Chapter One
Phoenix, Arizona
David Parks glanced from one anxious, worried face to another - a rather staggering number of family members, seven in all, who were crammed into his office - and thought anew that this had to be the very worst part of his often trying job as a pediatric oncologist. He’d known, of course, how emotionally challenging and even heartbreaking his specialized field of medicine would be, had been cautioned and counseled by other such specialists during his years in medical school and as an intern, but had made the decision anyway to work with young cancer patients. And while there had been far too many gut-wrenching moments in his two decades plus career thus far, there had also been countless times when he’d celebrated with a child’s family when that child had gone into remission or even been pronounced totally cancer-free. On this particular afternoon in late April, however, the news he had to share with the family of Hannah Brockmeyer - one of his favorite patients - was unfortunately not something to celebrate.
David directed his words to Hannah’s parents - Neil and Laura - even though he was all too aware of the intimidating presence of Hannah’s maternal grandfather close by. Barton Gilmore was a prominent businessman in Phoenix, plus a generous donor to this hospital, and, as such, thought nothing of throwing his weight around and demanding answers to his questions. But no amount of money or threats or demands could change the news David had to impart at this moment.
“As you’ve all undoubtedly noticed,” he began gently, “Hannah hasn’t been responding very well at all to this most recent round of chemo. In fact, her latest scans show that her leukemia is worsening instead of improving. Her white cell count is higher than it’s been in months, and if the new medication she started a few days ago doesn’t bring her count down soon, I’m going to recommend hospitalization so she isn’t at risk for an infection.”
David kept his gaze directed towards Hannah’s parents, noting how the often fragile Laura paled and looked about ready to faint at his announcement, while Neil kept a stoic expression on his face and squeezed his wife’s hand in support. Barton, meanwhile, had a thunderous look about him and most likely would have started issuing demands and threats if his youngest - and most level-headed - son Jackson hadn’t given a quick shake of his head. Barton glared briefly at his son before directing that same icy stare at David instead.
Neil cleared his throat, visibly choosing his words carefully so as not to further upset his wife. “So if the chemo isn’t working, Doctor Parks, what do we do next? Another transfusion, perhaps? Or a new medication, maybe some sort of clinical trial?”
David hesitated, knowing full well the impact his next words would have on the group assembled in his office, and belatedly wished yet again that he’d set his foot down from the very beginning about dealing solely with Hannah’s parents about her case. He had thought it a bit odd that not only her grandparents but all three of her uncles, and on occasion her two aunts by marriage, had wanted to be present for the various appointments and consultations. At first, David had just put it down to the extended family wanting to lend their support to Neil and Laura, and figured that as time went on it would be just Hannah’s parents in attendance. But he’d been mistaken when it came to predicting how deep the Gilmore family loyalties ran, and even more than two years after Hannah’s initial diagnosis, there were always at least four to five family members present at each appointment. David suspected that Barton’s influence and ironclad will was the real reason his sons and daughters-in-law showed up so frequently, and that the patriarch of the family wasn’t used to being defied by any of his children.
Relatively early on in the case, David had actually tried to insist he would only deal with Hannah’s parents from that point on, and that the rest of the family could not attend the various appointments. He’d been told, however, in no uncertain terms by the board who ran this hospital that he would be expected to extend every courtesy, indulge every whim, and go above and beyond for just about anything the Gilmore family asked of him. Not only had Barton made several very large donations to the hospital over the years but he had many prominent friends and contacts in the state, counting present and former governors, senators, and congressional representatives as close personal friends.
David had grudgingly gone along with the board’s demands, even during those times - too many to count - when Barton had tried his patience. It was only for Hannah’s sake that he hadn’t asked to be removed from her case, since he genuinely liked and cared for the sweet-tempered fourteen year old.
“No, Neil,” replied David firmly but compassionately. “I’m sorry to say that we’re more or less out of options at this point. Nothing we’ve done over the past two and a half years has cured Hannah’s leukemia - chemo, radiation, medication, or any of the other treatments we’ve tried. Hers unfortunately is an extremely aggressive and stubborn case, and is especially resistant to all the usual therapies. We’ve tried absolutely everything we can. Except, as you all know, the bone marrow transplant, which has its own particular set of complications.”
All seven members of Hannah’s family gathered around were very well aware of the frustrating set of circumstances that had thus far prevented her from receiving a much needed bone marrow transplant - a procedure that David and every other specialist in his field he’d consulted felt sure would be the one to save Hannah’s life. The major obstacle to this solution was that Hannah’s type of HLA, or Human Leukocyte Antigens, had thus far proven to be nearly impossible to match with a potential donor’s. Every single family member on both Neil’s and Laura’s side had been tested, but no one was considered a close enough match. Neil’s mother Eileen, Hannah’s fraternal grandmother, had been the closest match but still not close enough to take the chance that Hannah wouldn’t reject the transplant and thereby place her already tenuous health at even greater risk. The potential side effects of a rejected bone marrow transplant included a very serious infection and quite possibly death, risks that David or any other specialist would dare not take except as a very last, desperate resort.
Besides family members, the Gilmores had appealed to their wide circle of friends and all of their employees to be tested, but no one had been a match. The hospital was constantly checking the donor registry for a match but continued to come up empty. The possibility of ever finding a compatible donor was growing slimmer with each passing day, just like Hannah continued to weaken and worsen a little more, bringing her that much closer to running out of time.
“I think,” David ventured hesitantly, “that all of you should start preparing yourselves for the very real possibility that it might be time to let go. The realization, impossible as it might sound, that Hannah might not be with us for much longer. She’s getting a little weaker, a little sicker each day, and I’m not sure how much more she can take at this point. I’m so sorry to have to tell you this, you’ve all been totally devoted to Hannah from the very beginning of her illness, but quite frankly there’s very little left we can do for her at this point, except to keep her comfortable and make sure her last weeks are pain free.”