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Taken from the book "Edge Against Cancer" by Bob Brody.

Ch.8-Getting a Grip

Lightning Bolt is praying.

After all, 24 year old Jason Vale has to prep up for his next armwrestling match. Vale is nicknamed Lighting Bolt because he pins opponents so fast. He takes down adversaries as if he's double parked at a fire hydrant. On this warm Sunday night in June 1992, he squats near a platform stage with his head lowered, his hands clamped over his ears, and his eyes squeezed shut, the better to block out the clamor of the festival going on around him. He's getting what he calls "prayed up".

More that a million people are thronging through Flushing Meadows Park to sample carnival rides, music, games of chance and hot-off-the-grill food at the annual Queens Festival. But Lightning Bolt has come to grapple in the 15th Annual New York Pro Invitational Arm Wrestling Championship sponsored by the New York Arm wrestling Association. And to meet this challenge the 5-foot, 11-inch, 182-pound Vale is praying hard. He rocks himself back and forth, a squint creasing the skin around his eyes, and tries to patch himself through on the switchboard to God.

The other two dozen competitors mill around behind the stage, where the trophies for each weight division are lined up on a makeshift shelf. These are rough customers here, truck drivers and construction workers, cops and former Marines, no Wall street dilettantes need apply. Many arm wrestlers have arms like suspension-bridge cable, thick and striated from pumping weights. They run through private rituals designed either to psyche themselves up or psyche adversaries out, preferably both. They shadow-box of grandly flex the torso, and glare at likely opponents, or avoid eye contact.

Lightning bolt, in blue jeans and a green T-shirt, goes through his own ceremony: he keeps praying. Even with more that a hundred hard-core arm-wrestling fans and curious passersby clustered shoulder to shim, he stays submerged in his trance. He calls for God to safeguard his soul so that, win or lose, he'll emerge from this tournament without feeling defeated where it counts-inside.

For the moment, he is oblivious to his surroundings. Onstage, competitors clash. the wrestlers sit at tables, directly opposite each other, and clutch each other with nutcracker grips. In the thick of a match, they wince and grimace, snarling and grunting through twisted lips. Jaws quiver from the effort, neck tendons pop out, cheeks puff out like those of adders. "Rip his arm off!" audience members scream.

Lightning bolt is no newcomer here. He has won larger tournaments than this and comes in as a favorite. But this time he is competing in the 170-pound division, a heavier weight class for him. So he prays extra hard to come through with yet another victory in his usual no-nonsense, slam-bang, all-business, take no-prisoners style. He's juicing himself up, hot-wiring his trip-hammer, bear-trap of a right arm with fresh volts of faith. His mother and father and brother and sister-all have witnessed this prepping ceremony of his before-know enough to stand back and leave him alone. Lightning bolt powders his right hand with resin and takes the platform stage, to a chorus of whoops from family and friends. The Whitestone, New York resident had plowed through eight opponents to reach this stage in the event. He's also overcome a long, bitter campaign against cancer. Only six years earlier Jason had prayed for much higher stakes-his life. His back bears a scar from surgery and it's a doozy, a tire-tread imprint two feet long that curves under his left latissimus dorsi and swoops around beneath his shoulder blade, in a smiling crescent, passed his spine.

Now he has surfaced as surfaced as lightning bolt, and sits at a padded table facing Paul Walthers of New Jersey. Walthers rolls up the sleeve on his right arm, revealing a tattoo on his biceps. Hey, check me out, the move seems to say. Each contestant extends his right arm to clasp hands with the other guy and, with his left, grabs a six-inch-high post on the table for stability. They shift and squirm, jockeying in a tug-of-war for the right grip, an extra millimeter of turf, and finally unclasp. In arm wrestling, everything comes down to grip. More than a matter of comfort, grip gains an advantage, maintains equality, or gives away the marbles.

The referee, in black-and-white striped shirt, put his hands on the tense lock between wrestlers. He pulls a thumb back over here, cocks a wrist and inch over there, sculpting the grip in a bid for balance. "You're up too high," he says. "Get down, now. Right there. Yeah, that's it. Now straighten up. Shoulders back. Okay, good. Let's do it, boys...Ready...Set... Go!"

Immediately Walthers drives Jason back, like the hour hand of the clock tilting toward 1 p.m. Resin flakes off the hands of the wrestlers and flutters into the audience like specks of snow. "Rip his arm off!" a spectator yells. Walthers keeps the pressure on and quickly gains ground, his wrist bending farther forward, lowering his adversary to within two inches of the table. Few wrestlers ever come back from such a disadvantage to win.

But now Lightning Bolt feels the spirit."Pump it up, Jason !" his friends yell. "Pump it up!" He cranks his arm higher and higher, inch by inch, forcing Walthers into retreat. The crowd cheers louder. "Get mean, Jason ! Get mean!!" Suddenly, they are dead even, both arms upright, back at Square One, But only for a moment, because now Vale switches on the auxiliary power. He turns his right shoulder toward Walthers, adding torque, and pressed him down toward the table. The audience is going nuts. Then Vale suddenly pins him and it's all over. Lightning Bolt has struck again, another prayer answered.

In June 1986, six years earlier, Jason Vale ranked among the top handball players in Whitestone, Queens, a middle-class neighborhood consisting mostly of single-family residences in the second most populous borough of New York City. He had won handball tournaments and seemed likely to win more. A popular 18-year old, handsome and athletic, he had just graduated from Holy Cross high School in Flushing, New York. He was playing handball every day as he prepared to leave for a job as a counselor in a summer camp. It was the best of times for him. Every day, in the schoolyard around the corner from his house he slapped the hard rubber handball with an echoing "thwack" against a cement backdrop.

Then Vale started to cough. he coughed regularly and hard, short of breath. With each cough, he felt a throb in his left side, near his left lung and ribs, toward his back. Each day the pain grew more severe. He hurt worst at night when he lay down for sleep. Sometimes the pain seemed to emanate from directly under his heart, and Vale suspected he might suffer cardiac arrest in his sleep.

his parents took him to the emergency room at Flushing Hospital. A series of chest X-rays revealed, at the base of his left lung, a shadow on an otherwise white canvas. The attending physicians diagnosed pneumonia and prescribed intravenous antibiotics, but after a few days, the medications failed to improve his condition. Then the doctors thought he might have an empyima, also an infection of the lungs. nurses hooked him up to another IV solution and planned to administer more tests.

"No way" Vale said to his parents and the doctors in his whispery voice "I'm not staying." The banquet for his high school graduation would be held in church that night, and he had no intention of missing it. "I've waited years for this," he said. "I'm going."

"Jason," his mother, Barbara, said "You have to stay here in the hospital. It's for the best."

"There's nothing wrong with me," he insisted. "No way am I staying." And with that adamant refusal, he yanked the IV tube out of his forearm.

"What am I going to tell the doctors?" Barbara asked as he changed into his civilian clothes.

"you can tell the doctors whatever you want. Now take me home or I'll take a cab." Barbara declined to play accomplice in this act of defiance and her son walked straight out of the hospital. An hour later, doctors came to his room and found only Barbara

"Where is he?" they wanted to know.

"What can I say?" his mother answered. "he's 18. he decided to leave."

"Well, something is not right. you better get him back."

Fat chance. Jason attended the graduation affair and went to camp, as planned. But again the pain in his side flared. He took more antibiotics, without benefit. He stopped eating and within six weeks lost 20 pounds. He sprawled in bed at camp, too agonized to move, and finally called his parents to pick him up and drive him home.

On August 10, he entered booth Memorial hospital in Flushing. Dr. Fouad Lajam, chief of thoracic surgery at the surgery at the hospital, immediately ordered a CAT scan. Vale slid under the machine and lay still. Computerized axial tomography, or CAT, gives a cross-section view of the body with photographic "slices" one centimeter thick. By glimpsing otherwise invisible structures inside, a CAT scan can produce a more accurate look at an abnormality-its size, shape and location- than a conventional X-ray.

The scan revealed a sizable mass extending along the left chest wall, and Dr. Lajam told Mr. and Mrs. Vale that he suspected a cyst on the lung. Barbara Vale, a full-time homemaker with light freckles and short blond hair, and her husband Joe, a camera-store owner, listened quietly. Dr. Lajam explained that he needed to operate. He wanted to perform a surgical procedure known as a thoracotomy, primarily to draw excess fluid from the ling, and then explore to wee whether anything else was going on inside Jason.

The boy underwent the operation the next day. dr. Lajam sliced an opening from the scapulae, the two flat, triangular bones forming the shoulder blades, and carved deeply across the cavity of the chest to gain access to the lungs. Within a few minutes of getting inside, the surgeon discovered that the mass was no cyst. It was a tumor. The growth was about 15 centimeters wide and 25 centimeters long, roughly the size of a grapefruit, and fastened onto the chest wall. Gingerly, Dr. Lajam cut the tissue around the tumor and took it out. Because the growth was so large and deeply implanted, the delicate surgery lasted four hours.

