His mother smiled at him, and his father nodded approvingly. Owen wanted to scream at them to cut the shit already. He was so beyond tired of the lies that people peddled in an effort to make him reject reality. But he kept his emotions in check, a frozen, neutral expression on his face suggesting that he believed the doctor’s every word.
“I’m sure you want to know what this is going to look like,” Dr. Cammerman said, now with a smile of his own. “First step is we need to do some more tests to confirm that you’re eligible for the transplant. I’m not going to bore you with all the things we’re looking for, or seeking to rule out, but I can say that I’m almost certain that when we’re done with that process, we’re going to conclude that you’re a good candidate. But as you’ll hear me say a lot, there are no guarantees on any of this. So, I can only tell you something after I know it. I can’t predict beforehand.”
“Okay,” Owen said, even as he was thinking that the first thing the doctor had said—that if he underwent the treatment, it would all turn out okay in the end—was precisely the type of prediction he’d just said he’d never make.
“Good,” Dr. Cammerman said with another smile. “So, let’s assume that you’re a viable candidate. What comes next is we put in a central venous catheter, which we call a CVC. It can be done as outpatient surgery, which means you will not have to stay overnight in the hospital. It won’t hurt. The CVC allows us to more easily draw blood and give you medicine. It stays in you during the entirety of your treatment, and even for a little bit after it’s all over. We take it out once your new stem cells are firmly in place and starting to reproduce the way we want.”
“Okay,” Owen said again, wanting this entire thing to be over.
“Good. It’s easiest to think about the procedure as occurring in two phases. Stage one has a fancy name called myeloablation.”
Owen knew all about myeloablation too. The internet had practically made him an AML specialist.
“The myeloablation process is basically another round of chemo,” Dr. Cammerman continued. “The intent is to remove the cancer cells in your body and to make room for the transplant we’re going to do in phase two. Now, I know you’re a chemo veteran, so you’re familiar with the drill. It’ll be like it was the last time, except the regimen will be shorter. About a week, give or take. It’s a different type of chemo, different medicines than the last time, so I can’t guarantee—there’s that word again, right? But I can’t predict whether you’ll tolerate it better or worse or about the same as you did the last time. Also, you’re older and stronger than before, so that might help, but it’s a high-dose regimen, so that makes it more likely the side effects will be more severe, I’m afraid.”
Owen touched the ends of his hair out of reflex. It had taken him three years to get it to this length, and now it would be gone in a matter of weeks. As if reading his mind, his mother reached over and caressed his shoulder.
“Okay, now we’re done with phase one,” Dr. Cammerman continued. “We give you a day or two to rest. Then, after forty-eight hours of downtime, the main event occurs. The transplant. Here’s how that works: you’ll be under sedation, so all you have to do is sleep, and my team does the work. The transplant takes only a few hours. We’ll be placing donor stem cells into your bone marrow. Sounds like fun, right?”
That smile again. Out of his peripheral vision, Owen saw his parents wearing stupid grins too.
“Now, I said that there were two phases,” Dr. Cammerman continued, “but I’m going to add a third one: posttransplant. There are some strange side effects to the procedure that you may or may not experience. For instance, you might have a strong taste of garlic or creamed corn in your mouth. Sucking on candy or sipping flavored drinks during and after the infusion can help with the taste. I know, not pleasant. I’m sorry to say, your body will also smell like this.”
“So that might be a little bit of improvement for you, huh?” his father said with a chuckle.
Dr. Cammerman laughed. “Don’t worry. The smell fades after a few days, but this is something that most patients tell me about, and I don’t want you to worry if you experience it. You’re not becoming a vampire or anything like that.”
Owen wanted to tell him that vampires were repelled by garlic; they didn’t smell like it. Instead, he smiled while silently praying that the doctor would stop talking already.
But Dr. Cammerman still wasn’t finished. “So, at this point in the process, posttransplant, we’re waiting to see if the transplanted stem cells engraft and start to multiply and make new blood cells. That usually occurs within a few weeks. Unfortunately, you’re in the hospital this entire time. No exceptions.”
Owen knew this from the internet too. Still he asked, “How long am I going to be in the hospital? I mean after the transplant?”
“Anywhere from three to six weeks. During this period, you’ll be highly susceptible to infection, which is why we require the hospital stay. Your visitors will be limited to your immediate family, and everyone else who comes in contact with you will have to wash their hands before entering and then wear surgical masks, glasses, and gowns.
