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In Memoriam

Rebecca Alison Meyer
Ahuva Raya bat Kayla
7 June 2008 – 7 June 2014

Rebecca Alison Meyer, adored daughter of Kathryn (née Fradkin) and Eric Meyer.  Beloved sister of Carolyn and Joshua.  Loving granddaughter of Arthur and Cathy Meyer, Steven and Sandy Fradkin, and the late Carol Meyer and Ada Fradkin.  Rebecca was a cherished niece, cousin, god-daughter, and friend.

Services will be held Thursday, 12 June 2014 at 3:00pm at Anshe Chesed Fairmount Temple, located at 23737 Fairmount Boulevard, Beachwood, Ohio.  Interment will be at Mayfield Cemetery in Cleveland Heights.  The family will observe Shiva at their Cleveland Heights residence Thursday (following services) until 9:00pm; and then Friday, Saturday, Sunday, Monday, Tuesday, and Wednesday from 3:00pm–7:00pm.  A brief minyan will be held Thursday night, and Saturday and Sunday at 2:30pm.

The family requests charitable donations be made in Rebecca’s name to the Philadelphia Ronald McDonald House or the St. Baldrick’s Foundation.  They further request that those who attend the services and are comfortable wearing purple do so in honor of Rebecca and her favorite color.


If you have a mind to be there, please know that you are welcome—adults and children alike—to the service, interment, and Shiva.  Community has sustained us, and anyone who wishes to be there should be there.  Those traveling to attend should look to the Chagrin/I-271 area for lodging, which is very near Anshe Chesed and near to our home as well.  The service may be live-streamed—apparently that’s a thing our temple does these days—but I can’t be certain that the technology will cooperate.

I will update this post as necessary.

The Thief of Light

When Rebecca was almost 17 months old, she had her first real Halloween—the year before hadn’t really counted, since she spent the whole evening sitting in her bouncy seat dressed as a chile pepper.  It was a big occasion.  We dressed her in her Tigger costume and sat on the front porch with the bowls of candy we’d prepared for all the trick-or-treaters to come.  She loved candy and was thrilled to be sitting with her big sister and all that sweet stuff, even if we did keep telling her not to eat it.

Right on schedule, the first group of trick-or-treaters came up the front walk.  Carolyn, who loves giving out candy far more than she does receiving it, deposited a few pieces in each bag.  Rebecca watched this whole process very intently.  She watched the kids walk away, and saw that another group was headed up the front walk.  She looked at Carolyn, then the approaching kids, then down at the candy bowl in her lap.  Back up at the kids, then back down at the bowl.

And then she leapt up and took her bowl of candy to a far corner of the porch, hunched over her candy, defying anyone to take it.

Now if you offer her candy, you might get a nod or just a shrug.  Taking it from her elicits no reaction at all.


While she was never a super-chatty child, Rebecca was verbal pretty early and always happy to express herself, especially in disagreement or, really, any other form of opposition.  She was never shy about speaking up, a trait we subtly encouraged even as we tried to direct it.  If she thought you were being silly, she’d say so.  “Well that’s just lame,” she become fond of saying in the last few months.  Always with a little smirk, unless she really was angry.  The Brits would say that she absolutely loved taking the piss out of everyone around her, and loved even more that she could get away with it by making her target laugh along with her.

She barely speaks now.  Early in the day, we’ll get a some short sentences in response to questions or observations, but she almost never speaks on her own initiative.  A lot of her spoken answers are an answer of “sure”, delivered in a flat, almost bored tone.  Most of our communication with her is in the form of head shakes, nods, and shrugs.  Toward the end of the day, they become so subtle that Kat and I are the only ones who can be sure what she meant.


Rebecca was always athletic, running and throwing like a much older child.  Like a boy, we would have said in my unenlightened youth, but it was never really like that.  Like a gazelle, I once thought, knowing very little about actual gazelles.  She just threw hard and well, and ran hard and fast, and loved to do both.  I have pictures of her sitting on a trapeze bar, holding the ropes, and her posture looks like that of a seasoned circus performer, sinewy and controlled and poised to do great things.  She excelled in gymnastics, to the point that last summer they moved her up to an older class, placing her on track to join the competitive gymnastics team.

