Dear Friends and Family,
Three days ago, I wrote that our medical team thought that Nancy’s immune system was on the rebound.
They were wrong.
Nancy’s immune status remains unchanged, and the last two days have been less than great because the anticipated rise in the level of her white blood cells has not yet occurred. White blood cells are the cells that fight infections.
Nancy’s fevers have become more frequent and her temperature levels are higher. Our medical team has concluded that an unwanted enemy has more than likely gained a foothold. An infectious disease consultant has been recruited to help find the exact spot and type of germ, as well as to manage the many different anti-infectious agents Nancy is now receiving.
I wish I could report better news. My heart is full of agony.
A few hours ago, I was sitting on the bed, holding Nancy’s delicate hand. Most of her bruises have faded, deep purple replaced by faint blue. Nancy made a soft, guttural sound indicating she was pleased that I was gently stroking each finger. Her skin was not so hot as it was an hour earlier and her face was calm, the hint of a smile on her lips. I thought she might be dreaming. I even found myself wondering if her spirit could be in a better place, far away from tubes and needles, bells and buzzers, pills and tests.
Unexpectedly, Nancy’s entire body twitched and I nearly fell off the bed’s edge as I jumped backward by reflex. She opened her eyes and I was mesmerized by the blue sparkle, as bright as the day we met more than two and a half decades ago. Once Nancy closed her eyes again, my mind drifted back to that fateful August day during the summer of 1978 when Nancy walked into the medical clinic at Mammoth Hot Springs in Yellowstone National Park.
Though it was a sun-filled day outside, “lightning” struck me in that exam room so many years ago. Nancy’s soft voice and ready smile instantly made me feel like we were old friends. I almost forgot everything as we exchanged initial pleasantries. From that very first second, I was drawn into Nancy’s gaze. Her eyes were the color of the summer sky on a cloudless day. They exuded the warmth of that season. Nancy’s smile was full, kind, and part of an expression that was both deep and inviting. I remember reacting to my feelings with nervousness, and I’m sure I acted like an intern interviewing his first patient. My heart raced, my hands were clammy, and I stuttered more than once as if my mouth wasn’t connected to my brain.
Once the visit was complete, I walked Nancy into the waiting room, trying to figure out what I could do to prevent her from driving off in the late afternoon sunset and out of my life.
“What are you doing tonight?” I sheepishly inquired. “Would you be interested in experiencing an authentic cowboy town? Gardiner, Montana, is just a bit north of us.” Such brashness was completely out of character in my normal interactions and, looking back, even further “on the edge” given that I had met Nancy as a patient.
It turned out Nancy was struck by the same “lightning” bolt.
To my surprise and delight, she answered, “I’d love to . . .”
Subsequently, we spent a magical night talking about life, love, politics, religion, and most of all, each other. Our first date ended as the sun rose, and we continued our friendship and subsequent romance for many months by phone. (Mobile phones didn’t exist back then, so we had triple-digit long distance bills.)
Six months later, having physically spent only twelve days together (because she was living in Boston and I was residing in Yellowstone and then Park City), we tied the knot. Our friends and family thought we were crazy. They were right. As they say, “All the rest is history.” And that was over twenty-seven years ago.
Just as I finished my soliloquy, Nancy opened her eyes again.
“Did I fall asleep?” she asked me.
It’s the time of day when Nancy is weak. Her tiredness can mean her blood count is so low that she needs another transfusion. Or that the wrong combination of her ever-increasing list of medicines is making her loopy. Or that her temperature is elevated. Sometimes it means that her oxygen needs adjusting. Each condition alone can sap her dwindling reserves and make it a Herculean effort for her to just open her eyes. In Nancy’s case, several of these conditions often are in play at the same moment.
About an hour ago, Nancy experienced a “rigor,” the violent shaking that occurs when the body attempts to lose heat during a rapid temperature spike. Some of us have seen our children do it. Nancy is not a child. Our kind and competent nurse, Becky, was visibly flustered when she pulled the thermometer from Nancy’s ear.
“Forty degrees Celsius! Oh! I’ll call the doctor.”
“Isn’t that 104 Fahrenheit?” I cried.
It didn’t matter. Nancy’s temperature was high—extremely high and a reflection of the silent battle somewhere in her increasingly fragile body. Becky left the room and I was left holding Nancy tight, tears streaming down my face.
“It’s all right, Winnie.” Nancy told me between chattering teeth.
I felt powerless. Inept.
I’m a doctor, aren’t I?
I held Nancy ever tighter while Becky returned with Tylenol and more ice. Ten minutes passed, and Nancy fell once again into an exhausted sleep.
Nancy didn’t move for the next hour or so as I sat and watched her chest rise and fall. I visualized for her. I imagined waves sneaking up a white sand beach touching Nancy’s toes as she lay on a towel, basking in the bright sunshine. The air smelled salty and fresh from the breeze off the ocean. It was a pleasant contrast to our sterile hospital room. I hoped my thoughts were transmitted into Nancy’s dream. It was so peaceful on the beach.
Nancy’s eyes opened again, “You didn’t answer me. Did I fall asleep?”
I nodded and stroked her forehead.
“I’m sorry, Winnie. I can’t believe I did that. I’m just so tired.”
“Don’t be sorry, love. It’s much better when you fall asleep in the middle of your sentence than in the middle of mine.”
We both laughed and I kissed the soft stubble above her forehead.
Nancy’s immunity is severely suppressed. The chemotherapy that killed the leukemia, or “bad guy,” cells has also killed the ones she needs to fight off normal and unusual infections. Her situation is akin to “friendly fire.” Without one type of white blood cells called neutrophils, it is common for a germ to attack. Our medical team is now in full mobilization to find the infection and adjust her drugs appropriately.
Just now, Nancy has endured a procedure called a “bronchoscopy.” A tube was inserted down her throat and into her lungs and samples were taken.
In between fevers, Nancy and I are now able to talk and even laugh. But the easiest way for me to see a smile on her face is to read her the news all of you share with us.
We wait and we hope.
Summary: Nancy is much sicker than the last time I wrote. Fortunately, she is lucid and not in pain. Though her vital signs remain stable, she is requiring more oxygen.
Thanks all for your hopes and prayers,
Winnie