Page 37
Thirty
SHE TOOK THE time to shower before going into the vet’s office, knowing she hadn’t in... well, she didn’t know the day, never mind how many had passed. Fresh clothes helped, but her eyes would betray her grief with even the most cursory inspection.
She also forced herself to eat a few bites and drink a sip of water. Her hands shook and she couldn’t decide if the reaction betrayed her mental or physical state. Likely both. But she wouldn’t be any help to anyone if she collapsed.
Creeping into the vet’s office, as if by entering that way she could avoid any bad news, she caught Deanna’s eye.
“Room three,” the receptionist mouthed, jerking her head toward the back.
Entering, Abby poked her head through the open back door, glancing past a desk with a bank of monitors, a few microscopes, and glassed-in shelves above holding tools and medications.
Dr. Stevens wore a pristine, white lab coat like a cape around his shoulders. Flanked by two vet techs, he caught sight of Abby and nodded, then gave a few, final directions to one of them. Approaching, he and the other tech joined her in the small exam room.
Without Gen’s enthusiasm to fill it up, the room echoed. The dog had always loved her vet, had loved the treats and the full-body massage he gave her during his exams. Even the occasional vaccine hadn’t been enough to teach her to fear a white coat.
“Abby.” He reached for her hand and gave it a quick shake, then frowned. “I won’t belabor the point. I’m afraid the news isn’t good.”
Abby sucked in a quick breath at his words but forced herself to stillness.
“Gen has a form of lymphoma that focuses its attacks on the gastrointestinal system. It’s malignant.”
Abby struggled for a moment, reached deep, found the place of center, of quiet, she’d spent years honing as an EMT, let the right words find their way out.
“Prognosis?” Her voice rippled but didn’t break.
“It’s hard to say. You mentioned yesterday she’d been struggling with some tummy issues, which, to be honest, is what made me suspect this instead of something milder.
More...treatable. The blood screens came back positive, so I ordered a scan to find out how much it had progressed.
If it hadn’t, surgery would have been an option. ..”
“But it has.” Abby swallowed hard. “How far?”
He shook his head. “It’s spread throughout her intestinal track and has begun moving into other areas. Surgery isn’t an option.”
Abby closed her eyes. “How... How long?”
“Abby...” Dr. Stevens reached out and squeezed her arm. “You can’t do that. This isn’t your fault.”
She gritted her teeth and repeated herself. “How. Long.”
He sighed. “If we’d caught it when you came in a few months ago? Maybe a year? Hard to say. The prognosis would be better, though.”
“And now?”
“Well, there is some positive news, if you can call it that.” Dr. Stevens knew about her background and Gen’s therapy work.
Her familiarity with human medical diagnoses meant he didn’t have to sugarcoat or explain.
He could simply give her the facts. “I’d recommend starting her on chemotherapy.
It’s spread, but I wouldn’t call it systemic quite yet.
If we treat it aggressively, she may be uncomfortable for a while, but there’s as much as a sixty percent chance of survival.
With remission, she could have another few years, still. ”
Abby’s knees gave way, and she grabbed at the small exam table to catch her balance. “Sixty percent? That’s... That’s so low.”
It wasn’t. Objectively, she knew kids whose chances of survival were much lower. But nothing in all her years of therapy work with Gen had prepared her for the stark reality of facing exactly what every parent she’d ever met in the oncology department faced.
Gen’s entire battle reduced to a simple number.
“There’s another option, too.” Dr. Stevens spoke slowly, carefully, as if unsure Abby could handle his words.
She pulled her shoulders back and cleared her face. If Liam and Ethan’s mother could face years of these conversations, Abby could manage a few more minutes.
“There’s a clinical trial that opened up recently at the university: combination chemotherapy and adoptive T-cell therapy.
I went to grad school with the doctor overseeing the study, and Gen would be an excellent candidate.
She’s otherwise healthy, at a good weight, active, and I know they’d take the very best care of her.
Of course, it’s a study, so she might end up in the control group, but it’s worth considering. ”
“I... I don’t know...”
“You don’t have to decide today. I’ll pull the information and send it home with you so you can think about it.
I’d like to keep Gen another day or so, try to take care of the dehydration and at least give her a foundation for improving.
If you weren’t going to join the trial, I could start treatment right away, but if you’re willing to consider it, it might be better to wait until she’s enrolled. ”
Abby shook her head. “No. Start the treatment.”
“Are you sure? It’s not cheap...”
“It’s fine. I’ll figure it out.”
“Abby...” Dr. Stevens held his hands open in surrender. “I know you love Gen. Believe me; I know it. But you need to think about what’s best for her. You need to listen to all your options before you make any decisions.”
Abby paused, closed her eyes, nodded. “Sorry.”
“I know this is difficult to hear.”
“No, you’re right. I’m sorry.”
“Okay. We can do chemo independently of the trial. It would mean weekly shots for sixteen to twenty weeks. Radiation therapy has also had good outcomes, but we don’t do it here.
I could refer you to a veterinarian oncologist with the proper facilities if you wanted to go that route.
