22. Cole

TWENTY-TWO

Cole

UAB Hospital

5:18 pm

I sit in the uncomfortable plastic chair, my mind spinning as I try to make sense of everything that's happening. The beeping of machines and the constant bustle of nurses and doctors blur into a cacophony of noise around me.

My eyes are fixed on Maddie's small form in the hospital bed, tubes and wires attached to her tiny body. I'm trying to summon the strength of the Vulcan in the park, to be strong and unyielding for her. But I feel anything but that.

Buster's presence beside me is the only thing keeping me from completely falling apart. His calm, steady voice explains medical terms and procedures that would otherwise be incomprehensible to me. I cling to his words like a lifeline.

"Cole, they're running more tests to confirm the diagnosis," he says, his hand resting reassuringly on my shoulder. "Dr. Bellinger is the one who suggested the cause. If it is AML, she's in good hands."

I nod numbly, unable to form words. The possibility of leukemia hangs heavy in the air, a terrifying specter I can't quite wrap my head around. How could this be happening to my vibrant, energetic little girl?

Cancer.

That word has always been so ephemeral, somebody else's tragedy.

It's a scary word, representing something I don't know much about except that it is deadly and painful and pretty much the worst thing I can imagine.

Buster continues to explain what AML might mean and what treatments could be involved. I try to focus and absorb the information, but it's like catching water with my bare hands. Everything feels slippery, elusive.

"Thank you," I manage to whisper, looking up at Buster. His presence, expertise, and unwavering support are more than I could have hoped for in this nightmare scenario. "I don't know what I'd do without you here."

He squeezes my hand, and momentarily, I allow myself to lean into his strength. The weight of potential decisions looms before me—treatment options, long-term care plans, financial considerations—but for now, I focus on breathing, on being present for Maddie, and on the comfort of having Buster by my side.

Wednesday, August 21

9:41 am

The last 48 hours have felt like an eternity. After Dr. Bellinger performed the bone marrow biopsy on Maddie, we've been left in a state of suspended animation, waiting for the results. Each tick of the clock grates on my nerves, the minutes stretching into unbearable hours.

I haven't left Maddie's side. I sleep, when I can, on the recliner beside her bed. My body is exhausted, but my mind won't rest. Every time I close my eyes, I see her lying there, so small and fragile, and the fear grips me all over again.

Against everyone's advice, I've been googling AML. I know I shouldn't, but I can't help myself. The things I've read… they terrify me. Words like "aggressive," "low survival rate," and "intensive treatment" swim in my mind.

I try to focus on the positives and the success stories, but it's hard when the worst-case scenarios loom so large.

A day after we arrived at the hospital, Maddie finally regained consciousness. They had given her fluids, antibiotics, and oxygen support, stabilizing her enough to wake her up. The relief I felt when her eyes fluttered open was indescribable. She was groggy and confused, but she was back with me.

"Mama?" she had whispered, her voice weak.

"I'm here, sweetie," I said, squeezing her hand gently. "You're going to be okay. The doctors are taking good care of you."

Since then, Maddie has been in and out of sleep, her minuscule body fighting so hard. She's scared and uncomfortable, and I do my best to soothe her and be strong for her. She complains of being tired and having aches all over, and each time she says it, my heart breaks a little more.

Dr. Bellinger checks in regularly, and his presence is a steady anchor in the chaos. Based on Buster's assurances, he is the best doctor here to be helping us. Dr. Bellinger reassures us that Maddie's vitals are holding steady, but he's careful not to give false hope. The wait is excruciating, but he reminds us that this time is necessary to get the most accurate results.

This is the the third day, and it feels like the three hundredth. Dr. Bellinger walks into Maddie's room, his expression unreadable. My heart pounds in my chest as he holds up the lab report.

"We have the results," he says, his voice calm but serious. "It's AML."

The words hit like a sledgehammer. I gasp my grip on Buster's hand tightening. My mind races, trying to piece together everything I've read. Acute Myeloid Leukemia. Aggressive. Deadly. My baby girl.

"What do we do now?" Buster asks, his voice steady despite the fear I can see in his eyes.

"We start with induction therapy," Dr. Bellinger explains. "It's aggressive chemotherapy to get the leukemia into remission. Maddie will need to stay in the hospital for the initial treatment, and we'll monitor her closely for any side effects or complications."

I nod, tears streaming down my face. "How long will it take?" I manage to ask, my voice barely above a whisper.

"The induction phase usually lasts about a month," Jonah replies. "After that, we'll evaluate her response and determine the next steps. It will be a tough road, but we're here for her every step of the way."

Buster squeezes my hand, trying to offer some comfort. "We'll get through this. Maddie is strong, and so are we."

