The Ties That Bind

by Lexi Landsman

  ‘Sounds like you have a special relationship.’

  ‘We did,’ Adam paused and Jade detected the telltale signs of loss that she knew so well. ‘He died when I was twenty-two. Mesothelioma. Asbestos cancer. A lot of firefighters from his time got it. They didn’t know the dangers of asbestos back then.’

  ‘I’m so sorry,’ Jade said. ‘There are so many dangers that come with your job. And I guess not all of them are as plainly visible as fire.’

  ‘Most people think that fighting fires is all we do, but there’s a lot more to our job. We deal with all emergency situations. Road accidents, floods, terrorist incidents, spillages of dangerous substances, rail crashes, rescuing trapped animals and people. That,’ he said, gesturing to the boundary of the fires in the distance, where the forest went from green to black, ‘was different. I don’t think I’ll ever get over what I saw that day. No amount of training can prepare you for that.’

  He went silent and then quickly shrugged off the sombre mood. ‘So, basically what I went a roundabout way of saying is that if you ever can’t sleep, I’m always up.’ He smiled softly. They emerged through the thicket of trees to a cottage that was painted midnight green. ‘That’s where you can find me,’ he said pointing. ‘That’s Riley’s place.’

  They walked a little further and then followed a walking track with an undergrowth of ferns and still-thick bracken up to the waterfall, which had always been a popular tourist lookout. They sat on the grass with a view of the mountain range as the sun was setting.

  They sat for hours and talked about their lives, until the sun faded, until the sky was as black as the trees below them. Jade took in the smell of the eucalyptus, the sound of Adam’s voice and the current of his breath. She lost track of time. She had a deep yearning to touch his skin, to know what his lips felt like against her own.

  As night fell it started to get cooler and they were both in short sleeves. She tried to keep her body from trembling. ‘You’re cold,’ he said. He rubbed her shoulders and down her arms, and the feeling of his hands on her skin made her heart flutter. ‘Do you want to go back?’

  ‘No, I’m okay,’ she said. There was nowhere else she wanted to be except for right there, with him, as the night closed in around them. He kept an arm around her and she leaned against his body, taking in the way he smelled of pinecones and hay, of smoke and summer.

  She looked up at him, their eyes meeting, and a pulse ran through her unlike anything she had felt before. Then his lips were over hers, soft and hypnotic.

  It started to rain and they ignored the drops that fell over them. The rain would dampen the earth. It would put out the smaller fires still burning across the countryside. It would signal starting over.

  What began as a drizzle quickly became torrential and soon their clothes were drenched and they couldn’t ignore it. Reluctantly, they pulled apart. ‘I’ll walk you home,’ he offered.

  Home is not a place I know anymore, Jade thought. And yet she followed him as if he could take her there.

  20

  IF NIGHTMARES could manifest into reality they would look like Doctor Anderson’s office. So normal, so neat, so orderly you wouldn’t believe that this room harboured news that had thrown their perfect world into turmoil just forty-eight hours earlier.

  Sitting through the rest of Matthew’s game that day had been excruciating. But they had forced smiles when all they both wanted to do was cry. Matthew had come off the pitch beaming. He’d told them it was the best day of his life. They had both looked down, afraid to meet his eyes in case he saw a bitter truth: it was actually the worst day of his life – he just didn’t know it yet.

  Courtney rested her hands on Doctor Anderson’s mahogany desk, feeling the soft wood beneath her palms. David was oddly still and so composed that it made her feel even edgier. She reached for his hand, his touch momentarily calming her before he pulled it back at the sound of footsteps.

  ‘David, Courtney,’ Doctor Anderson said, his lips upturned so slightly that it was hard to discern if he was smiling or frowning. ‘Sorry I kept you waiting,’ he said, sitting down.

  He pulled out Matthew’s file and flicked through the biopsy results. Courtney eyed his every movement, which to her felt like a slow and agonising prolongment of what was to come. She noticed two framed photos on his desk – one of who she assumed were his three adult children, and the other of two grandchildren. He closed the manila folder, crossed his arms and looked at Courtney and David for a moment, as if gathering the courage to speak.

