Laura's List

By Michael McCord

Laura had it all. She worked her way through college while raising a family, earned her registered-nursing credentials, advanced through the ranks of hospital administration, moved to the town people lined up to vacation in, and fell in love. That was this morning. Now she's alone on the floor, each seizure is worse than the one before, and her right hand and eye are twitching so hard she can't dial the phone to call for help. It reads like a novel, but unfortunately for Laura, it's true. Laura's List speaks through Laura, her friends and family as it flashes through memories of the good times that led Laura to Bend, Oregon, before seizures dumped her on the floor, and then it follows the challenges presented when breast cancer returns with a vengeance in the form of a deadly brain tumor. You'll get to know Laura's friends, parents, sisters, children, and grandchildren as they remember the good times with Laura, enjoy the humor of day-to-day events, and face the future without her. Laura's List explores making the most of every day, especially when those days are numbered. It will make you laugh and cry and never, ever take another day for granted. Winner of the 2018 Indie Book Human Relations Awards: -Gold Award in Medical Issues -Silver Award in Family Challenges -Bronze Award in Health Memoir -Honorable Mention in Life's Challenges

• Language: English
• Publisher: Page Publishing, Inc.
• Release date: Dec 15, 2017
• ISBN: 9781635686531

Book preview

1

Laura Mason: Changes

Wednesday, July 14, 2010, 10:52 a.m.

Something is very wrong.

Everything started out fine this morning. I was up at 5:00 a.m. before the alarm sounded, and I left Mike snoring in bed. He is not a morning person and did not even roll over as I showered and dressed.

This morning, I met with nurses on a root cause analysis (RCA) in the acronym-filled world of hospital administration as the graveyard shift left and the day shift arrived.

RCAs have become a big part of what I do these days. It’s ironic that, after twenty-five years in hospitals, when I finally know my way around a hospital well enough to stay out of trouble, trouble now comes to me. Each time there is a negative outcome that might have been preventable or avoidable (someone, some system, or some process screwed up), it’s my job to investigate it. Then I write it up and make a presentation to the doctors and staff at my employer, St. Charles Medical Center in Bend, Oregon. With their input and their help (or sometimes over their objections), I try to make sure it doesn’t happen again.

I did not get too far into the latest RCA as this is a travel day. The governor appointed me to be part of a task force on health-care-facility-acquired infections. Since reducing patients’ risk while in the hospital is my mission as clinical-risk manager, I am ready to learn what I can and hopefully bring back plans to become more effective.

I stopped by the house to change clothes and pick up a toothbrush and a change of clothes in case I end up spending the night in Portland.

Now, I’m not sure traveling is a good idea. Something isn’t right. My assistant calls as I arrive at home. The right side of my mouth goes numb during the conversation, and it seems like it’s getting more difficult to pronounce each word.

My right eye starts blinking and twitching. It is just annoying in the beginning, and then it stops for a few minutes. The blinking comes back and is stronger this time.

I go into the bathroom, and one glance in the mirror has me scared. The right side of my face has fallen and doesn’t move with the left side. I’ve seen half smiles before, and even without the blinking and twitching, I know something is wrong with my brain.

My toothbrush falls out of my right hand, and I can’t pick it up. The fingers of my right hand move on command, but they are totally numb. Now my right hand starts twitching.

I need to call Mike. I really think I’m having a stroke. He can be home in five minutes.

Pick up the phone. No, pick it up again, and this time, use the left hand. Dial.

Hello.

Is Mike available?

No Mike here. Click.

Damn fingers. I never could use my left hand.

Is Mike there?

No Ike here. Is anyone really named Ike these days? Click.

It’s not my fingers … I can’t remember the number.

Now what?

2

Laura Mason: Lights Out

Wednesday, July 14, 2010, 10:57 a.m.

I almost make it to the front door. I guess walking the three miles to the hospital probably isn’t my best idea, and I know I cannot drive. I manage to get halfway to the floor before I fall the rest of the way, but I’m barely horizontal before the next wave of eye-and-hand twitching starts. It is worse than last time.

