“Why does he need four? Is it that bad?” she sobbed.
Lauren leaned forward and rested her forearms on her knees, clasping her hands. “I know it sounds like a lot, but most patients get multiple chemotherapy drugs at once. Cancer is sneaky, and a drug that works on some cancer cells may not work on others.”
“Wily bastards,” Andrew put in.
Lauren flicked her gaze to him and grinned for a second. “That’s one way to put it. That’s why we mix several drugs together that work in different ways, to make sure we hit them all.” She moved to squeeze Mrs. Bishop’s hand at the same time she looked at Andrew. “Dr. Patel is the one to speak about response rates, but I can say in your type of cancer, ABVD typically works well.”
There was a beat of silence.
“It will work, Mom.” Jeni’s tone was resolute.
“You’re right.” Mrs. Bishop sniffed and took a deep breath. She moved her hands in a repeated motion near her face, as if to waft fresh air toward her. “We have to keep a positive outlook about this.”
“We?” Andrew raised an eyebrow. “You’re the only one crying.”
This brought on a fresh wave of tears. “You’re my s-son! And you have c-c-cancer.”
“I’m aware.” His tone was deadpan, but he put his arm around her shoulders.
“Andrew,” Jeni admonished. She pulled another tissue out and handed it to her mother. “Stop making Mom cry.”
“Seriously? Don’t get mad at me.” He turned to Lauren. “Don’t I get a free pass? A card to put in my wallet or something? An ‘I have cancer, so give me a break’ card?”
“Uh…” Lauren shifted on her stool. He was joking, right?
“For heaven’s sake. Can we let her tell us about the chemo?” The dark-haired woman standing against the wall spoke up for the first time.
The blond sister wiped a tear from her cheek.
“Yes, let’s get back on track,” Lauren said with a nod. Heat rushed through her when she turned her attention to Andrew, but she pressed on. “You’ll come in every two weeks for chemo and get all four drugs each time. Two rounds of chemo make up one cycle.”
Once she got in the groove, she relaxed and regained the confidence she usually felt when talking about the drugs she knew so well, spending the next half hour reviewing side effects he could experience. She mentioned which ones were common—fatigue, increased risk of infection, nausea, and vomiting. And a few that were rare but serious enough to mention—lung toxicity, heart damage, neuropathy.
She also told him about the nausea medications she’d send in for him to use at home in between cycles.
Lauren’s eyes met Andrew’s brown ones. “Everyone has a different experience. Dr. Patel or her PA, Emma, will see you after your first chemo to find out how you did after you got home.” And just because he was a guy, a young guy, and they were sometimes hesitant to be honest about their symptoms, she added, “They can’t fix something they don’t know about. You have to speak up if you have any issues. Okay?”
Andrew nodded at the same time his mother said, “We will.” Andrew shook his head the tiniest bit, and Lauren bit her lip to contain her smile.
“Will we see you, too? When we come back?” his mother asked.
“Actually, this is my last day in this clinic. Starting tomorrow I’m moving to a different one. But there are several clinical pharmacists in the building available to Dr. Patel and her staff if any medication questions come up,” Lauren said, burying the disappointment she felt that she wouldn’t be following Andrew’s care. “What other questions do you have? About the chemo?”
“Will he lose his hair?” Jeni asked.
Lauren couldn’t help but glance at the thick, brown, soft-looking hair covering Andrew’s head. Her fingers twitched, and she gripped her thigh as she brought her eyes down a few inches to meet his. “Yes, I expect you to lose all of it. It starts to thin right after chemo begins, but it usually isn’t noticeable until after the second or third treatment. There comes a point where people get tired of hair everywhere, and that’s when they get it cut short or shaved off.”
Andrew nodded slowly. He swallowed hard, his Adam’s apple bobbing in his throat. “When do I start?”
“I’ll write the chemo orders as soon as we’re done. It takes some time to obtain insurance approval, and we have to get your port placed first. Our nurse, Kiara, is probably getting that appointment set up as we speak. Best guess, I’d say in a week.”
“Does he need to wear a mask when he’s in public?” This from the short-haired, blond sister.
“That’s usually unnecessary with this chemo. We’ll get lab work done often, and if we ever feel something indicates special precautions, we’ll tell you.”
“I have two young kids. Can he be around them?” the same sister continued. That explained the PTA shirt.
“You can’t keep them from me.” Andrew said to his sister, then frowned at Lauren, like she actually had control over who he saw and who he didn’t. “I’m not going months without seeing my niece and nephew.”