of unimaginably nerve-taut waiting while David, Donna, and Sarie worked every minute to make Matt as comfortable as possible and strained to alleviate his mental alarm.

“Hope, Matthew. Hope.”

11

A sleepless son to a sleepless parent at three o’clock in the morning.

“Is there an afterlife?”

How does a father answer such a question from a son in danger of death?

David sat up from the cot beside Matthew’s bed. He chose his words carefully, and each word tasted like salt. “Afterlife? I promised I’d never lie to you. The truth is, I don’t know. There’s no way to tell. I think there is. I want to believe there is. For sure, a lot of people do believe there is. But unless they get there, they’ll never know.”

“I’m pretty sure there’s something after death,” Matt said.

“You mean like heaven?”

“Sort of. I’m confused.”

“We’re all confused. So many theories. A lot of Eastern religions believe that we live many times and that when we die, we’re reborn in a brand-new body.”

“I’ve heard about that. What’s it called? No, I remember. Reincarnation.”

“I’m surprised you know that.”

“I’ve been reading. I want more time. There’s so much I want to learn about.”

“You’ve learned quite a lot already.”

“Not enough.”

David forced himself to keep talking. “Those Eastern religions believe that eventually, after several lives, we die one last time and go to God.”

“I remember. But…”

“What is it, son?”

“Am I good enough for God?”

That was one question David could answer without a doubt. “You’re the finest person I know, the most honest, the most fair, the most decent. By all means, you’re good enough, more than good enough for God.”

“I love you, Dad.”

“Matt, I can’t express how much I love you.”

12

The waiting finally ended. The results of the tests came back. Three physicians and a nurse surrounded Matthew on his bed, while David, Donna, and Sarie waited anxiously in the background. This was it. The day of judgment. And the physicians had such blank faces it was impossible to predict what they would report.

Hurry! For God’s sake, tell us! David thought. With so many people crowding the room, he felt smothered.

“Matt, your bone marrow’s clean. There’s no sign of Ewing ’s sarcoma anywhere else in your body. The remnant of tumor on your spine is so small we can’t see it on X rays. That and the fact that you recovered so strongly from your surgery makes us very much determined to go ahead with the transplant.”

The room became silent. David couldn’t believe he’d heard correctly.

But Matt showed no reaction.

“Matt, don’t you understand? You’ve got a chance!” David kissed Matt’s forehead.

A doctor started grinning. “And there’s something else. The pathology results on the tumor showed it was necrotic.”

“What?”

“Necrotic,” another doctor said. “The tumor was partially dead. That’s why it shrank after the investigational protocol.”

“But then it started growing again,” Sarie said.

“Because it got used to those chemicals. We’ve said all along the tumor’s resistant to treatment. But the fact that some of it was dead proves it can respond. It’s not completely resistant. Before, the tumor was huge, and the chemicals were given in non-life-threatening amounts. But now with such a small segment left inside and with the massive doses of chemicals we’ll be giving you, we’ve got reason to hope we can kill it.”

“Yeah.” Matt started to grin.

13

But his suffering still continued. Another operation was required-to remove a pint of marrow from his hip bones, then to implant a tube in the right upper chamber of his heart (a match to the one that months ago had been inserted in his left chest) for the purpose of making it easier to administer the chemicals.

“In the long run, it’s more painless,” a physician said. “With the tubes in place, we won’t have to keep sticking IVs into your veins.”

David interrupted. “We understood that in January-when you put in the first tube. That first tube did its job well. But why this second tube? Why so many tubes?”

The doctor’s answer seemed vague. “Well, sometimes a bone marrow transplant gets complicated.” The doctor rubbed his neck. “Sometimes we need a few more ways to gain quick access to a patient’s veins.”

With so much good news, David didn’t pause to consider this hint about possible disaster. His son had a chance. That was all he cared about.

14

Bone marrow is the substance within bones that produces blood. If a patient has a resistant disease (leukemia, for example) that attacks the marrow, the treatment consists of extremely high doses of chemotherapy, accompanied by full-body radiation. The effect of this treatment is, in theory, full destruction of the disease within the marrow.

