Arden: Part I

Arden Smith was diagnosed with neuroblastoma in August, and in fact, was the sickest new oncology diagnosis I had ever seen. (Neuroblastoma is a tumor of the nervous system that usually originates in the adrenal gland, a small piece of tissue that sits on top of the kidney and makes all kinds of important hormones.) 

Arden had quite the journey: First, her pediatrician in the tiny Oklahoma town where she lived told her parents that the mass growing in her belly all summer long was "no big deal" and probably just a big spleen. Fortunately, they sought a second opinion in the nick of time, which saved her life. A CT scan showed a gigantic mass filling her belly, even invading some of her other organs. When she finally got to us at the Children's Hospital, Arden looked pregnant- except the bulge was too irregular and nodular to be a pregnancy, and resided mostly on the left side of her abdomen. She also just looked ill. 

One thing all doctors learn to do: look at a person and judge how close to death they might be. You'd be surprised how quickly that skill is learned. 

Arden then went to the OR to have the mass biopsied and almost bled to death on the operating table as her surgeon, Dr. Puffinbarger, tried to get a piece. Puffinbarger saw what we saw in Arden: "This baby needs chemo!" She almost shouted when she saw me in the OR hallway afterward. "She's on the edge. When are you guys going to start some and save her life?!"

She was right. Arden was on the way out, and fast.