As I lie on the floor, twitching, our springer spaniel, Gracie, starts barking at me. I helped raise her from an eight-week-old puppy after Mike’s ancient springer spaniel, Abbey, made her exit, and now Gracie is acting like she doesn’t know me. Remembering the way my face looked in the mirror, I guess that’s not surprising.

The gravity of my situation is becoming clear—or at least as clear as anything can be through the twitching and blinking. I am not walking to the house next door, let alone to the hospital. And while it has never been a problem before, it turns out that the phone lying beside me is worthless without the clarity to remember and dial ten numbers.

It seems a cruel joke that after twenty years of working in hospitals, I will die with a hospital just minutes away and no way to get there. All my medical training, and I cannot even call for help. At least the twitching stops for another minute.

I reach for the phone just as the twitching return, and I type a few numbers. What the heck, any number is better than none. The phone rings twice and clicks as the twitching worsens. Then everything goes black in the middle of a bright sunny day.

3

Laura Mason: Match

Nearly eight years earlier in Albany, Oregon

Saturday, August 10, 2002, 9:42 p.m.

Laura, you need to try Match.com, Theresa suggests. I’ve met some great guys over the Internet.

I can find all the bad dates I need without a computer, I answer, pouring another pair of glasses of Chardonnay. Theresa has been complaining about the flameout of her latest fling, and I’m trying to drink enough to forget mine.

At least have a look at the pictures, Theresa pleads.

There can’t be any harm in looking. That one is cute. OK, how does this work? Is that me or the wine talking?

Theresa teaches me how to specify my parameters: first, Woman looking for a man. It sounds a little desperate, but accurate. My daughter, Kelley, is married and living in Seattle, and my son, Bobby, has just graduated from high school and joined the marines. I’m no longer responsible for keeping the soccer and basketball teams fed and watered, so I’ve had plenty of time on my hands. I’ve had a few bad experiences, but even with three glasses of wine, I’m not ready to switch to women.

Next: plug in age range. How about forty to fifty? How close to Albany, Oregon? Twenty miles. I fill in a few activities I enjoy, turn-ons, turn-offs, brown hair, brown eyes, athletic build (hey, I’m trying to generate interest here, not go to confession), and my profile is born.

According to Theresa, all I have to do is sit back and wait, that men will come to me, electronically at least. She should know. And it works—just not very well. Men from Corvallis and Albany e-mail me and chat me up. It is fun, but a little scary. Theresa teaches me to check out their profiles, and I learn to weed out the currently separated and those hoping to be employed soon.

After a few months sorting through guys I remember from high school and others who never saw the point of graduating from high school, Match.com starts to resemble summer television shows—mostly reruns. I decide to expand the search. How about 150 miles?

This is more like it. There are college graduates and employed, and a few are hot. Maybe it is my turn to choose.

4

Bend, Oregon, Chapter 911 Operator: In Rough Shape

Wednesday, July 14, 2010, 11:07 a.m.

’Ello? is her opening line.

Great, it’s not even noon, and this may be the first drunk of my shift.

Can you give me your name and the address you are calling from, please?

Silence.

What is your emergency?

Silence.

I believe most people would be hanging up about now, but my job is just getting interesting. I run the reverse directory, and it shows Michael B. McCord and an address on the west side of Bend.

Mrs. McCord?

No.

At least she knows who she isn’t.

Can you give me your name?

Stroke is her answer to the question I’m about to ask.

She may have just had one too many Bloody Marys and stroke may be an out-of-context reference to her last golf game, but I dispatch an ambulance and send it code 3. If she is a tipsy housewife, she is going to be embarrassed when the sirens come up her quiet street in the West Hills.

I hope that’s the worst of her problems, but something tells me this one is for real.

5

Dr. Christopher Richards: Our Laura

Wednesday, July 14, 2010, 11:16 a.m.

This isn’t your run-of-the-mill ambulance run. The signs of a brain tissue damage are written all over her. She is brought in with sirens blaring and with twitching of the right hand, right eye, and facial muscles. Something is obviously wrong on the left side of the brain.

And who is this patient? Most of the department ask Our Laura? when they see the name Laura Mason.

Whether she is a janitor or the new CEO, she needs Dilantin to control the seizures and a CT of the brain and spinal stem to see what is causing them. While radiology develops the x-rays, maybe I can find out who Our Laura is.

