Maybe One Day (30 page)

I felt what I can only describe as terror, a terror darker and blacker than anything I had ever felt before.

“What is it?” I asked. It was hard to get my tongue around the words. As I spoke them, I realized there was only one answer: Olivia had to have gotten some kind of infection. That was the only explanation. She’d gotten some horrible, life-threatening infection.

Mr. Greco swallowed, and he took a deep breath. “Zoe, we got some terrible news this morning.” Over his shoulder, I could see Mrs. Greco and Jake sitting on a couch in the living room. Across from them, on the other couch, sat Olivia and the twins. No one was speaking. Luke had his head in Olivia’s lap.

Olivia didn’t look like she had a terrible infection. She didn’t look any different than she’d looked any day for the past week. “What is it?” I repeated, my voice a whisper.

He put his hand over his eyes, his voice breaking as he spoke. “The most recent blood test showed that the leukemia has come back.”

“Does that mean . . .” The thought was too horrible to utter, but I forced myself to say it. “Does that mean she has to have another bone marrow transplant?”

“They can’t do another bone marrow transplant,” said
Mr. Greco, and now his voice was calm, almost like Olivia’s had been when she’d first told me about her diagnosis. “She wouldn’t survive it.”

“I don’t understand,” I said, even though somewhere in my brain a warning bell was ringing loudly. “If they can’t do another bone marrow transplant, what can they do?”

“I don’t know,” said Mr. Greco, and I realized as he said it that I had never, in all the years I’d known him, heard Mr. Greco say those words.

We drove to the city in Mr. Greco’s car: me, Olivia, Mr. and Mrs. Greco, and Jake. Mrs. Greco’s sister had taken the twins to her house. When Olivia had said she wanted me to come with them to meet with Dr. Maxwell, neither of her parents had objected. I sat in the backseat, with Olivia between me and her mother. Mr. Greco and Jake sat in the front.

Nobody talked.

We went into a different building of UH, one that seemed more like a regular office tower than a hospital. When we got off the elevator on the eighth floor, we headed down a corridor that was surprisingly cluttered; there were carts with boxes on them and, up against one wall, several old computers piled on a sagging office chair. Instead of holidays, the walls advertised upcoming lectures with complicated titles. We wound left and then right, and I began to feel like I was in one of those terrible dreams where you have to get somewhere and you
know something awful is going to happen to you if you don’t get there but you can’t find your way. Olivia was squeezing my hand, her grip so tight it was almost painful.

She was going to be okay. No one who could hold on that tightly was going to die.

Mr. Greco knocked on room 818, and an unfamiliar male voice called, “Come in.”

He pushed open the door to a small office. There was brown carpeting on the floor. Sitting at a table with half a dozen chairs around it was a balding man with a beard who was wearing jeans and a gray sweater. Dr. Maxwell was leaning against a cluttered desk. It was strange to see her not in her white lab coat, and for a second I didn’t recognize her. Her hair was in a ponytail, and she had on a pair of running shoes. Like the man, she had on a gray sweater, as if that were the uniform for doctors who weren’t on the floor of a hospital. As soon as we entered the room, both Dr. Maxwell and the unfamiliar man stood up. He was astonishingly tall, maybe six and a half feet or taller. He was the tallest person I’d ever seen who wasn’t on television playing basketball. Dr. Maxwell came over and hugged Olivia, then took Mr. and Mrs. Greco’s hands in hers.

“This is difficult news,” she said. “I’m so terribly sorry.” She gestured for us to sit down, and as I walked by her, she squeezed me lightly on the shoulder. “This is Dr. Gold,” she
said.

The tall man nodded. “Hi, Olivia,” he said. “I’m sorry to be meeting all of you under these circumstances.” Mr. Greco reached across the table, and the two men shook hands. Then we all sat down. There weren’t enough seats for everyone, so Dr. Maxwell and Dr. Gold remained standing. Olivia had not let go of my hand.

“Olivia’s leukemia is aggressive,” Dr. Maxwell began. “AML is rare in teens, and as we discussed, the genetic profile of Olivia’s leukemia has always been worrisome. We suspect that’s why it came back after the second round of chemo.”

Olivia, Jake, and their parents nodded. I couldn’t move.

“She responded beautifully to the bone marrow transplant,” said Dr. Maxwell. She smiled at Olivia. “But at this point, our options are limited.”

“But we do have options,” said Mrs. Greco, her voice slightly breathless.

“We do, yes,” said Dr. Maxwell. She glanced at Dr. Gold.