Now she can barely stand upright.  When she has enough energy to walk, she has the slow plodding gait of a clumsy toddler, weaving in unsteady curves from side to side.  When she reaches for something, always so slowly, her hands visibly tremble.  The most activity we see in her comes from obsessive, repetitive motions, pulling over and over at a loose thread or worrying the beads on a bracelet or picking tiny crumbs of food off a plate.


Rebecca delayed potty training mostly because she knew we wanted her out of diapers.  If we hadn’t encouraged it, she probably would have done it sooner.  But she put it off, and put it off, just because she could.  When she finally did, though, she was done.  There was no night-training period, and hardly an accident.  She just gave up diapers one day, on whatever impulse made her decide to do it, and never needed pull-ups after.

Until now, because she’s lost almost all control of her bladder and bowels.  At first she was mortified, but now the most she registers is a distant sort of anger at us when we change her.  We have to change her several times a day, and she just lies there, staring vacantly at the ceiling until we tell her we’re done.  Then, sometimes, she moves her eyes to look at us and wait for us to help her up.


She was full of energy, our Rebecca.  She was always dancing through life, Kat used to say, singing her favorite songs when there was no music to be heard and making a walk on the sidewalk into a skip-steppin’, butt-wigglin’ festival of joyful movement.

Now she sits inert for hours, staring off into space for long stretches of time.  We have to say her name loudly, and sometimes move her head to face us, before she suddenly snaps back.  Her eyes focus on us, the eyebrows raise a bit in query.  We ask her if she wants this or that, sometimes more than once, before she responds.  Sometimes, if she’s more with it, she’ll sit inert and look at one of us.  When I gave her a bath tonight, she sat up in the tub, but as the water rose, her legs floated upward with it, slowly tilting her body backwards until I had to put a hand on her back to keep her upright.  And the whole time, she stared half-vacantly at the chromed overflow drain cover.  At her reflection in it.  At the person there, who I cannot be certain she recognized as herself.


Everything we felt so fortunate to have kept, all her intact neurologic function and physical health and vitality, her ineffable sun-bright spark, have been leached away.  She is dying by slow millimeters, sinking further and further into a miasma of lethargy both physical and mental.  All her emotions crushed flat by the rising pressure in her head.

For all that, she is still Rebecca.  She shakes her head no when she knows we want her to nod yes, and if there’s no smirk to go with it, maybe we can see the faintest echo of a crinkle around her eyes.  When we verbally fence her to the point that no isn’t an option, she just looks at us as if she has all the time in the world to wait out our interest, her eyelids slid just a fraction shut to register her disdain for our feeble attempts to outwit her.

At bedtime, Kat read Rebecca “Madeline”, a favorite they’ve long shared.  Rebecca was so drained that she was basically asleep before we put her in bed, but as Kat started reading, Rebecca’s eyelids slid partly open, her eyes rolling a bit before the lids fell shut again.  Her eyes kept cycling through this, over and over, as Rebecca fought to stay awake enough to hear her mother read her a beloved bedtime story.  She kept fighting until the closing passge:

“Good night, little girls!
Thank the lord you are well!
And now go to sleep!”
said Miss Clavell.
And she turned out the light—
and closed the door—
and that’s all there is—
there isn’t any more.

And as the last syllable passed Kat’s lips, Rebecca’s eyes stilled and she sank deep into sleep.


She lies sleeping on her back, her arms at her side as though not just asleep, but actually unconscious.  She has always been a side-sleeper, ever since the day she was born.  Now she lays inert, her head straight on her pillow, as if rehearsing for the casket she will never occupy.  But when a friend came in to give her kisses, she turned her head slightly, her brows drew together a bit in annoyance, and she folded defiant arms across her chest—still sleeping.

Her pulse is still strong and regular, and her breathing is slow and steady, the calm notes of a child at rest.  She relaxed her arms a while ago; they still lie across her chest, but separated a little bit.  Her jaw has stopped constantly working in her sleep, another new symptom we don’t know how to interpret.  Maybe she was dreaming of chewing gum, one of her favorite things in the whole world.  Maybe it was something very different, and much worse.  It still happens every now and again.

