Story by Julia O'Malley | Photos by Marc LesterA couple of weeks after Mitchell Xayapraseuth's best friend, Steve Vue, was diagnosed with a rare childhood cancer, Mitchell's P.E. teacher at Service High School sent him to the nurse's office.
It was Mitchell's first day back after a semester at South. He couldn't keep up with the other students on the basketball court.
Mitchell slid onto the wooden bench in nurse Panna Jarussi's office. She barely recognized him from the year before. His skin color was off.
"He looked really, really thin -- I mean thin," she said.
Mitchell told her his skin crawled. Itching drove him crazy. His fingernails had turned yellow. He woke at night, sweating through his sheets. He'd lost 20 pounds. And lately, he confided, he'd been coughing up blood. He told her he felt sad and anxious all the time.
"He had this sense of doom," she said. "His whole affect was wrong."
Jarussi hadn't seen anything like it since she'd worked with AIDS patients, she said later. Mitchell had been to Laos recently. Jarussi wondered if he'd been exposed to tuberculosis. Cancer was fresh in her mind because of Steve's diagnosis, but two kids who knew each other getting diagnosed with cancer in the span of weeks? Impossible. She'd only seen a handful of childhood cancers in her whole career.
"(The idea) wasn't on my hard drive," she said.
Jarussi sent Mitchell to Hillside Family Medicine, just a she'd done with Steve. Mitchell's mom, Pat Siboualapha, left work at Thai Town to meet him. His sister Tiffany came too. The doctor ordered a chest X-ray. Ten minutes later, she came back into the room and said she saw something behind his lung. She suspected cancer.
Mitchell's eyes filled with tears. His hands shook. This was the thing that had been chasing him. The serious, horrible thing he'd feared for all these months.
His mom's face was all shock.
"No, it's not," he heard her say. "No, it's not."
That statistic doesn't exist
Like Steve, Mitchell went to Providence Alaska Medical Center, where he was admitted. For the first day, he couldn't say "cancer" out loud. Neither could his mom. Test results came back: He had Hodgkin's lymphoma, a cancer that attacks the lymph system. With his mother and sister, he met with Dr. Laura Schulz, the same pediatric oncologist who was treating Steve. The cancer was Stage 4, she said, the most advanced. Mitchell could participate in a clinical trial in Portland, the doctor said, but he needed to get on a plane right away. Without treatment, she said, the cancer could kill him.
Mitchell watched his mom and sister nodding at the doctor, wiping tears from their faces. All he could think about was the time in sixth grade when his teacher looked around the room during a health lesson and said that, statistically, three out of 30 of them would someday get cancer. He was one of the three. Steve was another. What kind of luck was that?
Mitchell was 17 years old. Everything he imagined about his future after high school was theoretical. He'd had vague ideas about becoming a cop or opening an indoor go-cart track. But dying? He didn't know how to think about it.
Logistics soon eclipsed all the emotion. Tiffany, then 20, signed papers to become his guardian. The two of them would go to Portland. Tiffany would be in charge of making decisions. His mom would keep running the restaurant.
That night, in the hospital, Mitchell called Steve, who was home after a round of chemo.
"I have cancer," he said.
Mitchell was the king of practical jokes. Leave your cellphone lying around, he'd change the access code. Think you're alone, walking down a hallway, he'd jump out from around the corner. He loved giving fake reports of accidents and illnesses, getting people upset before saying, "Just joking!"
"No way," Steve said. "You're lying."
Mitchell had just stayed over at Steve's house after Steve got out of the hospital. They watched "Fast & Furious." Mitchell looked skinny, and seemed tired, but still cracked jokes like he always had.
The next day, Steve went to Providence for a lab test and stopped at the information desk.
"Is Mitchell Xayapraseuth in the hospital?" he asked.
He was given a room number. He rode the elevator to the third floor. There was Mitchell, sitting in a bed, hooked up to an IV.
I interviewed Mitchell for the first time last spring at Service. By then, Steve and Mitchell had been bouncing in and out of hospitals for radiation and chemo for a few months. Steve's treatment was at Providence. Mitchell took two trips to Portland. Both lost their hair and eyebrows.
They had been in the hospital together a couple of times, shuffling between rooms, puking, arguing over the remote, discussing topics like whether they would get girlfriends once their hair grew back and how long it would take Steve to learn to drive a stick shift from watching YouTube videos. (Conclusion: an hour, easy.) The B-Boys organized a dance fundraiser for them. Steve and Mitchell watched it live over the Internet, huddled together in one hospital bed. It netted $20,000.
I met Mitchell in the dance studio where the B-Boys practice at lunch. Steve was in the hospital that day, preparing for surgery. Mitchell had just finished chemo. He carried a box of animal crackers to stave off the urge to throw up.
What the B-Boys do is more exertion than dance. They are all limbs, serious expressions and shadowy facial hair. When the music cranks up, they nod their chins and sweep their arms. One of them launches into the top-rock, jogging a step in one direction, then a step in the other. Maybe he'll drop and do a six-step, crab-walking around his body. And then, if he still has the energy, he'll launch into a power move, standing on one hand, body frozen in the shape of a question mark. Then he'll crash to the ground, panting, on his back. At any given time, as many B-Boys are recovering as are dancing.
Mitchell wore a baggy white T-shirt and a beanie pulled down to the top of his glasses. When the rhythm caught him, he brought his palms up to his chest and dropped into a move that was part crab-walk, part Russian kazachok. But soon he got behind the beat and stood up, shoulders hunched in pain.
