Wednesday, September 2nd, 2009 - 7:35 PM

I rinse out the rest of my beef stew from the bowl and put it in the dishwasher. Ann has listened to me cry tonight for things even I can't comprehend. She understands that it is hard to deal with all the unknowns of the situation. She understands that we'll probably never know anything about the recipient, how he lived, how he died. But she knows that there was no other choice to be made. We had an opportunity, a moment in time to do something for someone else. We can't even say whether it was successful or worth the effort. But, she says, we would do it exactly the same way next time. She is - as always - right.

The National Marrow Donor Program connects people willing to donate bone marrow or peripheral blood stem cells to people genetically identified as possible recipients. The success of their work is dependent on having a large database of potential donors in order to create the best matches for those in need. To learn more go to Marrow.org, or consider joining the registry.

Thursday, January 15th, 2009 - 12:30 PM

Today is the first day we'll be conducting an integrated sim with the Japanese simulator for the HTV mission. I've been preparing for this sim for about a year now and am totally living on adrenaline. As the adrenaline slowly wears off, I plan to transition to caffeine. The ten-hour sim doesn't start until 3:00, but I want to have plenty of time to get ready, to mentally prepare for a long night of what are sure to be some very stressful situations. My cell phone rings; an unknown number. It's a representative from the National Marrow Donor Program. They think they've found a match and would like me to come in for further testing. I agree, set up an appointment to go to the blood bank, and hang up. Added to the stress of the upcoming simulation, it feels like too much to process right now. I file it away for later, remembering the last two times I got this call and how it turned out to be nothing. Probably won't be anything this time either.

Saturday, February 28th, 2009 - 8:30 AM

Ryan and I stand among a crowd of thousands. Somehow I'd let him talk me into participating in a 5k run with him. Anyone who knows me at all knows that running isn't really my "thing." In much the same way that root canals aren't my "thing." Later I found out that the run was scheduled for the same day as my first round of shots. I complete the race in about 35 minutes, crossing the finish line with the theme song from Indiana Jones blaring through my iPod. After a short break I go back to my car, put on a clean shirt, and drive to the clinic.

Martha is already there waiting for me. I know what to expect but I'm not a huge fan of getting shots. Today I'll get two of them. After the blood draw. And let me tell you, those two shots hurt a lot more than those tiny little needles would lead you to believe. I have to sit with her for an hour after the shots to make sure I don't have an adverse reaction.

I go home feeling a little shaky and a lot tired, but I suspect that's mostly because of the 5k. Martha will come to my home every morning for the next three days, each time giving me two more injections of filgrastim. At the end of it all, I will have received a total of ten filgrastim shots. My only hope is that it might turn me into something cool, like Spider-Man. I will ultimately be disappointed as "achy" is not, apparently, a superpower.

Wednesday, March 4th, 2009 - 9:00 AM

I am, of all things, excited about a day off, especially on a Wednesday. The last couple of months at work have been very busy. I have two small children at home. The thought of sitting in a chair all day long reading books and watching movies is very appealing even if I have to have blood sucked out of my body by a large machine to get the day off. I have three DVDs in my bag (The Dark Knight, Madagascar 2, and Wanted), and I've even brought my brand-new Kindle.

My entire body is sore. The filgrastim injections I've received since Saturday have increased the amount of peripheral blood stem cells in my system, resulting in flu-like symptoms. Mostly I've just been tired and my back has ached. It's certainly not incapacitating, and nothing compared to what the recipient has been going through. But it gets old after a while, especially after the late-night simulation I had on Monday. Hot showers and ibuprofen help some, but I'm ready to have this stuff sucked out of my body so I can get back to normal.

Martha is there with the technicians. They expect the procedure to take about four hours based on my size and the number of stem cells the recipient requires. I tell them I've got at least six hours of movies so they can take as long as they need. The room is very clinical in appearance but then, it is a clinic. There are several couches and they show me to mine. Over the next fifteen minutes the technician inserts a needle into my left arm that draws the blood out and sends it through a centrifuge machine, separating out the layer of peripherical blood stem cells. Another line feeds into my right arm sending everything except the PBSCs back into my system.

Over the course of the day others come and go for treatment. A middle-aged woman is wheeled in next to me. She is clearly very sick, presumably with cancer, and is receiving chemotherapy. I think about the last time I sat this close to someone receiving chemotherapy treatment and hope her story ends as well.

