Chương 35: Robin's Trap

"Just tell me." Una turned the key in the ignition. The Falcon started with a cough. She turned to Robin, red-eyed.

"I will tell you if you want, but I only know a little. It would be better to wait to speak with Dr. Suarez. She can explain everything."

"How long have you known?" Robin demanded. Her face gave everything away. It wasn't just a cold. This wasn't just a check-up. Una paused.

"Since Friday. Dr. Suarez called me while the power was out. You were still at the game."

"Why didn't you tell me?" Robin's voice was hot. The rising sun caught her eyes. They were wet. Una swallowed so hard the cords of her neck rose.

"I wanted you to have a fun weekend with your friends and not worry about it." Robin put it all together. Una hadn't kept it from him; she'd carried it. It hurt for no good reason. Robin didn't want Una to be right. He needed someone to be the villain. He wanted to shout and curse at someone who deserved it. Instead, he was stuck in the Falcon with Una. The only person he'd ever been able to depend on. It was a long, silent ride to Bernalillo County Medical Center.

Una drove past the visitor lot and pulled into the one for patients. She killed the engine.

"Robin, I'm sorry."

"You were right. It was the best weekend I can remember. I wish it never ended." Robin could wish all he wanted, but it was still Monday. Half the cars in the lot were covered in dust, untouched since the storm. Inside the Oncology Wing, everything was too bright and too clean. The Lysol smell in the waiting room couldn't quite cover whatever they'd cleaned up recently. Una had the chessboard, but neither of them had the heart to begin a game. The waiting hurt. Finally, a nurse came to take Robin for his vitals.

They checked him over and drew blood. He peed in a cup like he'd done a hundred times before. Robin assumed they'd send him back to Una afterward. Instead, the nurse brought him to Dr. Suarez's door and rapped twice on the frosted glass. The figure behind the desk didn't move. Robin couldn't make out a face to see if Dr. Suarez was dreading this, or if she was just busy. The shadow rose and approached the door. Robin had a dumb urge to run away.

"Good morning, Robin. Please come in." Dr. Suarez smiled, but it was strained.

"Just me?" Robin asked. There were two empty chairs in front of her desk. Where was Una? She'd been there for the first diagnosis. Dr. Suarez nodded.

"This conversation works a little better if it's just doctor and patient. If you want, you're welcome to have your grandmother present. She's going to join us a little later in any case. It's your choice."

"Okay." Robin went along with her. Adults always told him he could choose, as soon as they'd explained it was crazy to do anything but what they wanted him to. Dr. Suarez probably thought it would be easier to get through this without Una sobbing and talking to God. He sat down and felt like he'd walked into a trap. The office was spotless. To Robin's right, Dr. Suarez's diplomas and awards were all perfectly aligned. Her desk was sparse and neat. No wonder Una liked her so much.

To his left was the wall with all the patients who'd made it. Most of the photos were outside and everyone was smiling. Their hair had grown back and no one looked like a vampire. A few of the pictures were double frames. The left side showed the patient after recovery. The right showed them all grown up. One held a diploma, another was at the altar. Dr. Suarez had been practicing for a long time. Robin stared. Dr. Suarez didn't interrupt.

There was something in the way the grown-up patients smiled that was different from ordinary people. The joy was deeper. They'd come so close to losing everything. There was a shadow too, something he recognized. They could never forget; it could all be taken away. Robin's photo wasn't there. Not yet. He'd asked Dr. Suarez about the pictures as he was preparing for discharge. She had explained she didn't put patients up until they'd been in remission for one year. She'd said she could not wait to see him there.

"Robin, I have some bad news." Not yet. Not ever.

"I know."

"Tell me about that. What do you know? What are you feeling?"

"My head has been hurting a lot since the last aspiration. Aspirin helps a little. I've been very tired and achy. My appetite is all right, but last night, I brushed my teeth and my gums were bleeding. I was hoping it was just a cold but I suppose it's back, huh?"

"Yes, I'm afraid it is. Your last aspiration showed an elevated count. Now, we're finding myeloid blasts instead of lymphoid ones. Your cancer has changed. We call this a 'lineage shift'. Do you want to see a diagram?"

"Yes, please." The diagram had two circles side by side, like bowls of cereal. NORMAL BLOOD looked like a bowl of Corn Pops. The cells were regular, mostly round. The LEUKEMIA BLOOD diagram was more like Lucky Charms, but they weren't lucky at all. The ugly-looking 'marshmallows' were the myeloid blasts. Those were in his veins, tearing him apart from the inside.

