by Jan Karon
“I’m diabetic,” he said. “Type Two.”
“You’re managing it?”
“Yes. Pretty well.”
“Most likely not a problem. Generally, there’s nothing life-threatening in the donation of stem cells if you’re in reasonably good shape. We’d give you a thorough donor workup and do blood and lab work, of course. What we’ll need, bottom line, is an identical match of blood types. Without that, we go nowhere.”
“I hear you drill into the bone, then siphon the marrow with a syringe.” There it was; that’s what he’d been skittish about.
“That’s for a biopsy. We wouldn’t take actual marrow from you, only blood. The older method is to remove bone marrow from the donor and transplant it to the recipient. Now we use a procedure called apheresis, which centrifugates the blood—spins it, actually, so the heavier particles, the red cells, fall to the bottom, and the lighter particles form a very thin layer on top—a layer of white blood cells including the stem cells—the gold, the cream. We siphon off the white layer, and that’s the infusion we give to the recipient.”
“What are the chances of an identical match?”
“With full brothers, the chance is only one in four. With half brothers, the chances are slim. Very slim. Maybe five percent.”
“But worth moving ahead?”
“No question. To put it plainly, you’re all we’ve got. If you find you’re willing to do it, I can fast-track it. We could start doing blood work first thing Monday morning; we’ll go from there, see what we have.
“If everything looks good, we’d get Henry up to Memphis and start the chemo immediately. Then we’d start mobilizing your white blood cells with a shot a day for five days. If it looks like we’re getting what we need, we’d do your apheresis.”
He and Cynthia looked at each other. The centrifugation had already begun—his head was spinning.
“Apheresis,” said Cynthia. “Is that what you said?”
“Yes.”
“Is it painful? Risky in any way?”
“Neither. The donor loses some red blood cells in the process, but only a few, and they’re rapidly replenished. Apheresis is actually a pretty comfortable procedure. We insert a catheter in each arm—it’s double-barreled to spin more blood, faster—and put the donor in a recliner for five or six hours. If you need it, we could give you a mild anesthesia, but that’s rarely needed. Meanwhile, your family comes to visit, you read the newspaper, watch TV—there are worse ways to spend a few hours. We could have you on the road the following day.”
“When would the infusion happen?”
“The same day. Soon after the apheresis.”
Jack Sutton leaned forward. “I don’t know if you can spare the time, Father, but between you and me, Henry doesn’t have any time to spare.”
The little boy under the house—as Henry talked, he’d been under there with him, both of them searching for their father.
Cynthia appeared skeptical. “From the donor’s standpoint, it sounds too good to be true.”
“The suffering,” said Jack Sutton, “is done by the recipient.”
“Tell us about that,” he said.
“During the five days we’re mobilizing your stem cells, Henry would receive chemo—perhaps even radiation therapy. He could have a high level of nausea and a good bit of vomiting. Plus myalgias, diarrhea, shaking chills—not to mention a terrific physical exhaustion.
“Later, there’s always the risk of kidney or liver failure. I’m sorry to sound grim, but these are the facts.
“The point of the chemo, of course, is to do away with his immune system. We handcuff it, you might say, so the chemo can create space in his own bone marrow for your stem cells. Once your cells start circulating in Henry’s system, we’re on our way. Then we pray for them to engraft.”
He realized he would want to be there as his cells flowed into the life stream of another human soul.
“Can anyone other than your team be in the room with him?”
“When we suppress his immune system, he’ll have no way to fight infection, so we’ll have to isolate him. The air in the room is filtered, and anyone who goes in wears gloves and a mask. He could have some visitation, yes, but limited and monitored. It’s a delicate piece of business all around.”
“The engrafting—how long does it take?”
“Ten to fourteen days.”
“If all goes well, how much time before he can go home?”
“If he tolerates the transplant and his blood counts return, roughly four weeks.”
Why was he hesitating? The issue was closed.
“Without your help,” said Jack Sutton, “he’ll always need chemo. When he grows resistant to it, as he inevitably will, the cancer cells will increase. I’d give him a year, maybe less.”
“And with my help?”
“If you’re a match, if your cells engraft in his marrow, it’s very possible that he could lead a normal life.”
“Consider it done,” he said.
They were walking through the foyer after leaving Sutton’s office, where he’d felt dim-witted, trapped in a dream. As Cynthia stepped into a patch of light from the windows, something sharp and new suddenly awakened in him.
He took her hand and pulled her to him. “You dazzle me,” he said.
“Long time, no see, darling.”
She folded her arms around his neck and touched his nose with hers. “Dooley has a surprise for you.”
“You’re all the surprise I need.” He took her face in his hands and kissed her.
Home wasn’t Holly Springs; home wasn’t Mitford. Home was his wife.
TWENTY-SIX
“We’ve got it all worked out, Dad.”
He and Cynthia and Dooley sat in the hotel dining room with his surprise. Lace Harper was a great beauty, no doubt about it. He looked at the two of them, his red-haired son and this extraordinary young woman who had earned her early education from the bookmobile. Merely to gaze upon this pair moved him deeply.
