Square in the Face (Claire Montrose Series) (24 page)

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Authors: April Henry

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Chapter Twenty-six

Dr. Preston’s nurse beckoned them back into the office. Diana walked beside her father’s wheelchair, her expression unreadable. Vi was at home, on a morphine drip, but the hospice nurse had assured them that she would not die while they were gone. Lori followed, and Claire saw that she was unable to take her eyes off her, this child of hers who had been lost. Havi came behind his wife, his face as expressionless as his daughter’s. He had moved back into their house, and they were slowing repairing old tears. Claire brought up the rear. Both parts of Diana’s family had asked her to be here. Charlie was at home, watching both Max and Zach. Two days after Claire found Diana, Zach had been declared again in remission.

Both of Diana’s families had agreed that she would live primarily with Vi and John, and just John after Vi died. When Zach was well, Diana would begin to spend some weekends with her newfound family.

Dr. Preston waited until they were all gathered around his desk. Claire stood a few feet from Diana, who leaned against the wall in a studied slouch.

“Diana and Zach match on all four HLA antigen tissue markers and are mutually non-stimulatory in the mixed lymphocyte culture test.” The doctor must have seen how blankly they were looking at him. He cleared his throat. “What I mean is, Diana’s a perfect match for Zach.”

Claire watched as John signed the news to Diana, too fast for Claire to see more than fingers pointing, splaying, fluttering, wrists turning, hands moving toward the body and then away. Sign language was like dancing, and Claire, who had decided to try to learn at least the alphabet, was barely able to crawl.

Diana tilted her head and raised her the black wings of her eyebrows as she signed back to John. Sign language was as much body language as it was hand movements, so she could tell that Diana was asking a question. John answered with a nod. As Claire looked from Diana to Havi, it was easy to see that they were related. They had the same dark almond-shaped eyes, the same prominent noses and knife-like cheekbones. Diana’s hair was brown, not black, but otherwise she was clearly Havi’s daughter. But it was also clear from the way Diana and John acted toward each other, that he was her father, too, in ways equally important.

“What’s the next step?” Lori said. She asked the question of Dr. Preston, but she kept her face turned toward Diana, enunciating well enough to allow her to lipread.

Lori’s cues reminded Dr. Preston to lift his head and speak directly to Diana. “For Diana it’s not very complicated or painful. About a week from now, we will put her under total anesthesia and use a needle to harvest an adequate amount of marrow from the back of the large flat hip bone, called the iliac crest.” He stood up, and with one long-fingered hand he patted the back of his khaki Dockers. “Diana, all you will have a day or two of soreness.” He smiled. “Probably wouldn’t want to go out horseback riding.”

He turned to Havi and Lori. “The procedure is a little more complicated when it comes to Zach. In order for Diana’s bone marrow cells to survive and grow, the recipient’s own marrow and immune system need to be killed. Normally, we are limited in how much chemotherapy or radiation we can give a patient, because killing the diseased bone marrow would result in the death of the patient. When we do a bone marrow transplant, to put it crudely, the total body irradiation and the intensive chemotherapy kills both the leukemia and the patient. We then rescue the patient - but not the leukemia - through bone marrow transplantation.”

Claire saw Lori shiver, and then Havi put his arm around her.

“So, before we can infuse the marrow, we have to put Zach through a very difficult course of chemo and radiation. It’s going to be worse before it gets better. He will experience nausea, vomiting and fatigue. We’ll have to keep him in isolation, with only a few visitors, and those will have be washed, gowned, gloved and masked.

“After Diana’s marrow is filtered, we will infuse it into Zach’s Port-A-Cath, the same way we would a unit of blood. The marrow cells will find their own way to the marrow spaces inside the bones. As far as Zach is concerned, the transplant is not surgery - just a blood transfusion. Again, it’s not like a kidney that starts to function immediately. Instead, the cells will slowly repopulate the marrow over the course of a few weeks.”

“How long will it be until we know if it’s working?” Lori asked.

“Until the bone marrow starts to function, which may take a few weeks, Zach will be totally dependent on us for supportive care to defend against anemia, bleeding and infection. If the procedure is successful, the transplanted marrow produces a new crop of normal cells. That means mouth sores should heal, and nausea and vomiting will decease. Most importantly, Zach’s blood counts will gradually start to come up.”

There was a long silence, and then Lori asked the question that was on everyone’s minds. “And if we don’t see these things, these changes?”
Dr. Preston didn’t drop his gaze. “If there are no signs of new marrow growth within four or five weeks, then the engraftment has failed.”

