Before And After the Divorce - 6. It's Like Snowballs Rolling Downhill - In Summer

Monday

I leave work early and pick up Dominic for the appointment with the psychologist. We chat with her for a little while together and then she asks to talk to Dominic alone. He's a little unsure of it, but I convince him that Dr. Greene is only going to talk to him and see what she can do to help him deal with his mother's illness. He agrees to let me leave the office. After about 20 minutes, she invites me back in.

"Dominic is handling the situation very well for a child his age. Both you and your ex-wife have done an admirable job raising him so far. He's also a very intelligent boy, and I would say mature for his age. That being said, he is angry about his mother's illness. Understandable, and I think I should see him weekly, to keep an eye on his moods. He told me about the incident at daycare and how you weren't angry at him for hitting the other boy, and calmly discussed it with him. I think that went a long way to cool his temper, but it still may flare up. I gave him some methods to help him control his anger and will continue to reinforce them. Your advice to breathe and think if what is happening will hurt him was an excellent first suggestion."

"That's great to hear. He seems to be adjusting well from my perspective as well. It's good to know I'm reading the situation correctly. Your listing on my benefits website said you have evening hours. Would I be able to bring him back during one of those, at least most of the time?"

"Yes. It's just that after the short discussion with you, I felt it best to have this first session quickly, rather than wait for an evening session to open up. I know a lot of parents work, so I shift my hours Tuesday and Thursday, so I can be available for patients and families that need it. It's no good to someone who needs help to be unable to get it because the doctors all work banker's hours. Do you or Dominic have any other questions?"

I don't, but like any seven-year-old boy, Dominic did.

"Can I have one of the lollipops?"

"If it's OK with your father, you can. They're there as a reward for patients who behave and are willing to talk things over with me. You were very good today, so you may take two, and have one for another day if dad says OK."

"Daddy?"

"Go right ahead."

"Good, then. I'll see you both again in a week or so, depending on my calendar. I'll spend most of the time with Dominic alone, but I'll bring you in when I see it may be necessary Mr. Pastore."

"That's fine. And you can call me Dylan."

"OK. Have a good week Dominic and Dylan. Goodbye."

"Bye." "Goodbye doctor."

We got an appointment for the following Tuesday. On the way home I asked Dominic if he liked Dr. Greene.

"Yes. She's really nice. She didn't get angry or anything when I told her about Tommy, the boy at daycare."

"Has Tommy said anything else to you?"

"Nothing bad. He said his mommy told him he needed to say he was sorry he spoke bad about mommy, and never do it again. He said he got punished for it. We're friends now."

"That's good. And you're not angry at him anymore?"

"No. Dr. Greene told me why he may have said that. She said that sometimes children just say things that they shouldn't. They don't always think before they speak. Kind of like you said about hitting."

"Very good. What do you want to eat tonight? You did so well with the doctor, I think you deserve to choose."

"Do you think I'd like Chinese food?"

"I'm sure we can find something you like if you want to try it."

"OK, then. Chinese food."

We go to a nearby Chinese restaurant, and we decide beef and broccoli would be acceptable. I believe we'll be coming back.

"Do you want to see if mommy had a good day today?"

"Would you be mad if I said no?"

"No. I'm not going to force you, but you should make an attempt once in a while."

"OK. Just not today. I still get sad when I think about yesterday."

"That's OK. We'll go home and see if we can find a movie to watch together."

"Cool."

Tuesday

Another day like many others. After dinner, Dominic decided we would check if mommy had a good day today, so we took a trip to the hospital. We stopped at the nurse's station, found out she had a so-so day yesterday, it was probably good that we skipped. Today was a good day. I walked Dominic to her room and waited outside.

"There's my baby. How are you, Dominic?"

"Mo-om. I'm not a baby, but I'm good. I'm glad you're feeling good today."

"I am. Where's your father?"

"You're not going to get mad at him, are you?"

"No. Not today. I'd like to tell him something. Can you go get him?"

"Not necessary. I was eavesdropping to make sure things were OK."

"Hello Dylan. I'm sorry I treated you so badly Sunday."

"It's OK. I know it was the tumor causing that. You don't need to apologize."

"I felt like I needed to. There's something else you'd both probably like to hear."

"What mommy?"

"The tumor hasn't grown noticeably since Sunday."

"Really?" "Yeah?"

"Yes. The doctor thinks it's amazing. I've kind of been craving lemonade lately. Well, more than just lately. Unsweetened and strong. The doctor thinks that maybe the high acid content in the lemons might have something to do with it. I've been eating tomatoes too. I'm not sure what it is, I'm just happy it stopped growing."

"I think I know why it stopped growing mommy."

"Why do you think Dominic?"

"I've been praying really hard every day that God will let you live. He's listening."

"Well honey, that's as good an explanation as any."

"So, no growth? That's great."

"Yes. There's still a chance that I'll have days where I'm not myself obviously, it's large enough to still have an impact. But I'm hopeful it stays like this or even gets smaller."

"That would be amazing. I don't know how likely it is to shrink, but anything positive is great."

I let Dominic have some time alone and went to check with the nurses.

"Lacy said the tumor hasn't grown since Sunday. Is that really true?"

