Wish Upon a Star (3 page)

The pokes were more ticklish than anything. I laughed.
"Why not?"

"Because." Annie tried to maintain a frown, but couldn't do
it and started giggling. "Because, you dummy, I'm not in it and I know
for a fact the best movie of all time in your opinion would have to be
one your fiancé is in. Right?"

I grabbed one of her wrists to stop the poking. "Maybe."

"Maybe? Why you little snot." She hit me over the head with
a pillow. When I said it didn't hurt, she hit me again and again until
we rolled off the couch, Annie squealing in surprise.

It was a well-fought battle, but after a few minutes, I
managed to wrestle the pillow from her. Once the pillow was out of
her reach, I struggled to my feet and scooped her up in my
arms.

"I love you North Star," I said as I carried her to the
bedroom. I lay her on the bed, snuggled in beside her and pulled the
covers over us.

She took my hand and held it tight against her chest. "I love
you too, Lucky Star."

I lay awake until her breathing leveled out and I knew she
was asleep. Only then did I allow myself to relax.

"Sweet dreams pretty girl. We start getting you better
tomorrow."

* * * *

"Annette Wilson?"

I looked up from the two-month-old
Sports
Illustrated
I was thumbing through. A woman was standing at a
door that I assumed led from the waiting room to the exam rooms.
She had short, spiky blonde hair and wore a pink ribbon necklace.
After a deep breath, I tossed the magazine on the wooden end-table
and followed Annie toward the woman.

"I'm Julia Lyons, and I'll be your Navigator. I'd like to visit
with you and talk about how I can help you before you see Doctor
Furman. Would that be okay?"

Annie gave me a quick look. Her mouth was in a straight
line. As intensely private as she was, opening herself up to Julia
wasn't going to be easy. She'd accepted the fact that she was going to
be dealing with a handful of doctors and nurses. Getting comfortable
with additional people was going to take some time.

Anxiety radiated from her as she inspected her finger nails.
Out of the corner of my eye, I saw Julia waiting there, a picture of
reassuring calmness.

Annie cleared her throat. "That would be fine."

Julia gave us a quick smile and led us down a brightly lit
hallway. Paintings of flowers hung every ten feet or so. The third
door on the left opened into a sterile exam room. It had the usual
sink in a corner, a vinyl covered exam table along one wall, a
backless stool for the doctor and three metal-framed chairs.

The flower motif had been carried on in the exam room. A
painting of a field of sunflowers hung on one wall. It conjured images
of the Tour de France. Given my and Annie's mutual interest in
cycling and her half-French heritage, I chose to take it as a good
sign.

Once we were seated, I expected Julia to start the
conversation. Instead, Annie spoke first.

"I appreciate the patience you showed in the waiting room.
Thank you."

Julia leaned toward Annie just a touch. "I'm a nurse by trade.
Five years ago, I was in the position you're in right now. Even with
my medical background, I felt lost, confused, scared. When an
opportunity came up to work as a Navigator for people dealing with
breast cancer, I jumped at it. I understand how you may be feeling
right now and I'm here to help in any I can."

Annie's nod told me all I need to know. I got out my pen and
took notes as Julia gave us an overview of the role she could play for
us. She had just promised to research a question about insurance
when a nurse came in.

After a brief interview and the routine temperature and
blood pressure check, the nurse left. A few minutes later, there was a
knock on the door. In the blink of an eye, a razor-wire knot formed in
my gut.
Here we go
.

The door opened and a woman about Annie's size stepped
in. She had shoulder length, brown hair that was streaked with gray.
Her hazel eyes glittered when she smiled.

"Ms. Wilson, I'm Dr. Ann Furman. It's a pleasure to meet
you." They shook hands and Annie introduced me. Something about
the doctor's demeanor put me at ease, and I got the sense it was the
same for Annie. Maybe it was her warm smile, or the fact that her
sweater had little yellow ducks woven into it.

Annie had designated me as her official note taker, so I
focused on writing things down while the doctor went through
Annie's medical history. When that was completed, the doctor pulled
out two x-rays and hung them from a backlit exam fixture.