Earlier tonight, I was convinced by all these little clues, and a hundred more, that she would die tonight.  Now I’m not so sure.  The slow rhythm of her breathing gradually carried me from stupefied terror to a quiet reflection.  Now, as I stand guard over her sleeping body, I can look at her still, beautiful face without fear.  I can believe that she’ll wake tomorrow, no more herself than she was today, maybe even a little bit less so, but still going.

Still fighting to stay awake, stay alive, stay with us.

In Shock

Today’s MRI showed that the CT scan two weeks ago was inaccurate.  The tumor has grown significantly, and two of the flare sites are larger.  We’re out of the p28 study.  There are no other studies we or our doctors know of that can help.  Surgery is off the table.

Rebecca has a few weeks left at best.

We’re starting steroids to reduce swelling in her head, in hopes of restoring her to something like her old self.  And we will make whatever time is left as fun and amazing as we can for Rebecca and Carolyn and Joshua.

I built a memorial page for my mother, eleven years ago.

I’m not ready to make one for my daughter.

Deep in the Forest of Fear

Rebecca’s spark has dimmed, and we don’t know why.

On days we go to Pittsburgh, she sleeps the whole way there, is pretty normal at the hospital, and then sleeps some or all the way back home.  When we get home around mid-day, she usually stumbles to the couch and takes a long nap.  She might have a few normal hours of wakefulness starting mid-afternoon, get energized around dinner and bedtime, and then go to sleep for a full night.  Or she might spend those hours not doing much of anything except lie awake.

On days Rebecca goes to kindergarten, she usually walks there and has a normal morning.  And then, right around lunch time, she usually runs out of steam.  We had to go pick her up the other day because she’d fallen asleep at her desk, deeply enough that normal attempts to rouse her got no response.  (Normal, as opposed to “THERE IS A FIRE WAKE UP NOW!”)  We got her home, and she stumbled to the couch and took a long nap.  Once that was done, she didn’t do much for the rest of the day.

Even when she’s awake, at least half the time she seems distant, disconnected.  Much of the time she’ll just lie on a couch or a lap, not moving much, not doing anything but staring off into space.  You can catch her attention and get a warm smile or an air kiss when you do, but that’s it.  She’s there, and yet not there.  At her most energetic now, she’s much more subdued than she has been in the past.

And we don’t know why.

We’ve ruled out seizures.  The EEG showed absolutely no trace of any seizure activity, even when she just sort of stopped and stared off into space, as she does so often these days.  Everything was completely normal, diagnostically.

We think we’ve ruled out pressure due to tumor growth, given the latest CT.  We’ve moved up her next MRI, and expanded it to most of her body, to see if there are tumors elsewhere, or if the CT somehow missed something.  Maybe a thalamic tumor.  Maybe not.

We can’t definitively rule out a virus of some kind.  Her viral panel was negative, but it’s a limited test.  Everyone in the family has had a virus that drained us, as have some of our friends, but most of us recovered in a few days and Rebecca’s been like this for two weeks now.  If it’s a virus, then something is keeping her from recovering from it.  But her blood work is normal, her immune system apparently fine.

We can’t rule out the possibility of side effects from the p28 treatment.  Rebecca is the 38th child ever to receive this treatment, and one of a very few who’ve gotten it at her dosage level.  Maybe this is all just a huge side effect.  Except it’s been almost a week since her most recent treatment, and there doesn’t seem to be much, if any, improvement.

In the absence of certainty, it’s hard not to descend into fear.  Maybe none of these things are what’s wrong, we try not to think.  Maybe she’s just dying.  It’s a little like being deep in the heart of an unknown forest at twilight (or is it sunrise?), unsure which way to turn and what’s really dangerous.  A snake could be in that log.  A rotten tree might fall.  There might be a bear.

I grew up in forests; Kat’s totally a city girl.  But even I can’t help feeling like Rebecca is leaving us slowly, a tiny little bit at a time.  Intellectually, I know that may not be so, but in my gut I feel it.  I look at her lying limply on the sofa, her eyes vaguely focused on something a thousand miles away, and my stomach twists icily.  I want to shake her fully to life, drag her back to us, scream until the spell is somehow broken.

