They had always been close, sharing clothes and swapping stories. They snuggled together in bed and watched TV. They strolled hand-in-hand through the mall. So it wasn't unusual that Ashley Johns would consult her mother about a subject that many other 17-year-old girls would keep to themselves — or, worse, get advice from their girlfriends. "I want to go on birth control,'' Ashley said.
She was fast becoming a woman. She had given up cheerleading at Wesley Chapel High School so she could take a job at the YMCA. She bought a car and set her sights on becoming an anesthesiologist.
Ashley was serious. Nothing should get in the way of her plans. And while she and her boyfriend of three years had not taken the most intimate steps in their relationship, she wanted to be prepared — just in case.
"Oh my God, my baby is becoming a young woman," thought 44-year-old Lisa Farrell. "I knew at that point she wasn't a baby anymore."
Farrell, who had her first baby at 17, knew full well the consequences of young motherhood. A paramedic, she also understood the clinical realities of young people and hormones. She gave her blessing.
The obstetrician who had delivered Ashley performed the exam and wrote the prescription. He also ordered blood work to rule out any underlying conditions that would make the pill a health risk.
That test may have saved Ashley's life.
• • •
Ashley had never been seriously ill. She had recently noticed some abdominal pains after eating, but no big deal.
"They would come and go," she said. "They didn't make me double over."
Her mother chalked it up to a diet of too much fast food and half-price appetizers at Applebee's, a favorite teen hangout.
But the blood work for her birth control pills revealed elevated liver enzymes. A second test a few weeks later yielded the same result. A series of scans discovered the culprit: a tumor roughly the size of a tangerine inside her pancreas, a 6-inch, pear-shaped organ that secretes digestive enzymes. A biopsy tagged it as suspicious for cancer.
Farrell learned the results a week before Ashley's appointment with the surgeon. She kept it a secret until then. She went for long drives. She did her crying at a neighbor's house.
"I knew she would have a lot questions that I couldn't answer," she said. "I wanted her to feel like she was in the best hands."
• • •
Those hands belong to Dr. Alexander Rosemurgy II. He's a surgeon specializing in digestive disorders and pancreatic cancer and a professor for the University of South Florida College of Medicine. He refers to his young patients as "God's angels."
He has performed 16,000 surgeries over his 25-year career, including a thousand on folks with pancreatic tumors. Cases that turn out to be cancer don't usually have happy endings. It claimed the lives of actors Patrick Swayze and Michael Landon. U.S. Supreme Court Justice Ruth Bader Ginsburg was diagnosed in February. Of those who have the disease, only 5 percent survive five years after treatment. It usually strikes people older than 65, and smoking increases the risk.
Rosemurgy had a frank discussion with Ashley and her mom. The tumor had to come out.
"Do I have cancer?" Ashley asked.
The doctor didn't think so, but he wouldn't know for sure until the tumor could be removed and tested.
"I want it out of me," she said.
They set a Sept. 30 date.
Meanwhile, Rosemurgy had someone he wanted Ashley to meet.
• • •
Michelle Vice is a vibrant 21-year-old with dark brown eyes and long flowing brown hair and a cross tattooed on the inside of her right forearm. She's a student at USF. Her goal is to become a physician assistant.
Two years ago, Rosemurgy removed a tumor from her pancreas.
Vice's tumor was diagnosed soon after she returned from a trip to Jordan. She had pains and noticed a bump on her abdomen. She told her parents she wanted it checked out.
In her case, surgery was risky. The tumor was so big it could have closed off a major vein.
"They told me I might not come out," Michelle said.
Rosemurgy took out a mass roughly the size a soccer ball. The type of tumor she had was called a papillary cystic neoplasm. It's rare but usually benign if caught early enough and typically strikes young women. No one knows what causes it.
"Bad luck," Rosemurgy said.
After her surgery, Michelle told Rosemurgy about her interest in the medical field. He invited her to participate in his summer program that helps students find about if medicine is for them. She enrolled and now works part time on Rosemurgy's medical research team.
Rosemurgy told Michelle about Ashley.
When they first met before the surgery, they learned they had more in common than tumors. They had walked the same halls at Wesley Chapel High School, where Michelle was also a cheerleader.
Michelle had even gone to Quail Hollow Elementary School with Ashley's older brother, Cyle.
"I knew I had seen him somewhere," Michelle said.
Michelle gave Ashley a rundown on the post-op pain — it's intense but controllable with meds — and when things might start returning to normal. She estimated Ashley, whose tumor was much smaller, would be able to resume all her previous activities in a couple of months.
"I just wanted to be somebody to connect with," she said.
When they wheeled Ashley in for the 3 1/2 hour surgery, Michelle scrubbed and stood at her side. She visited Ashley several times during her weeklong stay at Tampa General Hospital, which ended Wednesday.
"I've been praying for you guys constantly," she said during a visit last week.
"Meeting Michelle and seeing her and how vibrant she was, it just affected (Ashley) a lot," Farrell said.
• • •
Right before Ashley was set to go home, the test results on her tumor came back. No cancer. However, the tumor could have turned malignant if left untreated, like a polyp on a colon.
"This is as good as it gets," the doctor told Ashley during a check before her discharge. "It's a thousand pounds off your shoulders."
Then he issued a challenge.
"You have an opportunity to really do something with your life," he said. "I hope you seize the moment."
"I will," she promised.
Lisa Buie can be reached at firstname.lastname@example.org or (813) 909-4604.