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Part 1 of the ABCs of chemotherapy
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Published:
2025-08-23
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3,104
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1/1
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promyelocytic

Summary:

At seven years old, Frankie Langdon hates hospitals — he thinks they’re yuck and the chemo makes his mouth taste like metal.

(Or, the drugs in Langdon’s locker weren’t benzos).

Notes:

Just something I had kicking around in my Drabble folder. 😘

Enjoy! 😉

Here’s a video on leukemia, if you’d like more information.

https://www.youtube.com/watch?v=Z3B-AaqjyjE

(See the end of the work for more notes.)

Work Text:


“But the story of leukemia — the story of cancer — isn't the story of doctors who struggle and survive, moving from institution to another. 

It is the story of patients who struggle and survive, moving from one embankment of illness to another. 

Resilience, inventiveness, and survivorship — qualities often ascribed to great physicians — are reflected qualities, emanating first from those who struggle with illness and only then mirrored by those who treat them. If the history of medicine is told through the stories of doctors, it is because their contributions stand in place of the more substantive heroism of their patients.” 

— Siddhartha Mukherjee, (The Emperor of All Maladies: A Biography of Cancer)

 

 

At seven years old, Frankie Langdon hates hospitals — he thinks they’re yuck and the medicines make his mouth taste like metal.

Still, he lies in his big hospital bed in the emergency room, shaking in a confusing, mean yoyo of both really cold and really hot at the same time. It’s big bad. It’s hurty. His head is so heavy, too heavy to pick up for long, like it’s full of pudding and being held up by squeezy hands that make all the sounds blur and stretch funny. The beeping of his machines feels like whole galaxies away, but the shuffling of rubber clogs and sneakers in the hallway feels super close. He keeps his eyes half-shut because keeping them open feels like holding up his stained ceiling with a toothpick, but he pulls them apart every few minutes anyway; he doesn’t want to be alone in the sick-dark. He wants to see sometimes.

He sees new faces come and go, big nurses with careful hands, their voices soft when they speak directly to him and sharp when they speak to each other. He doesn’t understand the numbers they’re talking about, but he understands the way they look at his machines, they don’t like his numbers — he has another ‘fection from the chemo. 

Chemo is a bad friend. Frankie’s had chemo loads of times. Cerubidine, Cytarabine, Arsenic and ATRA and a bunch of other ones, like the red one that hurted like fire going into his chest tubies and the yellow one that went into his back with a really big needle. He’s got leukemia — one of the weird kinds called APL, Acute Promyelocytic Leukemia, he practiced saying that one to his doctors because he’s big now — he got it first when he was two. It went away for a little while, but never for a big long time. So he’s getting the last of this round of chemo, so they can do the cells-go-byebye chemo and he can get new spongy hip bone cells that make blood, bone narrow. Only he started to feel real icky and his Mommy-nurse from the McDonald house said he needed to go into the ER. They put him in an ambulance and everything. He liked the wee-woo noises and they did the flashy lights too. 

“Hey, buddy.” 

Frankie coughs under his plastic air mask and pouts. The new guy is tall but bad at it, his scrubs wrinkly at the knees, he’s got a big droopy nose and puppy dog ears. Frankie’s eyes bounce to his name on his badge and scowl, that’s a hard one. His lips move faintly, shaping the letters in silence. The doctor shakes his head, smiling at Frankie in that way big people do because he’s bald and has tubies. “You can call me Robby. How are you feeling, Frank?” 

“Frankie and I feel yuck.”

Robby looks up at the machines and his face goes all squished. “Yeah, bud, you aren’t doing so hot. Do you have any questions for me?”

Frankie wets his lips under the plastic mask and thinks very, very hard. He likes when people ask him questions because then he gets to be the boss of answers, but his head feels like the inside of a washing machine. “Can I have a slushee?” He croaks, too quiet and crackly. His throat feels real puffy and hurty on the inside, like when he eats chips too fast and they scratch the insides.

Robby laughs, but soft like a pillow laugh not echoey like a bouncy ball laugh. “Maybe not tonight, Frankie. We’ll see how your tummy’s doing first, okay?”

Frankie frowns, his little eyebrows knitting together — or well, the space where they used to be, he doesn’t have them anymore. “Tummy’s dumb.”

