But nothing could have prepared them for Jules's sudden illness and the discovery of its cause - cancer. Sam tries to be a true friend, supporting Jules during the weeks of testing and doctors and treatments, but the horrifying pain and indignities that Jules suffers, and the feeling that she has lost control over her own life, force Jules to a place where even Sam cannot follow. Now both Jules and Sam must learn to accept the unacceptable - that Jules's cancer may not go away. How each, in her own way, comes to face the possibility of Jules's death, and learns to celebrate her life, makes for a searingly honest, unforgettable novel.
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JULIE My mom had left me at the door in Pre-Op, the coldest room ever built, and a nurse covered me with some thin space-age blanket that turned out to be quite warm. The IV needle had been put into my arm, and the anesthesiologist, Dr. Kim, had commented on the healthy size of my veins. Dr. Conner was now explaining The Procedure to me, in depth, with her award-winning tact, and if I hadn't been in so much pain, I would've been terrified. But IT had returned, and IT was pissed off, so even though I was looking at the doctor and nodding in what I hoped were suitably appropriate places, I was only getting a general idea of what she was trying to say. I only started really listening when she got to the part about the Valium.
"...will not put you under exactly but will take away the pain aHOORAY!!'and the immediacy of the experience. Are you ready'"
I nodded. Just say yes, I thought. Dr. Kim inserted something into the IV tube, and the orderly, or whoever it is that moves beds, got ready to go to the operating Room. I could get used to this, I remember thinking as I drifted into Twilight World. No pain, no problems. I could hear everything that was going on around me, but I didn't have to respond to it. Probably I would have been able to see, too, but since it seemed a more pleasant choice to keep my eyes shut, that's what I did.
I felt myself transferred to another bed. I knew Dr. Conner was in the room and giving orders. Someone sat near my head and kept putting a cool, wet towel on my lips, and I would smack them and swallow the moisture. Every once in a while, a voice I didn't recognize but nevertheless liked the sound of asked if I was feeling okay. "Jusss fine," I would answer, then float some more. Time had no meaning, pain did not exist, there was nothing in the world I had to think on, worry about, or do. I thought I had arrived in Paradise. Three hours later, I wasn't so sure. The Valium had worn off, and whatever the anesthesiologist had slipped in the IV as I was being wheeled back to my room "Here's a little whammy to help with the pain," he'd said, not asking if I wanted it was not in agreement with my system. I got horribly nauseated and vomited violently on the bed, on the nurse, on the floor. Over and over, missing the bedpan each time, until another nurse insisted on calling the doctor. It seemed years before she came.
"Are you hurting?" was the first thing she asked.
"Not yet," I replied, and tried to vomit on her.
"It's nothing to worry about," she assured me. "You're having a reaction to the pain medication. It happens to many people."
Whatever I would've said to respond wouldn't have been appreciated, and I couldn't have got it out between vomits anyway, so I just nodded.
"I'm ordering an anti-nausea medication."
"What if it makes me sick, too?"
"I don't think it will. Trust me."
By the time my parents and Sam came in, I had entered Phase Three. Over the Procedure, past the drug reactions, and now responding to the sleep inducer. I tried to smile at them, tried to let them know that I was finally feeling better, but nothing I said seemed to make any sense. They kept smiling at me and patting me, and then they left me alone with Sam for a minute. I managed to reach out my hand. She took it. She read my mind, as she usually does, and answered what I was unable to ask.
"They don't know anything yet, Jules. The doctor's meeting with you guys in the morning. Nine o'clock. After she sees what those tests have to say. How 'bout now are you feeling okay?" I nodded. "Do you need anything?" I shook my head. "Well, then let me tell you what I did today..." and she flashed her wicked look. I couldn't keep my eyes open too well, but my ears were working, and as she told me the story of Jack and The Freak and then the part about the dean, I smiled and smiled and smiled. Next morning, a nurse woke me at five to take my temperature and ask me stupid questions. I managed to go back to sleep, only to be awakened again by a different one. Temperature again, same stupid questions.
"You guys already did this once," I told her. She gave me her Indulgent Nurse Smile.
"Im the new shift," she explained.
Oh. Fine. The fact that I couldn't get back to sleep didn't seem to concern her. The fact that my hip, where the needle had gone in, was now on fire didn't seem to, either.
