Chapter Seven
The Next Step?

Part 1: Hermione

Hermione was in the first week of her Chaemotherapy break. She had completed 8 weeks of Induction therapy and was getting blood tests done twice a day. Of course, they didn't hurt - the blood was being taken from her Hickman's line. After her seventh week the blood tests started looking a bit better. Her red blood cells and platelet levels were increasing in number, and the cancerous cells were going down. Just not enough. She was getting better in some ways, but worse in others. Hermione could no longer move without vomiting and as a result she had been kept in hospital. The nurses tried not to move her unless they had to. The worst thing was that she had developed a pressure sore on her heel from laying in the same position for too long. At first it was undetected - the lack of red blood cells meant the redness did not show as a sign on the pressure area. She was also having daily pain medication which masked the pain of the pressure. So as a result, after days of not moving, the skin had broken down and she was left with a large ulcer on her heel. Her medication was increased so she would not feel the pain of the sore, or the pain of the dressings. The nurses had to make sure she changed her position regularly. So after her first week of no Chaemotherapy, Dr. Wilson came in to have a chat with her. He had gotten to know both she and Ron through the past 8 weeks, as he was with her daily. He knew what she liked and didn't like, and that more than anything - she wanted to start planning her wedding.

"Hermione, because of the sore on your heel I'm afraid you must stay in hospital whilst it heels. I know it's now what you wanted but I can't allow you to leave because it's a huge portal for an infection, and you don't have much of an immune system. If... If you develop a cold, or something much worse, it could just push you over the cliff. I'm sorry. We will try to have it heal quickly but until then it's more bed rest and more turning," he said. He was looking at her with no sign of pity. He knew her quite well now, after all the treatment and meetings, and knew she hated people showing her pity.
"Oh...," was all she could say.
"Well when can she come home?" Ron asked. He looked Grave. Dr. Wilson had noticed him slowly get thinner and depressed. He stayed in the room with her all day. He didn't even leave to get himself some food. The Nurses, taking pity on him, had made sure he had food taken to him. He rarely ate it though.
Dr. Wilson studied him for a few moments. He was now holding Hermione's hand and struggling to hold in his cries. "I'm sorry, I don't know when. It all depends on how soon Hermione can heal and start to feel a bit stronger. You need to be able to stand up and walk, and hold down food before I discharge you Hermione. I'm not letting you go if you can't move around or eat, I'm sorry," he said, raising his eyebrows. He had seen young ones like Hermione failing to take the Chaemotherapy seriously. He had seen people forget to come to appointments and to have blood taken. He had tested many patients in remission, after letting a week, two weeks... months pass with no tests, only to have to tell them that the cancer is back and more resistant than ever. Many times he has seen patients die. He was determined for Hermione to live.
She nodded her head and grabbed the bucket next to her. Ron moved quick as a ninja to rub her back whilst she retched, and retched, until only a small amount of bile and blood came up. Dr. Wilson handed her a glass of water, which she rinsed her mouth out with. Ron and Dr. Wilson helped her lay down, and placed pillows underneath her legs and on the right side of her back so she was no longer putting pressure on any areas. She fell asleep.

Part 2: James Wilson
James left soon after Hermione fell unconscious with sleep. He went to his office, ignoring all the comments coming his way; hello, Dr. Wilson, help, just a moment... He could not talk. Not with the knowledge of Hermione's condition in his mind. He sat at his desk and bit down hard on his lip. He couldn't cry over a patient! It would not be the end. He could still help her. He looked through her files once again, and looked at the tests. Her cancer cells had been going down, but only by a very small percent each week - definitely not enough. Her Red Blood Cells and Platelets were also going up, but only at a very small percent. She did not have the blood results to be able to go home. He also needed to give her another bone marrow biopsy to determine his next move. Then, to make matters worse again, she had developed a pressure sore on her heel. She couldn't walk on it without causing more damage to the skin. She was having frequent dressings, cleanings and lotions applied to the area, and thankfully she couldn't feel it being done. She didn't have many options at her stage, so he was going to suggest another more intense round of chaemotherapy. Seven days of administration, with three days rest, rather than 3 days of administration with 5 days rest. That was possibly her only option. He would also put her name on the waiting list for a Bone Marrow transplant, and ask her to bring her family to be tested. He didn't think she had any siblings though, so the best chance would probably be to put her name on the list.
He made a few calls and her name was there within an hour. He had decided to tell her the informaion that day. He thought she might like it all in one hit raher than take it blow by blow. There was a faint knock at the door, and he got up to answer it. Lisa.

