“The results of your bone marrow biopsy came back and they confirmed our fear that the leukemia is back.  I’m sorry bud.”

This was a huge blow to the three people present and an oppressive hush fell upon them.  Finally, a barely audible voice broke the silence, “Um, how long?”

“A few weeks, maybe a month; I’ve had a few guys make it a couple of months with a mild, oral chemotherapy we’ll put you on.”

He didn’t scream, burst into hysterics, or even sob.  He just sat on the exam table and stared at his feet dangling in his brown and grey Vans.  Without looking up he asked, “There’s nothing more?  What about infusing the last of the donor’s lymphocyte cells?”

“Unfortunately, it’s much more aggressive this time and the infusion won’t even make a dent in its progression.  There are no more options for a cure.  We can look into experimental treatments being researched in Europe.  It could give you a few more months…but you’d be in the hospital indefinitely.”

“He sniffled once and raised his head to meet the doctor’s gaze.  Calmly, and with an ever-so-slight grin on his face he replied, “Well, you guys did everything you could to help me beat this thing and I thank you for that.  I guess this just wasn’t my game.”

A little while later, after deciding quality of life won out over quantity, he sat across the hall in a private infusion room, cracking jokes with the staff as he signed his DNR order and discussed hospice care.  Once all the necessary paperwork was signed, a nurse accessed his Porta-cath for a series of transfusions.  He really didn’t want to waste any more time in the clinic, but he knew spending a few hours hooked up to the IV would buy him a few days of energized respite from agonizing fatigue.

He sat back in the familiar plastic recliner while plastic tubing pumped fluids into him for what would be the last time.  It seemed like everyone in the clinic stopped by to say hi (or goodbye), and he entertained them with his natural wit and charm.  The only evidence of his sadness was a text to his best friend Batman:

Dude, I got some bad news today…I’m in the clinic at the moment hence the text.  Don’t wanna talk on the phone with all these people around but I gotta tell someone other than Izzy. My AML came back with a vengeance.  My time is short…weeks to months.  Sorry to unload via text but I don’t wanna crack in front of strangers.

Within a few short hours of getting the heartbreaking news, his mother-in-law met the couple at the hospital, and they decided he would ride home with her to make plans for dinner while his wife took care of his meds.  While she embarked upon the great pharmacy-hunt to fill his numerous prescriptions of sizeable dosages, dinner plans proved to be much less complicated.  He quickly decided on pizza, figuring he’d take a risk and eat a greasy pie from the dive down the street he’d been craving for months.  As he called to place the carry-out order for a large extra pepperoni and cheese pizza, he embraced the reality that germs had now been replaced as his greatest mortal enemy.  Gone was the fear of the myriad dangerous pathogens that may or may not invade his system with potentially deadly results.  He knew his fate.  His calm demeanor and happiness over his upcoming meal indicated that he was either at peace with his new reality or in complete denial.

As they drove to pick up dinner, his mother-in-law was determined to focus on a positive but realistic approach with him over his imminent mortality.  Knowing he had spent the entire afternoon at the hospital discussing it, signing paperwork about it, etc., she didn’t dwell but knew she had to acknowledge the “white elephant in the room” somehow.  If there was any question about his state of acceptance (or lack thereof) about his terminal diagnosis, he definitely cleared it up when she asked how he was coping with his new reality.  With a calm repose, he replied simply, “All I have to do now is focus on making a few more awesome memories for Izzy with the time I have left.”