Friday, April 27, 2007

Thoughts of a father

Arman with a 6.5 cm lymph node, now ultrasound shows an 11.4 cm spleen, huge, upper limit of normal for an adult, much less for a six year old, blood work mostly normal, no clear diagnosis, mono test results two weeks away.

Thus the recommendation to biopsy. Look for cancer – lymphoma, Hodgkin’s disease, childhood death.

I held Arman as he screamed yesterday, the needle entering his vein, and I thought, “I hope and pray this is not the beginning.” My sweet six year-old child, so full of life and joy and determination and creativity and enthusiasm and lost in his plans to go up to the elementary.

We’d move the family of course, to MD Anderson or Sloan-Kettering or wherever could give him the chance for cure.

And should he be taken from us, such an emptiness would be left all my days. For Nava, her life a dance with his, she just two years older, a gaping emptiness. And every day I would talk to his soul beyond, and ask for his intercession on behalf of his father, for strength and patience to make it without him.

I can imagine all this, but in my heart, it has to just be an exuberant immune response to mono, right? Please? How can Arman have cancer?! Diverse genetic mix, mostly vegetarian diet, clear island air, no carcinogens. It’s just not possible.

And I try to cut a deal with God. The bargaining -- one of the five stages of grieving (I recognize it from my medical school days). Save my son, let this all be a lump of nothing, make it all smaller, and I promise I will be good. In however many ways that I’m not, I’ll be good.

All my personal concerns, various worries, evaporate under the heat of this lump.

I saw my friend Robert, from residency, last year in Hawaii at the eye conference. “How many kids to you have now,” I asked. “Two,” he responded, “a 12 year-old and a 10 year-old.” “I thought you had twins.” “We did. One died two years ago. Lymphoma.” He talked of how this trip now was the first he and his wife had been able to take. There was no time to mourn two years ago. “What can you do,” he said. “You’ve got these other kids that are alive and who need you. They need your love, your presence, your joy and enthusiasm for them. So you bury one child and try to keep moving forward.”

The universe and God I do not understand. Suffering and the suffering of the innocent, I do not understand. And at times like this, I don’t try to understand, fearing my explanation or theory may just be false placation. It’s just the way it is, and there is nothing I can do about it. Will my magical thinking help? Will the universe still respond with “your wish is my command”? Is my son any more important, just because he is mine? Thousands of despondent parents bury their children every day, death by lymphoma, or leukemia, or tuberculosis, or starvation or war or murder. And the world just keeps going on. I just keep going on, thinking about me, my concerns, my pursuits, my hopes, oblivious of their pain and the fragments of their broken hearts. Why would I be so special to receive my special request from the universe, from God? I feel reticent even to ask.

Over the last few year when death would come up in conversations (your great-great grandmother died, Duke died, the cat died), Arman has so often said, “I’m scared to die, I don't want to die alone, can you die with me, Dad?” We realized he thinks that the next world is in the ground, somehow related to the grave. “We’ll all see each other in the next world, Arman.” “But what if we get buried in different holes?”

For most of the day, I’m just doing something else. And I look up from my work, and wonder what it was that was causing my anxiety? Briefly forgotten. And the knowledge quickly rushes in, pushes the fragile calm out, my tears well up and I sob.


Vincent said...

Hi David,

Our family is praying for Arman and for your family.

I can not even fathom what you may be going through inside. The only thing I can tell you is that prayer really helped Hilma and me while going through Gunnar's ordeal.

You (Khorram's) are family to us and we are here for you. Don't hesitate to let us know if you need anything, anytime.

Vince Castro

Anonymous said...

My heart reaches out to you, your family, most especially your son. I pray.

BoReGo said...

It hurts to read your post, but it spurs me into prayer for Arman and your family. I will not forget to intercede.

Anonymous said...

I wish I could say all the comforting words for you and your family. I will pray hard for a mono

Melissa said...

Your words as a loving father brought me to tears, and I will continue to pray that God will heal Arman, and give you and your family peace.

Edward said...

Dr. Khorram:

My children and I will definitely include you and your family, especially your son, in our daily prayer. We hope that your beloved son will have nothing more than a harmless lump. Keep the faith as we will ourselves with the hope that Arman will come out of this as healthy as anyone.

Bruce A. Bateman said...

David, I was touched by your profound piece 'Thoughts of a Father' on Friday and want to express our family's hope that Arman is healthy and continues to be so. May this please be a false alarm. You have made this cynic's eyes well up.