In her mind, Claire paraphrased what he meant. If the engraftment failed, the leukemia would be dead. But so would Zach.

Chapter Twenty-seven

The day was perfect, the kind of day that Oregonians like to keep secret from the rest of the world. Eighty degrees and not a cloud in the sky. Boats bobbed on the shimmering blue water of the Willamette River that ran through Portland’s heart.

For two cans of food for the Oregon Food Bank and three dollars at the gate, Portlanders were enjoying a Fourth of July tradition, the Water Front Blues Festival. The grassy bowl between the Hawthorne Bridge and the River Place Hotel held a cross-section of the city. Suburban couples dressed head-to-toe in Eddie Bauer pushed strollers past blues fans wearing Levis and T-shirts. A man with a diamond-patterned python looped casually around his neck and its tail stuck in the back pocket of his jeans cut a wide swath through the crowd. Families spread out picnics in the grass next to people napping, and for once no one seemed to mind if the nappers had the look of people who spent every night lying out-of-doors.

One man dragged a heavy wooden cross through the crowd, past kids with safety pins and dyed black hair who hadn’t heard that no one dressed like a punk any more. Old friends stood in clusters drinking beer, college students played games of Frisbee that included the obligatory dog, and kids got their faces painted or stood in line for a balloon hat from Cosmo the Balloon Wizard.

On stage, the dancers for the current act appeared, having changed into different - but just as skin-tight - dresses for the next song. A tiny hunched over man, about the size of an elf, scooted past in an electric wheelchair without footrests. His stunted feet curled a half-inch from the ground. With one hand, he held a large gray bunny in his lap.

Zach, who had already consumed a fruit roll, a can of apple juice, most of a basket of curly fries and a corn dog, now ran up to where Claire and Lori were standing and asked for strawberry shortcake. With a grin, Lori reached into the pocket of her jeans and handed Zach and Max two dollars apiece. They ran off, briefly separating to run around a man wearing a top hat and tails and carrying a necromancer’s staff.

The adults were eating their way through the festival, too. They ate burritos and Thai noodles and Cajun chicken and pulled pork sandwiches. Fried dough was available from four different vendors. They could choose from elephant ears or Indian fry bread or Dough Boys or something called Fri Do, served by sturdy sweating women who were supposed to be Swedish, got up in some outfit that was a cross between the flying nun and a milkmaid in a bustier.

And from a beat-up trailer, J.B. was doing a roaring business in cinnamon rolls the size of dinner plates. A representative from Portland’s Saturday Market had already given him a card and asked him to call about setting up a permanent booth.

Squinting from the refracted light that danced off thousands of wavelets, Claire sat down on an old quilt next to Charlie, who was tapping her fingers on her knee in time to the music. Dante gave Claire a smile. He had been in Oregon since late June, and he and Claire had been making up for lost time and lost conversations. After a week spent walking along Oregon’s beach, exploring tidepools during the day, drinking microbrews in the evening, and spending long nights in bed, they had agreed to disagree about whether she should have ever tried to unearth what had happened to Ginny. They still hadn’t figured out how to resolve the three thousand miles between them. Friends and family kept Claire in Portland. And the reality was that Dante’s job at the Met could not be matched anywhere else.

Next to Dante, Jean shared a fried onion flower with her new boyfriend, Zed, whom she had met at Shoppers Anonymous. She put another batter-covered slice to his lips, and Zed playfully nipped her fingers, making her squeal. He was a tough-looking little guy, scrawny and wrinkled, who probably weighed a good fifty pounds less than Jean. A Teamster, he no longer had a TV in the sleeping cab of his truck, so that he could avoid temptation. Whenever they felt tempted to pick up the phone to buy something, he and Jean called each other long-distance instead.

Dante took a bite of the napkin-wrapped item that Claire had handed him, then spit it out into his palm. “What
is
this?”

“It’s a butter-pecan bagel,” Claire answered, a little defensive. She herself had liked the taste, like butter-brickle ice cream.

He groaned. “Oh, Lord, I am truly far from home.”

IMYRMAN

Key to License Plate Terms

10SNE1 = Tennis, Anyone?

1DRING = Wondering

6ULDV8 = Sexual Deviate

ALLLII = All Lies

AMAMTOH = Hot Mama (as seen in rearview mirror)

BAD DOG = Bad Dog

BITEME = BITE ME