Minutes later, Dr. Lajam went to the waiting room downstairs to tell the Vales. the physician favored candor over circumlocution. "We found a tumor, "he said. The Vales gasped in unison. "And we removed it."

"Is it cancer?" Barbara asked.

"We're not sure," the doctor said. "We'll send it to the lab for the pathologists to examine and then we'll find out."

Three days later, Dr Lajam received the biopsy report. "Unfortunately, it's malignant," he told the Vales. "But we still have to find out more."

Slowly, the Vales absorbed the verdict, and began to sob softly. Barbara thought, Now I have to tell Jason. Both parents went to his bed in the Intensive Care Unit. Jason lay pale and groggy, his eyelids drooping to half-mast, his mouth parched. Before the surgery, Jason had persuaded his parents to pledge full disclosure. "I want to know everything that's going on," he said. "Please, never hide anything from me or I'll never forgive you." The Vales had promised to inform him at every turn and now came time to make good on this vow.

"Jason," Barbara whispered. the boy turned his head on the pillow to look her in the eyes. "the doctors found that it's a rumor." She paused a few seconds to let the words sink in, before telling him the rest. "And it's malignant."

She will never forget his response to the news. "I was so worried about how he was going to take it ," Barbara later recalled. "But Jason was so sweet. He was so strong I'll never forget his first statement."

Without hesitating, Jason nodded and said, "It's okay...I'll be all right God is going to heal me."

"Good," his mother said, and thought about it for a moment. "Yes...You're right."



Barbara Vale taught Sunday school for 25 years. She also showed her own three children how to pray, starting with Jason and then moving in to his younger brother Jared and his sister Johanna. Before every meal, the family said "Grace" and every night she read her kids the Bible. the Vale family never missed Sunday or holiday services at the Free Gospel Church in Flushing.

From the beginning Barbara set a proper example for her children. "I have a responsibility to God, to my children and to myself," she explained. Jason readily invested himself in Christianity. "He always believed in prayer and faith," his mother said. "He would not only pray in church but also on his own." she would go to his room and see Jason in bed reading the Bible or down on his knees. praying. Jason appreciated the teachings of the Bible by age 15 to memorize passages of scripture and compete on the Bible quiz team at the Free Gospel Church, where he ranked second in the district. Barbara would serve him dinner at the table, alone and out of the corner of her eye she would notice him bow his head and, before he touched a morsel, begin to pray. "He always remembers," she said.

Jason channeled the same zeal toward athletics, the more competitive the better. In baseball, starting at age five, he played either shortstop or center field, both pivotal spots usually reserved for a team leader. Jason also enrolled in basketball and bowling leagues and engaged in pickup games of softball touch football and street hockey. One Saturday morning Jason was playing center field, with his brother Jared stationed at shortstop, in a playoff softball game. With two outs, the batter lofted a blooper to short center. As Jason trotted forward, Jared back-pedaled, both of them calling, "I've got it!" Neither heard the other, or much cared about this conflict of interest. Jason zeroed in first, caught the ball underhand, and accidentally slammed into Jared. The brothers crumpled to the outfield grass.

As they stood and brushed themselves off, Jason complained to Jared, "Hey, that was my ball." His voice growing higher and louder, he added, "The outfielder has the right to that ball. Anybody would know that." While the Vale boys came in from the field, Jason razzed Jared for trespassing on his turf. Barbara walked over to the bench to arbitrate between her sons. "That happens in the majors, too," she reminded Jason. "I saw an infielder and an outfielder collide on TV just the other day." But Jason, unappeased, kept backbiting about how Jared had almost blown the play.

"Jason was always very competitive," Barbara recalled. "He just tries very, very hard. He'd come home after a baseball game and mull over what he did wrong and how it happened, and call up his teammates and said, 'Come on, let's go to the batting cages and practice,' He was always more intense than the others. Sometimes he would get on people a little too much. He never let an argument go. With him, it could get like a Chinese water torture."

Later on, Vale switched to handball. He had fast hands and quick feet and pursued every ricochet. Soon he found that he preferred competing solo. You assumed all responsibility, depended only on yourself, received all credit and all blame. No collisions with teammates. In handball, he quickly learned the angles and the strategies, and could belt shots equally well with either hand. His confidence at the handball courts grew and he started to lay wages, $5 or $10 a game. he won a few games but lost money, mainly because he habitually challenged those whose prowess exceeded his. He would settle for nothing less than being the best in the neighborhood.

"Jason is competitive about everything, even chess," said his long-time neighborhood pal Johnny DiDonna, a student at Southampton University. Loves to win, hates to lose. He was always very demanding of himself. In handball. he always wanted to play the top guys, just to keep getting better and better."

Vale befriended a guy named Flip, a 1979 world handball champion who acted as his mentor, and practiced every day: if you wanted real respect, you never stooped to shortcuts. he played hundreds of games against Flip, until the protege had it all-the speed, the smarts- and could almost match the champ shot for shot. By high school graduation, Vale had become a first-rate new York City handball player.

Despite his Bible study and church visits and prayer, Vale was no angel, least of all in school. He wore sneakers, violating the dress code at St. Francis Prep, and ended up suspended. More than once he flung a tray of food in the cafeteria. He even climbed to the top of the school and scrawled graffiti. Once, he flirted with a young woman in the hallway, thinking her a student. she turned out to be a teacher and reported his impertinence to the principal. With religious regularity he got into such jams. For some reason, Vale always got caught. Though other kids would get away with boyish misdeeds far worse than his, he could never escape accountability. But because he believed in the Bible, he always knew when he had done wrong and admitted it.

Sometimes he crossed the line, though. Once, Vale and some friends got a master key for the high school storage room, and "borrowed" some band equipment (only to return it later, unsolicited). he also stayed out too late on school nights and came home to questions from his father about where he had gone. Joe was frequently frustrated at Jason's failures to return home by curfew and reveal his whereabouts.

Most serious of all. Jason developed a worrisome habit. he could always be counted on to get into nasty, knockdown fistfights.

***

The tumor that Dr. Lajam removed from Jason Vale's left chest wall puzzled Susan Jormark, a pathologist at booth Memorial. Dr. Jormark had never seen a growth quite like it, and had little idea what it might be, much less whether it might spread of how to treat it.

In the search for clues, Dr. Lajam ordered X-rays, CAT scans, sonograms, bone scans and magnetic resonance imaging for Vale, but the tests turned up nothing. All the physicians consulted on the case wondered why the grown gave no sign of metastasizing or invading any major organ. Sometimes a malignancy once excised from the body. leaves in its wake a trace of microscopic cancer cells that require further treatment. Stumped, the Booth Memorial team sent the biopsy slides to Dr Steven Hadju of Memorial Sloan-Kettering Cancer Center in Manhattan and Dr. Richard Dickerson of Massachusetts General Hospital in Boston, two of the leading pathologists in the United States.

by early October, Dr. Jormark had formed a provisional diagnosis. but rather that share her speculations with the Vales, she waited for the consensus from her colleges at other institutions. As it turned out, few fellow pathologists at Memorial and Massachusetts General concurred with her suspicions. Vale had an exceedingly rare form of cancer. The growth was characterized, variously, as a small-cell sarcoma, a neuroepithelioma, and a permissive neuroectodermal malignancy. The bottom line is that it was an Askin tumor, named after Dr. Frederic B. Askin, the physician who had first detected it.

"We'll take it step by step," Dr. Lajam told Barbara. Booth Memorial at this point could do nothing else for Jason Vale. Dr. Lajam referred him to Dr. Peter Sordillo, an oncologist at Memorial Sloan-Kettering who was one of the few specialists ever to treat an Askin tumor.

A letter dated October 6 bluntly spelled out the options facing Vale. Dr. John T. Fezekas, director of radiation therapy at Booth, sent the two-page correspondence to Drs. Lajam, Sordillo and Sidney Rabinowitz, the Vales' long time family physician. "The patient has recovered well and I believe there are plans for radiation therapy and chemotherapy," Dr. Fezekas wrote. "Physical exam reveals a pleasant and very healthy-appearing lad who looks his stated age of 18 and is in no apparent distress, totally recovered from his recent thorocotomy. his incision is beautifully healed and the lung exam is normal."

So far so good. But then the letter took a grim turn. The radiologist, in researching Askin tumors, had come across several articles on the rare malignancy, including a textbook chapter authored by Dr. Hadju of Memorial. The first research paper on Askin tumors appeared in 1979 in the journal Cancer and cited 20 cases. In the very last sentence of the letter, Kr. Fezekas wrote that each case culminated in "a uniform poor outcome and with essentially 100percent mortality," By this circumspect jargon, Dr. Fezekas tried to convey a simple, undeniable fact: Askin tumor is invariably considered fatal.

