1:3 April Fool's

It's what's on the inside that counts

Who doesn't love a good April Fool's joke?

Ewan delighted in scheming up pranks and tricks to play even from a hospital bed.

We'd been inside, inpatient for two weeks into treatment for Ewan's refractory leukemia. Outside the world woke up to Spring. From the view through Forest Floor 7’s window, I saw rows of cherry blossoms in full bloom. Clocks sprung forward, and the days grew longer. But from inside the hermetically sealed windows, the cadence of every passing day was the same. 

I latched onto any excuse to liven up our hospital-bound life. Our dear friend Petra, our rock, brought in a tiny pack of Cadbury mini crème eggs for the first day of April. This Easter specialty item came in a twelve-pack. The chocolates were individually wrapped in blue, red, green, and yellow-colored aluminum foil with the Cadbury crème egg logo in prominent print. Each piece was no bigger than a quail's egg. The chocolate eggs were cleverly packaged in a clear-lidded container. They sat perky and upright, nestled in a purple plastic rack. The overall presentation mimicked the appearance of a tiny bird’s eggs in a miniature egg crate. 

In case you are not familiar with Cadbury eggs, normally, they are the size of a chicken egg. Nowadays, they are sold year round, but when I was little they were only available around the lenten season; they were the single most decadent and desired treat of my childhood. I remember eight-year-old me sitting crisscross applesauce in front of the television watching a commercial with a white rabbit bokking like a chicken. The rabbit laid an egg and hopped away. A voice-over said, "You are looking at a very unusual kind of egg from Cadbury that is only available 'til Easter. Its shell is pure, rich Cadbury rich chocolate. But look inside sits a sweet, creamy yolk surrounded by delicious white filling."

Now, Petra planned to deliver a dozen tiny versions of my favorite chocolate. But these were not the usual milk chocolate treats with soft fondant-crème centers, and only Ewan and I were in on the secret. Petra had purchased the sweets in the Easter aisle of the grocery store. Once she got home, she lovely unwrapped each piece of chocolate and replaced the foil's contents with a surprise. She smoothed out creases in the wrapping and returned each egg to its original container. Now transformed, there were twelve foiled-wrapped plump, purple grapes in our special Cadbury egg carton instead of sweet chocolate treats. A discerning eye would surely recognize the luscious Cadbury logo. We hoped an undiscerning eye would not notice that the unwrapped content was a piece of fruit instead of chocolate. Our April fool's goal was to take chocolate-loving recipients by sweet surprise. 

On April 1, 2018, the one and only opportunity came during rounds. In addition to the foil-wrapped grapes, Ewan and I had brainstormed a variety of pranks. We settled on asking Dad to bring a box of food coloring from home. In the morning, Ewan woke up and urinated in the commode that was now a permanent fixture in the room since he could no longer make the long, tiresome walk to the bathroom. Because he was hooked to IV pumped fluids, he always woke with a full blander. Typically, the urine rested in the commode’s pan until a nurse came in the room to take vitals. They'd perform a dipstick test and record his urine output before emptying the pan.

On April Fool’s day, after Ewan peed and perched comfortably back in bed, I put five drops of blue food coloring in his waste water. The blue food coloring mixed into the yellow pee made a tropical aquamarine color. I place the dozen fake chocolate eggs on Ewan's food tray. The stage was set with several traps. We waited with as much excitement as we could muster, which honestly wasn’t very much. Ewan’s energy had been waning rather than waxing through this round of treatment. Chemo had taken a toll. But there was still a little mischief and enthusiasm in the air.

