This morning right before lunch Audra received a voicemail from our case manager, Mary, at Rady Children’s Hospital asking that we call back—the results of Eva’s second biopsy had come back from the lab in Seattle.
I returned the call to the case manager—heart pounding, adrenaline pumping—and got Mary’s voicemail. Ugh.
Thankfully, case managers stay right on top of things. Ours returned the call within five minutes. I stepped into the play room and closed the door behind me. “Thanks for calling me back so fast,” I said. The rest of the conversation went quickly. Mary said she had good news. The leukemia cells are gone from Eva’s bone marrow and her “minimum residual disease” number came back at 0%. The induction phase of Eva’s treatment was successful. She is in remission.
I choked out a couple monosyllabic words like, “yep,” “kay” and ”thanks” before ending the brief phone call. I opened the door to find Audra and Eva standing there. Tears in my eyes and a lump in my throat I just nodded my head, embraced my wife, and blurted something—I can’t remember what—to indicate that the news was good. After a brief moment we assured Eva that we were crying because the news was good. I got to my knees and looked her in the eyes to tell her that the leukemia was gone from her bones and blood—the medicine she worked so hard to take every day for 29 days had worked. She smiled a proud little smile. We all embraced.
The standard first course of treatment (induction) for acute lymphoblastic leukemia most commonly yields remission after 29 days. We had been hopeful for this outcome. We knew that this was the most likely scenario. We are glad to have our hope become reality. We are thankful for the work of physicians and cancer researchers over the last several decades that has produced such a rapidly effective treatment. That we are able to gain such unmerited benefit through the innumerable hours of study and practice invested in the medical vocation is a testimony to the grace of God. He uses human vocations as his instruments of mercy.
We are thankful that Eva is in remission, but remission does not mean she is “cured.” Remission means that there are no visible leukemia cells in her bone marrow and that the disease is not actively multiplying inside Eva’s body. Remission is awesome news, but Eva must still pursue the second (consolidation) and third (maintenance) phase of her treatment over the next two years. If we stopped now the disease would certainly return. Up next is consolidation, which will include frequent chemotherapy infusions for the next six to eight months. We don’t know what that treatment plan looks like yet; Eva’s physician will show us the roadmap at our consultation on Monday. There is still a lot of difficult chemotherapy in the future, the rest of Eva’s hair will fall out, and there is always the higher risk for dangerous infection and subsequent hospitalizations. Nevertheless, news that the induction treatment was successful is an important, positive step. Eva will remain at “standard risk” instead of going to “high risk” or ”very high risk.” We have some much-needed good news to carry us through the rest of the treatment. Things are looking up.
For now we will live between the “already” and ”not yet” that characterizes the Christian life. We already have the good news that Eva’s treatment has been effective to this point. But we are not yet able to enjoy the full results of this good news. That will take many years, and there remains a chance we will never enjoy the good news of a full cure for leukemia. We just don’t know yet.
In the same way—and more so—our Lord Jesus has already achieved the victory over death that animates the distinctively Christian value of life. But our Lord Jesus has not yet permanently inaugurated the eternal kingdom that he has promised will come. We know that death has already been defeated, but the time has not yet come for Jesus to wipe every tear from our eye. We live between the “already” and the “not yet.”
But this is not a bad place to be. The accomplished fact of the “already” makes even the “not yet” into genuine joy as God’s gifts of faith, hope, and love circulate in our lives already now.