Keep Me in Your Heart (2 page)

“Any one of your teachers could tell them you skipped half a day.”

“So what? I want to be here when you get your test results. You don’t think your folks will mind, do you?”

“No. They won’t care if you’re with me.” Her parents liked Jeremy and approved of their dating. Just so long as she graduated in June and started college in the fall, they would be happy. Come fall, Jeremy would begin his senior year and she would be attending Georgetown, so she’d be able to see him whenever she wanted.

“When you get out of here,” he said, “I’ll take you to see the cherry trees blossoming along Pennsylvania Avenue.”

“Will you put the top down on your car?”

“We’ll freeze.”

“We’ll turn the heater up and wrap blankets around us,” she countered. She loved his little sports car, a gift from his parents on his sixteenth birthday.

“Anything you want.” He rubbed his thumb over her knuckles. “I just want you well again and out of here.”

“Me too.” The familiar fear clutched at her. For a few minutes she’d forgotten where she was and why, but now reality returned with a jolt. She was sick. Mysteriously and genuinely sick. When she’d first protested that she was fine and didn’t want to be checked into the
hospital for testing, her family doctor had said, “Perfectly fine teenage girls don’t exhibit such severe symptoms as yours. I want you checked out thoroughly, Jessica.”

She’d come to the hospital and spent two days enduring blood tests, X rays and CAT scans. In a few hours she’d know what was wrong. No matter what it was, she hoped she’d have the courage to face it. She squeezed Jeremy’s hand. “I’m glad you’re here with me. It makes me feel braver.”

“I won’t leave you,” he said. “I promise, I won’t.”

Her parents arrived at four o’clock, looking tense and worried. They hugged her and told Jeremy they were glad he was there. “Are you feeling all right?” her mother asked anxiously.

“My feet and legs are swollen. I feel like a water balloon.”

“You look pretty,” her father said.

“I think so too,” Jeremy declared.

“I look terrible,” she insisted. “And I can’t shake this headache.”

“Maybe you’ve got a headache from stress,” her mother offered. “I often get stress headaches.”

“Maybe so,” Jessica said, hoping to calm her mother, who’d been a nervous wreck ever since Jessica had gotten sick. “If it’s stress, once I find out what’s wrong, the headache will disappear, won’t it?”

Her parents looked frightened, and she hated being the cause of their worry. Her father’s heart wasn’t strong, and her mother had had a bout with breast cancer two years before. She was all right now, but still Jessica worried about their health. It wasn’t fair that she should be sick when she should be healthy. Her parents were older—she’d been born late in their lives—but they adored her. She was their only child.

“How have you been, Jeremy?” her father asked.

“Okay. I’ll be better when Jessie’s home.” He gazed at her tenderly and she smiled.

“We all will.”

The doctor was late. “Maybe I should have the nurses page him,” her mother said. “What do you think, Don?”

“He’ll be here, Ruth. You know doctors. Always with a million things to do.”

Jessica felt the tension in the room and wished she could do something to lessen it. But she was feeling slightly nauseous and couldn’t think of anything to say to her parents.

Jeremy turned on the TV and found the CNN channel. The newscaster’s voice droned, but it was enough to grab everyone’s attention. Jessica told Jeremy “Thank you” with her eyes. Finally, at five-fifteen, Dr. Kowalski breezed into the room along with Dr. Harris, the family physician. Their faces were masklike and unreadable, but Jessica felt a stab of fear. If only they’d been smiling.

“I think we’ve got a diagnosis,” Dr. Kowalski said, getting right to the point. “I asked Dr. Harris along because he was able to help figure out the
how
that went along with the
why
.”

“What are you talking about?” Jessica’s father asked.

Dr. Kowalski set a thick file folder on the tray table over Jessica’s bed. He looked straight at her. “You’re in kidney failure, Jessica. Your symptoms could fit the profile of many diseases
and medical problems, but the itchiness was the clue that led me to suspect your kidneys weren’t functioning properly.”

“My kidneys?”

“It isn’t cancer?” her mother blurted.

“No,” Dr. Kowalski said.

Her mother was so relieved that she sagged.