  ‘I am sorry to have given you his results over the weekend, but I didn’t want you to go through the pain of waiting for longer than necessary,’ Doctor Anderson said. ‘I wanted to see you first thing this morning so we can go through his treatment options.’

  And yet still, at the back of Courtney’s mind, denial remained firm. The diagnosis was a mistake.

  ‘As I told David, the results confirm that your son has acute lymphoblastic leukaemia.’

  Hearing him say the diagnosis aloud made Courtney’s head throb. All weekend she had been in a numb state of shock. She looked down at her trembling hands, the pain in her heart like an open wound.

  No one spoke. David and Courtney stared at Doctor Anderson, waiting for him to say, ‘But everything will be okay … But he will be fine … But actually this is all a mistake.’

  Except no ‘but’ came, only silence and a crushing reality. ‘What does that mean?’ Courtney managed to utter.

  The doctor stretched his fingers, and she noticed how short his nails were, as if they had been chewed off. ‘Acute lymphoblastic leukaemia – ALL – is a cancer of the bone marrow and blood that progresses rapidly if not treated. It’s characterised by an overproduction of immature white blood cells called lymphoblasts, or leukaemic blasts. These are leukaemia cells. As they increase, they crowd out the bone marrow, preventing it from making healthy white blood cells, red blood cells, and platelets. This leads to infection, anaemia, and easy bleeding. Due to their immaturity, these cells are unable to function properly to prevent or fight infection. Leukaemia cells usually invade the blood fairly quickly. They can then spread to other parts of the body, including the lymph nodes, liver, spleen and central nervous system.’

  Courtney looked at David, who was as still as before, except his eyes wouldn’t meet hers. ‘David?’ she said, hoping he would register her question without her having to articulate it. But his gaze remained fixed on the doctor.

  ‘It’s the most common form of childhood leukaemia,’ Doctor Anderson continued. ‘The good news is most children are cured of the disease after treatment. He’ll have to begin chemotherapy as soon as possible, in three phases. The first phase is called induction, which kills the leukaemia cells and aims to put him into remission. In the next phase, called consolidation, the treatment wipes out any remaining cells that could begin to grow and cause the leukaemia to return, to relapse. And after that, the final phase is maintenance to destroy any remaining cancer cells that might have survived the first two phases.’

  He was going too quickly. Courtney was staring at him, dumbfounded, until she realised she was crying.

  The doctor spoke gently now, his eyes softening. ‘Just taking a step back,’ he said, ‘the goal of induction chemotherapy is to achieve remission. This means that leukaemia cells are no longer found in bone-marrow samples, so the blood count returns to normal. He’ll have to stay in hospital for up to six weeks during this phase of treatment. An interventional radiologist will insert a central line under the skin of his chest into a vein close to the heart …’

  ‘But he’s a small boy. Won’t it hurt?’ Courtney asked.

  Doctor Anderson’s shoulders dropped as if he could feel the weight of the fear she held for her son, and he leaned forward, resting his elbows on the desk. She noticed the deep frown lines on his forehead, markings of the harsh toll of his job. ‘It will be put in under a general aesthetic and after a few days, he won’t even know it’s there. It
will stay in for the duration of his treatment. It allows us to administer medications, fluids or blood products or to withdraw blood samples for cell counts and chemical tests.’

  But I will, Courtney thought. I’ll see it and know that my son is hurting.

  ‘More than ninety-five per cent of children with ALL enter remission after one month of treatment,’ he said, his tone optimistic. ‘However, if blast cells are still evident after the first course of induction therapy, we give a second course of the same chemotherapy.’

  Courtney was focusing on the first part of his sentence, ignoring the second. ‘Ninety-five per cent. So, that’s good, right?’

  The doctor ran his hand over the bristles of his beard. ‘If he had normal ALL, that would be the case. Except remission is not necessarily a cure.’ He paused as if carefully choosing his next words. ‘And unfortunately the biopsy has shown that Matthew has high-risk ALL.’

  ‘High risk?’ David asked.

