It’s OK. The parents were prepared.
After this, I don’t believe anyone else will die. I tell myself a loss so large won’t be followed by another. This belief is childlike, willed blindness. Children die here. But I believe it.
When Bobbie comes to work I say, “Did you know Sam?” She nods. She wells up. I have the sense that even when she is at home, mothering her own four sons, she is thinking of her patients. Occasionally, she calls the ward on her days off to see how Gracie is doing, how the other kids are.
Many of the nurses on our unit respond to the loss with an understandable steeliness. Bobbie, by contrast, transmutes her grief into a reservoir of caring. Instead of being inured to the suffering of the children, she is wholly present. For them. With them. Into every mundane interaction, she brings to bear all her skill, all her experience, all her heart.
DAY ?1
Rabbit was the right choice. No fever, rash, vomiting, chills, burning bladder, or “more serious” allergic reactions. Probably this can’t last. It’s cognitive dissonance—bone-marrow-transplant girl feels terrific or at least no worse for wear. Probably we are in a liminal space, a calmed threshold before the storm. But I prefer to believe transplant is nothing worse than a bored girl eating bag after bag of Cool Ranch Doritos, hoping Nemo finds his father.
Her crankiness and fatigue are probably as much from the bad food and confinement as anything else.
Tomorrow is the actual transplant.
Just before dawn, she sits up and says, “I don’t want this shirt,” then topples back asleep. Brian says Gabriel woke up around the same time at the apartment and said, “Bad pony!” They are having a conversation, from across town, dreamer to dreamer.
I don’t want this shirt.
Bad pony!
They are connected and will soon be more so.
We haven’t emphasized that her donor is Gabriel, but it seems worth saying, “Gracie, tomorrow you’re going to get Gabe’s blood, and then your body will get well.”
She looks puzzled and annoyed. “You are giving me Gabe’s blood for my blood?”
“Yes, sweetie, but once it is in your body, it will be yours.”
“OK,” she says, as if to say, not my first choice.
Maybe she doesn’t like the idea of getting Gabe’s blood because he’s a boy or her brother, or maybe because it is inherently icky to allow someone else’s blood to circulate through you. We don’t tell that her bones have been emptied, that without an infusion of new cells she’s made of straw, a scarecrow girl.
DAY 0
Transplant Day. All day our people send emails from California and New York, wishing Gracie well, asking for updates. The word transplant has everyone hyperactivated. It sounds like the violent rearrangement of delicate interior spaces. In reality, it is shockingly simple.
Last week Gabriel’s cord blood was FedExed from Oakland to Durham. I’d said to Dr. K, eyebrows up, “FedEx?” Life on dry ice, life with a tracking number. But the bag arrives unscathed. Ready for its big debut.
My mom and Gabriel and Brian are all present. Bobbie is on duty, great luck. Around noon she walks in the room with a plastic bag of scarlet fluid. Life force harvested from one child, conserved, frozen, and flown cross-country to be thawed and poured into a second child. It is odd to imagine the biology of our two children mixing in this way. It seems like a garage science experiment concocted out of boredom on a summer afternoon: OK, we’ve got this Barbie and this Ken. Let’s pull limbs off one and attach them to the other and see what we get!
Another nurse follows Bobbie in; together they read the numbers on the bag aloud to each other, back and forth, several times to affirm that it is the right bag, for the right recipient. The wrong bag, with incompatible cells, is a lethal mistake. But this is the same bag Brian helped the doctors fill in the moments after Gabriel was born, the same one that waited for us so patiently.
Gabriel’s gift. A glorified Ziploc stuffed with stem cells from the day of his birth.
Now Gabriel is two; he has opinions and verbs and aversions. He has an incredibly complicated cocktail of feelings about his sister: love and anxiety and jealousy and admiration. But the bag is more or less invisible to him. He looks up at it, in Bobbie’s hand, without seeing it. It is another piece of hospital paraphernalia, another thing of mystery.
Bobbie says it will take Gabe’s cells about four hours to flow into Gracie’s bloodstream. She plans to “run it slow” so that the blood won’t give Gracie a chill.
While Bobbie hooks up the bag, Gracie gallops a turquoise My Little Pony up the length of Tough Guy to one of the pumps, where the pony lies down. Bobbie primes some tubing with Gabe’s blood and threads it through the pump with the pony on top, to regulate the speed. Then Bobbie attaches the other end of the tubing to Gracie’s central line catheter, which leads directly to her heart. Girl and bag are now attached. Bobbie programs the pump with a series of fast, syncopated bleats.
“Bobbie, your machine’s too loud for my pony,” Gracie says. “She likes to sleep in dust puddles.” The pony lies motionless, a tiny plastic horse corpse.
“Bobbie’s doing her work, sweetie,” I say.
Brian touches Gracie’s arm and says, “Do you want to watch Spirit?” I stroke her hair; he strokes her arm.
Gracie says yes to Spirit, and we put it on. Bobbie releases the clamp on the central line, and the stem cells begin to exit the bag and enter the girl. This is the big tah dah. Gracie is oblivious to the momentousness of the moment. Her eyes are glued to the opening credit sequence, in which a Mustang herd gallops across a western landscape, leaping gorge after gorge. “They chase!” she shouts, as she shouts each time. “They chase!”
Brian and I are on opposite sides of her bed, both of us watching the pump and the bag. We do not look at each other. Brian pats her. “They do, sweetheart,” he says, “they do chase.”
I say nothing. I want us to exchange a look, an affirmation. But I am afraid that if I look at Brian, I won’t see confidence. We watch the numbers on the pump tick forward as the blood streams through the tubing and travels toward her.
For lunch, Gracie wants rainbow sherbet. Brian volunteers to run out to a place nearby. Good, let him be the sherbet hero. I want to be alone with Gracie. I want to put good juju around her, though I’ve no idea how.