Sarah Mack should look pale or hollow-eyed - something to indicate that leukemia nearly had its way with her, that chemotherapy ruined her heart, that she refused an abortion to save her life.
But her brown eyes are bright with life and a healthy blush occasionally creeps under the freckles on her face. At 21, she’s a tribute to modern medicine or proof there’s a higher being. Or maybe both.
“I don’t know where I’d be if I hadn’t gone through all that stuff,” she said last week, shaking her head with wonder. “I know I would be stuck in the rut of life if God hadn’t taken me through all that.”
Mack and other cancer survivors will tie ribbons on North Idaho Cancer Center’s trees today to celebrate National Cancer Survivors Day. She is one of 4,600 Kootenai County residents on record who beat cancer and one of 8 million survivors nationwide.
The special day began nine years ago to give hope to the ever-growing ranks of cancer victims.
“There are thousands of survivors living among us. We don’t always remember that,” said Cindy Shannon, center spokesman. “It’s important for people going through cancer to know it isn’t always a death sentence. Sarah’s quite a person, an inspiration to a lot of people.”
The leukemia hit Mack in 1990. She was 14 and didn’t notice the symptoms. Neither did her mother, who’s a nurse. A friend’s father thought she was too pale and tired. He urged her to see a doctor.
“I didn’t have a clue what leukemia meant,” she said. “I just wanted to know if I needed chemo and would go bald. I never thought about dying, just about my hair.”
Chemotherapy started the day after the diagnosis. She lost her blonde hair and her fingernails. Her skin peeled from her hands like dried glue. “That grossed me out,” she said, wrinkling her nose.
The second onslaught of chemo killed all but a smidge of the cancer. But enough was left to prompt a third, highly intense chemo session that was too much for her.
She slipped into a coma and onto life support. A month later, doctors suggested her grieving family pull the plug. But she awoke first.
The leukemia was gone for the moment. She was too weak for a bone marrow transplant, so her doctors urged her to continue a low level of chemotherapy. She refused.
“I had an inch of hair by then,” she said. “I didn’t want to lose it again.”
Finally, her oncologist bribed her with $50 payments after each monthly chemo treatment. The deal saved her then, but nearly killed her later.
She returned home to her divorced mother, who desperately needed to protect her daughter. But she didn’t want protection. She wanted independence with no thought to its cost.
At 16, just months after X-rays showed her heart was dangerously enlarged from the chemo, she moved out of her Coeur d’Alene home. She bounced from one friend’s house to another’s. She camped, traded room and board for baby-sitting, mixed with a tough crowd.
“It was the most devastating thing,” said her mother, Elizabeth Fees. “But I felt powerless to keep her here. If I was her age and didn’t know if I’d live or die, I’d want to go out and experience as much as I could.”
By 17, she was pregnant. She didn’t want the baby or the father. She blamed her fatigue on her pregnancy. But the cardiologist told her she was tired because only 11 percent of her heart was working.
Her doctors recommended an abortion to save her life. She was six months pregnant.
“It was the medically correct thing to do,” said Dr. Tim Icenogle, a Spokane transplant specialist.
But she refused.
“I didn’t want kids, but I was raised a Christian and I knew that abortion was wrong,” she said. “I knew that God was testing me.”
Even her mother encouraged the abortion.
“They gave her a 10 percent chance of surviving the delivery,” Fees said. “I thought this pregnancy was going to be what kills her.”
Mack told doctors they could take the baby when it had a good chance of living - at 28 weeks.
On April 6, 1993, doctors removed 3-1/2-pound Faith by Caesarean section. She couldn’t part with her baby after Faith wrapped her tiny fingers around her mother’s pinky.
“My heart exploded. I totally loved her,” she said.
Giving birth weakened her heart so much that her doctors at Spokane’s Sacred Heart Medical Center pressed to get her on the transplant list immediately.
While she regained her strength, she graduated from alternative school. But she wasn’t convinced she wanted a transplant.
“I’d heard transplant patients only live five years,” she said, laughing a little at her ignorance. “I thought it’d be better to go before Faith really knew me.”
She had little choice in the matter. The committee that decides who gets the few hearts available rejected Mack twice for several reasons. She hadn’t shown the will to live; her doctor had had to pay her to undergo chemo. She’d abused herself. Her cancer hadn’t been in remission long enough to consider her cured.
Finally, Icenogle, the director of Sacred Heart’s transplant team, overruled the board.
“Many of us as teens don’t display the most mature judgment,” he said last week. “In Sarah’s case, she got her act together pronto. She became the model transplant patient.”
Motherhood had begun a transformation in her. Icenogle saw her potential and appreciated her deepening faith.
“Her decision for the Lord saved her. It gave her the kind of reference to put her life in its proper perspective,” he said. “It was a miraculous turnaround.”
In September, the phone call came. Her heart was in. It came from a 14-year-old Washington girl who was killed in a car accident. Her doctor and her mother were discussing insurance as she drifted off into a drugged sleep.
When she awoke after surgery, she could breathe.
“I felt like I could run a marathon,” she said. “That’s when I realized how sick I was.”
Doctors kept her 21 days after the transplant, then released her with a stern warning.
“They said, ‘Your heart is a gift from God and you’d better take care of it,”’ she said. “It really freaked me out.”
In the three years since the transplant, she has married and dedicated her life to her family and God. Her blue-eyed daughter has taught her the importance of life. She finally understands what she put her mother through.
“I’ve grown,” she said, with a reflective smile at Faith who, at 3, already can recite the story of Adam and Eve. “I know God got my attention through all that.”
Now she wants to spread the Christian message, which she plans to do in India with her husband, Schon, this summer.
Her body is healthy - doctors place no restrictions on her - and she has the winning energy doctors want other cancer patients to see.
“God gave me strength,” she said. “I feel like everything inside me is new now.”
, DataTimes ILLUSTRATION: Color Photo