"Do you see these purple lines? These inclusions are called Auer rods. Lymphoid blasts never have these."

"Are those bad?"

"Possibly. They don't appear in healthy cells, but some research suggests they can mean a slightly more favorable prognosis. I want to caution you: our understanding of this disease is incomplete. We're finding out things and making new discoveries all the time. Our current options to treat acute myeloid leukemia are very challenging. Are you ready to talk about what this diagnosis means for you?" Robin shook his head, no. He knew he would have to find out anyway.

"Um. Do you have any more diagrams?" Robin asked.

"It's easier if I can see."

"Yes, of course." Dr. Suarez showed him photographs of his slides, where the blasts darkened when stained with Sudan Black B. She showed him charts and explained each. The pounding feeling in his ears faded. The data helped him feel like this was happening to someone else.

"How did it morph from one kind to another?"

"We don't know for certain. This kind of shift is very rare, and children usually don't get AML. It's possible that you had both types of cancer at the beginning, and that the myeloid cells didn't fully express themselves until the chemotherapy wiped out the lymphoid cells. A history of cancer in your family is a factor. There's also a chance that the drugs we used in the first round of treatment caused the cancer to mutate."

"Did the chemo do this to me?"

"It's impossible to say at this stage. It's a risk factor we consider when we create a treatment plan. Leukemia is very difficult to treat. These are your body's own cells. Just like healthy cells, they have the ability to adapt to fight off things that attack them. They can become resistant to drugs. They can hide in the spine. Your first round of treatment was what we thought would give you the best chance to recover."

"But it didn't work. It was all for nothing." Robin shut his eyes and lowered his head. He was afraid he was about to start bawling. Dr. Suarez's voice grew sharp.

"It was very much for something. Acute Lymphoid Leukemia is a very aggressive cancer. It is absolutely fatal if untreated. We caught your case very late. I have lost patients your age in just weeks. The only reason we can have this conversation is because you got treatment immediately and you worked very hard to complete it. You won that battle, but there is another one ahead. A harder one." Robin didn't like where this was going. His breath came in jabs. Dr. Suarez gave him space to settle.

She must have done this so many times.

"Robin, would you like me to ask your grandmother to join us?" He wanted to be brave and face this like a man. But, he couldn't take it. He nodded and shuddered. Dr. Suarez called for a nurse to bring Una in.

"You're doing fine. You can take as much time as you would like. Being sick isn't your fault and it doesn't change who you are. You are not alone. Your grandmother cares so much about you." The words meant to reassure him skipped off the surface. Una came in and sat down with a grimace. She put her hand over his. The older women exchanged pleasantries; he didn't even hear them. Silence filled the room. They were both looking at him.

"Is it okay if I talk about treatment now?" Robin couldn't say no again with Una here. He nodded.

"AML is a much more serious diagnosis. Unfortunately, we need to do another round of chemotherapy."

"No. You're joking," Robin protested. During the first treatment, they'd warned him it was a possibility. He'd worried about it for weeks. Everything about this meeting was leading there. The moment came and he still couldn't believe it. Unauthorized duplication: this narrative has been taken without consent. Report sightings.

"Lo siento (I'm sorry)," Dr. Suarez said. Something broke. He couldn't be brave anymore." No quiero! No puedo! (I won't, I can't!)." Robin panicked. Una's hand pressed harder on his. How could they do this to him?

"Robin, it's all right." Una had a hitch in her voice.

"It was so bad, Tita. I can't do that again."

"It's the only way you can get better," Una said.

"I can't. I can't!"

"You can and you will. You are Robin Martillo. You're stronger than you know." Robin felt so small, crying in front of two grown women. Dr. Suarez handed him a tissue to blow his nose.

"Will it be the same as last time?" Robin asked.

"I'll be honest with you: it will be much harder. This is a much more serious form of cancer. You'll be on a continuous infusion of cytarabine for seven days. For the first three days you'll get daunorubicin. After seven days, you'll be in isolation. This is a very critical period where the risk of infection is high. We'll do a marrow check at day fourteen. At around day twenty-one, your blood count should start to recover. At twenty-eight days, we will check to see if you're in remission."

"When do I get to go home?" Robin asked.

"If your numbers are good at twenty-eight days, we can release you. Sometimes, it takes a little longer. When you do go home, you'll have to isolate again, just like the first treatment. An infection can send you right back to the hospital."

"For how long?"

