“You look sad, Jessica.”
The nurse’s statement intruded on Jessica’s dark thoughts. She sighed. “Do you realize that I see more of this machine than I do my friends and family?”
The nurse, Pat, pulled up a stool next to Jessica’s recliner. “I know how limiting this can be for a girl your age. Most people who come here are elderly or diabetic.”
The dialysis unit was a large room with about twenty recliners and dialysis machines. Nurses and social workers made their way down the aisles, visiting with patients, checking lines and medication flows, attending to those unable to leave the confines of the chair during the dialysis process. TV sets were suspended from the ceilings, and most people watched the afternoon soap operas and game shows. Jessica was the only person under the age of fifty, and she felt like a freak and a foreigner.
She turned toward Pat, being careful to keep her arm steady. “I still throw up after most sessions. And the headaches are awful. Dialysis isn’t making me feel as good as the doctors said it would.”
“Sometimes it takes a while to work out a balance.”
Dr. Witherspoon had changed mixes and medications several times already. Jessica took a fistful of prescription pills, plus vitamins, measured every morsel she ate, and still had problems. “Well, at least I’ve learned to knit. I’ve been knitting a ski cap that’s five feet long for Jeremy’s Christmas present and it’s only May. Imagine how long it’ll be by December twenty-fifth.”
Pat smiled. “A positive attitude really helps, you know.”
“Well, as they say around here—consider the alternative.” Jessica studied Pat, then asked, “Have you known many patients who got transplants?”
“Several. A few drop by now and again to say hello.”
Jessica had been thinking about transplantation more and more, and the idea both attracted and frightened her. While it would be wonderful to be free of the machine, it was scary to contemplate a life with the ever-present threat of rejection. She asked, “What if I did get a transplant, and then it rejected on me?”
“Then you’d go back on dialysis until we found you another kidney.”
Jessica couldn’t imagine getting to live like a regular person again, then having to return to dialysis. It seemed terribly cruel. How many chances would the doctors give her? How many kidneys would they allow her?
“So, how’s Jeremy?” Pat changed the subject. “Is he taking you to your prom? My daughter’s been looking for just the right dress for her prom for a month, and she’s not even been asked yet!”
Jessica was glad to shift her thoughts to her favorite topic—Jeremy. “No prom for me. I really don’t want to go.”
“But you’re a senior. You should go.”
“You sound like my mother. But I get the cold shivers when I think about having to find a dress that covers my arms, or picking a restaurant and having to think about every bite I put in my mouth, or getting sick right in the middle and having to rush home.”
“Where there’s a will, there’s a way.”
“No will, no way,” she confessed.
“Still, it’s only one night,” Pat said. “I’ll bet you could make it.”
“Proms aren’t simple little dances anymore. Around here they’re two-and three-day marathon parties. Kids move from party to party, even from city to city. One guy in our senior class has parents who own a horse farm, and he’s invited a third of the class there for picnicking and riding all weekend. Another friend’s father owns a boat, and she’s having a gang come for an overnighter on the Potomac.”
“Gee, what ever happened to simplicity?”
“It’s passé.” Jessica looked up to see Jeremy walking down the rows of recliners toward her. As always, her heartbeat accelerated. He meant so much to her, and she regretted that his life had changed because hers had. She wondered often why he hadn’t started looking for another girlfriend.
“Am I early?” he asked, dipping down to kiss her lightly on the lips.
“No, Boris and I are about through for the day.” She motioned toward the blue-and-white machine that shuttled her blood back and forth. “He’s made me squeaky clean again, and I don’t have to look at his smiling face for two whole days. That’s the best part about Fridays.” Her routine was to come every other day after school, with weekends off. Except on Mondays, when she arrived at six in the morning so that she could dialyze before school. But after a weekend away from dialysis, she was sick and puffy with water weight and built-up toxins.
Jeremy waited while Pat unhooked Jessica and bandaged her arm. “We’ll see you Monday morning,” he said to Pat when they were ready to leave.
Outside in the bright sunlight, Jessica sucked in the fresh air to drive out the medicine smell of the dialysis unit. Sometimes she felt as if the odor clung to her body permanently and no amount of bathing could wash it away. She drenched herself in cologne daily.
Jeremy pulled out of the parking lot and merged into the fast-moving traffic, heading toward her house. “You up to a movie tonight?”
“Maybe. I’m feeling a little lightheaded. All this clean blood, I guess.” She leaned her head against the seat, fighting down nausea.
Concerned, Jeremy glanced over at her. She looked pale, and his stomach constricted. He’d thought that dialysis would make her well again, but it hadn’t. She still had many days when she could barely function. She tried her best to hide it when she felt sick, but he could always tell when she was faking it. “You want to stop for a snack? Maybe you need to eat something.”
“Eating isn’t much fun anymore. Too many restrictions.”
“How about something to drink?”
“Same thing.” She had to measure every ounce of liquid. If she drank too much fluid, it built up, put pressure on her lungs and made it harder for her to breathe. “Look on the bright side. Since I don’t drink much fluid, I don’t go to the bathroom very often.” She patted his hand. “Now isn’t that a bonus? No more waiting on me while I go to the ladies’ room at the movies or the mall.”