  ‘There are several sub-types of ALL. And Matthew has one of the rarer forms.’

  Courtney looked perplexed. ‘So, what does that mean?’

  ‘I know this is a lot to take in, so I’ll try to simplify it as best I can. With most cases of ALL, as I mentioned, we treat patients in the three phases: induction, consolidation and maintenance therapy. If a patient then relapses, they go through chemo again until they achieve remission. To prevent a second relapse, we advise on stem-cell transplantation from a matched donor. In Matthew’s case, it would be best to try to find a stem-cell match immediately so we can do stem-cell therapy in his initial remission to prevent the chance of relapse.’

  Courtney had heard the words stem-cell therapy thrown around, but she had never really understood what it was or how it worked.

  ‘Do you have any other children? Because there is a one in four chance a sibling will be a perfect match.’

  There it was – the question Courtney always dreaded being asked.

  ‘No, we don’t,’ David said quickly.

  ‘I see,’ the doctor said. ‘In that case, I’ll arrange for you to meet with the clinical nurse specialist – Belinda Symonds. Belinda will coordinate all of Matthew’s appointments and tests within the multidisciplinary team that will be responsible for his treatment. That includes myself, a haematologist, the bone-marrow transplant team, physical therapists, a dietician, psychologist and so forth. Belinda will arrange for Matthew to have a blood sample collected, which will tell us his HLA type. This is much more complex than matching blood types. Your immune system uses HLA markers to differentiate between your cells and someone else’s, so it’s crucial to have a close match for a successful transplant.’

  Courtney reached for David’s hand as the doctor continued. ‘His information will be sent to the Bone Marrow Donors Worldwide registry, which has millions of people listed. If Matthew has a common HLA type, it will hopefully return at least one match. But if he has inherited a rare HLA type from either of you, the search can be a lot more challenging.’

  Courtney felt nauseated. ‘What about us?’ she asked. ‘Can we be a match?’

  ‘Since half of a child’s HLA markers are inherited from each parent, you and David are both half-identical matches to Matthew. A half-matched transplant is referred to as haplo-identical, but is still an experimental treatment. We would only consider it if all other avenues are exhausted.’

  Courtney gripped David’s hand tighter, struggling to accept the fact that they couldn’t be a perfect match for their son. The doctor registered the sudden fear in her face and he continued calmly and delicately with warmth in his eyes. ‘I know that must make you feel very disempowered, but try not to get despondent. It’s important that you stay positive for Matthew’s sake. Until a match is found, we follow the course of chemotherapy and do everything else possible.’

  Courtney looked at David for reassurance but his expression was unreadable.

  ‘What happens if a match isn’t found when he’s in remission?’ David asked.

  ‘Well, if Matthew relapses, and there is a strong chance he will, and a match hasn’t been found by that stage, he’ll have to go through the process again and hopefully we’ll achieve another remission, which will buy us more time to keep looking for a donor.’

  ‘What about our extended family?’

  ‘Depending on his tissue-typing results, we might recommend that they be tested.’

  ‘But it’s possible?’ Courtney asked.

  ‘Yes, it’s possible.’ He was measuring his words.

  ‘Right, then,’ Courtney said, her voice full of determination. ‘How soon can we meet with Belinda?’

  21

  THE ONLY boyfriend who had ever come close to making Jade believe in any sort of thing like love was her high school sweetheart, Flynn Kramer. She had started dating Flynn when she was sixteen and he was two years her senior. He’d pick her up from school in his beat-up Volvo, the seats of which he had duct-taped down so they didn’t fly up over every pothole. He’d play Michael Jackson songs on repeat and cruise through their small town with the windows down and the music up, pretending he was a city slicker in a fancy car. He wasn’t particularly handsome. His teeth were crooked, his beard grew in patches and he couldn’t seem to tame his thick black mop of hair, but he made Jade laugh and she was smitten.

  They dated for nearly three years, and in that time Jade started to believe that couples could make each other happy, that they didn’t have to exist in the silence that rang through her house. She had even started to daydream about what their life together would be like: a big family, a sprawling farm that overlooked the mountain range, long road trips together around the country.

