Authors: Brenda Bevan Remmes
“BMT?” Grandpa
Hoole looked at Liz.
“Bone Marrow Transplant, Grandpa.”
“Sounds like a sandwich.”
Liz smiled
.
Rachel appeared momentarily flummoxed
. “One reason is we’re concerned about you, the donor, and your health.”
“I’m in good health
. Only medication I take is for blood pressure and a little something for indigestion every now and then.”
“Yes, I realize there are many people in their seventies who are in excellent health, but there are concerns about a general anesthesia with older citizens
. Even more important is that the success rate for the patient is not as high when the donors are older. The chances for success would be greater with a match from a younger donor.”
Though Grandpa didn’t respond, he didn’t seem satisfied with this answer
. “What if there isn’t a younger donor?”
Rachel ignored his question
. “This is a difficult procedure. It’s difficult on the donor. It’s difficult on the patient. We want to be very sure that we’ve maximized the possibility of success before we put them through it.”
“When will you know if you find another match?” Grandpa rephrased his question.
“Does this individual have any brothers or sisters?”
“Not full brothers or sisters
…a half brother and sister.” Grandpa didn’t look at Liz when he said this. Liz’s mind immediately jumped to Chase and Sophie. They didn’t know. She couldn’t tell them.
“Well, that’s interesting
. With full brothers and sisters, there’s about a one in four possibility that one of them will be a match. We need to have seven out of ten antigens match when we test for donors.”
Grandpa raised his eyebrows and she rephrased: “
Antigens are sort of a coding marker that’s found on your white blood cells. Half come from the mother and half come from the father. There are millions of combinations, but we focus on ten of them for a BMT. Sometimes we find what we call a half-match. There are numerous studies on that possibility right now, but so far we don’t have any clinical data to put it into practice.”
“Is there a possibility that a half-brother or sister would be a full match?” Grandpa asked.
“Anything is possible, but it would be extremely rare. There is, however, a new procedure that has been successful with cord blood from an infant. If there is a match there, the antigens don’t have to be quite as many to make it work. Anyone in your family expecting a baby?”
Grandpa and Liz looked at each other
. “Yes, in November in New Mexico.”
“How are they related?”
“My first grandchild?” Liz bragged.
“How would that child be related to the patient?” Rachel seemed more interested.
“My husband is her half-brother.” As the words came out of her mouth, she couldn’t believe she’d actually verbalized that Chase and Maggie were siblings. It was the first time she’d said it out loud. “So the baby would be a great-nephew or niece of a half-brother.” Before Rachel spoke, Liz knew the answer.
“Not probable.”
Rachel shook her head and seemed to dismiss that option, although she added, “But it might be worth testing. Even if it isn’t a match for the individual in mind, it could be a wonderful gift for someone else. Cord blood can be frozen.”
“It would have to be collected in New Mexico,” Liz added.
“That’s not a problem. We ship blood around the world, as you well know.” She glared at Liz over a raised eyebrow as if to say
of all people, you should know.
Liz disliked this woman more and more.
“I presume that the doctor has already placed this patient on a national registry list for a donor. Depending on the ethnicity of the patient, if she is a white American, we have a fairly high chance of a match, usually in two to four months
. You would be better off to go with an anonymous match than a half-match of a relative.”
“All the
same, I’d like to be tested.” Grandpa was not to be put off from his original purpose and appeared completely oblivious to the tension that was building between Rachel and Liz.
“Mr.
Hoole, you would be responsible for the cost due to the fact that your age does not permit you to be a donor.”
“Even if I were the perfect match?”
“Even if you were the perfect match, which is not likely.”
“I don’t see why it’s less likely than finding someone in Ohio or Montana who’s a full match
. I’d like to be tested,” he insisted.
“Very well
. I will walk you to the clinic and they will handle everything from there. Count on a couple of hours with paper work and wait time. We’ll just need to draw a little blood.”
Grandpa was on his feet and waited for Rachel to lead the way.
“And how would you like your results reported?” Rachel asked as they followed her.
Grandpa looked over at Liz
. “Would you just call Liz and let her know?”
“That would be fine,” Liz said
. “Call me at my office.”
Two
hours later and after an early lunch in the cafeteria they retraced their steps down the red dotted corridor to the blue corridor to find Maggie.
Richard
Shannon came to the waiting room, stripping off his mask. “Hey, didn’t know you all planned to come by.” He appeared fatigued and frustrated.
“Well, we had to come to Durham, and thought we’d stop in
. How’s Maggie doing?”
“Not too good right now
. I’m at a loss for what to do. She’s had some kind of reaction to the chemo…blisters in her mouth and throat. She’s very uncomfortable. For the time being I’m pretty much shoveling ice chips into her to suck on, which seems to be the only thing that helps.”
“Is there anything we can do?” Liz asked.
“I’d welcome any help.”
After Liz showed Grandpa how to put on the PPE outfit, with masks over their faces they slipped into the room
. “Maggie,” Liz whispered, and brushed her hand across her damp forehead, “Grandpa is with me. We had things to do in Durham today.”
Maggie’s eyes flickered between Liz and Grandpa like a frightened animal
. “I’m dying,” she said in a hush so quiet that Liz could barely hear her.
“No, you’re not, Maggie
. It’s the drug making you feel this bad. It’s going to get better.” Liz tried to control the tears. “Roll over, hon, let me rub your back.”