Robby sits on the rolling stool, spinning once like he’s testing it, then steadies himself. He leans forward so his big doctor face isn’t a hundred miles away. “Your tummy’s working really hard right now. You’ve got a strong little army in there, trying to keep you safe while the medicine works.”

Frankie hates armies. He hates soldiers and fighting and all that. He wants soft things, not sharp things. He shakes his head. “No armies. I just want Mommy-nurse.” His voice wobbles, and his hands clutch the edge of the blanket, all twisty.

“She’s on her way,” Robby coos gently, all soft like he’s singing a lullaby. “The ambulance was faster than her car.”

Frankie tries to nod but it makes his world swoop sideways. He clutches his skinny blanket tighter and whispers, “Don’t go away, ‘kay? Don’t go away till she comes.”

Robby swears he won’t, even though Frankie knows you aren’t supposed to swear. He stays, sitting right there, even when a nice blonde nurse lady comes in with another bag of clear drippy medicine and makes a sad face at him. She says something about Robby having to go do other stuff. But Robby waves her off without moving. “He doesn’t have anyone, Dana.” He whispers, but Frankie can still hear him. “Foster.”

Frankie’s eyes flutter again, heavy like bricks, but he fights it, because the sick-dark is scary. But when he peeks, Robby’s still there. His doctor is drawing little smiley faces on his blown-up glove with a pen, and when Frankie blinks again, it has bunny ears and a face.

“See?” Robby wiggles the ears at him. “Not an army, just a bunny squad.” He stops, then smiles really big. “You know, I have a friend named Jack Abbot, he’s the best. And, I call him Jack Rabbit, ‘cause he’s always bouncing around like the Energizer Bunny.”

Frankie makes a weak sound that might almost be a laugh, and it hurts but feels better too. He scrubs at his tired face and pulls at the edge of his blanket, rubbing the threads between his thumb and finger. His eyes are slipping half-shut again, but he’s still awake, still listening. “It’s okay,” He sighs, his voice tiny under the mask. “I know you’re making me laugh ‘cause you’re sad. But I been on chemo lots, Robby. This ain’t the worst one, or the worst ‘fection after.”

Robby tilts his head, eyebrows lifting. “Not the worst one, huh?”

“Mm-mm.” Frankie shakes his head slowly. “The red one was the bad one. The fire one. I screamed. That one made me get all shaky and floaty in my head.” He frowns, eyes glassy, then adds, “I ‘member that. But this ‘fection’s just tummy yuck and hot-cold and metal mouth.” His free hand sneaks up and taps his lips. “Like chewing pennies.”

Robby lets out a breath, he looks like he just hit his foot funny. “That still sounds pretty tough, buddy.”

Frankie shrugs. “I get ‘fections sometimes ‘cause the chemo’s fighting my cells. But it’s okay. They’re gonna give me new bone narrow.”

Robby blinks, going whiter. “Bone marrow?”

“Yeah,” Frankie nods, proud of the word. He practiced it with his Mommy-nurse from the McDonald House. “Bone narrow. They take all the bad cells—” He waves one hand like he’s sweeping crumbs off a table, poking at his hips. “—and then I get new spongy ones. Then I can make blood that’s not dumb, Robby.” His words are slurring at the edges, but he’s determined, his chin lifted.

“That’s a good plan,” Robby huffs softly. “That’s a really good plan.”

Frankie smiles faintly, then coughs, pulling the mask tighter to his face. “I know. I just gotta be brave ‘til then. But sometimes with the chemo, being brave is just swallowing the goopy meds after.”

Robby rubs at his eyes and leans forward, resting his arms on his knees as he squeezes the necklace around his neck, the one with the pretty gold star. “You are brave, Frankie. Braver than most grown-ups I know.”

Frankie’s eyes peek open at him again, tired but stubborn. “You’re a grown-up. Are you brave?”

Robby pauses, a tiny smile tugging at his lips. “Not really.”

Frankie thinks about that for a second, then lets out a little sigh, eyes sliding shut again. “Liar. You fix people’s bad hurts sometimes, with blood and stuff, that’s scary.”

“Sometimes, but mostly it just makes me sad.”

