The Button Behind Her
by Brenna Manuel
“New City” by Suzana Stojanović
My fear is that my daughter won’t get her stem cells before Putin starts a nuclear war; she will be left here with nothing in her bone marrow. If she gets the transplant, we have two days at least after that. We could hope that she might make it with those cells from the nineteen year old, if she doesn’t get an infection. Even if we have to run out on to the street if a bomb blasts Boston, we would run with some chance. The odds of making it through the first month after transplant without the drip and drugs in the hospital are slim. Of course, the hospital would be one of the first on Putin’s list, here in a major city on the East Coast- a strategic hit. Last night, Putin said he was removing holds on his “nuclear deterrent,” whatever that means. I get the gist-he is throwing around the one word that terrifies the world and me.
So, I imagine, as I walk from the Boston House for Families in the crunchy snow, what I would say if I had a coffee with Putin. First, I would let him know that I am open to understanding his way of thinking, and I have respect for other cultures. The West is arrogant for bombing Baghdad and invading Afghanistan. Why should the West see this take-over in the Ukraine as any different from our own invasions? These people in the Ukraine are Slavic, and they sit at the Russian border-not half way across the world. Yes, Mr. Putin, I see why you feel slighted. I mean, the least we could do is to invite you to coffee, like normal, umm, human beings. So, isn’t that really all that you are asking for here- some casual banter or maybe a bit of warmth from the NATO allies?
I learned to negotiate this same way with the medical “Overall Survival” vs. my “Quality of Life” argument. Most of the doctors, including the one who gave us a second opinion, the former Head of Pediatric Leukemia, do not mention life happiness for Celeste. We both know that the “Q of L” is not represented fairly in the studies. It is “down the line” and subjective, and not a notch of success for researchers doing the studies. The focus is on OS, where seven months alive past a chemo treatment or transplant is a four star rating. If a patient has itchy skin over her entire body for the rest of life or has no babies, it is not as important as being alive for a certain amount of time, possibly just months more than with another drug in the previous study.
The syringe is empty, so the beeping starts. It won’t stop until I find the remote control. I avoid contact with objects that might contaminate Celeste, so I say, “Behind you.” She fumbles and grabs it behind her head on the mattress. She pushes the big “Nurse” button by feel.
Her stem cells arrive in a bag hanging off an I.V. pole. The nurses make a big hoopla and bring in a hand-made sign, “Happy Transplant,” and they tape it the bulletin board. I am thrilled too to see that 1,100 ml bag of blood cells, with its full array of red and white ones along with platelets for clotting. The teen donor produced at least three times the average volume of cells, so we are encouraged.
Celeste’s face puffs up right away, and she gets red ears and lips. Her eyes become glassy as she absorbs the cells into her blood stream. I am relieved that she has the cells in her before Putin attacks the U.S.
MSN News Reports Russian Forces Invade Mariupol
The next morning the dreaded pain and burning in her back, abdomen, throat, and head begin as the chemo. drugs, given during the last week, kill and suppress her immune cells, so that her body accepts the donor cells. She touches her head often, hoping she will keep a few downy hairs that had grown over the last three months during the immunotherapy from pre-transplant treatment. We are doing this transplant to prevent her leukemia from coming back. The doctors agree that a transplant is the only chance for survival from a relapse of acute lymphoblastic leukemia.
MSN News reports today that the Russians shelled the Chernobyl Nuclear
Power Plant.
All but one reactor has been turned off in preparation for the Russians
to take over the plant, but that one reactor could have a meltdown
if it doesn’t have electricity to cool it.
“So I get it now Vlad. The cities don’t really mean much. The nuclear capabilities in the Ukraine are what you worry about-they’re right next-door. That must be quite a source of anxiety for your people. I see how urgent it is for you to level things out, like balancing a teeter-totter. You know… this board on a… “ I make a triangle with my thumbs and pointer fingers. “The board goes up and down.” My flat hand moves in the air to show him. “The kids play on it,” I say. He nods.
