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Final Grains of Sand

By David Harder

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CHAPTER ONE

“JAMES, WOULD YOU STEP INTO my office, please?”

At the doctor’s appearance, Jim stood up. He had been scanning, but not reading, a tennis journal. Jim flopped the magazine on the side table and followed the doctor down the hallway. He was apprehensive about why Doctor Nolan wanted to meet with him— face to face—on short notice.

During the quick drive from his business office, Jim was distracted as he mentally ran through the various reasons why he might be here. He wondered if it was a mistake to cancel his important sales meeting this morning. He’d had a physical a few weeks ago, but it was routine. Most likely the doctor was following up on test results—perhaps the blood tests or the PET scan. Jim felt confident he’d get a glowing report, since he was in excellent health. Surely there wasn’t anything the doctor couldn’t tell him in a few days.

“Please have a seat, James.”

The office felt warm, and Jim’s mouth was dry. He was suddenly thirsty.
“What’s the urgency, Doc?” Jim tucked his long legs under the chair and watched Dr. Nolan close the door before walking around to the other side of his desk. Sitting up straight, Jim edged forward in his seat.

Dr. Nolan removed his glasses and rubbed the red spots on the bridge of his nose before speaking.

“James, we need to talk about your lab test results because they’re concerning. I ordered so many tests because I wanted to be sure of the results.”

“Everything is fine, isn’t it?” Jim shifted uncomfortably, his cocksure, business attitude deflating at the sight of the doctor’s grave face.

Dr. Nolan looked him in the eye. “James, we’ve been friends a long time. I’m going to give it to you straight. It appears your body has an invasion of three different cancers that are feeding off each other in several vital organs. Cancer has invaded your liver, pancreas, spleen, and possibly your kidneys. I can’t begin to tell you how exceedingly rare your condition is.”

“Wait a minute, Doc. This makes no sense. I feel fine, and I’ve never been sick a day in my life.”

“You feel fine now, yes, but I’m afraid those feelings aren’t permanent.”

Jim shook his head and then ran his hands through his dark hair. This couldn’t be happening. But he’d known the doctor for decades; he wouldn’t lie.

Dr. Nolan sat back and waited for Jim to absorb the enormity of the situation.

“I have three cancers? I . . . I . . . How is this possible? I’ve always been so healthy.” Jim began to pant, his breathing labored. “Okay, wait a minute. So, I’ll need to take some time off from work, but you’re saying chemo, radiation, surgery—they’re an option for me, right?”

Dr. Nolan got up and sat in the chair next to Jim, putting his hand on Jim’s shoulder.

“The cancers are fast-growing and widespread. You could go that route. We might buy some time and maybe add two or three months at the most. However, you would have to decide if the side effects are worth it.”

Time came to a screeching halt for Jim. Frightened, he inquired in a nervous voice, “What kind of time are we talking about?”

“After seeing the scan images, I conferred with several friends and oncologists around the country. Short of a miracle, the consensus is three to maybe four months. I wish I had better news, James.”

Jim shook off the doctor’s hand and stood up. “What caused this? Why don’t I feel anything drastic?”

“Those are questions I can’t answer.”

“I know I’ve felt fatigued a lot lately, but I just figured I was working too hard and not sleeping enough. Everyone has fatigue, right?” Jim paced, rubbing his face. He stopped. “What if I hadn’t come in for the physical?”

Dr. Nolan did not sugarcoat his next edict, and his voice was kind. “You would still experience your illness, but you would face it thoroughly unprepared.”

Jim suddenly felt faint, like someone had sucked all the oxygen from the room. He collapsed into the chair. He was unprepared for the dreaded word cancer. Random thoughts hit him in machine-gun succession. Normally self-reliant, Jim was quickly devoid of immediate answers. He bent over at the waist and placed his head between his knees and slowly began to rock.

Dr. Nolan’s hand hovered above Jim’s back.

“James, are you in any pain at the moment? Can I get you something?”
Jim shook his head but continued to rock.

“If it’s okay with you, I’d like to confirm my findings with a couple more biopsies—perhaps run another PET scan with contrast.”

Jim stopped rocking and sat up, staring at Dr. Nolan.

“Doc, I mean no disrespect, but poking holes in sensitive areas of my body, yanking out tissue or bone, and pumping me full of radioactive junk doesn’t sound pleasant. Will it help rule out cancer?”

“It will confirm my findings.”

“This can’t actually be happening. Why now? Why me?”

“James, you’re not even sixty and—”

“No, unfortunately, I turned sixty last week.”

Startled, Dr. Nolan said, “Seriously, James? Has it been that long? I remember delivering you. I know you have three lovely children, but you should be looking forward to a full life with grandchildren and retirement.”

Jim put his head in his hands again, making a wordless, groaning sound.

“I would recommend reaching out to family and getting some support. In less than two months, your organs are going to start to fail, and before the third month is finished, you’ll be needing twenty-four-hour care. Right now, while you can, make some decisions by planning and making arrangements.”

Jim blankly stared at the doctor.

“Well, I guess that last part is easy. When I’m dead, cremate my body, and scatter the ashes to the wind.”

“James. I’m serious. If you want, I could contact your family.”

“Please don’t! Your information is a lot to digest, and it appears I haven’t much time to spend it casually.”

Jim stood and turned, facing the door.

Dr. Nolan reached out, grabbing Jim’s shirt sleeve.

“If you need anything, anything at all, please get in touch with me. My receptionist will give you my personal cell phone number, and you can call me day or night. If you’re in pain, I’ll immediately arrange for something at the hospital or your pharmacy. If you don’t mind, I would like to see you again in one month.”

Resting his hand on the doorknob, Jim stood frozen, staring at the closed office door. His voice was flat, monotone.

“I need a little time to figure some things out, and I appreciate your concern. You’ve been a terrific doctor, but I think I need to spend some time alone. Please do not discuss my condition with anyone or make any family calls. I beg you.”

“Of course. You have my word, James.”

Jim walked out of the office to the parking lot. After dropping his full weight into the leather seat of his BMW 540, Jim looked at his watch.

Three o’clock!

In a fit of frustration, Jim yanked the Rolex off his wrist. He tossed it on the passenger side of the car’s floor. Clenching his fists, he hammered on the steering wheel with eyes tightly closed.

“I can’t be dying. I’m too young.”

Peering in the rear-view mirror, Jim studied his chiseled face, looking for signs of any sickness. He pulled down on one lower eyelid, staring at the steel-gray iris, and then opened his mouth, inspecting everything with his tongue stuck out.

Jim shook his head. He then started the engine and ignored the seat-belt warning indicators. The BMW screeched backward from the parking stall, and then jerked to a stop. Heading for the exit, the car leaped from the curb like a cheetah. The tires squealed as Jim drove off in a rush, speeding down the boulevard.

* * *

Dr. Nolan gathered the lab reports and various papers associated with his patient. He took his time as he slid the papers into a thick folder. Sitting down, Dr. Nolan let his finger trace out the name, James Kreider, printed along the edge.

Dr. Nolan buried his face in his hands and wept. Choking on his words, he began to pray.

“Our Father, Who is in heaven, great is Your Name. Your kingdom come, Your will be done—”

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