 

 

The curtain rustles open with a squeak of metal rings, and a new shadow spills into Frankie’s little room. He’s too busy spitting up sour stuff into the plastic basin Robby is holding under his chin to really care, but he hears the hitch in Robby’s breath first. His tummy hurts real bad, he thinks the ‘fection might be hiding in there. 

“Hey, Robby, I need you for a minute, brother.” The new man grunts, half-whisper, half-loud like he’s been running and only just remembered he’s inside a hospital and you're supposed to walk inside hospitals. Frankie blinks his watery eyes up and for a second the figure by the door looks like a soldier stepped out of one of those old shows his Mommy-nurse puts on the DVD player for him; MASH. He’s got tough shoulders, a square jaw, and a big green jacket over his doctor clothes. His eyes are kinda wrinkly behind his skinny metal glasses — he looks at Frankie before down to Robby’s hands, steady even though his bucket is half-full of Frankie’s sick.

Frankie coughs, wipes his mouth clumsily with the back of his hand, then squints over. His voice comes out croaky again: “You look like a green army guy.”

His space goes quiet, except for the IV pump clicking and his ragged breathing.

The army guy blinks once, then twice, like someone’s just slapped him with a memory or a mirror at the same time. Frankie gets it, sometimes he looks in the mirror and cries a little bit, because he doesn’t look like himself, all puffy and bald. “Frankie,” Robby starts gently, adjusting the mask back over his mouth and nose after wiping up all the ick from his face, “This is Jack. Jack Rabbit. He’s one of my — one of the other doctors here.”

Frankie’s bleary eyes stay fixed on Jack. He shakes his head, still catching his breath. “Not a doctor. Green army man. The kind with the standy-feet, so he don’t fall over.”

Jack crouches down, and his knees pop when they bend. He rests his elbows against them, steadying himself. “Army man, huh?” His voice is softer now, low in his chest. 

Frankie nods once, very serious, his whole head bobbing under the weight. “Green army man with glasses. They don’t usually have glasses. You’re special. Are you a sniper?”

Jack lets out a long breath and his face goes real soft, for a minute he looks like he’s the one about to be sick, all the color drained away from his face. Frankie goes to reach for the bucket again, not for him this time. But then Jack Rabbit smiles — just a little, tight at the edges, but still a smile. “Got it in one, kid. But then I became a doctor.”

Frankie doesn’t smile back; he’s already slumping sideways into his pillows, exhausted by the effort of talking and throwing up. Robby hands the bucket off to a nice man with dark hair who slips in and out with a broom, then adjusts the blanket over Frankie’s narrow chest. “Thank you, Beto.” Robby whispers, and Frankie lets the words drift away. 

He’s not sure how long he keeps them closed, but when they flutter open again, he finds Jack’s face first. “You can stay too. But don’t shoot anybody. ‘Kay?”

Jack swallows hard, something sharp catching behind his eyes. He nods slowly. “Promise, kiddo. No shooting.”

But Frankie purses his lips under his mask, pouting for a second as he thinks better of it. “Actually...” His words tumble out between shallow breaths, all sticky-slow with tired. “You can shoot my ‘kemia,” He insists, eyelids popping open and closed like moth wings. “It’s in my blood. Makes my cells bad.” His little fist comes up and thumps weakly against his left hip to point where it lives. “You can pew-pew it.”

Jack crouches even lower, poky elbows not letting him lean in as much on his knees, the green fabric of his jacket bunching awkwardly. One of his legs looks extra shiny when his pants move funny. Up close, Frankie can see his glasses slip down the bridge of his nose. Jack swallows like he’s got a sore throat, like it gets stuck halfway through.

But Robby’s hand stays steady on Frankie’s back, drawing slow loopy circles, as his eyes cut sideways at Jack. 

Frankie’s lips tug into a hurty smile, crooked under his hot, sticky, plastic mask. “It’s okay. You can shoot it lots, like army guys do. Pew-pew-pew.” He lifts a finger weakly and aims it at his IV pole, a clumsy pretend-gun. “So it can’t come back no more.”

Jack forces a sound out, thick and hoarse, he must be getting sick too. Not Frankie-sick, but regular sick. “Yeah, buddy. I’ll make sure of it. We’ll blast it all away.”

