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Mother's Day

patient Blair Collins

by Elizabeth Jane Walker

Freight trains are powerful. So are tornadoes and supercomputers and jet engines. But none of those holds a candle to the fierce power of a mother’s love. Judy Huddleston attributes God and St. Jude with saving the life of her daughter, Blair Collins, who is now a mother herself.

DNA determined the color of Blair Collins’ eyes, the texture of her hair, the tilt of her chin. But the legacy she bequeaths to her son and daughter will be just as important. From their mom, Tyler and Katie will learn how hope can arise from heartbreak; how adversity can spawn resilience; how faith can conquer fear.

Blair began mastering those lessons on a cold January afternoon in 1970, at the age of 3. That was the day doctors announced that she was going to die.

The darkest nights

Blair’s mom, Judy Huddleston, remembers the scene as though it were yesterday. The dire prognosis occurred at 5 p.m. on a Tuesday.

“We don’t have a cure for acute lymphoblastic leukemia,” the doctor said. “But we can help your daughter. We can give her some time—a few weeks, a few months, maybe even a year to live.”

“I remember feeling like I wanted to die,” recalls Judy, who had three other children ranging in age from 5 years to 5 months old.

But Judy didn’t die. Instead, like thousands of other St. Jude parents, she cried. She prayed. She persevered.

Doctors at St. Jude Children’s Research Hospital immediately began treating Blair with chemotherapy as well as radiation to her brain and spinal column. Only eight years before, the treatment for acute lymphoblastic leukemia (ALL) had consisted solely of chemotherapy, with only four children out of 100 surviving the agonizing regimen. Most patients who achieved remission later died when leukemia cells returned in the fluid surrounding the brain and spinal cord.

When Blair arrived at St. Jude, physicians had recently begun pairing chemotherapy with preventive radiation to the central nervous system. This combination therapy would revolutionize leukemia treatment.

Physicians admitted Blair into the hospital for 10 days. The toddler spent mornings and afternoons with her parents, lulled by the gentle sway of a rocking chair or comforted by her mom’s proximity during spinal taps, radiation sessions and innumerable needle sticks.

For Blair, the day’s discomforts were minor when compared to the terrors of the night.

In that era, parents were not allowed to remain in the hospital after 6 p.m. Nurses told Blair’s mom that the toddler would huddle in the rocking chair all night, resolutely refusing to eat or sleep until her parents’ return.

“I was only 3, but I can remember being really sad. I wouldn’t eat my breakfast until they got there,” Blair says.

The evenings were interminable for her mom, as well. “I would come home from St. Jude and be so upset because I’d had to leave Blair behind. My arms would just ache to hold her,” Judy says, her voice cracking with pain as raw today as it was 40 years ago. “Our daughter Angie was 5 months old at the time. I’d pick Angie up gently—so as not to awaken her—and rock her in the dark while I cried and cried. Then I’d get up, put her back in the bed and slip out of her room, feeling just a little bit better.”

Heaven can wait

The next few years were a blur of treatments and medical challenges—colds that morphed into bronchitis, a life-threatening chicken pox outbreak and countless other crises.

“I faced the reality of death head-on,” Judy recalls. Once, during a radiation session, Judy inquired whether the treatment would affect Blair’s reproductive system. The doctor replied, “Mrs. Huddleston, we are trying to save her life. We really can’t be too concerned right now about her ovaries.”

Judy realizes that the physician was being brutally honest. In that era, few children survived ALL.

“I remember thinking, ‘But what if she lives?” Judy says. “I was hoping for Blair to live; I was praying for it. I had to treat her as if she would survive.

“It was hard to keep hope going when you didn’t know what was going to happen and you were waiting for that relapse,” Judy continues. “So many children died. We’d go back every week and there’d be more who had passed away.”

Even though she was young, Blair was well aware that the odds were stacked against her.

“Mom and Dad prepared me for heaven,” she says. “I remember being really sick one night. I asked them, ‘Is this the night I’m going to heaven? Are you coming with me?’ Mom said, ‘I won’t come yet, but you go on if you need to, and I’ll be there soon.’ When I woke up in the morning, I’d run through the house and shout, ‘I didn’t go to heaven—I’m still here!’”