Or, if you went with the trial, it’s possible they would recommend some kind of additional combination treatments. ”
Abby nodded. It’s a case study. Find the symptoms, treat the cause. It’s not Gen; it’s just a case study.
“Chemo in dogs isn’t as bad as it is in humans, but it can cause vomiting and diarrhea.
Given it’s already her intestines that are most affected and she’s showing signs of malnutrition and weakness, that is a concern, but I think this is still the best option, regardless of what you choose to do otherwise.
“As for cost, I can print you an estimate. The chemo alone would probably be around four thousand dollars. The radiation, I couldn’t really tell you.
If you were accepted into the trial, it would be cost-free, but, again, you could end up in the control group.
At least the chemo would be covered, though, even if she didn’t end up getting the T-cell injections.
” He paused. “I know it’s a lot to take in.
There are a lot of options and decisions. Do you have any questions?”
Abby choked on a bitter laugh. How often had she heard a doctor give this exact spiel? A cancer doctor. The universe had a cruel sense of humor, to put her in this position. “Are there any other options?”
“You could take her home.”
Abby couldn’t help the sob that escaped her.
“You could love her like crazy, visit some kids, let her eat cheeseburgers and all the junk we always tell owners never to allow their dogs. You could have this time with her, and, when you’re ready, you come back. You take this time to give her a good life. To say goodbye.”
Abby gritted her teeth, turned her face away. “I can’t...”
She couldn’t even finish the sentence.
Dr. Stevens nodded. “It’s okay. You can think about it.
Call me tomorrow and let me know what you want, you can either pick Gen up then, or we can start treatment, and she can go home the next day.
In the meantime,” he tipped his head toward the tech at his side. “Jenny can take you back to visit her.”
“Thank you.”
Scott scrubbed the towel through his hair and debated texting Abby.
From the next cubicle, as if he could read Scott’s mind, Finn asked, “Has Abby called, yet?”
“Not yet.”
“How long you gonna wait?”
Scott pulled an undershirt over his head, voice muffled in the fabric. “I asked her to let me know. She said she would.”
To be honest, it stung she hadn’t called sooner, either when Liam had died, or when Gen had gotten sick. And now the afternoon had almost passed and still nothing. Did she remember Dylan had a concert tonight?
He mentally kicked himself.
He wasn’t being fair; she’d been through hell this week. If she missed it, he would simply have to explain what had happened to Dylan. Still, a small seed of anger burned, and he didn’t know how to stamp it out.
“What if she doesn’t?”
“She will,” he snarled, angry at his best friend for putting words to the niggling worry he couldn’t suppress.
Finn held up both hands. “Okay, man.”
Scott shook his head. “Sorry.”
“No worries. Have you told Dylan?”
“Not...yet. Things are so unsettled right now, I don’t want to rock the boat more, you know?”
“I hear you.” Finn frowned. “When’s the final hearing?”
“January fifteenth. I’m not sure why the judge wanted six weeks to make a decision, but I can’t say I don’t appreciate I won’t have to fight Lindsay for Christmas this year.”
“Speaking of. Kelly wants to know if you guys want to come by for Christmas Eve?”
“Let me ask Abby. I’m not sure it’s a good idea this year, but I’ll see.” Scott’s phone chirped, and he snatched it up. “It’s Abby.”
Finn flipped him a wave and he hustled out of the locker room.
Scott knew Abby had retreated to a place he couldn’t follow when her wooden voice spelled out Gen’s diagnosis and options, utterly devoid of emotion.
In some ways, though it broke his heart, he’d rather she sob again, allow the pain to penetrate, experience it instead of pushing it away, pretending it didn’t affect her.
Her clinical voice bothered him. She’d used it with him only a few times before: that long-ago morning on the playground on the day they’d met, speaking professional words of reassurance to his son as he cradled a broken arm; then again the day she’d told him about Will’s death.
What had been calming then terrified him now.
How could she disconnect from herself so completely? It couldn’t be healthy.
It’s not , a small voice insisted. Maybe she isn’t as stable as you thought.
Scott shook his head, burying the voice. “What are you going to do?”
When she spoke again, the words were small, scared. Not an EMT or a medical professional anymore, but someone whose dog was dying.
“I don’t know.”
Scott weighed his next words carefully.
Let me be a part of this , he wanted to beg. Come to Dylan’s concert tonight; we’ll go back to my place afterwards and talk . Don’t shut me out.
He said none of these things.
“Will you let me know when you decide?” Perhaps it wasn’t fair, but the vicious, small voice in the back of his head won.
If she loved you like she claims, she’d say those things all on her own.
“Yeah, of course.” The distance returned, far away and receding, like a riptide pulling away from the shore, dragging her to a place he couldn’t—wouldn’t—follow.
Scott paused, waited, thought about speaking again. He could push. Prod. Remind... He should, he told himself. She’d had a horrific week; she couldn’t be blamed for forgetting about Dylan’s concert. But he remained silent, and then she’d hung up.
Table of Contents
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- Page 37 (Reading here)
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