Forty-Eight

Three weeks later

Riley’s eyes hopped from a fog-embraced castle to miles of emerald green hillside overlooking a serene blue sea. The breathtaking images housed in rustic wood frames felt more travel agency than cancer center, but it made a refreshing change from the usual prim watercolor paintings found in most hospital settings.

“I’m guessing Ireland?” Riley turned to Maggie, sitting beside her in the doctor’s office, its cheery robin’s egg blue chairs further underlining the ‘We’re not a medical center’ décor.

“Hmm, it looks like something out of Lairds, so I’m going with Scotland. Wherever it is, we should add it to our dream tour itinerary.” Maggie scratched at the soft fuzz growing underneath her head scarf. “I bet Ben would know where it is. Have you heard from him?”

“Just a text saying to message when we’re done. If he doesn’t answer right away, he’s in his audition.”

“I hope he gets the part,” said Maggie. “It’s a good sign he’s been called back twic—”

“Maggie, sorry to keep you waiting.” A familiar face above a pristine lab coat slipped into the office and closed the door. Carrying a file folder thick with papers, Maggie’s oncologist, Dr. McLoughlin, sat down at her small desk. “It’s great to see you and Riley.” She logged into her computer and opened the folder, her chin dipping toward the top page. “How’s your summer been?”

“Good, too muggy for my liking, but that’s New York.” Maggie shrugged while Riley nodded in agreement, her knee jittering under the tote bag lying on her lap.

“Yeah, coming from Arizona, I never get used to the humidity here.” Dr. McLoughlin looked up from her paperwork, poker face in full effect. “Well, the results came back for your scans and blood work. The cancer in your liver hasn’t spread, but I’m afraid it has grown slightly—”

“Grown…?” Riley’s eyebrows furrowed with confusion. “But—” Third time lucky…

“So, what does that mean?” Maggie reached over the armrest, her warm hand enveloping Riley’s.

“Well, we have options.” Dr. McLoughlin nodded. “We can try a clinical trial for a new drug, but…I’ll be honest, its success hasn’t been proven with your type of cancer. If you decide to try it, we’ll weigh the benefits against risks and side effects—”

“Sorry, wait.” Avoiding Riley’s stare, Maggie jumped in. “In April, the cancer was advanced. I could live with it…but now, what does a slight change in size really mean? Is it…?”

Is it…what? Riley’s eyes darted from her mom to the oncologist.

“Maggie…” The oncologist shifted in her chair. “The cancer has grown, but it hasn’t spread beyond your liver. If it does, we’ll make you comfortable for as long as possible. We’ll relieve your symptoms, control your pain…”

“You’re…” Maggie’s voice cracked. “You’re…talking about palliative care?”

Palliative—what?! No! A vice clenched Riley’s stomach, its suffocating squeeze traveling higher and higher. Her mouth fell slack as words—jagged, horrific, life-changing words—burned the back of her throat, unable to escape. Symptom relief…pain control? Palliative care? Isn’t that just a fancy way of saying, ‘Sorry, there’s nothing we can do’?

Dr. McLoughlin didn’t nod, didn’t shake her head. Her lips pressed together, like they were unwilling to surrender the inevitable.

Say it. Riley swallowed, but the thickness wouldn’t budge. It’s easy. Just say NO, it’s not palliative!

“Yes, but there are…”

Yes?! Riley clenched her Mom’s hand. “No…no,” she choked out, her lungs desperately fighting for air, but it felt thin and nonexistent, like all the oxygen had been sucked from the room, like she was going under.

She swore her heart stopped.

For how long, she had no clue.

Valuable seconds with her mom…

…one…

…by…

…one…

…slipping away, vanishing…gone—lost forever. Memories flashed and then twisted, fading into a dizzying spiral of thoughts, drowning her…

How long until…? A year, six months…one month?

I don’t know how to make your red velvet cake.

What will birthdays be like? Mother’s Day?

Who will watch cheesy Christmas movies with me?

Share donuts, walk shelter dogs?

I’ll miss the smile in your voice

when you realize it’s me on the phone.

Will I forget your scent?

How you can wear a sweatshirt and still look chic?

What happens to your stories, the ones I don’t know?

Will they be lost—forever?

