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I cross my left leg over my right, trying to get more comfortable in the cushioned chair I’m sitting in. I continue to fidget futility before I accept that the pain in my lower back isn’t from the chair. My parents look at me, and my mother places her cool hand on mine sympathetically. Annoyed, I pull my hand away. She sighs and folds her hands in her lap, looking at the floor.
Inhaling the smell of the doctor’s office, I think about how I’ve rarely been anything but angry lately. Before we’d left the house, I’d yelled about my mother moving my shoes. In the car on the way here, I’d screamed at my father for being a terrible driver. I feel marginally guilty for abusing them the way I’ve been doing, but not enough to say anything. I’m preoccupied anyway.
The walls seem to be closing in tighter and tighter, the off-white flowers on the wallpaper threatening to suffocate me. I want nothing more than to run from this room, from this office, from this future. Each heartbeat, soft at first, feels as though it’s stronger than the last. The muscles in my legs pull taut, hoping that I’ll tell them it’s okay to run. Before they receive the command though, the door opens, revealing a pale, balding man in his fifties.
“Ah, Mr. and Mrs. McKinley. Emily. How nice to see you.” he says, smiling dryly.
“Doctor Adams.” responds my mother, smiling widely and shaking his hand.
He sits in the rolling, backless chair across from us, and leafs through a manila folder. My mother and father stare at him intently, as though willing him to bring good news. Finally, when he decides the papers are in order, he smoothes his hands over them and looks up at us.
“Well,” he begins, clearing his throat. “Unfortunately, Emily’s lymphoblast count isn’t as low as we’d like it to be. I’d like to try a more aggressive form of chemotherapy, before the cancer metastasizes any further.”
“You said the same thing last time,” said my mother, as though correcting the doctor might make his latest test results wrong.
“Yes, I’m afraid I did, Mrs. McKinley. The problem with treating cancer is that it varies from patient to patient. While the last mixture of drugs should have killed more lymphoblasts than it did, we cannot go back now. I’d like to start the next round of chemo as soon as possible.” he said gently, attempting to calm my mother.
“Just how aggressive will this be?” asks my father, interrupting my mother’s nitpicking with a voice of reason. “Emily has already been complaining of pain in her lower back.”
The whole time, I sit and watch, more an outsider than the people in the waiting room down the hall.
“Well, I have the utmost confidence in this round of chemo. If it works the way it should, it will kill off the lymphoblasts collecting in her joints, causing the pain. It should all go away,” Doctor Adams says, not even looking at me.
“Don’t talk about me like I’m not even here. I’m not dead yet.” I say harshly, my voice rippling the air, thick with my parent’s worry and the doctor’s nonchalance.
“Emily!” my mother gasps, turning toward me. “How could you say a thing like that?”
“Oh, don’t act like it isn’t happening.” I spit at her. “Why can’t you just accept it? I have leukemia, mom. It’s not just a cold. It’s not going to just go away. I’m going to die. Haven’t you figured this out by now? How many different kinds of chemo have we tried? Do you remember? Because I do.”
“She’s been so angry and pugnacious lately. Can’t this be a side effect?” my father asks the doctor, his eyes pleading for some confirmation that this isn’t just me accepting my prognosis.
Doctor Adams ignores him and turns to me.
“Please, Emily. Be reasonable. Your parents have been with you through all of this. They deserve some credit, too. Don‘t do this to them.” he says,
“Oh?” I ask, his words spurring my own, ones that I didn’t mean to say. “Oh? Were they the ones who had to sit and mainline toxic chemicals for days on end? Were they the ones who ended up too weak to stay awake for more than a few hours at a time? Did they feel the burn as the drugs ate away at my veins? How many nights have they spent over the toilet, dizzy from the nausea?”
“Emily, please. If this new chemotherapy works, then you won’t have to deal with any of that anymore.” he says, moving closer, his voice growing soft and comforting.
“It won’t.” I say simply.
“How could you possibly know that?” he asks pleadingly.
“Because I’m not doing it. I’m through with all of this. Every time I see you, my lymphoblasts have gone up. The chemo isn’t working. The pain in my back is getting worse by the day. Why can’t any of you accept this? I’m going to die. No one can change that.” I say, relishing the liberation I feel in finally letting these words out.
“Emily!” this time it’s my father pleading with me. “Emily, you can’t stop chemo. Do you know what that would mean? There’s still a chance to turn things around. I know it’s hard, but you can’t give up.”
“Watch me.” I snap, rising to my feet.
As I make my way to the door, my mother grabs for my hand. I whirl around, her eyes meeting mine. They glisten wetly, and for a fraction of a moment, I drown in guilt. I quickly surface, though, and pull my hand out of hers. The door is only feet away. My fingers find the handle and shove down hard, the door swinging open toward me. I burst into the hallway. Doctor Adams emerges after me.