Instead, I take her hand and smile at her.  I sign “I love you”, tapping it to my heart as we always have in our family, to see if she’ll do the same.  Usually, she speaks “I love you” back, because that takes less energy, less movement than signing.  Her eyes crinkle with warm affection when shes says it, looking into my eyes, holding my gaze for a few moments.  Until her gaze slides away and loses its focus on the here and now.

If Rebecca were cranky and irritable from exhaustion, that would actually be easier on us, because that would make sense.  That would be normal.  It’s the quiet inertia that really, deeply scares us.  Whatever our heads may derive from looking at all the maddeningly incomplete data, our hearts are filled with fear.  We’ve tried to push it away, and also tried to accept and acknowledge it, and neither approach seems to help.  The fear persists.  We’re afraid that her light is very slowly going out, that she’s fading from this world, that she’s leaving us.

And we don’t know why.

Perhaps posting this publicly will make all the symptoms go away, and I’ll wonder some day what I was so bothered about.  I hope so.  I’ll absolutely take feeling foolish in exchange for having her be herself again.  I’ll even accept never knowing why she’s been like this.  Just as long as we can put this forest behind us.

A Good Day

As soon as the doctors came back into the room from looking at the just-completed CT images, I knew the news was not bad.  I didn’t know exactly how not-bad it was, but I could tell just from the way they walked into the room that the worst had not come to pass.  The expressions on their faces simply confirmed it.

And then their words: the primary tumor’s size is essentially unchanged since the MRI that was done three weeks ago.  There are no obvious solid tumors arising from the flare sites.

This is huge.  The rate of growth previous to starting the p28 study was frighteningly rapid.  If unchecked, it should have been at least a third bigger, maybe half again as big, maybe even twice as big, by now.  Instead, it’s basically the same size.  The flare sites have not produced tumors of any notable size, and may have produced none at all.

I can’t say if the primary tumor is exactly the same size, or a little bigger, or what, because today’s image was a CT scan (done in the Pirate Island imaging room, by the way).  As such, it can’t be directly compared to the last MRI.  We won’t get a more precise estimate until another MRI is done, and even then it won’t be ultra-precise.  Medical imaging can only get you so far, precision-wise.

The tumor isn’t being eliminated, because that’s not how this treatment works, but it is being held in check.  The p28 is buying us time—enough time, we can hope, to find a way to shrink or possibly even eliminate the tumor.  That’s where our energies will be directed in the next few weeks and months.

So after all my angst and worry about making a blind choice, there was no opportunity to make it.  In a sense, we had no choice, though of course we always had the option to refuse.  Given the situation, though, we ended up imaging earlier, and differently, than expected, for unexpected reasons.

The reasons were that, starting Friday afternoon, Rebecca became very tired, almost to the point of listlessness between daytime naps.  She hasn’t napped in years, and suddenly she was sleeping twice a day, going to bed early, waking up late, and still having low energy.  There were periods where she’d rally and be her usual self, but they got shorter and less frequent.  Yesterday, there really wasn’t a time where she had her usual energy levels.

Our instincts basically got whipsawed into pulp.  There were a few times over the weekend where I nearly tweeted that she was dying, because that’s how it felt to both me and Kat.  Then she’d rally, and we’d think that maybe it was just a virus.  And then she’d slide into a torpor that felt so much like the days before her seizure last August.

The thing was, it was only fatigue and lethargy.  There wasn’t vomiting, as we would expect with intracranial pressure, nor complaints of headaches.

Then, last night, there was an incident that seemed like a very small seizure.  We talked with the on-call nurses both here and in Pittsburgh, and both agreed that we should get her to Pittsburgh for her p28 infusion and further evaluation with the study doctors.

Kat and I were pretty well convinced that the CT would show a much larger tumor, not driving up pressure so much as disrupting the normal brain tissue and slowly killing her.  We were braced for the news that the drug wasn’t working and that she was out of the study.

As we waited for the CT machine to spin up, Kat broke from our embrace to look me in the eye.  She asked, “Are you ready for the results from this?”

“No, of course not,” I said.  “But whatever they are, we’ll deal with them.”