She flipped a switch and the x-rays lit up to reveal images of
Annie's breasts. With a pen she pointed out two masses, one very
small, the other larger, in her right breast. Each mass was identified
with a tiny, bright square.

"These are images from the MRI you had taken. As you can
see, there are two tumors. The bright spots are markers that were
put in place when the masses were biopsied. The markers can help
us identify the locations of the tumors as your treatment
progresses."

She pointed to the other image. "In your left breast, there's a
single tumor here. This is where I need to be honest with you. The
fact that there are multiple tumors is indicative of a malignant form
of breast cancer."

"Form of breast cancer?" Annie's voice came out
uneven.

Dr. Furman nodded. "Yes, there are many forms or types of
breast cancer. The name of this type is Invasive Ductile
Carcinoma."

Annie steepled her fingers in front of her while I flipped to a
new page. "All right, what does that mean?"

"Invasive Ductile Carcinoma is a very common type of
cancer that grows rapidly, but is very treatable."

"In what way?"

"The standard course of treatment at this stage would
involve chemotherapy, mastectomy, reconstruction, and potentially
radiation."

A chill came over me as my pen dug into the paper. This
sounded bad.

Really bad.

"What do you mean by at this stage?" I said.

"When we are looking at the growth of cancer cells, we
identify the growth by stage, and grade. Stage refers to how far along
the cancer is, from one to four. Grade refers to how rapidly the
cancer is growing, again from one to four."

"And mine is?"

"Stage two, grade three; which means the cancer cells have
metastasized and spread to the lymph nodes at a rapid rate." The
doctor took a breath. When she resumed, she spoke in a measured
tone. "The issue you face Ms. Wilson, is the cancer has possibly
reached the lymph nodes. If it has the opportunity to progress, it
could spread throughout your body."

"So what are my options?" Annie took my hand as she asked
the question. I gave it a tight squeeze.

"There are two courses you can take. One is bi-lateral
mastectomy to remove the tumors, followed by chemotherapy to
eradicate any other cancerous cells. When the tumors are removed
we'll also remove some of the lymph nodes to check them for cancer.
If the lymph nodes are positive for the cancer, then I'd recommend a
course of radiation to help prevent recurrence of the cancer. The
second course flip-flops the chemotherapy and surgery. The
advantage to the first course is that you get the tumors removed
immediately. However, there is typically a six-week recovery period
before chemotherapy can begin, and in that time—"

"Any cancer the surgery didn't get has a chance to
grow."

The doctor smiled. "Exactly. I can tell you've done your
homework. With the second course, we're able to go after the cancer
cells immediately, and if you respond to treatment, we will be able to
monitor your progress by feeling the tumors shrink."

I looked up from my notes. "Is there a downside to that
option?"

The doctor switched her focus from Annie to me. For some
reason, that tiny gesture was more reassuring than I would have
thought possible. "Yes. First, your fiancé's options with regard to
reconstructive surgery will be somewhat limited. Given her level of
fitness, right now I would recommend reconstructive surgery be
conducted during the same surgical procedure as mastectomy. And
second..." She glanced at Annie's chart. "You're in your early thirties.
Have you thought about children?"

Annie and I looked at each other. Children had come up in
conversation a few times, but not recently.

"I have," she said.

"As you may know from your homework, chemotherapy can
cause infertility. There are procedures available that can allow you
to freeze eggs before you start treatment."

"That will cause treatment to be delayed though, yes? And
I'd have to take estrogen, which can increase the cancer rate."

Dr. Furman chuckled. I got the impression she was
impressed with Annie's level of preparedness. The sound also
conveyed a deep empathy she clearly had for her patients. I couldn't
speak for Annie, but it made me feel safe.

"You've been thorough in your homework. The answer is
yes to both."

"Or I can roll the dice and hope for the best after this is all
over."

I felt like I was a step behind in the conversation. Annie and
I had discussed many things since her diagnosis, but kids and
fertility treatments hadn't been among them.