  Instead, Flynn showed up at her house unannounced early one morning and told her that he was leaving Somerset that day. He wanted to experience life outside their sheltered town, and instead of asking her to come with him, he kissed her cheek, told her he loved her and then drove off.

  Jade still remembered the pain she felt in her chest as she watched his old Volvo drive off, spraying dirt at her feet as a final insult. She received the odd letter from him after that but all it reinforced in her was that in relationships, someone always got left behind.

  And now, here was Adam, who had come into her life unexpectedly and with such intensity that she couldn’t suppress the feelings that rose up in her. For the first time since Flynn, she had that same niggling in her chest, the same sense of possibility, the same yearning to be close. Except for one burning caveat: Adam would, in seven days, leave Somerset to go back to Melbourne.

  Instinctively, Jade’s guard came up. She couldn’t bear to be hurt again, yet she found herself thinking of him in every free moment. Like now, as she walked to the Reids’ property on her street, she was thinking of the way his lips felt, the smell of his skin, how he tasted of ginger beer and cinnamon, the way his gaze warmed her skin.

  It was the day after heavy rainfall and Jade wanted to do something to remember her neighbours, Fred and Jane Reid, who had been among those who lost their lives in the fires.

  A garden bed at the back of the Reids’ property was still in reasonable shape so Jade asked permission from Samantha and Jake Reid, their two adult children, if she could plant daffodil bulbs in their parents’ memory. She had no idea that her simple act would inspire others. Soon, however, word spread, with other residents wanting to be involved, and so Samantha and Jake decided to donate that part of their land to the community for a permanent memorial. They called it the Somerset Garden of Memory, in honour of everyone who had perished in Somerset.

  A few days later, Jade organised for people to gather at the garden, and together they planted thousands of bulbs. It was an uplifting feeling, seeing her town come together with spades and shovels in hand, eager to do something to remember the people they had lost. There was laughter, reminiscing and a few tears shed, but mostly there was a sense of positivity in the symbolic gesture of remembrance, and hope for starting over.

  When the l
ast people left the new garden, Jade stepped back and admired what they had created. By spring, the garden would be in full bloom. Its colours would claim back the land, covering over the destruction.

  As the sun was setting, Jade started gathering the gardening tools when she heard a car pull up into the driveway. It was Adam.

  He got out of the car and, without saying a word, he put his hand around her waist and kissed her lips. ‘Wow,’ he said when he looked up to see hundreds of hand spades and empty bulb packets lying next to the freshly turned soil of the garden bed. ‘You did this in one day?’

  ‘We all did.’ Jade wiped a line of dried mud from her cheek.

  ‘You’re missing one thing.’ Adam walked back to his car and pulled something from the boot.

  ‘Here,’ he said and placed a potted young olive tree at her feet. ‘Someone told me that olive trees have a way of bouncing back.’

  22

  SOMETIMES patients have an ailment for so long they don’t even realise there is anything wrong with them. It becomes their version of normal. And usually when David delivered their diagnosis, followed by a treatment plan, they were overwhelmed with relief. Many patients hugged him, sometimes squeezing so hard they almost knocked the breath out of him. Some told him it felt like they’d had a curtain over their eyes that was finally being removed. And now that was how David felt, except without the relief that usually followed. His vision suddenly had clarity. Matthew’s bruises seemed more poignant, their shifting tones sharper, the outlines more defined. His pants seemed to hang lower on his hips and his knees seemed bonier. But his face, with its youthful innocence, remained unchanged.

  David just couldn’t accept his son’s diagnosis. He would oscillate between convincing himself Doctor Anderson had muddled up their son’s results, and moments of sheer gut-wrenching terror. Things were going to happen fast. Matthew would start chemotherapy in just under a week. In the meantime, they had to keep him at home doing as little as possible. And with a ten-year-old who had no idea he was sick, that alone was going to be hard. Already he had questioned why his parents hadn’t seemed excited at the end of the game. Why they hadn’t stayed longer to chat to the coach. All Matthew could talk about was the match and when the scout might call.