On Sunday evening, three days after he arrived in Maryland, Lucas Townsend finally got to sit down with the woman whose life he had become entwined with forever.
Townsend, a 22-year-old outdoor enthusiast from Michigan, had helped rid Karen Kruger, of Towson, of her leukemia by donating his bone marrow, and two year laters, the two finally met, stealing off to the living room in her home to talk about the decision.
His visit had been a four-day tickertape parade, from lunch in Little Italy to a crab dinner to participation with Kruger in the Swim Across America fundraiser for Johns Hopkins' Kimmel Cancer Center held Saturday at Meadowbrook Aquatics Center.
But with so much on the agenda, there wasn't time for what Kruger called the "in-person conversation" about the marrow donor-recipient experience. When it finally took place, the two were comfortable enough to speak of the inevitabilities that led to their first meeting after over a year of communication.
Townsend had been moved by a story in his local newspaper several years ago and knew he'd love the opportunity to donate bone marrow.
Kruger, 56, knew she wanted to meet Townsend, and Townsend, who spent a year not knowing whether Kruger had been cured, wanted to see her as well.
All inevitabilities, they said, communicating simply through smiles as if they'd known each other for years. All inevitable — but only because Townsend followed through on a curious desire to donate bone marrow to save a life, which turned out to be Kruger's.
'I was terrified'
For Kruger, who works at a Baltimore law firm, her discomfort began in the autumn of 2010 as near-crippling back pain with no sign of a cause. She endured the pain for months, and in January 2011, when she couldn't sit through a day of work unless she constantly iced her back, a doctor called her and said her lab work revealed high calcium levels in her blood.
She was immediately directed to the emergency room, and after a week in the hospital, was diagnosed with multiple myeloma — cancer of the bone marrow — and plasma cell leukemia, which occurs when the bone marrow cells leach into the blood.
Kruger decided on Dr. Ivan Borrello at Johns Hopkins' Kimmel Cancer Center, who had treated a friend's father for the same illness.
"He said to me, 'You have a very aggressive disease, and we're going to treat it very aggressively,'" Kruger said. "His plan from the beginning was a bone marrow transplant."
Preparation for the transplant included five months of chemotherapy, from January to May, in order to weaken both the cancer and her immune system. This would allow the healthy new marrow to take hold in her body. As the chemo weakened her already slight body, Kruger still had to convince herself to go through with the transplant.
"I was so frightened I couldn't even talk about it," she said. "I was terrified, so that psychological impediment was an issue. If I didn't want to have it, they weren't going to make me have it."
As Kruger became more open to the treatment, she was surprised by a call from her doctor in June 2011 that the presumed August transplant date had been moved to the following week. They'd found a bone marrow match — a young man from Michigan who was inspired to join the bone marrow registry by a story in his local newspaper about a leukemia patient who desperately needed a match.
Leading up to the transplant, Kruger endured another aggressive round of chemotherapy. Townsend had bone marrow drawn from his hip, and the marrow, which needed to be used within 24 hours, was delayed on its flight out of Detroit. It arrived just under the deadline, and Kruger's body ultimately responded well to the transplant, which was like a blood transfusion.
After the transplant, the expected stay at Hopkins for Kruger was predicted to be anywhere from three to six weeks. When nurses told her someone had been healthy enough to leave in 22 days, Kruger sought to beat it.
She was discharged in 21.
'I'm part of their life now, too'
Back in Michigan, Townsend had heard no news about Kruger's fate. Shortly after his marrow was drawn — a process he said was less painful than getting a tattoo — he went west to a nine-month survivalist camp in Washington, and then lived with a cousin Portland, Ore.
He asked medical personnel at the hospital what happened to his match, but they couldn't tell him much more than that she was "OK."
Meanwhile, Kruger made continuous progress in her recovery. Her husband, Gary McLhinney, and daughter, Annie Lacher, 15, assumed the household responsibilities and stood by during every small step, with milestones including walking to the end of the driveway and doing a loop around the cul-de-sac where they live.
It wasn't until one year after the transplant — July 7, 2012 — that Kruger and Townsend were allowed to contact each other. Both had filled out a form through the Be A Match Foundation, in which they said they'd like to meet each other, but Townsend's form didn't arrive in Towson until last September.
The two continued to exchange emails and then shortly after that one-year waiting period was over, Kruger learned of the Swim Across America, which benefits Johns Hopkins Hospital that treated her.
"It kind of satisfied three things for me," she said. "One is to pay back Hopkins in some small way. The second was to have this small challenge to myself. And the third thing that I learned — there's no way to really thank the people that took care of you who saved your life. I realized the best gift I could give them is to be healthy and live well."
The Swim Across America event on Saturday turned out to be a perfect hook to bring Townsend, a former swimmer, into town. Townsend arrived Thursday, Sept. 19, his flight delayed the same way his marrow was.
Both ended up swimming the full mile, as did Kruger's daughter, Annie.
Townsend's family got to enjoy the weekend as well. The event organizers made travel arrangements for Townsend, and his sister, Hannah, was flown out by Kruger's family. Townsend's parents also made the drive from Michigan to take part in the weekend. By all accounts, it was a success.
Townsend, the soft-spoken outdoor enthusiast, who's finishing his four-year degree in outdoor education at Northern Michigan University in Marquette, Mich., said a combination of proving he could donate and the desire to help someone motivated him to give bone marrow.
"You could have turned out completely different, and I still would have been happy to meet you, no matter what," he told Kruger on Sunday evneing. "I just wanted to do it to help whoever it was, and finally meeting you and your relatives and close friends and seeing all the people — I'm part of their life now, too."