As Albert gazed out the hospital window he began to drift into unconsciousness.
Suddenly his world changed. He was back in his childhood at the end of the war with the image of a truck rumbling through the streets of Zwickau. Ahead of them was a car of the legation sporting the Lithuanian flag. As they left the city early in the morning the sun shone brightly in the sky. The vehicle took the highway with signs pointing towards Bamberg, which everyone knew was inside the American zone at least for now.
As the truck came closer to Bamberg his father announced.
"When we get there my family and I will rest for a few hours and then head further to the west. I don't know where the Allies are finally going to draw the lines, but I don't think that any of us want to get caught anywhere near the Russian zone. Bamberg is the end of the line for the truck."
The US GI's all around them made the lad feel safe. The boy knew that it was the end of the hell that had been their life for the last four years. He looked upwards at the blue sky and felt good. He lay down on the bundles and gazed upwards at it as though he was seeing the light for the first time. Somehow Albert's mind wandered between consciousness and oblivion. He was in limbo when it settled on the four horsemen and the old man. Yet in this confused state he could still see the passing sunny countryside. He had a premonition that his nightmares were over and that he would start his new life without them, yet there was something that was troubling him, which was just out of his reach and it made him anxious.
The trip was slow and tedious. The truck barely got out of the first gear. The road was congested with civilian traffic: people walking, and horse drawn wagons. There were columns of German prisoners of war being led by their captors to assembly points. The American soldiers had their rifles in the crook of their arms, but seemed to be walking slowly and deliberately as though taking a stroll in the park. Sometimes one would shout something at the prisoners, but the whole scene seemed to be surreal as though the German soldiers were a gang of workers walking to their jobs. In this organized confusion moved the American army going to their politically pre-agreed destinations where they would draw the new lines for the occupation zones. From time to time one could hear some shots in the distance, which a few days ago had been normal, but now was an exception.
The endless human column, a mixture of civilians and military, would stop from time to time until the noise ended and then continue on its way.
The mother looked towards the horizon. She didn't have to ask the question.
The father gazing towards the noise commented. "Some diehard SS are still putting up a struggle even though officially the war is over. Some of them know that their days are numbered and figure that's a better way to die."
Suddenly the word die made him flash back to the present.
Albert had colon cancer and was being treated with 5FU. Many who knew him were not sure of his future. Even his oncologist at one low point in the journey had indicated that he didn't think that the patient would make it. His wife however had told him that there was no way that their time together was over. Albert himself knew that if he survived the next five years that he might beat this dreadful disease.
The day before Albert's surgery his wife insisted that they go to a little garden on the roof where there were benches and some small trees. She felt she just had to be alone with Albert to digest this shocking revelation. She refused to think negatively and when Albert made the comment that they had had a good life together she got angry. She wanted to know what he meant when he said, "had." She told him that she would be at his side and that they would have many more years together.
He had his surgery and some weeks later met with the oncologist.
During this period his wife had done some research on colon cancer. Their daughter had bought her a medical manual about cancer, which she had under her arm. The book stated that if 5FU was used early then the patient had a fighting chance.
"What is my prognosis?"
"Your chances of survival without the chemo are twenty percent. On the other hand if you take the chemo you have an eighty percent chance of making it.
"There is a risk that you could die from the first injection. You could lose your hair, be nauseated and vomit and one of the most important things is that it could do damage to your heart. There is a great risk of a heart attack. If you make it the first time then that risk diminishes with the subsequent treatments."
Albert looked at his wife and stood up.
Before long the nurse showed up and took him to the chemo clinic. There he spent some more time answering a number of questions and then a nurse hooked him up to an IV. She gave him a cocktail of medications. One drug was to help him relax, another for nausea. There were a few others before she gave him the 5FU that was to kill the infected cells. The process went without a hitch.
Albert took the treatment for four days without much of any reaction. He felt tired and a bit nauseated. On the fifth day when he got home he began to experience some pains and became violently ill. During the night he could not sleep and developed sores in his mouth and a fever. His lips swelled and began to crack. Suddenly he experienced an acute pain under his chest. His wife had instructions to get him the emergency if even the slightest fever occurred. Arriving at the emergency room after the triage he was hospitalized. Tests revealed that he had a partial blockage of the portal vein by a blood clot, which restricted the blood flow to the intestines and liver. The examining doctor told him that they would try to unblock it with blood thinners. The doctor came and checked on the progress with a nurse.