"Hi Lisa, come in," he said, standing aside. She took a seat across from his.
"James I need to say that her boyfriend really isn't coping with this. Hermione is coping better than he is. I wonder if it might be helpful if you have a chat to him about it, and see what is going on with him... maybe give him something, you know?" she said.
He nodded. "I've been thinking about that for a while. I've seen how bad he is getting. I'm really worried about telling them the news..." he said, and told Lisa everything. After all, Lisa was getting to know the two more than he was, and she could give her opinion as to how to tell them.
"Tell them now," she said.
He nodded again and stood up, "Will you join me?" he asked.

They walked out his office and knocked on Hermione's door before walking in. James took a seat at the end of her bed, and Lisa tried to make a fuss. She adjusted her pillow, refilled her glass of water, and neatened her blankets before asking "Are you comfortable?"
James frowned slightly at her, and she stopped. "Hermione, the results aren't good I'm afraid. I didn't want to tell you before, but I think I must now. The results aren't what I had wanted. Although your good cells are slowly increasing, it's not quick enough and I'm afraid we need to begin intensive chaemotherapy soon. I'll start with a month and we will do seven days of administering the drugs, followed by two or three days rest. Three days to begin with, but the results will determine whether it will be a two or three day break. We will do three rounds of that, and then take another biopsy which will ultimately determine whether our next step is consolidation therapy or... or a bone marrow transplant," he said. He felt so horrible having to break this news to her. He looked over and saw Ron's face crumple even more with grief. Now he would have to have a discussion with him. Hermione let a few tears escape from her eyes and nodded.
"I think I knew this was going to be the case," she said. "I just can't move or anything and I would have thought if the results were good I would be feeling better. I'd have good cells to help me feel better. What are my chances?"
He tilted his head to the side in thought, "I don't want to say just yet. It really could go either way Hermione, but your last results might make me think that this intense round should help. But don't get your hopes up."
She reached over and pulled Ron over. He was sitting in the chair and had started to sob. The sounds escaping his mouth were heartbreaking, and Lisa started to cry too. She patted Ron on the back gently before leaving the room. Ron sat next to Hermione on the bed and she held his head over her heart, kissing him and rocking him.
Before long he started to calm down, and he wrapped his arms around Hermione. Dr. Wilson cleared his throat, "Excuse me Ron, would you mind coming with me to my office please? I just want a quick word," he said, and smiled slightly to Hermione. Just to let her know it wasn't about her.

Part 3: Ron
Ron somehow found some courage to get off the bed, and walk away from Hermione. He followed Dr. Wilson down to his office and collapsed into the chair. Dr. Wilson didn't sit down across from him, but took the seat next to him. He put his hand on Ron's back. "Ron, me and Lisa are becoming concerned about you. We completely understand how difficult this has been for you, but..." he took a breath, "You're not coping. And we don't really expect you to, but it is worrying us. I want you to ask me any questions you have about anything and I will try to answer them for you. Do you ha-"
"Will she die?" he asked. His eyes pleaded with James Wilson for the answer to be no.
And James wished he could give him the answer he wanted. "Ron, I can't rule that out, because there are shocks and unwanted discoveries in cancer patients all the time. But, with the results as they are now, and the treatment we have lined up, I can say that her chances of surviving are quite high. But there are always complications. And as you have seen, she has one on her heel right now. That's why we need to keep her in here because if she gets an infection it could really change the results."
Ron nodded. He tried to think clearly. He had seen Hermione over the past 8 weeks deteriorating. She had lost all her weight, and was now almost literally skin and bone. She looked Green most of the day, and when she wasn't green she was white. Sometimes she was purple, black and blue, bruises spreading over her entire body. She was so weak, sometimes Ron had to itch her face or put her straw in her mouth for her. He just wanted to be home in their bed. He wanted her to walk down the aisle to him. But would that ever happen?
"Ron would you accept a prescription to an antidepressant if I wrote one for you? I really think you need it," James said.
Ron shook his head, then cried more. He couldn't understand that people were concerned about him. It should be Hermione, but maybe he was doing worse than her. He would have crumpled into a black hole if Hermione didn't still have her cheery spirit.

Moments later he was at the Hospital Pharmacy getting his prescription processed with the muggle money he and Hermione had gathered together. When he went back to the room Hermione was asleep. He fussed over her as much as he could without waking her, to make sure she was comfortable. Then he took out some parchment and a muggle pen and wrote a letter to everyone back at home.

Hi Everyone,
Just letting you know Hermione isn't doing too good, but she will be okay. I don't know if I have the courage to write everything down but her results just aren't what they were hoping for. She just needs more treatments and there could be the possibility of a bone marrow transplant.
Love you all,
Ron and Hermione.

The parchment was stained with heavy tears.