Author's Note: This was yet another assignment for my Creative Writing class. It's a fictional piece based on when my father had leukemia. I hope you will tell me what you think of it.

-LSR_7

Changing Seasons

She was walking home on a clear autumn day. The pebbled dirt road led away from the stop sign where the school bus had dropped her off at and wound down to her home. The trees that lined the road were an orangish gold that seemed to shine and glitter when a soft breeze filtered through the leaves. The gold of the trees contrasted with the light blue sky of forever.

Sara took this all in, pulling her white sleeved blue letter jacket closer to her body all the while.

The crisp, cool air was welcome to the high schooler. She was amazed by the bright red on the leaves of the fireweed. The formerly all green of the plant now looked as if bright, crimson flames were eating at it from the edges towards the remaining jade of the center.

She walked on down the dirt road, starting to tire and get out of breath.

'School's probably wearing me down a bit. I better stop reading so late,' Sara absently thought.

Lately, Sara has been feeling tired and in need of air at times when she used to not. The breathtaking and vibrant scenery slightly faded as she half labored for breath while climbing the short length of steps to her home, where her mother had opened the door for her.

In the beige and white of the down stairs bathroom with the off-white tiled counter, Sara was undressing to change into her well used pink and white plaid flannel pajamas. During this time she would do a brief inspection of her body, amusing herself with the little muscles of her biceps she had slightly developed in her first quarter weight training class. Along with her biceps she also examined her slightly flabby stomach. She stepped onto the scale.

'Yay! I'm maintaining my weight!' Then, with a mental sigh, she'd also note, 'I still have fifteen pounds to loose so I'm not overweight.'

At that she'd look pointedly at her pale stomach which would look back innocently.

Sara noticed a couple small bruises on her legs and on her arms, a little more than usual, a passing thought. She didn't pay them any mind really since bruises appeared when she crawled on her knees, perhaps searching after a dropped pencil.

'How did I get this?' she asked herself, scrutinizing her inner arm.

'Did I bump into something today?'

She derailed that train of thought and changed into her pajamas.

It was the second day of the second quarter and forty-five students jogged laps on the spacious gym. Kids in T-shirts, shorts, and sweatpants bobbed up and down on the hard rubber of the floor that was getting smacked by tennis shoes.

Sara was near the back, her head throbbing earnestly. She had never felt a headache like this before. Only a couple times had she experienced a twinge, but not an actual headache. Her ragged breath rasped through her throat painfully, making it feel like an open sore and her body ached. She tried to catch up with the main herd of students.

'I didn't think I was this outta shape,' she thought mournfully.

She felt a wetness trickle from her nose. 'Strange,' she thought, 'I didn't have a runny nose earlier.'

She swiped the back of her hand under her nose and saw it out of the corner of her eye.

'What the hell?!'

Sara abruptly stopped and stared at her hand, a slight panic overcoming her. Blood was smeared on it. Sara wiped her nose again, it seemed that her nose was bleeding and it hadn't stopped. She has never had a bloody nose before.

Holding her nose she walked to Mr. Kane, the gym teacher, anxiously.

"Mr. Kane?" she called in a weak voice.

"What happened?" the gruff, bowlegged man asked, concern shading his voice.

"I don't know, I was running and I just started bleeding," Sara said meekly.

"Go to the nurse's office," he ordered, looking up and away from Sara, whose white gym shirt had received a few bright red spots of blood. He spotted a girl nearby and called her over.

"Stephanie, take Sara to the nurse's office."

The impersonal, glaring white light added some pain to the sensitive brown, damp eyes of the young not-quite-woman. Sara just stared at her hands on her lap in the small, white, spartan room.

She was back in her street clothes, the doctor had said it was all right to change back. Currently she was waiting for her mom to come back in while doctors studied her blood samples, or whatever else is done to vials of blood.

She was being signed up for several tests, none of which she could pass with what she learned at school.

How many hours had she been in this hospital? She didn't know, but the initial shock had somewhat worn off and now she was stuck with a numb disbelief, a feeling that left her feeling isolated. She had also been in the hospital long enough for the sun to set and leave the sky in a seemingly eternal darkness.

The door swung open behind her.

"Sara…"

It was her mother. Neither knew what to say and an uncomfortable silence shrouded the room. Diane sat next to her only child and put a reassuring arm, reassuring for who she did not know, around Sara's slouched shoulders.

"The doctor said that you can go home now. They'll call us back as soon as the results are in."

Sara nodded slowly, her thick brown hair almost limp in its ponytail.

"You show the symptoms of acute leukemia…I'm very sorry…"

The graying doctor had explained to Sara and her mother what acute leukemia was, how it affects the body, the seriousness of the illness, and several treatments for it. It had taken less than half an hour to find that her white blood cell count was miles above the average number.

"We'll be checking your white blood cell count several times throughout…"

Impersonal.