"Could I please have something for this pain?" I asked. She gave me her Concerned Caregiver Face.
"I'm sorry," she dripped, "but Dr. Conner didn't indicate any medication on your chart."
"Would you call her, or something, please? This really hurts."
"Well, she'll be in at eight-thirty. Let's ask her then, shall we?"
"Okay." She smiled again and started to leave. "Excuse me," I said, "could you tell me what time it is now?"
"Seven-fifteen." And she was gone. An hour and fifteen minutes is not a long time under the best of circumstances. I, however, was not under those kind. I hurt, I was tired and cranky, my mouth tasted like caca, and I wanted my mother. Or Sam. Or somebody. Plus I did not want to think about the meeting with Dr. Conner.
Eight-thirty came and went. No doctor, at least according to Miss Happy-Face. Afew minutes later, my mom and dad showed up. I was in pretty bad shape. I didn't know which part of me hurt the worst.
The second he saw me, my father was furious.
"This is ridiculous," he announced to no one in particular, and went to get help. My mom stroked my face and talked softly, about nothing, really, just to keep my mind occupied. My dad came back, nurse in tow, with Dr. Conner right behind. No smiles this time. The nurse took a vial and inserted its contents into the IV tube. She'd obviously been spoken to by the doctor. Almost immediately, the pain started to go. I sighed. Nurse Happy left, and Dr. Conner checked my pulse and felt my forehead.
"No excuse for that, Im afraid," she told us.
The medication was indicated. My dad started to open his mouth, but Dr. Conner wasn't through. There are chairs right outside. Let's pull a few in here and have a little talk.
A chill like ice cut through my entire body. My mouth went dry. I wondered if maybe I was having another reaction to the medication, but then I looked at my mom. She was a ghost. My dad pulled a couple of chairs in, next to the bed, but both my parents remained standing. Dr. Conner stood across from them and looked at me as she talked.
"As I suspected it might, the marrow shows that you have diffuse histiocytic lymphoma. Because it has shown up in the marrow, we can assume it is Stage Four. This means it did not originate in the hip. The hip is a secondary site, and there are undoubtedly other affected areas. My recommendation is an immediate aggressive program of chemotherapy. Your age is a definite advantage. Your body can withstand much more than an older, adult body can. This increases our chances significantly."
She paused a moment and smiled encouragingly, then continued.
"We can do the therapy here, or if you would like, arrange for an outpatient facility. Of course, certain side effects may occur severe nausea, weight gain or loss, skin disorders, and low blood count, which means you will have to take extra care against infection. Oh, and almost everyone has loss of hair. I would be happy to orchestrate the program, if you so desire, or I can put you in touch with other oncologists. I welcome a second opinion, should you wish to seek one, but I recommend you do it immediately. Time is of utmost importance in cases of this type." She peered at each of us. "I think I've covered everything. Do you have any questions?"
Almost out of breath from listening to her, I realized I had understood only part of what she had been saying. I looked at my parents and saw the same confusion. My mother asked the question.
"Doctor, you need to tell us... exactly what is diverse histiowhatever?"
"Diffuse histiocytic lymphoma she paused, sighed is a type of cancer."
She continued speaking, explaining, but it didn't matter what she said after she said the C-word. We didn't hear any of it. We'd find out later, as we lived it, but just then, we couldn't move. We didn't look at each other.
We didn't speak. I don't think we were even breathing. Dr. Conner murmured something about giving us some time, then left the room. My father sat down. My mother stayed frozen by my bed. Except for her hand. It walked across the bed and found my cheek. She stroked me, softly, over and over, like she'd done when I was three and fretful, or thirteen with my first broken heart. Then she made herself move, and she turned to look in my eyes. My father stood up and came to the other side of the bed. He didn't make a sound, but tears were running down his face, and I remember thinking, Hey, this is weird I've never seen my father cry.
No one said a word. What was there to say? I had cancer. SAM Sixty-year-old men who have smoked their whole lives get cancer or women who don't do Pap smears or forget to check their breasts. People in other countries get it, or other states or other towns. But not a sixteen-year-old beautiful dancer girl who has never done anything bad to anyone in her entire life. Not my best friend.
