4

April was alone in her room the following day when Mark knocked on her door. “You up for a visit?”

“Sure.” April closed the book she was reading. “How are you doing?”

“I may get out tomorrow if I pass all my breath tests.” She must have looked puzzled because he explained, “There’s a machine I have to blow air into and the gauge has to jump into a certain zone. That lets my doctor know how much lung capacity I’ve regained.”

“I hope you pass.”

“How about you?” he asked. “Know anything more about your problems?”

“Not yet. I’m not too sure I want to know either. I mean, as long as I don’t know, I can pretend it’s nothing really bad.”

“Why do you think it might be bad? You look healthy. I’ll bet you’ve never been sick a day in your life.”

“You’re wrong.” April wanted—needed—to confide her fears to somebody. On impulse she decided to tell Mark about her childhood brain tumor. “I’ve got plenty of reason to be worried,” she said, and told him her story.

Mark listened intently, nodding and looking grim. “It must have been horrible for you.”

“It was. But why am I telling you? You’re certainly no stranger to hospitals.”

“I honestly can’t remember my life without them. CF and I reluctantly share the same body. Unless medical science comes up with a miracle, it’s here to stay.”

“I don’t know how you stand it.”

“I consider the alternative,” he said with a wry smile.

April sighed. “I guess you’re right. The alternative is what you’re trying so hard to avoid.”

“So let me get this straight,” he said, moving back to their original topic. “After years of feeling fine, you suddenly start getting headaches and dizzy spells again.”

“I staggered around like I was drunk. And I blacked out too.”

“So you’re afraid the tumor is back, even though they told you twelve years ago it was gone?”

“Yes, I am.”

He looked at her and for a minute nothing existed except the dark brown of his eyes. “I hope you’re wrong,” he said softly. “I can’t imagine anything terrible happening to you.”

April suddenly felt self-conscious. She struggled to find something else to talk about. Her gaze fell on the bud vase. “Thank you for the rose. It was nice of you.”

“It looks pretty puny next to your other bouquet.”

“My dad never does anything halfway.”

“You’re lucky he can afford to do things first class.” He paused. “April, when this is over, when you’re out of here, can I call you? Come see you?”

April hesitated. His interest in her was flattering, but she couldn’t lead him on. “No, Mark. I told you I have a boyfriend.” His expression told her that he didn’t think this was a good reason. “I mean it, Mark. Once I get out of here and back to my real life, I don’t want any reminders of this place.”

“Including me?”

“You’ve been nice to me and I appreciate it. But this is only a temporary interruption of my life.”

“No matter what your tests say?”

She squared her chin. “No matter what the tests say.”

Her parents were with her when Dr. Sorenson came in, pulled up a chair, and said, “I believe we have a diagnosis.”

April’s mouth went dry and her heart began to hammer. Her parents were on either side of her bed. They reminded her of guard dogs jealously surrounding their young. “May I have the envelope, please?” she said, trying hard to keep things light.

“You are having a recurrence of your earlier problem,” Dr. Sorenson told them matter-of-factly.

“But they told us it was gone,” April’s mother said fiercely.

“They told you it was a low-grade astrocytoma and that the chances were good that it would not return,” Dr. Sorenson corrected her. “But it’s never been gone; it’s only been dormant.”

April suddenly felt cold, as if all her blood had turned to ice. She clenched her teeth to keep them from chattering.

“So what is it now?” April’s father growled impatiently.

“Now it’s a high-grade astrocytoma.”

“Meaning?”

“It’s growing rapidly and consequently it will be harder to treat.”

“This is ridiculous,” her father snapped. “First it’s there, then it’s gone, now it’s back. Can’t you doctors get it right? This is my daughter we’re discussing.”

“I’m very sorry,” Dr. Sorenson said. “I wish I had better news for you.”

Her father rocked back on his heels. “What are our options?”

April scarcely heard him. A rushing sound was filling up her ears and their voices seemed to be coming from far away. This couldn’t be happening. It had to be some mistake.

Dr. Sorenson attached X rays to a portable light board he’d brought into the room with him. A human skull was outlined perfectly. “This is your skull, April. And here”—he pointed to a dark area at the base of her skull—“is the tumor. You can see it better on the MRI.” They peered at the contours of her brain on another piece of film. The tumor looked dense and sinister. “The tumor’s entrenched here, and it’s growing.”

April shuddered. How could something be growing inside her body without her knowledge or permission? “Can’t you cut it out, remove it?” she asked.

“Maybe not.”

“Why not?” asked her mother.