Acute leukemia. Why didn't the sounds of the words match their meaning? It sounded so innocent, but its meaning…

'…suppression of normal bone marrow function…susceptibility to infection due to the predominance of immature and abnormally functioning white blood cells, bleeding tendency owing to decreased platelet count…increased need for rest…'

Sara read through the medical dictionary, trying to find answers, maybe a secret cure. None were forthcoming. The way it was written was so…clinical? As if it wasn't dealing with a human being who had a life, friends, family…

'As with other diseases of this kind, the acute form of leukemia causes a rather sudden onset…'

Sara slammed the blue book shut, disgusted with it.

She had failed the test. Her white blood cell count was high and her platelet count was low. These were solid facts. And another solid fact was that she and her mother were going down to Seattle for chemotherapy.

She lay propped up on the narrow sterile white hospital bed, mindlessly watching the television that was hanging from the upper corner of her room. Next to the television, a large window showed her the grey winter of slushy snow that was Seattle. An I.V. bag containing the opaque yellow platelets attached to a needle in her inner elbow hung above and beside her.

Sara hated needles, but she knew that it was for her health. No matter how much she didn't like getting shots and the I.V.s put in her arm, she put up with it since it was a matter of her life.

She was residing within the University of Washington Medical Center for her chemotherapy. When she first came here she thought it was weird that a hospital was part of a university.

On a corkboard, near the door of her room, there were get well cards from her family, friends and a couple teachers. Although she didn't tell anyone, she loved the homemade cards made by a friend's younger sister and from her younger cousins best. Not to say she didn't appreciate the other cards, but there was just something about the colorful, messy, and handmade ones from the younger children…

"I brought you lunch," said Mark, Sara's father. He was a tall, slightly rounded, black-haired man with a mustache that had a grey streak in it. Diane had insisted from time to time that he shave it off.

"Ah yes, the infamous hospital food," Sara commented, trying to make light of her situation.

Her father smiled down at her and set the tray of cooked food on the rolling table by the bed. Everything Sara ate had to be fully cooked; it was risky to Sara's health if it wasn't since the chemotherapy was weakening her immune system.

Mark came down with Diane and Sara to Seattle until they settled in. He had to go back up to Alaska soon for his job. His employer had been understanding enough to allow the impromptu traveling.

Sara lifted the hard plastic lid off the main plate to a slightly dry looking chicken. It didn't look that bad, it was lightly seasoned with a thin slice of boiled lemon decorating it. Some rice, fried vegetables, and a dessert of custard with wafer cookies were laid out filling the other squares of the tray.

Mark took a seat next to Sara and watched her eat for a moment.

"This tastes pretty good, want to try some?" asked Sara after a couple bites.

"No, it's okay. I already ate, but you're right, the hospital food is pretty good."

He cleared his throat and then stopped when Diane stepped in with her own tray of food. She pulled up a seat next to Mark and by the bed.

"Well, as you know, I'll have to go back home for work. The doctors say that people in your condition stay for treatment from a few months to a year, depending on the seriousness of the situation.

"We have an apartment at the Manhattan. When you become an outpatient Mom will show you. We moved our things in already."

Sara nodded and said, "Okay. So, where is the Manhattan?"

"It's within walking distance of the Swedish Medical Center," Mark paused then added, "that's where you'll go to next for your radiation treatment and transplant after your chemotherapy is done here."

Again Sara nodded and said nothing further as she ate her lunch.

The children's floor in the Swedish Medical Center was brightly decorated with colorful animals and the city of Seattle painted on the walls of the halls. If only for a moment, fears and the reasons people were here were forgotten as they smiled and wondered at the seeming cheerfulness of the floor.

Sara explored her new surroundings. She had been checked in to the children's floor of the hospital because it was full everywhere else. Three months of chemotherapy had left her feeling nauseous and pale most days, but today was a good day.

She paused at a decorated door and looked carefully at the photograph on it. There was a small, pale, and bald boy wearing a huge smile on his face. Holding his hand was a cheerful Robin Williams.

Sara smiled at it and continued down the halls.

'Must be from Make a Wish Foundation,' she thought.

Sara was wearing pale blue loose pants and button-up top pajamas a kind nurse had given her. The nurse had pleasantly laughed when Sara told her of her enormous relief that she didn't have to wear one of those gowns that didn't close in the back.

Sara walked back to her room, stopping at the sanitation chamber that led to it and washed her hands with the sanitary foam and water at the sink.

She began to feel dizzy and slowly walked to her bed for a rest. Having leukemia wasn't exactly as she thought it would be. She had imagined herself stuck in a dull hospital in total depression (although sometimes she'd come near), eating gross hospital food, and having hardly any visitors. But actually the hospital staff was nice, the food edible, unlike what she had always heard, and she did get a few visitors. She was also allowed to leave the hospital sometimes and visit nearby relatives for a day, or tour Seattle.

Sara woke up from a restless sleep and got up to go to the bathroom right next to her bed. As she washed her hands she looked up into the mirror and saw some loose hair. After drying her hands she ran her hand through her hair and looked at her hand. She was transfixed on the clump of hair in it. She brushed her hand through her hair again and another clump fell away. She paled in shock and with shaking hands opened the bathroom door to go to her bed. Diane was waiting; she came in while Sara was in the bathroom.

