Monday was the 29th and final day of Eva’s “induction” phase of leukemia treatment. On the agenda for the weekly clinic visit was an intrathecal (in the spine) dose of chemotherapy and a follow-up bone marrow biopsy. Both procedures were done at the same time under relatively light, general anesthesia.
I had been bracing myself for this day because Eva has been any procedure that requires anesthesia includes certain food and drink limitations. Eva had been on twice-daily steroids for 29 days, the primary side effects of which were a constant, ravenous hunger combined with volatile mood swings. The morning routine on day 29 includes no food from 5am until the procedure (sometime after 11am). We would have no way to alleviate the pains and expected that the moods would be extremely difficult as a result. In reality, Eva did a tremendous job. In fact, Monday’s procedure day was her most patient and well-regulated trip to the clinic yet.
The day started with an early departure from the house (about 7:00am) for the 8:00am check-in at Rady Children’s Hospital. Traffic was difficult that morning so we arrived a bit late, but not so late that it had any impact on the day’s schedule. By 9:00am Eva had her port access complete and blood drawn for lab tests. Then it was time to wait. Procedures begin at 11:00am, so we had a least two hours of time to pass with games and crafts while we watched Monsters University on the iPad. As I said, Eva worked patiently through her hunger and was in very cheerful spirits virtually the entire time. The day before the procedure she had told me, “I’m nervous about the sleeping medicine tomorrow, but for some reason I’m also excited.” She knew that this was a milestone and an accomplishment. I think she was looking forward to getting through the day as well as she could and being “done” with the first phase of her treatment.
Her procedure went quickly and before long she was back in our little “infusion suite” waking up from the anesthesia. Patients who receive intrathecal chemotherapy are required to lie flat for 60 minutes after waking up to prevent the common side effect of headache. The 60-minute rest is about the only treatment needed to mitigate the side effects of intrathecal chemotherapy. She munched on the snack bag they give after each anesthesia procedure and watched one of her favorite movies again, Ratatouille.
She was able to sit up again at 12:30pm and by that time the nursing staff had briefed me on Eva’s blood numbers and what to expect in the coming week or two.
The bone marrow biopsy they took on Monday will be tested to determine whether Eva is yet in remission or not. The current diagnosis on her chart is “acute lymphoblastic leukemia not having achieved remission.” We want the diagnosis updated to “acute lymphoblastic leukemia having achieved remission.” The results of the biopsy will help to determine the course of Eva’s future treatment. If she is in remission, which is the most likely scenario, she will continue on the treatment protocol for “standard risk” patients. If she is not in remission, she will begin a treatment plan for “high risk” or “very high risk” patients.
We will most likely have to wait until next Monday, December 19, to learn the results of Eva’s biopsy. It seems there are two reasons for this length of time to determine the results. First, only part of the test is done at the local lab in San Diego. The results that the local lab can rapidly determine indicate if someone has leukemia (thus they can diagnose the disease from these quicker tests), but the result that can accurately determine remission status requires more time to physically process, prepare, and interpret. Second, the marrow is shipped overnight to a lab in Seattle for that part of the test, adding a shipment day to the timeline. Nevertheless, there remains a small chance that they will have the results back by Friday, in which case we have asked that Eva’s managing physician call us with the results. Audra and I differed on that decision. I preferred to learn the results at a set date and time (Monday, December 19 at 2:00pm is the appointment), while Audra wanted the option to know as quickly as possible. We agreed to accommodate her preference on the matter. Now we wait, we watch, and we pray for the results of Eva’s biopsy and, more importantly, for the old order of things to pass away.
You see, on Monday Eva and I got to see the future. We caught a glimpse of what it will be like in the future, how it will be when the old order of things passes away. As we waited for Eva’s procedure there came laughter and singing to interrupt our anxiety. Down the hallway stood a bare-headed little girl surrounded by smiling faces—her family and most of the clinic’s nursing staff grinned ear to ear as they sang new words to the familiar “Happy Birthday” melody:
No more chemo for you,
No more chemo for you,
No more chemo, dear name
No more chemo for you!
Eva and I happened to be in the hallway at that moment heading to the restroom, so she saw the whole thing. And she most definitely put two and two together. She knows what the bare-headed kids mean. She is well aware that will soon be her new look. But she also knows why that girl was smiling at the end of the hallway—she was finished with her tough medicine, ready to start growing her hair back, and about to get her life back again. All the whispers of assurance she had heard in the last year had just come true.
That little girl is Eva’s future.
We know this because the Lord Jesus has already made it known. In Revelation 21 the Lord Jesus says from his throne that “he will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away.”
Moments like the celebration in the clinic on Monday are the light of future glory bursting through the cracks of this fallen world. These glimpses of God’s healing providence are the rumors of truth rippling through reality from the throne room of the ascended Jesus himself. Once you see them you can’t unsee them, once you hear them you can’t let them go—they are everywhere, and like the stars in heaven these healing deeds of the Lord are meant to proclaim his glory and point you somewhere.
These glimpses of light and rumors of truth do not point you to your own seemingly good life or the seemingly good lives of others. Even the greatest stories of virtue and the most moving accounts of healing come from human beings irrevocably corrupted by sin. I realize that there is nothing very popular about the biblical teaching of sin—who wants to be told they are corrupt, broken, and doomed? But can we come to any other conclusion? Especially if we are weighing the evidence responsibly? So far it seems to me that every human alive today will one day be dead. And while we live each of us fails to do the good we wish we could do and continue to do the evil things we wish we could avoid. Something is not right. It seems to me that the ones who are really bringing the bad news are not the ones who accurately diagnose the problem of sin, but the ones who deny the mountain of evidence in front of us that proves we are sinners, and therefore we sin, and therefore we die.
The glimpses of light and rumors of truth are meant to point you somewhere outside your own story, because your story ends in death. They are meant to point us to the one who is and who was and who is to come—God in flesh, Jesus Christ. the one whose story ends in life and who wishes to bring you into the same story.
It was he who came at Christmas not to be the cute and cuddly reason for the season, but to be the stand-in for every sinful human being. He who had no sin—he was God, of course—became sin for us. Every corruption of your sin was laid on him and it lead where we know sin always leads—to death.
But death could not hold him because death has no power over him. It’s quite the opposite, really. Christ burst the chains of death and showed hundreds of eyewitnesses what it looks like when the old order of things passes away, when he wipes away every tear from every eye, when human bodies pass through the grave clinging to Christ by faith. And he has assured every Christian—in writing, no less—that he who has passed from death to life is the only way to do the same.
Eva will pass from death to life no matter how her leukemia treatment ends. Her future is found in Christ and Christ alone. Her future is the future we know awaits all who hope in the Lord. And the sound it makes is the sound of parents laughing and nurses singing. It’s more than that, even, it’s the sound of divine joy as the Lord himself announces on the last day:
No more crying for you
No more crying for you
No more dying, dear Christian,
No more dying for you.