Dr. Bellinger nods, giving us a reassuring look. "We'll start the treatment immediately. She's in good hands." My eyes fixate on the tattoos sneaking out of the bottom of his shirt sleeve—anything to quiet the constant worry and chatter in my mind.

As the medical team prepares to begin Maddie's treatment, I take a deep breath, steeling myself for the fight ahead. We're in for a long and challenging journey, but I'm determined to see Maddie through it. I won't let anything stand in our way for her sake and Buster's.

I'm still reeling from the AML diagnosis when Dr. Bellinger returns, his face even more serious than before. My heart sinks. What now?

"I'm afraid I have more bad news," he begins, his voice gentle but firm. "When we ordered the biopsy, we also ran genetic tests. The results show that Maddie has a particularly aggressive form of AML."

The words wash over me, each one feeling like a physical blow. Aggressive. My baby girl. How can this be happening?

Dr. Bellinger continues, his words becoming a blur of medical jargon. I catch phrases like "FLT3-ITD mutation," "poor prognosis," and "intensive treatment protocol," but I can't make sense of it all. I look to Buster, desperate for clarity.

After Dr. Bellinger leaves, Buster takes my hand, his eyes full of concern. "Cole, I know this is overwhelming," he says softly. "Let me break it down for you."

I nod, unable to speak.

"Maddie's AML has a specific genetic mutation called FLT3-ITD," he explains. "It's associated with a more aggressive form of the disease. This means the treatment will be more intense, and the risk of relapse is higher."

I feel like I can't breathe. "What does that mean for her chances?" I manage to ask.

Buster takes a deep breath. "It's going to be a tough fight," he admits. "The five-year survival rate for this type of AML is lower than other forms. But Cole, that doesn't mean there's no hope. There are new targeted therapies specifically for this mutation, and Maddie is young and strong."

I look over at Maddie, sleeping peacefully in her hospital bed, unaware of the battle her body is about to face. "What do we do now?" I ask, my voice barely above a whisper.

"After reviewing Maddie's case, we've determined that chemotherapy alone won't be enough," he explains. "Maddie will need a bone marrow transplant, also known as a stem cell replacement."

I look to Buster, my eyes wide with confusion and fear. He squeezes my hand reassuringly.

"What exactly does that mean?" I ask, my voice trembling.

Dr. Bellinger takes a deep breath. "A bone marrow transplant replaces the diseased bone marrow with healthy stem cells. These new cells can then produce healthy blood cells, effectively fighting the leukemia."

Buster chimes in, his voice steady and calm. "The tricky part is finding a donor who's an exact match. It's not like a blood transfusion where we just need the right type. For a bone marrow transplant, we need someone whose tissue type matches Maddie's precisely."

"How do we find that?" I ask, desperation creeping into my voice.

"We'll start by testing you and Maddie's father," Dr. Bellinger explains. "Siblings are often the best match, but since Maddie doesn't have any, we'll look to her parents first. If neither of you is a match, we'll expand our search to other family members."

"And if none of us match?" I can barely get the words out.

"Then we'll turn to the national bone marrow registry," Buster says gently. "There are millions of potential donors registered. We'll do everything we can to find a match for Maddie."

I nod, trying to process all this information. "What's the next step?"

"We'll start the testing process immediately," Dr. Bellinger says. "We'll take blood samples from you and Maddie's father. In the meantime, we'll begin preparing Maddie for the transplant."

I sit in the cold hospital chair, my mind reeling. Maddie's life hangs in the balance, and I'm faced with an impossible situation. Steele, Maddie's supposed father, isn't even in the picture. He's never acknowledged her, never been there for us. How can I reach out to him now?

Buster's voice cuts through my spiraling thoughts. "Cole, I know it's difficult, but we must contact Maddie's father. His blood could be the match we're looking for."

And then it occurs to me. Buster could be the match.

I nod numbly, unable to form words. The weight of my secret presses down on me. Should I tell Buster now? That I suspect he might be Maddie's father? The timing feels all wrong, but with Maddie's life at stake, does timing even matter anymore?

A nurse approaches with a tray of equipment. "Ms. Johnson, we're ready to take your blood sample now."

I roll up my sleeve mechanically, watching as they draw my blood. It's a small thing, really, compared to what Maddie's going through. But it seems uncomfortable, at best, and could mean everything.

As the nurse walks away, I turn to Buster. His presence has been my anchor through this nightmare. He's been here every step of the way, explaining things and comforting me. And now, I might have to turn his world upside down.

"Buster," I start, my voice barely above a whisper. "There's something I need to tell you."

He leans in, his eyes full of concern. "What is it, Cole?"

I take a deep breath, steeling myself. This isn't how I wanted to have this conversation, but Maddie's life is on the line. I have to do whatever it takes to save my daughter.

"It's about Maddie's father," I begin, my heart pounding in my chest. "I... I think there's a possibility that…"