I had ditched school the next morning and gone to San Francisco to Campton Medical. Priorities are priorities. I got up to Jules's room pretty soon after Dr. Conner had left, I guess. I knocked and when no one answered, peeked my head in. Sandra and William were on either side of Jules, and they were all three holding on to each other. Jules was the only one not crying. I knew right then it was something bad real bad. Part of me wanted to just turn around, right there and then, and go away. Forever. If I didn't hear whatever it was, maybe then it wouldn't actually be. But I didn't move. I stood where I was, waiting.
Jules saw me first. The minute our eyes locked, she started to cry. Soft, no sound, just tears coming down.
"Is it fucked?" I asked.
"Cancer." She whispered it so lightly I almost didn't hear. Then the word flew over and smacked me.
I stopped, as in ceased. Completely, utterly, no life in me for what seemed like years. Immense silence descended. I could only hear my heart. Everything else had moved outside my range of perception. Nothing was possible not speech, not tears, not thought.
Sandra came over and led me to Jules. I kept staring at her. I shook my head. I kept trying to make my brain start functioning again. I wanted one of them to say, Ha, ha just teasing. I wished I could go back to yesterday and skip right to tomorrow, so this could not occur.
Then I wanted to laugh. Bubbles of it came up from inside, and there wasn't a thing I could do to stop them. Sounds started coming outrigid, ugly sounds and I wanted to tell Jules I was sorry, I really didn't think it was funny, that I didn't mean to laugh, but I couldn't stop. The sounds kept pouring out. All of a sudden, it wasn't laughing anymore it was tears. My Jules, my Juliana Dancer Girl, my One and Only, reached out and pulled me in. I put my arms around her and we cried. And cried. Im not too clear on the rest of the day. I couldn't tell you when I left the hospital or how I drove back over the bridge to my house. When my mother asked how everything was, I don't know why the words came out sounding normal and easy. I do remember lying, not wanting my mom to know anything about anything, at least not then. She's not the kind of woman who can deal with things. She always overreacts. She would call the Michaelses; she would ask them and me an endless assortment of stupid questions. I would only make me mad. Besides, this was too important. No one who was on the outside could know. Not yet. It belonged only to me and Jules and her family. So I just said fine when she asked how Jules was, and went into my room.
I remember I turned on the radio and then I reorganized my history notes and rewrote all the due dates for my school assignments in a different organizer. I read the same paragraph in my history book four imes, and somehow I finished my homework. Then I went out and did the dishes. Around midnight, I started cleaning my room. That was good until an old scrapbook emerged from the bottom of my closet.
Jules and I had put it together in eighth grade, page after page of collages, using pictures and words from magazines, and even cutting out photos from the yearbook. I could remember doing it, right there in my room, giggling and cussing, trying out all our bad language and exercising our newly acquired slang. Our entire middle school experience was summed up; what we thought, who we liked, what we wanted to grow up to be, who we wanted to kill. I laughed until tears came out. When I finished, I sat holding it close to my body. I thought maybe I should be crying, but there didn't seem to be any tears available. Knowing I wouldn't be able to sleep, I tried to figure out something else to do. I couldn't, and my body was too tired anyway. Finally I made myself think about now, and I made myself say it out loud.
"Jules has cancer. My best friend, Jules, has cancer."
Then silence. I could almost see the word hanging in the air around my head. I conjured up whatever I thought I knew about it. It occurred to me then that I didn't really understand what it meant, not specifically in relation to Jules. Sandra had explained as much as she could, but she didn't really know, either.
Obviously then, the first thing would be to go to the library and read up on it. I would be able to tell how worried I should be or if I needed to be worried at all. Hey, Jules was young, strong, and a fighter. This could be over sooner than we thought. Maybe it was the kind of cancer you could get an operation for. So it would be a hard few months and then everything would be okay. We could get back to being normal. It didn't matter if we didn't dance or go on tour or do the concert. It didn't matter if stupid Jack stayed with The Freak forever.
The one important thing in the whole world was to have Jules be well. But how could she not be? She was my One and Only. We were together in this world, and nothing could change that, ever. Copyright ©1997 by Davida Lewis Hurwin. Published by Puffin, a division of Penguin Putnam Books for Young Readers. All rights reserved.