The two doctors turned their attention to Jessica. Dr. Harris picked up her hand and held it gently between his palms. “You’re in end-stage renal disease,” he told her quietly. “Total kidney failure.”

“But people can’t live without kidneys,” Jeremy said, coming up beside her bed and locking eyes with the doctor.

“You’ll have to begin dialysis immediately,” the doctor continued, turning his attention back to Jessica. “It will take over the function of your kidneys and keep you alive.”

“K
idney failure! But how is that possible?” Jessica felt as incredulous as her father. With her heart pounding and her mouth as dry as cotton, she waited for the doctors to answer his question.

“That’s what I wanted to know,” Dr. Harris told them. “When Dr. Kowalski called with the results of your lab work, I went back through all your files. You’ve been my patient since you were a newborn, and your family’s given you the best of care.” He paused to nod toward her mother and father.

“Two years ago, I treated you for a strep infection—but not until it was pretty advanced. Whether you know it or not, untreated strep
can cause a host of problems, including rheumatic fever, which affects the heart. In your case, I believe it took a toll on your kidneys. The damage progressed slowly and relentlessly until you were so far along that now there’s nothing we can do about it. Except put you on dialysis.”

Jessica’s head was spinning. This couldn’t be happening to her! How had something gotten so serious with so little warning?

Dr. Kowalski added, “The point is you’re in kidney failure, Jessica, and that’s what we have to deal with.”

“How are ‘we’ going to do that?” Her voice was barely a whisper.

“You’re getting a new doctor. My colleague Ronald Witherspoon is a top-notch nephrologist—that’s a specialist in the treatment of kidney disorders. He’ll be in shortly to explain your course of treatment. He’ll put you on a hemodialysis machine, which will do the work of your kidneys and make you feel a whole lot better. Your edema will clear up, as will the headaches and itching. You’ll feel good again in no time.”

The news was so devastating that she couldn’t imagine ever feeling good again. Certainly not emotionally, anyway. Her body had turned on her, betrayed her, destroyed her kidneys, and her life would never be the same.

“H-How long will Jessie be on this dialysis?” her mother asked. Her face was ashen and pinched, and suddenly she looked much older than her fifty-five years.

“For as long as she lives,” Dr. Kowalski said quietly. “Her kidneys won’t regenerate.”

My whole life!
A wave of nausea swept through Jessica.

“Three days a week you’ll come to the dialysis center and be placed on a dialysis machine. The machine takes over the function of your kidneys, cleanses your blood of wastes and toxins, adjusts your body fluids and balances blood chemicals. Unfortunately, it can’t replace the hormone that aids in making red blood cells, so we’ll have to treat your anemia with medication.”

She didn’t care about how the process worked. She only wanted to wake up from this terrible nightmare.

“Is being hooked up to this machine the only way you can help Jessie?” Jeremy asked. She held on to his hand as if it were a lifeline.

“There’s always transplantation,” the doctor said. “But finding a donor isn’t always easy. Many factors have to be weighed, but kidney transplants are our most successful area of transplantation if you become a candidate for one.”

He made it sound like an election. “Do I have a choice?” she asked.

Dr. Harris patted her arm. “Dr. Witherspoon will be better able to discuss the next phase of your treatment with you. Write down all your questions for him.” He peered down at her through steel-rimmed glasses; his eyes seemed clouded and misty. “I’m sorry, Jessica. So very, very sorry.”

When both doctors had gone, she began to cry. Her parents wept with her, holding her, soothing her as if she were once again a tiny child. Only Jeremy remained dry-eyed, but when he took her in his arms she could feel the tension in his muscles, the fierceness in his grip as he crushed her against him. “You’ll lick this thing, Jessie,” he whispered. “You will.”

“How can I? Didn’t you hear them? It’s incurable. I don’t want to be hooked up to a machine for the rest of my life. How can I have a life when I need a machine to help me live?” She sobbed until there were no more tears left in her. Jeremy continued to hold her.

Finally her father spoke. “I know this is horrible, honey, but it’s not the end of the world. You
are
alive. Mom and I will help you however we can. The first thing to do is read up on it. Find out all we can.”

She knew it was her father’s way. He tackled life’s problems armed with as much knowledge as possible. He’d raised her to believe that fear was the true enemy and that knowledge did much to banish fear.

