Perfectly Unpredictable

Perfectly Series Book 4

LINDA O’CONNOR

Table of Contents

PERFECTLY
UNPREDICTABLE

Acknowledgements

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Chapter 9

Chapter 10

Chapter 11

Chapter 12

Chapter 13

Chapter 14

Chapter 15

Chapter 16

Chapter 17

Chapter 18

Chapter 19

Chapter 20

Chapter 21

Chapter 22

Chapter 23

Chapter 24

Chapter 25

Chapter 26

Chapter 27

About the Author

The Perfectly Series

PERFECTLY
UNPREDICTABLE

Copyright©2016

LINDA
O’CONNOR

This
book is a work of fiction. The names, characters, places, and incidents are the
products of the author’s imagination or are used fictitiously. Any resemblance
to actual events, business establishments, locales, or persons, living or dead,
is entirely coincidental.

All
rights reserved. Thank you for buying an authorized edition of this book and
for complying with copyright laws by not reproducing, distributing, or
transmitting it in any form or by any means without the prior written
permission of the publisher. The only exception is brief quotations in printed
reviews.

Cover Design by Rae Monet, Inc.

Published in Canada by Interlock Publishing

[email protected]

Library and Archives Canada Cataloguing in Publication
 

O'Connor, Linda (Linda A.), author
 
          Perfectly unpredictable
/ Linda O'Connor.
 

(Perfectly series ; book 4)
 
Issued in print and electronic formats.
 
ISBN 978-0-9949173-3-1 (paperback).--ISBN 978-0-9949173-2-4 (pdf)
 

          I. Title. 
II. Series: O'Connor, Linda (Linda A.).  Perfectly series
 
; bk 4.
 

PS8629.C652P48
2016                   
C813'.6                  
C2016-904028-3
 
                                                                                          C2016-904029-1
 

With love to Mom,

and to Dad, my
guardian angel

Other Books in the
Perfectly Series:

Perfectly Honest

Perfectly Reasonable

Perfectly Planned

Wow – book 4! This has been a
thrilling journey, and I couldn’t have done it without the support of my family
and friends.

Special thanks to Jenny Govier, editor
extraordinaire, and to Rae Monet and Karen Duvall for the beautiful cover
design.

Thank
you from my heart to:

Brad, Tom, and Mark, who laugh
with me;

my Mom, for all of her wise
advice;

Karen Marcotte, artist of
beautiful cards and my most avid supporter;

Susan Pettit, Lesley Rooke,
and Anne Richards, for their positive voice and unwavering support;

and to everyone who read the
Perfectly Series books and are perfectly supportive!

Here you have it – Perfectly
Unpredictable – who’d have thought?

Kalia Beck sat at her computer with a cup
of coffee, enjoying the wave of alertness that accompanied the first few sips. Still
in
her pajamas, loose pale blue cotton pants and
a matching teddy, with her long, wavy brown hair carelessly pulled up in a twist,
she tucked a leg up under her and opened her emails.

She scanned the dozen or so new ones and
deleted three that looked like junk. The one from her mother contained happy
news about Blaine, Kalia’s brother, and another thank you for the e-reader
Kalia had given her for Christmas. Her mom had figured out how to put
newspapers from around the world on it and happily read the Parisienne news,
even when settled in their country home, nearby, in Emerson, Ontario.

She fired off an email to her mom in
perfect French. Kalia came upon her love of languages honestly. Her mom, fluent
in French and English, had spoken both interchangeably to her and Blaine from the
time they were little. Her dad had grown up in Germany and added German,
English, and a smattering of Russian into the mix
.
With
her dad’s position at the German embassy in Canada, they were often host to
international guests and had lively dinner discussions in a mix of accents and
dialects.

By the time Kalia graduated high school, she
could easily converse in English, French, and German and knew a smattering of
Spanish and Russian. After studying languages at university, she added fluency
in all five languages and picked up Mandarin along the way. Now, she was as
busy as she wanted to be working as a freelance translator and interpreter. The
freedom, the traveling, the variety of jobs – she loved it all. And
to the delight of her parents, she regularly sharpened her skills with them.

