The Holly and the I.V.

December, 2017

The Holly and the Ivy, when they are both full grown

Of all the trees that are in the woods, the Holly wears the crown.

Now the Holly bears a blossom as white as the lily flower…

This week my father is starting his long awaited treatment for lymphoma. The process works like this: we go into the clinic; my dad gets comfortable in a medical easy chair, feet up, laying back, pillow behind head. He remarks on how white it all is: the walls, the ceilings, the floors, the uniforms. Our white Christmas. In the midst of that flurry of white, they take my father’s blood to do baseline counts so they can know what kind of effect the treatments are having. Then they hook up the IV.

IV stands for intravenous. Into a vein. A portal into the circulatory system. All kinds of things can go through that portal. There’s a pole next to my dad’s chair. The bags of stuff that they’re going to be pouring into him hang from a hook on that pole. This is our Christmas tree for 2017. The first ornament is a bag of saline solution meant to get his fluid levels up. We sit watching the bag drip into the tube that leads through the needle that’s now sticking into his vein. This is not a quick process. We’re here for the day. And we’ll be back again every day this week.

The Holly and the Ivy, when they are both full grown

Of all the trees that are in the woods, the Holly wears the crown.

Now the Holly bears a berry as red as any blood…

Blood is, by far, the most colorful ornament on the tree. Because my dad is anemic from the cancer, they need to give him a boost with a blood transfusion. This also takes a while, but the effect is pretty quick. Dad gets perkier and more energetic as the blood drips its crimson way through the IV.

While we’re watching the drip, Santa drops by for a visit. He stops at each easy chair to give Christmas greetings and cards, his Coca Cola red suit a bit brighter than the blood. Dad’s card was made by an 11-year-old named Ashanty. “To the best person!” it says on the front of the card. Opening it up we find:

“Dear You,

Hope you have the best holidays ever!! Belive in yourself.”

Some kind of baked acrylic ornament comes with the card. It has candy canes and a Christmas tree pictured on it. A piece has broken off of the ornament. Ashanty reinforces the “belive” message on back:

“Belive in yourself and you will accomplish anything.”

It’s funny. She spelled “accomplish” right.

My dad is a pretty “bah- humbug” kind of guy when it comes to Santa, so I’m fairly certain the greetings don’t do much for him. He’ll be getting two or three blood transfusions over the week. But I don’t think Santa is coming back.

The Holly and the Ivy, when they are both full grown

Of all the trees that are in the woods, the Holly wears the crown.

Now the Holly bears a prickle as sharp as any thorn…

One of the great advantages of an IV is that with one prick (hopefully) you can administer any number of treatments. My sister, my dad and I are all tough pokes. High on our Christmas wish list is a good phlebotomist. Sometimes we get ‘em, sometimes we don’t. But once the IV is established the poking is over.

Dad’s next course is an injected pastiche of steroids, anti-inflammatory drugs, and drugs to combat nausea. No infusion or drip for this, they push it all into the IV with a syringe to get him ready for the cocktail that comes afterwards. The nurses are pretty nervous about this cocktail, particularly the one called rituximab, a drug I’m sure I read about in the Book of Revelations. It’s a biologic, which is to say it’s supposed to help my dad’s immune system attack the cancer cells. For all that “helpfulness”, this is the drug they’re being extra careful with. They start the drip slow. It will take about four hours to get through the bag. They watch him like a hawk the whole time. With the intravenous Benadryl they gave him in the pastiche, he sleeps through the whole thing.

Dad’s nurse has a button that says “I’m the nice nurse.” And she is. They all are. Generally speaking, nurses are a lot more clued in than doctors. Nice nurse communicates the facts and risks throughout the whole procedure without seeming dire or hopeless. She listens attentively and answers the questions she’s asked. If it weren’t for nurses I’m pretty sure there would be a lot more homicides involving doctors.

The Holly and the Ivy, when they are both full grown

Of all the trees that are in the woods, the Holly wears the crown.

Now the Holly bears a bark as bitter as any gall…

The chemo drug he gets is called bendamustine. Like everything but the blood, it is clear and colorless. It only takes about an hour to drip through the IV. Chemo drugs are supposed to destroy cancer cells. Problem is, if they do the job too well, Dad will end up with a bunch of dead cell detritus flooding his system and freaking his kidneys out. So they’ve added more drugs to his already prodigious meds list. (Dad and I have created an Excel spreadsheet. We only print a few days worth at a time. It’s a dynamic list.) They push other drugs, like Lasix, through his system to keep water from building up and his renal system flushed.

Dad weathers the whole procedure without any sign of wear or tear. The nurses say this is a very good sign. And his attitude throughout has been amazing. He has stayed relentlessly upbeat, when conscious, and at the same time seems ready to face whatever comes without any fear. We talk about when Mom died. How she faced death with such grace and courage. I don’t know if Dad is walking into that same valley or not. But he’s certainly in the neighborhood. My sister and I are lucky to be able to watch such capable role models do this.

Still, it’s an odd juxtaposition, this business of fighting death during the holiday season. The world is celebrating and shopping and feasting and caroling and otherwise clamoring for our festive attention. And we are settling into the now familiar tunnel. Those who have ever spent days, weeks, months, or longer, laser-focused on the vital signs – the blood pressure, the temperature, the pain, the fatigue, administering the meds – know what I mean. In this tunnel, Santa’s “Ho, ho, ho!” has a Tim Burton flavor. More Hitchcock than holiday.

And yet, as I write, I see Ashanty’s card and ornament lying next to me. It occurs to me that 11-year-old Ashanty is communicating something different than I thought. I read it earlier as a misspelling of “believe”. But maybe “Be Live,” is what she really meant. “Be Live in Yourself,” she says. For most 11-year-olds this is probably easy. For my dad it is glib advice. But he is trying. Through the transfusions and infusions, the naps, the fevers, the struggles to walk. With 88 years of being live behind him, my dad is trying to be live for whatever he has in front of him.

And maybe Ashanty is speaking to me too. In these nights of long darkness, in this tunnel with no perceptible light at the end, here in this nebulous neighborhood of death, the night before Christmas, with not a creature stirring, “Be Live,” is the best advice I’ve gotten in a long time.