“I’ll quit my job,” her mother announced. “I want to take care of you.”

In spite of her grief, Jessica felt a twinge of guilt. She didn’t want her parents sacrificing themselves on her account. “Mom, please don’t do anything drastic yet.”

“But you’ll have to go to dialysis three days a week. I can’t let you go alone.”

“I’ll drive her,” Jeremy said quietly.

“She’s our daughter,” Ruth said.

Jessica disliked having them discuss her as if she weren’t even there. “I might be able to drive myself, you know,” she said. “I’m sure if this is something that I’ll have to do the rest of my life, I’ll have to manage on my own eventually.”

The conversation stopped abruptly when Dr. Witherspoon entered the room. He was a short, balding man with expressive brown eyes. After introductions, he explained more about the different kinds of dialysis. Jessica felt a glimmer of hope when he told them that sometimes dialysis could be done at a patient’s home, on a smaller dialysis machine, and could be done at night while the patient slept.

But her hopes were dashed when he said that at first, and “for a while,” she would go to a treatment center near the McMillans’ home in Reston, Virginia, a suburb of Washington. He told her that early the next morning she’d undergo a minor surgical procedure to create a fistula under the skin of the inside of her left arm.

“I’ll join together one of your veins to one of your arteries, and in a short time the vein will
enlarge and strengthen. This makes it easier to insert the two needles of the dialysis machine. In the meantime, we’ll prepare an external shunt, which does the same thing but shows more on the outside of your arm. A nurse will cap off the special tubing after each treatment and bandage your arm.”

Jessica gulped. “Do I have to have the needles stuck in me every time I go for dialysis?”

“Yes. It won’t be so bad,” he said, patting her arm. “The nurse will numb your arm before inserting the needles. Then you’ll be attached to the dialyzer, and your blood will be cleansed and pumped back into your body. The cleaning process doesn’t hurt, and while you’re being dialyzed you can read, watch TV, talk on the phone, do homework.”

“I’ll look like a freak!” Jessica didn’t like the idea one bit.

“The fistula is under the skin; no one can see it. However, it’s very important that you take good care of the site regardless of the type of access device we use. I don’t want it to become infected or have a blood clot form. Don’t worry, you’ll get plenty of information about
proper care. And, of course, you’ll be going in for treatments often, and the staff will keep a watchful eye out for problems.”

“Our daughter will be all right, won’t she?” Jessica heard the edge of hysteria in her father’s voice.

“As long as she remains on dialysis, she’ll be able to lead a fairly normal life.”

Normal!
Jessica almost laughed in his face.

Dr. Witherspoon must have caught her expression because he added, “As normal as possible anyway. You’re going to be bombarded with information over the next few days,” he added. “It may seem overwhelming at first. You’ll have to go on a special low-potassium diet. You’ll have to be treated for anemia, maybe high blood pressure. You run the risk of hepatitis, bone deterioration, neuropathy—that’s nerve damage.”

“You’re scaring us,” her father said.

“I want you to understand how serious your daughter’s condition is.”

Jessica felt numb with the understanding.

“You can’t miss dialysis treatments.” Dr. Witherspoon looked directly at her. “I know you’re young, and I know how devastating this
news is for you. But you can’t ignore your disease, or mistreat your body. Renal failure once was an automatic death sentence. But today, with dialysis, kidney patients can have long, productive lives.”

“And a transplant? What about a transplant?” Jessica knew no machine could truly take the place of a living, working organ, so she was interested in that option.

“This hospital has one of the best transplant facilities in the country, so that is a possibility. But that path isn’t an easy one. For starters, thousands of people are waiting for kidneys. There’s a waiting list and a sophisticated system of selection.” He folded her chart, glanced at his watch and prepared to leave.

“I know you have other questions. I’ll send in some of my support staff, who will bring you literature, videotapes, books. A dietician will be in to see you too. And tomorrow morning I’ll insert that shunt. It’ll take a few days for the internal connection to strengthen before it can be used. In the meantime, we’ll begin dialysis while you’re here. You will get through this, Jessica. I promise.”

Alone in the room with her parents and Jeremy,
she glanced helplessly from face to face.