"At least three or four weeks." It felt like she'd said he would lose three or four fingers. Robin would miss so much of the campaign. There was a huge weekend of gaming planned for the weekend when school let out. The Adventures game had just begun. Everyone would move on, and he'd be left behind. Robin squeezed his eyes tight.

"It's so hard already. I can't do more," Robin pleaded. Hot tears ran down his cheeks.

"You can. It won't be that bad," Una promised. Robin looked to Dr. Suarez, hoping she would agree. She didn't. * It was so bad. Dr. Suarez had warned Una, but she still wasn't prepared. They spoke privately while Robin went to get cleaned up. Very carefully, Dr. Suarez avoided talking about odds in front of Robin. Una wasn't spared. Now, she wore a paper gown and a surgical mask. Her hands stank of Betadine. The nurse had watched her scrub and put on gloves. The chessboard and the pieces were swabbed with alcohol.

It wasn't the most dangerous phase yet, but they weren't taking chances. The nurse instructed Una to make Robin's moves for him. They needed him to stay very still during treatment. The room was small, but Robin seemed smaller still, propped in the adult-sized bed with the side rails up. He wore a yellow paper gown. The IV stand towered over him, silver branches hung with poison fruit. There were four 1000 ml cytarabine bags. The pump wheezed twenty-four hours a day. This noisy machine would haunt Robin all week.

His right arm was strapped to a board to ensure he couldn't fidget. There was a little television on a swinging arm, but the screen was cold and gray.

"The TV's broken," Robin told her. Todo está quebrado (Everything is), Una thought.

"I'll ask them about it," she promised. She set up the chessboard, hoping to get Robin's mind off what was next. The devil was on his way.

"I don't feel like playing, Tita. I can't even move the pieces."

"That's fine. I'm tired of winning anyway." She flipped to a new page in his Diario and wrote down Una vs Robin.

"E4," Una said. She thought he wouldn't reply.

"E5." The spark was still there. They played that way for a while. Una was surprised when Robin opted for Petrov's Defense, and then went for the Stafford Gambit. He had been reading. The boy learned so fast. She would need to start studying too, if she didn't want to get surpassed. Though she couldn't remember the line well, Una accepted the gambit. She took the pawn and tried to hold on. After she castled, his queen flew up the board. Three pieces converged on poor little f2. Now she had a problem.

As Una wondered what to do, someone rapped on the glass. Their eyes flew to the door. It was the infusion nurse. The heart monitor beeped faster. Robin watched the new IV stand as if she was wheeling in a bomb. Under the fluorescent lights, the daunorubicin glowed cherry-red. The devil had arrived. Above her mask, the nurse had a hard face that fit her task. No one was ever happy to see her. It almost seemed a joke: who would put that vile-looking stuff into a child? The nurse was very serious.

She warned Robin that he must be very, very still. Daunorubicin was caustic and would melt his skin if the needle got ripped out. She told them the nausea could be bad, even with drugs to help. Robin looked afraid. For the next hour, the devil would reign. Una placed her hand over his. He squeezed it back. At the nurse's urging, Una returned to her chair and the treatment began. The infusion nurse sat beside Robin and pushed the needle. She checked regularly for blood return. The nausea hit almost immediately.

Robin's eyes rolled upward with suffering. Earlier that morning, he had an EKG to make sure his heart was strong enough to take the jolt. When she envisioned this, Una had assumed she would be strong enough. She'd been with Hector as he died and with Lucinda as she went through withdrawal. Somehow, it was so much harder to watch her grandson suffer. His face was like Saint Erasmus on the windlass. Again and again, she silently recited the Anima Christi.

SOUL of Christ, sanctify me Body of Christ, save me Blood of Christ, inebriate me Water from the side of Christ, wash me Passion of Christ, strengthen me O good Jesus, hear me Within Thy wounds, hide me Separated from Thee let me never be From the malignant enemy, defend me At the hour of death, call me To come to Thee, bid me That I may praise Thee in the company of Thy Saints for all eternity. Amen.

When the ordeal was through, the nurse delicately withdrew the needle and wheeled the stand with the withered bag away. Somehow, there were two more days of this. Una sat with Robin and watched him shrink away. The chess game was forgotten. He stared into space without blinking. She fought the urge to close his eyes for him. They'd warned Una this might happen, but she was still worried. She hit the call button. A new nurse arrived and checked the machines.

"That happens," he explained.

"Some people faint. Let me check his pulse." He did so. As he looked over Robin's charts, Una thought she saw him flinch.