6

Mike McCord: The Call

Wednesday, July 14, 2010, 12:15 p.m.

The vibration of my cell phone is subtle, but it surprises me so much I spill my soup. My daughter, Jennifer, midway through college and checking in a few times per week, is typically the extent of my incoming cell phone calls.

This is the emergency room at St. Charles Hospital, Bend. Laura was brought in by ambulance, and she can’t communicate. Can you come—

I’ll be there in fifteen minutes, I interrupt. My daily lunch spot is only about six blocks from my law office, and as is my custom, I have used the six-block walk to clear my head after a morning at work. This gives me a long sprint back to my old Datsun 280Z. I cover the distance in four minutes despite wool pants and leather dress shoes.

The ride across town doesn’t take much longer but seems to take forever. What has happened?

Laura being at St. Charles is nothing unusual. She is the clinical-risk manager there. But she is supposed to be on her way to Portland as the governor’s appointee from Central Oregon on a health-care-acquired-infection advisory committee, not in the emergency room as a patient. And Laura not communicating—that is unusual.

Has she had an automobile collision on the Santiam Pass?

7

Mike McCord: It’s Back

Wednesday, July 14, 2010, 12:42 p.m.

I speed through a few green lights and actually slow down for two red ones on the way through town. My heart is still racing from the run to the car, and I’m breathing harder than is comfortable as I sprint from the parking lot into the emergency room.

Laura Mason?

Room 2.

I rush through the door and into the room on the left. It is crowded with medical personnel, and Laura has an IV in her arm. I reach for her left hand as her right arm and hand start shaking. Her right eye blinks faster as I watched.

A woman steps up and says, "Thanks for coming. She was brought in by ambulance and couldn’t identify herself. She’s pretty well known here, and we found her chart, but the only words she has said are Mike, stroke, and Tien."

Has she had a stroke?

No, these are seizures, and the Dilantin should start helping soon.

Why is she having seizures?

She has a brain tumor, and pressure has caused the seizing. We should have the seizures under control soon.

I feel my world start to spin, and I slide into the nearest chair. My throat tightens up, and my vision of Laura is blurred with tears before I hit the seat. My mind starts spinning and lands on a bright sunny day late in August of 2004.

8

Mike McCord: Laura vs. Todd Lake Trail

Saturday, August 28, 2004, 2:43 p.m.

If this isn’t the most beautiful place on earth, it must be in the top ten. I’m sitting on top of a ridge above Todd Lake, a deep-blue jewel of a lake in the Oregon Cascades west of Bend. Todd Lake is pretty enough, surrounded by fir forest except on the north shore, where the wild flowers are still blooming through the grass-covered meadow. While we can’t see them from here, thousands of tiny frogs are hopping between the flowers.

The lake is just the beginning of the view as just beyond it, rising out of the Sparks Lake marsh, is 9,000 feet of Mt. Bachelor still sporting a few patches of snow despite the long dry summer. To my right, away from the lake, is the east side of the South Sister, the third highest mountain in Oregon, along with partial views of the Middle and North Sisters, which are nearly as high as the South Sister, and beyond that obstructed views of Mt. Jefferson and Mount Hood. I keep turning, and there is Broken Top to the east, looking like it might have been the highest of them all, if only the volcano hadn’t blown its top off.

My brother, Mark, is beside me on the ridge, slowing as he approaches to take in the view. Laura is still making her way up the ridge, and we both watch her climb up through the sparse forest below us.

She’s having a tough time with this hike, I say as he stops to wait. The last time we were out, I spent all day trying to keep up with her.

She’ll be fine, Mark says. This isn’t even a trail, and she’s probably not used to the elevation yet.

What elevation? I thought we were coming up on the beach, Laura says with a smile between gasps. What are you waiting for? Dinner is waiting for us at the end of the trail.

With that, she breaks over the ridge and heads off down the ridge toward the road that goes by Todd Lake and back to Century Drive and Bend.

Mark and I scramble down the hill after her, once again working to keep up. I don’t give it much thought, but her breathing is heavy halfway down the ridge.