If Jason Vale had a singular specialty as a boy, it had to be his talent for getting into fights. He had fights in elementary school, fights in junior high school, and fights in high school. He routinely came home with a bloody lip or a bruised jaw. He once had a front tooth knocked out. Twice had his nose broken. He seemed to have a confrontational, combative attitude that led to brawls wherever he went.

Barbara often heard about his aggression from teachers, friends and neighbors. "People would run up to our house screaming, 'Hurry up, Barbara! Jason's in a fight again!'" his mother recalled. "Or I would hear yelling and run outside the house and see an altercation with Jason in the middle of it. He would come home all beat up and want to go back. He told me that you had to face the other kid right away because otherwise you became afraid. So he would go right back out there. He was a fighter, plain and simple."

As his buddy Johnny DiDonna remembered, "When we were kids, Jason probably fought everyone on the block. I remember that he and I fought, too; we were angry about something, but I forget what. Anyway, every summer Jason would go away to camp and our block would be so quiet. Nobody would be fighting, and we realized it was because he was someplace else."

In fighting, rather than randomly lashing out, Vale followed a strict protocol. A would-be opponent had to fit certain criteria: be bigger than he; challenge him to fight, even without words; and/or try to push around him or a friend of his. Vale always fought clean - no knees to the groin or gouging of eyeballs - and he never, ever bullied anyone. And finally, as a matter of inviolate principle, he would throw the first punch. Always. "Some big kid around here would push you around, scream in your face, whatever, and it would look like he's about to give you a good shot," he explained. "you just anticipate his punch and deliver yours first."

"My father taught him always to strike first," said Joyce Vedral, his aunt, an author of self-help books and a former English professor. "That's his fighting philosophy." Sometimes Vale would dispatch the big right hand and knock a troublemaker out cold, the first punch also being the last. "I know how his face would look," DiDonna said. "Jason would get worked up to a point where there was no turning back. In his face I could always see it coming. Suddenly: boom!"

When Vale was about 15, Frankie Santos, who was taller and heavier than he, beat up his own friends with impunity. On night Vale scoffed at this rude practice. "Hey, Frankie," Vale screamed at him. "You beat up your own friends. What's your prob?"

"Shut up pal," Frankie parried.

Vale, 30 pounds lighter and several inches shorter, waltzed over to Frankie and commenced screaming in his face. Frankie turned red. Witnesses swear he was about to unload some serious firepower on the upstart. Just then, Vale popped him square in the jaw, a pile-driver thrust that drove him to the pavement. This was a big event in Whitestone because until then, neither had ever lost a fight. They grappled on the ground, flailing away, gasping and grunting. Finally, Frankie stood, bruised and bloodied, and backed off, holding his palms aloft in a signal of surrender. Thanks to Vale, he never again picked on his friends.

"If Jason had gone into boxing, he would have become a champion," said his Aunt Joyce. "He has the strength and the guts and an incredible will. He's so strong it's scary. And he has a certain anger boiling inside him. His mother and his grandmother and I were always afraid that someday he would kill somebody. He put more than one person in the hospital, just from one punch. I remember Jason once followed a drug dealer to a housing project in the middle of nowhere and punched him out with one shot. He ended up being unconscious for several days."

Barbara, neither proud nor ashamed, took a neutral stance on his penchant for fisticuffs. In mixing it up, she contended, he was simply taking care of business. "According to everyone I talked with," she said, "the fights never seemed to be his fault, and I believe that. Even in school, the principal would say Jason never seemed to provoke the fights. He was never disrespectful, never rude, never used foul language. His teachers always said he just had a lot of aggression that had to be channeled in the right direction.

"We had bullies around here who would take away your handball and kick you off the courts," Barbara continued. "I remember this one guy, Mike Rivera, who was about 17, and he always pushed around Jason, who was then about 14. I once warned Mike. 'You wait,' I said. In a few years Jason will be bigger and you'll have to cool it.' And one day about two years later, Jason had had enough. He must have done some number on Mike because the kid came crying and said 'Look what Jason did to me.' He had a gash in his mouth, and I got a could cloth and wiped away the blood. He went to the hospital and needed 14 stitches. But he said he had no hospital insurance. And you know what? Jason let him borrow his Blue Cross card. 

"I never did get to the bottom of all those fights," Barbara said. "I talked with Jason about it until I was blue in the face. I would ask him to reason with people rather than settle everything with his hands. He's very powerful and I was worried that he would really hurt someone with that right arm of his. As Jason got older, my husband would say to him, 'You better be careful. Your punches are getting lethal. One day you'll hit someone and by accident he'll crack his head on the concrete and die and you'll go to jail.'"

Jason felt lousy about his east intimacy with violence. "I'm not going to do it again," he would tell his mother. "I'm really going to try to cut it out."

"It's not like he tried to justify the fights to me," Barbara said. "He felt bad."

Hard-pressed to understand his actions, Jason explained, "The fighting had to be done. I'm not saying it was right or wrong. But some fights just had to happen."

Maybe it was just as well. Whatever his motivation, Vale would later draw deeply on this readiness for battle. It would come handy when he faced a deadly bully named cancer.

The day Vale came home from the hospital, he felt pretty full of himself, certain he had the disease licked. He decided to show off to his friends, despite the staples still embedded in his back from the thoracotomy. He bent over, pressed his palms down on the driveway alongside his house and sprang into a handstand. He maintained this upside-down position, with arms quivering, for a few long seconds. See? the gesture declared. See what I can do? I'm as good as new. No cancer is going to push me around.

The next day Jason found out otherwise. He invited his brother Jared to play some handball. Although Jared was athletic in his own right, Jason was bigger, stronger, and faster, and had always prevailed in such contests. The score stayed close from the start, seesawing as Jared edged ahead and Jason inched back. But ultimately, Jason lost to his kid brother for the first time. "I was very upset about that," Jason remembered. It dawned on Jason that if you go through an eight-hour operation to take out a grapefruit-sized tumor from your chest, you might wind up the lesser for it on the handball courts.

Yet his newfound humility was short-lived. He craved the rough-and-tumble contact of street hockey; he wanted to roller skate along at high speed and whack at the puck with his stick and slam into somebody. He felt compelled to pit himself against an opposing force, if only to measure himself. For him nothing could articulate better than competition what he had inside himself.

Dr. Lajam warned Vale to avoid all contact sports. The intensive surgery had left his midsection fragile and vulnerable., and street hockey might subject him to body blows of concussive force, undermining his recovery. Vale begged the Physician for permission to play. "Please," he pleaded. "I'll be careful." And the doctor said, "Well, maybe it'll be okay if you get a special brace."

Vale visited a local sports equipment shop and bought such a brace. The padded, customized brace fit tightly around his waist, like some kind of corset, and hampered his movements. Playing street hockey in the protective device, he felt stiff and straight-backed, slow to swivel on his skated. But at least the brace shielded his ribs from injury. And with Vale back in action, his team voted him to be it's captain, and then won more often than not.

"That's how determined Jason was to get back to normal in a hurry," his mother recalled. "He was going to play hockey, no matter what. This upset me more than his fights used to. I was afraid he would hurt himself skating around in the streets. I think he wanted to prove something- to himself and the rest of us. Prove that he was not going to lie back, that he still had the right stuff. He was going to do what he always did: take everything into his own hands."

Meanwhile, Barbara kept the letter from Dr. Fazekas tucked in her pocketbook. She frequently pulled it out to read again, but the words about poor outcome and 100 percent mortality never changed. She grasped the jargon all too well. The other patients had died. Only one interpretation seemed possible. Jason would die, too.

Barbara wanted to conceal the letter from him, but she remembered her promise. If she neglected to tell him everything that was going on, he threatened never to forgive her. Finally she showed Jason the letter. Fazekas, he saw, regarded him as all but officially terminal. But even with this prognosis, the 18-year old kept himself in check. He repeated to his mother that he had said in the hospital on first hearing about his cancer. "It's okay...I'll be all right....God is going to heal me.," he said.

Now the Vales had to come to terms with the issue of treatment. Dr. Sordillo of Memorial reviewed the case and referred Jason to Dr. Edward J. Beattie, an internationally eminent thoracic surgeon, and Dr. Noel Raskin, also a thoracic surgeon, both of whom agreed that Dr. Lajam had scraped away the tumor, leaving no hint of lingering cancer. Accordingly, they called for the standard next step-radiation and chemotherapy-to prevent the tumor from growing back. Dr. Raskin wrote a letter to Sordillo saying, "As this tumor is apparently quite aggressive, I think careful follow-up is certainly needed.

