All those forgotten birthdays

When the promise of another year is better left to pass by quietly

Photo by Annie Spratt via Unsplash

Tomorrow is my second birthday, or my re-birthday as

Karen Richards

, my fellow-transplant Substacker, called it in her own post. Over the last couple of years, I’ve also had a bad habit of forgetting it.

Nine years ago, I received a cord blood transplant as a potential cure for my leukemia diagnosis. As I’ve written about previously, due to my biracial makeup, finding a fully-matched bone marrow donor proved to be difficult so my team decided to go with cord blood.

Interestingly, a cord blood transplant uses the stem-cell rich umbilical cord blood taken from a newborn’s umbilical cord. The tether that kept a baby alive, the bridge from mother to child— can be re-used to potentially save another life. Talk about utility.

As a brief how-it-works, the blood that exists inside that umbilical cord is taken from the room and cryofrozen and preserved. Sometimes it is kept and frozen by the parents themselves, in the event that their child might need it for themselves— An expensive new bill to be paid. Or, it can be generously donated and placed on a directory to be used for patients with any of these diseases who might be matched.

I have always found there to be a bit of circle-of-life wonderment to the idea that newborn babies might have a cure for those of us who are being threatened with leaving this earth. All told, my transplant birthday was the direct result of another real human being’s birthday.

Managed to put on a nice shirt for the big day.

I was told I would never be able to contact my cord blood donors, only knowing that one came from a newborn female in the Seattle area and the other from a newborn boy somewhere in Germany.

As the transplant engrafts, only one of the two cords would win out. In my mind, a cellular wrestling match would dictate who liked me best— and in the end the young girls’ did. For three years my blood was hers, and mine was genetically female. Meaning if you were to type my blood it would come back as being (XX), that of a female’s— which I always joked made for a perfect CSI episode.

On days like today, I wonder about the young girl who I hope is out in the world somewhere. In my mind, she exists as a nine year-old, though cord blood can be frozen for up to 27 years, so she could also be around my age.

I wonder if her parents ever think about the umbilical cord they donated or if the girl even knows about it. I wonder if it was an after thought or an intentional act— such a momentous gift of generosity that they will never know about. To this girl, and her parents, I owe three years of my life.

But the birthday would not hold, through no fault of her own. After three years the transplant failed and I relapsed— which would lead me to a second, second birthday and special tie to a known donor— my cousin Pat (we’ll save that post for November).

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Interestingly, cord blood transplants have been slowly phased out of leukemia treatments, except for specific instances. Most of it is due to the development of new treatments that carry less risk or have better outcomes or are better tolerated by patients. And specifically in blood cancer patients that new procedure is increasingly becoming something called a CAR-T cell infusion.

When I was first diagnosed and was being prepped for my cord blood transplant, CAR-T was a sort of mythical whisper. It had been in clinical trial for a number of years, and more exclusively for children, but studies for adults and the idea of FDA approval were on the horizon.

But five years after my cord blood transplant I would be on the hunt for a new suitor, and lo and behold, I would receive my own CAR-T infusion. Strangely and wonderfully, I had gotten sick enough yet lived long enough to receive what was once a whisper. It is a testament to the prowess of modern medicine, a proof-is-in-the-pudding that the oftentimes ephemeral nature of cancer research is yielding real results— myself being a suitable data point.

On a personal level though, it can also feel like a slap-dash strategy, a sort of cannonball run ethos to somehow live long enough in the hopes that someone, somewhere finds a way for you to live a little longer if you can make it far enough.

But it’s worked so far, and my oncologist and I always share a bemused fist bump whenever we see each other now— I’m sure he’s just as tired from running as I am, but the checkpoints of modern medicine always turn my eyes skyward as I begrudgingly force myself to believe that the answer is out there somewhere. Call me Mulder because I want to believe.

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The truth is that I don’t really think about my original transplant too much anymore. Nine years is certainly approaching grey areas of memory recall— though it was how I met my wife, so some of it certainly sticks out. I did have the foresight to commit the date to being a repeated annual event on my Google Calendar. It is it’s own time capsule, my own type-written words capturing the excitement of how I must have felt a year our from my first transplant.

Birthdays can be hard to ignore, but they do seem more prone to be intentionally forgotten as we go on. Maybe a spouse or partner or family member becomes the person who prods you a few weeks ahead of it, or they do the heavy lifting to plan something, or they make sure there’s at least some edible acknowledgment of making it to another year. The celebrations tend to get smaller and more insular (though we all have that one friend who still insists on a whole production).

There are plenty of reasons to forget a birthday; getting older isn’t always fun, trying to dodge planning anything when we’re already busy enough, or maybe you just don’t want to call too much attention to yourself.

In my weekly quest for content, I saw my transplant birthday sitting next to a Tuesday and it has forced me to reflect on it. I’ve been thinking about “great’ birthdays that I’ve had.

One time my parents rented out a church so that me and all of my friends could race remote control cars around inside its carpeted gymnasium. Another one was a big sledding outing that played out in my mind like a demolition derby. Recently I was gifted a surprise party that would stick out as a data spike on the fun-chart of my recent years.

I know why we try and forget birthdays. But it’s too easy to look at time passed without change, or even with backsliding into old routines, as some kind of failure or bland ice cream lacking chocolate chunks or interesting sprinkles. A new beginning might not give us the new life, or year, that we want or imagine, but it’s worth remembering that…. It could be worse.

But I don’t want to end on that. Let’s end on the evergreen hope that to be alive should be gift enough. The smile is worth it when you blow out the candles— we made it another year.

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Sensory Activation: Things I Was Into This Week

My consumption this week has largely been the beginning of the NBA’s post season— and my beloved Chicago Bulls quick excision from the meat of it. In that time

Katie Heindl

wrote a wonderful piece on Blake Griffin’s retirement announcement.

As a late-citizen to Lob City, Griffin’s high-flying image always captured my imagination and his biracial origins made him feel a bit like distant kin. Heindl always writes beautifully, but here I found her usual mix of basketball and feelings a la a “career recap” piece to be especially poignant.

Helios or nothing

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