Page 66 of Doctor Neighbor

“They’re running a lot of tests to figure out what’s going on,” I explain to Cole, who’s watching me with wide, fearful eyes. “They’ve already done a CT scan to check for any brain issues, blood tests to look for infections or metabolic imbalances, and a lumbar puncture to rule out meningitis or other infections in her cerebrospinal fluid.”

Cole nods, but I can see she’s barely holding it together. “What does all that mean? Do they have any idea what’s wrong?”

I shake my head, frustration gnawing at me. “Not yet. The tests take time, and they need to rule out a lot of possibilities. Right now, they’re monitoring her closely to keep her stable while they wait for results. It could be any number of things, honestly. But these tests should be able to narrow it down significantly.”

Cole’s shoulders slump, and I place a reassuring hand on her arm. “We’ll get to the bottom of this, I promise. Maddie’s in good hands. I won’t stop until we have answers.”

I take a deep breath, knowing we need more help. “I’m going to call Dr. Bellinger personally,” I tell Cole. “He’s a general surgeon but also did a fellowship in pediatric metabolic conditions. It’s fortunate he was here today when you brought her in. If anyone can help figure this out, it’s him.”

Cole nods again, a glimmer of hope in her eyes. “Thank you, Buster.”

I leave the room, pulling out my phone to call Jonah. As I wait for him to pick up, I glance back at Maddie and Cole, determination hardening my resolve. We’ll get through this. We have to.

Just after the first ring, I spot him walking down the hall, his white coat flapping slightly with each determined step. I quickly end the call and put the phone away. Relief washes over me, and I hurry towards him, pocketing my phone.

“Jonah!” I call out, my voice seems a little too loud in the quiet corridor. He turns, surprise flickering across his face before he sees the urgency in mine.

“Buster, what’s going on?” he asks, concern immediately replacing the surprise.

I catch up to him, slightly out of breath. “It’s Maddie Johnson,” I say, my heart tightening even further at the prospect of talking to him about this little girl I’ve come to care about. “Her mother is my friend.”

Friend? We’re so much more than friends, but right now, that’s just semantics.

“Can you take a look at her chart? She was found unresponsive at school. They’ve done a CT scan, blood tests, a lumbar puncture... but we still don’t know what’s wrong.”

Jonah’s eyes narrow, all professional now. “They’ve ruled out sepsis?”

“Yes,” I confirm, swallowing hard. “But we need to get to the bottom of this. Do you have any thoughts about what could be going on? Can you take the lead on this?”

Jonah nods, his expression grim. “I have a hunch it could be Acute Myeloid Leukemia, AML. Her symptoms fit, but I need to see a few more things before I can say definitively.”

My stomach drops. “AML,” I repeat, the weight of the words pressing down on me. “What do we need to do?”

“We need to confirm it with a bone marrow biopsy,” Jonah explains, his tone steady but urgent. “If it is AML, we’ll need to start treatment immediately. It’s aggressive, but catching it early gives us a better chance.”

I nod, my mind racing. “Whatever it takes.”

Jonah places a reassuring hand on my shoulder. “We will, Buster. Let’s go back to her room. I’ll check her vitals and order the necessary tests. We’ll get through this.”

As we head back to Maddie’s room together, I feel a surge of determination. Maddie’s life is in balance, and I won’t let her down. With Jonah’s expertise and our combined efforts, we’ll find a way to pull her through.

As we walk back to Maddie’s room, my mind races, trying to gather everything I know about AML from med school and residency. It’s been years since I’ve encountered it, and the details feel frustratingly elusive.

AML… It’s a type of cancer that starts in the bone marrow but quickly moves into the blood. I remember it being aggressive and requiring immediate intervention. Symptoms include fatigue, frequent infections, and easy bruising or bleeding, all because the bone marrow fails to produce normal blood cells.

“Jonah,” I say, my voice tense, “I’m trying to remember everything about AML. It’s been a while since I dealt with it. Can you fill in the gaps?”

Jonah nods, his expression focused. “AML is a rapidly progressing cancer of the blood and bone marrow. The bone marrow produces abnormal white blood cells that crowd out the healthy cells, leading to a variety of symptoms. In Maddie’s case, her unresponsiveness could be due to severe anemia or an infection her body couldn’t fight off.”

I nod, recalling the basics. “Right, and the treatment typically involves chemotherapy, right?”

“Yes,” Jonah confirms. “The first phase is called induction therapy. The goal is to kill the leukemia cells in the blood and bone marrow, putting the disease into remission. This is followed by consolidation therapy to eliminate any remaining leukemia cells and prevent a relapse. The entire process is intense and can take several months.”

“What’s her prognosis if it is AML?” I ask, needing to know what we’re up against.

Jonah’s face softens with empathy. “It varies depending on a number of factors—her overall health, how well she responds to treatment, and the specific genetic mutations of the leukemia cells. Children generally have a better prognosis than adults, but it’s still a tough road. Early diagnosis and aggressive treatment are key.”

We reach Maddie’s room, and I take a deep breath, trying to steady my nerves. “So, what’s our next step?”

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