I want to find out for myself, Jason thought. So one fall morning, he and his father Joe drove over the Whitestone bridge, along the Cross-Bronx Expressway, down the East Side Drive into Manhattan, and headed for the library at the New York Academy of Medicine over in Morningside Heights. With Joe looking on, Jason flipped through the card catalogue. Askin tumor, Jason said to himself. Where is Askin tumor? References and citations about the disease are about as rare as the condition itself. Jason rifled through the voluminous records, Joe marveling at his initiative and industry. Why should I listen to the doctors? Jason asked himself. I want to know the real deal for myself. Within an hour he had discovered what he needed to know.

It was true, just as the Fazekas letter said: All of the patients who contracted Askin tumor died from it. In every case documented, the malignancy had spread quickly and killed the patients, always within a year. But wait a minute now. Look here. This was a fact no doctor had mentioned to him. All the Askin tumor patients covered in the medical literature had gone through radiation and chemotherapy, the same treatment recommended for him. Result: the tumor would fade away, seemingly obliterated, only to resurrect itself within a month or two. The therapy make no difference. The patients died anyway.

Why bother? Vale thought. If the chemo and radiation failed with others, why would they work on me? Maybe the doctors just killed those patients faster. Maybe treatment does more harm than good. Maybe, he thought, he should just pray - and by praying, get in the first punch.

So Vale decided against therapy, just flat-out refused to go through with it. No radiation would beam down onto his chest; no chemo would seep into his system, either. Not if he had anything to say about it. "I believed I could take care of myself," he said. "Cancer was just something else in my life I would have to fight."

His physicians pressured Vale for the next six months to accept treatment. Dr. Rabinowitz, his family physician, urged him to get therapy, and so did the surgeons Dr. Lajam and Dr. Raskin and the radiologist Dr. Fazekas. Oncologist Dr. Sordillo was so concerned that in March, 1987, he wrote Vale a certified letter "to emphasize again to you how strongly I feel that you not continue to delay treatment for your condition." Sordillo went on, "As you know, I have felt strongly since you first came to see me that you should be on chemotherapy to try to prevent your tumor from coming back... Dr. Raskin and I have spoken numerous times about you and we spoke again today... Please do not delay any further in allowing us to do this."

Barbara had plenty of time to think through this controversy. The upshot was that she put limited stock in what the doctors said. Go ahead, say your piece, she thought. I'm sure you went to a terrific medical school and I appreciate the letter. But what you should understand here is that this is Jason Vale we're talking about and he's my son. He's another story altogether. So let's not get bogged down in facts. 

Jason believed he could recover on his own, and his faith was catching. "I believed every case was different and I knew Jason was a fighter," Barbara explained. "He took the initiative and I felt he was making rational decisions. He was not going to abandon all medical help. But we just decided he would refuse the treatment and we would take it from there. Prayer can change everything, and now we would pray together."

Jason prayed that, in declining treatment, he had decided for the best. "That whole first year of cancer, I felt overwhelmed by my faith in God and the hope He gave me," he recalled. "God just planted faith in my heart and mind and I went ahead without any chemo or radiation. I had faith that He was going to take care of me and work it out somehow and I was going to keep on going. I never felt defeated inside and I never thought about dying. The idea that I was going to die never even came into my head."

The months passed, and Jason returned to handball. He swore to his mother, in her moments of doubt, that he would be all right, and after he turned 19, he seemed to be back to normal, warrior spirit and all. One day a huge teenager named Tenny, who weighed nearly 400 pounds, rode by the handball courts on a motorcycle with his girlfriend clutching his torso. Jason waved an innocent hello to the girl and Tenny, taking exception to such hospitality, climbed off his bike and cursed at Jason. The recovering cancer patient was in no mood to fight and expressed his lack of evil intent in waving hello. Terry grabbed his shirt and that's all he had to do. Jason landed a shot flush on his jaw and Tenny toppled like a redwood, out cold.

For more than a year now, Jason had skipped chemo and radiation without suffering adverse consequences. With his patented first-strike capability, he had rendered unconscious a motorcycle thug more than twice his size. Against all odds, the kid seemed to be in the clear.

***

But not for long. In the fall of 1987, now enrolled as a freshman at Queens College, Vale felt the same pain as he had endured a year earlier, in exactly the same spot along his left side, the site where Dr. Lajam had discovered the Askin tumor. The pain was so bad it prevented him from sleeping on his back, but however much he tried to lie on his stomach and side, it kept him awake all night. Even to walk tormented him. The relentless pain upset his balance and he swayed from side to side as he climbed stairs, resorting to the railing for reassurance, stepping as if on hot coals.

The pain grew progressively worse and degenerated into agony. He wanted to chalk up the pain to handball, to twisting his torso too abruptly in swatting a shot and pulling a muscle or ligament. But he saw no profit in trying to kid himself. Maybe bypassing treatment was a mistake after all. Maybe the tumor had recurred.

Dr. Rabinowitz prescribed Percocet, a narcotic, and recommended the standard dosage regimen of two pills every four hours. But even heavily medicated, the boy found little relief. Once the drug wore off, the pain came back. Day by day, as he built a tolerance to the chemicals, the pain returned sooner and sooner. And with each resurgence coming on the heels of a lull, the pain would feel harsher, more jagged and piercing.

Vale begged God to take away the pain, prayed for the pain to migrate out of his body and into the ether. It was a simple proposition. If the pain left, he could play handball and study for college. He could sit, stand and walk without difficulty. He could sleep through the night. Granted a reprieve from the smoldering in his side and back, he could even envision a life without cancer.

"Jason was in such pain all the time," Barbara said. "It got to the point where he could not lay down in bed. He would sit in a chair all night because the pain was so bad. I'd fall into a fitful sleep and get up during the night because I knew he was still sitting there, unable to sleep. I was dying inside, seeing him in such constant pain. It hurt me so much."

Desperate for relief, Jason found unendurable the four-hour wait between drug doses and grew more and more impatient. One day he held off for only three hours before popping another pair of Percocet, if merely to walk or sleep comfortably for a spell. They he shortened the delay to two hours, and finally to only one. Now, instead of downing two Percocet every four hours, he liberally medicated himself with six every three hours, more than thrice the recommended quantity. He went through a vial of 20 pills in half a day. And Dr. Rabinowitz had no intention of giving him a refill. So Jason forged prescriptions, a violation of federal law. To the figure "20" on the RX vial, representing the number of pills, he added a zero. The unsuspecting local pharmacist then dispensed 200 Percocets. "I had to," Vale said, "because nobody would believe the pain."

Barbara believed it. She could see it for herself. But she worried he had gotten hooked. "We argued about his taking all the painkillers," she said. "I would hide the pills and dole out only what I thought was necessary."

Sometimes Jason would like in bed on his stomach and his mother would massage his back. She would rub the site from which the piercing pain emanated, the spot on the left side of his back, under the shoulder blade and around the ribs, the same location where the Askin tumor had swollen and the surgeons had done the thoracotomy. Barbara would press her fingers into his muscles to muffle the pain, and after an hour her knuckles and wrists ached. "Pray with me," Jason would say to her as she kneaded his back, and they would pray together. He put credence in the science and folklore that surrounded the laying on of hands. "Whenever my mother massaged my back," he recalled, "it was like magic. The pain would go away. I was so thankful that I wanted to cry."

***

However much Jason wanted to depend on narcotics, massage, and prayer, his father now urged him to go in for a CAT scan. "We have a CAT scan scheduled in two days," Barbara said. "NO," Joe replied. "Call now" The Vales alerted Dr. Beattie. And on October 14, 1987, Jason hobbled into Beth Isreal Medical Center in Manhattan, flanked by his parents, who held him upright and guided him into the emergency room.

Quickly, an orderly wheeled the boy into an X-ray suite. Dr. John M. Cosgrove, chief surgical resident, examined him first. "Jason was lying on a stretcher twisting around and grimacing in pain, yet still upbeat," Cosgrove recalled. "We shook hands and could tell, just by his grip, that he was strong. He gave me such a tremendous squeeze."

Now Vale had to lie down straight and stay still for the CAT scan to pass over him. The doctors had to see inside his chest to find out whether the tumor had again cropped up. But the pain in his back prevented him from sufficiently uncoiling his body to lie flat. An anesthesiologist dosed him with Demerol, then morphine. The nurses then injected him in the spine with a contrast dye, for a clearer, more telling CAT scan image. As the machine hummed over him, photographing away, Jason drifted into a painless sleep.

The next day, a radiologist led Jason into a room to look at film of the results. There, on a brightly illuminated screen, the boy at last glimpsed the source of his pain. "My body had a new tumor," he said., "and I saw it for myself. Now I knew exactly what it looked like. It was a white spot where it was supposed to be dark, near my left lung. It looked like a big white cloud. Like a ghost."

The size of a fist, the chest-wall malignancy had grown on his left lung, close - perilously close - to his spinal cord. The Askin tumor, reprised, had begun to eat away at bone, compressing his spine. This growth represented a new danger: complete, permanent, irreversible paralysis of the legs. If allowed to spread over the next 48 hours, it threatened to render Jason paraplegic.

