The remarkable story of how Angela Ambrosia was struck by leukemia at the age of l6 and survived-‑as a woman and wife
By Ray Errol Fox

By the time she was 16, Angela had grown accustomed to feeling disliked, and being disliked, for spoiling everyone else's fun. From the age of 13, she had persistently complained of sore throats and pains in her groin. She was always tired, couldn't keep up with anyone‑- "lazy," her family said. Then her aunt accused her of carrying mononucleosis and Angela was rushed to the family doctor for blood tests. No sooner was she cleared of the charge than a second call came from the doctor, "We don't know what it is, but separate all her dishes and silver from the rest of the family's," and a third, the only explanation available at the moment, "We haven't seen anything like this for a long time." Blood test followed blood test, until a bone‑marrow extraction was required. The doctor extracting the marrow was more intent on answering his phones and his door than on being attentive to a 16‑year‑old girl who had to have her sternum cracked to admit the upright needle between her breasts. "I can feel my spine and shoulder bones being sucked out through the syringe," she rasped, and went into shock. The result of this crudely administered test was days and nights of nightmarish reaction from which she in due course recovered, but which produced a diagnosis from which she could never recover. She wasn't told-‑she was never to be told‑-she had six months to live.

You can't blame the family doctor for despairing of a cure. This was 1968 and leukemia didn't respond to treatment. But her family didn't want to know that. Her sister’s husband Tony, sought the advice of an ex‑professor of his who was a physician and who urged Tony to take her to Dr. Monroe Dowling at Manhattan's Memorial Sloan‑Kettering Cancer Center. Doctor and hospital were three trains and at least as many worlds away from Angela's parochial Brooklyn neighborhood and her Italian Catholic upbringing. She had never been asked to undress fully for a doctor before. Now she stood before a tall, light‑skinned black, hoping that this awesome stranger could tell her what was wrong.

Putting oneself in the hands of a doctor is always a complicated matter. He's supposed to find something wrong, but not too wrong‑-not as wrong as things were with Angela. The first doctor had found a white‑cell count of 50,000, five to 10 times the rate of a normal count; the second doctor had found that the bone marrow, "the blood factory," was producing abnormal cells. Their diagnosis of chronic myelogenous leukemia, an infrequent blood disease more common among middle‑aged males, was clinically correct. But at Memorial her white‑cell count tested at 14,000; and Dr. Dowling was dissatisfied.

While Angela craved any explanation for feeling as she did, and her parents harbored the secret of why she felt that way and prayed for a miracle, Dowling could neither confirm nor refute the diagnosis without repeating the bone‑marrow test. The Ambrosias were distressed, certain Angela would be "impossible." Dowling promised it would be different, and thought the thing to do was to explain the entire situation to her. But they were adamant in their refusal to tell Angela and, because his concern was to take care of the girl, he proceeded‑-only for the time being, he hoped-‑on their terms. She suffered no ill effects from the second bone‑marrow extraction, which confirmed the accuracy of the diagnosis of chronic myelogenous leukemia.

She never asked what was wrong with her. But after her visits, Dowling could always expect three phone calls. Mrs. Ambrosia would ask how her daughter was doing, perhaps a few more questions until she was satisfied that Angela was going to be all right for another week. Then big sister Camille would call, and in a sense, in the way she asked the questions and Dowling answered them, she was the patient, the one to be informed, to understand what was wrong and what had to be corrected and what was being done about it. She was the one Dowling tried to tell everything to, because she was the one, he knew, who was going to interpret the facts for the family. Then came Camille's husband, Tony, to pick up anything that was too technical for Camille to fathom. So he could interpret it for her. So she could reinterpret it for them.

That was the family trio. Papa Ambrosia never called, but if something didn't go the way it was supposed to, when trouble occurred, he appeared. And, at home or at the hospital, when he put his foot down, everybody moved. He'd sit back and listen without comment, and then he'd ask two or three questions. Not even important questions. Except that they were always worded in a way that made it clear he was going to be sure that nobody was careless, nobody was going to do something that could hurt a member of his family.

Finally, she had her first operation, but she still didn't know what for. Angela began to miss classes, to miss more and more school. She felt like a liar and a misfit. She was unable to cope with school and radiation. She had red lines on her body that outlined her spleen. They didn't come off with soap. They were a constant reminder that she was different. At the hospital, they would take a picture of her, draw their red lines, take another picture, strap her down, close a steel door‑with a sickening hollow thud‑-and watch her.

Angela, now 26 years old, has been through operations, radiation, radical chemotherapy, and insurmountable pain in demonstrating an invincible will to live. She holds her friend, Joshua Moses Rubel.

Soon the world at the hospital became more real to her than the one outside. She hurried there from school and never hurried home. She formed relationships she couldn't have outside. Professional people were dedicated people; so were sick people. She began to shed high school "friends" for friends who "knew where it was at." She preferred adults to teenagers because teen things confused her. She preferred sick adults to healthy ones because she could take illness better than she could take anything else. It was becoming the only thing she knew how to do.

