The Consent Form

One of the hardest decisions that I have ever had to make was to consent to Michael undergoing chemotherapy. The truth is that the word therapy should never be attached to the word chemo. Chemo does one thing and one thing only: kill. In Michael’s case the types of chemo that he is on are designed to kill “fast growing cells". Hair cells fall into this category which is why most chemo patients lose their hair.

Another type of fast-growing cell is bone marrow. Michael’s chemo regimen is designed to systematically destroy his bone marrow. The way that it has been explained to me is that our bone marrow is like the factory that produces blood cells. At some point one or more of Michael’s bone marrow cells mutated and began producing “blast” cells. Blast cells are immature white blood cells that are rapidly produced and attack and crowd out our normal red, white, and platelet blood cells. These immature cells cannot fight off infection and therefore compromise the body’s immune system.

Chemo destroys the bone marrow cells, both the good and the bad so that the body can regenerate new cells that have not mutated and thus start producing the good blood cells once again.

The challenge is that in the process, your white blood cells are literally reduced to zero, leaving the chemo patient severely immunocompromised. To protect from various forms of infection, the patient is pumped full of antibiotics, and antifungal medications. The chemo, and the other various drugs have a number of side effects which are addressed with even more drugs.

Over the course of the next two and a half years Michael will be given various cocktails of approximately 30 different drugs. The long-term side effects include things like heart disorders and infertility. How do you go about telling a thirteen-year-old boy that he may never be able to have children? How does He even process that at this point in his life? The simple, child-like trust that Michael has in his mom and dad to do what’s best for him is both humbling and burdening. He is trusting us to take care of him while we are being forced to make a decision that no parent should ever have to make.

Agreeing to move forward with the chemo was one of the most difficult decisions that I have ever made. On the one hand, I could agree to pump him full of drugs that will damage his body and have potentially serious, long-term side effects. The alternative is letting him die. I know there are those who would advocate for going the “natural route” whatever that means to you (I have learned the term natural means a host of different things to different people). But I have never known anyone who has chosen the natural route and survived cancer. I am not saying that those people do not exist, but I have never met one. I have known plenty of people who have chosen the natural route only to succumb to their cancer. I have also known many who have gone through chemo and are living healthy lives today.

When decision time came, through tears, I told the oncologist I needed her to look me in the eye and tell me that chemo is what she would do with her own child if faced with our situation. She did exactly that, and Sarah and I reluctantly signed the forms.