The War

* * * * * * Jimmy and nurse Jessica Thomas * * * * * * *

5AM It's hard to sleep in hospitals, with the constant activity, and people in and out of the room all night long; they're quiet and considerate, but still...

This stem cell transplant really is like a war. It IS a war. Jimmy is the country that has been invaded and taken over by the enemy, the evil Myeloma. Dr. Lonial is General George Patton, the military strategist ,who is going to orchestrate the attack, wipe the Myeloma out, and restore the country to its rightful inhabitants.

The first wave of the attack is the heavy chemotherapy, the Melphalan, the B-52's that bomb everything; it destroys the Myeloma, but there is also collateral damage: Jimmy's hair follicles, the lining of the mouth and gastrointestinal tract, the bone marrow. The next day, the Melphalan bombers come back in a second wave, and attack again.

On the third day, General Lonial sends in the special forces, the Velcade, paratroopers who come in to mop up any surviving Myeloma. The Velcade is a molecular chemotherapy, sort of like a Smart Bomb, that targets only the myeloma cells; additionally, it destroys the myeloma's DNA, to keep it from mutating and coming back.

With the Myeloma now destroyed, the war-ravaged country needs outside help, so General Lonial sends in the good guys, the pristine, healthy Stem Cells, who go about repopulating the country, and restoring it to its former health and glory. Another part that needs to be mentioned is that of the Resistance: Jimmy's fever. Dr. Lonial thinks that some patients, like Jimmy, perceive the enzymes created by the dying cancer cells, and attack them with fever. Like one of our favorite nurses, Jessica Thomas, was telling us last night, "Fever is your friend."

Dr. Lonial is a brilliant medical scientist and a great general, and he's right on the edge of curing multiple myeloma, and winning this war.