The Last Letter

Letter #6

Ella,

Thank you for the cookies. And yeah, your brother stole them while I was in the shower. You think he’d be three hundred pounds by now.

I thought about what you said about gravity.

I’ve never really had that—anything tethering me anywhere. Maybe when I joined the army, but really that was more about my affinity for the unit than it was for anywhere or anyone. Until I met your brother, and they started pushing us through selection. Unfortunately, I am overly fond of him, as is most of our unit. It’s only unfortunate because sometimes he can be a real pain in the rear.

Why do they call me Chaos? That’s a long, unflattering story. I promise I’ll tell it to you one day. Let’s just say it involves a bar brawl, two really angry bouncers, and a misunderstanding between your brother and a woman he mistook for a prostitute. She wasn’t.

She was our new commanding officer’s wife. Whoops.

Maybe I’ll make him tell you that story instead.

You mentioned in your last letter that Maisie wasn’t feeling well. Did the docs get to the bottom of it? I can’t imagine how hard that has to be for you. How is Colt doing? Did he start those snowboarding lessons yet?

Gotta go, they’re rounding us up, and I want to make sure I get this in the mail.

Catch you later,

~ Chaos

…

The only sounds in the hospital room were the thoughts screaming inside my head, begging to be let free. They demanded answers, shouted to find every doctor in this hospital and make them listen. Knowing Telluride wasn’t going to look any deeper, I’d brought her an hour and a half away to the bigger hospital in Montrose.

It was almost midnight. We’d been here since just after noon, and both the kids were fast asleep. Maisie was curled in on herself, dwarfed by the size of the hospital bed, a few leads sending her vitals to the monitors. Thank God they’d turned off the incessant beeping. Just seeing the beautiful rhythm of her heart was enough for me.

Colt was stretched out on the couch, his head in my lap, his breathing deep and even. Although Ada had offered to take him home, he’d refused, especially while Maisie had a death grip on his hand. They never could stand to be separated for long. I ran my fingers over his blond hair, the same nearly white shade as Maisie’s. How similar their features looked. How different their little souls were.

A soft click sounded as the door opened only enough for a doctor to poke his head in.

“Mrs. MacKenzie?”

I put up one finger, and the doctor nodded, backing away and closing the door softly.

As quietly as I could, I moved Colt off my lap, replacing my warmth with a pillow and my jacket over his little body.

“Is it time to go?” he asked, snuggling deeper into the couch.

“No, bud. I need to talk to the doctor. You stay here and watch over Maisie, okay?”

Slowly, glazed-over blue eyes opened to meet mine. He was still more than half asleep.

“I’ve got this.”

“I know you do.” I grazed his temple with my fingers.

With sure steps and very unsure fingers, I got the door open and shut behind me without waking Maisie.

“Mrs. MacKenzie?”

I scanned the guy’s badge. Doctor Taylor.

“Actually, I’m not married.”

He blinked rapidly and then nodded. “Right. Of course. My apologies.”

“What do you know?” I pulled the sides of my sweater together, like the wool could function as some kind of armor.

“Let’s go down the hall. The nurses are right here, so the kids are fine,” he assured me, already leading me to a glass-walled area that looked to serve as a conference room.

There were two other doctors waiting.

Doctor Taylor pointed me to a seat, and I took it. The men in the room looked serious, their smiles not reaching their eyes, and the guy on the right couldn’t seem to stop clicking his pen.

“So, Ms. MacKenzie,” Doctor Taylor began. “We ran some blood tests on Margaret, as well as drained some fluid from her hip earlier, where we found infection.”

I shifted in my seat. Infection…that was easy.

“So antibiotics?”

“Not exactly.” Doctor Taylor’s eyes shot up toward the door, and I glanced over to see a woman in her midforties leaning against the doorframe. She was classically beautiful, her dark skin as flawless as her French twist updo. I was suddenly very aware of my state of dishevelment but managed to keep my hands off my no-longer-cute messy bun.

“Dr. Hughes?”

“Just observing. I saw the girl’s chart when I came on shift.”

Dr. Taylor nodded, took a deep breath, and turned his attention back to me.

“Okay, if she has an infection in her hip, that would explain the leg pain and the fever, right?” I folded my arms across my stomach.

“It could, yes. But we’ve found an anomaly in her blood work. Her white counts are alarmingly elevated.”

“What does that mean?”

“Well, this is Dr. Branson, and he’s from ortho. He’ll help us with Margaret’s hip. And this…” Dr. Taylor swallowed. “This is Dr. Anderson. He’s from oncology.”

Oncology?