Who will walk me down the aisle on my wedding day?

If I have kids, they’ll never meet you, learn from you, love you.

How will I make you proud?

When time runs out…

How do I do this?

Alone…

…without you.

Female voices floated in and out, but they were garbled like an underwater conversation as the thrashing of Riley’s heartbeat pounded through her ears. Words formed on her tongue but weren’t spoken.

Or were they?

Did I say something?

She felt pressure…her hand…a squeeze? Maggie’s touch reawakened her senses. Riley turned to her mom, her pretty face and head scarf blurry in a wash of pink, blue, and green. When did I start crying? The drone in her ears began to shift, and a few fragments spoken by the doctor ricocheted around her mind.

…“unresectable bile duct cancer”…

…“liver transplant”…

…“national wait list”…

A warm chuckle invaded the words, pulling Riley back to the surface. Mom?

“Yes, do it.” Maggie’s voice was firm, assertive—the quiver from earlier gone. “Add me to the list. I’ll wait for as long as it takes.”

“A liver transplant?” Riley wiped her eyes, streaking her hand with teary mascara smudges.

Offering a box of tissues to Riley, Dr. McLoughlin’s gaze hopped to Maggie. “Well, you’ll have to be evaluated by a transplant hospital to see if you’re healthy enough for surgery. They’d run a series of tests, both physical and psychological, and then a committee discusses the findings and makes a decision. If it’s a yes, you’d be added to the wait list, but I have to tell you, Maggie, there’s no guarantee you’ll receive a liver. The list is…extremely long.” She typed something into her computer and scrolled the screen. “Right now, there are over thirteen thousand people waiting around the country. Most of them…” The oncologist took a deep breath. “Won’t live long enough to receive a transplant.”

“I’m not most patients.” Maggie held Riley’s hand, refusing to let go.

“We have to try.” Riley sniffed behind a tissue.

“I don’t want to dissuade you, but you should know the reality,” said the oncologist. “Every person on the list is ranked based on how urgent their need is within the next three months. This protocol places the sickest patients at the top of the list.”

Maggie nodded. “You said my type of cancer can grow quickly—would that make me an urgent case?”

“Not necessarily. Bile duct cancer cases aren’t always accepted by transplant centers, and livers from deceased donors often go to people with more curable diseases.”

Maggie looked confused. “So, a transplant wouldn’t cure my disease?”

“No, there’s a good chance it could since your cancer is localized to your liver, but we’re dealing with a numbers game—the need for donated livers exceeds the supply, and living in New York state makes it even harder to receive an organ.”

“Why?” Riley’s stare bounced between both women. “I thought the wait list was national?”

“It is, but organs are shared regionally, not nationally, so areas with higher populations, like New York or California, have a greater need and a longer wait.”

“So, if I lived in…” Maggie shrugged. “Idaho, my chances of receiving a liver would be better?”

“Yes.”

Seriously? Death by geography? Mom will lose out on a liver and die because she lives in the wrong state? Tears trickled down Riley’s cheeks.

“There is one other option.” The oncologist sat back. “A living donor.”

Living donor? I could save her—ME. Riley sat up like she had been given a shot of adrenaline. She rubbed her swollen nose, her eyes wide. “I’ll do it. I’ll give Mom my liver—”

“Honey, just…wait.” Maggie patted her hand. “You’re not giving anything—”

“Why not?!” Riley leaned forward, swiping tears away as quickly as the words rushed out.

Dr. McLoughlin half-smiled at Maggie then back to her daughter. “Riley, there’s a lot to consider—it’s major surgery and recovery can be painful.”

Riley refused to be dissuaded. “How does it work?”

The oncologist shifted in her chair. “Well, the liver is comprised of two lobes—the left and the right. The donor gives their right lobe, about sixty-percent of their liver, to the recipient.”

Maggie grimaced. “More than half?”

The oncologist nodded. “But the amazing thing is the liver will regenerate itself.”

“Really?” Riley listened intently.

“Within six to twelve weeks of surgery, the donor and recipient’s livers will have grown back to about eighty percent their original size.”

“That’s amazing.” Riley gripped Maggie’s hand tighter.

Dr. McLoughlin softly smiled. “The body can do some incredible things to repair itself.”

