Disclaimer: I do not own Phantom of the Opera. I also do not own any of the Lurlene McDaniel books some of the ideas come from. And of course, I don't own the song "Reflection"… not even the On the Record version.

Chapter One:

"Christine Daae!" Antoinette Giry called above the sound of the music. "Please attempt to keep up!"

Christine blushed, and stumbled, knocking over the dancer next to her.

"I'm sorry!" Christine squeaked, offering the girl her hand.

"It's ok," Sorelli said, taking the proffered hand with a smile. Sorelli was sweet, graceful, and gorgeous, but she didn't have much going on inside her head.

"Maybe," Ann began, "it would be best if you sat and watched..."

"Yes ma'am," Christine grumbled.

She had never really wanted to take ballet, but Ann's daughter and her best friend, Meg Giry, had decided it was her calling, and Christine had always been a follower. No, Christine dreamed of becoming a singer. But unfortunately, it looked like her dream would never be realized.

Sighing, she plopped down on a bench and leaned back, closing her eyes.

Suddenly she felt someone shaking her shoulders. Her eyes snapped open, and found Meg sitting beside her.

"Did I fall asleep?" Christine questioned.

"Yup… about forty minutes ago," Meg replied.

Christine glanced around; everyone had left but Meg and Ann.

"Do you feel well?" Ann asked.

"Of course I do..." Ann gave her a look, and Christine added, "Okay, I might feel tired, and I might have a headache, but I'm fine."

"All right, honey..." she said uncertainly."Come on, Margaret... we need to go..."

Meg cringed at her mother's use of her real name. Grabbing Christine's bag as well as her own, she glided out of the room after her mother. Christine rose and followed wordlessly out the door, taking her bag from her friend.

"Do you need a ride home, Christine?" Ann asked.

"No... I think I'll walk home. But thanks, Ms. Giry..."

Christine shivered against the cold night air and pulled her coat closer to her. She stared jealously as Ann helped Meg into the cab. If only her mother were still alive…

Stop it! She told herself. Thinking about it won't help any!

When Christine reached her apartment, she unlocked the door and slipped inside, throwing her bag on the floor and kicking her shoes off.

"Christine!" she immediately heard her younger sister call out, "I'm hungry!"

Carly walked into the living room/dinning room/kitchen area dramatically clutching her stomach.

"Where's dad?" Christine asked.

"He's in his room, sleeping," Carly replied, plopping down on the couch and reaching for the remote.

Once she was lost in some ridiculous cartoon, Christine began preparing dinner. After popping the leftover casserole in the oven, she joined her sister in front of the television.

"What are we having?" Carly inquired.

"Leftovers," Christine responded, grabbing the remote and changing the channel to her favorite show.

"That's all we ever eat," Carly complained. "I'm surprised we even have leftovers to heat up. And I want that back!" Christine sighed and tossed the remote to her sister.

"If you want something else, make it yourself." Christine stood up and went to the room she shared with her sister. She threw herself across her bed, and, before she knew it, Carly was shaking her awake.

"Christine! The casserole burned! Why didn't you get it out of the oven before then?"

Christine sat up and yawned, sniffing the air. It smelled of burnt chicken.

"Why didn't you take it out of the oven when the timer went off and you noticed I didn't come out?"

Carly shrugged. "It's not my job."

"Ugh," Christine moaned, rolling over, "I feel horrible… Can't you make your own dinner?"

"Again, not my job," Carly bounced out of the room.

Sighing Christine followed her sister. "Do you mind if I just order pizza?"

Carly shrugged. "It'll be better than whatever you just burned, I bet."

After calling the pizza parlor and placing her order, Christine began cleaning the kitchen. She took the scorched food and scraped it into the trashcan. Then she vigorously scrubbed the casserole dish until any remains of the food were gone.

By the time the pizza had come, Christine was much too exhausted to eat. She tipped the deliveryman and set the box on the table before going to her room to get ready for bed.