Less than an hour later, we were asking the doctors to repeat their findings.  No change.  Our intertwined fingers contracted, squeezing as one, disbelief translated into white-knuckle pressure.  We turned inward, fell into each other’s arms, and wept tears of relief and a kind of joy.  For the first time in months, our tears came from something other than fear and sorrow and pain.

Tonight, Rebecca is in yet another hospital bed, this time at the Cleveland Clinic.  She’s still deeply tired all the time, and if the tumor isn’t exerting pressure, then there has to be another cause.  We might have waited it out to see if it’s viral, but there are enough other signs—the incident last night, some subtle physical changes, behaviors that might not be behavioral—to tell us that she’s probably having micro-seizures, and having them pretty often.  The tumor would be the most likely culprit here, considering where it’s located.

So tonight a technician is gluing a couple dozen electrical leads to her scalp so the EEG monitor can tell us if we need to add an anti-seizure medication to her daily routine.  In one way, I hope that it does, because that would be a known, fairly easily-addressed problem.  We’ve done anti-seizure medication in the past, and have a good idea of what works for her.

Of course we don’t want her to be suffering seizures of any kind—she’s suffered enough as it is—but as Kat observed, we’ll take a seizure disorder over an unchecked brain tumor any day.

We’re not out of the woods yet.  Even if the p28 is preventing the tumor from growing, which is all we can realistically expect it to do, the tumor is still there.  We have to find a way to deal with it, because we can’t expect the p28 to be effective forever.  But if this initial effect holds up, we might have several months, possibly even a year or two, in which to search for a stronger, more permanent treatment.  We’re checking into a number of clinical trials, some you’ve heard about in the news and others that were unknown even to our neuro-oncology doctors.  (That’s not a knock on the doctors; there are a lot of studies happening at any one time, and always more being launched.)  We’ll use the time the p28 is giving us as best we can.

A long day, and a very emotional day, but a good day, one of the best in a long time.  Any day you end with more hope than you started with is a day worth celebrating.

Afraid

Half an hour after we left UPMC this morning, just as we were approaching the entrance ramp for I-76 West, Rebecca threw up with no warning.  She threw up a lot.  We pulled over and scrambled to get her out of the car so we could clean her off and check for any other symptoms.  She stood with her arms held away from her body in the classic “ick” pose, until I peeled her shirt off to get most of the vomit away from her.  “It’s all over my arms and legs!  Why do I have to be like this?” she wailed miserably.

I pulled her to me, wrapped her in my arms, and said over and over, “I know, honey.  I know.”  Keeping my voice as level and calm as I could.  I don’t think I did a very good job of it.

By the time we’d gotten her and her car seat mostly clean, she felt fine, except for the taste in her mouth, which she pronounced “disgusting”.  We found the nearest drug store, bought some wipes and paper towels, completed the cleanup, and got back on the road, a newly fresh set of fears riding with us.

It could be the experimental treatment she’s taking, which is known to induce nausea in some kids, though she’s never been sick from it before.  It could be an aftershock from the GI ailment that went through the house the past few days, which had every single one of us dealing with unpleasant symptoms at one point or another.  It could be that she choked on her juice and triggered the gag reflex.  Or it could be the tumor, finally grown large enough to kill her.

I don’t know.  But the last time Kat and I were cleaning her off by the side of a Pennsylvania highway, she had four days to live.

Three Interludes

We lay snuggled together in her bed, the stories read and books put away, the lights turned low, listening to her nighttime music.

“Rebecca, can I tell you a secret?”

“Sure.”

“I love you super a lot.”

“I already knew you were going to say that, Daddy.”

“Oh, so it’s not a secret?”

“Nope.”

“Well then, can I tell you something that’s NOT a secret?”

“Sure.”

“I love you super a lot.”

“(exasperated sigh)”

I answered with a small chuckle, which earned me an affectionate glare.  Five minutes later, she was asleep, her breath quiet and even and calm and as normal as it had ever been, in the years before the tumors and the months after.


We were at the local playground, Rebecca and her sister Carolyn and brother Joshua and some friends and me.  At no apparent prompting, Rebecca came running toward me, then slowed to a walk and beckoned me to lean down closer to her.

