My blog for today – April 22 – is a true story Marilyn Gerriets reminded me of after church today. It’s a tale of karma I hadn’t thought of  in twenty years. As always, I’ll put a link on my facebook.

Twins

Thirteen-year-old Renee had to compose an essay about American health care for a school project, so she’d decided—perhaps her mother had a part in this—to interview me.

It was five years since her last visit to my oncology clinic; I’d decided Renee didn’t need any more routine follow-ups, because her father was on our Neurosurgery faculty and regularly updated me on Renee’s exploits  in the coffee line or when we passed on the stairs.

Renee and I faced each other in tall rockers at the nurses’ station. She shuffled the pieces of paper laid out on the knees of her jeans and started to quiz me.

“Why did you become a doctor? Why a pediatrician? Why an oncologist?”

It took me back a decade. She was already a couple of inches taller than her mother, standing silent and still behind her chair.

“Do you have children? What do you do when you’re not working?”

Did she have any memory of those countless days and nights she and her mom had spent here?  Dad had told me recently that his wife would sometimes hear in her dreams my tread down our Cancer Center corridor as she waited for the verdict of her daughter’s blood count. The judgment that could tell her Renee, too, was to be taken from her.

I’d first met the family twelve years earlier, when the twins were just twelve months old. Renee was diagnosed with acute leukemia in late February, on my own birthday. A month later to the day, her sister Lise earned the same diagnosis. Not so unusual—two cases of leukemia in identical twins. We still know precious little about the causes of this disease, but there have to be faulty genes, or else some cancer-causing virus gets inside this single embryo at a critical time in pregnancy. But what virus, which gene, that’s a mystery.

When identical twins are both affected, the leukemia usually behaves very much alike, and initially, both twins responded to chemotherapy the way almost all children with leukemia do. Within a month, Lise had followed Renee into remission: not a trace of cancer to be seen in either of them. I told her parents they had every reason for hope, hoping to offer a crumb or two of comfort. And so it proved—with Renee. She came through her three years of chemo without a setback, while Lise’s state of remission lasted less than six months. Once her leukemia exploded in full force once more, she achieved only a shaky further remission, and within fifteen months from first diagnosis she was dead. If her parents doubted my competence to care for their surviving daughter, they were too courteous or reserved in emotion and judgment to express such thoughts. But Mom’s dread of Renee’s monthly blood counts never left her mom’s dreams.

Ten years on, her surviving daughter continued to ply me with her carefully rehearsed questions. I started to loop a few of my own back at her:

“Do you remember me? The hospital? All those shots?”

“Yes,” was all she said, her mother’s daughter in every way. What feelings were hidden behind her steady gaze I had no way of discerning. I ventured the question that was beating away inside my chest. “And your sister Lise? Do you remember her?”

“Yes, I remember her.”

She said nothing more. Her mother stayed silent and still behind her chair, her eyes fixed on a point a top her daughter’s head. One question I held back, left forever unasked, and unanswered:

Why was it that Lise, your twin, was taken? And why do you, Renee, remain here, a young woman in glowing health, to question me for your school project?

Four years later came a postscript to this story. Renee, now seventeen, was celebrating the Fourth of July with her family and friends at Crescent Beach on Florida’s east coast. She had always been a water baby, and had had been on her high-school swim team since tenth grade. The teenagers were toweling off after bathing, realizing the currents were gathering strength, when they heard frantic screams from some way out in the ocean. A young boy had been swept out and was in clear danger of not making it back to shore. Without hesitation, Renee tossed her towel aside, plunged back into the sea, and after several dozen strokes through turbulent waves reached the boy and hauled him to safety.

If you believe in karma, perhaps I had the answer to my unasked question.