“Well…” Riley swallowed, trying to mute the quiver brewing in her throat. “Sign me up.” Her puffy nose made her voice come out nasal.

Maggie shook her head. “Riley, you’re not doing this.”

“I AM.” Eyes flashing, Riley pleaded with Maggie. “I’m an adult, Mom. You can’t stop me—”

“Riley—”

“There’s nothing you can say that will change my mind.”

Even when things are at their worst, I refuse to believe all is lost.

I will never go down without a fight.

Riley wiped her eyes a final time, straightened her posture, and turned to the doctor. “What do I need to do?”

• • •

Ben squinted into the afternoon sun, his shades left behind at his audition in Chelsea. She’s jumping in so fast. “Are you sure about this?” He threaded his fingers through Riley’s, giving her hand a squeeze as they walked to the convenience store near Maggie’s apartment. “It sounds… risky.”

“All operations involve risk, even simple ones.” She swerved, pulling Ben off the sidewalk, so two boisterous kids on scooters could fly past, their golden retriever loping behind. “So, whatcha hungry for? I’m gonna make Mom quesadillas. I might have pasta—no! A burger.”

Now’s not the time to talk burgers! “This isn’t wisdom tooth surgery. It’s removing half a vital organ—an actual organ, Riles! And how do you know you’re a match?”

“I’ll find out after an evaluation.” Her eyes, still puffy from crying earlier, lingered over her shoulder, following the dog.

“You mean tests, right?”

She smiled, watching the pet disappear.

She’s stalling. His posture stiffened. “Riley, what tests?!”

“Oh, nothing scary.” Her voice was cheery as she flashed a ‘Don’t worry!’ grin. “It’s stuff like a chest x-ray, abdominal ultrasound, CT scan. There’s also a psych assessment, which…” She lifted her chin. “I’m thinking of starting therapy again.”

“Really?” Ben’s tight expression eased slightly. “Riley, that’s great.” He raised her hand to his lips and kissed it. “I’m proud of you, going back.”

She grinned and resumed swinging his hand in hers. “Mom mentioned it a few months ago, but I wasn’t ready. I am now. I’m going to do this properly, all of it—therapy, the donation, blood tests, liver biopsy…” Glancing away, she quickly mumbled the last two words, taking in a jagged breath.

What? Did…? Ben’s eyes widened. “Did you just say liver biopsy? Jeez, Hope! That’s—”

“The biopsy isn’t for sure. It’s a…maybe.” She tugged him to the right, turning onto a side road.

“Did you sign something already?” Tinged with worry, his voice rose an octave.

“No, not yet. Mom’s appointment with the transplant hospital is Monday. They’ll decide if she’s a good candidate and put her on the list.”

“You going to that?”

She shook her head. “She wants to go on her own in case it’s bad news. I said that’s why she shouldn’t go on her own, but she won’t budge. I have to pick my battles. I’ve won the ‘I’m donating’ fight, so I’m not pushing it.”

“So, she still goes on the waiting list even though her liver is coming from you?”

“Yep, and once she’s on the list, her insurance company is notified, and then I go for my evaluation.”

“So, you’re on hold for bit.”

“Kinda, but I can find out my blood type on Monday. It only takes a few minutes. I’d go tomorrow but…”

“Oh, yeah, Erika’s wedding.”

Riley frowned. “My heart’s not really into bouquet tosses right now.”

“But you’re a maid of honor—you can’t blow it off.”

She sighed. “I know, but…Erika and I, we’re not as close as we were, and with everything with Mom—”

“Riley, I’ve already said I’ll hang with Maggie.” He adjusted his backpack on his shoulder. “Tomorrow is booked off, and it’s not like Erika will miss me.”

“But I will. I’d have fun if you were there, taking the piss out of everything.” Riley smiled. “But I’m glad you’ll be with Mom. Today was hard and I know you’ll cheer her up.”

“Yeah, she said she can’t wait to tell me her embarrassing teenage Riley stories!”

“Hey!” She stepped in front of him, blocking his progress. “Be nice to me, Brit boy. I’ve got blood tests on Monday, remember? Big scary needles…”

“You’ll be fine! It will hurt for, like, a second. Just think of the lollipop they’ll give you afterward.” He kissed the top of her head and they started walking again. “Do you want me to come with?”