Nonetheless, without healthy marrow to produce healthy blood, the patient will die. So healthy marrow has to be inserted into the body. This procedure is accomplished by, first, finding a donor (usually a brother or a sister) whose marrow is compatible with the patient’s white blood cells. Marrow is then extracted from the donor and introduced into the patient. If everything works as it should, the donated marrow grows within the patient, produces healthy blood, and the patient is cured. Sometimes the patient’s body rejects the marrow, and the patient is given marrow from yet another compatible donor. If the patient continues to reject donated marrow, there’s no way to save that patient from the lethal effects of the massive chemotherapy. But more often than not, David learned, the treatment works.

The miraculous part of the procedure is that, while the marrow has to be extracted surgically from a donor, it’s introduced into the patient’s body through the simple means of pumping it through an IV tube. Because bone marrow, like a homing pigeon, somehow knows where to go. It enters a vein and flows toward its proper destination, the center of bones, where, marvel that it is, it feels at home and, God willing, multiplies.

A wonder of nature.

In Matthew’s case, his marrow was not diseased, so he needed no other donor than himself. The pint of marrow that had been surgically extracted from him was combined with a chemical preservative, placed in a plastic bag, flattened in a metal tray, and frozen much below zero in a liquid nitrogen container that resembled a conventional freezer. The advantage of being a self-donor, of returning his own marrow to his own body, was that Matt didn’t risk complications due to biological rejection of foreign marrow. What’s more, since his cancer was localized, he didn’t have to undergo full-body radiation as well as the chemotherapy. That was the good part.

But no matter if other-donated or self-donated, the marrow couldn’t enter the body until the blood-destroying treatment was completed.

And that was the bad part. When you receive what a physician calls “humongous” doses of chemotherapy, your blood becomes worthless. It has no platelets to enable it to clot if you’re injured and start to bleed. It has no white blood cells to combat infection. It has no red cells to carry oxygen.

You get the idea.

Each day, for seven days, as Matthew received intravenous chemotherapy, monumental, life-threatening doses of it, a nurse wrote numbers on a chart on the wall. These numbers were in columns and referred to the various vital aspects of his blood.

And each day the numbers went lower. A white-blood count of six thousand is wonderful, but David, Donna, and Sarie watched Matthew’s white-blood count descend to…

Zero.

That’s when a simple ingenious system gets scary. Someone with a slight case of the flu can contaminate a bone-marrow-transplant patient, and instead of giving the patient a mild stomach upset, the flu makes him very sick indeed. Because the patient has no white blood cells to attack the usually mild infection. Further, the bone-marrow physicians can’t assume that the patient’s fever and nausea are merely produced by the flu; to guard against other, potentially lethal infections, they might be forced to administer unnecessary extreme medications.

Before entering Matt’s room, David, Donna, and Sarie washed their hands thoroughly, then put on hospital gowns. They interrogated Matt’s visitors to make sure no one had been exposed to even a cold. “Wash your hands. Put on that gown.”

After seven excruciating days, and a day of rest that allowed the deadly chemicals to be purged from Matthew’s body, his bone marrow has unfrozen and returned to him.

Cause for joy.

But Matt was fifteen, past puberty, though the hospital classified anyone under sixteen as a child. The preservative in his bone marrow, which worked well on children but caused occasional allergic reactions in adults, sent his blood pressure soaring to one hundred and seventy. His head ached so severely he told David he feared his skull would burst. He convulsed. His breath (because of a peculiarity of the preservative) filled his room with the smell of garlic, and that made him vomit. But medication reduced his blood pressure. The headaches and convulsions stopped. The garlic stench eventually went away. And everyone waited for a zero white-blood count to climb.

15

That was when David took his turn sleeping next to Matthew… when Donna went home to rest… when Donna returned to the hospital in the morning and David went home to run as was his custom… and stumbled into the house, couldn’t stop sweating, filled a glass of water, raised it to his lips, and suddenly fainted on his kitchen floor.

16

Time present and time past

Are both perhaps present in time future,

And time future contained in time past.

– T. S. ELIOT

Four Quartets,

“Burnt Norton”

17

Floating.

His daughter grieving below him.

Hovering. His aged body succumbing beneath him.

Forty years later.

Or forty years earlier in a nightmare on his kitchen floor?

He didn’t know! He didn’t understand!

Rising. Drifting.

Floating through brilliance.

A radiant hallway. A splendrous door.

Pushing. The door swinging open.

Fireflies.

Power chords.

But where was Matthew? He had to save Matthew!