He and I found a place to sit in an unused office that belonged to Frank Shaffer, the B-Boy club adviser. Mitchell took me though the story of how he was diagnosed, and how Steve was diagnosed before him, and how it was all crazy. He pulled off his beanie and rubbed his hand over the stubble on his scalp. His stepfather, a former Buddhist monk, told him he got sick because he had a problem with his karma, he said. Wrongs in a previous life created bad luck in this one.
"If I didn't get cancer," Mitchell told me, "maybe I would have died in a car accident or something."
After we talked, I went with him out to the parking lot. He opened the back of his car and slid his longboard out. He didn't have class that hour, so he usually did homework, he said. Because of the cancer, teachers were used to seeing him out of class at odd times. He tended to walk around school as he pleased. He carried the longboard back inside. I followed. We said goodbye in the hallway.
Then he climbed on his skateboard and gave a kick. I watched him float away down the tiled floor, past the banks of lockers and the open classroom doors.
'Something we don't understand'
Childhood cancers are rare. The chance of being diagnosed is about 1 in 7,000, according to the Centers for Disease Control and Prevention. The chance that children who know each other will get diagnosed with cancers at the same time? That kind of statistic doesn't exist.
When I first heard about it, I felt sure there had to be some science to explain it. Maybe the probability of their cancers was more common among Southeast Asian children. Maybe their mothers had been exposed to something similar when they were pregnant. My search of articles and studies found no explanation.
Schulz, the boys' oncologist, told me she had no evidence of any connection. Mitchell and Steve had different cancers, she said. Steve had his for a long time. Mitchell's developed faster. Neither cancer has a single environmental or genetic cause.
"It's really bizarre," she said. A coincidence. That was all.
In her practice, Schulz does see a disproportionate number of kids with cancer in certain socioeconomic and ethnic groups, she said. One of those is Southeast Asians, though it may be more a function of economics than increased cancer rates, she said. According to the U.S. Census, Southeast Asians in Anchorage tend to have larger families and lower incomes than average, so they are less likely to be able to afford to go Outside for treatment.
Schulz has seen other coincidences like Mitchell and Steve, she said. More than once she's had children who lived near each other or knew each other diagnosed about the same time.
"It's hard not to believe that there is something we don't understand going on," she said. "Maybe the science isn't advanced enough to explain why it's happening."
As I got to know Mitchell, it became clear he didn't accept the idea of coincidence. He believed his cancer happened for a reason. He told me later he felt his luck go bad. He remembered the moment it happened. He'd been visiting Laos the summer before his symptoms started. He was sleeping in a van on the way from the capital, Vientiane, to the country.
"There were, like, dogs everywhere," he said. One of them ran out in front of the van, which was going fast. He never actually saw it, he said, but "I'm pretty sure it died."
That gave him a terrible feeling, the idea of that dog with all the other dogs, and then suddenly being the one to die. He was an agent of its death, he felt, riding in the van and dozing off. Right after it happened, his foot started to itch.
He didn't tell anyone about the dog for a while, worried that hitting it might make him guilty of a crime, even if his uncle was driving. He was relieved when I told him it wasn't. But he still felt as if he'd done something wrong, something to steer his luck off course.
"I was born in the year of the dog," he said. "When you think about why you got stuff, you think of all the options."
For a while, among the B-Boys, there was speculation that break dancing might cause cancer. The school nurse had to be called in to set them straight. In Mitchell's family, everybody looked to his great-grandmother for an explanation.
A prayer, a promise
I visited Thong Souk Xayapraseuth in Mitchell's living room one evening several months after I first met Mitchell. She was a delicate woman with soft hands and her white hair pulled into a bun. Born in Laos in 1932, she spoke very little English. She visited the Wat Lao, the Buddhist temple in Mountain View, every day, bringing offerings of food to the monks. When we talked, two of Mitchell's aunts translated for her.
Thong Souk believed Mitchell's stepdad was right about his karma, the aunts said. Mitchell had to repair it. After he was diagnosed, she tied string around his wrists right away to begin changing his luck.
Mitchell went on his first trip to Portland for treatment. Thong Souk set about making a special prayer to help him. I asked her to describe it. She got up from the couch where we were talking and disappeared into the back of the house. When she came back, she held a plastic plate full of half-burned yellow candles and dried flowers.
To make her prayers, she explained through the aunts, she held a lighter to the ends of the candles and then stuck them upright on the plate. Next, she sprinkled the plate with the flowers and lit the candles. She carried the plate out into the yard.
Keep the cancer from killing Mitchell, she said she prayed to the winter sky over their South Anchorage cul-de-sac. If he lived, she promised, he would repair his karma with faithfulness. He would become a monk. He would shave his head, don a robe and dedicate himself to prayer at the temple. His devotion would put things back in balance. She set the plate under a tree near the front step. The candles twinkled in the snow. Their light, she said, sent her promise to the heavens, to all of Mitchell's relatives who had passed away.
If Mitchell survived the cancer, she said, he had to make good on her promise.
I asked Mitchell later if he believed that. He said he wasn't sure.
Julia O'Malley writes a regular column. Email her at firstname.lastname@example.org, find her on Facebook or get her Twitter updates at twitter.com/adn_jomalley. Reach staff photographer Marc Lester at email@example.com and follow his Twitter updates at twitter.com/marclesterphoto.