The surgeons would have to go in again, no later than the next day.

Dr. Beattie would supervise the second operation at Beth Isreal, with Dr. Cosgrove at his side. This time, the doctors would perform a laminectomy; they would remove three ribs, a section of his left lung, and about three inches of his spine. That afternoon, the white-haired grandfatherly Dr. Beattie swiftly pressed into service Drs. Cosgrove and Raskin, neurosurgeon Richard Bergland and the rest of the multi-disciplinary surgical team and diagrammed the details of the procedure on a blackboard. All the healthcare professionals attending this briefing had a sense, given the rarity of the tumor, that this was an operation of some historical import.

That night, at the Free Gospel Church in Flushing, where the Vales had attended services for many a year, Pastor Marvin Boyce led a special service for Jason. With several hundred congregants listening, including family and friends, Boyce announced that Jason would undergo major surgery the next morning at nine. "Let's remember Jason Vale in our prayers," the pastor said. "He's in a lot of pain, but we believe God will heal him." Boyce recited passages of scripture to illustrate the restorative powers of the deity,. The Pentecostal congregants knelt in the pews, heads bowed and hands clasped, and prayed for Jason. Some members of the flock shouted "God heal him!" Others sang "Hallelujah!" All the prayers came together, fusing into a single voice, a choral plea for mercy floating toward the heavens.

Jason remained in the Intensive Care Unit that night, closely monitored. If his conditioned worsened, Dr. Beattie would operate ad hoc. Every hour through the long evening, with paralysis still an imminent threat, the nurses approached Jason to make sure his legs still had feeling. They would tickle his foot and, reflexively, he would kick.

The next morning, Jason awoke and opened his Bible. He read in Romans 5 the following verse: "We rejoice in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope." In these words, he found comfort. "In my heart I felt this peace," he said. "That was all I had to read to be happy." He took the Bible with him down to the operating room and pored over more passages. "God spoke to me on the operating table. It was like He was right there with me, speaking to me through the verses." As 9 a.m. neared, and orderly asked Jason to close the book. "Relax," a nurse told the orderly. "Let him read his Bible."

In the operating room, team Vale - six surgeons, three anesthesiologists, and two nurses, all scrubbed and ready - gathered around Jason to exorcise this stigmata.

"Do whatever you have to do," Jason told Dr. Beattie.

Cosgrove felt butterflies swooping through his system. The doctor, himself age 29, only 11 years older than his patient, had played football at Harvard University and had quickly come to feel a special rapport with the young, athletic Vale. Likewise, Jason sensed a growing affinity with the 235-pound, crew-cut Cosgrove and his brisk, drill-sergeant manner. "Many people at the hospital thought Jason would not survive," the doctor recalled. "In the back of our minds, all the surgeons involved thought his lesion was lethal."

As Jason inhaled anesthetic through a tube in his throat, his eyelids drooped, his breathing deepened, and his head sagged to the side. He seemed to have sunk into unconsciousness.

Then he suddenly bolted upright on the operating table, eyes wide open. "Fooled you!" he taunted. For a moment, everyone stood flabbergasted, saying nothing. Then team Vale exploded in laughter, Jason included. The comic prank, so exquisitely timed, defused the tension ion the room. "At first, nobody could believe it," Cosgrove said. "Everyone thought Jason was out cold, but was only a little groggy. The anesthesiologist rolled her eyes and laughed and said she had never seen a patient do that before. He fooled us, all right, but it was positive and upbeat. It put us in the mood to really rock and roll and get the tumor out. I think Jason was also trying to send us a signal: that he still had some control of the situation."

Finally, Jason went under, no kidding around now.

The surgeons cut through the scar tissue formed around the incisions made by Dr. Lajam in the thoracotomy at Booth Memorial 15 months earlier. With painstaking finesse, and in perfect synchrony, Drs. Beattie, Cosgrove, Raskin, and Bergland set about taking out pieces of Jason Vale, the better to clear a path to the fist-sized Askin tumor that again threatened to kill him. With the tumor now spreading in the spinal canal, and and all roadblocks had to come loose.

Out came three ribs from his left side, the surgeons also paring away the surrounding tissue. Out, too, came a section of his left lung, three thoracic vertebrae in his backbone, and the nerves connecting ribs to spine. Dr. Bergland operated directly on top of the spinal cord. Any false move, such as an errant severing of the cord, would mean lifelong paralysis. Only after clearing all roadblocks could Dr. Beattie reach in through the chest and snip away at the potentially fatal malignancy, until he had plucked it clean from the body and could hold it aloft in the sterile air where no harm could come from it.

Now, with the 18-year-old boy so rudely laid open, Dr. Beattie had to close the flaps of his chest. The only problem was that so much of the skin from his chest was gone. So the surgical team pieced together a synthetic mesh, much like a scaffolding, to seal the exposed cavity. Given the copious bleeding, the doctors transfused Jason with five units of blood, about a liter in all, one-third the amount available in the average human body. The laminectomy had lasted eight hours.

Moments later, Beattie came out of the operating room and told the Vales that Jason was fine, resting in stable condition. Barbara and Joe wanted to know whether the boy would walk. Too early to tell, the doctor answered. And what about the tumor? Probably all gone, Cosgrove said, but again, too early to tell.

The doctor took the Vales to the recovery room to see Jason. The boy remained woozy, unable to speak. "We're praying for you," Barbara said. She grazed her hand against his cheek and leaned over to hug him. Then Cosgrove took the opportunity to conduct a test on Jason. He flickered his fingers along this right foot to tickle the slumbering boy. If Jason moved his foot, the doctor explained, it meant paralysis. Instantly, the foot twitched.

Only later would the parents find out that Joe, in his insistence on taking Jason in immediately for a CAT scan, had saved the day. Had the Vales waited another 24 hours to bring the boy in, Jason might have ended up paralyzed for life.

***

The second surgery was not the end of his troubles but only the beginning. Jason would need at least two weeks in the hospital to get going on his recovery. The staff in the Intensive Care Unit at Beth Israel had to cast a vigilant eye on him. When he moved into a regular room on the third day, his parents bought him a TV and an electronic chess set to keep him occupied. (read: out of trouble). On the forth morning, Dr. Cosgrove visited Jason and his parents. "This young man will have to get treatment his time," he said. But Jason remained unconvinced, even now, that he should go through chemo and radiation.

The boy would collect no trophies as a model hospital patient. He refused to eat, complaining the food was lousy, and went eight days without a shower. The doctors ordered him to stay in bed, but he got up by himself anyway. A few times he pretended, once upright, to stumble to his knees, a stunt somehow amusing to Jason but unnerving to the nurses. "He clowned around, trying to throw the nurses into a panic," Barbara recalled. "But nobody thought any of this was funny.

Nurses came into his room all day to carry out routine chores. They brought in his meals, drew blood, checked his blood pressure, changed the bed sheets, took out the garbage, cleaned the bathroom. If a nurse came into his room to give him a shot, Jason would ask, "What's in the needle?" Once, a nurse replied, "Don't worry about it." He said, "Well, I want to know what you're giving me and I want to know why." He hated being so closely watched, hated letting everyone do everything for him. After a week, he took a stand. He refused to let the nurses put on clean sheets. He pulled shut the curtain around his bed, the better to maintain a semblance of privacy, as if to enfold himself in a cocoon. He wanted to hang a sign on the door to his room saying DO NOT DISTURB. "The nurses came in 30 times a day and it bothered me," Jason said. "I never got to sleep. Some days I shut by door so nobody would come in." Twice the hospital sent in a psychiatrist to visit him.

Jason ran a fever and went on intravenous antibiotics. He blamed the fever on the antibiotics and snatched the IV tube out of his forearm and let the medicine dribble into his urine bottle. A doctor, exasperated at these hi-jinks, called Barbara. "I'm taking myself off this case," he said. "If your son isn't going to listen to me, I'm not going to be responsible."

The doctors took Jason off Percocet, despite his continuing pain. "I would wake up in the middle of the night hurting so much," Jason said. "It was the worst." This sudden withdrawal from the narcotic left Jason thin-skinned and cranky. One day an intern went to his room and, unprovoked, sat on his bed and called him "truculent and cantankerous." Jason preferred to keep his bed to himself and resented this presumption. "Get off my bed or I'm going to punch you in the face," he threatened. Barbara, right there, blushed.

Startled, the intern said, "See? You're truculent and cantankerous." Jason looked at the intern and adrenaline surged through his system. He stopped feeling pain at that moment. Intoxicated with fury, he wanted to take a swing at the doctor.

The comment became a running joke between him and his mother. If Jason acted pigheaded or protested too much, Barbara would tease, "Jason, you're being truculent and cantankerous." By the same token, if Jason caught himself acting stubborn and temperamental, he would coyly ask, "Mom, tell the truth. Am I being truculent and cantankerous?"

