Originally published July 10, 2006. Second of four parts.
The winter sun is beaming down on Cyndie French's chilled skin, and she tilts her face toward the sky.
Beneath her dark glasses, her blue eyes are droopy and tired. But her son Derek is having a good day, so what else really matters?
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On the picnic table in front of her, a chocolate birthday cake she has fashioned to look like a mound of fresh dirt is crawling with gummy worms. Kids in blue jeans and sweat shirts tear at a bag of spicy Cheetos, dip spoons into vats of potato salad and fill paper plates with slices of congealing pizza.
In the middle of it all is her boy Derek, who has made it to his 11th year.
He dips into the icing of his cake and runs his gloppy index finger across his tongue. He looks over at his mom, a dimpled grin on his face.
Victory, Cyndie thinks.
"Not bad!" she says, hands on her hips, blonde hair tumbling from her straw hat.
Not bad for a 40-year-old single mother of five whose bank account is inching toward zero, and whose refrigerator contains a milk carton that is nearly empty.
Cyndie has three older boys, and she has no idea what she will put on the dinner table tonight. If not for a generous friend and a trip to the Dollar Store, she never would have been able to throw this party, which she is calling Derek's Life Celebration.
Her son's yearlong medical crisis has cost Cyndie almost everything, including time with her other sons and her daughter, Brieanna, who is almost 6 and now lives mainly with her father in Orangevale so that Cyndie can focus on Derek.
Derek has neuroblastoma, a rare childhood cancer that begins in the nerve cells and spreads to the rest of the body. The good news is that UC Davis doctors have harvested enough healthy stem cells from his bone marrow to perform a blood transplant that could save his life. The bad news is that the treatment is risky and comes with no guarantees. But at least it carries hope.
Right now, Derek's happiness is Cyndie's priority, and everything else in her life is secondary. Even her job running a nail and tanning salon. Even her love life. Even her other children.
"She brings home steak for Derek, and I'm like, 'Hey, what about the rest of us?'" jokes her son Vincent, who is 15, has two-toned hair and wants to be in a rock band.
Cyndie's son Micah, a philosophical boy of 16 who is Derek's closest buddy, has started to spend more time away from the house, at the local teen center. Her oldest son Anthony, bright and sharp-tongued at 18, is simmering with anger about his mom's lagging attention and the family's precarious financial situation.
But at the moment Brieanna, at least, is happy. She is dashing toward her mother, silky blonde pigtails bouncing at the sides of her head. It has been five days since they have seen each other, and it shows.
"Hiiiiiiii, Mom!" Brieanna shouts in her small voice, as Cyndie opens her arms wide.
"How have you been, beautiful girl?" Cyndie trills, sweeping Brieanna up in a hug.
It's not easy being Cyndie French these days. Her head is crammed with details, spinning with places she needs to go and things she needs to do. One slip-up, and everything falls apart.
On a dreary morning in the middle of December, Cyndie is trying to figure out a strategy to get Derek from their home in West Sacramento to UC Davis Medical Center in Sacramento for the first of two radiation treatments. They cannot miss another appointment, she promises herself.
The doctors already are unhappy that Derek, who will do just about anything to sabotage a trip to UC Davis, has skipped some clinic and doctor visits. Once, prior to a test that could be done only if he had an empty stomach, he deliberately scarfed a bagel. A couple of times, before Cyndie started noting their schedule on calendars she carries in her purse and car and posts in her kitchen, she simply got confused about the dates and times of appointments, which sometimes number three a day.
Nothing will stop us today, she vows. Maybe she will bribe Derek with lunch at Nick's, a 1950s-style diner and his favorite haunt. But, she says only half-jokingly, how will she pay for the meal?
She has not been into the nail shop much lately, and her application for Social Security payments for Derek is still lost in a bureaucratic maze. She may have to borrow money to pay this month's rent. Maybe the folks at Nick's will give her a break. It wouldn't be the first time.
Before they can get on the freeway headed toward the hospital, Cyndie needs to give Derek his medicines and flush out his Broviac catheter, a tube in his chest used to deliver drugs and other liquids without poking him with needles. She needs to make sure he brushes his teeth and puts on clean clothes. The breakfast dishes can wait.
Today Cyndie also must find time to return a call from a businessman who hires her to do promotional work for restaurants, bars and furniture stores. She has to phone her contact at the American Cancer Society, where she has signed on as a committee member, and call River City High School, where her three older boys have been skipping classes and falling behind in their schoolwork. She wants to bake some homemade cookies to pass around to Derek's doctors and nurses, and to patients biding their time in the waiting room.
How will she get it all done? she asks herself out loud. Is she neglecting her family? What choice does she really have?
Maybe, she says, she will invite her boyfriend Jeff Herzog to dinner, since she likely won't be able to be with him over the Christmas holiday as he had hoped. She can pull something together with the chicken in the freezer and the bags of groceries that someone, most likely the folks at Journey Christian Church down the street, dropped off on her front porch. Thank goodness for friends, she says. Grabbing her car keys and her cell phone, she rushes out the door and heads toward UC Davis Medical Center.
Stretched out on a table beneath a device that resembles the inside of a giant washing machine, Derek seems particularly small and vulnerable.
Cyndie watches his fuzzy black and white image on a screen in an adjoining room as technicians punch computer keys, programming the direction and amount of radiation to be delivered to the cancerous tumor just above her son's kidneys. The tumor is growing, and doctors want to try to shrink it before Derek gets the critical blood stem cell transplant.
Cyndie gives her final pitch to the radiation specialists to allow her inside the chamber, close to Derek, but they refuse. Too dangerous, they say.