9

Laura Mason: My Lump

Monday, August 30, 2004, 10:16 a.m.

I felt the lump since a few weeks ago under my arm. I have been losing a little weight, and I thought maybe with a little less padding, I was just, well, lumpy. That explanation worked for about a week before I decided that whether it was serious or not, I had to find out. I’m a registered nurse!

I made an appointment with Dr. Kornfeld, an oncologist, last Friday. He looked it over and ran some tests, and now he wants to talk to me again. I’ve been around doctors long enough to know that he doesn’t need a personal visit to tell me that I’m lumpy and will be healthy for the next fifty years.

So I’m here at Bend Memorial Clinic, and the news isn’t good. It appears to be a lymph node that is enlarged. Dr. Kornfeld reviewed the lymph system with me and told me what I already knew. The lymph nodes are in various parts of the body and filter out harmful cells before they spread throughout the body. One or more can be enlarged when the patient has a cold, a flu virus, or even a slight infection in a cut.

My sentinel lymph node (the first one) is really big, and there is no good reason for it to be enlarged. Given the location of the lymph node, one option for the swelling node is that the node is filtering out cancer cells from cancer in the breast tissue nearby. This is not the explanation I want to hear.

We set an appointment with Dr. Andy Higgins, a Bend surgeon I know from when we both worked in Corvallis. The plan is to have a needle biopsy of the lymph node, take a bit of tissue and fluid from it, and have the lab analyze them. If the contents are cancerous, the node must be removed, and we will schedule a surgery to remove it.

There are dozens of nodes in the area, and the surgeon will keep taking and analyzing them until they quit coming back positive for cancer. Further, the location of the cancer has to be determined and the cancer removed. If it’s cancer, it is such a small one we haven’t been able to locate it yet. It is hard to believe such a small cancer could cause a lymph node to swell to the point that I could notice the lump. Oncologists use the term aggressive for cancers that are particularly efficient at spreading mayhem.

Now I have to tell Mike. I’ve only been here for a few months, and now this. I guess this Bend adventure may not be meant to be. If this is cancer, it will be a long process with multiple surgeries and chemotherapy with uncertain results. That really wasn’t what he and I were signing up for when he asked me to move to Bend and see how it goes.

After taking an hour to pull myself together, I make my way across town. Mike asks why I’m home early, and I tell him I have some bad news. I explain that I have an enlarged lymph node and that it may be a sign of a yet undiscovered cancer. If that’s what’s happening, I will need to go back home to Albany and have the surgery in Corvallis, where I have some family support.

Mike asks whether we have qualified cancer doctors in Bend, and I tell him I believe that they are some of the best.

Then I think you need to get your treatment at home, but the last time I checked, your home was here, Mike says. We’re in this together, so let’s get started. What do we do next?

We beat this, I say.

10

Mike McCord: Beating Cancer

Saturday, May 28, 2005, 11:35 a.m.

Hit it! Laura calls out from the end of the wakeboard rope. I give her about half throttle, and she easily pulls out of the water and skims across the wake. We have miles of Lake Shasta, California, water ahead of us, and Jennifer, Bob, and Ellen all cheer from the back of the ski boat.

Laura’s wakeboarding is still coming around, but this Memorial Day weekend is definitely cause for celebration.

On September 9 last fall, Dr. Andy Higgins took out Laura’s sentinel lymph node, and analysis confirmed it was full of breast cancer cells. He kept taking them for what seemed like most of the morning. Twenty eight of the thirty-two nodes removed tested positive for cancer. The cancer was from a source so small that it was difficult to find but was well established and aggressive.

The cancer cells were analyzed after the surgery, and they were classified as triple negative by the oncologists. Triple negative means that the cancer’s ability to thrive is not correlated with estrogen receptors (ER+), progesterone receptors (PR+), or overproduction of human epidermal growth factor receptor 2 (HER2+).

