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reinjected after the drugs complete their work.This procedure is called autologous bone marrow transplantation.
    Again, Helen feels fortunate to be treated by the best in the South.These are doctors with impeccable credentials and reputations.Would they have treated a black woman fifteen or twenty years earlier?Now they treat her like any other patient.She enjoys their courteous treatment—and she trusts them.
    Kuhn explains that Helen’s insurance will pay for most of the cost of the transplant and chemotherapy.The procedure requires hospitalization, but it’s usually just for a few days.There will be some side effects.Helen will lose her hair, but it will grow back.She might feel tired for a while, and the risk of infections will be increased.All of this seems to be a small price to pay for the security that comes with Kuhn’s promise to make the cancer go away forever.
    Given these arguments and that she and her husband trust the doctors and are satisfied with the care they are receiving, Helen agrees to the transplant.
    Helen checks into a private hospital, which she knows didn’t integrate until 1980.There, she is taken to the OR and given general anaesthesia.She wakes up three hours later with a bandage over her upper buttocks and her bone marrow harvested.It will come to the rescue after the chemotherapy eradicates the disease.
    Helen returns to the hospital ten days later, after some wound healing.High-dose chemo is about to start.She is put in a private room where no flowers or raw vegetables are allowed.(They might have infectious agents on them.) The next morning, a central line is inserted into the subclavian vein in her right upper chest.
    Helen and the nurse starting the first infusion joke about how this feels similar to an execution by lethal injection.However, Helen quickly reminds herself that the cocktail of poisons she is about to receive will kill the cancer, not her.
    Infusions cause unease.Even twenty-four hours after treatment ends, she has nausea.Five days after getting the chemotherapy, it has washed out of her system.Her white blood cell count and platelet count start to fall.The harvested bone marrow is thawed and infused into her subclavian vein.
    The side effects Helen experiences are far more severe than she expected.She is unable to recall most of them having been described to her prior to the procedure.She has nausea, vomiting, diarrhea, dehydration.Her marrow is slow to reimplant and start producing.She has bleeding caused by a low platelet count and severe anemia.She has both gastrointestinal bleeding and bleeding from the incisions made to harvest her bone marrow.She has mouth and gum problems.She has cardiac-rhythm problems.She has a change in mental status due to electrolyte imbalances.She has a respiratory arrest and is put on a ventilator.She develops pneumonia.She has a tracheotomy.Altogether she spends five months in a hospital, only to be discharged to a rehab hospital.Helen survives it all and returns to work nearly a year after leaving for the bone marrow transplant.
    Three years after her discharge, she reads a news story about randomized clinical trials that showed that bone marrow transplantation for breast cancer doesn’t prolong survival.
    At her next scheduled appointment, Helen brings up the trial results with her oncologist, Kuhn.Yes, the results are disappointing, the oncologist concedes.Though he still believes that transplants are beneficial in some cases, he is no longer performing the procedure, he says.Mostly, he stopped because the media has unnecessarily scared the patients, and insurance companies are declining to pay.
    Helen asks whether her transplant had been performed as part of the clinical trials that showed that the procedure didn’t work.Being part of the group of women who helped science learn the truth would have made her suffering worthwhile, Helen reasons.It wouldn’t be too different from getting clubbed in a civil rights march.
    No, says