“Daddy, I need to tell you something.”

“What?”

“I love you.”

“I love you too.”

“I love you more! I love you to infinity… and BEYOND! No really, I do.”

And she was already headed back to the slides, smiling at me over her shoulder, her eyes squinted in a knowing amusement, before she turned away and rejoined the other kids at play.


We lay snuggled together in her bed, the lights turned low, listening to her nighttime music and admiring the rainbow arc projected onto the ceiling by a bedside light.  It fell across the ceiling fan and some of the get-well stars strung in a line from one side of the room to the other.

“Daddy, did someone put a rainbow on that star?”

“No, it’s from the rainbow light, sweetie.”

“Oh.”

“What do you think when you look at your stars?”

“I think that my friends are always cheering for me.  Always.”

“You bet they are.  Always.”

“I love you, Daddy.”

“I love you too.”

“I will love you forever.”

“I will love you forever and ever.”

“Daddy, why are you copying me?”

“Well, because your words are beautiful, and they’re all true.”

“Oh.  Okay.”

“I love you to the moon and the stars and back again.  I love you to infinity and beyond.”

“Okay, okay, Daddy, we get it already.”

“Good.”

She smiled at me like we shared a gentle secret, as normal as ever.  I kissed her forehead, and within two minutes, she had fallen asleep.  I listened to her slow, steady breathing, my arm still curled around her—not to protect her, but just to hold her close—and looked up at the stars and watched the rainbow until its timer reached zero and it faded away.

Heroic Measures

This morning, I walked Rebecca and her best friend to kindergarten, all of us enjoying the crisp spring sunshine after the long, cold winter.  The girls ran ahead of me to see if the playground had been re-flooded by last night’s rains (it hadn’t) and then balance-walked a low retaining wall.  Once inside the school doors, I hugged and kissed Rebecca and told her to have a good day, collecting a hug and kiss and a “Love you, Daddy“ in return.  I watched as she tromped down the hallway in her sparkly new Bella Ballerina shoes and pajamas (today is a special Pajama Day at school) and rounded the corner out of sight.  And then I handed her principal a Do Not Resuscitate order.

She’s still so alive, so very vital, but we know that could change at any moment.  We’ve lived through it once already, last August, when she went from playing on the beach to the literal brink of death in just three days.

We carry DNR cards with us, and have given the school a DNR form sealed into a manila envelope with our names and phone numbers written on the outside, because if she suddenly seizes, our overriding goal is to make her as comfortable as possible while she dies.  The EMTs or hospice or we ourselves will give her medication to take away the pain and, if at all possible, the fear.  As much as she needs.

Because we know what will happen if the tumor induces seizure and she’s forced back to life.  We know that once it’s reached that stage, there are mere hours left, even if we permit life-prolonging measures.  Heroic measures, they’re called.  Hours, possibly days, spent in misery and pain and fear.

We can’t do that to her.  If there were a reasonable chance of her suffering leading to a cure, yes.  We did that last August, submitting her to multiple surgeries and the difficult recovery afterward, because there was reason to think that doing so would save her life.

Now we know better.  We know that when the cancer overwhelms her, there is nothing that can stop it.  We know that the best we can do is make what’s left of her life as normal and happy and full of love as possible, and minimize any horrors as it ends.

We’ve thought about pulling her from school entirely.  That would ensure that if she does have a sudden seizure, she’ll do so with one of us.  By sending her to school, we risk it happening when she’s not with us, and inflicting that experience on her schoolmates instead.

We send her to school because she loves it there, however much she may complain about having to get up in the morning and get dressed and put on a coat to walk to school.  Try as she may to hide it, she loves to learn.  She loves her teacher, her classmates, and her friends, and they love her in return.  It would be selfish of us to take that away, despite the risks, despite the hours of separation.  It would shift some of our burden onto her shoulders, force her to pay the cost of our sorrow and fear.

There are so few things we can do for her now, so very few things, but we can do this: we can give her her life, as whole and unbroken as we can manage, and an unspoken promise to fiercely guard it from even ourselves.  We can give her this.  Our last gift.

July 2014
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