I refrain from drinking very much. Once I'm hooked up to the machine there's no un-hooking so if I need to pee they draw a curtain around me and hand me a plastic bottle. Fortunately this is only necessary once over the course of the day. Admittedly the process is much simpler as a guy but handling all the equipment with one arm mostly incapacitated and the other completely immobilized takes a little more concentration than normal. Going through the process once is more than enough.

An LCD TV is mounted within easy viewing distance and the technician is happy to swap out movies as often as I want. The apheresis machine requires constant management by the technician and his company is appreciated.

We sit next to each other for seven hours.

Wednesday, March 4th, 2009 - 4:00 PM

The technician takes the tube out of my other arm. It has been a long seven hours. The stem cells were not as concentrated in my blood as they'd hoped and the apheresis took longer than expected. Physically, I feel better than I'd feared I might. I don't have the light-headedness I sometimes feel after a blood donation which makes sense since they put all the blood back in. Mostly I'm just tired of being in that chair and want to go home. And I'm relieved that my contribution to this process is effectively over. In some ways it feels a little anti-climactic - a lot of effort for a small bag of yellow fluid. Especially since that fluid is basically just the extra cells I had floating around. But he needs them. In a week or so he'll receive a massive dose of chemotherapy that will kill all of his bone marrow. The stem cells they just sucked out of my body will be injected into his. If the transplant works, his blood type will change from whatever it was before to mine, AB-positive. The stem cells will begin creating new, undiseased blood and his leukemia will disappear. If the transplant doesn't work, he'll be left without a way to make blood and will die within days. I can't think of a much better definition of "last-ditch effort."

Mid-April 2009

My phone rings and I find myself talking to Martha. It's been about six weeks since the procedure and I've eagerly awaited this call. No one has ever accused me of being an optimist. I tend to plan for the worst and hope for (but rarely expect) the best. Martha tells me that my recipient is doing well. The transplant appears to have been successful and he has recovered enough to go home. Other than that, the details are sparse. There's no prognosis, no talk of how much longer he might live. There's certainly no use of the word "cured." But under the circumstances this is the best news I could've expected. I picture a frail man being taken to his car in a wheelchair, pushed by his wife or maybe his grown son. He's still weak and tired all the time but there's a little hope for his future, a chance at a few more years. Maybe.

Wednesday, September 2nd, 2009 - 12:30 pm

My phone rings and I find myself talking to Martha again. I haven't spoken to her since I got the good news several months before. Her voice is as always cheerful, but she tells me that I might not be so happy once she tells me the news. My recipient has had a relapse and died. I'm stunned but not entirely surprised. He was in his sixties and the transplant is risky under even the best of circumstances, with about a one-in-three chance of being successful. But the last I'd heard was that he was doing well and had checked out of the clinic and gone home. I had assumed that his recovery was progressing and he was moving on with his life. Finding out that he'd died was an unexpected end to this journey. Martha asks if I want to stay on the registry. I reply that I do, update my information, and then hang up. I'm not really sure how to feel at this point, but there's work to do, so sorting this out will have to wait until later.

Wednesday, September 2nd, 2009 - 7:30 pm

Ann and I are sitting across the table from each other. I'm amazed at how little flavor food has when one has been crying for 20 minutes straight. She'd made a delicious beef stew several days before and we are having leftovers. Even after several shakes of Tabasco sauce, it tastes like warmed-up cardboard with extra carrots. I'm somewhat stunned at the intensity of my own reaction. People I don't know die all the time. I know nothing about him, not even his real name. I don't know where he lived, what he looked like, whether he had a family. I never met him. All I know is that he was in his sixties and that he died after his disease relapsed. And yet I am mourning his passing. I wonder if these extra four months gave him time to meet a new grandchild or to make it through another birthday. Or maybe he was just sick the whole time and the treatment prolonged the suffering. It's startling how much I am struggling over the what-ifs and unknowns, and I wonder if I'll ever know more than I do now.

Written sarcasm

Sarcastic speech is an art-form largely based on body language and tone, neither of which are effectively communicated in written text. Far too often a carefully crafted biting remark is completely lost on the reader. I recently heard someone suggest that we need a font to denote sarcasm. This idea is, of course, nothing new and certainly not my own, but I offer a different take on it. Therefore in my writing I will be instituting a new standard: squiggly brackets shall henceforth border a sarcastic remark. Besides, when was the last time you used brackets for any other purpose? Examples would be:

• I saw the report you wrote yesterday. {Good job.}
• Your dog puked on my sweater. {Thanks for that.}
• {I think Transformers 2 was a serious work of art.}