My gaze swung to meet the aging doctor’s, but my mouth wouldn’t open. Not until he said the words his specialty had been called in for.

“Ms. MacKenzie, your daughter’s tests indicate that she may have leukemia…”

His mouth continued to move. I saw it take shape, watched the animations of his facial features, but I didn’t hear anything. It was like he’d turned into Charlie Brown’s teacher and everything was coming through a filter of a million gallons of water.

And I was drowning.

Leukemia. Cancer.

“Stop. Wait.” I put my hands out. “I’ve had her at the pediatrician at least three times in the last six weeks. They told me there was nothing, and now you’re saying it’s leukemia? That’s not possible! I did everything.”

“I know. Your pediatrician didn’t know what to look for, and we’re not even certain it is leukemia. We’ll need to take a bone marrow sample to confirm or rule it out.”

Which doctor said that? Branson? No, he was ortho, right?

It was the cancer doctor. Because my baby needed to be tested for cancer. She was just down the hall and had no clue that a group of people were sentencing her to hell for a crime she’d never committed. Colt… God, what was I going to tell him?

I felt a hand squeeze mine and looked over, my head on autopilot, to see Dr. Hughes in the seat next to me. “Can we call someone? Maybe Maisie’s dad? Your family?”

Maisie’s dad had never so much as bothered to see her.

My parents had been dead fourteen years.

Ryan was half a world away doing God-knew-what.

Ada and Larry were no doubt asleep in the main house of Solitude.

“No. There’s no one.”

I was on my own.

…

The scans began in the morning. I pulled a small notebook from my purse and began to jot down notes of what the doctors said, what tests were being run. I couldn’t seem to absorb it all. Or perhaps the enormity of it was simply too much to take in.

“Another test?” Colt asked, squeezing my hand as the doctors drew more blood from Maisie.

“Yep.” I forced a smile, but it didn’t fool him.

“We just need to see what’s going on with your sister, little man,” Dr. Anderson said from where he stood perched at Maisie’s bedside.

“You’ve already looked in her bones. What else do you want?” Colt snapped.

“Colt, why don’t we go grab some ice cream?” Ada asked from the corner. She’d arrived early this morning, determined that I not be alone.

I could have been in a room with a dozen people I knew—I still would have been alone.

“Come on, we’ll grab some for Maisie, too.” She held out her hand, and I nodded to Colt.

“Go ahead. We’re not going anywhere for a while.”

Colt looked to Maisie, who smiled. “Strawberry.”

He nodded, taking his duty with all seriousness, then gave Dr. Anderson another glare for good measure before leaving with Ada.

I held Maisie’s hand while they finished the draw. Then I curled up next to her on the bed and switched on cartoons, holding her small body against mine.

“Am I sick?” She looked up at me without fear or expectation.

“Yeah, baby. I think you might be. But it’s too early to worry, okay?”

She nodded and focused back on whatever show Disney Junior was airing.

“Then it’s good that I’m in a hospital. They make you better in hospitals.”

I kissed her forehead. “That, they do.”

…

“It’s not leukemia,” Dr. Anderson told me as we stood in the hallway later that night.

“It’s not?” Relief raced through me, the physical feeling palpable, like blood returning to a limb too long asleep.

“No. We don’t know what it is, though.”

“It could still be cancer?”

“It could. We’re not finding anything other than the elevated white counts, though.”

“But you’re going to keep looking.”

He nodded, but the sheen of certainty he’d had in his eyes when he’d thought it was leukemia was gone. He didn’t know what we were dealing with, and he obviously didn’t want to tell me that.

Day three and four passed with more tests. Less certainty.

Colt grew restless but refused to leave his sister’s side, and I didn’t have the heart to make him go. They’d never been separated for more than a day in their lives. I wasn’t sure they knew how to survive as individuals when they thought of themselves collectively.

Ada brought clean clothes, took Colt for walks, kept me up to date on the business. How odd it was that my obsession with Solitude had been my number three priority behind Colt and Maisie for the last five years, but at this moment felt utterly unimportant.

Days blended together, and my fingers were damn near raw from the internet searching I’d done since Dr. Anderson dropped the C word. Of course they’d told me to stay off the net.

Yeah, right.

I couldn’t remember a damn thing they said half the time. No matter how hard I tried to concentrate, it was as if my brain had shields up and was only taking in what it thought I could handle. Using the internet filled in the gaps that my memory and my notebook couldn’t.

On the fifth day, we gathered in the conference room once again, but this time I had Ada next to me.

“We still don’t know what’s causing it. We’ve tested for all the usual culprits, and they’ve come back negative.”