At rounds, the attending, Dr. C, came in the room, accompanied by our favorite hem/onc fellow, Dr. Meera, a resident and the usual entourage of support staff. It was a typical morning with the team at the foot of the bed. The resident presented Ewan’s case, reviewed medication and checked in with me on how things went over the course of the night in case updates or amendments were needed. Next, it was Dr. C’s turn to visually and physically inspect Ewan from head to toe. I sat in the recliner next to Ewan and observed while they went through their morning motions. Ewan’s red blood cell count was critically low. He’d be getting an infusion today. No blast cells were present, but neither were any white blood cells. The last dose of chemo had wiped everything out of Ewan’s system. So, no changes to treatment. While the team discussed details of the infusion orders, I saw Dr. C’s eyes shift over to the sea-green urine in the commode, but he said nothing. Later, Dr. C confided he had noticed the unusual caribbean-colored urine and planned to check the chart and make sure Ewan was given the wrong chemo. Mitoxantrone is a drug that turns urine blue-green. He said, “It’s a good thing you didn’t add red dye. That would have stricken pain.” I didn’t understand how blood in the urine would incite more panic than giving the wrong chemo. Given that Ewan had hardly any blood in his body, at least blood in his urine was not a concern we’d ever had to address.

Rounds always concluded with the attending asking me if I had questions. Dr. C looked at me and said, "Mom, do you have any concerns?"

"No, "I said. This was true. Ewan was bone-tired, but this was nothing new. His nausea was under control. His cancer was undetectable. My biggest concern was with his spirits. The day-today tedium was taking a toll.

It was my turn to ask a question. I stood up and said, "Would you like a piece of chocolate?"

I reached to the cart, and took the lid off of the Cadbury crème egg container. I offered up eggs as if presenting a tray of hors d'oeuvres. Dr. C's jaw clenched down. His gave his head a brisk and slight jerk to the side. "No, thank you" he said.

But Dr. Meera's eyes lit up. She had been actively attentive to everything in the room. She leaned forward, enticed by the eggs. Chocolate is her Achilles heel. I egged her on and said, "Come on, have one. We can't eat all of them by ourselves."

She resisted. I motioned the container to her and nodded approvingly. She smiled, acquiesced and finally said, "Ok," as she plucked one of the delicate foil-wrapped treats between her fingers.

Ewan’s blue eyes widened when she picked up the egg. He was so very tired. Tired of the room, the rounds, the poking and prodding, the medications, and the motions with unfavorable results. He said nothing throughout the visit, but suddenly, he saw something hopeful. The bait was taken; the trick was in her hand. I adored Dr. Meera, and I desperately wanted her to fall prey to the prank. I was afraid she’d pocket the treat only to find it a few days later, squished and wrapped with lint. I needed to build on the moment and get her to open and eat that sweet.

I offered another egg to the nutrition specialist, already knowing his answer. He was a spoilsport when it came to food. He put his hand up as if to block the chocolate from biting him. I asked the petite blonde nurse at the corner computer taking notes and charting whatever one charts. I lied and asked, "Would you like a piece of chocolate?" She declined with a smile. I knew nurses welcomed Starbucks drinks dropped off at the station and boxes of bagels for the break room, but it was taboo to eat anything in a patient's room. 

The stalling and deflecting of pressure worked. Dr. Meera relaxed on her heels and peeled back the foil from her fake chocolate. Ewan watched with hawk-eyes. Would the joke work? Would she notice the berry’s skin before she put it in mouth? I desperately wanted Ewan to have this moment of joy, to have a laugh, for playfulness to return to his life. I pleaded inside, please, give this child something to make him smile. Please eat the grape. It had been an eternity since one small thing went his way. I didn’t want to trick Dr. Meera or make a joke of her, but of all the people in the room she was the right victim. Earnest and fierce and loving, she wanted Ewan to live and laugh nearly as much as I did. I desperately wanted Dr. Meera to unwrap that grape and pop it into her mouth. 

And that's precisely what she did. Oh, how we love Dr. Meera! When she ate it, her eyes nearly popped out of her head. She gagged. Then she coughed like a cat with a hairball. For a second, I was afraid she would choke because she put her hand up to her throat. Oh, dear god, did we just kill Dr. Meera? I’ve heard of people choking to death on grapes. No—she spit the grape out into her palm and started to laugh. An a awkward laugh at first - like a person trying to smooth over a misunderstanding. Then, she looked at the mangled, crushed grape in her hand. She made sense of the flesh and juice switched gears into a whole-hearted, vivacious laugh—a laugh we know well, as if she is being tickled. She was now in on the joke. Dr. C didn't understand. 

With a soft smile, Ewan said, "April Fool's."