“It’s embedded itself in the cerebellum here, near the brain stem.” Dr. Sorenson pointed to the area on the MRI. “This is the part of your brain that’s responsible for involuntary reflexes, like breathing and coordination. That explains your dizzy spells. The tumor mass is pressing and intruding into these areas. If we do traditional surgery, you could be maimed for life. No scalpel can untangle it.”

“Are you saying there’s nothing you can do?” April’s mother gasped, her eyes wide with fear.

“No. We’re going to try some things. First, a drug to reduce brain swelling. There are some side effects, but I want to get the swelling down so that you won’t have so much pain.”

“What kind of side effects?” April swallowed hard, feeling slightly detached, as if they were discussing someone else.

“Water retention, puffiness, and an incredible appetite.”

April had always been tall and slim and able to eat whatever she wanted, and she didn’t like the idea of a forced weight gain. “I’ll look like a freak.”

“What else?” her father asked the doctor.

“We’ll start her on radiation treatments.”

April remembered the radiation sessions from before. They had strapped her on a table, alone in a room, with a massive machine aimed at the back of her head. She’d shrieked and screamed, not because it hurt—it hadn’t—but because she couldn’t move. And because she was all alone. But she was older now and she knew that the technician had to leave the room to avoid the high doses of gamma rays emitted by the machine. Still, just the memory terrified her. “Will I lose my hair?” she asked. “Will I have to cut it off?”

“Just a little spot in the back. You can comb the rest of it over. No one will be able to tell. Radiation has come a long way. You’ll have a radiation oncologist, a special doctor who does only these treatments. It’s an exacting science and you’ll be in good hands.”

“But she’s already had radiation once,” April’s mother interjected.

“It’s the best treatment for this kind of tumor,” the doctor insisted. “We must radiate again.”

“And once it’s shrunk?” her mother wanted to know.

“Then more MRIs and X rays to see if she’s a candidate for gamma knife surgery.”

“I thought you said you couldn’t cut out the tumor.”

“Not with a regular scalpel, but with a gamma knife, a high concentration of gamma rays aimed at the tumor.”

“Why can’t you just do that right away?” April asked breathlessly. “Why do I have to go through all the other stuff first?”

“Because we can’t use the gamma knife on anything larger than three centimeters.” He pulled a ruler from his pocket and held his thumb on a mark. “Right now, your tumor is larger, about five centimeters.”

She watched his thumb slide upward on the ruler and wondered how two centimeters could make such a difference. And yet it did. Surgery was out.

“What about chemotherapy?” her mother asked. “I have a friend who had breast cancer and they gave her chemo. She was sick for a while, but it worked. She’s been cancer-free for six years.”

Dr. Sorenson shook his head. “Chemo is ineffective on this kind of tumor.”

April felt as if the doors of her options were being closed. “I don’t have a lot of choices, do I?”

“Radiation’s your best hope,” the doctor answered.

She felt sick to her stomach. “And if radiation doesn’t work?” Her voice trembled, but she had to ask the question.

“We’ll cross that bridge when we come to it,” he said.

But she knew instinctively that the bridge was a narrow rope hanging over a precipice that led down to a dark abyss. She turned her face into her mother’s shoulder and hid, like a frightened child.

“You’re leaving?”

Mark stood in April’s doorway, and she turned at the sound of his voice.

“Mom’s downstairs finishing up my paperwork now.” April continued to pack her small valise.

He came up beside her. “I’m getting out today too.”

“Oh, Mark, that’s good. I’m glad for you.”

“I’m sorry your news wasn’t better.”

“I guess I’m not destined to be normal and healthy after all.”

“When do you start your radiation?”

She should have been surprised that he knew so much about her case, but she knew that the hospital floor was a hotbed of gossip. “Next week. Five days a week for six weeks. So, I guess I can kiss my extracurricular activities goodbye.”

“I brought you a present,” he said. From behind his back he pulled a large red balloon with a hand-drawn smiley face on it and tied with a long yellow ribbon. “I blew it up myself … which is what I used to do when I was a kid to prove I was well enough to get out of the hospital and go home.”

The gift touched her. “Thank you.”

Their hands brushed as she took the ribbon from him. Her skin tingled from the contact.

“Take care of yourself.”

“I will.”

“Uh—my phone number is written on a scrap of paper inside the balloon.” A wide grin lit up his face. Then, more soberly, he continued, “Just in case you ever want to talk. Sometimes talking helps. And I’m a good listener.”

“I told you—”

“I know, you have a boyfriend. But if things change between you two, call me.”

She held on to the bright yellow ribbon and watched him walk from the room.