It was nature's call that rudely woke Ryan up - for the third time that night. Heaving himself onto his side, he saw that the small clock on his bedside table read 3:57. He'd only managed to get a couple of hours more since the last time his bladder had woken him up.
That was another sad side-effect of spinal cord compression - bladder and bowel changes, which meant his bladder felt like it was full even when it wasn't. Still, he tried to console himself, it was better than being incontinent.
After the increasingly arduous task of going to the bathroom to relieve himself had been accomplished, he realised that he was actually extremely thirsty. It wasn't surprising, as he'd more or less been forced to drain himself completely dry.
The problem - the only way to get drinkable water was to go down the stairs to the kitchen.
Ryan hadn't cried since being diagnosed, but at that moment, he came close to letting out tears of frustration.
He stayed sitting in the bathroom for a while, weighing up his options. He could go back to bed and try and get back to sleep in spite of the cottonmouth, then get someone to get him water in the morning. Most of them were unlikely to say no - he did have cancer, after all, and so-called "cancer perks" were no secret - but he wanted to show that he could still do such simple tasks as getting himself a drink.
Alternatively, he could go downstairs, have a drink and some Codeine since his spine was complaining again, and try and get back up, or he could do all those things and just crash on the sofa instead of getting back up.
In the end, he plumped for the second option, figuring that getting up the stairs would be easier once the Codeine kicked in. He could also use the time to ponder over treatments again.
Several minutes later saw him sitting at the kitchen table, a glass of water next to him and his flow chart in front of him on the table. A frown creased his forehead as he stared intently at it as if he expected the markings to shift by themselves.
He was so deep in thought that he didn't hear someone else come in. He probably wouldn't have heard anyway - wheels were quieter than footsteps on the kitchen tiles.
That was until the chart was unceremoniously snatched away from in front of his eyes.
"Hey!" he protested, his head snapping up to meet his offender.
Chloe ignored his indignation and instead scanned the flow chart with narrowed eyes. "What is this?"
"None of your business," Ryan muttered, trying to grab it back, but she held it out of his reach. "Why are you even up at 4 in the morning?"
"Why are you?" Chloe countered.
"I was thirsty," he said simply, deciding not to mention his cancer's involvement in that. "You?"
"I heard you coming downstairs, thought I'd investigate," Chloe replied, equally as curtly. Ryan wasn't leaving it there, however.
"How'd you know it was me?" he continued, his gaze pricking her. "And I'm not that loud, am I?"
"You're the only one here who walks like they've got three legs," Chloe started, ignoring Ryan's expression darkening and his fist clenching around his cane, "and no, you're not that loud, but I have to keep waking myself up so I can change my sleeping position."
Ryan raised an eyebrow. Despite the paraparetic effects of his cancer, he still didn't claim to be an expert in all things paraplegic. Thoughts suddenly occurred to him that before long, he would have to become an expert out of necessity - thoughts that he tried to push out of his mind.
Chloe, meanwhile, had turned her attention back to his flow chart. "What is this?" she asked again.
"Potential treatment plan," Ryan explained. "I thought that maybe writing it all down would help me decide better."
"And has it?"
"Not really."
"Well, what does all this mean?" she asked. "'Radiotherapy'? 'Works' or 'doesn't work'?"
"Basically, the first option they gave me is to have radiation therapy, but there's only a small chance it will work," Ryan explained. "If it doesn't work, I'll have to have chemo."
"The kind that makes you lose your hair?" Chloe asked. A nod, then she shrugged. "It'll grow back."
Ryan sighed deeply in frustration, running his fingers through his hair (that, as Chloe had pointed out, he would very likely lose), applying pressure to the throbbing points. He really wasn't in the mood to go through this again. Maybe doing this at 4 a.m. hadn't been the best idea - lack of sleep, thirst and stress were an insufferable combination, making him feel like someone was holding an axe at the crown of his head. (It didn't help that the headache was also inducing a niggling thought that the cancer had somehow managed to spread all the way up his spinal cord to his brain overnight, even though he knew that even the most aggressive cancer wouldn't spread that far in the space of several hours.)
Her brother's silence and motion eventually caught Chloe onto the fact that he didn't want to talk about the effects of chemotherapy. "Do you know what you want to spend your wish on?" she asked, changing the subject slightly.
Ryan shrugged his shoulders.
"No idea at all?"