Celeste has a fever. “We are starting some antibiotics, and we’re doing blood tests,” the nurse says. I look at her head and the blond hair pulled up into a knot at the top. She has the nurturing quality that is familiar now, even though her facial expression is covered by the mask and goggles. I have learned to accept the best intentions of others. She says she is giving Celeste a bolus of magnesium, so she will be on a heart monitor for a while. Magnesium is usually retrieved from ancient sea beds, like those in the Mediterranean. We use this up when our bodies are under physical or emotional stress. Is it possible that all of this illness is just because we don’t visit the seashore enough? Isn’t it old wisdom to send the sick to recuperate and revitalize on the beach with sun warming their skin and their lungs breathing the fresh air? I have thought of thousands of possible causes and remedies for leukemia during the last four years that this disease has occupied our lives. I store the information from personal observation and research articles in my head. I will one day spit out a ticker tape with all of the dots and connections in a final readout. We will all sigh, “It is so simple, and it has been right in front of our noses all along.”
Putin and Zalensky agree to a cease-fire, so that civilians can flee Mariupol,
however, this morning all the civilians run back to their covers because the
shelling is still going on.
“But Vlad, you do see that it is common that kids don’t want to be friends. I know that you offered to be friends with the US. You smiled at the summit because you meant, “Let’s be friends” and “Do you want to play?”
I notice more raw, rash-like skin underneath Celeste’s arms again this evening. I don’t say anything because she is about to fall asleep.
The big decision for today is the blockage in my daughter’s bowels. The doctors confirm constipation by doing an x-ray. It shows a mass centered in her colon that they say has to come out soon or it could contaminate her with e-coli. My remedy for this has always been to give her a few dried organic apricots, but this fruit is thin skinned, so it might be full of germs that she can’t fight off. The chemo treatments and the total body irradiation wiped out her immune system intentionally so that she would accept the stem cells and avoid graft versus host disease. We are fighting on so many fronts that it just seems like a game of catching the side effect before two more sprout up. When this transplant was first described to me I saw an endless list of assaults and damage on Celeste’s frail body; the non-functioning ovaries, the lung and heart weakening from the radiation, and the cataracts. I had no idea of the expanding list that we fight each day here. We have the constant fight to keep her ANCs, the infection fighting cells, high enough for her to live, but low enough to accept the donor cells. We are on a treadmill of fending off infections and fevers; Tylenol lowers the fever, but harms the liver. The intravenous feeding contributes to constipation, and the morphine stops the colon muscles from contracting properly. The antibiotics wipe out most of her intestinal flora, and the low bacteria diet prohibits her from eating most fresh vegetables like carrots, and cucumbers.
Two of her fluids bags are empty, so we have a persistent beeping in our ears. Celeste pushes the button for the nurse. She pushes the button again.
Brenna Manuel spent her childhood in the suburbs of Detroit. She later moved to the West Coast and received a B.F.A. in Painting at Western Washington University and then to New York for her M.F.A. in Sculpture at the City University. She lived as an artist and teacher in NYC for many years before moving to New Hampshire. She taught Humanities at Franklin Pierce University for sixteen years and now writes stories and poems in the rural New Hampshire countryside.
Suzana Stojanović, an artist and writer, studied literature at the Faculty of Philosophy of the University of Niš in Serbia. She is the author of the book “The structure and meaning of the border stories of Ilija Vukićević” and many literary, artistic and philosophical texts, short stories, satires, essays and poems. She is also the recipient of the 7th September award of the city of Vranje, public recognition for exceptional achievements in the category of education, and for the numerous prizes won in the field of art, musical and literary creativity. Her writing has appeared in “Cardinal Sins”, “Your Impossible Voice”, “Fiction International”, “Mount Hope”, and elsewhere. Also, her work has been nominated for the “Best Small Fictions 2023” anthology.
Website: https://www.suzanastojanovic.com