 

 

His locker door clangs shut with a hollow metal-on-metal sound, echoing louder than it should as Dr. Frank Langdon sits down heavily on the bench below it, his scrubs wrinkled from a long shift, his ID badge swinging crookedly from his chest, looking down at the emesis basin in his hands, the one that lives in his locker for this specific occasion.

He’d arranged the little white-and-orange box on the top shelf of his locker like contraband, only popping it into the basin when it was time to administer it: Zofran, prefilled syringes. Cold from the pharmacy fridge, tucked into a lunch bag with a freezer pack. His lifeline. He wouldn’t be able to get through a shift without the industrial strength anti-emetics every couple hours. It’s only been a week, but he feels like he’s floundering. Abby, his ex and best-friend, the mother of his two little darling terrors: Tanner and Robin, had begged him to take a sabbatical, to come live in her guest room so she could take care of him through treatment. He’d just kissed her forehead and grabbed his work bag. He loves her still, part of him always will, enough to not turn her into a nurse.

His hand lingers against the syringe a second longer than it needs to, his thumb dragging over the printed numbers. He knows the routine too well: oral chemo on Monday, Tuesday, Wednesday, the worst nausea ever on Thursday, IV chemo through his Hickman on Friday and Saturday and Sunday to rest. He remembers the bone-deep ache that follows him again like an old friend, the bruises blooming in colors no textbook had ever described accurately, the mouth sores already reopening after his second coffee of the day. It’s his seventh round of APL. 

Lucky number seven, he thinks dryly.

He pulls his stethoscope from around his neck and sets it carefully in his lap beside the syringes, as though the two belong together — tools to keep him working, one against his patients’ sickness, one against his own.

Frank leans forward, elbows on his knees, the fluorescents burning overhead. He breathes slowly, deliberately, the way he had as a kid in the ER, through bone marrow transplants and recurrences, and now well into adulthood. Except now, he’s the doctor. He’s the one sitting at the bedside, answering questions in soft voices while hiding the sharp ones for the hallway.

And yet, he’s still the boy with bad cells.

He rolls his sleeve up just enough to see the familiar constellation of faded scars from old IV lines, from PICCs that tunneled into his chest. He pressed a thumb into one, grounding himself. Then, with practiced fingers, he uncaps the syringe, taps it once with his pointer nail, and slides it into the thick muscle of his exposed thigh. No hesitation, just the sting, the burn, the faint relief that would come later, enough to keep him steady through another grueling shift.

The empty syringe clinks softly as he drops it into a sharps container he’d tucked into his locker days ago.

Frank sits back, eyes closing briefly. Outside, the hallway bustles with nurses, orderlies, residents, med students, and the unrelenting urgency of the ED. He listens, then pushes himself to his feet. Another round. Another shift. Another child who will look up at him with that same fear in their eyes, wanting to know if they’re alone in it. 

He locks his locker and squares his shoulders. Whatever his own marrow is doing, whatever his body is plotting, it can wait.

Jack’s gone home, but Robby needs him out there. 

Frank doubts they remember him. He doubts they’ve connected the hollow-cheeked seven-year-old from the Ronald McDonald House — sweating with fever, talking about army guys — to the fourth-year resident writing orders beside them. He’s never told them, never pulled the thread of memory that would unravel the neat distance between then and now. But sometimes, when he catches Robby leaning over a patient with that same careful crouch he once used for him, or when Jack’s laugh breaks out in a room too heavy, something inside Frank warms with recognition. A secret tether, unspoken but unbreakable.

He smiles at odd times, and no one knows why. 

Smiles when he should be too tired, when the chemo burns through him now and his mouth tastes like metal, when he forces himself to keep walking because stopping would mean drowning. He smiles because he remembers. He smiles because when he thinks of fathers, of what it must feel like to belong to someone’s unshakable orbit, it’s not strangers on TV he imagines. It’s Robby. It’s Jack. 

He was a foster kid, he had nobody — but he could pretend, he could dream up a little perfect world in his head and in his pretend little boy dreams, Frank sees them as the closest thing to a father he has ever known.

 

 

Notes:

I’m on tumblr now 🩷 😘 @microbiologistmusings

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