“No, you can’t afford to take time off.”

“Will Maggie’s insurance pick up the cost?”

“Retroactively, yeah. They’ll pay for all my tests and hers, but we’ll be out of luck on living expenses, rent, my lost wages…”

“Bollocks, yeah…you’ll be off work for a bit. Well, what about that crowdfunding thing? Could you pull money from there?”

She shook her head. “I hoped it might pay for the bills Mom already has, but it won’t even do that. We’ve only raised two thousand of the fifteen-thousand-dollar goal.”

“That’s better than nothing.”

“Yeah, but it barely makes a dent, especially now that she needs a transplant. I kinda wish we hadn’t done it; I haven’t told Mom about it yet…”

“She still doesn’t know?”

“No. It’s depressing, seeing such little interest.” She smiled tightly. “So, I have to take all the Sephora shifts I can get and keep saving like Scrooge. It’s not like I have a choice.”

“Isn’t there anyone else in your family who could do this? I worry about you. Call me selfish, but I don’t want anything to happen to my girlfriend—”

“Girlfriend?” She stopped, jerking Ben to a halt.

Well, that just slipped out. “Um…” Still holding her hand, he moved closer. There’s no sense denying it—not anymore. I’m ready for a commitment. I can’t lose her—to anyone or anything. “I know we haven’t talked about being exclusive, but…I think you know I have been, and I want to…with you. So, yeah…I want to be your boyfriend.” Agh! Ben held his breath. Did I do that right? I feel like I’m fourteen! First time for everything…

Her smile grew. “You like me, huh?”

“Yeah.” His gaze fell to her lips. “Quite a lot, actually.”

Grin widening, Riley cupped his face and kissed him softly as Ben slipped his arms around her waist. He settled in, the need to go deeper reserved for another day when hospitals and organ donations weren’t at the forefront of their minds.

A passing car laid on its horn…several times.

Gotta love New York. Ben laughed against her lips and broke away, reclaiming Riley’s hand as they moved forward.

“So, boyfriend”—she giggled, ducking under a low-hanging tree branch—“don’t worry, I’ll be fine, and so will Mom. I can feel it.”

“There’s no talking you out of this?” Ben gripped a dangling leaf, pulling it with him.

“Nope.”

He let go and the leaf snapped back. “You’re amazing. You’re also scaring the bejesus out of me, but I get it.”

“Good.” She swung his hand, walking in silence for a few steps. “So, how did the audition go?”

“Eh…all right.”

“Just all right?”

“I don’t think I’m what they’re looking for.”

“Really? But you read for them three times.”

“Yeah, but all the callbacks today were blond, captain-of-the-football-team types. I felt like the brown-haired runt of the high school litter.”

“But runts are more interesting. They’re stupid if they don’t pick you.”

“Riles, if only you were the casting director.” Ben wrapped his arm around her.

“Well, never say never. I was looking at BBC job postings yesterday when I was supposed to be doing data entry and I found a casting position in LA. Not that I’m qualified, but a girl can dream…”

“Maybe one day, eh? See anything else that looked good?” She deserves a break. She works so hard.

“A few entry-level jobs in production, a part-time assistant and a full-time one—right here in the New York office.”

“You should apply.” Ben squeezed her shoulder.

“I already did! I know it’s not LA, but I need to keep my options open.” She shook her head. “I don’t want to be scared about the future anymore. I need to focus on now, on Mom—you—” Her smile grew. “Mom’s appointment today was scary, but when the doctor said there was an option to donate…Ben, I felt so empowered! From now on, it’s like I’m scaling rocks again—I’m using everything I’ve got to hang on and keep climbing to help Mom beat this, once and for all.”

“You’ll like this, then.” Ben reached into his backpack. “I got you something the other day.” He pulled out a re-sealable plastic pouch.

Riley’s eyes immediately lit up. “Climbing chalk!”

“For a better grip on your climb, brave girl.” He kissed her cheek.

“Thanks, Ben, really…”

“Boyfriend did good?”

“Yeah, you did good, but it’s more than that.” She squeezed the pouch in her hands. “Thank you…for believing in me.”