After taking a hot shower, Christine began brushing her teeth. Looking down, she noticed she had nicked herself shaving. She bandaged it and continued to brush.

Once in bed, she instantly began drifting off. The last thing she heard before she dozed off was the sound of her sister laughing at something on the TV.


When Christine finally awoke, she glanced at her clock. 10:30! She had already missed her first two classes! She jumped out of bed and saw her sister's sleeping form.

"Carly!" she cried, shaking her sister, "Get up! It's 10:30! We're late!"

"Why didn't you wake me up?" Carly snapped, sitting up.

"I guess I must have forgotten to set my alarm…" Christine began.

"Eww. You're bleeding," Carly wrinkled her nose.

"Oh, I cut myself shaving last night… It's really no big deal. Now come on! We have to go."

Carly rushed to the bathroom, where she proceeded to spend half an hour getting ready.

"Hurry up!" Christine called. "I need to get ready too!"

When Carly didn't respond, Christine groaned and went to her room to get dressed. She then applied some cover up to a few bruises that had mysteriously appeared during the night. Finding an old brush Christine attempted to comb out her tangled, light brown curls, to no avail.

Christine popped her head in her father's room to find him working on his computer.

"Daddy?" she questioned quietly.

Looking up from the screen, he gave a small smile. "I thought you guys had left already."

"I forgot to set my alarm. But we're going soon- I think."

"Are you sure you want to go? You look like you don't feel well…"

"I'll manage," Christine paused, "But if it's all the same, I'll probably skip ballet. Hopefully Meg will understand."

"Honey," Charles said, rolling over in his wheelchair, "I know you've been dumped with a lot of responsibility since your mother passed away, especially considering my condition, but don't let people walk all over you. It breaks my heart to see you submitting to everyone."

Christine's lips curled into a sad smile and she walked over to kiss her father.

"I love you Daddy," she whispered.

"I love you too."

When Carly finally came out of the restroom, Christine quickly brushed her teeth and hurried out the door.

By the time they caught a bus and arrived at Carly's school, where Christine checked her in, Christine had missed all of her morning classes and half of lunch. She arrived at her school at after noon and checked herself in.

"Christine?" her counselor Ms. Martin stuck her head out of her office. "Can I see you for a moment? I'll write you a pass."

Why does she want to see me? Wouldn't the principal want to see me about my tardiness?

Christine walked into the room and sat in the chair Ms. Martin had motioned toward.

"If this is about me being tardy, I'm really sorr-" Christine began.

"Oh, no honey, it has nothing to do with you being tardy. I'm just worried. You've been acting, oh, how should I put it, odd. You're grades have started to slip, you're tired, and well, I've noticed some bumps and bruises."

Christine was still confused.

"Christine, honey, is everything all right at home?"

Christine shot out of her seat. "Are you implying that my father beats me?"

"No, not necessarily. I'm just saying…"

"My father has MS! He can hardly walk, much less hit me!"

"Okay, honey, please sit down. I'm sorry. I- I didn't know about your father. But how would you explain your bruises?"

"I don't know. Maybe I'm just extremely accident prone," Christine said with a hint of sarcasm in her voice.

Ms. Martin sighed and reached for a piece of paper. "I'm going to let you go to class, but I'd like for you to come back and talk to me. Perhaps today after school…"

"I have ballet practice, and I can't miss it," Christine explained.

"Okay well, then how about tomorrow during your lunch?"

Christine couldn't see herself getting out of this, so she nodded and stood up, taking the pass from Ms. Martin.

"See you tomorrow!"

Christine just nodded and walked to her class. When she opened the door, Mr. Johnson, her calculus teacher, said, "Glad you finally joined us, Miss Daae."

Christine looked down, blushing, and took her seat. Meg leaned over.

"Where were you?" her friend asked worriedly.

"I didn't set my alarm, and I didn't wake up until ten-thirty," Christine explained.

"Ladies, would you care to share something with the class?" Mr. Johnson was now standing over Christine's desk.