"Come on, baby," Cyndie whispers, staring at the screen in front of her. "Hold still. You can do it."
Derek is lying rigidly, his bony chest bare, the white tube of his catheter dangling down. Eyes closed, he presses his lips together as a red light appears on his abdomen.
Cyndie is holding her breath, hoping her son stays still. Derek knows that the treatments will make his stomach churn, and he dreads the feeling. It's not worth the trouble, he has said many times in the past. It's too hard to keep still for so long. It won't help.
This time, he cooperates.
But on the way home from the medical center, sitting in their aging Saturn and already feeling queasy, Derek starts to cry quietly.
"Why did I have to get this, Mom?" he asks. "Why do I have to be the one with cancer? Why am I the one who's always sick?"
Cyndie stops the car.
It is a question that she cannot yet answer.
She has been searching for inspiration in the story of the biblical figure Job, who loses his health, his wealth and his family but keeps his faith in God.
"God gives you gifts," she tells Derek. "And God puts you through trials. I think God has something very special planned for you."
Cyndie touches her son's cheek, then puts her arm around him.
He doesn't pull away.
Three days after Christmas, Derek and his mother are back at the hospital.
They are talking to Doug Taylor, a curly-haired pediatric cancer specialist whom staffers call "Doc Hollywood" for his movie star good looks and charisma.
A few weeks ago, Taylor managed to harvest enough healthy stem cells from Derek's hip bones to infuse back into his body. This transplant, which would occur only after another round of cancer drugs and radiation treatments, would theoretically allow him to start growing healthy marrow and save his life.
Taylor wants to lay out specifics, but Derek has had it with all this. He has grown to distrust doctors, or anyone in a white coat, and thinks of his cancer treatments as torture.
He blames his mother for all of it. The pain. The nausea. The fact that he cannot go to school or run around with his friends. The fact that everything is different now. He just wants to be normal again.
"Why do you let them do these things to me, Mom?" he asks, over and over. "It's your fault. I hate it! You don't care what I think!"
He threatens to call the police and tell them she is abusing him. He points his finger at her face and threatens to call Child Protective Services. He threatens to call 911.
"I'm doing everything I can," Cyndie assures him again and again. "But you have to help me help you."
As usual, she had to offer Derek a reward to get him here today. This time it is the promise of an ice cream sundae on the way home.
Taylor starts to tell Derek about the transplant. He will have to get more chemotherapy and more radiation treatments to get rid of any trace of cancer in his blood, and he will feel weak and sick all over again. After doctors infuse the healthy stem cells he will have to be isolated for weeks in the hospital and then at home, to protect his vulnerable immune system from infections that could overwhelm his body and kill him. He will need to wear a paper mask over his mouth. He will have to brush his teeth several times a day. He will have to be very, very vigilant about keeping bacteria away.
No! Derek screams. I'm not going to do it.
Even if it will save your life? his mother asks gently.
No, Derek replies, louder this time, and no amount of soothing speech will calm him. He is becoming more and more agitated.
I'm tired of this! he tells Cyndie. Do you know how it feels? You don't have any idea!
Derek stomps out of the room, and Taylor is alone with Cyndie.
I have to be honest with you, he says. Even if everything goes perfectly, the transplant will give him only a slightly better chance of survival. But Derek's attitude is a big problem. If he refuses to wear his mask, or is careless about keeping his mouth clean, the odds plummet. If he is fighting these things now, is he likely to cooperate later, when he's feeling terrible? No, probably not, Cyndie admits.
The transplant, Taylor concludes, likely would cause Derek more harm than good right now. That goes against everything we believe as healers.
Talk to him again in a week or so, the doctor says. We have the healthy stem cells. Maybe his attitude will change and we can do the transplant later. Until then, we'll keep him going the best we can.
Cyndie is shaken. Deflated. All of the misery of the past year plays like a movie in her head. All of the times she had to literally pin Derek down for chemotherapy treatments. All of the hours of waiting in doctors' offices, only to get bad news. All of the begging to get Derek to submit to radiation treatments. All of the holidays spent in the hospital. All of the long nights sitting up with Derek when he couldn't stop vomiting.
All of it has been accompanied by hope for a lifesaving transplant.
Now it may never happen.
For the first time, she thinks seriously about the notion that Derek might die.
"I shouldn't be driving," she says, after retrieving him and heading for the elevator.
Somehow, she maneuvers the Saturn to the diner for the promised chocolate sundae, and then home.
That night, before she goes to sleep, Cyndie gets down on her knees and makes a bargain with God.
An unlit candle and a photograph of her family sit on the table next to her bed, with its frilly comforter and matching lavender pillows. Across the hall, Derek sleeps in the twin bed that he shares with an army of stuffed animals and a plush SpongeBob toy.
"Please," Cyndie prays, crying so hard that she has to gasp for breath. "Please, I'll do anything. But don't take my little man from me."
HOW THIS STORY WAS REPORTED
Reporter Cynthia Hubert and photographer Renee C. Byer met Cyndie French in May 2005, about six months after her son Derek Madsen was diagnosed with cancer. French invited the journalists to observe all aspects of the boy's care and document its impact on him and his family. For the next year, Hubert and Byer spent countless hours with Derek and his friends and relatives at home, on family outings, and during doctor visits, blood transfusions, surgeries and other treatments.
Bee journalists witnessed all but the final scene in today's story at the hospital with pediatric oncologist Doug Taylor. To gather information for this scene, Hubert interviewed Cyndie French after French met with the doctor and interviewed Taylor a few days later.