Page 25 of All the Way to the River

“Are you sitting down?” she asked, just like people do in the movies.

I sat down.

“They found tumors,” she said. “Lots of them. Not just in my liver. In my pancreas, too.”

The breath left my body and for a long moment did not come back.

I’d known that Rayya was getting a liver ultrasound that day, but I had assumed—as had she—that the results would be not only good but also cause for celebration.

Rayya had recently learned that there was an amazing new treatment available for hepatitis C, a disease that had dogged her body for years, causing her fatigue and stomach pain, bruising and bleeding, and swelling in the legs and abdomen.

Hepatitis C had always been classified as incurable, but recently DAAs (direct-acting antiviral medications) had been shown to eradicate the virus completely from the liver when taken in intense doses over a period of six months to a year.

It sounded like a miracle to Rayya. Without the virus in her system, just think what she could do! The energy she would have, the clarity of mind! There could be a whole new life for her!

The promised cure was indeed miraculous, but it wasn’t cheap.

Most insurance companies didn’t cover the treatment, and by some estimates, it could cost up to eighty thousand dollars to gain access to these wonder drugs.

But I had told Rayya I would help pay for her treatment if her doctors advised it.

What was money if it could restore my best friend, my person—my Rayya —to health and wellness?

Before she could get access to the DAAs, though, she had to get a liver ultrasound, to find out whether she was a good candidate for the cure.

It had seemed like almost a formality. Her doctor had assured her she’d probably be fine.

As long as she didn’t have advanced cirrhosis, or liver cancer, or something crazy like that, she’d be eligible for treatment.

So she’d made an appointment for a scan in New York City early on a Monday morning, assuming she would get the green light.

She’d been so cheerful and chatty with the medical staff that morning, joyful at the prospect of being released at last from a disease that had been dragging her down for nearly thirty years.

But when the technician had passed the ultrasound probe over Rayya’s abdomen and looked at the images on his screen, he had suddenly gone quiet.

Then he’d left the room and called for a doctor, who came in and looked at the images, too. The doctor also went quiet.

“I swear, the temperature dropped in that room by about ten degrees,” Rayya told me later. “Nobody was talking. And right then I knew I was gonna die.”

“We’ve noticed some unusual masses in both your liver and your pancreas,” the doctor finally reported.

Rayya said the man looked ashen. He was young.

Painfully young. He clearly did not know how to do this part of his job yet—the awful, emotionally gutting part where you have to tell someone that they might have a fatal illness.

“What did you find?” she asked.

“One large mass and more than a dozen smaller ones.”

“Tumors?” Rayya asked.

“It would appear so.”

“Is it cancer?”

“I wouldn’t be able to answer that. You’ll have to take these findings to your primary care physician and make an appointment for a biopsy.”

The doctor handed her a folder with the test results. He was unable to meet her eyes.

“Does it look bad, though?” Rayya pushed.

“Again, I wouldn’t be able to answer that,” he said, turning away from her. “But do you have any further questions for me?”

“I don’t know, man. Do you have any fucking answers for me?”

“Um … no.”

“Then I guess I don’t have any questions for you, dude.”

Rayya left the clinic and stepped back into the bright light of day, carrying a folder under her arm that she already knew contained her death sentence.

It was a gorgeous, sunny morning in New York City on the Upper East Side—a neighborhood Rayya hardly ever visited.

She felt lost. Her mind wasn’t working right.

She knew she needed to call people, but she’d forgotten how.

She knew she needed to get herself to where her friends were, or to family.

She needed to get herself to where somebody could hug her, but that seemed impossible to figure out.

She walked toward a subway entrance, without even paying attention to which subway, and started to descend into the darkness.

Then she stopped at the bottom of the stairs. Her body refused to take another step.

I’ll be underneath the ground soon enough , she thought. But not today .

She climbed back out into the sunlight and hailed a cab.

Might as well start spending all my money now , she thought.

She laughed.

Then she started crying.

That’s when she called me.