But inside Tampa General Hospital, Nick Carter was facing a day full of tests to determine what stage his newly diagnosed bone cancer was in.
Yes, it was a perfect day all right.
Right after breakfast, Nick was taken to x-ray for his first two tests, the chest x-ray and the ultrasound. According to Dr. Kingsbury, these were the easy tests. The hard one, the bone marrow exam, would take place later that afternoon. The chest x-ray and ultrasound turned out to be quite simple and not as uncomfortable as the CT scan he had gone through days before. But the bone marrow was another story.
When Nick was wheeled into a small room with a padded table in the center that afternoon, he really did not know what to expect. He was nervous, but still, part of him was thinking, It can’t be that bad. He was in for an unpleasant surprise.
A nurse and technician greeted him at the door and helped him onto the table.
“Hi, Mr. Carter, I’m Lily,” the nurse introduced once Nick was sitting upon the table. “Has your doctor explained this test to you at all yet?”
“Uh, no, not really,” answered Nick.
“All right. Well, what we’re going to do is insert a needle into your hip bone and extract some bone marrow cells from inside it.”
Nick blanched, the color draining from his face. So it was going to be that bad.
Seeing his face, the nurse smiled understandingly. “We’ll give you a local anesthetic to numb the area and relieve the pain. You’ll probably feel some pressure when the needle goes in, but other than that, it shouldn’t be too bad.”
Yeah right, Nick thought, but he nodded and tried not to reveal the fact that he was on the verge of panic.
“I’ll need you to lie on your stomach on the table, Mr. Carter,” said Lily, crossing the room to an area where there was a counter and supply cabinets. Nick re-positioned himself on the table, and Lily came back over to him.
“I’m just going to sterilize the area first,” she said. “This will feel a little cool.” She pulled back Nick’s hospital gown, exposing his back. He flinched as she rubbed a cold liquid over his left hip. “There. Now I’m going to give you a small injection of the anesthetic to dull the pain. This will only hurt a second.”
Nick squeezed his eyes shut until he felt his skin being pricked with the syringe. It really wasn’t bad though, just a regular shot, and he relaxed a bit, thinking the actual withdrawal of his bone marrow could be no worse. After all, it wasn’t even going to hurt, not with the anesthetic.
Lily waited a moment for the anesthetic to kick in, and when Nick’s hip region was numb, she said, “Okay, are you ready, Mr. Carter?”
He really wasn’t, but he figured he might as well get it over with. “Sure,” he said through gritted teeth. Lily and her assistant got into position, one on each side of the table.
“Okay, Mr. Carter, you need to hold still while I insert the needle. It will only take a few seconds.”
“’Kay,” said Nick. The technician placed his hands on Nick’s back and shoulder, holding him in place, and Nick felt a pang of fear. This procedure must be pretty bad if they had to bring people in to hold even adults down...
Nick took a deep breath, trying to keep calm and lie still. Only a few seconds, he told himself, remembering Lily’s words. Then it will be over.
Those few seconds were among the worst in Nick’s life. Keeping his eyes shut tight, he never saw the needle Lily used. But, based on what he felt when it slid into his pelvis, it had to be gargantuan. Although the anesthetic was supposed to have numbed him, Nick felt the needle slid through his skin and into his bone. First there was a great deal of pressure, then pain. Searing, sucking pain that ripped at his insides and brought tears to the corners of his eyes.
Finally, the needle was retracted, and the heavy pain faded, replaced with a dull, burning ache.
“You doing okay?” Lily asked.
“Yeah,” Nick exhaled, swiping the back of his hand across his eyes.
“Good. Your hip might be a little sore for a few days, but other than that, you shouldn’t have any problems. If you’re ready, we’ll get you back into your wheelchair, and you can take off.”
Nick nodded, wincing as he rolled over and got off the table. Lily and the technician helped him hobble to his wheelchair and then rolled him out into the hall, his hip throbbing with every bump, every jostle.
At least it’s over, he thought as he was taken back to his room. He normally wasn’t much of an optimist, but sometimes you just have to try to look at the bright side of things, despite how hard it is. And he knew this was definitely going to be hard.
