By John Kelly
Thursday, January 18, 2007
The fight to save Grayson Espinal's left kidney has moved from Operating Room 9 at Children's Hospital to the pathology lab one floor below.
Here Dr. Atif Ahmed moves a slide under a microscope. He peers down at a thin slice of tissue taken from a tumor Dr. Tony Sandler and Dr. Bob Kanard removed from the Lanham boy's kidney.
What he sees is good, if unexpected. There are cancer cells, yes, but they're all dead, killed by the chemotherapy Grayson, 6, has undergone.
"Now we're really in a quandary," says Dr. Sandler. "We can see ghosts of the tumor, but no viable tumor."
Dr. Sandler returns to the operating room to prepare to save what remains of Grayson's left kidney. But a few minutes later, the phone in the OR rings and Dr. Sandler is called back to pathology to look at samples removed from elsewhere in Grayson's organ.
This time, the news isn't so good. "Bob," Dr. Sandler says when he comes back, "I looked at the pathology and I'm 100 percent certain we have to take the kidney out. There's classic blastoma in two places."
And so the roller coaster lurches again. A feeling of disappointment permeates Operating Room 9. Both of Grayson's kidneys were invaded by a type of cancer known as Wilms' tumors. Part of his right kidney was removed when he was 2, and now Dr. Kanard removes his left. It's hard to predict what the future will hold for Grayson. Dialysis? A transplant?
If the five hours of surgery so far have been like climbing a mountain, now it's time for the descent. Circulating nurse Bennyama Joseph and scrub nurse Terrence Sams count all the instruments -- all the forceps, clamps, needles and pads that have been used over the course of the operation. ("How many sutures do I have?" asks Terrence. "Sutures? You have 53," answers Bennyama. "Fifty-three," says Terrence. "That many?")
After Dr. Kanard closes the incision in Grayson's belly, anesthesiologist Dr. Janelle Vaughns and Elenora Mazover, the anesthesiologist assistant, start to wake Grayson from his sleep. Dr. Vaughns removes his breathing tube, then puts a mask of pure oxygen over his face.
"Can you squeeze my hand, Grayson?" she asks. "Grayson, you're just waking up now. You're doing great."
He squirms and a single tear rolls down his cheek.Six Weeks Later
That was in late November. Last Friday I saw Grayson again. We pulled up some chairs in the Children's Hospital lobby. The kindergartner was assembling a Lego figurine as deftly as Drs. Sandler and Kanard had disassembled his kidney.
His mother, Lesly Guevara, said that the first two weeks after surgery, Grayson was a little tentative. "Now, he's jumping," she said. "He's a little boy. He likes to play. He has good energy."
Best of all, his right kidney is working like a champ. And that means Grayson won't need dialysis.
Grayson continues to visit Children's regularly for chemotherapy but, says his mother, "He's doing well." He's back in school, back playing with his brothers and sisters, back devouring the Honduran food his mother makes.
Children are incredibly resilient, bouncing back from ailments that would defeat their parents or grandparents. Maybe that's why it's so unfair when a child is sick. It turns the natural order on its head.
But children do get sick. They get cancer, they get HIV. They get in car accidents, and they get caught in crossfire. And when that happens, the people at Children's Hospital work to save their lives. Thanks in part to readers such as you, no child is ever turned away because his or her parents can't pay the bill. Please keep this so by taking part in our annual campaign.
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