“Emily, I can’t make you do the chemo. I understand your frustrations, I really do, but this has real potential to work. Please, please, try it.” he says soothingly. His eyes, so indifferent before, seem to hold real concern now.
“I can’t.” I tell him.
The pain in my back is building now, and I push myself forward through the waiting room. My parents rush after me, the three of us startling the bald-headed children and their equally distraught parents. Before I can stop myself, I mentally remark that at least the chemo never made my hair fall out.
I grab the shiny, metal handle on the glass doors that lead to the rest of the hospital, and inhale the smell of hospital food and antiseptics. The air seems thinner here, not so wracked with the emotions of children and parents dealing with fate. My parents have stopped trying to pull me back to Doctor Adams, now, and follow me to the elevator. We ride to the ground floor in silence, and make our way to the car.
Outside, it’s gray and raw. It drizzles slightly, chilling my bones. The pain in my back becomes even more acute now, a constant ache. I climb into the back of the car and hug my knees to my chest. The ride home is completely silent. There are no words to be said.
I pull my robe around me tighter, letting the soft material cascade over me. I’m finally alone, sitting in my room, my parents having gone out to dinner without me. They’ve finally begun to accept what I had shoved at them that cold, rainy afternoon, months ago. What I had known for a long time, beginning on the day they told me what was wrong.
The day I was diagnosed with acute lymphoblastic leukemia was the most beautiful day I could conjure, even in my dreams. The sun smiled down upon the earth, warming all that it touched. The air was perfectly warm, flowing all around in a soft breeze. The sky was the most clear, perfect blue, dotted with puffy white clouds here and there.
I was nearly sixteen, and my life, like that of any other teenager, seemed unbearable to me. Little did I know, as I walked across the parking lot toward the doctors office, I would be wishing for it back night after night for a long time to come.
A monumental event though it was, I don’t remember too many of the details from that visit. My mother had simply told me that my doctor had asked us to come to the office, and I went with her, too preoccupied with my trivial teenage woes to think much of it. I remember my surprise to find two doctors that day, one that I would later find out was my new oncologist.
The thing that I shall never forget, though, was the strangled noise my mother made in response to the oncologist’s words, somewhere between a gasp and a sob, as it caught in her throat.
“ALL. Acute lymphoblastic leukemia.” He had said. He explained what it was, and what it meant my future would be like, as my mother clutched my hand in hers.
I never even cried.
Sitting on the window seat by my bed, I pick at the robe I’m wearing, noting how threadbare it’s become. I think about how if things weren’t like this, I might stop by the mall next weekend and pick up a new one. The plush material crumples as my hands ball up in fists, tears landing on them. I know that I won’t get a new robe. In all likelihood, I won’t be around next weekend.
The pain that originated in my back is everywhere now, more severe than ever. I barely have the energy to get out of bed anymore. My body, already ravaged by the months of aggressive chemotherapy, is withering away. The cancer is going to win. And soon.
I bring my cold, shaking hands to my face, and begin to sob into them.
I don’t want to die. I’m only seventeen. I don’t want to die.
Time and time again, I’ve sat in this same place, each time slightly weaker than the last, wondering if I’ve made the right decision. What if Doctor Adams was right? What if it would’ve been just one more course of chemo to put me into remission?
There will always be what if’s in life. There will always be doubt. But even with these doubts, I know that I’ve made the right choice.
Life with chemo was even worse than this. I would stay in the hospital for days on end, hooked up to bag after bag of chemicals, each enough on its own to kill me. The feeling of a needle entering a vein became familiar, and even welcome, compared to the tearing, burning sensation as the first cocktail of drugs would surge through me.
After the chemo, there were the days of nausea and fatigue. I would sleep all day, getting up only to take sips of water. My tortured body, poisoned and confused, would send me running to the bathroom, force me to my knees, and shudder as I vomited up the nothing inside.
None of the drugs worked. There were short periods of decrease in lymphoblasts, but never once did I near remission. That cold, gray afternoon was not the first time I’d thought of stopping chemo, but it was the first I’d ever made it known. I was afraid of hurting my parents. I was afraid of hurting my friends. But I had to stop hurting myself. Believing in recovery was futile and delusional. No matter how many times I wanted to run back to the doctors and their clean white coats and their complicated answers, I knew that I could not.
I had to stop chemotherapy because I had to stop lying. I had to admit defeat. At seventeen, I had to accept what many adults cannot. I am going to die. Much sooner than I thought. I will not be ready, and it will not be easy. But it will be necessary.
I stare out into the darkness, and look up at the stars. I try not to think about my funeral, or my parents. I look up at the stars, and I try to imagine being one of them. I’m not afraid to die. But I’m not ready. Not in the least.
The cool glass is a comfort as I close my eyes and rest my cheek against it. I can feel what’s left of my strength draining from me. My breathing grows more and more shallow, and I’m sure that tonight is the night. A tear escapes and slides down my cheek, falling onto my chest.
I’m not ready to die.