With memories of that first meeting with the nurse roiling in her brain, Grace followed her into the treatment area. The place abounded with plaques and posters with pithy life-affirming sayings. There were even stuffed dolls carrying placards that read things like:
There were also notifications of various financial-aid plans for treatments for patients without insurance-low- interest loans for up to $200,000. Grace said a silent thank you to Steadfast Health or Excelsius Health or whoever they were today. She couldn’t imagine going through this hell and having to worry about how to pay for it. She had seen the statements of benefits for the tests and surgery to date, and they exceeded the value of their Saab. She was sure these next four months would approach the cost of their house.
In addition to the literature, there were huge baskets of hard candies in every room.
“You might want a couple of these,” Judi said. “The taste of chemo can be pretty awful.”
“I thought it was intravenous.”
“Oh it is, but your bloodstream carries the medicine throughout your body, including the nerves in your mouth and nose. You can taste it from the inside.”
They entered the expansive treatment room. Toward one end was a long, cherry-paneled nurses’ station. In front of it was a horseshoe of eight leatherette recliner chairs. Each had an IV pole and a side chair for a guest. There was a bank of TVs above the nurses’ station so that patients could try to divert themselves during treatment.
Grace gazed around the room. All but two of the recliners were occupied. In one lay a woman sound asleep under a blanket, the IV tube twisting to accommodate her position. Her bandanna had slipped off her head, revealing tufts of brown-gray hair scattered around an otherwise bald pate. Her pretty gold hoop earrings contrasted sharply with the grayish cast of her skin.
Feeling nauseous even before the treatment began, Grace followed Judi to her designated recliner. How hale and hearty she must look in comparison to the other women here. She still had her hair. Her skin, one of her best attributes, still had its unblemished glow.
She managed a sad smile at the sudden notion that the room looked like some kind of weird day spa in reverse-a place that took beautiful women and made them tired, bald hags.
“Spa Toxique,” she thought, and then realized she had said the words out loud.
“Don’t think of it that way,” Judi said, as if she had heard versions of the dark humor before. “Think of the medicine as Pac-Man hunting through your body, munching all the evil cells.”
Judi donned her latex gloves and asked Grace if she was ready. “First, I am going to insert this needle into the port Dr. Hollister implanted during surgery.”
The port was right below Grace’s right collarbone. She could feel it just under her skin.
“Take a deep breath.”
Grace inhaled and clutched the arms of the recliner as Judi passed the needle through her skin and into her upper chest. Surprisingly, it didn’t hurt as much as she had anticipated.
“Now we’re going to draw some blood through this tube to see what your cell counts are. Today is really a formality and a baseline because we’re pretty sure your red and white blood cells and platelets are all present in healthy numbers. But as you go through your chemo, your counts will drop considerably. We can’t start a treatment if the counts are too low. In fact, sometimes you may need medication to bring them up. Otherwise there’s a danger of bleeding or infection or severe anemia.”
Once the tests were done Judi returned with the drugs-some form of steroid, and one to make her drowsy. Next was a large syringe filled with what looked like cherry Kool-Aid but was, in fact, the cellular poison Adriamycin. In spite of herself, Grace watched the liquid pass into her chest. From within her bloodstream, Grace could smell and taste the powerful medication-a sharp, almost musty odor, reminiscent of some sort of cheese. . a taste like. . like what?
“Just close your eyes and relax,” Judi said.
With the help of the sedative and the Serenity Prayer, she began dozing off, cloaked in the conviction that soon this theater-of-the-absurd production would end and she would find herself back in her life.
The dream she drifted into was at first pleasant. . the lake. . two young girls playing together at the water’s edge. . she and her sister, Charlotte. . their mother, arms folded, back to them, standing on top of the water, gazing off at nothing in particular. . their father, shoulder against a tree, eyes narrowed, watching, watching. . Did he know already what he was going to do to his girls?. . Had he already started?. . The dream became a strange, drug-aided montage of images in which Grace was both a participant and an observer, totally aware she was dreaming, yet completely immersed in the scenes.
When the itching first began, it was as if it were happening to the Grace in the dream. She wondered if somehow, seeing her father like this, watching her, watching Charlotte, knowing what he had done to them, was causing the uncomfortable sensation. The itching increased and now was joined by a burning sensation. . her arms, her belly, her face. Along with the girl in her dream, Grace began to scratch.
Over just minutes, the itching grew more intense and the burning more disturbing. The dream blurred, then faded altogether. Grace opened her eyes and raised her arm. Her fingers were swollen and stiff. Crimson welts with irregular, pale margins interlocked with one another like a jigsaw puzzle, until they virtually covered all the skin on the arm. Her belly, too, was covered, and her other arm.
“Hello! Help me, please,” she called out. Her voice was harsh and cracked, and not nearly as forceful as she expected it to be. “Help me. .”
Her lips felt badly swollen-swollen and on fire. The breathing problem was rapidly getting worse. She needed to sit up to get air in. Needed to sit up. . needed to sit up. .
Now there were footsteps. . then voices.
“Oh my God! Grace, can you hear me?” Judi’s voice. “Nod if you can hear me. Get a stretcher out here and get her to the examining room!”
“There’s not much room in there.”
“Just get the stretcher! Run that saline wide open. Grace, you’ve got to lie back. Get oxygen on her, a mask. Five liters or more. Tell Carla to call nine-one-one. Get an ambulance here! Also tell her to call Dr. D’Antonio. Tell him she’s having an anaphylactic reaction. . We need the crash cart
“She’s hardly moving any air!”
“Get a blood-pressure cuff on her! Quick. Here, help me lift her onto the stretcher. Jesus. Carla, did you make those calls?”
“She’s not moving any air. I can’t get a BP.”
“Epi is in. Get her into the corridor by the examining room. We need the crash cart. Jesus, this has never happened here. . absolutely never! Grace, can you hear me? Squeeze my hand if you can hear me.”
“No BP.”
“Carla, are they coming?”
Grace’s panic had exploded. It was as if someone had pulled a broad piece of tape tightly across her nose and mouth. No matter how hard she sucked, air just wasn’t getting in. She struggled against the hands that held
