Story by Julia O'Malley | Photos by Marc LesterSteve Vue's cough wouldn't go away. That's how the story starts when he tells it. His mom took him to an urgent care. Bad virus, they said. Give it time. But the ache in his bones in the fall of 2011 got worse, especially in his chest, as if his heart were swelling under his ribs. Fatigue snowed him. He went to urgent care again. They gave him antibiotics. He stayed home from school for a week, then another.
The day Steve, then 16, went back to Service High School was a Thursday, right before the start of Christmas break. He wasn't better. In fact, he felt worse, but he missed the feeling of being in school. He missed the fuzzy beats of Madcon and The Heavy at lunchtime. And he missed his friends, a crew of juniors known as the B-Boys, who were obsessed, as he was, with the head spins, handstands and street-styled gymnastics of break dancing. The B-Boys, an official student club as well as a loose-knit, mostly Asian clique, were to perform at an assembly the next day. Steve wanted to be there.
Steve was a stocky, soft-spoken Hmong kid, the oldest of eight. His family moved to Anchorage from Sacramento, Calif., in 2008. His parents wanted better jobs and to shelter their children from the lure of Southeast Asian gangs. They were part of a wave of Asian migration to Anchorage over the past two decades that has changed the face of the city. The move was only the second time Steve had been on an airplane. The first was when his family relocated to California from Minnesota, where he was born. In Anchorage, they settled in a three-bedroom trailer off Elmore Road. His father, Koua Vue, took a job in medical transcription. His mother, Ia Yang, found cleanup work with a company that restores buildings after fires and floods.
Steve arrived at Service early that day in December. Like the other B-Boys, he wore nearly the same outfit every day regardless of the weather: an oversize T-shirt, tapered jeans and new-looking Nikes. He was an average student in a late phase of boyhood when his social life still revolved around other boys and activities like trying to dominate at Super Sega GT at the Dimond Center arcade or surfing the Internet for videos of pogo-stick tricks that end with groin injuries. Among his friends, he had a reputation for two things: always being in a good mood, and an inability to be mean. Girls weren't really in the picture. He didn't have his learner's permit yet.
Steve made a pass through the halls, slapping palms with a couple of friends, and then parked himself in the cafeteria, where music from a speaker attached to an iPhone ricocheted off the walls. Matthew Lomboy, a twiggy, bespectacled B-Boy with Filipino roots, twisted windmills on the waxed floor. Usually Steve danced with him, but that day he couldn't make himself move.
Two minutes before the bell, Steve stood up and his vision went soft. He made his way toward World History class through the swirls and eddies of hallway traffic. Halfway up a flight of stairs, the pressure in his chest turned sharp and suffocating, like his little brother was stomping on his ribs. He clung to the railing until he could catch his breath, then limped to the nurse's office.
'Just come to the hospital'
Nurse Panna Jarussi eyed Steve when he came through the door.
"He just didn't look good," she recalled later. "He had FLK: funny-looking kid."
Steve listed his symptoms. Breathlessness. Coughing. Chest pain. Vomiting.
She got a bad feeling. Maybe Steve's illness was some kind of treatable respiratory infection, like pneumonia, but she suspected something worse. He needed a chest X-ray and a white cell count. He should have gotten those at urgent care. He didn't have insurance or a regular doctor. He'd gotten a cursory exam and a prescription. She'd seen this many times before.
Jarussi called Hillside Family Medicine and got Steve an appointment for later that day.
What happened next is blurry when Steve tries to remember it, because as the day wore on, the sickness made him drowsy and weak. His chest X-ray revealed a mass near his heart. His mom took him from Hillside Family Medicine to the emergency room at Providence Alaska Medical Center. By then, he was having trouble breathing. He remembers lying there for a long time, waiting to hear what was wrong with him. He went from one room to another. He put on a gown and got into a bed. Doctors examined him. They took samples of his blood and drained fluid from his chest. He slept. Sometime the next day, Dr. Laura Schulz, a pediatric oncologist, gave Steve and his mother the news: It was cancer.
A tumor, swollen to the size of his two fists, was wedged in his chest near his heart, Schulz told them. It was crushing his right lung, making it hard for him to breathe. The cancer had been growing slowly for a long time, she said, but now it was very serious. He needed chemotherapy to shrink it right away. Then he needed surgery to remove it. Without these treatments, he would die.
Steve heard this, but the meaning didn't sink in. A dreamy feeling washed over him like a rising tide.
His mother went pale and started to weep. Steve heard her talking to his dad, alternating on the cellphone between English and Hmong.
"Just come to the hospital, right now, please," she said.
Steve fell into a heavy sleep.
'Are you Hmong?'
A week or so later, Mitchell Xayapraseuth, 17, pulled his stepdad's blue Subaru into the Providence parking lot. The way he remembers it, he had a bag full of Taco Bell steak burritos, still hot from the drive-through, sitting in the front seat. In the back seat was his longboard. He rarely traveled without it.
Mitchell and Steve called themselves best friends, though since summer they hadn't seen much of each except on Facebook. Mitchell had transferred from Service to South High at the start of junior year.
