The Right Time (44 page)

‘What can we do? I feel so helpless.'

‘We just have to wait, Evie,' said Liz. ‘These scans can take a while.'

Ellen and Evie hadn't seen Emma yet; she had been taken off behind closed doors before they'd arrived at the hospital. Liz had been in and out, keeping them informed. She had given Emma a thorough examination and was relieved to report that there were no other suspect lesions. Now they were preparing Emma for a scan of her lymph nodes. Once that was under way, Liz had come through to wait with her sisters.

‘So what is this scan?' Evie asked. ‘Is it like an MRI?'

Liz shook her head. ‘An MRI can't detect lymph nodes.'

‘So this is to check if the cancer has spread to her lymph nodes?' said Ellen.

‘No, you can only tell that by actually dissecting the nodes and examining them under a microscope.'

Evie frowned. ‘But they couldn't do that to all her lymph nodes, could they?'

‘No, of course not,' said Liz. ‘They used to take out whole clusters in the most obvious area. But that can have some pretty nasty side effects. Somebody eventually worked out that there are sentinel nodes, which are the first nodes that will be reached by cancer cells when they spread. So nowadays they inject a radioactive tracing substance into the area of the original tumour, and it actually maps out the pattern the cancer would take, all the way to the sentinel nodes. Then they only have to remove those particular nodes for dissection. So Emma will only have a tiny scar, maybe a couple of centimetres under her arm, and none of the nasty side effects.'

‘And that's it?' said Evie.

‘Well, yes, for the biopsy. But they also have to do what's called a wide excision around where the melanoma was, and take a good chunk of the tissue away to be safe.'

‘So they'll do the biopsy today?' asked Ellen.

Liz shook her head. ‘They do that at the same time as the
wide excision. Right now they're scanning to locate the sentinel lymph node in the first place. They'll take pictures, and then they'll actually mark the spot with an X on Emma's skin, so Rob, the surgeon, knows where to go in.'

Evie frowned. ‘That doesn't sound very high-tech.'

‘He doesn't just go by that,' Liz assured her. ‘He'll use a gamma probe to pick up the path of the tracer they use today, and he'll also inject a dye into the original site of the tumour, which will follow the lymph paths as well, so he can very precisely pinpoint the sentinel nodes.'

‘It still seems like a risk to me to take only a couple,' said Evie. ‘Wouldn't it be better if they just took out a bigger section, to be safe? Like they do with that other thing you said, the excision?'

‘That's different,' said Liz. ‘Like I said before, a block lymph dissection has some very nasty side effects. It can disrupt lymph drainage in the area, causing serious swelling and infection, mobility problems – it can be really awful. So this method avoids all that. Of course if they do find cancer cells in the sentinel node, they'll have to do a block dissection after that, but it's essential then, it's actually removing cancer cells you know are present. It's a bit extreme to do that just to check. But aside from all that, they actually get a much more accurate result this way.'

‘Why is that?'

‘Well, the pathologist can be way more thorough examining just two nodes, compared to twenty or more in a clump. This method has the highest reliability rate for detecting the spread of cancer.'

‘Does that translate into survival rates?' asked Ellen.

‘Not directly, but the fact is, early and accurate detection is the key, especially with melanoma. If they know exactly where the cancer cells are, they can get in and get them out as quickly as possible before they spread further.'

‘So how soon can they do the surgery?'

‘They usually schedule it the day after the scan, or sometimes later the same day if they start early,' said Liz. ‘I had to call in a friend of mine especially to consult on a Saturday, and we both had to twist some arms to get Emma scanned today, but this way she'll be all ready for surgery on Monday.'

‘They might put it off as late as Monday?' said Ellen.

‘It's just going to be more difficult to get together a surgical team on a Sunday,' said Liz. ‘But Rob is a really good guy, and an amazing surgeon. I trust him to do what's best. He'll only put it off till Monday if he thinks it's safe to do so.'

‘And how long after that will we know if it's spread?'

‘It takes around five to seven days for the full pathology report, maybe a little sooner for preliminary results.'

Evie groaned. ‘I hate all this waiting,' she said, getting up and walking over to the window.

‘You haven't told us what happened with Blake,' Ellen said to Liz.