The doctor let us absorb the information in silence. She
wasn't being pushy or bossy, which was reassuring, even though I
still felt like a five year old alone in a forest at night. I hoped Annie
felt as encouraged as I did. After a moment or two, she gave her
decision-is-made nod.

"I want option two."

Dr. Furman made a note in the chart. "Good. Given the
current state of your cancer, that's the option I would have
recommended. There are no guarantees with fertility procedures
and I don't want to postpone your treatment. There are a number of
wonderful hematology oncologists with whom I work. Julia will give
you a couple of names for your consideration. Before you can start
chemotherapy, there are a few procedures you'll need to complete. I
recommend a heart scan, a full body MRI and you'll need to decide if
you want a port for the chemotherapy infusions."

I wrote as fast as I could while Annie and the doctor
discussed these additional procedures. All the while, a question
festered inside me, like an abscess that had been left untreated for
far too long. When Annie said she was satisfied, the doctor looked at
me.

"I know you've been busy taking notes, Mr. McCarty, and
that's great. So I'd like to ask if you have any questions."

I glanced at Annie, and then at the doctor, and finally down
at my notes.
Now or never, dude
. I took a deep breath.

"Based on what you know, what are Annie's odds?"

Dr. Furman straightened her collar. "That's a question I
often get from men. You want a number, something concrete. I get
that. You need to understand that everyone responds to treatment
differently, and while it's impossible to predict the future, at the end
of treatment, Ms. Wilson will either be cured or she won't. But if I
had to give you a percentage on a successful treatment, I would say
sixty percent."

The blood in my veins froze. Sixty percent.

That meant Annie's odds of survival were better than half.
But... It also meant a forty percent chance of her not surviving. My
head began to swim.

We'd just sent out the wedding save-the-date notices, for
crying out loud. Annie and I were supposed to ride off into the sunset
together. Mom and Dad were both gone. I couldn't lose her, too.
Stop it. Be her rock. Focus on the sixty
. I swallowed and looked
into Annie's eyes.

"That's better than half. The odds are in our favor. Time to
get to it?"

Her eyes were a little watery, but she sat up straight and
nodded again.

"Time to get to it."

Annie poured over my notes on the drive home, adding a few
things here and there, putting question marks next to words she
couldn't read. She reached toward the heater and wiggled it a couple
of times before turning the knob up full blast.

"Does this thing ever warm up?"

The control freak in her was coming to the fore. While she
couldn't control those malevolent cells inside her, I could tell she was
determined to control everything else. I'd told myself I was going to
be the strong one, but the guts and determination she was showing
had me in awe, even if the insult to the car stung a little.

We hadn't been home more than an hour when my phone
rang. It was Julia. When I told Annie who was on the line for her, her
cheeks turned a little pink.

"Sorry hon, I put your number on the forms. Didn't want to
take the chance of mine getting out."

She spent the next thirty minutes or so taking more notes,
and alternating between saying "Yes" and "I don't know." When she
disconnected, she tossed the phone to me and let out a long
breath.

"This cancer treatment thing's going to be a full-time job.
With all the tests and procedures they want to put me through, I
have to be at the hospital practically every other day over the next
two weeks. I need to call Randi and get her take on the doctors Julia
gave me.

"I want pizza. I'll buy if you fly, yes?"

By the time I got back with Annie's favorite—mushrooms,
bell peppers and sun dried tomatoes—she was lying on the couch
with her eyes closed. Her nose twitched when she evidently caught a
whiff of the aroma emanating from the cardboard box in my
hands.

"Mm, Bazbeaux's. Excellent."

Piece by piece, we made the pie disappear, Annie using a
knife and fork, me using my hands and a stack of napkins.

"So how was the call with Julia?" I said, while wiping my
hands after my second piece.

"Good. It helps knowing I'll be working with someone who's
been there. I'm so overwhelmed right now, but she helped me break
things down into manageable chunks. She's going to keep in touch to
answer any questions I may have and help me with issues that come
up."