Angela had been handled day and night. She had been cut and sewn; strapped and clamped-‑was swabbed, scrubbed, shaved, and sponged; stuck; "scoped"; dressed, and bandaged. Her only connection to the world outside of herself was one big surgical finger.

She collected a few issues of Playboy and Vogue from the waiting room and read them at night. "I wasn't a Bunny, but I still liked what I saw when I looked at myself in a mirror. I had a good figure." What it was good for was still part of the mystery. She knew doctors liked what they saw. She had gotten used to that already and liked the attention. It made her feel sexy while at the same time she could claim total innocence. She knew she had good legs, the value of which her brother Philip had once explained to her: "It's not legs themselves, but what they lead to." Right now, they led nowhere. "I had large brown eyes, high cheekbones, a small straight nose, and a mouth that my back issues of Playboy taught me was sensuous."

Dr. Monroe D. Dowling had a young daughter of his own. He had other young patients, many of them. His experience with teenagers convinced him that they needed to be told quickly. He had seen too many renounce their families and disappear when they discovered no one had been "honest" with them. But the Ambrosias made the rules and he had to play by them.

Angela was willful and erratic. Her body was maturing rapidly; she was wildly immature. He gained her confidence with that first bone‑marrow extraction‑-swift and painless. He acquired more: her admiration, her gratitude, her untested, undeveloped feelings. Her parents stood firm. She flirted outrageously with the doctor, who recognized that she was flirting with sex, flirting with life, and-‑if he failed to get through to her in some significant way‑-flirting with death. He had to make certain that she take the situation seriously without discovering the seriousness of it. He encouraged her-‑a little flirting of his own.

She used to look in the mirror and wonder what it would be like if she didn't have any scars on her stomach. "I spent a fortune trying different cosmetics to make my scars lighter. The real reason I got Playboy was to see a normal stomach. I could stare at a picture of one, or the real thing, for an hour. Still, I was lucky. I looked good in negligees, and whatever I had that I couldn't get rid of, I could hide."

She had yet to have her chance to be a girl, but she was accepted as a woman among the other women in the hospital, every one of whom was older than she was and dying. Knowing life would never be the same for them again, they lived by talking it, particularly the sex part of it. It was all beyond her, and all she learned at the time was that unfulfilled women were raunchier than Playboy.

What she never learned was that she had leukemia. For four years she'd been in and out of hospitals and had had countless operations. During that time Angela had believed every lie. She cooperated, preserving her ignorance.

"As soon as anyone else knows what I have, I become my disease and I come second, says Angela. 'With Ted, my blood is just a part of me."

Hospital psychologists explain a process of denial prevalent among terminal patients. Usually, denial is necessary for whatever day‑to‑day comfort a dying man can find. What is denied is death. Foremost, one's own; but the mortality of anyone with whom the patient identifies is a warning, a reminder; and an inevitable physical setback. The medical charts of an entire ward have been known to dip the day after one bed has been vacated. Consequently, not only is death not dwelt upon; it is, whenever possible, scarcely noted. Death is a failure of the patient, not the system. The system makes you well.

Before Angela had to come to terms with the prospect of death, her death, she had to face‑-or shy away from‑-its prospective cause. A healthy mind in an unhealthy body, she denied her disease. With an instinct that knowledge could be harmful to mind and body, she learned to overlook every clue. Even while she held the magnifying glass to others. Even when she followed the tracks and the paths crossed. For four years, for Angela, denial was practically synonymous with survival.

It had all the makings of a soap opera, Angela and Ted began to tell it that way. Young hospital technician meets lovely young sickling in laboratory. He is charming, attentive, tells her he hopes to see her again but doesn't want to see her "down here." What he really wants to see, anywhere, is her healthy older sister. Who is married, happily, and doesn't want any part of him‑-for herself; she wants him for her sickly younger sister. Technician and sickling sibling are thrown together.

Ted took her to a concert in Central Park. This was their first evening date. Perhaps at night he would kiss her. He hadn't yet‑-because she was sick, she assumed-‑she began to have her doubts about a future with any man. During the concert, he put his arm around her. He was beginning to relax from the uneasiness he felt being with a patient who was out illegally at night.

For the longest while, she doesn't move. She hates to break the mood by saying anything, but has to tell him she's due‑-a little overdue‑-for her medicine. No, she doesn't want something to wash it down with; she has to give herself an injection, and someone has to steady her heparin lock while she injects the syringe. It's as if she has just jabbed the needle into the bottom of his foot. His composure races his color to oblivion. It's at the height of the hard‑drug craze, and even knitting needles are suspect. He commands her to let the song finish and then exit unceremoniously with him. Damn it. She doesn't want to leave and she shouldn't delay the shot. "But you don't under­stand…” And he claps his hand over her mouth. And again. As they weave their way between the huddled bodies on the ground, the next selection, "I've Got You Under My Skin," begins... and repeats and repeats in his pounding ear.

On the edge of the park, they share a nervous shot, a nervous laugh, and a nervous kiss. For Angela, the ride back (INCOMPLETE)

Ray Errol Fox is a New York theater and film lyricist. This story is condensed from his first book, "Angela Ambrosia ,"to be published this month by Alfred A. Knopf Inc.