David Morrell - Fireflies - A Father's Classic Tale of Love and Loss

So Matt, with utter calmness, allowed himself to be prepared for surgery. The nurse who took his heartbeat and blood pressure readings was astonished by how relaxed Matt’s vital statistics made him seem. David, Donna, and Sarie walked beside Matt’s bed as he was wheeled toward the surgical area. Then the family was told to go to a waiting room.

The waiting room. A horror in itself. Plenty of televisions and magazines, but everyone stares at the floor.

An eight-hour operation, and the major risk is paralysis, but the surgeon is optimistic and says he’s going for total cure. So you know when three hours into the operation you get a message to meet with the surgeon, something’s horribly wrong-and when not one surgeon but three of them join you in a consultation room, you know that whatever’s wrong, it’s worse than you can imagine.

“We ran into troubles,” the first surgeon said.

“You don’t mean he’s paralyzed!” Donna said.

The second surgeon shook his head. “Not that at all.”

“Then…?”

The surgeons didn’t respond.

“For God’s sake, tell us.”

“The tumor may be inoperable.”

“What?”

“It metastasized,” the third surgeon said. “It’s not just on his rib.”

Metastasized. When David later repeated that word to friends and business associates, he was amazed by how many didn’t understand what metastasized meant. To spread. The tumor had sprouted seeds. Roots were growing throughout Matthew’s lung.

“No!”

“The metastases are so close to the spine I don’t think I can get them all,” the first surgeon said. “I’ll probably have to take several more ribs than I hoped.” The surgeon exhaled. “And all of his lung.”

David ached.

“The point is, if I don’t get every offshoot from the tumor, several other tumors will start to grow, and in areas where I can’t operate without killing him.”

“He’s going to die?”

The second surgeon nodded. “I’m sorry. You have to be prepared for that possibility.”

“But isn’t there anything we can do?”

The surgeons glanced at each other.

“The tumor’s been resistant to chemotherapy,” the third surgeon said. “The only thing I can think of is to really give it a dose, I mean a humongous dose, of chemicals. To go for a bone marrow transplant.”

David vaguely recalled having heard the term before, but he had no idea what it meant.

“It’ll take too long to explain right now,” the second surgeon said. “The treatment’s severe, much worse than the chemotherapy your son’s already received. It’s risky, but in many cases, especially leukemia patients, it’s been known to work.”

“But you’ve got to make a decision,” the first surgeon said. “As soon as I opened Matt and saw what I was dealing with, I put him on hold. Don’t worry about him for now. The respirator and the other machines are keeping him alive. But I can’t leave him like that very long. You’ve got a decision to make.”

What’s the worst thing that ever happened to you? How about the worst question you ever faced?

“The options are this,” the first surgeon said. “I can leave the tumor as it is. I can close Matt up. The tumor will continue to grow. But Matt will be able to have a more or less tolerable summer, provided he gets enough pain medication. He will be dead by the fall.”

Donna’s face streamed with tears.

“And the alternative?” David breathed.

“I can go ahead with the surgery, take several more ribs than I hoped, probably all of his lung, leave the parts of the tumor I can’t get at, close him up, and hope that chemotherapy combined with a bone marrow transplant kills the rest.”

“But remember, the tumor’s especially resistant,” the second surgeon said. “The bone marrow treatment might not work.”

“And the treatment’s extremely severe, worse than anything he’s already been through. He could die from it,” the third surgeon said. “He might not even have the tolerable summer he’d have if we took the first option and stopped the operation right now.”

“I can’t keep Matt on hold up there forever,” the first surgeon said. “I’ve either got to stop the procedure or get on with it. Soon.”

“How soon are you talking about?”

“You’ve got fifteen minutes to make up your mind. And this is a one-time-only decision. You can’t change your mind tomorrow or next week. Matt couldn’t survive another exploratory operation of this scope. And if the tumor gets any bigger, I’d have to leave much more of it inside him, which means the bone marrow treatment would have a great deal less chance of being effective.”

“Fifteen minutes?” David’s voice rasped as if his throat were packed with broken glass. “If you just sew him up right now, he’ll die for sure?”

“Sometime in the fall.”

“And if you take out what you can and go for the bone marrow transplant…?”

“He still might die, and you’d be denying him a tolerable summer. With the transplant, his summer would be a distress, to put it mildly.”

Donna kept weeping. Sarie seemed about to faint.

“Fifteen minutes?”

“Less than that now,” the first surgeon said.

“And a one-time-only decision?”

“Correct.”

“Tell me what to do!”

“I can’t. That’s why I came down here to speak with you. The situation’s too complicated. It’s up to you to make the choice.”

“I can’t”-David gasped for breath-“face Matt when he wakes up and tell him we did nothing. I couldn’t bear the look in his eyes. I couldn’t bear telling him that he doesn’t have a chance-that he’s going to die.”

David looked for agreement from Donna and Sarie. Cheeks raw with tears, they nodded.

“Go ahead and cut the sucker out,” David said. “Get as much as you can. We won’t give up. Matthew’s strong. He’s proved it before. He’ll prove it again.”

“Just so we understand each other,” the second surgeon said. “Whatever happens, it’s extremely important to your mental health that you never second-guess this decision. You made it in good faith. Never reconsider it.”

“Cut!” David said. “Get as much of that bastard tumor as you can!”

Another waiting room, this one outside Intensive Care. Matt’s operation, as predicted, took eight hours. The chief of the surgical team came into the crowded room and found a place to sit across from David, Donna, and Sarie. His eyes were red with exhaustion. He was scheduled to perform another operation within an hour.

“How bad?” David asked.

There must have been forty people in the room, all afraid for their own friends or relatives. Eavesdropping unabashedly, they waited for the surgeon’s answer. There are no secrets-privacy is impossible-in the waiting room for Intensive Care.

“Actually it went better than I expected.” The surgeon rubbed his raw eyes.

David straightened.

“I only had to take four of his ribs and a third of his lung.”

Only? When it comes to your son, and you were told he’d probably have a quarter of his body cut away, you actually feel a bizarre relief when you learn it was only a fifth.

“Then the roots of the tumor hadn’t spread as far as…”

“Not as extensively as I feared,” the surgeon said.

“Then”-David took a breath, afraid to ask-“you actually got it all?”

The surgeon bit his lip. “No. There’s a growth-it isn’t big, the size of the tip of my little finger-that I had to leave against his spine. It wasn’t just a matter of risking paralysis if I took it. I’d have killed him.”

The other people waiting apprehensively to hear about their friends or relatives listened more intently.