Most of all, Jason hated the tubes. The surgeons had carved a gaping hole in his chest and plugged in two thin tubes to drain excess blood and fluids and to vacuum out air to prevent his diminished left lung from collapsing. The tubes bubbled all day from the suction, and relayed the accumulated discharges into a gurgling collection device that reminded Jason of an aquarium. "This is useless," Jason told the hospital staff. "Get these tubes out of me."

He just wanted to get out of there. Fed up with the indignities of hospital life, Jason wanted to detach himself from the fist tank and go home. He believed he could take better care of himself in his own house. So he plotted The Great Escape.

He called his friend Jo Marie Penna. "Listen," he said, "I could lay around like this at home and still get better. I'm leaving the hospital."

"Leaving?" Jo Marie said.

"Yeah."

"What do you mean leaving?"

"Walking out. I can't stand it here anymore. I want you to come in from Queens and drive me home."

Jo Marie, along with her friends Therese DeCarlo and Julie Shu, went to Beth Israel on the pretext of an ordinary visit to Jason. But when they arrived planning to take him home, the three young women noticed the tubes poking out of his chest. The tubes burbled and looped into a repository, like a portable septic tank, that Jason pulled alongside him as he walked.

"You're not leaving," Therese said. "I'm not driving you home."

"You have to drive me home," he said.

"No," she said. "I don't and I won't. Not with all those tubes sticking out of your chest."

"If you're not going to help me out," Jason said, I'll leave on my own."

With that statement, his three friends left. Jason disconnected the tubes from the tank and coiled the ends dangling from his chest under his overcoat. He stepped outside his room and looked down the hall - left, then right - to check whether anyone who knew him was coming. He might encounter too many people in an elevator, so he took the stairs and walked down from the seventh floor to the lobby. He headed toward the from door, passing the security guard, and made it outside, his hospital gown peeking out below the hem of his coat. He felt so tired. For a moment, he just stood there out on Seventh Avenue near 17th Street in Manhattan, breathing in the open air. He went to a pay phone to call a cab.

Instead, he called his mother. Barbara answered on the second ring.

"Hi, Mom."

"Jason, I hear a lot of cars and trucks. Is your window open?"

"No, Ma, I'm downstairs in the street, at a phone booth. I'm not staying here anymore. You have to come get me or I'm going to take a cab."

"Jason!" she screamed.

"Ma, I'm not staying in the hospital for one more minute."

"What about the tubes?"

"Listen, that's nothing."

"Are you walking around with the tubes coming out of you?"

"I'll take the tubes out myself at home. I can do that without a doctor."

"Jason!" she screamed again. Don't do this! You can't do this, for God's sake! You're going to injure yourself."

"But Ma..."

"...No, you listen to me very carefully. Nobody knows you're gone yet. Nothing will happen, no repercussions, if you quietly go back upstairs and sneak back into your bed. Please! If you honor your mother and father, if you have any fear of God, you will get back in that hospital!"

So much for the Great Escape. Jason said goodbye and hung up the phone. He went back into Beth Israel and rode the elevator to the seventh floor. He shrugged off his overcoat, climbed back into bed and called for a nurse. It seemed the tubes had come loose, he told her. Could she please fix them?

"All I know is, I was beside myself," Barbara recalled. "How was I going to make this kid listen? He gave everybody a very hard time: the doctors, the nurses, and me. Usually, when something traumatic happens, I just shift to a lower gear and become ultra-calm. I think, Okay, something has happened. Let's see what we can do about it. But this time I just lost it."

Drs. Cosgrove and Beattie later that day god wind of the incident. Beattie, incensed at this flouting of the rules, threatened to kick Jason out of Beth Israel. But Cosgrove, feeling protective, stepped in and told Beattie he would take care of the kid.

That son of gun, Cosgrove thought. He actually disappeared from the hospital with tubes coming out of his chest. That's how much he wanted to get out of here. I'm going to go up there and kick his butt.

The young surgeon immediately paid Jason a little visit. "I was concerned about his cocky attitude," Cosgrove said. "I told him he'd better straighten out his act and that we're the bosses in the hospital. I told him he'd better do what we say if he wants to get better, and that if he pulled a foolish stunt like that again, it would just prolong his hospitalization. He promised it would never happen again. It was impossible to get mad at him. He'd gone through so much." Cosgrove later told Barbara that Jason, in pulling the tubes from the tank, had run a serious risk. If the tubes had popped out of his chest, his lung could have collapsed. Such an accident might have invited an infection. He could have died.

Cosgrove suspected that Jason would persist in his refusal to cooperate. The physician stopped in on him two or three times a day, not only to check him but also to lecture him. "I felt a special fondness for the kid because we were so close in age and both played sports," Cosgrove said. "I knew he would be a tough patient. But I'm tougher. I knew that if anyone could bring him around, I could."

***

Jason finally relented on treatment and went in for emergency radiation therapy a few days before Thanksgiving. He lay on a table and let technicians mark his back with blue emblems designating the site of treatment. Then the radiologists fired high-energy ionizing radiation at the spot to kill any vestiges of cancer cells. The plan was to blast him with radiation for 30 straight days. Such treatment snaps the strands of DSA molecules inside these cells, preventing the cancer from growing and dividing. The first round of radiation rendered his mouth raw inside, so dry he became unable to swallow his own spit. But the treatment shrank the unidentified swelling in his back and Cosgrove put Jason on morphine and steroids to ease the pain and inflammation.

During the second such session, Jason thought, I should just walk out now. Walk out and never go back. Not for this.

No matter that he had come so close in the last year to paralysis and death. Now Cosgrove arranged for the radiation department at Beth Israel to stay open on Thanksgiving just for him. Despite his appointment, Jason had a better idea: a sequel to The Great Escape. He called his cousins Eric and Corey Dash to drive home to Whitestone for a surprise visit with his family on Thanksgiving. Here a major New York City hospital had kept open an entire department specially for him, at considerable expense. But Jason nonetheless put on a raincoat, ducked into a cab with his cousins and showed up, unexpected and unannounced, at the Vale residence. His parents and siblings were there, and so was Grandma, along with some aunts and uncles, all hovering over a buffet of turkey, stuffing, candied sweet potatoes, and baked-cheese macaroni.

"He walked in the door during Thanksgiving dinner looking emaciated," recalled his Aunt Joyce. I thought he was going to die right there."

Barbara, aghast at this breach of common sense, said. "Jason, what are you doing here? Are you crazy?"

A few minutes later, she received a phone call from the hospital. "They were frantic," she said. "Jason had never shown up for his radiation appointment. That's because he was with us at the time. I told the radiologist Jason was there at the hospital, visiting friends on another floor, and would be right down. I covered for him."

Then she turned to Jason and said, "I will harm you unless you get back to that hospital right now."

His cousins got him back to Manhattan, posthaste.

***

Proud and independent as ever, Jason still wanted to skip treatment. "After the second operation, I tried to get him to do what he was supposed to do, to just show up there at the hospital and fight the cancer," Barbara said. "But I had to fight with him, just to get him to go along with the doctors. It was a constant battle." Team Vale once again went on special alert: watch out for this kid. "Come on now, Jason," Dr. Stephen Malamud, an oncologist at Beth Israel said. "No more shenanigans this time. You're going to get treatment." Jason had second thoughts, his resistance melting into reluctance.

"I prayed to God for guidance and wisdom," he said. "And He told me to get the therapy."

From December 1987 to January 1988, Barbara drove him to Beth Israel for radiation therapy and chemo treatments (the latter consisting of injections of vincristine, adriamycin, and cytoxin). In combining radiation with chemo at the same time, the doctors went all-out to prevent a third tumor.

With each session, Jason grew sicker and weaker, succumbing to the toxins introduced to his system. Chemo is often a crapshoot, the treatment as harrowing as cancer itself, maybe worse. Quickly he lost his appetite and lapsed into nausea and vomiting. He dropped 40 pounds, his weight plummeting from 181 to 141. His temperature periodically soared as high as 104 degrees. He would wake in the morning and discover that overnight, his hair had shed in clumps all over his pillow. If he ran his fingers over his scalp, more came out. With his hair so patchy, Jason asked his friend Mike Messina to bring him razor blades, and he shaved himself bald.

The treatments indeed took a heavy toll. "I saw how sick Jason was during chemo," Barbara said. "That's what made all this so hard for me. He had no appetite. The radiation had burned his esophagus so badly that he could not swallow his saliva. I had to spoon feed him. He could not go to the bathroom. Nothing was functioning right. Some people with cancer get a certain death look. I had seen it in my own father. And that's the look I saw in Jason. His eyes were sunken. He had no eyebrows, no eyelashes, no hair. He was skinny. His hands were emaciated. A death look. For awhile he just laid in his bed at home with a pillow against the window during the day to keep the room totally dark. His room was like a crypt."

She would go down to his room and say, "Jason, I'll let in some light."