After all, what could possibly be good about having cancer?
***
Dr. Kingsbury came to Nick’s room to talk to him that night with the results of that day’s tests in her hands.
“Good news, Nick,” she said with a smile, and he gave her a skeptical look. After all the bad news he had gotten, he hadn’t really been expecting to hear anything good.
“What?” he asked.
“I have your test results, and everything looks good. The cancer hasn’t spread.”
“Well, that’s good,” said Nick, but he didn’t feel as relieved as she probably expected him to. When it all came down to it, the fact was that he still had cancer.
“Very good,” the doctor stressed. “This makes your prognosis much better. You can beat this, Nick.” Her tone was encouraging, and Nick offered her a tiny smile he didn’t feel.
“So what next?” he asked, wondering how long he had until he had to start chemotherapy, if that was the route they were still taking.
“Next we’ll begin your treatment,” answered Dr. Kingsbury, confirming what Nick had thought.
“Will I have to stay in the hospital for all that?” he wondered aloud, dreading the prospect of it.
“No. You’ll need to stay for a few more days while we get you started on chemo so that you can adjust to it. But after that, what we’ll probably do is have you use a portable chemo pump so that you will be able to go home and not come back as an outpatient for treatments. I know that would probably work out much better with your schedule.”
“Yeah,” Nick said in relief. “A portable pump though... uh... how exactly does that work? IV?” He grimaced at the thought of having to be hooked up to an IV all day while he tried to go about his normal activities.
“Actually, not quite. If you decide to go with the portable device, what we’ll do is surgically implant a catheter into your chest, just below your collarbone. The line will feed directly into the catheter so that you won’t have to have an IV in your arm. It’s much easier that way.” She said this very casually, as if it were all perfectly normal-sounding, but Nick’s mouth dropped open in revulsion.
“Wait, what? You want to put something inside me? In my chest?! No, no way!” he exploded, his voice trembling.
“It’s a very simple surgical procedure, Nick,” Dr. Kingsbury said patiently. “Not much worse than the biopsy. And the catheter is very small – the only part that can really be seen is the opening on the outside of the skin, but if it bothers you, just wear a shirt – it’s not noticeable under your clothes.”
“But... but... I’m going to have a freaking tube sticking out of me?!”
“Nick, many patients do it this way. It’s not really as strange as it may sound once you get used to the idea. But if you don’t want the catheter, you can always come in for outpatient chemo treatments. You would have sessions probably three times a week, for a few hours at a time.”
Nick gaped at her. Was she insane? She wanted him to either have a catheter implanted inside his body or come to the hospital three times a week for treatments? Both alternatives sucked, and he shook his head in frustration. “No,” he said. “I can’t do that, and I’m not having that catheter thing done either.”
“Those are your options, Nick. You have to choose one. I would strongly recommend the catheter. It would be much-‘
“No! God, I’m sick of this! What if I just got up and walked out of here right now? That’s my right, isn’t it?”
“Yes,” Dr. Kingsbury said, narrowing her eyes coolly at him. “But without treatment, your cancer will most definitely spread, and you will die. No question about it. Is that what you want to happen?”
The words hit him like knives, and he slowly shook his head, feeling the now familiar prickling sensation in his eyes. He blinked in annoyance, refusing to let himself cry in front of her.
“Nick,” the doctor said, her voice gentler now. “I know this is hard. The treatment for this disease isn’t easy. But it’s the only way to get rid of it. You’re young, you have everything going for you, your whole life ahead of you... you need to fight, Nick. And this is the way to do it. It’s not going to be fun, but it won’t last forever, and it will be worth it in the long run.”
“Yeah. If it works,” Nick said tonelessly.
“Nick, look at me,” Dr. Kingsbury said softly, and reluctantly, Nick obeyed. It was a mistake. As soon as Nick looked up into her face, which was warm and motherly, slightly lined with age, the tears he had fought to keep back rose again. Giving him a smile of sympathy and understanding, Dr. Kingsbury placed a comforting hand on Nick’s shoulder. As soon as he felt the touch, Nick’s tears spilled over.
***