"Nope," Ryan said. "Even if I did know, I'll probably save it for if I become terminal."
"You won't be terminal, Ryan," Chloe said, before her expression and tone changed. "Well, unless you spend so long choosing that you die before you decide."
"Shut up," Ryan said sharply, his fuse considerably shorter than it once had been, and it was getting shorter every time his sister spoke so casually of his illness, as if it was a minor setback like a forecast rainstorm. He couldn't believe that he'd initially wanted to hide his cancer from her for fear of her taking it hard. "Do you really want to know what I'd spend my wish on?"
Chloe blinked in surprise, given that he'd said less than a minute before that he didn't know what he would wish for. Nonetheless, she was curious, so she said, "Sure, what?"
"I want to see Mum again."
Chloe didn't know what she was expecting, but it definitely hadn't been that. She thought that after what their mother had done to her and Ryan, he would be quite content with never having to talk to, see or think about her again. The fact that he would actually wish to see her seemed to go against everything she knew about her brother - which, admittedly, wasn't that much. "W-why-"
"She pinned the blame on me for something I would never dream of doing," Ryan started, as a storm started to brew behind his eyes. "She neglected us to go shopping and then when it went wrong, she threw me under the bus to save herself - on my birthday, no less," he growled, spitting out the words like they were venom. "And it wasn't the first time either, I can hardly remember a night where she wasn't out drinking or entertaining ..." Ryan opted to cut himself off there, deciding that his 12-year-old sister didn't need to know those details. He wasn't even meant to know them himself - he'd only found out when he'd sneaked into the office to read his own file not long before coming to Ashdene Ridge. It was there that he'd found out about his father's cancer and the meaning of his mother's absences - though in the file, it said that she'd managed to turn away from that several months before Chloe's accident.
"Entertaining ..." Chloe prompted.
"And guess who paid the price for all of that?" Ryan continued, ignoring the loose end she'd just presented. "We did. You're in a wheelchair and I carried a false blame around with me for nearly 10 years. Do you know what it's like to be a little kid, taken away from everything you've ever known, and be dumped somewhere full of strangers that all treated you like scum?"
"Well at least you stopped carrying it around!" Chloe retorted. "It doesn't matter whose fault it was, it doesn't change the fact that I've had to grow up with this!" She aggressively jerked her right wheel. "I didn't understand why I couldn't get up and run around like all the other kids, or why I had to go to the doctor so many times, and I'll still have to live with this for the rest of my life, and everything that comes with it!"
Her undiluted outburst actually caused Ryan to flinch under his sister's gaze. It occurred to him that she had probably felt the same way when he'd raised his voice at her previously - only unlike her back then, he probably deserved it. For a few seconds, he was at a loss of how to respond to that - before he remembered what had led up to it.
"And that's just it," he said. "That's why I want to see Mum again. She never got her just desserts for what she did to me and you. She even had the nerve to abandon you and run off to America, without even bothering to keep in touch - you said so yourself. I just feel the need to get everything out at her, rip her a new one - in case I'll never get that chance again."
Chloe's hard face relaxed and she looked down briefly, as if guilty. "About that ... we kept in touch for a bit, I sent her letters just like I sent to you, but the letter I sent her the week we met up ... I told her everything. I knew that she'd lied to me and everyone and framed you for my accident. After that, I never got any more letters back."
Ryan reached across the table and found her hand in her lap, squeezing it slightly awkwardly. To his surprise, Chloe responded by wheeling around the table and wrapping her arms around his neck. It was, again, an awkward gesture, but one that symbolised trying to hold on to the only person you felt you had left in the world. Ryan started to lift his arms to hug her back, but a sudden strong ache in his shoulder caused him to wince and he had to push her away gently.
"What's wrong?" Chloe asked, seeing Ryan pull down the side of the neck of his pyjama top until his shoulder was exposed. Yet again, he was worrying that his cancer had metastasised, and the painful red blemish that he saw did nothing to help.
Chloe craned her neck to get a better look, and she instantly stopped looking worried. "Oh, don't worry about that, that's just a pressure sore. You probably slept on that shoulder for too long."
Ryan frowned.
"I know all about pressure sores," Chloe went on. "I used to get them all the time. Sometimes I still do, but now I wake myself up every few hours so I can turn myself over."
