bathroom in mid-discussion with a sudden bout of
diarrhea.
Marcoux recommended a different, more standard
chemotherapy, with two drugs called carboplatin and
paclitaxel.Butthepaclitaxeltriggeredanextreme,nearly
overwhelmingallergicresponse,soheswitchedhertoa
regimenofcarboplatinplusgemcitabine.Responserates,
he said, were still very good for patients on this therapy.
She spenttheremainder ofthesummerat home,with
Vivianandherhusbandandherparents,whohadmoved
in to help. She loved being a mother. Between
chemotherapy cycles, she begantrying to get her life
back.
Then, in October, a CT scan showed that the tumor
deposits in her left chestand in her lymphnodes had
grownsubstantially.Thechemotherapy hadfailed. She
wasswitchedtoadrug calledpemetrexed.Studies had
shownthatitcouldproducemarkedlylongersurvivalin
some patients. In reality, only a small percentage of
patients gained very much. On average, the drug
extendedsurvivalbyonlytwomonths—fromelevento
thirteenmonths—and that wasin patients who,unlike
Sara, had responded to first-line chemotherapy.
Sheworkedhardtotakethesetbacksandsideeffectsin
stride.She wasupbeatby nature, andshe managed to
maintainheroptimism.Littlebylittle,however,shegrew
sicker—increasinglyexhaustedandshortofbreath.Ina
matterofmonths, itwasas ifshe’d ageddecades.By
November,shedidn’thavethewindtowalkthelengthof