He clasped his hands together. “Dr. Maxwell asked me to be here today because I am running a clinical study that I could get Olivia into. It’s a drug that has had limited success with patients who relapse after a BMT.”

“How limited?” asked Mr. Greco.

“Limited,” admitted Dr. Gold. “And because Olivia’s relapse happened very quickly after her transplant, in all honesty I’m less optimistic about possible outcomes than I
would be otherwise.”

I could hear the quiet whir of a motor coming from another room, and then it shut off. The silence in the room seemed to pound against my ears.

“I still don’t understand why we can’t do another bone marrow transplant,” said Jake. His voice was strong; he sounded almost angry. “I could give her more bone marrow. Dr. Maxwell told me it only takes a few days for marrow to regenerate.”

Mrs. Greco reached over and took his hand. I watched her knuckles turn white as she squeezed it.

“Given how recently she had one, Olivia would not survive another bone marrow transplant,” said Dr. Maxwell. “Her system is simply too weak.”

Again, there was silence.

“And what are the other options?” asked Mr. Greco.

Dr. Gold stroked his beard. Dr. Maxwell shifted slightly. “The other option,” she said, “would be palliative care.”

“What’s palliative care?” asked Olivia. Her voice was hoarse. I realized neither of us had spoken in over an hour.

“Palliative care is medication to make you feel better,” explained Dr. Maxwell. “Things like pain medication.”

“You mean so I can die more easily,” said Olivia, and suddenly she began to cry. Mrs. Greco also started crying. Dr. Maxwell reached behind her for a box of tissues and placed them on the table, but nobody took any.

“Yes,” said Dr. Maxwell gently. “So you can die more easily.”

“The drug in your clinical trial,” said Mr. Greco, his voice sharp. “You said you think it won’t help Olivia, but you don’t know that for sure.”

“That’s correct,” said Dr. Gold. “I don’t know that for sure.”

“How sick will the drug make me?” asked Olivia, her voice small. Now she reached to the middle of the table and took a tissue.

“It would be like the first time you had chemo,” said Dr. Maxwell. “You would have flu-like symptoms. Some nausea.” Again she glanced at Dr. Gold.

“There have been some severe side effects associated with this drug, including liver damage,” he said. “But the biggest concern for Olivia at this point would be cardiac toxicity.”

“Cardiac toxicity,” Olivia echoed. Her eyes were wide. “You mean my heart would be toxic?”

“Not exactly,” explained Dr. Gold, smiling. “It’s the drug that is toxic to the heart. It weakens the heart and makes it unable to pump blood through the body as well as it needs to. You can’t get enough oxygen.”

He didn’t add
and you die
. He didn’t need to.

Jake toyed with the box of tissues, knocking gently at one corner, then at another.

“What would you do?” Mr. Greco asked Dr. Gold. “If it were your child, what would you do now?”

“Every family is different,” said Dr. Gold slowly. “What’s
right for one family isn’t—”

“Okay, cut the crap,” snapped Mr. Greco, and everybody at the table jumped slightly. I’d never heard Mr. Greco sound quite so angry, but I wasn’t surprised by it. It was like all the years I’d known him, this was why I’d been just a little afraid.

“Carlo,” said Mrs. Greco.

But Mr. Greco didn’t seem to have heard her. He leaned forward, almost across the table, and stared at Dr. Gold. If Dr. Gold was horrified by what Mr. Greco had just said to him, he didn’t show it. His face remained calm, and he continued stroking his beard.

“If it were my daughter, I would leave no stone unturned,” he said finally.

“Fine.” Mr. Greco sat back. And then, as if we’d just been negotiating a contract or a major merger or anything, really, except his only daughter’s life, he folded his arms across his chest and looked around the table with a determined expression on his face. “We’ll try the new drug.”

Mrs. Greco sat on the bed with her hand on Olivia’s forehead after Dr. Maxwell inserted the needle into Olivia’s IV. Outside, it was getting darker and a light rain was falling. I remembered Livvie’s saying how weird it was that there was weather outside when she was stuck in the hospital all the time.

“I’ll come back and check on Olivia in a little while,” Dr. Maxwell said. “We’ll be watching her very carefully over the
next few hours to make sure she can tolerate the medication.” The moment was anticlimactic, nothing like the bone marrow transplant. Mrs. Greco said, “Thank you,” but there were no lowered heads and no prayers. Maybe we were beyond prayer by now. Eventually Olivia fell asleep and Mr. Greco and Jake went to get something to eat.