"We must be very careful and monitor his blood pressure and count. Since we must give him a massive dose of blood thinners we don't want for him to start bleeding internally."
Albert listened to the instructions. "What about the cancer?"
The doctor turned to him. "I wouldn't worry about the cancer."
"Why not? Didn't it cause this whole trouble? I would like to know what's going on."
"If you must know I'll tell you. The vein is part of the system that supplies the gut area and liver with blood. If the system is blocked and these organs are deprived they begin to die immediately. The process is so fast that you would be lucky to make it to my operating theatre still alive. You're fortunate that only half of the vein is blocked. If we're lucky we'll be able to clear it. Now rest. The nurse will get you something to help you relax, to get some sleep."
As the doctor left the room the old man turned his head towards the window, looked at the bright sunlight and thought.
"I have beaten death once more. Why and for how long this time?"
The pain subsided from the medicines and blood thinners. The nurse gave Albert another tablet and he began to drift into unconsciousness. In this period of sleep and drug induced oblivion he began to dream and regress to his youth.
After leaving the hospital it was a week or two before he was well enough to visit the cancer clinic. His oncologist had not visited him in the hospital so this was the first time he was seeing him after his ordeal. Albert had an appointment to see his oncologist at the cancer clinic. As he waited in the examining room the doctor entered and seemed surprised.
This man who had always been so serious now seemed different. He flung one leg over the examining table and looking straight into Albert's eyes stated.
"I didn't think you would make it. We'll have to insert a pick line so that your meds can be dispensed continually at a slower rate. Your heart can't stand the regular mode. This has to be done by a specialist in another hospital. Once it's in your body you must come back here so that we can hook you up to a computerized pump."
Albert was instructed to return to the cancer clinic directly after the insertion of the pick line. He developed problems breathing after they inserted the tube because one end was only inches from his heart. As he arrived at the cancer clinic they immediately sent for his oncologist who examined him and delayed the chemo, which was going to be the 5FU with a mixture of other medicines. The doctor had the old man admitted to the hospital in the cardiac ward to be monitored for a couple of days.
When they were assured that it was safe they hooked him up to the pump, until the end of the year. A nurse came to the house to flush out his pick line and monitor his condition. Again one night he developed a fever. His wife called the nurse who came immediately and after an examination she called for an ambulance. His wife rode in the ambulance with him.
Albert was once more seriously ill and would not eat. Then one morning he awoke fully refreshed and felt hungry. He picked up the phone beside him and rang his house around six thirty in the morning.
He heard an anxious.
His wife sounded fully awake.
The old man was surprised because usually when he was home both of them slept in until nine.
"What time is it?"
"Six thirty. I woke up and have a real craving for a chocolate milkshake and some fried chicken."
"Are you sure? That's quite a change from the last few days when you wouldn't eat or drink anything."
"I don't know why but I'm famished."
"What about the hospital? Will they let you have the food?"
"I don't think they'll object they have been trying to make me eat something and anything this past week."
"Okay. I'll get them and bring them to you. I was just preparing to leave when you called."
By the time she arrived it was around seven thirty with his food and drink that he requested and to her amazement saw him wolf it all down. He turned towards the window and stared at the leaves gently fluttering in the breeze.
Around eleven thirty an attendant brought the lunch tray. He ate the food to the last scrap. Surprisingly it tasted very good that day. After another day for observation the doctors released him.
It had been a long five years but Albert and his wife were anxious at this particular visit to the cancer clinic hoping to hear that the last CT he had along with the Blood Work and results from several other tests would show that he was now in remission.
Their hopes were shattered.
"There's an active cancer in your body. If it's colon cancer then all we have to offer you is a palliative chemo to keep you comfortable."
Albert wasn't feeling too much discomfort and was shocked.
"If that's the case I'll wait for the treatment until I can't stand the pain or control it any other way."
The doctor agreed.
