Some children don't like school and stay home when they can. Other children don't like to stay away, even if they're sick. And then there's Meaghan McCarthy, a five-year-old in Toronto.
As the school year comes to a close, Meaghan still hates to miss a day. For six months of her very first year in school, in junior kindergarten at Earl Haig Public School, she went to class even after her regular chemotherapy treatments. Sometimes, saving minutes, she left hospital with a tube dangling from a sticky patch on her chest.
Once, her mother, Johanna McCarthy, told her teacher, Matthew Bush, that she was starting a new treatment the next day and would have to miss a visit from a scientist. Meaghan showed up anyway, wearing a surgical mask to protect her against germs.
She went to school when she had no hair. She went when she needed a walker to get around. She went when she could no longer use the walker because she'd broken her tumour-weakened arm. The school board supplied an assistant, Stephanie Tam, who watched over her and carried her downstairs to music and upstairs to library and literacy classes. Ms. Tam could see her waiting outside the classroom door, impatient for class to begin.
Meaghan has hair now because the chemotherapy didn't work on her rhabdomyosarcoma (a cancer that forms in soft tissue), the operations and the radiation didn't work, and her parents, Dean and Johanna, are trying something else, an experimental protocol - a second one - overseen by the Hospital for Sick Children, which involves a weekly chemotherapy injection and a daily oral dose of anti-rejection drugs at home.
"It's yellow," she says of her hair, in a spirited, clear, high-pitched voice.
"It's not yellow," her father says.
"Yellow- ish," she insists.
In September, Mr. Bush explained to the class about Meaghan having cancer. She was late starting because she had a broken leg. Her leg broke last July, says her father, because the radiation had made her left femur soft as Swiss cheese, and she fell. Mr. Bush told the class to be careful around her. In October, she shed her body cast and came to school for the first time.
She was always smiling. Always happy. Always curious and engaged in everything possible, whether in learning her letters, role-playing at the dramatic-play centre or in gym class, which she is now able to take some part in.
"She's been an incredible teacher to us," Mr. Bush says. "She has a real radiance. Her joy in coming to school means that when she's here, she's beaming. I think her classmates have some enhanced empathy because of what she's taught them - all of them."
Her classmates would take her backpack to the cupboard, and fetch it again at day's end. "There were students who would just show up at her side and do whatever needed to be done," Mr. Bush says. "Some kids have really put their best foot forward in including her into the fabric of the classroom. When she leaves, they say, 'Bye, Meaghan, we love you.'"
Her cousin Joshua, who is 6, told her one day about Terry Fox and how he lost his leg and would take his artificial leg off when he went swimming.
"Why did he lose his leg?" she asked.
"Because he had cancer," Joshua said. "Not the same kind of cancer you have. You're not going to lose your leg."
But her left leg will not grow again between the thigh and the knee, because of the radiation. It is shorter than the right leg. When she stands in her bare feet, one foot is on its toes. Even so, she likes to run, with her uneven gait.
Why does she love school?
Mr. Bush explains it this way: "She makes connections with people and with her own knowledge and experience, and shares that with others, and gets back that feeling of being loved and valued and included."
"She gets normalcy," says her father.
"Because I get to play," Meaghan offers.
A few days ago, in a terrarium in Mr. Bush's class, a butterfly emerged from a cocoon with a broken wing. In past years, other broken-winged butterflies have been trampled by their peer butterflies. Not this year.
The class celebrated Meaghan's fifth birthday this week with cupcakes, and her grandmother gave the thumbs-up at another milestone achieved. "My goal is to get her to graduate kindergarten."
The only time Meaghan cried in class was when she was doing a presentation for "show and share" about her dozens and dozens of bravery beads given out by the Hospital for Sick Children, one for each medical event she has endured. And the other children cried with her.
One day in the spring, her parents learned that the first experimental protocol of chemotherapy and anti-rejection drugs was not working. That night was the spring concert - a highlight of the year. Meaghan stood on the stage with her classmates singing ("Sitting on the farm, happy as can be …"). At the end of the song, all of the students fell down. Only Meaghan remained standing, because her bones might break if she fell.
But Meaghan didn't mind. "I was the only one who got to stay standing!"
What is rhabdomyosarcoma?
- A cancer that effects soft tissues, such as muscles, Rhabdomyosarcoma can occur anywhere in the body. It is most common in the head, limbs and genitourinary system, around the reproductive and urinary systems.
- Two-thirds of cases are found in children under six-years-old, for whom it is the most common soft-tissue tumour.
- This cancer occurs in 4.5 out of every 50 million children, according to the National Cancer Institute in the United States.
- According to the Canadian Cancer Society, 153 new cases were reported in children and adolescents between 2003 and 2007 in Canada.
-- Survival rates are good -- about 70 per cent in children by one estimate -- if the cancer has not spread. The National Cancer Institute reports that overall, children under 15 years survive at least five years in 65 per cent of cases; the adolescent five-year survival rate is 47 per cent. Both survival rates have seen improvements of more than 10 per cent since 1975.
- Within these age groups, survival rates fluctuate significantly. Children between one and nine years of age, for instance, have a five-year survival rate of more than 80 per cent.
-- 49 children and adolescents between 0 and 19 years of age died of the disease in Canada between 2002 and 2006.
- Generally treated with surgery where possible, followed by chemotherapy. Failing that, doctors will use radiation.
Compiled by Adrian Morrow