“It’s funny,” said Mrs. Greco. Her voice startled me. I was sitting on the radiator, watching the river, and she’d been so quiet I’d assumed she was dozing too. “This whole time I’ve wanted to trust Dr. Maxwell. But I’ve been thinking this afternoon about how often doctors are wrong and how it’s just as likely that Dr. Maxwell and Dr. Gold
don’t
know. I’ve been hoping that, really. That they’ll be surprised by how well Olivia responds to this medication.”

“I know,” I said. I looked at Olivia sleeping on the bed. I’d gotten so used to seeing her with her duckling fuzz that she didn’t even look strange to me anymore. “I’ve been thinking about how
somebody
has to be the five or ten percent that responds well to an experimental drug. Why shouldn’t it be Olivia?”

Mrs. Greco had one hand on Olivia’s arm, and she gestured toward me with the other. I walked around the bed until I was standing by her side. She took my hand in hers and looked up at me. “What a good friend you are. Olivia is so lucky to have you. We all are.”

I’d made it through everything that had happened today without crying, but as soon as Mrs. Greco said that, I started to weep.

“I’m sorry,” I mumbled, wiping my cheeks and nose with my free hand.

But Mrs. Greco didn’t seem to mind. “A person’s whole life, she’s lucky to have one or two
real
friends. Friends who are like family.” She smiled. “You and Olivia are like family.”

Now I was crying so hard I couldn’t even talk. Mrs. Greco put her arm around my waist and patted me gently. “I know,” she murmured. “I know. But it’s going to be okay.” She kept patting me, and I saw her other hand was also patting Olivia. “You’ll see.” She almost sang the words, like a quiet lullaby. “You’ll see.”

I don’t know how much time had passed when Olivia woke up complaining that she was having trouble breathing. Jake and his dad still weren’t back. I buzzed for the nurse while Mrs. Greco propped pillows behind her to help her sit up. When no one answered my buzz, Mrs. Greco told me to go find someone, and I ran out into the hallway, almost crashing into the nurse who was racing into the room.

Livvie was panting now, and she looked frightened. “I can’t . . . ,” she started to say. “I can’t breathe.”

I stood, frozen, by the door.
This is it
, I thought.
This is how Olivia is going to die
.

The nurse ripped some tubing out of a drawer, put it into Olivia’s nose, and pushed a button on the wall. “This is oxygen, honey,” she said. “It’s going to make it easier for you to breathe.”

“Paging Dr. Maxwell. Dr. Maxwell to room 1225.” The announcement came over the loudspeaker. Had the nurse made it? She seemed totally focused on Olivia. It couldn’t have been more than a minute later that Dr. Maxwell burst into the room. She said something to the nurse, who ran out. Olivia was still breathing rapidly. I stood at the foot of her bed as Dr. Maxwell spoke quietly to her. The nurse ran back in, pushing a cart that had a computer on it, and Dr. Maxwell grabbed a white stick attached to a long cord, slathered some clear gel on it, and ripped Livvie’s hospital gown open. She watched the screen for a minute, then said to the nurse, “Page Dr. Gold and Dr. Connor.”

I went over to the side of the bed. Livvie’s eyes were wide with fear, and Mrs. Greco was holding her hand. Dr. Maxwell was still moving the wand-like thing over Olivia’s chest. When Dr. Gold and another man came into the room, we all looked at them, but they only had eyes for the computer screen. A long piece of paper came out of the side of the computer, and the three of them stepped back from the bed and studied it, Dr. Gold tracing something along it as Dr. Maxwell held the end up.

Dr. Gold asked Dr. Maxwell a question, and she shook her
head, and then they both looked at the other man—I guess Dr. Connor—and he said yes, loud enough for us to hear.

Finally, Dr. Gold, Dr. Maxwell, and Dr. Connor stepped away from the computer screen and came to stand next to Olivia’s bed.

“What just happened?” asked Mrs. Greco. Her face was very pale.

“Olivia’s heart is overwhelmed by the medication,” explained Dr. Gold. For the first time, he was speaking without stroking his beard. “As we feared, the drugs are simply too toxic for her to tolerate. Her blood is becoming oxygen poor.” He looked at Olivia. “That’s why you have the sensation of not being able to breathe. Your heart’s not pumping enough oxygenated blood through your body. It’s clear from the echocardiogram, the machine we were just using. It shows us pictures of your heart.”

“What are you saying?” Mrs. Greco demanded. She looked frantically from Dr. Maxwell to Dr. Gold to Dr. Connor.