"It is. We're all completely surprised. Actually, Dr. Hsu stayed late hoping you'd be in. I'll page him so you can talk to him."

"Thanks. I'd appreciate that."

I went into the lounge to wait. Not sure what to think. Is this just a temporary halt? A few minutes later Dr. Hsu came in.

"Good evening Mr. Pastore."

"Dylan, please. And thanks for staying late on the chance I'd be here."

"No problem. I often stay late; paperwork, you know?"

"Sure. So Lacy and the nurses tell me the tumor hasn't grown since Sunday."

"That is true. And the growth from Saturday to Sunday was minimal as well. I'm at a loss to explain it, honestly."

"Lacy says drinking strong lemonade and eating tomatoes has helped."

"Well. While it is true acidic foods do have some benefit in the prevention of cancer, and in the control of tumor growth, it isn't common, and all the research I've done doesn't indicate it makes a difference on this type of tumor. There is one odd thing about it though."

"What's that?"

"Let me show you images from Saturday and today's CT scans."

He shows me two side-by-side images on his tablet.

"Do you see the thin dark ring around today's image, on the right?"

"Yes. What do you think that is?"

"I've done another Stereotactic needle biopsy to be sure, hopefully the results will be back tomorrow, but my suspicion is that it is a fine layer of dead cancer cells."

"Your suspicion?"

"Yes. There's no history that I've found to support such a theory, but it's the only thing that makes sense. The thin layer is unusual."

"Unusual, but not unheard of?"

"Correct. Sometimes there is one temporarily due to the radiation treatments, which ideally, are intended to kill the cancer cells. Under normal circumstances though, dead cancer cells around the tumor are more randomly placed."

"But the lack of growth is good, right?"

"Oh, yes. Very good. And if my suspicion is correct, and it's just a rare instance where the dead cells remain attached to the rest of the tumor, we may actually see reduction. There is one other possibility though."

"What's that?"

"There have been cases of spontaneous remission. Where the cancer essentially dies on its own."

"But you said the cancer dying is expected with radiation treatments."

"Yes, but Lacy hasn't been getting radiation treatments. We chose not to initially because, well, we felt it would do her more harm than good, based on the initial growth rate. She'd likely have seen the side effects with no improvement otherwise. That may have been the wrong decision. But the fact that the tumor is apparently dying off renders that decision moot. We'll continue to do a daily check and see where it goes."

"Wow. It almost seems like my son's praying is helping."

"I wouldn't discount that as a possibility either, Dylan."

"I suppose. It's hard to put much stock in it if one doesn't believe in God."

"Well, yes. My apologies if I avoid getting into a theological discussion with you."

"I understand. I probably shouldn't have said anything."

"It's usually alright to speak your mind, as long as you don't disparage another's beliefs by doing so."

"That's true. Thanks for the information, Doctor Hsu. Dominic and I have some hope to grab hold of."

"You're quite welcome. And I 'hope' that I can continue to give you good news. Good night."

"Good night, doctor."

Thursday

Lacy was good again both Wednesday and Thursday. Thursday evening, I had another visit from Dr. Hsu.

"Good evening, Dylan. Just curious, why is it you're always here in the lounge?"

"I think Dominic needs to have some alone time with Lacy. It's apparently been good for him."

"That makes sense. I have some more good news for you. Sorry I couldn't come down yesterday."

"That's OK. I get updates from the nursing staff. Not as detailed, but high level is good too."

"Yes. The biopsy came back yesterday, as I hoped. The layer covering the tumor is indeed dead cancer cells."

"So that's good, right?"

"Yes, and even better because the layer of dead cells is growing wider with no overall growth."

"So, more dead cells, less live ones?"

"In a nutshell, yes. The reduction of the live cells isn't huge, perhaps 500 micrometers since Sunday. About half a millimeter."

Friday

Friday evening Dr. Hsu found me again.

"Hello Dylan."

"Hello Dr. Hsu. How are you?"

"Oh, I'm fine. Even better than fine. I'm always in a good mood when a patient shows progress. That isn't the case anywhere nearly often enough."

"More progress?"

"Yes. You know what happens to a snowball when it's rolling down the hill over more snow, correct?"

"Yes, it grows... And?"

"Up until this past Sunday, that was a fair analogy to use to describe Lacy's tumor."

"OK."

"The snow is no longer on the ground and spring has arrived. The tumor shrunk another 500 micrometers since yesterday. Plus, the outer layer of the dead cells remains about the same thickness as yesterday."

"I'm not connecting the dots. Sorry."

"The combination of the tumor and its dead cells is shrinking overall as well."

"That's wonderful news."

"It is. The overall combination is now approximately 1 mm smaller than it was at its peak of 37 mm."

"Does Lacy know this?"

"Not yet, there were a couple emergencies today, so Lacy's scan didn't occur until mid-afternoon. I was on my way to tell her when I figured I'd check if you were here first."

I follow the doctor back to Lacy's room, hoping I don't spoil the good news for her by having a humongous smile on my face. After the doctor shared the news, Lacy started crying tears of joy, and Dominic was jumping around, happy as a lark, as the saying goes. Fuck if I know what that means, though.

Next up - "Smokey (Robinson) Brings His Friends to Visit"