The next few emails were responses to
enquiries she had made about potential or completed projects. It was the sixth
email that sparked her interest. She paused and reread it carefully.

Dear
Ms. Beck,

We
are very excited to be hosting the International Forum of Neuroscience this
fall from October 15-24 in Nice, France.

This conference
is held every three years for scientists and medical doctors to share the very latest
in research and developments in the field of neuroscience. We anticipate over
800 registrants from all over the world. The main lectures will be presented in
multiple languages, but we are hoping to offer their translation to English.

Your work
as an interpreter comes highly recommended by members of our planning committee
who have worked with you in Canada, and we are wondering if you would be
available to do this.

If
you are interested, please respond by February 22nd and we will provide you
with further details. We look forward to hearing from you.

Sincerely,

Maurice
Bastille

Planning
Committee, International Forum of Neuroscience

Now that sounded intriguing. Challenging,
no doubt. How much would her work at the hospital help with a neurosciences conference?
She usually interpreted for patients in the emergency department. Not much
neuroscience there. But the work she’d done at the art exhibit last year had
been neuroscience-ish. “Mental Health Revealed” had stretched her medical
translation skills, but the international judges had seemed pretty happy with
what she’d done.

She sat up straighter. Working with all
those languages had been a lot of fun. It was so different from the work available
to her in a city of a hundred thousand here in Rivermede. And it involved traveling.
How could she turn that down?

She scanned the letter again. She came
“highly recommended.” Wasn’t that sweet? She owed someone a big hug. And Nice
in the fall sounded heavenly, especially compared to the freezing temperatures
and snow piling up outside of her condominium this time of year. She flipped to
her calendar to see if she had any commitments in October. All clear.

She was definitely interested.

Dear M.
Bastille,

Thank
you very much for your email. I am very interested in this type of work, and I
would love to discuss it further.

I am available
to speak on the phone or through a video conference, whichever is most
convenient for you.

Thanks
again.

Kalia
Beck

It would be late afternoon in France, and
she wasn’t likely to hear back until tomorrow. A thrill ran through her.
Can’t wait.

In the meantime, she needed to start her
day and get to work on the manuscript she was translating. It was a fairly big
project, and she had set aside three weeks to finish it. So far, it was on
track. And since the full effect of the caffeine was kicking in, it was time to
get to work.

Dr. Alexandre Sinclair lay back in the
hospital bed in Paris and stared at the ceiling. It had been only two days, but
he was ready to write the discharge orders himself. He had a new appreciation
for how patients felt. It sucked. It was much easier to be on the other end of
things. A few more tests, they kept telling him. One more thing. What were they
looking for? What had they found?

These were his colleagues. He’d sat at teaching
rounds with them, shared cases, gone golfing, and had dinner with them. They
had an easy camaraderie. Usually.

But mon Dieu.

Now he couldn’t get them to sit and talk
with him for five minutes. What was it that they were so afraid of telling him?
His gut clenched. It didn’t look good when the doctors started avoiding the
patient. When they looked away and evaded the conversation he needed to have.

Frustration didn’t even begin to explain
how he was feeling.

Disappointment. Sadness. Isolation.

Fear.

He sighed. Now fear. It was sneaking its
way in. Like a snake slithering into his gut, his heart, his mind, his soul. He
had managed to push that away. Focus on the positive. There was always hope, he
had told himself, just as he had told his own patients countless times. But
with each grim-faced visitor, each one deflecting his questions, hope became
harder to hold onto.

He studied the hospital bracelet on his
wrist. It had been surreal when they’d slapped it on and was worse now. Alexandre
Sinclair. 76852-00. Just a name and a number. It didn’t really tell the whole
story.