Sara's mother immediately became concerned when she saw her daughter's grey face and asked, "What's the matter? Are you feeling sick again?"

Sara's face crumpled and she threw her arms around Diane, crying into her mother's soft chest. Diane soon found the reason for Sara's discomfort when she patted her daughter's hair. She, too, was shocked. They had been expecting this, but it was so sudden. Just the day before Sara's hair was fine.

The chemo and radiation therapy had done it. Yesterday Sara had her first session of radiation therapy. The combination finally affected her in a way that made this leukemia real. The paleness and sickness just wasn't as firm and real as when your hair fell out.

They agreed that it was better for Sara to cut and shave the rest of her hair rather than seeing it fall out in clumps, leaving evidence on her pillowcase every time she got up.

Sara sported a khaki Special Olympics cap on top of a soft bandanna on her head. She carefully scratched an itch around the Hickman that was planted in one side of her chest. It grossed her out seeing it at first, but now it sort of fascinated her, in a strange way. The Hickman was a tube that was put through her chest, like a large I.V. The advantage to it was that it didn't have to be changed as much as an I.V. in the arm has to be. She just had to be careful with it and keep it clean.

They, Sara and Diane, were in the waiting room at the Fred Hutchinson Medical Center. Bald adults and children sat in chairs lining the walls with supportive parents and spouses beside them. Hutchinson, the center that is usually in charge of cancer patients, borrows other hospitals' facilities like the Swedish or University of Washington (called "You-dub" for short) Medical Centers for treatments and to promote cancer research.

The waiting room of the Hutchinson can be both a happy and sad place for all those with the cancer connection. Someone will always ask carefully, "How are you doing?" and several different answers may result.

"I'm feeling really good today!"

"The treatments are going along well."

"My transplant is going to be next week."

In hushed tones of defeat and/or exhaustion others may answer, "It's not going good. This is the second time my cancer came back."

"We have to worry about his kidney and liver. The treatments are too strong for children."

"She's hanging in there."

No matter where everyone is from they all can talk about their cancer and treatments, share the good and bad. Through their understanding they support each other.

"Sara Johnson?" a nurse in a pastel smock called out.

Sara and Diane smiled and nodded at the others as they got up and followed the nurse to a curtained off bed in the large hall-like room full of white sheeted beds.

A corner of Sara's mouth was quirked up, her eyes showed a tired smile.

She was receiving her transplant of whitish-pink stem cells in a heavy plastic bag that hung on the I.V. stand. A clear vine with the pink liquid led from the bag above her to the Hickman under Sara's pajama top.

Sara, Diane, and Mark were surprised to find out that the stem-cell transplant was such a simple procedure. Sara had thought it would involve a surgery where doctors would have to cut her open and use lots of needles.

Outside her window, the cherry blossoms bloomed in their calm, pale pink. Loose petals littered the pathways around the hospital while more fell to join them.

Thick saliva, mucous, and sores had been plaguing her mouth the last couple of days. She was given a "spit sucker" with a clear fat cylindrical container attached to it that was on a lower shelf behind her bed where she couldn't see it unless she leaned over the edge and twisted her head back. Her throat hurt like she had run a marathon in a flat out run.

Her appetite went down, even the sight of food made her want to heave. Sara had lost weight as was evident from her shallow cheeks. She had also been a sickly pale color and she would joke that she looked like Uncle Fester from the Adam's Family.

Simply said, she's sick.

The transplant seemed successful, but side effects from her chemotherapy, needlessly and inadequately said, "bothered" her.

Sara squinted through her heavy lids to look at the dim light that filtered through the curtains. A wistful expression set in as she stared at the covered window. The energy used to look at the plain curtains sapped her of her strength; she gave in and slipped into an uncomfortable unconsciousness.

Sara tucked her curls behind her ear and away from her face. She had "chemo curls" which will fade back into her thick, rough, hair in a few months. She sat on her bed, almost unfamiliar to her after months of living in Seattle. A foot was tucked under her, a notebook on her lap as she wrote.

On the paper were her experiences with her leukemia, from where she thought it all began, through her treatments, and now. She had not yet had her first second birthday. The second birthday is what the anniversary of the transplant is called.

She has to go through five years, one day at a time, hoping that the cancer doesn't come back. In the mean time she has a new lease on life.

Tapping her pen against her lips, Sara decided she had written enough for now and set the notebook aside.

Pulling her letter jacket out of the closet she called out, "I'm going out for a walk!"

"Don't go too far!" answered Diane from an unseen location upstairs.

"Okay!"

Sara slipped the blue and white jacket on, opened the door, and stepped out from the dim doorway into the fresh, warm, air and the vibrant green world.

Bibliography

"Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health Third Edition," Miller and Keane. Published by W.B. Saunders Company, Copyright 1983 Pg. 642