"No, sir," she said, shaking her downcast head. She opened up her notebook and opened it to a blank page.

Mr. Johnson continued his explanation of integration. Normally, Christine would have been listening intently, but unless she wanted to fall asleep in the middle of class, she had to distract herself.

Meg, would you mind if I skipped ballet today. I feel awful.

Christine looked up and, seeing Mr. Johnson with his back to the class, writing something on the board, tossed the note on Meg's desk.

But Christine, today Mom's going to pick parts for the Christmas recital!

We both know I'm going to end up with a minor part. Honestly Meg, can't you spare me for one day?

"Ladies, I don't know if you know this, but I do not allow passing notes in my class," Mr. Johnson said, confiscating the folded piece of paper. "And if I catch you passing them again, I'll be seeing both of you after school in detention."

Christine attempted to cover her reddening face with her hair, but Meg seemed unfazed by their teacher's threat. She just flashed him one of her famous grins and replied, "Then I'll make sure you don't catch us next time."

Mr. Johnson opened his mouth to respond, but the bell rang before he could get a word out.

"See you tomorrow," Meg chirped. Christine followed her friend out the door, sending her teacher an apologetic look.

"Spill," Meg demanded once they were safely outside of the classroom. "Why don't you want to go to ballet? Is it Raoul?"

"No," Christine replied, "I feel sick, that's all."

Meg reached up to place a hand on her friend's forehead, but she quickly pulled it back. "You're burning up!" she cried. "You need to go to the nurse."

Meg began steering her friend toward the office, but Christine pulled away. "You're exaggerating."

"Oh no, I'm not," Meg continued to drag her friend along, "and I'm going to prove it to you."

"You're going to be late," Christine said dully.

"You're more important than some perfect-attendance plaque."

"No, really," Christine pleaded, "I insist you go to class. I can walk myself to the nurse."

"Nope, and besides, we're already here."

Christine sighed as her friend opened the door and shoved her inside.

"Hello," Meg greeted chipperly. "This is Christine. She's not feeling well." Christine rolled her eyes. She wished her friend would just leave her be.

"Okay, I've got it from here, hon. You can go to class now." Meg turned to leave, and Christine attempted to follow. "Christine, sit down. please." Christine turned slowly back around and sat on the nearest bed.

The nurse placed her hand on Christine's forehead. Feeling the warmth, she pulled out a thermometer and instructed Christine to hold it under her tongue. After a few minutes, the nurse pulled it back out. "101.2," she read. "I'm sending you home." The plump woman sat down at her desk and began scribbling on a piece of paper. "Give this to the receptionist when you check out." Christine nodded and took the paper.

Once she was safely out of the nurse's view, she dropped the note in a trashcan and made her way to class. After all, she didn't need to worry her father…


Christine sighed. Could she be any luckier? Here she was, in the most wonderful boyfriend any girl could ever dream up's arms, finally away from her nagging sister and her responsibilities. Here, in his arms, she could be like any other seventeen-year-old girl.

"Raoul," she broke their comfortable silence, "I love you."

"You too," he replied, kissing the top of her head. She sat up and studied him for a few moments. He was incredibly handsome. With his stylish blond hair and deep blue eyes, she was lucky that he had even picked her from the other girls at school- like Meg. Meg was beautiful. She had glimmering waist-length black hair and the most incredible violet eyes. Every boy in school was chasing after Meg, and every girl wanted to be her. Christine was somewhat plain with light brown hair that fell in curly waves half way down her back and brown eyes.

Christine laid her head back on his chest, where she fell into a calm sleep.


Christine sat in the ticket booth on Saturday afternoon and watched as hordes of people gather to see various movies.

"Two tickets to The Hills Have Eyes Two," an all-too familiar voice rang out.

"Carly," Christine said. "If I'm not mistaken, you're under seventeen, and therefore, you aren't old enough to get in."

"True, but," Carly sighed, "I have an older sister that can get me in."

