Sara’s point of view (Kate’s mother)
Conversation with Doctor Regarding Kate’s Cancer
Kate's leukemia is back.
She's no longer remissing.
We've looked at her smear, and her
leukemic cells are showing at 23%.
- How many is bad?
- Any.
What about chemo?
It's an option, but Kate doesn't seem
to take it very well.
And her cancer may be too far along.
So you need more bone marrow?
Yes, but the leukemia
isn't Kate's biggest problem now.
She's lost the function of her kidneys.
They've quit.
They're gone.
- Not a match?
- No.
We're her parents, don't we have to be?
Everyone inherits two sets
of chromosomes containing HLA genes.
Unfortunately,
there's only a 1 in 200 chance...
...that parents and their children will be
perfect histocompatible HLA matches.
What about Jesse?
I'm afraid not.
It's possible that a donor will crop up
on the national bone. marrow registry.
I thought you said getting a transplant
from an unrelated donor was dangerous.
I did.
But Kate's situation is time. sensitive,
and sometimes that's all we've got.
I'd like to suggest something
completely off the record.
Many times one sibling isn't a match,
but another is.
Have you considered
having another child?
Not to be forward...
...but umbilical blood can be
an incredibly effective tool...
...in treating leukemic patients.
It's like a miracle.
Well, how would you know
that the new child would be a match?
- We could make sure of it.
- In a test tube?
Yes. With preimplantation
genetic diagnosis...
...it would be a 100 percent match.
A donor child?
It's not for everybody.
And legally,
I can't even officially recommend it.
But like I said,
cord blood would be invaluable.
Well, we gotta do it.
We gotta try.
That was it.
Grown in a dish,
they would have an in vitro child.
A perfect chromosomal match
who would be Kate's genetic savior.
Courtroom Scene
Mrs. Fitzgerald, how old was Anna
when she started donating to her sister?
She was a newborn.
And at 5, she started donating
lymphocytes, is that correct?
- What does that involve?
- Giving blood.
- Did Anna agree to that?
- No, she was 5.
So you didn't ask her if they could
stick the needles in her arm?
I asked her to help her sister,
and she agreed.
Really?
Didn't two nurses have to hold Anna
down because she was fighting so hard?
So she didn't completely agree,
now did she?
Mr. Alexander, it's just us chickens.
No showboating, please.
I'm sorry, Your Honor. Force of habit.
Mrs. Fitzgerald, how old was Anna
the next time she was hospitalized?
- When Kate was 9, she got a...
- That's not what I asked.
I want to find out what happened
to Anna when she was 6.
- She donated granulocytes.
- And what's that? More needles?
Yup.
And did you ask Anna if she was willing
to donate the granulocytes?
Her sister needed them.
She was the only match.
But did you ask her?
Mrs. Fitzgerald,
answer the question, please.
No, I didn't.
We talked about it a lot, but no,
I didn't ask her permission.
Next was the bone. marrow aspiration.
Could you describe
that procedure for us?
They put needles into Anna's hips.
- Into the bone? Big needles?
- Yes.
Using your hands, would you indicate
to the court the size of those needles?
It's a tough procedure, am I right?
Anna had to be hospitalized afterward.
- Yes.
- For how long?
Six days.
There were some complications.
I see.
You add it all up,
it's not so innocuous, is it?
It's tough to hear it
all hashed out that way.
I don't see the point. Court's well aware
of the family's medical history.
Of Kate's history, Your Honor,
but not of Anna's.
Fair enough. Proceed.
Mrs. Fitzgerald, looking back and only
taking into account Anna's well. being...
...do you think it's reasonable to conclude
that you might have taken this too far?
Looking at only Anna's situation...
...yes, it is.
But I have to think about
my entire family.
- But Kate comes first?
- Kate's sick.
So this is a triage situation.
Compromising one child's health
on behalf of the other. Where's the line?
- For Kate, it's life or death.
- Not for Kate, for Anna.
- She's why we're here.
- That's a trick question.
Because Anna
isn't the only person in this equation.
And if we were looking at it only from
Anna's situation, sure, it is brutal.
I mean, who wants to be stuck
and poked and prodded by needles?
And you can look at me and you can say
how awful I am for doing that to my child.
You know what? It is awful.
But it's not as awful
as putting your child in the ground.
- You stand up for your family.
- It's my job.
- And you stand up for Kate.
- I do.
But the real question is:
Who stands up for Anna?
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MSK Point of Sara`s views