Charles Bock - Alice & Oliver

She did not seem to follow, but stayed silent until she was sure he’d finished. “Until you rectify this situation,” Miss Culpepper said, “your wife’s appointments have to be approved once at a time. There’s a hold. On Mrs. Culverts’s account. Hospital won’t make appointments after first of May for her. So that’s three months you have. You still under the cap come May we can revisit the situation. If I were you, though, I’d have this problem solved by then.”

IT TOOK ANOTHER hour before they let him back inside, where electric light, bright and pitiless, beat down on the sight. His wife was curled on her side, protecting herself in a sad imitation of a cocoon. Her bright blue wig, now askew, looked ridiculous, and worse. Her eyes were shut, but she wasn’t asleep, just recovering, breathing softly, a thin white sheet over her torso.

An unopened can of cranberry juice sat next to a plastic cup near her head. A spot of blood marred the plastic exam table paper, which was creased and crumpled and had been ripped along the top edge. Oliver softly kissed her raised cheek. She was fragrant with heat and sweat, her skin chalky on his lips. Oliver kissed one shut eyelid. Then the other one, half-pressed against the starched sheet. Alice lifted her hand to his cheek. Fluttering eyes were unfocused, her smile sleepy. She looked beyond his shoulder, to the carriage, checking.

“Dr. Howard Eisenstatt, MD, is upset at me.” Alice sounded airy, girlish, a little drugged. “I wouldn’t let him tell me any results until you came back.”

A brain trust of physicians were right outside the room, gathered over the equipment tray, checking the same paperwork and looking at the same clipboard; Oliver hadn’t noticed them, but now they began entering. Eisenstatt stepped forward, his forehead and cheeks still tinged with the flush of exertion, his expression uncertain. How was Alice doing? he asked. Indicating concern as to whether it was okay to talk, he glanced toward the carriage.

“Thanks for asking,” Alice said. “It might be a good idea to use our indoor voices.”

Eisenstatt helped himself to a cup of water, looked toward the nurse, who was prepared with a Magic Marker and then a dry-erase board the size of a lunch tray. “I know it’s been a long day,” he said.

The doctor uncorked his marker and started writing, first on the left, then the right side of the marker board, slanted, quick, and a little sloppy, forest-green capital letters appearing parallel to one another:

Eisenstatt accentuated the T with a squeaky, tight checkmark. “We need to get you to the transplant, ” he said. Circling the I, he continued. “You’ve been through induction. That was big, and you came through with flying colors.”

“Doctor?” Alice’s head was lying on its side, resting atop her hands. “This is going to explain my aspirate results?”

“The board allows us to understand your results as they relate to the bigger—”

More knocking. An orderly entered with a carton of milk procured from a lunch tray. Alice thanked Miguel, then looked over to Dantelle, and mouthed Thank you . Oliver had already started toward the sink, where he began washing out the plastic nipple. Watching, the doctor seemed impressed, but also taken aback.

“I’m with you,” Oliver said, still pouring milk into the plastic baby bottle liner.

Only when the nipple top had been screwed back onto the bottle did the doctor allow his lips to form that tight smile, by now recognizable as a sign of growing irritation. “We want to make sure the cancer stays in remission,” Eisenstatt said. “The way to do that is to stay on top of things, be proactive — everyone with me? Standard plan of attack. Two months after induction, we bring you into the hospital, give you another dose of chemo. This time it’s a high-impact dose of cytarabine. We call this consolidation. ”

On the chalkboard he scribbled:

“During consolidation, you’ll stay in the hospital for five or six days. For another week or two, your counts will plummet, that’s typical, and you’ll need a fair amount of support. But we’ll also do your HLA typing, and get searching for your donor. HLA takes about three weeks to process. Gold-plated, best-case scenario, one consolidation, we find a match while you’re recovering, move right into the transplant.”

“That happens?” Oliver asked.

“It does.” The doctor’s voice trained on Alice, making sure she’d heard him.

“You are white, American, of European descent,” Eisenstatt continued, “so the numbers are as much in your corner as anyone could ask. If you were an Eastern European Jew, the history of pogroms and the decreased breeding pool complicates a lot of genetic structures. Or with African Americans, the donor pool isn’t as deep as we’d prefer. I don’t make a habit of predictions, and can’t promise anything. But in the case of Mrs. Culvert, it’s conceivable we’ll find a match. I’d say finding one quickly is within the realm of possibility.”

“And if not?” she inquired, from her little protective shell.

“We will,” Oliver said.

“I know. But if not—”

“We keep searching,” Eisenstatt said. “It’s not ideal. Time is a factor. And the way to solve this is a transplant. But consecutive consolidations” “are an available option.”

“I’ve got to get on top of the insurance thing,” Oliver said. “I’m going to get that taken care of.”

The doctor was quick, kept the discussion focused. “Let’s talk about time frame. It’s been seven weeks since you were diagnosed and started with induction. The normal waiting period between chemotherapies is about eight. Seven weeks is a bit early, but still in the ballpark.” With military precision, his marker tapped against the dry-erase board, two hard taps.

“There are issues with your blood work.”

The doctor spoke with a tone as even as was possible. “I took a quick look at your aspirate slides. Probably ninety-five percent of the cells look clean. But that five percent, they’re a question.”

Alice’s eyes were shut in a way that meant she’d retreated into a mantra, one of her private worlds, and the sight was both a relief to Oliver and a little scary. Eggs of worry had hatched through his stomach, spawning colonies at the base of his spine. Eisenstatt was saying that the structure of Alice’s leukemia cells was particularly complex: it was possible the cancer could go dormant for a time, then reemerge. He was saying those five percent cells might just be regular, small, dead, noncancerous cells, in which case everything was fine. “The other possibility”—he spoke as if he had no choice—“these cells are, in fact, cancerous.”

A skilled palm wiped the board clean. Eisenstatt waited, checking whether Alice wanted to watch. “We have to be vigilant. We wait a few days with these cells, see how they mature, what happens when they replicate.” The doctor’s cheeks ballooned, he let out a breath, glanced at Oliver.