"No, I'm going to get in trouble." Christine ripped two tickets to Are We Done Yet instead and handed them to her sister.

"Thanks for ruining my life!" Carly cried, storming off with her perky blonde friend following close behind her.

Christine yawned and glanced at her watch. She still had four hours left of her shift. There was no way she was going to last four hours. After closing down her booth, she went to speak with her manager.

"Hey, Marcus," she called, "I'm not feeling well. Could I go early?"

"Uh," Marcus replied, clearly distracted, "Yeah, sure…"


Christine set her nametag on the counter in front of him and hurried out of the lobby. In her rush to get out, she ran into someone.

"Sorry," she began, "I didn't see…" She quieted as soon as she saw his face. Oh, he was normal enough, in his hooded sweater and slightly baggy jeans- normal, that is, except for the black leather mask tied to his face.

"In many countries, and I'm sure this one included, it's considered rude to stare."

"Oh, um… I-I'm sorry," Christine sputtered, pushing her way past him. She tucked a stray strand of hair behind her flaming-red face. His patronizing tone irked her, and she was glad to know that she would never see him again…


"Keep up! Keep up!" Ann shouted about the stereo system, counting and clapping the beat.

Christine was struggling to stay with everyone else, but she was grateful Ann hadn't singled her out this time. She was telling herself the steps in her head as she danced.

Suddenly, everything went black. When Christine finally awoke, she found herself in the back of an ambulance as it flew, as fast as any vehicle can in New York City, down the street.

"Where am I?" she asked.

"You passed out sweetie. We're taking you to the hospital now so we can find out why," a uniformed EMT replied

"But what about my dad? My sister?" Christine panicked.

"It's okay. They've already been informed. Your ballet teacher, Ms. Giry, called your father. He'll meet us there," the EMT assured her.

"But how will he get there? My God, there's no way he can drive in his condition. And Carly's not old enough. And there's no way we'd be able to afford a cab!"

"Sweetie, I'm going to need for you to calm down. Take deep breaths. Now, can you tell me about your father's condition?"

Christine followed the woman's instructions and began explaining how her father had been diagnosed with multiple sclerosis many years ago, when she had just been a baby. Then her mother died from pneumonia when she was seven, and the stress had only served to progress his MS. With her and her sister being so young, her father had, at first, hired a nanny/nurse to take care of him and his family. Then, when the expense became too great, Christine's aunt had moved in to help care for them. But when Christine turned fifteen, she applied for a hardship license to drive her father to appointments in their enormous van, and her aunt moved out. So for the past two years, she had kept her entire household running with her part-time job and constant care, all while still attending school and leading as normal of a life as she could.

"Hmm…" the EMT pondered. "This could be the result of too much stress. Maybe if you hired a nanny again- at least part time. Or get your sister to help out some. How old did you say she was again? Fourteen? I think that's old enough to take on a few responsibilities."

Christine merely nodded, although she knew Carly would never agree to that. She also knew that, as badly as she wanted to go away to college, she'd never be able to go anywhere by NYU, and even then only part time.

"We're here," the technician informed her as she recorded Christine's vital signs. "We'll get you checked in. You'll most likely be held here overnight, so don't be too surprised when you do."

"Okay," Christine replied meekly before she fell back into the welcoming blackness.


When Christine came to her senses, she found herself in a hospital room, attached to a tube that led to an IV.

There was a nurse taking her vital signs, said, "Dehydration."

"Huh?" Christine's mind was still a bit foggy.

"The IV is for dehydration. You haven't been drinking enough fluids. Can you tell me why?"

"My throat's been hurting a lot, and I didn't want to bother it by drinking a whole lot."

The nurse hummed and continued her readings. "Dr. Keaton will be in momentarily to explain the tests that we'll perform on you."

"Where's my dad?" Christine asked.

"He came by earlier, but he had to leave because he began to feel tired. He said he'd be back as soon as he could, but not to expect him before Thursday evening." And with that, she left Christine alone.