She shook her head. ‘Emma was so distressed when she called. She said he just packed a bag and walked out. He said he didn't want to go through with it any more.'

‘What a bastard, to leave her now.'

Liz shrugged. ‘She said he'd been complaining about how much the wedding was costing . . . she reckoned he seized upon this as an excuse to get out of it.'

‘What kind of a man would do that?' said Evie.

‘You said he was upset when you called and told him about the melanoma?' said Ellen.

‘He was,' Liz confirmed. ‘He was in shock. I can't explain it. Emma was so distraught, I couldn't really get much sense out of her, I had to give her something to get her to sleep. In the end I was just glad she agreed to come in for the tests. I wanted to focus on that.'

‘Liz.'

She looked around as Rob McGrath strode into the waiting area.

‘Hi Rob, how did it go?' said Liz, getting to her feet.

‘It all went fine,' he said, glancing at Ellen and Evie as they drew closer.

‘These are my sisters, and Emma's sisters,' said Liz. ‘Ellen and Evie, this is Dr Rob McGrath.'

‘All your names start with E?' he remarked with an amused smile.

‘Take that up with our parents,' said Liz.

‘Well, anyway, we've located the sentinel nodes under the
arm, as expected. The tracer flowed nice and evenly, so it's all looking as good as we can hope at this stage. I've booked a theatre for Monday. I bumped her up the list so she'll be first cab off the rank at seven.'

‘Thanks Rob.'

‘No worries,' he said. ‘But now I have to head home. It's Madeleine's birthday party today.'

‘Oh, Rob, why didn't you say?' said Liz. ‘I feel terrible.'

He shook his head. ‘She has one every year. It's a makeover thing this time, I was just in the way,' he added with a grin.

‘That's so good of you,' said Evie.

‘I'll be home before she blows out the candles,' he dismissed, glancing at his watch. ‘Can I have a word, Liz? Maybe you can walk me out?'

‘Sure.'

Soon after Liz had left with Rob, Emma was escorted into the waiting room by a nurse.

‘Hi,' she said as they jumped up to greet her. ‘You both came.'

‘Of course we did,' said Ellen, giving her a kiss on the cheek.

‘Where's Liz?'

‘She's just seeing Dr McGrath out, she'll be back.'

‘Hm,' said Emma, raising an eyebrow. ‘They make a pretty cute couple, those two, don't you reckon?'

‘He's going home to his daughter's birthday party,' Evie told her.

‘Drats, foiled again.' Emma took a seat, wincing a little as she eased her back against the chair.

‘Did it hurt?' asked Evie as she and Ellen sat down again.

Emma shrugged. ‘It stung a little when they injected the stuff. After that it was just boring. It takes forever.' She looked at them. ‘Thanks for coming all the way in,' she said. ‘After the way I carried on last night . . .'

‘Don't worry about it,' said Ellen. ‘You were in shock.'

‘I'm so sorry about Blake,' said Evie.

Emma blinked, her eyes glassy. ‘Yeah well, so much for “in sickness and in health”, eh? It's just as well this happened before we went through with the wedding,' she added, but then her face crumpled.

Ellen reached over to take her hand, while Evie jumped up to sit on the other side of Emma, putting her arm around her.

‘It doesn't feel real,' Emma sniffed. ‘None of this feels real. One day I'm running around with my whole life ahead of me . . . and the next . . .'

‘You still have your whole life ahead of you,' Ellen said firmly. ‘You've done the right thing, Em, getting on to this early. You are going to have a long, healthy life . . .'

‘Without Blake,' she said sadly. ‘He was my life.'

They didn't know what to say to that.

‘Do you want something to eat?' was the best Evie could do.

Emma shook her head. ‘I'm not hungry,' she sighed. ‘God, there are so many calls I'm going to have to make.'

‘You don't have to worry about that now,' said Ellen.

‘But they will have to be made soon,' Emma insisted. ‘Things have to be cancelled. People have to be informed.'

‘I could do all that for you,' said Ellen. ‘Maybe you could make a list?'

‘There's a folder, at the apartment.' Emma paused. ‘God, the apartment . . . what am I going to do about the apartment? I can't afford it on my own.'

‘Emma,' said Ellen, ‘you really don't have to worry about that now. Blake hasn't dropped off the edge of the earth.'