“Why doesn’t that sound like a good thing?” Ada asked. “You’re saying you haven’t found cancer, but you sound disappointed.”

“Because there’s something there. They just can’t find it,” I said, my voice turning sharp. “The same as Dr. Franklin. Maisie said she hurt, and she was sent home with a diagnosis of growing pains. Then they called it psychosomatic. Now you’re telling me that her blood says one thing, her bones say another, and you’re just out of ideas.”

The men had the good sense to look embarrassed. They should be. They’d gone to years and years of school for this very moment, and they were failing.

“Well, what are you going to do? Because there has to be something. You’re not going to send my little girl home.”

Dr. Anderson opened his mouth, and I knew from the set of his face, the next excuse was coming.

“Oh, hell no,” I snapped before he could get a word out. “We’re not leaving here until you give me a diagnosis. Do you understand me? You will not wash your hands of her, or me. You will not treat her as a mystery you simply couldn’t solve. I didn’t go to medical school, but I can tell you that she’s sick. Her blood work says it. Her hip says it. You did go to medical school, so figure. It. Out.”

Silence roared louder than any excuse they could have given me.

“Ms. MacKenzie.” Dr. Hughes appeared, taking a seat next to Dr. Anderson. “I’m so sorry I haven’t been here, but I split my time between this hospital and Denver Children’s and just returned this morning. I’ve seen your daughter’s test results, and I think I might have one more thing we can test for. It’s incredibly rare, especially in a child this old. And if it is what I think it might be, then we need to act quickly.” A clipboard appeared in front of me with yet another consent. “One signature is all I need.”

“Do it.” My name scrawled across the paper as my hand moved, but it wasn’t a conscious effort. Nothing felt like a choice at the moment.

Two hours later Dr. Hughes appeared in the doorway, and I stepped out, leaving Colt and Maisie wrapped around each other in front of Harry Potter.

“What did you find?”

“It’s neuroblastoma.”

…

Ada followed in my car, Colt strapped into his car seat behind her as we made our way through the curves and bends of I-70 toward Denver. I’d never been in the back of an ambulance, not even when I went into labor with the twins. Now my first trip in one lasted five hours.

They took us immediately to the pediatric cancer floor at the Children’s Hospital. There was no amount of festive cartoon murals on the walls that could have possibly lightened my mood.

Colt walked beside me, his hand in mine, as they wheeled Maisie down the wide hallway. Little heads peeked out of the doors or raced by, some bald, others not. There were kids dressed as superheroes and princesses, and one very charming Charlie Chaplin. A mother with a cup of coffee gave me a tentative, understanding smile as we passed where she sat.

It was Halloween. How had I forgotten? The kids loved Halloween, and they hadn’t said a single word. No costumes, no trick-or-treating, just tests and hospitals, and a mom who couldn’t remember what day it was.

I didn’t want to be here. I didn’t want this to be happening.

But it was.

The nurse who checked Maisie into her room made sure we had everything we needed, including a pullout bed that she said both Colt and I were welcome to sleep on.

“Do you have costumes?” she asked, too chipper to like and too kind to dislike.

“I…I forgot it was Halloween.” Was that my voice? So small and wounded? “I’m so sorry, guys,” I said to the twins as they looked up at me with a mix of excitement and disappointment. “I forgot your costumes at home.”

Just another way I’d let them down.

“I’ve got them, no worries,” Ada said, plopping a duffel bag onto the couch. “Wasn’t sure how long we’d be away, so I grabbed what I could think of. Colt, you’re our resident soldier, right?” She handed Colt the plastic-wrapped costume I’d purchased a few weeks ago.

“Yes! Just like Uncle Ryan.”

“And Maisie, our little angel. Want to put these on now, or wait?” Ada asked.

“They’re welcome to get dressed. We actually do a little trick-or-treat around five, so they’ll be all set,” the nurse said. I couldn’t remember her name. I barely remembered my name.

I nodded my thanks as the kids opened their costumes. Such an ordinary thing in extraordinary circumstances.

Ada wrapped her arm around my shoulders, pulling me in tight.

“It feels more trick than treat,” I said quietly so the kids didn’t hear me. They giggled and changed, trading pieces so Maisie wore Ryan’s Kevlar helmet and Colt had a sparkly, silver halo.

“These are rough days we have coming,” Ada agreed. “But you’ve raised a pair of fighters right there. Maisie won’t give up, and Colt sure won’t let her.”