After about ten minutes, a man, about 35, walked in, looking at the clipboard at the end of her bed. After a few hums and has, he looked up.

"I'm Michael Keaton," he introduced himself, offering his hand.

"I'm Christine, although you probably know that already."

The doctor chuckled a bit, and then adopted a more formal tone. "First we're going to take a simple blood test. If I don't like how it looks, I'll have a electrocardiogram and bone marrow aspiration done. The electrocardiogram should rule out rheumatic fever, and the bone marrow aspiration will tell us if you have a number of conditions like multiple myeloma, anemia, pancytopenia, and leukemia."

Cancer? she thought in a panicked state of mind I thought maybe the flu, but cancer?

"Yes," Dr. Keaton said, reading her mind. "Leukemia- a cancer of the blood."

Christine nodded. She was too shocked to respond. It's probably just protocol. I can't have cancer. I have my whole family to care for…

"Ah," Dr. Keaton looked up as a pretty blond woman entered the room, "Stephanie, would you mind drawing some blood for me while I go check up on some other patients?"

Nurse Stephanie flashed him a brilliant smile and told him it was no problem. Dr, Keaton took Christine's hand and gave it a squeeze before he left. Nurse Stephanie used a sanitizing wipe to clean Christine's arm before pricking her arm with the sterilized needle. After she was done, she placed a bandage on the arm and left.

Christine watched as the nurse walked out, and then fell fast asleep.


The next morning, Christine was scheduled to have electrocardiogram and bone marrow aspiration.

The technician smiled sweetly when Christine was wheeled into the room, despite her protests that she could walk. "Good morning," was the cheery greeting Christine received. She nodded, and the woman continued. "First we're going to do an electrocardiogram. I don't know if Dr, Keaton told you, but this is used to rule out rheumatic fever, which can cause heart damage, so it's best that we find it quickly, if you have it."

Christine nodded again, and the woman stuck small metal disks on the exposed skin of her chest.

"Rheumatic fever," the nurse explained to keep Christine's mind occupied, "Is caused by untreated strep throat. This machine gives us a good idea about how your heart is functioning." Once the nurse was silent, Christine listened to the sound of the machine as it scribbled on a piece of paper.

Christine was moved into another room after the first test was completed. Here, she was asked to lie down on a cold metal table for her bone marrow aspiration.

"Lie perfectly still. This test is definitely not as painless as the last. Now, I'm going to apply a local anesthetic to the site of the injection. Then I'm going to remove the marrow from your pelvis and send it off to be tested. I'm going to leave you in here to apply pressure to the site, and, assuming there's no bleeding, after about 15 minutes of lying still, you should be able to go about your normal activities."

Christine gulped as the cool anesthetic was applied to her skin. She watched in horror as the nurse picked up a foot-long syringe and proceeded to push it into her skin. As the marrow was being removed, Christine felt as if her insides were being sucked out.

"Good job sweetheart," the woman said, leaving Christine to recover from the procedure.

After 20 minutes, the nurse came back in with the wheel chair. Christine was only too grateful to see it. The nurse rolled her back to her room and helped her into the bed.

"If you're feeling up to it later, you might want to go check out the rec room. There aren't many kids your age on the pediatric wing, because we normally put people over sixteen in with the adults, but we made an exception for you, because well, you've never been through this before, and we felt you'd be more comfortable here."

"Thanks," Christine offered weakly.

"I'll leave you to sleep now." Christine listened to the nurse's footstep fade, and she began to drift off. I've been sleeping a lot lately. she thought caustically before she fell asleep.


It was about 6 P.M. when she finally woke up, dinnertime, and Christine knew she couldn't stand the sight of food, much less consume it. Finding her mind had become restless, she climbed out of her bed and began wandering the halls. Her whole body hurt, but Christine hoped she could walk most of it off.

She decided to look at the rec room the nurse had been so insistent she check out. On her way, she bumped into someone.

