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Medical Humanities

When Ella grows up…

Mala Talekar

She laid there in the hospital bed, her hazel eyes closed and her skin paler than the white sheet draping her body. There was a faint smile on her lips, and the soft glow of her angelic face seemed to light up the darkness of the curtained room. Her mane of long, golden brown hair rested on the pillow while a single curled strand played on her cheeks. Her mother stood up with Ella’s brown toy truck held firmly in her grasp as I walked in. “Are the results back?” her wet, anxious eyes asked. I nodded, “Ella has leukemia”. I paused, placed my hand on her shoulder as she sank back into the chair, tears flowing. Ella’s father looked away. I tried to follow his eyes, expecting contempt in them, hatred for the messenger. Yet all I saw was an empty stare.

As the sobs lulled, I began my practiced monologue of “how we pediatric oncologists have come a long way. How, we can now cure nearly 80% of all kids with cancer. Acute Lymphoblastic Leukemia, the most common childhood cancer – we can now cure 9 out of 10
  kids. This is what is going to happen next…” I went on…

Life is beautiful, they say

The sun shines and spreads light, everyday

Why do I see shadows then?

Who took my happiness away?

I was just at the beach

Passing my fingers through the sand

Staring at the horizon in her eyes

Silently humming to her lullabies

Why was this meant to be?

Why did it happen to me?

Life is beautiful, they say

How did it become all shades of gray?

“Why her?” was the only question she asked. “Why her?” I asked myself, while trying to comfort her. “I wish I knew...” I continued my scientific sermon, hoping that my jargon would drown the pain of her reality. 

And then, there was the pause again… I looked at Ella and felt my heart shift uncomfortably inside my chest. 

“I will be back to see you again.” I walked away, my head lowered and my heart crushed… I left her side to arrange for painful procedures and to write chemotherapy orders, feeling confident that infusing dangerous drugs into the delicate veins of this little four-year old was going to make her all better. All better…Ella was so strong….

"Why do kids have cancer, mumma?” my son asked me once; “You make them better, right?"

All better? 

And every couple of weeks, I do this again. Over and over. I am a Fellow in Pediatric Hematology-Oncology. It’s my job.

Really? Is this what it is? My job? To shatter the lives of a family and tear apart all the fragile strands that were holding them together? 

I am an eternal optimist. My glass is always half full, but my husband sees through it. He knows that it is half empty too. He asks me not to share my day’s work with him. We have two children and he is scared I will tell him that I diagnosed cancer in a six year old, or a 19 month old… the same age as our children. How do I tell him that I am scared too, that I have the same fears each and every day. Even when I am not sitting in front of a family, crushing their dreams. Even when I am just watching a cartoon on television with my kids on my lap.

I know the percentages and the inevitabilities, but I choose not to think about them. I choose to believe in a cure. I choose to fight. I choose to “kick cancer’s butt” as some of our patients like to say. I amuse my son by telling him how I used a new medicine to kill cancer cells in my lab. “Can I be a cancer doctor too mumma? When I grow up, I am going to kill all the cancer cells with my pirate sword!”

When I grow up….. 

I write chemotherapy orders with the complete faith that these dangerous drugs will seek out and kill all the cancer cells in Ella’s body. They will make her all better, so she can go back to playing with her brown truck in her backyard. Go back to giggling and screaming and driving her mother crazy. So that the breeze can gently rustle through her golden brown hair as she builds castles out of sand. So that her mom can once again appreciate the horizon in her daughter’s eyes. I write chemotherapy orders because Ella is strong, and life is worth living. 

I pray…

When I sit with the mother of a child with cancer, I say we can do this. The journey is long and full of obstacles, but we can do this. I treat patients. I read to keep up-to-date with novel therapies. I apply chemotherapy to plates of cells in a research lab, because we can still cure only eight out of ten kids with cancer, leaving two out of ten whom we cannot. We have five-year-survival rates. Five-year? And I thought life was made up of decades.

Cancer is bad. Period.

Everyday there is a breakthrough in a laboratory somewhere. One of those, I hope, will one day help us cure all ten out of ten kids with cancer. I dream, and smile.

Help me through this day

So I can make all fears go away

I can hold a hand

Please guide the way

I can whisper hope

And comfort the heart in pain

I can wipe a tear

Overcome my own fear.

I can lead through the dark tunnel

Together we will fight

This night will surely end

And together we’ll find light

I am a Fellow in Pediatric Hematology-Oncology. Curing children with cancer is my job. May I find strength in the smiles and giggles around me, and may I remember the good endings. Life is beautiful, they say. I choose to keep it this way.

The shadows will disappear

Happiness will be here to stay

Ella will grow up

We will find a way.

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