‘Pity,' Emma muttered.

‘What I was getting at,' Ellen explained, ‘is that he's going to have to sort out all of that with you, but that doesn't have to happen today, or tomorrow, or this week or next. For now, tell me where I can find this folder, and I'll pick it up on my way home and start making the calls.'

‘Or I could do all that?' Evie offered. ‘You have to work next week, Len. I have more time.'

Ellen nodded. ‘See, Em? We'll work it out.'

But she seemed deep in thought, staring out in front of her, a worried frown on her face.

‘Emma, seriously, the only thing you should be worrying about is getting through this –'

‘And getting well,' Evie added.

Emma stirred. ‘Sure, I know. But I was just wandering, whether
I'd prefer you to tell everyone that I've got cancer, or that Blake dumped me.' She glanced from one to the other. ‘Which one sounds better, or worse, if you know what I mean?'

Evie looked faintly horrified, but Ellen detected a glint in Emma's eye.

‘Well, cancer's always going to get you the sympathy vote, naturally,' said Ellen. ‘And the dumping thing, that never spins well, does it?'

‘You're right,' Emma agreed. ‘Cancer's more noble, more heroic. Whereas being dumped is just pathetic.'

‘You're not pathetic, Emma!' Evie declared. ‘You mustn't say things like that about yourself.'

Emma and Ellen both broke into wide grins. Evie groaned.

‘Why do I always let you guys suck me in?' she said. ‘Every time!'

Liz came back into the waiting area and pulled up a chair. ‘Hey, how are you doing?' she asked Emma.

‘I'm okay,' she said. ‘I hear that cute doctor is married.'

‘All the cute ones are,' Liz sighed. ‘Anyway, he's booked you in for surgery Monday morning.'

‘He's waiting till Monday?'

‘That's a good sign.'

Emma sighed. ‘Well, at least I can go home in the meantime.'

‘Yeah, you can, but you'll have to be back again in the morning,' said Liz. ‘Rob's ordered more tests for tomorrow. He wants to get them out of the way so that you're ready to go first thing Monday.'

‘More tests?' Emma frowned.

‘It's routine to do a chest X-ray to check your fitness for surgery.' And to look for signs of spread to the lungs, but Liz decided to keep that part to herself. ‘And Rob thinks it's worth doing a complete MRI, just so we have the full picture.'

‘So they can see how far the cancer has spread?' Emma said bluntly.

‘Emma, the chances of that are very small, and it's too early to detect anything on an MRI anyway.'

‘So why are they doing it?' Ellen asked.

‘To have a point of comparison for the future,' said Emma. ‘Isn't that right, Liz?'

‘What does she mean?' Evie was getting confused.

‘Yes, okay,' Liz admitted. ‘It will give us a map of your internal organs so if there are any concerns in the future we will have a point of comparison, as you put it. But Em, they're just being thorough. Please try not to worry, you're in good hands, the best.'

Emma sighed. ‘Okay. So how early do I have to come in?'

‘Earlier the better,' said Liz.

‘I don't really want to stay in that apartment alone tonight.'

‘You won't have to,' said Liz, covering her hand. ‘You can come home with me if you like. Or I'll stay at the apartment with you.'

‘Or I will.'

‘Or I will.'

‘I'll be the one staying with her.'

All four of them turned around and cried ‘Mum!' in unison.

‘What are you doing here?' said Emma, as Evelyn walked over to them. ‘Aren't you supposed to be climbing Machu Picchu right about now?'

‘It's not going anywhere,' Evelyn dismissed, leaning down to kiss her daughter on the cheek.

‘Is Dad with you?'

‘No . . . or I should say yes,' she corrected herself. ‘He's here in Sydney, but he's gone with Eddie to book us into one of those serviced apartments.'

‘Why not just stay with me?' said Liz.

‘Or me?'

‘Or me?'

‘You girls are like a gaggle of geese when you get together,' said Evelyn. ‘We wanted to be nice and close to the hospital, and there are apartments just up the road. Dad and Eddie both send big kisses,' she said as Evie made room for her so she could sit next to Emma. ‘They'll be here just as soon as they've checked in and dropped off the luggage. I had them bring me straight here from the airport.'