"Sorry," she said, looking up. She couldn't help but allow her gaze to linger on the man's face. Here she was, standing face to face with the man from the movie theater- the one with the mask!

But her gaze didn't remain on his mask for long. It drifted to his incredible yellow eyes, where it remained until he said, "Once again, it's really quite rude to stare."

"Oh, sorry," she apologized, turning red and continuing her journey.

Christine entered the empty rec room and walked over to the piano sitting off to the far side. It was seldom used, and she ran her fingers over the wood, collecting dust. She wiped it on her hospital gown and sat down on the stool. Her fingers lightly brushed over the dust covered keys before she began playing. After playing a few bars, she began to sing.

Look at me

You may think you see who I really am

But you'll never know me.

Everyday, it's as if I play a part.

Now I see,

If I wear a mask

I can fool the world,

But I cannot fool my heart.

It felt so good to play again. This was her usual method of venting, and by far her favorite. She felt, for the first time since her hospitalization, as if everything was going to be all right.

Who is that girl I see

Staring straight back at me?

Why is my reflection someone I don't know

Somehow I cannot hide

Who I am, though I've tried.

When will my reflection show

Who I am inside?

There's a heart that must be free to fly

That burns with the need to know

The reason why.

Why must we all conceal

What we think, how we feel?

Must there be a secret me I'm forced to hide?

I won't pretend that I'm someone else for all time.

When will my reflection show

Who I am inside?

When will my reflection show

Who I am inside?

Christine had become so wrapped up in the music that she didn't realize that anyone had come in. That's why she was surprised when she looked to see the masked man standing in the doorway.

"Oh," Christine blushed, "I'm sorry. I didn't know anyone was here."

"It's fine," he replied. "Actually, I thought your performance was pretty good."

"Thanks," she kicked a foot shyly.

"I'm Erik," he said, walking over and offering her his hand.

"I'm Christine," she grabbed his hand and gave it a gentle shake.

"Your technique was all wrong," Erik finally broke their silence.

"Excuse me?" Christine looked surprised.

"Just now. When you were singing."

"Well, you certainly know how to make a girl feel special," Christine mused.

"I-I'm sorry," Erik stammered. "I… haven't had a lot of experience with girls."

"You could have fooled me," she replied sarcastically.

Erik turned his head downward, and Christine instantly felt bad for her snide remark. "That sounded really rude, and I'm sorry," she apologized.

"It's fine," Erik replied, looking up. "I probably shouldn't let things like that get to me. It's just- well, never mind."

"What?" Christine asked.

"Nothing, really."

"Okay." Christine decided not to press any further; if he didn't want to talk about it, she'd change the subject.

"So what are you here for?" she questioned.

"What are you here for?"

"I asked you first."

"But if I tell you first, we'll never get to the reason I'm here," he explained.

"Tests. I don't actually know yet. Hopefully I'll find out soon. Now you go."

"Surgery," he said, pointing to his face. "I pity the doctors who have to perform it."


"Because they have to deal with the sight of my face," he answered.

"Oh, it can't be that bad…"

"Trust me, it is," he interrupted. "Now about your performance, I can help."

"Really?" Christine asked excitedly.

Erik laughed and replied, "Really."

A few kids had begun to file into the rec room, and Erik began acting weird. "Uhh… we can start tomorrow, I guess, about the same time you came in here today."

Before Christine could respond, Erik was half-way across the room. Sighing, she sat back down on the piano bench.

"Excuse me lady," a small boy, about five or six, came up to her. "Can you paint with me?"

Smiling, she replied, "Sure." Hey, he was adorable, and she had a weakness for kids.

He dragged her over to a small table with paper and paint supplies, and began to reach for the red.

"I'm Benny," he informed her, looking up and smiling a toothless grin.

"Hey Benny, I'm Christine."

"Can you open this?" he held out the jar of paint.

Christine took it and began unscrewing the lid. "Is red your favorite color?" she asked.

Benny shrugged. "Either red or blue," he said, never taking his eyes off this work.