Ah-ha moments

Thanks to St. Jude combination therapy, Blair’s disease went into remission and she never experienced a relapse. But the treatment that saved her life also caused memory and learning issues, which tormented her throughout high school and college. Neither her teachers nor her family realized that those problems were related to her cancer treatment.

When Blair attended the hospital’s first Survivor Day, she shared her frustrations with Joseph Simone, MD, who was then director and CEO of the hospital. “I can’t do the work; I don’t know what’s wrong with me,” Blair told him. Simone explained that she had received radiation to the part of the brain that controls short-term memory. “That knowledge was very helpful,” Blair admits. “After that, my school allowed me to take my exams orally, and my grades improved.”

A few years ago, Blair attended a St. Jude seminar in which survivors were asked if they had encountered memory problems.

“Everyone in the room raised their hands,” Blair says. “I had an ‘Ah-ha’ moment. I realized that I’m not the only one who struggles with these issues.”

When Blair married, she also discovered that radiation and chemotherapy had adversely affected her fertility. She and her husband, Jeff, were heartbroken when she gave birth to a stillborn baby boy.

“It was a blessing that I got to see my son and hold him and tell him goodbye,” she says. “My faith and my mom’s strength helped me deal with the disappointment and move forward.”

The couple’s heartbreak turned to joy with the adoption of Tyler and later Katie.

“Adoption is an amazing option,” Blair says. “Giving birth and adopting feels the same to me. I held my own little son who looked just like my husband. Then I held these little guys. There was no difference in the depth of love that I felt.”

Helping future survivors

Blair and her mom marvel at the drastic improvements that have occurred in cancer therapy during the past four decades. St. Jude clinicians have replaced cranial irradiation with carefully personalized chemotherapy and supportive care. As survival rates skyrocketed, physicians began designing treatments that minimized many of the side effects that plagued Blair and other patients.

By participating in one of the early ALL protocols, Blair played her part in boosting the survival rate for thousands of children around the world. Recently, she agreed to participate in a program that will help current and future survivors. Blair enrolled in St. Jude LIFE, an initiative that brings childhood cancer survivors back to campus to evaluate the long-term effects of their disease and its treatment. Not only will the study help clinicians develop safer therapies for future patients, but it also provides Blair and other survivors with individualized information about their health risks. Sometimes patients end up educating their doctors.

“Blair was in a group that received a significant dose of radiation,” observes Tim Folse, MD, of St. Jude Oncology. “A general practitioner may spend an entire career and never see a patient who has been exposed to radiation therapy as a child.”

When Blair returned to the hospital for St. Jude LIFE, she underwent an extensive battery of tests that provided further data for researchers studying the late effects of cancer therapy. At the end of her visit, Blair returned home to Virginia with a document summarizing the treatment she had received in the 1970s, her current health status, her risk for specific late effects and a schedule of suggested exams.

“Without this summary, Blair’s physician may not have known that she has a higher risk of skin cancer and that she needs a yearly skin exam,” Folse says. “She also needs an echocardiogram annually because she had chest radiation at such a young age. These are issues that many general practitioners may not realize, unless they received training at a pediatric cancer institution. The summary provides them with the details they need to provide our survivors with the best possible care.”

Mothers and daughters

Decades have passed, but still families come: Just as Judy did in 1970, trembling parents deposit their hopes and dreams and darkest fears on the doorstep of St. Jude.

A couple of years ago, Judy and Blair watched a distraught young woman push a stroller into the lobby of the St. jude Patient Care Center. Judy immediately recognized the terror on the young mother’s face.

“I can’t do this,” the woman wept. “My daughter’s been diagnosed with leukemia, and my husband has left me. I’m not going to be able to make it.”

“Yes, you can do this,” Judy said. As she wrapped her arms around the young mother’s shoulders, Judy pointed to Blair. “Do you see her? That’s my daughter. She was here 40 years ago with leukemia. You can do this.”

Judy knew that, like scores of other St. Jude parents, the young mother would pray. She would persevere. And—with a St. Jude ALL survival rate of 94 percent today—she would have reason to hope.

Promise magazine, Summer 2011

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