“Are you completely in favor of Dooley’s scheme?” he asked Lace.
“Yes, sir. Completely. I slept for twelve hours last night.”
“It might have been longer,” said Cynthia, “but I snored and woke her up.”
“Fourteen hours for me,” said Dooley. “I’m good to go. We’ll finish lunch and head back with Barnabas; that’ll put us at Meadowgate by eleven tonight. Which means I can help Hal castrate steers at High Ridge Farm in the morning.”
“That’s something to hurry back for, all right.”
Dooley grinned. “You got to do it all.”
“I like your plan. Barnabas is always happy at Meadowgate. How’s the pool table working out?”
“Great. Thanks for letting us put it in the living room.”
“You have Cynthia’s generosity to thank for that.”
“Lace shot a game, she was pretty good.”
He liked looking at Lace and Dooley, who were looking at each other. “When we get home to Mitford, we’ll all shoot pool ’til the cows come home. I’ll bring barbecue.”
“Chopped,” said Dooley.
“Sliced,” said Lace.
“Both,” said his wife. “I love barbecue.”
He dug out his wallet and handed over a bill. Dooley Kavanagh was worth big money since the inheritance from Miss Sadie, but it felt good to give his son a few bucks.
“You don’t have to.”
“I know. Get yourself a nice dinner, no fast food. There’s a great Mexican place the other side of Knoxville. You can practice your Spanish.”
“Muchas gracias, Papito. And at one o’clock”—Dooley glanced at his watch—“hasta la vista.”
“I wondered,” he said, “why you had to think twice about picking me up at the dealership.”
“I knew Barn would take up most of the cab, and we couldn’t all fit on the front seat. So we decided to save the surprise ’til after the doctor’s visit.”
“You can surpr
ise me anytime with Lace Harper. Seeing you two together is a profound blessing.”
“We love you both,” said Cynthia, “and want the best for you in everything.”
Dooley took Lace’s hand. It was the most open display of affection he’d ever seen Dooley make toward the girl who once slammed him in the ribs for swiping her hat.
“I promise to pray for you and Henry,” said Lace. “I think it’s wonderful you have a brother.”
Lace had a brother with the character traits of her malevolent father; there had been no contact in years. “You’ll like him; he has fine sensibilities—and he writes poetry. Are you still writing?”
“Yes. But mostly just letters to Dooley.” Her cheeks colored.
“Love each other,” he said. “Whatever you decide to do with your lives, love each other.
“Loving can be hard. Sometimes we don’t feel loving, but it isn’t all about feeling. Very often it’s about will. Practice that if you can.” He thought he may have said too much, but he looked into their eyes, and knew he had not.
Under the hotel canopy, he prayed for their safe travel and gave the Old Gentleman a good scratch behind the ears. Watching the red truck pull away, he felt oddly bereft. His dog had been his right arm, his confessor, his soul mate on this trip.
Cynthia looked at him and smiled. “My turn now,” she said, reading his mind.
They lay in bed on Sunday morning, watching the slow illumination of the sheers at the window.
“First light,” he said. He’d read that Thomas Jefferson arose at first light, never deigning to wait until sunrise.
“I love first light.”
“The ducks,” he mused. The Peabody was famous for its twice-daily march of mallards from the elevator to the fountain in the lobby. “We must see the ducks.”
“Absolutely. I love ducks.”
He rolled onto his side and looked at her lying next to him. “What don’t you love, Kavanagh?”
“Road food, magazine ink that comes off on my skirt, and lovers who can’t find the courage to love.”
“We’ll be married eight years in September, and you’re still ticked with me for taking so long to make up my mind.”
Her smile was ironic. “No use crying over spilled milk. But it does help me understand their relationship. Dooley hasn’t an ounce of your blood in his veins, yet his approach to love is very like yours.”
“Fear, you mean?”
“Yes.”
“With both parents abandoning him, why shouldn’t he be fearful?”
“I didn’t say he shouldn’t be, I mean that he simply is. Just as you were. You were abandoned, too—by your father, by Peggy.”
“And you, by your parents and then Elliott. So how did you know how to love in spite of that?”
“Perhaps because I had nothing to protect, nothing to lose by loving. You had your life as a bachelor to protect. It was a good life, you said, and I saw you living it and knew that it was good and deep and true. And of course you had your congregation to protect—after God, they came first, as they would with any shepherd worth his crust.
“But I didn’t need to protect my calling, I find it improves with loving. And my heart—yes, it was broken as a child and then by Elliott, but God had healed it, and I knew it could never be truly broken again. So, if I had any fear when I found I was in love with you, it was only the fear of not measuring up to all you’d been protecting.”
He never knew which way to step when they talked about these things. He lifted her hand and kissed it. “All we can do is watch and wait.”
“What you said to them yesterday was perfect.”
“It was you who taught me that.”
She plumped the pillow and propped herself up on her elbows. “We could have breakfast in bed.”
