Nicholas Sparks - Two by Two

“If it’s a boy, I like Josiah. Elliot. Carter. If it’s a girl, I like Meredith and Alexis. Of course, Liz is going to have her own ideas, but I haven’t spoken to her about it yet. It’s still pretty early in the process, so we have plenty of time to make a decision.”

Plenty of time.

Marge must have heard herself because she looked first toward the clock, then the door of the room, which was propped open. Nurses hurried past, going about their duties as if today were no different than any other day. “I wonder when they’re going to finally let me out of here,” she said. “What’s taking them so long? I’ve been here for hours already. Don’t they know I have things to do?”

When I had no answer to that, Marge sighed. “You know I’m going to be okay, right? I mean, I’m not ignoring what happened this morning, but I don’t feel all that bad. I feel a lot better than I did before I left for Costa Rica, in fact. I probably just picked up some parasite while I was down there. Lord only knows what the sanitary standards are like in those kitchens.”

“We’ll see what the doctors say,” I murmured.

“If you see them, tell them to hurry up. I’d rather not waste my whole weekend here.”

“I will.”

Marge continued to wind and unwind the sheet. “London comes back tomorrow, right?”

“She does. I don’t know what time exactly. Early evening, I’d guess.”

“Why don’t you bring London over for dinner with Liz and me this week? You’ve been so busy lately, we haven’t had time for our normal sit-downs.”

Watching her work the sheet, I could feel my throat tightening again. “Dinner sounds great. But none of that Costa Rican food. What with all the parasites, right?”

“Yeah,” she said, looking right at me. “Trust me when I tell you that you don’t want what I have.”

The day crawled by.

Midafternoon. Late afternoon.

Vivian texted, asking if there was any news. I replied that we were still waiting.

Emily texted, asking how I was doing.

Scared to death, I replied.

As dusk approached, the sky began to cloud over. Marge’s hospital room was bathed in flat gray light, and the TV was tuned to Judge Judy , though on mute. The machine monitoring her vitals beeped steadily. A doctor that we hadn’t met came into the room. Though his demeanor was steady, his expression was grim and I already knew what he was going to tell us. He introduced himself as Dr. Kadam Patel, and he was an oncologist. Over his shoulder, in the hallway, I watched as a young girl in a wheelchair was rolled past the room. In her arms was a stuffed animal, a purple pig.

Just as my mother had dreamed.

I went blank, my mind tuning out almost as soon as he began to speak, but I caught various bits and pieces.

Adenocarcinoma… more common in women than men… more likely to occur in younger people… non-small cell… slower growing than other types of lung cancer, but unfortunately, it’s advanced and the CT scan shows that it has metastasized to other parts of the body… both lungs, lymph nodes, bones and her brain… malignant pericardial effusion… stage IV… incurable.

Incurable…

My mom was the first to let out a cry; the plaintive wail of a mother who knows that her child is dying. Liz followed a moment later and my dad took her in his arms. He said nothing, but his lower lip trembled while he squeezed his eyes shut, as if trying to block out reality. Marge sat unmoving on the bed. Watching her, I felt as though I would topple over but somehow, I remained upright. Marge kept her gaze fixed on the doctor.

“How long do I have?” she asked, and for the first time that day, I heard fear in her voice.

“It’s impossible to say,” Dr. Patel answered. “Though it’s incurable, it’s treatable. Treatment has improved exponentially in the last ten years. It can not only prolong life, it can alleviate some of the symptoms.”

“How long?” Marge demanded. “With treatment?”

“If we had caught it earlier,” Dr. Patel hedged. “Before it had metastasized-”

“But we didn’t,” Marge said, cutting him off.

Dr. Patel stood a bit straighter. “Again, there’s no way to know exactly. You’re young and in good condition, both of which increase life expectancy.”

“I understand that it’s not a question that you want to answer. I also understand that every patient is different, which means you can’t really know for sure. What I want, though, is your best guess.” Marge’s voice made it clear she would not be deterred. “Do you think I have a year?”

The doctor didn’t answer, but his expression was pained.

“Six months?” Marge pressed, and again, the doctor didn’t answer.

“Three?”

“Right now,” Dr. Patel said, “I think it would be best if we start discussing treatment options. It’s critical that we get started right away.”

“I don’t want to discuss treatment ,” Marge said. I could hear anger in her voice. “If you think I only have a few months, if you’re telling me it’s incurable, then what’s the point?”

Liz had collected herself enough to wipe her eyes. She moved toward the bed and took Marge’s hand. Lifting it to her mouth, she kissed it. “Baby?” she whispered. “I want to hear what the doctor says about treatment options, okay? I know you’re afraid, but I need to know. Can you listen? For me?”

For the first time, Marge turned from the doctor. The trail of her tear had left a streak on her cheek that the light caught, making it shine.

“Okay,” Marge whispered, and only then, did Marge begin to cry.

Systemic chemotherapy.

Over the next forty minutes, the doctor patiently explained to us his reasoning for the course of treatment he was recommending. Because the cancer was so advanced, because it had spread throughout Marge’s body and reached her brain, there were no real surgical options. Radiation was a possibility, but again, because of the spread, the benefits weren’t worth the costs. Usually, patients were given more time to consider all the pros and cons of chemotherapy-including side effects, and he went over those in detail-but again, because the cancer was so advanced, the doctor strongly recommended that Marge start immediately.

To do that, Marge would need a catheter. When that part was underway, my parents and I left the room to go to the cafeteria. We didn’t speak; instead, we sat in silence, each of us simply trying to process what was happening. I ordered coffee that I didn’t drink, thinking that chemotherapy is essentially poison, and the hope is that the cancer cells are killed before normal cells. Too much poison and the patient dies; too little poison, and the medicine does no good at all.

My sister had already known all this. My parents and I had known all this as well. We had grown up knowing about the cancer. All of us knew about stages and survival rates and possible remission and catheters and side effects.

The cancer, after all, spread not only through human bodies. Sometimes it spread through families, like mine.

Later, I returned to the room, and I took a seat in the chair, watching as the poison began to be administered, killing as it flowed through her system.

I left the hospital when the sky had turned black, and I walked my parents to their car. To me, it seemed like they were shuffling rather than walking, and for the first time, they seemed old. Beaten down and utterly wrung out. I knew because I was feeling the same way.