Energy Warriors - Bob Ellal

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      It’s impossible to feel festive with the sword of cancer hanging over our heads. After the New Year I’ll have my first mini-transplant stay in the hospital. I’ll have the second in February, the third in March. In April or May, depending on the strength of my blood counts, will be the actual bone marrow transplant.

      Last week I had a dose of CHOP chemotherapy designed to shrink the tumor in my shoulder as much as possible before transplant. The next day, woozy and tired, with a feeling that a hot liquid was bubbling against the inside of my skin, I went Christmas shopping at the Rhode Island malls. I wanted to get it done before my hair started to fall out.

      Sheryl and I were at the point in our marriage where we no longer bought each other big-ticket items at Christmas. We spent the lion’s share on presents for the kids. Gifts for each other were now almost an after-thought. It was clear that in a year or two they wouldn’t even be that.

      It was depressing that something that once had been a pleasure—running to the malls for the weeks before Christmas to find the right gifts for one another—had become almost a chore. Was this the normal evolution, or dissolution, of a marriage? Or had the presence of cancer accelerated this decline?

      A mirror presented itself as I veered into Filene’s to use the restroom. The dose of chemo from the day before had reddened my pale cheeks and made them puffy. I stopped and smoothed my hair back from my sweaty forehead. I did it again and noticed a clump of dirty-blond hair smeared across my fingers and palm. The medicine was moving very fast.

      On the way out, on impulse, I stopped into Victoria’s Secret and bought a nightie for Sheryl. It made me think back to the days before all this cancer business, when we still were passionate about one another. Could we ever get that feeling back?

      In the last few years, repeatedly, continuously, we summoned up our willpower and courage to fight a life-threatening disease. Add this to parenting our children, and no energy was left for passion. Did I think a nightgown could turn back the clock? No; just being nostalgic. That’s a glum thought—in your thirties and already looking back.

      After we arranged the children’s gifts under the tree we opened ours in front of the fire. Sheryl opened the box with the nightgown and stared silently into it. A few minutes later she disappeared, then returned wearing it. Merry Christmas, Bob.

      What a force, or instinct, is the sex drive! It could even make cancer disappear, at least for a short while. If this power somehow could be harnessed, loaded into a gun and pointed at a tumor or a disease! Nothing could withstand its impact.

      For a short time, instead of fear I experienced most of the entire catalog of male feelings and emotions: Lust, passion, power, conquest, intense pleasure, an explosion that took me away from myself, exhaustion, then contentment tinged with sadness, a sense of safety being entangled in my wife’s body, a feeling of nurturing, compassion and love. Everything but anxiety and terror.

      Not to worry—the cancer and the cancer treatment completely covered those last two feelings. What a silver lining! The disease had made me a complete man. Thank you, Monster, for grounding me firmly in reality. Thank you, God, for allowing me to experience every emotion a man could feel.

      But while you’re handing out Christmas gifts, Lord, please do me one more favor: Please, Lord, please—do not let this be the last time I make love to my wife.

      The top half of my butt throbs. A few hours ago the doctors put me under, then inserted thick needles attached to syringes approximately one hundred times through the surface of the bone at the back of my pelvis. Each time they pulled marrow from the inside of the bone. They deposited this bone marrow into plastic bags and froze it. Later they’d drip it back into me, after the high-dose chemotherapy had destroyed the rest of my marrow and, with luck, the cancer cells remaining in my body.

      Thank God I had anesthesia; when your bone marrow is merely tested for the presence of cancer cells, the doctors perform the same procedure, but only once. They do not endanger you with unnecessary anesthesia or pain medication for this test. A needle with the diameter of a drinking straw is plunged through your buttock and into your pelvic bone; as it sucks the marrow through your pelvis into the syringe, it feels as though a molten wire is being drawn through the center of the bone. It is a very medieval procedure, practiced with the most modern of technology and science.

      It is at times like this, times of excruciating pain, when consciousness is altered, that one can achieve marvelous breakthroughs in understanding. For instance, during my first bone marrow test I gained a profound insight into Einstein’s Theory of Relativity, the relationship between time and space. The five seconds or so it took for the doctor to syringe a core of marrow from my hip seemed like five eons to me. Where pain is concerned, time is relative. Your perception of time is influenced entirely by your position in space. Mainly it depends on which end of the syringe you’re on.

      Nowadays, of course, the manual removal of bone marrow for transplants is the exception rather than the rule. Today, stem cells, immature white cells, can be painlessly harvested from the blood with a machine that works on the principles of the kidney dialysis procedure for eliminating impurities. These stem cells are a much purer product than bone marrow, which contains mature white cells, which aren’t as resilient as stem cells, as well as many other cells that just get in the way of the immune system rebuilding itself.

      The doctors at UCONN had warned me that because of the prior transplant chemotherapy I’d received in Boston, my immune system was suppressed. That meant my stem cells almost certainly would not “mobilize” (be present in sufficient quantities in my bloodstream for harvesting) for use during this second transplant.

      The upshot? They would have to gather my bone marrow the old fashioned way—through my backside. The result of using bone marrow would be a much longer hospital stay during the transplant and the need for many more transfusions of blood products, such as platelets and red cells, afterwards.

      After my first “mini-transplant” hospital stay, it seemed the doctors were correct about the state of my immune system. High-dose chemotherapy had been pumped into me for four days in the hopes of achieving two results. First, to reduce the cancer cells that might be hiding undetected in my body; second, to bring my immune system down to almost ground zero, then allow time and growth hormones to raise the white count back to acceptable levels.

      Normally, once the white count returned to normal levels, stem cells would be present in sufficient quantities in the blood for harvesting. Mine weren’t. My stem cell count was 0.1, when it should have been 1.0 to allow stem cell collection. The doctors felt it unlikely that my stem cells would mobilize in sufficient numbers after my second mini-transplant. That’s when they decided to go after my bone marrow with a hundred needles, making my backside feel like the victim of a rabid porcupine attack.

      CHAPTER 3

      THE MARK OF CAIN

      …The monster who lived in darkness suffered when he heard the music ringing, day after day, from the great Hall of Men. They were happy! They were chosen by God to walk freely in the light—he was condemned to roam the marshes and moors by night in rage and pain… Why? The monster was born of monsters, whose ancestors, the descendants of Cain, were damned by God for an ancient crime. It didn’t make much sense, even to the monster….

      You squat on a damp log by the water’s edge, splintering a bone with your canines, staring at the untroubled face of the lake. Suddenly the moon emerges from the dark racing clouds to reveal the huge caricature of a human face: elongated jaw, heavy brow ridge, immense nostrils with virtually no nasal bridge, and fur, not hair, covering all but the tiny eyes. Instantly the splintered femur, oozing marrow, leaps from your talons to shatter the face of the water and annihilate the reflection of the intruder moon.

      Monster, I understand your rage every time I lapse mentally and look in the mirror. Why is my face a bloated caricature of not only itself, but of a human face? Why me? Was this disease programmed into my genetic code from the instant of conception? Am I genetically damned? Why do they

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