Seventy years old and still blushing at the thought of a waiter serving him breakfast in bed. “That would be great,” he said, trying to mean it.
“Life is so full of the unknown, Timothy. Wouldn’t it be lovely if we could absolutely count on Henry to grow strong and keep writing poetry and raising collards and beets?”
“Speaking of which.” He threw the covers back and went to the closet and dug around in his duffel bag. He’d been eager to read it soon after Henry gave it to him, but the notion had escaped his befuddled mind.
“Look,” he said, climbing back in bed. “It’s one of Henry’s poems. He wrote it while Peggy was praying about how to contact me and what to say. He says she often sits with the Bible open on her knees while she recites the text from memory.”
“Read to us,” she said.
He unfolded the handwritten pages and scanned the words; a chill ran along his spine. His brother’s poetry.
By the open window
in April afternoon light,
my mother’s brown head—
bald as a river rock
beneath the scarred cross—
bends over pages worn slick
by the oil of years.
Dignified and solemn,
the supplications of the Prophet
assemble themselves in
the hall of her memory.
She closes her eyes and
summons them forth; they
speak with power and might.
Bless the Lord O my soul
and all that is within me
bless His holy name.
O Lord, I will praise Thee;
though You were angry with me,
Your anger was turned away,
and You comforted me.
God and God alone is my salvation;
I will trust and not be afraid:
for the Lord God Jehovah
is my strength and my song.
Stirred by a breeze from the garden,
the white curtain drifts onto her shoulder
like a mantle of snow.
Shadows quicken in darkened corners;
light trembles in the mirror of the floor.
Mighty God Jehovah,
blessed Lord Jesus,
I aks you—
let these old ears hear
a word behind me saying,
This is the way, Peggy, walk you in it.
There comes a scent
as of wash dried on the line
and hurried inside before
a summer storm.
I am at home in the long silence.
Then the old prophet speaks:
The Lord has written the letter.
She closes the Book
and sits small as a child
on the hardback chair.
I go to her
and kiss the graven cross
on the dome
of her brown head
and say, Amen, Mama,
and amen.
Somewhere an early church bell pealed.
He dropped the pages onto the blanket and took Cynthia’s hand. They sat for a long time, their eyes closed, as the morning light increased.
TWENTY-SEVEN
Since his lab work and Henry’s admission to the hospital, time had been one long siege, with few markers to distinguish the days.
That his blood had proved an identical match was “miraculous,” according to Jack Sutton. But when he gave the news to Peggy by phone, she wasn’t surprised or incredulous—it was, she said, the news she’d been expecting.
Masked and gloved and fervent in prayer, he visited Henry each morning and again in the early evening. Afterward, he had a walk and then dinner with Cynthia. Now allowed to drink, she had lost no time in renting a car and amusing herself at the library, a museum, and the bookstores. On Wednesday, Sutton initiated the series of shots that would mobilize his bone marrow to produce more cells. The days seemed vague as shadows, though punctuated by unexpected moments of clarity, and a heightened awareness of breathing, thinking, living.
His body felt the wallop of the shots. His bones ached as with flu; he maintained a low-grade fever and ate sparingly. He wanted onl
y to be at his post in the recliner, getting the thing done. Henry Winchester was fighting for his life while Tim Kavanagh merely proffered his arm for a daily needle.
Sutton’s comments on Henry’s reaction to the chemo were mixed. “I’ve seen worse,” he said. “But not much worse.”
To hear the laundry list of side effects expected during Henry’s chemo had been one thing; watching him suffer the effects was another. The chills were racking, and the nausea so severe that he, Timothy, unsnapped his tab collar and twice used the toilet for his own heaving. He begged God to give him a portion of the agony, then realized this petition had been fulfilled. Blood answered to blood—on some incalculable level of his being, there was an agony quite his own—it was an excruciating sense of helplessness in the face of suffering.
When he had left his father’s bedside, he had in a sense let him go. Unless God Himself ordained it, he would not let Henry go.
He alerted his bishop to the need for petitions throughout the diocese.
“I’ll tell you everything later. Right now, pray for Henry Winchester to accept a stem cell transplant and live a normal life. Henry Winchester, yes. Pray as if he were your brother.”
He called Lord’s Chapel in Mitford and talked with Father Talbot’s version of Emma Newland.
“Get the word out,” he said, “that someone close to me is in a struggle for his life. His name is Henry Winchester. Write his name down, please. Call the churches in town, especially Bill Sprouse at First Baptist, and thanks.”
He rang his friends at Whitecap Island, then called the young curate serving Holy Trinity on the high ridge beyond Mitford.
“Especially ask Agnes and Clarence for prayer; devote time on Sunday to special petitions. Many thanks. And the preacher down at Green Valley Baptist—ask him, too, if you would; he’s a prayerful fellow. Winchester, yes. Henry. Someone important to me. Please.”
He was marshaling troops, he was calling up regiments; this was war.
TWENTY-EIGHT
His wife smoked him over, eyeing first the back of his head, then the front. “It isn’t exactly your John the Baptist look.”
“Good. Great.”