"No, it's okay, Ma," he would say. "It's all right."

"Are you sure? It's so dark in here."

"I want to be in the dark. I need this. I like it. It's good. It strengthens me."

As he lay swaddled in the soothing shadows of his room, Jason daydreamed about getting back to handball. Not even chemo and radiation could stop him from imagining his return to the sport. I have to get back to those courts, he thought. I'm going to get back and play.

"I thought about handball all the time," he said. "That's all I thought about. I saw myself making certain shots - boom! - and being even better than before."

He told his friends about his impending comeback. "The second I get better," he would predict to a partner, "I'm going to beat your butt." Look, he wanted to say. It can be done. You can come back from the dead.

To rise anew, Jason prayed every day. He knelt beside his bed and prayed until he heard God speak to him. He read the Bible, too, and found peace in sayings and stories about healing. In Proverbs, he read, "The spirit of a man will sustain him when he is sick." And he took this idea to heart. He would get better; nothing was going to stop him.

"The Bible is the best therapy," Jason said. "t tells you exactly what to do to get healed."

Barbara kept Pastor Marvin Boyce, of the Free Gospel Church in Flushing, posted on his progress. From the pulpit, Pastor Boyce would pass along the latest news and implore his flock to pray for Jason. Almost everyone in the congregation had known Jason since he first attended church there as a baby, and now parishioners wanted a blow-by-blow account.

Shortly after the second chemo session, the pastor came up with the idea of a 24-hour prayer chain. Jason had bounced back more slowly from the second round than he had from the first, and his oncologist had to cut the drug dosages for safety. Slowly Jason slipped deeper into the twilight between promise and doom, the chemo enfeebling him, and Boyce hoped the prayer chain would make a difference.

In a prayer chain, everyone could take turns praying for his recovery. Friends. Family. Neighbors. All people had to do was commit to a schedule telling what time they would pray. At the end of services, parishioners would sign up for a half-hour slot any time of day or night for the coming month. If you might miss doing your duty because of a conflict, you called another member of the church to take over you half-hour. In this prayer chain, dozens of people, maybe 50 or more, would be praying for Jason, hour after hour, for 24 hours a day, day after day, week after week, each one silently submitting a bid for his health and survival.

Still, Jason declined rapidly. After his third chemo treatment, his white blood cell count sank to practically nothing, and he needed a blood transfusion. He developed a fever and went back to the hospital for IV antibiotics and another transfusion. He refused, adamantly, to go back to the hospital for any more chemo. Why did he have to get so sick before he could get well? He felt like a yo-yo, as if her were just being strung along, never knowing for sure what was what. Cosgrove warned Barbara that Jason would die unless he let the hospital take care of him.

Finally, barely able to walk, leaning on Barbara and Joe for support, Jason gave in and returned to Beth Israel for a final chemo session, at a much lower dosage than before. Meanwhile, the participants in the 24-hour prayer chain kept at it. Bernadette and Jimmy Rosario prayed, and so did Ed and Ester Eliason. The Bensbergs, the Francos, and the McKenzies put in a word, too. The Messinas, the Mackens, the Nuccitellis - all patched themselves through on a special hotline to the heavens, as if dialing a toll free number: 1-800-CURE-JASON. Almost everyone at the church prayed, each congregant chipping in a half hour of hope, all day and all night, the voices harmonizing, soaring skyward. The most potent medicine, they believed was not chemo or radiation, but faith.

***

After chemo, Jason hung out in Northern Cue, a pool hall on Northern Boulevard in Flushing, and took up arm wrestling for the first time since high school. his father Joe had taught him the sport at the age of 10, and for years Jason would dabble in it, never more than casually interested. Before the cancer, he could pin almost any other guy in his class, including some of the biggest and strongest.

What he really wanted now was to play handball or street hockey. He even bought himself a pair of $200 roller skates. Hey, let's get down to it. Time to bust heads. But before he could make a move, Cosgrove told him to forget it. The boy had lost three ribs and a chunk of his lung and some vertebrae. Any forceful contact could easily hurt him. He had to face facts. The two surgeries, the chemo and radiation, the infections and transfusions, had siphoned away his strength and his stamina. He could hardly stand. He still walked with a wobble because his legs, for now, were gone. No more handstands in the driveway, and no more quick steps in pursuit of a handball shot, either, at least no now. He needed a sport that called for short spurts of exertion but no legs. Hence, arm wrestling.

Now, in the smoky half-light of Northern Cue, with his frame all but wasted and his head shaven bald, Jason would look at a guy from across a pool table and think, I can take him. Over and over he heard this refrain in his head. Old habits die hard. He still needed to go eyeball to eyeball, to measure himself against an opposing force.

Now, though, he would lock hands with an opponent and give it all he had, only to lose. Still, he kept going at it, because even losing was better than nothing, better than living strung out on Percocet, with tubes in your chest. Here, in this pool hall, Jason would start his rehab. Dim and quiet except for thi hiss of flip-top soda cans opening and the clack of billiard balls, Northern Cue was an environment conducive to recovery. He felt as if he were underwater, the pool hall reminding him of his hospital room with the curtains pulled shut, of his room at home with the pillow stuffed against the windows to keep out the light. Here he would begin to reel himself back from the lip of the abyss.

"Arm wrestling took my mind off everything else," he said. "It was therapeutic. And for some reason, I took it seriously. I wanted to get really good at it."

He would even arm wrestle Shorty, of all people. His real name was Paul, but because he stood 6 feet, 7 inches, everyone naturally called him Shorty. Shorty beat everyone in the joint and Jason was no exception. Just wait, Jason thought. I'll show you. One day Jason went so far as to tell Shorty, "When I'm better, I'm going to beat you." Cool, Shorty thought. The kid had plenty of nerve and they took a shine to each other.

For months, Jason challenged everyone in Northern Cue to arm-wrestle bouts. He resumed normal eating and put on weight and slowly regained his strength. "I prayed God would make me one of the best arm wrestlers," he said. "I felt that if I became one of the best, I would pay it back to God and glorify His name." Within a year, Jason had defeated all the arm wrestlers in the place - except one. But one night he locked hands with Shorty and pulled him down, too.

By chance, Jason heard about an arm-wrestling tournament held every summer at the Queens Day Festival in Flushing Meadows Park. He never realized he could compete in front of a crowd and maybe collect some money or a trophy. He called the promoter of the event for a flier and application form. With the contest only two months away, Jason practiced arm wrestling at every opportunity. He built a table in his bedroom basement, complete with handgrip pegs and rubber elbow pads at both ends, and there simulated matches, pretending to push down and pull back. I can win it. I know I can win it. He thought of a particularly relevant passage from Samuel: "He trains my hands for battle; my arms can bend a bow of bronze."

Now at age 21, and weighing in at a much-improved 165 pounds, Jason competed in the arm-wrestling tournament at the 1989 Queens Day Festival. He won the first match, but lost the second, getting plastered in a blink. "First time I ever lost like that," he said. Still in the running, though, he faced off against the arm-wrestling champion of all of Virginia. Jason could tell by his grip that the guy had more power than he. Grip is the single most reliable measure of overall body strength; a strong grip generally means one is strong. "I knew it would be a hard match for me," Jason said. "I just wanted some respect and to put fear into the guy. I decided that if he was going to beat me, I would make the match last as long as possible."

Instantly his opponent wrenched him low, pushing his quivering right hand to within an inch of the table. In such a predicament, the arm wrestler being overpowered usually loses within 30 seconds. But Jason held his own for a full minute, then two minutes, praying all along. "I held and held until I had nothing left," he said. Then Jason let go of the peg with this left hand, a foul, and the match resumed, until he fouled again, disqualifying himself from the match. "But it's not as if I lost," he said. "I never let the guy actually beat me." Jason had made his point, and so in this, his first tournament, he came in fourth.

He plunged into the subculture of arm wrestling. It's a sport where guys start at the kitchen table and the high school cafeteria. From hanging out with experienced grapplers, he learned the moves and the lingo. Hey, you could go with a wrist curl or a shoulder roll, a crunch move or a drag hook. You could take a high grip with your thumb, then hawk low on a guy and put the hammer down. Gradually, he picked up inside tips. He saw that some wrestlers wore special arm gloves, covering wrist to bicept, that kept the muscles warm during breaks between matches. He learned that the human hand is the most intricate, specialized precision tool in all nature - levers and hinges wired into a network of bone, tissue, ligament, and nerve - and that you generate the most power if you keep your hand within 12 to 15 inches of your chest. He learned that you never shake hands with your wrestling arm because it's your prized instrument (besides, you might rub off the resin you patted on to give your grip some extra traction).