"Yes. You should keep your options open. Once the pain becomes intolerable let us know. In order to ensure that it's the type of cancer that we suspect we'll have to do a biopsy on the lower abdomen. There is a difficulty getting anyone to do this biopsy because of the spot where the condition exists. The physicians are concerned with infections, but we have reached the point when we must take the risk if you agree."
Albert was silent for a moment. "I'd rather take the risk and find out for the peace of my own mind."
After the biopsy Albert's wife kept calling his primary nurse to find out the type of cancer. Then on one day she was told that it was follicular lymphoma. An appointment was set up to see Albert's oncologist to talk about the results.
The doctor entered the examining room. Albert was anxious to get the official version.
"Did you get the results of the procedure?"
The doctor flipped through his charts.
"Yes the sample showed that you have follicular lymphoma. It's a slow growing cancer, but nevertheless…."
"Can you do anything about it?"
"We can slow its progress, but there is no cure. In some ways you're lucky. It's a low grade so you could go on for years, but if it begins to spread we have some drugs that keep it in control or at least slow it down."
"Should I take the treatment immediately?"
"Since this type of cancer is out of my area of expertise I'll arrange for you to see the haematologist group that handles it. They deal with lymphomas on a daily basis and will give you a better understanding of the disease and prescribe the treatment."
Albert met with the haematologists who after examining him recommended that nothing should be done for the present time but they would monitor the condition during regular appointments every three months.
"We'll see you every three months. In the meantime if anything changes or you feel that you need to see us make an appointment and we'll review the situation."
Albert had a CT done in November 2007 and a scheduled visit with the haematologist in December. As he sat in the examining room with his wife they were not prepared for the news they were about to be told.
"The CT shows that some of the large nodes have doubled in size and now there are many other small nodes that are infected. You should start your chemotherapy."
"Could I wait until after the Christmas season?"
"No. Once the cancer begins to move no time should be wasted. We'll make an appointment with the chemotherapy clinic to start the treatment next week. You need six treatments three weeks apart. The therapy would consist of a cocktail of medicines and we will monitor its effectiveness. If it works then we'll put you on a maintenance program and give you a treatment of one of the new drugs that should slow down the growths and multiplication of the cancerous cells."
The arrangements were made for the chemo and Albert went home. He was restless that night and began to dream about when he was a child again, but woke up without finishing his nightmares. Lately all of his dreams revolved around his childhood and mostly his horrible experiences from the past.
He had put the nightmares that he'd had in the hospital in the back of his psyche and they had become only faint thoughts somewhere in the recesses of his mind. During the last few years his dreams were normal. Nothing out of the ordinary or special, but now he had a strange feeling that things were going to change. Not giving any more thought he turned over and went to sleep.
Throughout his treatments Albert developed gallstones, polyps and a cataract that had to be operated and removed which added to his predicament and discomfort. After he completed the six treatments of cocktails of chemicals he consulted with the oncologist. Again the side effects sometimes made the old man wonder whether all this was worth it. During this visit Albert shared his feelings with the physician.
The oncologist read the reports.
"We have done everything possible. We should discontinue it otherwise we might cause other irreparable damages."
Albert didn't care any longer whether he would be cured or not. The treatments had such horrible side effects that he just wanted to stop. His quality of life lingered in the realm of knowing that he was alive, but nothing else was worthwhile, whether it was eating, drinking or even enjoying the TV that kept him from going mad just as before when he took the 5FU. During the period that he was unable to eat his mind wandered back to another time when he was a child in Dresden at the point when food didn't matter anymore. The clinic discontinued the treatment and put him on what they called 'maintenance' which consisted of one treatment every three months with a drug that would attack only the lymphatic cells. Every time before the injections of this drug they would give him a cocktail of other medicines so that his body would accept this new miracle drug. He would fall into a deep sleep, which would last for hours.
Sometimes during these 'maintenance' treatments he would fall into a deep sleep that was almost like a coma. The attending nurses or his wife who was always there would have to wake him up so that he could answer some questions. During one of these incidents Albert began to drift back into his past.
The dream returned him back to his childhood at the end of the war with the image of a car of the legation sporting the Lithuanian flag.