Mitchell was delicate-featured and lanky. He wore thick-framed glasses. He was the high-strung youngest son in an extended Lao family dominated by women with opinions. School came easy to him. He was prone to high-pitched, rapid-fire bursts of speech that, when written, required both an exclamation point and a question mark. "Shutupnoway?!" "Whatwhere?!" Mitchell had texts from girls on his cellphone and cash in his pocket, thanks to a sometimes-job busing tables at Thai Town, a Spenard restaurant his mom and stepdad owned.
Mitchell and Steve had been tight since eighth grade at Hanshew Middle School, right after Steve arrived from California. They both like telling the story of how they first met. Mitchell saw Steve first.
"Are you Hmong?" he asked.
"Yeah. How'd you know?" Steve said.
"I can tell by the look," Mitchell told him.
Then, depending on who is telling the story, one of them asked, "Do you like to break dance?" To which the other answered, "Yeah."
And that was it.
They used to live two blocks apart off Elmore. It didn't take long before they were staying over once or twice a week. They bummed rides from their moms to the Dimond Center, where they trolled for kids they knew, hung out at the arcade, and, if one of them had money, ate at a fluorescent-lit Vietnamese restaurant called Pho Saigon. Steve always ordered pho, Mitchell favored banh mi sandwiches so hot they made his mouth numb. At any given time, Steve could recite every movie playing at the theater.
Like most of the B-Boys, Steve and Mitchell had a secret handshake that took at least 15 seconds and involved a fist bump, a snap, a pinky-promise and several versions of a high-five, and ended with a salute. (Like most B-Boys, they were both in JROTC.) After Mitchell transferred, neither of them was good at keeping in touch. The last time they hung out was Halloween. Just after Christmas, Mitchell heard from some B-Boys at the mall that Steve had been diagnosed with cancer.
'Turning into a crazy person'
Steve's room was on the third floor of the hospital. Mitchell waited at the elevators, staring at a dour portrait of Emilie Gamelin, founder of the Sisters of Providence, said to have miraculously cured a teenager with leukemia who prayed to her spirit. The hospital smell was a combination of antiseptic and deep-fryer grease. It made Mitchell think of decay, of his great-grandfather at home slowly dying of kidney failure, and of his own health problems, which had been causing him considerable worry.
Whatever was wrong with Mitchell had started a year before with an itch on the arch of his foot. The itch soon turned constant, maddening, embarrassing. He had to take off his shoes to scratch in class. It spread to his arms and his back. Patches of his skin grew raw. He complained to his mom. She took him to a dermatologist. The dermatologist prescribed cream, but it only took the edge off. He got another cream. The itching kept on. With each passing week, his mood grew darker. He didn't want to swim or play basketball or dance.
Then he started waking up at night drenched in sweat. He couldn't lie on his back because the sheets irritated his burning skin. He lay on the floor, unable to sleep. He lost weight. His mother asked the dermatologist for a blood test. The doctor said it showed he was healthy. Mitchell didn't believe it. The itching started to make him anxious, like something very bad was about to happen.
The changes in Mitchell caused problems with his family. Thai Town was a family business. Mitchell's mother, Pat Siboualapha, started out as a waitress and eventually bought the place. Her success moved them from a trailer into a four-bedroom house. Pat worked every day except Sunday. Mitchell's stepfather, Kab Keo Siboualapha, worked with her. So did his older sister, Tiffany, who was studying to become a nurse.
Mitchell was expected to work like he always had, padding around in his socks and Adidas slippers after school, busing tables, filling water cups, bringing out glasses of sweet Thai iced tea. But in the fall of 2011, as the itching intensified, he developed a cough that didn't look good in front of customers. He'd never been so tired. He quit coming to the restaurant. He couldn't even bring himself to take out the family trash.
Pat bought him a computer, saying that if he wanted it, he needed to do his chores. He gave it back. He was too exhausted, he said. Nobody believed that he was sick. They thought he was rebelling or being lazy.
"My (great) grandmother said, 'You're turning into a crazy person,' " he said.
Mitchell half believed her. He decided to move in with his aunt at the beginning of his junior year. That meant transferring from Service to South. He thought the change would help him, but he never settled in. He missed Steve and his other friends. People at South didn't know the old him -- before the itching started. They didn't notice that he was quieter than usual, that he was pale, that he was losing weight. He planned to start back at Service after Christmas break. By then, he'd lost 20 pounds.
The boy in the mirror
The elevator doors yawned open. Mitchell got in and rode up. He found Steve in a room in the pediatric ward trying to eat a hamburger with a fried egg on top. Steve looked swollen, but he smiled when he saw Mitchell in the doorway. A good mood, same as always.
Steve put aside the hamburger and ate the steak burritos. He told Mitchell about the coughing and the chest pain and his trip to the nurse's office. He told him about his parents being scared. He was in his first round of chemotherapy, a few weeks into his treatment.
A nurse came in to change Steve's IV. She was cheerful and talkative. Something about her made Mitchell want to open up. He told her and Steve about the itching, the night sweats and his cough. He told them about losing 20 pounds. Then he caught his reflection in the hospital room mirror. When had he gotten so pale?
Was it possible, he asked the nurse, that he had cancer too?
Julia O'Malley writes a regular column. Email her at email@example.com, find her on Facebook or get her Twitter updates at twitter.com/adn_jomalley. Reach staff photographer Marc Lester at firstname.lastname@example.org and follow his Twitter updates at twitter.com/marclesterphoto.