Most arm wrestlers compete for fun or ego or both, and almost none earn a living off the sport. They wrestle in benefits and fund-raisers, underwritten by sponsors such as Budweiser to cover the cost of trophies. They compete no more than once a month, because an individual may lock horns for as many as seven or eight matches in a single tournament. They have to watch out for those inevitable micro-tears in the shoulder and forearm; occasionally a guy comes away with a fractured arm. Competitors stay local, scraping together a few bucks out of picket to travel to major regional or national trournaments out of state, and prizes seldom run higher than $1,000 or $2,000. But the sport is growing fast. About 40 of the 50 states have an arm-wrestling association, championships now draw at least 23 countries. Further, arm wrestling will become an Olympic exhibition sport in 1996.

Jason pulled matches in sports bars and at Lions and Elks Clubs, and subscribed to The Arm Bender, a quarterly magazine. Then, in February 1991, he drove to Stamford, Connecticut, to the Sports Gallery Cafe, for a Yukon Jack Arm Wrestling Championship. About 300 spectators turned out to catch 103 competitors in 11 weight divisions ranging from 121 pounds to 234. Jason, weighing a sliver under 160 pounds, came away the winner of the lightweight division, with a $200 first prize.

"His attitude from the start was: learn, learn, learn," Johnny DiDonna said. "Keep practicing. Gain experience. He knew he was strong and had incredible speed and strength in his wrists. But Jason also had faith in himself, faith in God. He always believed he was going to win. And every time he lost, he saw it as a set of stairs to climb. He would think, 'Okay, I lost, but some good has come out of it."

A month later, he entered the New York State finals and won all six matches in the tournament, capturing another first-place trophy. In September 1991, he returned to the Queens Day Festival for another stab at victory. Defending champion Joe Vanero had seemed virtually invincible. The previous year at the tournament, Vanero had slammed Jason down in about a second flat. How a crowd of about 500 onlookers, including a Vale entourage of now fewer than two dozen family and friends, gathered to watch the confrontation.

"I wanted revenge," Jason said. in the match, first Jason slipped out, then Vanero followed suit, and then out came the straps that bind wrestlers together and they tried again, both tied in place. "My family and friends chanted my name and screamed," Jason said. "I had goose bumps." This time Jason brought Vanero down in a flash, taking first prize. From then on, the arm-wrestling community officially designated him Lightning Bolt.

Al Virelli has seen Jason compete in about 50 matches. An accomplished arm wrestler himself since 1975, the tall, thin Virelli promotes tournaments and also acts as a referee and trainer in the sport. "Jason Vale is very strong," Viurelli said. "But the first year I watched him, I could tell he lacked table time - experience. Once, I saw him go up against Jimmy Fitzimmons, a former national champion. Right away, Jason popped him over. But he had trouble finishing him off. Fitzimmons then had time to think, He, I've stopped him. What should I do to get out of a losing position. And after about a minute, Jason lost. If Jason had ad the table time, he would have beaten him."

Early on, Virelli realized that Jason was different from the others. "He seemed very soft-spoken," Virelli recollected. "He would just go off by himself between matches and stand on the side by himself and pray. I've seen guys before a match who do high fives or bang heads against a door or come out wearing a collar and leash. But Jason stays quiet. Keeps to himself and concentrates."

"Funny," Virelli added. "I was never aware he had had cancer. He never mentioned it to me. I heard about it from Andrew 'The Cobra' Rhodes, a championship arm wrestler out of Muskegon, Michigan. Cobra once got to talking with him and Jason told him about his cancer and showed him the scar. Cobra says it's one hellacious scar."

Before matches, Jason always got himself plenty prayed up. Sometimes, afterward, he knelt and genuflected. One time he took down a guy who had gone nine years without losing, and Jason felt so grateful that he collapsed onto his knees and said thank you to God and walked outside into a parking lot and started crying. "I wish I could explain that feeling I get in a match," he said. "I'm not exactly sure what it is. It's like a heat in the middle of my body. Something inside me cries just as I get to the table. I cry because I've survived cancer. Because I'm there."

While attending Queens College in 1991, Jason ranked as the top middleweight in New York State, number-two in New Jersey, Connecticut, and Maine. He powered ahead with his armwrestling in 1992. Competing as a middleweight (170 to 190 pounds), he went to Albuquerque for the World Professional Arm-Wrestling Association (WPAA) Tournament. In one match, he faced the 1991 national champion, in front of 2,000 fans, his lsrgest audience ever. The opponent brought his hand to within a hair of the padded table, but Jason inched back to dead even, the audience shrieking louder and louder. Can I do it? he thought. Yes. Yes, I can. I can hold out longer than he can. Finally, he lowered the boom and shot his fist exultantly into the air. According to the WPAA, Jason finished the year ranked second nationwide in the 176 to185 class.

"How good can Jason Vale be?" Virelli said. "He can be world champion. No question in my mind. He can definitely be world champion and lead the sport forward. All he needs is a little more training and technique. He's like no other arm wrestler. Once in a hundred thousand like him come along. He's perfect for arm wrestling, just perfect. He has natural ability. He's a good-looking kid. He carries himself like a gentleman. He's come back from cancer. And he's only 24 years old. What else does he need?"

***

Five years passed since his last operation and the angel with the dirty face had already lived a lifetime. Lived through the pain and the Percocet, the CAT scans, the defiance of doctors, the escape from the hospital, the radiation and the chemotherapy, and massages and spoon-feedings from his mother. Nothing would get him down. Nothing and Nobody. He had fought against cancer just as he had Frankie Santos and almost everyone else on the block. And through it all, he had prayed his guys out. Five long years without evidence of cancer was long enough to mean he was almost certainly cured. Healed. To celebrate, the Vale family held no part, popped no champagne. They prayed.

At last glance, Jason was majoring in psychology and maintaining a 3.3 grade-point average. He had organized a team called the New York City Arm Wrestlers, who open every training session with prayer. He had also established a home-improvement business with himself as president. As for Barbara and Joe, five years later they were still paying the balance of his medical bills.

Why has Jason Vale survived? Could prayer alone do the job? Had he simply prayed away all traces of the tumor, no thanks to more conventional modes therapy? Or had he come through this ordeal by dint of his resolve, his spirit of defiance and rebellion? One by one, the witnesses to his recovery come forward to take the stand and offer expert testimony.

"The doctors told us nobody had ever survived that cancer," his aunt, Joyce Vedral, said. "His chances of staying alive were nil. The doctors cannot account for his survival. But I'll tell you this. Jason told me God was going to heal him. He never believed for one second in the possibility that he would die from cancer. And he was never afraid to ask questions or to doubt the validity of the treatments. He refused to let the medical team do whatever it wanted and he questioned everything. He never accepted anything at face value."

Close friend Johnny DiDonna said, "All the doctors thought it would be fatal. I read th report about Askin tumor: everyone who had it died within a year. You just put two and two together. When he got cancer, I think I was more scared than he was." But Jason lived. He believed God would heal him, and he did. If you have a desire to live, you will. It was his whole attitude. He always believed the cancer would pass and he would keep going. No one stayed closer to Jason throughout his trial with cancer than his mother. "It's hard to speculate what would have happened if Jason had had the radiation and the chemo after the first operation," Barbara Vale said. "The treatment might have so weakened his body that when the cancer came back, he might have lacked the strength to fight it. Who knows? Some people have a special purpose, and I think Jason is really a special kid. My friends ask me how I managed it. I deserve no credit. I think of the story, 'Footprints.' It's about a man walking along the beach with the Lord. Across the sky flash scenes from his life. Always he sees two sets of footprints in the sand, one from him, one from the Lord. The last scene from his life shows him low and sad, and he sees only one set of footprints in the sand. He could not understand and he asked the Lord to explain. The Lord said, 'During your times of trial and suffering, when you see only one set of footprints, it was then that I carried you.'"

The last word here does to Dr. John Cosgrove, now the acting chief of the Tumor Service at the Kings County Hospital Center and the State University Hospital in Brooklyn. His expert opinion as a physician carries significant weight. "We all felt Jason was special," he said. "Some patients are tough; you know they're going to do well. Jason was such a patient. You could tell from that look in his eyes and his attitude: He knew he was going to recover. As physicians, we have a sixth sense about something like that. Of course, I could have done without his flights from the hospital.

"But otherwise, he was very committed to getting better, no matter what kind of tumor he had and no matter what anybody said. I've never seen anything like it before or since. He's life. I've always felt that athletes have a singular toughness and sense of commitment. And he refused to let the disease get him down. A lot of other people would have given up. But Jason had one goal - to get better - and that must have helped him recover.

"Jason Vale is an inspiration to me as a physician," Dr. Cosgrove said. "Anytime I'm up all night on call, I think about how this determined 18-year-old kid fought an awful malignancy and came through it, and nothing I go through seems tough in comparison. When I'm tired and discouraged at the hospital, I think of Jason. I would venture a guess that after five years without evidence of disease, he's cured. And I believe his survival is a miracle. How, we have no scientific proof, and it's impossible to measure, but I have no doubts in my mind. It's a miracle."

Amen.
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