6

That very night I dreamed that a doe had broken into the small stone pool behind our house and was trapped in it. It was too tired to struggle, and only its nose and terrified eyes bobbed silently above the surface. Soon it would drown. Where was its mother? How had it gotten through the fence made of wood and steel cables? And once in the pool, could it be saved?

From the day of Adam’s telephone call to me, I began dreaming in a way I had never dreamed before. It was no longer safe to fall asleep at night, and waking up in the morning wasn’t much better. The dreams came in rude splashes of color, in orange and purple and yellow. But the dawn was always gray and weighted with liminal suggestions of dread.

One night I had a dream about a dream. In it, Adam’s diagnosis was only a dream and nothing more. I dreamed that another world had been revealed to me in a dream. It was a world in which Adam did not have cancer and was not terminally ill. The trick was to get from this dream to the other one and to find a way to the better world. But it existed on the other side of a large steel door that was not only locked but bolted and bordered with rivets. Why, I wondered in my dream, why should there even be such a door that leads to happiness if it can’t be opened? Of course, it was a relief to know that there was a place of safety in which he was not really dying, but, try as I might, I couldn’t open the steel door. And in my dream, I could not wake up from my dream.

Then the doorbell rang. I answered it to find the CEO of Duke Hospital standing at the side entrance to our house. I was surprised that such an important person would come to the laundry room door. What’s going on? I asked. He was shifting from foot to foot, looking very serious with a sheaf of papers in his hand. At his side stood the president of the university, his hands clasped across his midriff as if in prayer. My God, I thought, what has happened? They were flanked by two other doctors, including the head of oncology. A couple of university lawyers with briefcases were positioned just behind them.

Before I could say, “Why are you here?” the CEO addressed me in a voice that was both grave and unmistakably relieved. “There has been a terrible mistake,” he stammered, “a miscarriage of medical care. I don’t know how to begin, except to say, Adam does not have cancer.”

He went on to explain that the surgeon who operated on Adam is apparently a psychopath who falsified the lab reports on the tumors he removed in order to enhance his reputation. Adam never had cancer. He has been put through these various treatments for nothing. The lawyers apparently came along because no one knew if we would be angry or pleased. I was stunned, then overjoyed. A bottle of champagne materialized, and right there in our laundry room we drank a toast to Adam’s health.

In other versions of this dream it is the lab technician who is the villain, living to inflict misery on people she doesn’t know. In yet another version, the psychopath is the radiologist who had it in for Adam and has consistently falsified his findings. There are no tumors or lesions, and there never were.

I considered the Dream of the Mistake my flagship dream. It was so realistic and satisfying that it quickly evolved into a successful and long-running daydream. Whenever it rolled in, it took me away and cleanly separated me from whatever I was doing. If I was at the computer, I stared at the screen as if watching a movie of my dream. If I was driving, I was lucky not to run off the road.

So it would go for the duration of Adam’s illness: nothing less than a cavalcade of dreams, fantasies, and reveries—medical science by day, sheer Kafka by night. What must be contained at all costs in the light of day will run rampant at the midnight hour. Fear is suppressible, terror is not.

A friend of mine on our faculty put me in touch with her good friend in Alexandria, Virginia, whose husband offered to put me in touch with his colleague at the National Institutes of Health who was doing exciting research on the immune system’s response to metastatic melanoma. I thought of the film Six Degrees of Separation and quickly bought the concept.

I got hold of the man’s home phone number and shamelessly called him away from a dinner party to talk to him about a young man he had never met. He spoke to me with unbelievable kindness as if he understood and personally identified with all my fears. This wonderful man explained immunotherapy in detail and gave me the names of other leading researchers, some of whom he was sure would be willing to accept patients with lesions in the brain. I had hit a gold mine of hope.

While he attended to his law practice, Adam gave me the go-ahead to investigate additional forms of treatment. I came across the Musella Foundation Brain Tumor Guide for the Newly Diagnosed on the Internet; it advised aggressiveness in research: “Understanding current availability of clinical trials requires time and due diligence, something many physicians lack. You must search out the appropriate trials available for your specific tumor-type, always advocating in your own best interest towards a cure.”

A little due diligence confirmed and expanded everything the NIH doctor had explained to me. The Internet makes it possible to shop for treatments the way one searches for the best hotel buys or the cheapest airline tickets. It is not difficult to hook up with a hospital representative online, to indicate one’s preference for a specific doctor or treatment, to jet down, say, to Houston, and to be streamed into the assessment system of a major cancer center, all inside a week’s time. At MD Anderson, for example, seventeen separate melanoma trials were under way and available. How to market such complexity? One treatment center tried to simplify the immune system by means of a ridiculous analogy to an Alfred Hitchcock movie, Sabotage, in which a terrorist attempts to shut down London’s electrical system. The ad continued, “Change the setting from London to the microscopic world of living tissue, replace the actors with human cells, and the film could be an allegory for the drama that takes place between cancer cells and the immune system.” Adam’s doctor had no objection to our research, but he knew our problem wasn’t the confusing array of treatment options: he had seen the scans.

These desperate phone calls and Web searches must have stimulated another of my dreams, one of my favorites. It was about a father-son outing to a baseball game and an advanced cancer-research center. In my dream, Adam is admitted for treatment to a branch of NIH that, serendipitously, is located a couple of blocks from Yankee Stadium in the Bronx. The treatments are so mild that he feels well enough for us to have dinner and attend several games. We have a solid time. We eat hot dogs and share bags of popcorn, and I explain the finer points of the game to him. There is some suffering to be sure, but it is nothing the two of us can’t handle. Adam is miraculously/scientifically restored (who cares how?), and we return to North Carolina in triumph. The rest of the family meets us at the airport, and we stage a noisy celebration right there in the terminal. Again, there is champagne.

Within a few days of our inquiries, every cancer center we contacted rejected Adam as a suitable candidate for therapeutic trials. Overnight he had become the deserving student who through no fault of his own is turned down by every college to which he applies. NIH would accept him only if the radiation stabilized his brain lesions or reduced them, and that could not be determined for several months. There would be no treatments at a fictional research center, no male bonding in the Big Apple, and no champagne. Our trip to Yankee Stadium was off.

At his rejection by NIH, Adam appeared to shift into executive mode and disengage from his treatments. “It makes perfect sense,” he said, adding with uncharacteristic formality, “Thanks for your efforts, Dad.” His demeanor was that of the losing candidate who is determined to take the high road, no matter how bitter the loss. Earlier, he had been more candid with his mother. As soon as he found out about “the brain” he admitted to her, “It’s a relief, really. No last-minute maneuvers, no impossible choices, no surprises ahead. Weird to say, it’s a relief to know what I’m up against.”