"Let's give him twenty minutes. We'll call a doctor if he doesn't come around." The nurse had a calm voice, but Una's heart raced anyway. She must have looked at the clock a hundred times. In the end, the nurse was right. Robin came around and looked about the room as if he were caught in a fog." Un hueco en el mundo (A hole in the world)," Robin breathed. His voice was very small." ¿Estás bien? (Are you all right?)" Una gripped his arm.

"No tan bien (Not so good)," Robin admitted. He was in great pain. Still, Una was overcome with relief. Even this was better than if he was too hurt to talk. His eyes focused back on the board.

"Did you find it?" Robin asked. His voice was distant and dreamy. Una knocked over her king. It was mate in three.

"Well played," she said, since they couldn't shake. Grace in defeat.

"You're not letting me win, are you?" Robin worried.

"Never," Una promised.

"I shouldn't have taken the pawn." Robin closed his eyes with a thin smile that faded too quickly. Una packed the game away and tried to pray, but it brought no relief. Time dripped slowly while the machine wheezed and the heart monitor beeped. Finally, the nurse swept in and checked everything again.

"Ten more minutes," he assured them. When he left, Robin's eyes slid open.

"Tita… this is so bad. I can't…," Robin trailed off.

"It will get easier," Una lied. Robin looked right through her. The nurse returned and helped Robin from the bed into a wheelchair. The cytarabine stand came with them, puffing away on its battery. Una followed, but the nurse walked too quickly for her. A huff of discontent made him slow to her pace, but just a few steps later, he forgot. Una hobbled after him with hot bolts of pain arcing from her hip. She didn't want to let Robin out of her sight. At the elevator, the young man realized what he'd done.

"Sorry, ma'am. I have a lot of patients to get to."

"It's fine." Una clenched her teeth so nothing unkind could escape. It had been an awful day. Robin's room was drab and sad, but at least it was his own. They had warned Una that fruits and flowers were not allowed.

"Tita, is your hip all right?" Robin asked." De nada." She waved his worry away.

"A month." Robin pressed his head back against the pillow and wallowed.

"It will pass." Hidden in her pocket was a little brown paper bag. The surprise had gone through the nurses' gauntlet too, Una wouldn't dream of smuggling anything in. They'd swabbed everything with alcohol.

"I got you something," Una whispered. She passed him the bag. Robin's eyes flew open. He fumbled at the paper. His right arm wouldn't work quite right. She knew better than to offer to help. It was a toy soldier. A pewter wizard was inside a plastic bubble backed by cardstock. The colors had run a bit from the alcohol, but the contents were safe. Beneath the Lords of Rapaxoris logo, bold gothic letters proclaimed the little pewter wizard was Abaxios Oslune - The Reconciler. Robin's mouth was open.

"How did you know? I was saving up for this!"

"Duncan told me you need a new general and this one is a good fit for your army."

"Thank you!"

"Luckily, I kept a bit of bingo money aside. He gave me a good deal. Ese muchacho es un pan de Dios (That boy is a good seed). There's more: on Sundays, Duncan says he'll call you up and let you know how the games went. He says everyone loves your characters and he wants you to help him write the campaign. You can still be a part of the game, even if you can't play it for a while."

"I'd like that." Robin almost choked up.

"We are all rooting for you. All you have to do is listen to your nurse and Dr. Suarez. Do what they say and have faith. He will heal you. Soon, it will be like none of this ever happened. You just have to believe." Una searched for some sign her words had gotten through. Even in this dire hour, Robin only nodded along, humoring her. The boy had a soul like a stone. Just like his mother.

"I'll be so far behind everyone. The fights get bigger as the campaign goes on. Even if I get out in time, my army will be too small for the final battles."

"I spoke with the nurse. She says after three or four days, you'll probably feel good enough to read and paint. I'll bring everything. We can work on some birds and listen to the radio. It'll be just like we're at home in the kitchen."

"Really?"

"Yes, and there's another thing. When you make it through the second treatment tomorrow, there will be another surprise waiting for you. Same thing for the third. I know this seems all impossible, but it has an end. You won't be alone. I will be with you."

"What? What did you get me?"

"You'll have to get through treatment and see. Sleep now, conejito." The bingo money was a fib; it was all from birds. The three little surprises had cost Una many hours of sitting, squinting, and arthritis. But for a moment, Robin seemed to forget he was hurt. He was just a boy, excited to paint his little soldado. It was worth it.