He had been born in France to French
parents, both of whom were doctors. He was an only child but was never lonely. His
parents loved to entertain and socialize and had made him and the family unit a
priority. There were two other families with kids about the same age who were
close friends and shared in Saturday dinners, Sunday brunches, trips to the
beach, and holidays abroad. Weekdays were quiet family affairs, but weekends
were always lively and entertaining. He had gone to local schools until
university, where he’d studied science with a major in neuroscience. He had enjoyed
the basic science and research but found that research grants favored those
with a medical degree. That became a goal, so he’d continued and specialized in
neurology. He’d settled in Paris at the prestigious Neuroscientific Research
Institute and was able to balance clinical work with his research in addiction.
He was only thirty years old and already a world-renowned expert. Or so his bio
read from his most recent speaking engagement.

He supposed it was his enthusiasm for his
topic. He liked to make his presentations entertaining and used humor as an
icebreaker. His next engagement, two weeks away, was the keynote address at the
International Forum of Neuroscience in Nice. He was looking forward to the ten-day
conference. It would bring together brilliant scientific and medical minds from
all over the world and focus on current trends and research. The cutting-edge
stuff. He was looking forward to the seminars and presentations and the
collegiality of the forum because he enjoyed talking with his colleagues. Normally.

A young internal medicine resident came
into the room with a syringe and a tourniquet. She had purple-streaked hair
pulled back in two ponytails, a bright pink shirt tucked into baggy red capris,
and high-top sneakers with laces in two different colors.

“Good afternoon, Dr. Sinclair.” She greeted
him with a smile.

Alexandre sighed. Yet another blood test?
He ran a hand through his hair, brushing it off his forehead. “Bonjour.”

“I’m Clarice Van den Engel. I’m one of the
Internal Medicine residents under Dr. José.”

Alexandre smirked. So now they were sending
in junior residents.

Clarice gestured at the syringe in her
hand. “We’d like to repeat your blood test, if that’s okay with you.”

“Why?”

“Your uric acid levels were a bit high on
the last test, and we wanted to check them again.”

Alexandre frowned. “Why?”

“Ah . . . what do you understand about your
illness?” Clarice asked slowly.

“I have no understanding. I haven’t been
told anything.” He tried to dampen the bitter tone.

“Nothing?” she repeated with her eyebrows
raised.

Alexandre shook his head. “Nothing.”

“Would you like me to go over the test
results with you?” she offered.

“I would. More than I can tell you.”

“Un moment. Let me grab your chart.”

A few minutes later, Clarice returned with
the chart in her hands and sat down in a chair next to the bed. “I’ll explain
this as best as I can. If you don’t understand something, please ask. If I
can’t answer it, I’ll speak to Dr. José and get back to you.”

“Merci. I appreciate it.”

Clarice scanned the note. “You presented to
your doctor with an enlarged lymph node in your neck. Blood work and a biopsy
were done shortly after and then you were admitted to hospital for more tests. Is
this correct?”

He nodded curtly. “Yes.”

“Did your doctor discuss the possible
diagnoses?”

“No. No, he didn’t. I’d had a cold and sore
throat when this started, so I assumed the lymphadenopathy was due to that. But
the enlarged lymph node persisted, and because I was concerned about some
weight loss, I went to see my doctor,” he explained.

Clarice nodded. “Your hemoglobin, white
cell, and platelet counts were all low. Not dangerously low, but still lower
than usual. Your liver and kidney function tests were normal. And you had a bone
marrow aspirate and biopsy?” She flipped to another page.

Alexandre nodded.

“Ah, oui. This showed that the bone marrow
was involved, and although they saw large cells in the lymph node biopsy, there
were small cleaved cells in the bone marrow.” She paused.

“What does that mean?” Alexandre asked, trying
to curb his frustration.

Clarice looked him in the eye. “The
diagnosis is lymphoma. A diffuse large B-cell lymphoma. I’m sorry, Dr.
Sinclair,” she added in a gentle voice.

“Lymphoma?” he repeated slowly. “That’s
what they were afraid to tell me. Are they sure?”