“Thank you for the costumes. I can’t believe I forgot. And everything with Solitude, and gearing up for the season—”

“Stop right there, missy. I’ve been raising you since you came to Solitude. It’s always been you and Ryan, and Ruth, Larry, and me. Ruth was strong, but she knew it would take all of us to pull you kids through after you lost both your parents. Don’t you worry about a thing back home. Larry has it under control. And as for the costumes, you have bigger things in that beautiful head of yours. Just let me feel useful and remember the little ones.”

…

So many scans. CT. PET. The letters ran amok in my head while she was in surgery. They called it minor. The tumor they found on her left adrenal gland and kidney was anything but.

Another conference room, but I wasn’t sitting down. I was taking whatever news they had for me standing up. Period.

“Ms. MacKenzie,” Dr. Hughes addressed me as she walked in with a team of doctors. I was grateful for whatever arrangement she had with Montrose that allowed her to be here, to have the same face, the same voice with me.

“Well?”

“We performed the biopsy and tested both the tumor and the bone marrow.”

“Okay.” My arms were crossed tightly, doing their best to hold the rest of me together.

“I’m so sorry, but your daughter’s case is very aggressive and advanced. In most neuroblastoma cases, the symptoms present much sooner than this. But Maisie’s condition has been progressing without any outward signs. It’s likely been advancing undetected for years.”

Years. A monster had been growing inside my child for years.

“What are you trying to tell me?”

Dr. Hughes walked around the table to take my hand where I stood rocking back and forth like the twins were still babies in my arms in need of soothing.

“Maisie has stage four neuroblastoma. It’s taken over 90 percent of her bone marrow.”

I kept my eyes locked on her dark brown ones, knowing the moment I lost that contact, I’d be drowning again. Already the walls felt like they were closing in, the other doctors fading from my peripheral vision.

“90 percent?” My voice was barely a whisper.

“I’m afraid so.”

I swallowed and focused on bringing air in and out of my lungs, trying to find the courage to ask the obvious question. The one I couldn’t force past my lips, because the minute it came out and she answered, everything would change.

“Ella?” Doctor Hughes prompted.

“What’s her outlook? Her prognosis? What do we do?”

“We attack it immediately and without mercy. We start with chemo, and we move forward. We fight. She fights. And when she’s too tired to fight, then you do what you can to fight for her, because this is an all-out war.”

“What are her chances?”

“Ella, I’m not sure you want—”

“What are her chances?” I shouted with the last of my energy.

Dr. Hughes paused, then squeezed my hand.

“She has a 10 percent chance of surviving.”

That roaring returned to my ears, but I shoved it away, concentrating on every word Dr. Hughes said. I needed every ounce of information.

“She has a 10 percent chance of surviving this?” I echoed, needing her to tell me that I’d heard wrong.

“No. She has a 10 percent chance of surviving the year.”

My knees gave out as my back hit the wall. I slid, paper crumpling behind me as my weight took down whatever had been there. I landed on the floor, unable to do anything but breathe. Voices spoke, and I heard but didn’t understand what they said.

In my mind, they repeated one thing over and over. “10 percent chance.”

My daughter had a 10 percent chance of living through this year.

Which meant she had a 90 percent chance of dying, of those angel wings she refused to take off becoming very real.

Focus on the ten. Ten was better than nine.

Ten was…everything.

…

I pulled myself together. Chemo. PICC Line. Appointments in Montrose and Denver. Aggressive cancer meant an aggressive plan. Binders full of information, notebooks with scribbles. Planners and apps and research studies became my every waking moment. My life changed in those first few days.

I changed.

As if my soul had caught fire, I felt a burning in my chest, a driving purpose that eclipsed all else. My daughter would not die.

Colt would not lose his sister.

This would not break me, or my family. Holding it together was my second priority only to Maisie’s survival.

I didn’t cry. Not when I wrote the letters to Ryan and to Chaos. Not when I told Colt and Maisie how sick she was. Not when she started vomiting after that first session of chemo, and not when a month later, during her second week-long session, her beautiful blond hair fell out in clumps the day before her sixth birthday. I nearly lost it when Colt showed up from the barber with Larry—his head as shiny and bald as his sister’s—but I just smiled. He’d refused to be separated during their birthday, and as much as I didn’t want him to see what she went through during chemo, I was incredibly thankful to be with both of them, not to be in a constant state of worry about one while I was caring for the other.

I didn’t break down.

Not until New Year’s Eve.

That’s when the uniforms came to the door and ripped my strong facade to shreds with a simple sentence: We regret to inform you that your brother, SSG Ryan MacKenzie, has been killed in action. Due to the nature of their unit, that was all I could know. The details—where he’d been, what had happened, who he’d been with—that was all classified.

When there were no more letters from Chaos, I had at least one of those answers.

They were both gone.

I broke.