Fireflies - By David Morrell Page 0,26

veins.”

With so much good news, David didn’t pause to consider this hint about possible disaster. His son had a chance. That was all he cared about.

14

Bone marrow is the substance within bones that produces blood. If a patient has a resistant disease (leukemia, for example) that attacks the marrow, the treatment consists of extremely high doses of chemotherapy, accompanied by full-body radiation. The effect of this treatment is, in theory, full destruction of the disease within the marrow.

Nonetheless, without healthy marrow to produce healthy blood, the patient will die. So healthy marrow has to be inserted into the body. This procedure is accomplished by, first, finding a donor (usually a brother or a sister) whose marrow is compatible with the patient’s white blood cells. Marrow is then extracted from the donor and introduced into the patient. If everything works as it should, the donated marrow grows within the patient, produces healthy blood, and the patient is cured. Sometimes the patient’s body rejects the marrow, and the patient is given marrow from yet another compatible donor. If the patient continues to reject donated marrow, there’s no way to save that patient from the lethal effects of the massive chemotherapy. But more often than not, David learned, the treatment works.

The miraculous part of the procedure is that, while the marrow has to be extracted surgically from a donor, it’s introduced into the patient’s body through the simple means of pumping it through an IV tube. Because bone marrow, like a homing pigeon, somehow knows where to go. It enters a vein and flows toward its proper destination, the center of bones, where, marvel that it is, it feels at home and, God willing, multiplies.

A wonder of nature.

In Matthew’s case, his marrow was not diseased, so he needed no other donor than himself. The pint of marrow that had been surgically extracted from him was combined with a chemical preservative, placed in a plastic bag, flattened in a metal tray, and frozen much below zero in a liquid nitrogen container that resembled a conventional freezer. The advantage of being a self-donor, of returning his own marrow to his own body, was that Matt didn’t risk complications due to biological rejection of foreign marrow. What’s more, since his cancer was localized, he didn’t have to undergo full-body radiation as well as the chemotherapy. That was the good part.

But no matter if other-donated or self-donated, the marrow couldn’t enter the body until the blood-destroying treatment was completed.

And that was the bad part. When you receive what a physician calls “humongous” doses of chemotherapy, your blood becomes worthless. It has no platelets to enable it to clot if you’re injured and start to bleed. It has no white blood cells to combat infection. It has no red cells to carry oxygen.

You get the idea.

Each day, for seven days, as Matthew received intravenous chemotherapy, monumental, life-threatening doses of it, a nurse wrote numbers on a chart on the wall. These numbers were in columns and referred to the various vital aspects of his blood.

And each day the numbers went lower. A white-blood count of six thousand is wonderful, but David, Donna, and Sarie watched Matthew’s white-blood count descend to …

Zero.

That’s when a simple ingenious system gets scary. Someone with a slight case of the flu can contaminate a bone-marrow-transplant patient, and instead of giving the patient a mild stomach upset, the flu makes him very sick indeed. Because the patient has no white blood cells to attack the usually mild infection. Further, the bone-marrow physicians can’t assume that the patient’s fever and nausea are merely produced by the flu; to guard against other, potentially lethal infections, they might be forced to administer unnecessary extreme medications.

Before entering Matt’s room, David, Donna, and Sarie washed their hands thoroughly, then put on hospital gowns. They interrogated Matt’s visitors to make sure no one had been exposed to even a cold. “Wash your hands. Put on that gown.”

After seven excruciating days, and a day of rest that allowed the deadly chemicals to be purged from Matthew’s body, his bone marrow has unfrozen and returned to him.

Cause for joy.

But Matt was fifteen, past puberty, though the hospital classified anyone under sixteen as a child. The preservative in his bone marrow, which worked well on children but caused occasional allergic reactions in adults, sent his blood pressure soaring to one hundred and seventy. His head ached so severely he told David he feared his skull would burst. He convulsed. His breath (because of