“I’d wait for you outside a bathroom for three days if you could be well again.”
She felt a headache beginning to build, leaned her head against his shoulder and mumbled, “If only.”
At her house, Jessica’s mother insisted that she lay down until suppertime. She helped Jessica up the staircase while Jeremy stood at the bottom and watched helplessly. He would have traded places with her if he could.
“Stay for dinner,” Jessica called down to him from the top of the stairs. “After supper, if I feel better, I’d like to go to that movie with you.”
Her mother added, “Yes, please stay, Jeremy. Go on in the kitchen. I’ll be there as soon as I get Jessie settled in.”
He wanted to stay. He wanted to be with Jessica. His father was working late and that morning his mother had driven up to New York for a couple of days on business. Going home and being alone didn’t appeal to him at all. He went into the roomy kitchen and settled on a bar stool at the counter.
The kitchen island was piled with scrubbed vegetables and the makings of a salad. Roasting meat and freshly baked bread smelled delicious and made his stomach growl. On one wall there was an elaborate chart detailing the foods and their nutritional content along with the levels of calories, protein, sodium, potassium, calcium and phosphorus that a kidney patient could eat. Next to the chart was a memo board with a special pen where Jessica’s mother planned out every meal, factoring in the amounts of each nutrient Jessica had to have in exact proportions. It looked complicated and reminded him again of the difficult course her life had taken.
Ruth McMillan breezed into the kitchen. “She’s resting, but she made me promise to wake her in an hour.” Her brow furrowed. “She wants you to be here when she gets up. Can you stay?”
“I can stay.”
Ruth looked preoccupied.
Jeremy said, “I thought dialysis would make her better.”
“She is better.”
“But she’s not as better as I figured she’d be.”
Ruth looked up from her work with the food, her eyes dark with concern. Jeremy’s heart thudded, then accelerated its pace. “What’s wrong, Mrs. McMillan? I know something’s wrong.”
Her gaze flitted away, but he could tell she wanted to tell him what was on her mind. “You’re right—Jessica isn’t doing as well as she should be. She isn’t doing very well at all.”
Chapter
5
“How do you mean?” Jeremy pushed off the stool and walked around the island to face her.
“According to her latest blood work, her blood urea nitrogen, or BUN, level is still too high, and when dialysis brings it down, she gets nauseous and throws up. Even though I make sure she eats right, her BUN won’t cooperate.”
His mind worked rapidly, sorting through what Ruth was telling him. BUN tests measured the level of waste products in Jessica’s bloodstream. “Are you saying that dialysis isn’t helping her?”
“Oh, it’s helping. It’s just not helping enough.” She looked into Jeremy’s eyes again. “She is sticking to her diet, isn’t she? I mean, at school and all. Have you seen her cheat by eating something she shouldn’t?”
Even if he had, he wouldn’t have told on Jessica, but he could honestly say, “I’ve never seen her cheat.”
“Dr. Witherspoon’s concerned. He wants us to think seriously about a transplant.”
Jeremy froze. “That’s heavy.”
Ruth shook her head. “Her father and I are scared about it, but I think Jessica wants one.”
Jessica hadn’t spoken to him about it, and that hurt his feelings. He’d thought they talked about everything. “Wouldn’t a transplant make her well?” He longed for her to be free of the dialysis machine.
“If a new kidney takes, she’ll be much better off. No more dialysis. But a lifetime of antirejection drugs. Still, the trade-off seems to be worth it.”
Jeremy thought so too. He knew how much Jessica hated the machine and the way it limited and controlled her life. “There are other kinds of dialysis,” he said. “I’ve read about the kind they do through a tube in the abdomen.” The idea made him shudder, but he didn’t let on to Jessica’s mother. “And it can be done at home.”
“Yes, peritoneal dialysis. But she’d have to wear a bag under her clothes filled with the dialysis fluid.”
“That sounds grim.”
“It would be. But her doctor doesn’t feel she’s a candidate for that kind of dialysis. Of course, we can try it and get her a home dialysis unit so she can dialyze during the night. But that doesn’t seem like much of a solution to me either.”
“Which brings us back to a transplant.”
“Yes. Aside from it being major surgery, there are thousands of people waiting for kidney transplants. There just aren’t enough donor organs to go around.”
His hopes for Jessica plummeted. “Then why would he bring it up?”
“Because he thinks it’s her best hope. She’s a young girl with her whole life ahead of her. She wants to go to college and have a career. A transplant now would give her a chance at a more normal life.”
He weighed the information, seeing it as a complicated problem worthy of his most dedicated study. “Where can she get a kidney?”
“Of course there are cadaver kidneys—donated from dead people—but Dr. Witherspoon says she’s not a candidate for one of those. Something to do with antibodies already built up in her system.” She waved her hand. “I don’t pretend to understand it all. Anyway, he told us that the best transplant donors are live related ones. Like members of a person’s own family. Her father and I would gladly give her one of our kidneys.” She glanced around the kitchen as if someone might be listening in. “We don’t want Jessica to know it yet, but the doctor is running an antigen match on us.”