Maggie struggled to get on her side
. Richard still sat in front manning the ice chips. Liz stood on the opposite side of the bed with the hospital gown strings loose as she rubbed lotion into Maggie’s back and shoulders. In a chair behind Richard, Grandpa closed his eyes and folded his hands in prayer. The room became very still.
Within fifteen minutes, Maggie began to sleep peacefully
. Liz and Richard sat back in their chairs and joined Grandpa in silence. Forty-five minutes later, Liz and Grandpa got up to leave.
“That was amazing,” Richard said
. “What a difference. Thank you so much.”
*****
“Grandpa,” Liz said as they made their way back to the Interstate. “Have you ever said anything to Chase or Sophie about Sarah?”
“No.”
“Does Grandma know?”
“Not yet.”
They merged with the traffic onto I-85 and ran into road construction, which seemed to be never-ending. The drive back and forth should have been second nature to Liz by now, but she found that she became increasingly annoyed at minor delays.
“Are you planning to tell anyone besides me?”
“I keep thinking of all the people who will be hurt.”
Liz sighed
. “You know that I am bound by confidentiality?”
“I understand.”
“Grandpa?”
“Yes, honey.”
“Don’t make me lie to my husband.”
“I’d never ask you to do that….never.”
Chapter Twenty-eight
The phone rang as Nicholas and Evan gathered their books for school the next morning
. Long ago Liz had given up on forcing them to make up their beds or pick up their clothes from the floor. It was enough just to get everyone out the door on time; they didn’t want to start every day with a battle. Sunday morning became “pick-up day.” Every other morning was just “let’s get up and out without a fight.”
In her bedroom Liz wrestled
with a pair of panty hose that grabbed at the thighs and threatened defeat before they hit her crotch. She wondered what marketing genius had ever convinced women to wear these things.
“Can you grab the phone, Chase?” Liz yelled.
“Got it,” he called back.
As Liz walked into the den she heard him say, “Yes, this is Mr.
Hoole. I don’t understand. Would you say that again?” He looked over at Liz and waved his free hand with a confused look on his face and mouthed,
Duke Medical Center
? “You want me to come in today? Are you sure you have the right Hoole? Chase Hoole?”
Alarms went off in Liz’s head
. “Let me talk to them, Chase.” She tried to grab the phone, but he had already gotten an answer.
“I’m afraid you have the wrong
Hoole. There are two Nathan Hooles. One is my father and one is my son, but I still don’t understand why you’re calling.”
“Let me talk to her, Chase,” Liz insisted
. Chase’s eyes scrunched up as he handed his wife the phone. “This is Liz Hoole. We’re in the middle of getting everyone out the door to school. May I call you right back? Yes, yes.” She jotted the number down on the pad next to the phone. “In about ten minutes.”
“
Boys, run on out to the car.” She motioned to Nicholas and Evan who had stopped what they were doing and turned their attention on their parents, sensing something amiss. “They’ll be late, Chase.”
“Oh, no,” he said with a frown
. “You’re not going to dismiss me like that. Who was that?”
“A woman from the blood donor center at Duke,” Liz said.
“Why is she calling me?”
“She called for your dad
. She told you that,” Liz answered.
“She said they needed me to come in to donate plate
lets today if at all possible. Why would she want my dad to donate platelets?”
“I don’t know what it’s about
. I’ll call her back.” Liz tried unsuccessfully to dismiss the conversation, but Chase was having none of it.
“Oh, come on, Liz
. Why should she talk to you instead of me?” Chase was getting annoyed, an emotion foreign to him. In their years of marriage, Liz could count the number of times Chase had lost his temper on one hand.
“Because I have health care power of attorney,” Liz said sounding more defiant than she had intended
. “Let me return her call, would you please? Go on, take the boys to school and I’ll stop by the pharmacy before I go to work.”
Chase turned sharply
. Evan looked at both of them meekly and said, “We got plates. How many plates do they want?”
Chase gave him a little nudge with the back of his hand and Liz heard him snap at
the boys in the driveway. “In the car, both of you
, right now,
and not another word. I’m not taking questions this morning.”
Liz called Rachel’s office
. Her secretary answered. “Is Rachel in?” she asked.
“No, I’m sorry
. She’s in meetings all day today. Could I give her a message?”
“This is Liz
Hoole. I believe you just called my home phone number.”
Silence from the other end.
“I was there yesterday with my father-in-law, Nathan Hoole, who left a blood sample to be tested for a donor match for Marjorie C. Kendall. If you check her record you will see that she has signed a release form for you to talk to me about her medical condition.”
Silence.
“The instructions on the chart were to call my office phone. You called my home phone. You reached the wrong Mr. Hoole. You spoke with Chase Hoole, not Nathan Hoole. In the future, please ask for Liz Hoole or Nathan Hoole before you speak to anyone.”
Silence
.
Liz knew all too well the secretary was now in a panic,
because there had been a breach of confidentiality. The secretary had spoken to the wrong person and revealed information concerning someone else’s blood donation… an honest mistake, but still a mistake. Liz would confront Rachel with it later, but at the moment she wanted to know about the reason for the call.
“You asked Nathan
Hoole to come to Duke today to give platelets. Can you give me any more information?”
“I’m sorry, I am unable to provide that information,” the secretary said,
lapsing into a defensive mode. She knew she was in trouble and was cutting her losses. Liz didn’t waste time arguing with her. She knew the standard response to requests for information about other people’s records. The secretary was following the letter of the law. She could not be sure Liz was who she said she was.