Christine asked him a few questions as they worked. How old was he? Five and a half. Where was he from? Somewhere in Connecticut, although he wasn't sure exactly where

Christine was nearly done with her flower when Benny held up his paper, beaming proudly. "Do you like it?" he questioned.

She gazed at the heart he had painted. "I love it," she answered sincerely, "But why is there a hole in the center of it?"

"Because it's a picture of my heart," he told her matter-of-factly.

Christine felt tears sting her eyes, but she quickly blinked them back and replaced them with a smile. "What do you think of my flower?" she asked.

Benny giggled and replied, "It looks funny."

Christine gave an exaggerated pout. "I didn't think it looked that bad…"

Benny tilted his head to the side. "It's okay, I guess."

"Benjamin!" a cute red-haired nurse sang from the door.

Benny sighed. "Nurse Samantha," he explained, standing up.

She chuckled. "Thanks for letting me paint with you," she told him.

"Oh, I almost forgot," he began. "I want you to have this." He handed her his picture.

"Aww, thanks Benny. Want mine?"

"Naw, but thanks anyway. Bye Christine!"

"Bye!" Christine waved. Nurse Samantha gave her a look, and Christine instantly knew that Benny was dying. She also realized he had no idea.

After cleaning up, Christine grabbed her things and went back to her room, where she sat down on her bed and curled her legs up underneath her. Nothing was fair. People like Erik shouldn't go through life with a deformity. Children like Benny should live until they're ninety. And she should be home, with her family, taking care of them.

Christine lied down, and, after quite a bit of tossing and turning, finally fell into a fitful sleep.


The next evening, Christine had her first lesson with Erik. He was tough, criticizing her constantly, only giving a grunt when she did something well. Christine soon realized that he hadn't meant anything by condescending tone he had used the first time she met him, because he was, in fact, better than most people.

Despite Erik's secluded behavior, the lesson cheered her dreary disposition greatly. That's why she was surprised to find Dr. Keaton and a whole medical team in her room waiting for her when she returned to her room.

Dr. Keaton stepped forward and said, "Christine, we've gotten the results of your tests back."

"And?" she didn't like the way he had said it.

"You… uhh… may want to sit down."

"No really, I'm fine."

"Well, your tests revealed a low level of red blood cells. However, it isn't as simple as taking iron supplements. I'm afraid we've also found some abnormal white blood cells as well." Christine wasn't sure she was following. "What it all boils down to is this- you have acute lymphocytic leukemia."

"What?" Christine's head began reeling.

"I'm afraid it's cancer. Here's the lab report," Dr. Keaton said, handing her a formal-looking piece of paper.

Bone Marrow Pathology Report

Referring Physicians: Michael Keaton, M.D.

Specimen Number: JL21-85436

Hematology Associates

Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 441

New York, NY 10021

Date Collected: 10/21

Date Received: 10/21

Date Reported: 10/22

Diagnosis: Acute Lymphoblastic Leukemia

Gross Description

The specimen consists of 5 slides and 2 additional aliquots of 3 cc each, labeled "Bone Marrow Aspirate, Christine Daae."

Microscopic Description:

The bone marrow aspirate demonstrates extensive hypercellularity with normal bone marrow elements essentially replaced by infiltrating lymphoblasts. There are multiple mitotic figures seen. The lymphoblasts demonstrate a high nuclear/cytoplasm ratio and clumped nuclear chromatin. Some nuclei display a folded appearance. Scattered among the abnormal cells are small numbers of erythroid, myeloid, and megakaryocytic cells.

Flow cytometric immunophenotypic studies demonstrated a population of beta lymphocytes, which expresses the CD19 and CD20 antigens, and were weakly positive for CD10 (CALLA) antigens.

Cythochemistry was positive for TdT, further corroborating a lymphoblastic process and poor prognosis.

The findings are consistent with acute lymphoblastic leukemia.

Joseph B. Freemont


I have… CANCER?