Tamoxifen destroys and prevents the spread of tumors, which are ER+ and PR+, and Herceptin destroys and prevents the spread of tumors, which are HER2+. Nothing as effective has been found to prevent the spread of triple-negative tumors, leaving Laura with only basic chemotherapy (essentially poison that is only slightly more toxic to tumors than to humans generally) and radiation to try to push triple-negative breast cancer into remission. More often, the chemotherapy and radiation have little impact on the cancer and eventually wear the patient down until the cancer claims another victim. We were left with the hope that either the chemotherapy would be unusually effective and put the cancer at least temporarily in remission or that medical science would come up with a new treatment. The statistics put Laura’s chances of surviving the cancer at 20 percent.

Laura went about becoming one of the 20 percent. First, there were a total of five surgeries to remove the lymph nodes, cancer site, and suspected cancer sites, which turned out to be nothing at all, and then placement and later removal of a port just upstream of the heart to make chemotherapy easier to administer.

Then there were chemotherapy treatments every other week for sixteen weeks with three different toxic recipes and all the nausea and vomiting that come with them. After a few weeks, Laura’s hair started falling out by the handful. We tried to take control of the situation by shaving it off before it fell out, and Laura started wearing wigs, including a pink one now and then just to shake everyone up.

Just when Laura needed plenty of support, there were periods of low white blood cell counts, which lowered her immunity to outside infections. This kept us from socializing throughout the holiday season. Finally, when the chemotherapy routine was finished, Laura underwent another six weeks of daily radiation designed to make one final attack on the site of the original tumor.

It was all worthwhile, as the cancer went into remission. Testing revealed no cancer at the original site, the lymph nodes, or free floating in the body. Laura was left with only lymphedema to remind her of the cancer. Lymphedema is swelling in the area of the body served by the removed lymph nodes—in this case, the left arm. It is worsened by repetitive use of the arm, so Laura’s raking and snow-shoveling days are over, for which she remains grateful!

Laura handled it all in style. She learned to take the chemotherapy late in the week to minimize time loss at work, and she fine-tuned the medication until she could work four days per week during the chemotherapy weeks. With the later treatments, while being poisoned with the final two of the three chemotherapy recipes, she reduced the time off to half a day per chemotherapy week.

Radiation typically makes the patient progressively more fatigued as treatments continue. Laura went early to work, walked to and from the radiation treatments, and claimed she suffered no ill effects.

While the chemotherapy was working through the final two recipes, Laura’s hair started returning, although it grew back with distinctive Shirley Temple curliness.

Laura’s zest for life continued unabated throughout the treatments. She worked in occasional snowboarding days on Mount Bachelor and returned from a week of time in the sun in Baja California, in time to plan and pack for this Memorial Day weekend at Lake Shasta. She has abandoned the wigs and is now sporting a short curly-hair style that will not float away when she falls off the wakeboard.

The cancer is gone, and Laura is back.

11

Laura Mason: Not a Word

Wednesday, July 14, 2010, 2:06 p.m.

The lights are too bright, and there is way too much going on in here. It’s time to close my eyes and start over again. I’m Laura Mason, and I feel weak and just a little nauseous. Everything is spinning although I seem to be lying on a bed. I recognize this kind of room. I’m in a hospital room. What hospital? How did I get here?

Let’s try again. There’s Mike. Mike, where am I? How did I get here? Why do I feel like this? Mike is just looking at me and holding my left hand. Why doesn’t he answer?

There is a nurse. I’ll ask her. Where am I? Still, there is no answer. Why can’t anyone hear me?

Mike leans over and says, Laura, can you hear me?

Yes, I answer. This time, I notice that there is no sound when I speak.

Squeeze my hand if you can hear me. Mike squeezes my hand. My first thought is anger. He doesn’t need to show me how to squeeze his hand. I can’t talk, but I’m not stupid. I guess maybe he doesn’t know. I guess I don’t know; maybe I am stupid.

I squeeze his hand.

You are in the St. Charles emergency room. You are having seizures. The medication is taking effect, and the seizures are getting less severe and less frequent as it takes hold. We are getting you a room here for the night, and your people will take good care of you.

The shaking starts in my right hand and then the blinking in my right eye. After a minute, the shaking and blinking stop.

But how did I get here? I ask once again without making a sound.

Mike seems to know what I’m thinking, and he answers, You were brought in when you dialed 911, and then couldn’t provide a bit of information. Luckily, the equipment gave the operator the address, and Gracie met them at the front door.

I close my