Cancer Team Meeting

The Cancer Team Meeting takes place a few days after Hazel's release from the ICU, convened in a conference room around a big table. Dr. Maria leads the gathering, which includes Dr. Simons, other doctors, social workers, and physical therapists. Everyone makes a show of turning off their pagers to focus entirely on Hazel. Dr. Maria opens by stating the great news that Phalanxifor continues to control Hazel's tumor growth, but serious problems with fluid accumulation persist. The central question becomes how to proceed. Dr. Simons explains that most tumors eventually evolve a way to grow despite Phalanxifor, but since Hazel's scans show no tumor growth, that has not yet happened. He adds that the Phalanxifor may be worsening the edema, but discontinuing it would cause far more serious problems. Dr. Maria notes that very few people have been on Phalanxifor as long as Hazel has, and the long-term effects are not well understood. The decision is to stay the course while doing more to manage the edema. Hazel asks about a lung transplant, but Dr. Maria's lips shrink into her mouth as she tells her she would not be considered a strong candidate. Hazel understands: no use wasting good lungs on a hopeless case. Her father starts crying, his hiccuping cry the only sound in the room. Hazel hates hurting him, knowing she is the alpha and omega of her parents' suffering. She recalls a moment just before her Miracle, when she was in the ICU and her mother sobbed into her father's chest, "I won't be a mom anymore." That memory gutted her, and she cannot stop thinking about it during the whole meeting. At the end, Hazel asks if she can travel to Amsterdam. Dr. Simons actually and literally laughs, but Dr. Maria says, "Why not?" Simons objects, arguing that placing a patient—one of the most promising Phalanxifor survivors—an eight-hour flight from the only physicians intimately familiar with her case is a recipe for disaster. Dr. Maria shrugs, acknowledging it would increase some risks, but then turns to Hazel and says, "But it's your life." On the car ride home, Hazel's parents agree she will not go unless there is medical agreement that it would be safe. However, Dr. Maria later calls them and makes a convincing case that Hazel needs to live her life, and the trip is ultimately approved. The meeting thus becomes the hinge point: a clinical discussion that, through Dr. Maria's advocacy, opens the door to Amsterdam and the fulfillment of Hazel's deepest wish.