Glancing again at the pressure sore on his shoulder, Ryan released his pyjama top, folded his arms on the table and laid his head on them, feeling another harsh new reality settle on his shoulders like a heavy cloak. "I'm sorry, I guess I shouldn't complain. Like you said, you've been living like this for years, I've only been like this for a few days."
"You get used to it," Chloe shrugged. "Besides, even if I've had this for years, at least I know it's not gonna kill me."
But Ryan wasn't finished yet. "Maybe I deserve this, getting a taste of what you have to live with every day. I mean, whether I pushed you or not, it's still kind of my fault."
"What happened to Mum getting her 'just desserts'?" Chloe questioned. "Seriously Ryan, you need to stop being so indecisive. Just, cut it out."
Ryan blinked, sitting bolt upright.
Cut it out?
"Give me that," he ordered, holding his hand out so she could give him his flow chart back, which she had held onto the entire time.
She did so, slowly and with a frown, perplexed at his sudden change in mood. He retrieved his pen from the table top and laid the flow chart flat on the table. Ignoring the whole tree of possible treatments he'd completed the previous afternoon, he drew another arrow stemming from the Astrocytoma title and scrawled Complete surgery underneath the arrow head. He knew there was only a small chance that Dr Gareth would allow him to have the surgery, so he added two branches - allow and don't allow. If they didn't allow it, he would just go the route he had originally forseen - and wanted to avoid. If, by some miracle, they allowed the surgery, it would work - he'd be cancer free and this would end.
He wouldn't go the same route his father had.
"Are you sure?" Mike asked him the next morning, when Ryan announced his decision to him.
"No, I'm not sure, that's why I said I was sure," Ryan said sarcastically, rolling his eyes.
Mike huffed slightly. "They probably wouldn't let you have it anyway. You see, Ryan, doctors have to swear an oath to never do anything that would harm a patient."
"They shouldn't give me chemo either then," Ryan scoffed. "It does more harm than good and it might not even do good anyway."
"Well, let's be honest, Ryan, paralysis would probably be more harmful than losing your hair and making you sick and tired, literally. It won't do permanent damage, unlike this surgery," Mike said.
"It's been done before."
Ryan and Mike turned to see Joseph standing conspicuously outside the office door, looking thoroughly embarrassed about being caught eavesdropping. "I-I'm sorry, I ... couldn't help overhearing."
"Joseph!" Mike admonished. "This is a private matter."
"No, let him say what he has to say," Ryan insisted, eager for information that would help his case. "Come on Joseph, tell us, when has it been done before?"
"Well, it hasn't exactly been done before," Joseph admitted, looking down slightly, "but ... there's this cancer called osteosarcoma, which is when you have a tumour growing on a bone. Sometimes, the only way they can save you is by amputation if it's a limb, or even more than one if it's really bad. So looking at it that way, having surgery that would paralyse you to cure your cancer wouldn't be that different. I mean, losing a limb is technically harmful, but it would save your life."
If Ryan had the strength, he could've stood up and hugged Joseph. Sure, the boy's tendency to spout information could be annoying at the best of times, but he was smart, and Ryan couldn't fault that now.
Mike looked like he didn't know what to think. His gaze kept flicking between the two boys, his brain trying to form words but none reaching his lips. Finally, he let out a deep sigh. "I'll call your oncologist."
Thankfully, Dr Gareth had a free space for that day and could fit them in, so six hours later saw them sitting in the waiting room, surrounded by a few other patients all at varying stages of cancer, some bald-headed, some with oxygen tanks, some with mobility devices like him and some even with prosthetic limbs. Ryan couldn't help but smirk internally at the thought that people would notice Mike's lack of hair and assume that he was the one with cancer.
It seemed like Dr Gareth didn't specialise in paediatric cases, as the vast majority of their company had to be at least 50 or 60. There was only one other teenage patient in the room, slumped in a chair in the corner. He looked to be about a year or two older than Ryan, with thin, dark hair just starting to grow back. The expression on his face was a weary scowl, as if he'd been here countless times before.
Looking idly around the room, his eyes locked with Ryan's briefly.
A tingle shot up Ryan's spine.
And it wasn't the astrocytoma.
Some of you will probably recognise osteosarcoma as the cancer that Gus Waters had in The Fault in Our Stars, and I'd be lying if I said that this wasn't inspired at least a little bit by that. Don't worry, it's not gonna be a carbon copy, I'm gonna put my own spin on it.