“What’s an antigen match?”
“The closer the tissues match, the better the chance that the organ won’t be rejected. If an identical twin gives a kidney to his or her sibling, the match is ideal.”
“But Jessica’s not a twin. And she hasn’t got any brothers or sisters.”
“True. Her closest blood relative is a cousin, my sister’s son, but he’s grown and married with a family of his own to take care of. We can’t ask him to volunteer.” She shook her head. “I just hope one of us is a good match for her.”
Jeremy considered what she’d told him as she hurried to turn off the oven timer, which had begun to buzz loudly. He imagined Jessica back to a regular life with a transplanted kidney. If it happened soon enough, she might be able to start college in the fall as she’d originally planned. A transplant would put this nightmare behind all of them. Jessie would have her life back, and he would have his Jessie back. It made sense to him that a transplant was the way to go.
He glanced up at the kitchen clock. “It’s been about an hour since Jessie lay down.”
“Maybe I should let her sleep.”
“She wouldn’t like it. You know how she hates to feel babied.”
Ruth sighed. “Oh, all right.”
“Can I go up and wake her?”
Ruth smiled. “She’d appreciate seeing your face more than mine, I guess.”
He grinned, then left the kitchen, bounded up the staircase and down the hall to Jessica’s room. He knocked lightly, then eased open the door. The shades over the windows were pulled, darkening the room. Gauzy, flowing curtains pooled on the carpeted floor.
He thought Jessica’s bedroom reflected her perfectly. It was feminine and pretty, scented like summer flowers and fresh spring rain, softened with colors of May—lavender and white peppered with daffodil yellow. There were bookcases, a table with two white wicker chairs and a Queen Anne—style desk that held a computer. The incongruity of technology and romanticism sitting side by side made him smile. He couldn’t imagine this room filled with a dialysis machine and bags of fluid, and smelling of medicine.
Jessica lay on her bed, her hair spilling across her pillow. He stared down at her, caressing her with his gaze. She looked pale, yet beautiful. Her thick, dark lashes almost brushed her cheeks. He wanted to kiss her rosebud-shaped mouth.
Jeremy dropped to his knees beside her bed and tenderly stroked her forehead. She made a sound, but didn’t wake. Unable to resist, he leaned forward and ever so softly pressed his lips to hers. Then he laid his cheek on the pillow, close to her face, until their noses were almost touching.
Her eyes opened slowly, focusing on his face. She smiled. “Hi.”
“Hi, princess.”
“Are you my Prince Charming waking me from the spell of some wicked witch?”
“Fooled you. I’m really a frog in disguise.”
She touched his cheek. “Some frog.”
He wanted to crawl beneath the covers with her, hold her body against his and never let her go. “Have I told you today that I love you?”
“I can’t remember. Better tell me again.”
“I love you.”
Her eyes, large and the color of blue sky, studied him seriously. “Even though I’m broken?”
He reared back. “You’re not broken. You’ve got a health problem. But it doesn’t change who you are. And it doesn’t change the way I feel about you.”
She propped her back against the headboard. Her hair was disheveled, and she still wore the pale pink sweater from that afternoon. He thought she looked delectable. Like cotton candy. He sat on the edge of the bed and took her hands in his. “I’ve been talking to your mother. She says you’ve been thinking about a kidney transplant. Why didn’t you say something to me about it?”
“I was going to. I’ve been reading up on it.” She turned toward the window. In spite of the shade’s being drawn, she gave the impression that she was looking at the tree outside her window. “Kidneys are living things. If I ever get one, I’ll take very good care of it.”
“You should get one. You deserve one.”
She
cupped the side of his face in her hand. “I’m one of thousands needing a kidney. I have type O blood—the most common kind. That puts me even farther down on the transplant list because there are so many people with O blood type—rarer blood types often get higher priority than us garden-variety types.”
“You’re not garden-variety.”
She shushed him with a glance. “And I haven’t been on dialysis very long either, which is another disadvantage. Those who’ve been on the longest and who have the greatest need get first consideration.”
He saw the complexity of the issue. “But your mother said that if you have a live related donor, you wouldn’t have to go on the donor waiting list.”
Jessica shook her head. “I don’t have many relatives. I know that my parents want to be considered as potential donors because I saw them look at each other when Dr. Witherspoon was discussing it, but even if they’re a match, they’ve both had serious health problems.”
“So?”
“So, they’re ineligible.”
Her statement caught him up short. “Your mother doesn’t think so.”
“She doesn’t know yet.” Jessica gestured toward her desk, where pamphlets and books lay open. “Did you know that a kidney from a sixty-year-old transplanted into a twenty-year-old ceases to age? It’s true. Why, it can function for years and years.” Her expression clouded. “Provided it doesn’t reject, that is.”
“Are you afraid if you got one it would reject?”
She nodded. “I’ve had bad dreams about it. I see myself running in a field and just when I think I’m free, I notice this long plastic tube attached to my side. I wake up in a cold sweat, terrified I’ll never be rid of the machine.”
He took her in his arms, wishing he could chase away her demon fears. “If you reject, you reject. They’ll find you another kidney.”
Keep Me in Your Heart Page 3