She nodded silently and checked the chart
again. “Yes, the differential diagnosis before the biopsy included a lymphoma or
a leukemia of some type, and the bone marrow biopsy confirmed a diffuse large
B-cell lymphoma.”

“Can you tell me anything about it? What’s
the prognosis? Treatment?” he asked, trying to recall what he’d learned about
lymphoma in school.

“Well, the prognosis for all types of
lymphomas is improving all the time. Newer chemotherapy drugs have really made
a difference. Your age and the fact that you’re up and about and continuing to
work make the prognosis better. You had a blood test for lactate dehydrogenase,
which is an indicator for tumor lysis. Your level was high and that, along with
the enlarged lymph nodes in your neck and groin, and the bone marrow involvement,
indicates a more aggressive or faster growing tumor.”

Not what he wanted to hear.

Clarice looked at him hesitantly. “More
sites involved can be trickier to treat. But it doesn’t really change the
treatment.”

“So the survival rate is . . .?”

“The five-year survival rate is about
thirty to forty percent,” Clarice said softly.

Alexandre jerked back. “Thirty to forty percent?”

“Oui.” Clarice nodded and then glanced at
the notes. “Dr. José ordered a CT scan of your chest, abdomen, and pelvis and
that should be done tomorrow. Once we see the extent of the tumor, we’ll be
able to give you more information. The treatment is chemotherapy. The
oncologists will have the final say on that, but it’s usually done as an
outpatient.”

“Can I continue to work? There’s a
conference in two weeks . . .”

“Yes, you can carry on with normal daily
activities. You may find you tire more easily, especially if you try to do too
much, but it’s not harmful. It’s not infectious, and your white blood count is
still low-normal, so there’s no need to be overly concerned about contact with
others. Just be diligent about hand washing.

“One other thing for you to consider is
whether you’d want to have your sperm banked. Once the oncologists decide on
the chemotherapy, if there’s a risk to your testes, they may discuss that with
you. Especially given the fact that you’re young.”

Alexandre barely listened. Cancer. Chemo.
Sterility. Pressure built in his chest. He had a sudden aching need to be
alone. “Thank you for–” he swallowed “–sitting down and explaining
this. The uncertainty and silence . . .” He paused and looked off in the
distance before looking back. “I needed to hear this, and I know it wasn’t easy
because the house staff who are my colleagues and friends haven’t been able to
tell me. So thank you.” He looked at her through watery eyes.

She rested a hand briefly on his arm. “No
thanks is necessary. I’m sure you’ll have more questions once you’ve had a
chance to think about this. Is there anyone you’d like me to speak to or call
for you?”

His parents. He’d have to tell them, but
he’d wait. Maybe there’d be good news after the CT scan. “No, but thank you for
offering.”

Clarice nodded. “Your uric acid level was high
yesterday, and it’s something that needs attention before we start chemotherapy.
So we just wanted to re-check it today . . .”

“Yes, of course.”

Alexandre sat quietly as she drew the blood
and then left the room.

Lymphoma. B-cell. What did she say? Diffuse,
that can’t be good. Lymphoma. At age thirty.

Didn’t seem fair. He exercised, ate well,
never smoked, watched his weight, hell, he even flossed every day. And all that
time and energy spent on school and medicine and specialty training. He closed
his eyes as emotion washed over him.

Pictured telling his parents. Imagined the
grief in his mother’s eyes and the hug his dad would give him. They would go
through this with him. It would shatter their world, too.

There was no life-partner to devastate. But
close enough friends who had grown up with him, who were like brothers and
sisters, who would feel this, too. Would they be there for him, or would they
find it too hard to face and not come around because they couldn’t talk about
it? Like his colleagues.

So. Chemo.

Hair loss. Nausea. Retching. Weight loss.
Infertility.

His gut clenched. Sometimes having too much
knowledge . . .

There was still so much he wanted to do
with his life. He’d set goals and had worked hard to achieve them. Life was
good, and he wasn’t done.

I
don’t want to die. Please, just let me live.