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  • Mortality has teased me for years. At first she hid behind mirrors, plate-glass store windows, or in snapshots taken in harsh light or at a certain angle. She seemed to get an outlandish amount of pleasure from shocking me with those sneaky, random, revealing peeks.

    Recently she made a bolder move. Like the class clown who stands behind and to your right so he can tap your left shoulder to make you look the opposite way, my nemesis sneaked up on me while I sat in the clinic waiting room listening for a nurse to call my name. Instead of looking to my right toward the door where the nurse stood, I looked left and read the plaque above a different door: "Infusion Suite."

    I knew what those words said, but I couldn’t grasp what meaning they might have for me.

    The nurse called me and I followed her through the procedures of measuring my weight, height, temperature, and blood pressure. We exchanged a few remarks about the weather as she escorted me to the examining room.

    I liked the way Dr. Garcia introduced himself and shook my hand. I appreciated how he listened to me carefully as I told him what I had learned about my disease in the weeks since the diagnosis.

    When I first found out that I had hemochromatosis, a potentially fatal iron overload disease, Mortality had cast a gigantic shadow that threatened to obliterate my future. It took all the courage I could summon to overcome my panic and try to understand what was happening.

    I went directly to the Internet and found out that the U.S. Centers for Disease Control and Prevention estimate that more than one million people in the United States have the gene mutations for hemochromatosis. Me, one of that million, with a mutation on the C282Y allele in the HFE gene on chromosome 6, how could that be?

    The shadow over my future darkened as I realized that untreated hemocromatosis ends in death.

    I had come to the hematologist, Dr. Garcia, with hopes for a positive prognosis. My shoulders relaxed and I smiled when he recommended the same treatment option that my research had prepared me to expect. He wrote out the order for biweekly phlebotomies to lower my accumulated iron to an acceptable level. Each phlebotomy, the same procedure as a blood donation, would remove 500 cc of blood and extract about 250 mgs of iron. Although blood donors are only allowed to give blood every 56 days, I would be losing the same quantity every 14 days.

    I was almost too afraid to ask how many treatments would be necessary to reach an acceptable level of iron storage. He couldn't give a clear-cut answer. "Each patient responds differently," he said. But he could tell me that I would have to have phlebotomies, perhaps once a month or every two months to maintain health, for the rest of my life.

    As I left the building, I swore I could hear Mortality humming in the background.

    Two days later, I returned to the clinic for my first phlebotomy. I closed my eyes and turned my face away as my right arm got stabbed for two tubes of blood to establish a baseline of iron levels. I counted my breaths to overcome a spell of dizzy light-headedness. Relief flooded in as soon as I realized that the technician had found one of my tiny veins with the first poke.

    I had to straighten a sway in my step as I returned to the waiting room, joining five other patients with bright pink elastic elbow wraps. I could feel Mortality breathing on the back of my neck as the nurse walked me to the door beneath the Infusion Suite sign.

    Beyond the door, a long narrow hall opened into a large room with a nurses' station in the middle. The air felt crisp with antiseptic cleanliness. Sixteen overstuffed brown leather recliners defined the perimeter of the room. Almost every chair cradled an occupant. Quiet ruled the room. Not silence, but quiet, a respectful hush, much the same as in a library. Books lay about too, like a library. Every resident of every recliner brought a book, as I did, to transform the passage of time; but all books lay abandoned in favor of sleep or meditation or simple stillness under comforting white thermal blankets in the chilly room.

    A nurse directed me to a chair in the corner. On my left a man slept in his recliner, one arm connected to an IV dripping clear liquid through a transparent tube. His other arm wore the cuff of an automatic blood pressure monitor while a clamp on his forefinger measured oxygen concentration. His nostrils flared around the cannula streaming supplemental oxygen. His thick hardcover book lay face down on the floor.

    On my right, another man sat up, not yet connected to anything but the IV. A woman perched on a stool next to him, sipping from a cylinder with a prescription label. We three smiled and nodded.

    "It’s my first time," I said.

    The man smiled, swallowed, nodded again.

    The woman replied, "It’s his first time too. In fact, it’s cancer day at our house today."

    She lifted her cylinder in a mock toast. "I go for my scan as soon as he’s done in here."

    Humbled, I said nothing about my treatment. A phlebotomy seemed like a mosquito bite compared to the scorpion sting of chemotherapy.

    The woman commented on my tan complexion and I explained my yearly camping trip in the Florida Keys. The couple looked at each other and then told me about their annual trips to Hawaii.

    "They’re going to schedule my chemo so we can take our trip in October," he said. "I probably won’t be feeling very good, but where’s a better place to spend downtime?"

    Courage. Barefaced, clear and earnest courage. The room reverberated with it. Patience. Endurance. Hope? I wanted to list all of the required strengths on a signboard and hold them up for recognition and applause.

    A nurse came and moved me from my corner chair to a place across the room and I lost touch with my new friends. My nearest neighbor in the new location, an elderly gentleman, winked at me without interrupting his animated conversation with a younger woman and two children who stood at his side.

    More strengths to add to our banner: Spirit. Love. Caring. Humor.

    My skin prickled with goose bumps and an unfamiliar mix of emotions whirled inside. The gallantry of these courageous cancer patients challenged me with a high standard of bravery. Could I subdue my fear and perform well in my new community?

    Mortality tapped her long red fingernails on the nurse's cart where the instruments for my procedure lay. I shivered.

    The nurse – now "my" nurse – Rose, warmed my arm with a heating pad, brought me a glass of juice, and recorded my vital signs. She put a pillow under my forearm and a tourniquet on my upper arm. She gave me a small, yellow rubber, happy-face ball to squeeze to encourage a vein to swell.

    "A little sting now," she said, swabbing the site with alcohol and injecting lidocaine to numb the way for the big needle. I focused on the clock across the room. The thought of my blood draining out caused spasms in my gut.

    "Relax your hand now. We're in and flowing nicely." Rose patted my shoulder.

    I stared at the clock and fought to overcome the urge to flee. I knew that I had to hold on for at least 20 – 30 minutes, the normal duration of a phlebotomy.

    Mortality crossed her legs and swung one foot back and forth, taunting, tick-tock-tick-tock. When the elderly gentlemen who had held court in the neighboring recliner left with his entourage, waving good-bye as he passed my chair, the sheer loneliness of that moment brought me to the edge of despair. I struggled to focus on the clock and keep breathing; in - two three, out - two three, in - two three, out - two three.

    Just as my endurance started to crumble, Rose came to the rescue. She clamped off the flow, removed the tourniquet, pulled out the needle, and bandaged my arm.

    It was over. Rose checked my vital signs again and then weighed the bag of blood. "Good job," she said, "505 grams, right on target."

    Done. Well done. One down and how many to go? For the rest of my life. Mortality's face contorted in a sardonic smirk as she flicked a brief thumbs-up gesture my way.

    After the final standing blood pressure check, Rose surprised me with a big hug.

    "Take care, Sweet Lady," she said.

    "I will. You too. See you next time."

    As I left the hematology/oncology clinic, I wobbled a bit. Mortality linked arms with me. We walked together to my car. I felt renewed, infused with courage, spirit, love, and hope. This time Mortality, for once, had the good grace to take the back seat.
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