Mother Courage's story

IT TAKES 365 days for the earth to circuit the sun; a steady, inexorable movement of time compared to the speed with which the lives of the creatures clinging to its surface turn upside down. For 31-year-old Aberdonian, Vanessa Love, mere hours separated the elation of being told that she was expecting twins and the devastation of being told she was suffering from leukaemia.

Her world turned around completely, and in the few months since the double diagnosis in January, Love has refused chemotherapy to protect her unborn babies; gone into remission with the help of anti-leukaemia drug ATRA; had emergency life-saving surgery on a rare bowel disorder; and given birth prematurely to twins Blake and Rohan.

It was at a routine, three-month scan in January that Love and husband Charlie were told that their family of two girls, Amber, five, and Megan, four, would have a double addition. The diagnosis of twins explained a lot. Vanessa had been so tired. Twice she had suffered blackouts. Perhaps, medical staff suggested, she was a bit anaemic. They would take blood tests.

The next morning, the Loves' phone rang at 9am. "You know when the hospital phones on a Saturday that there's something wrong," says Vanessa. "I used to work in a doctor's surgery and I knew it wasn't normal to get a call like that. I had to go in. I think at first I thought I was really anaemic and would need a blood transfusion. But I had more blood tests, a bone marrow test, and in a couple of hours we knew it was leukaemia. It was horrendous."

Vanessa sits cross-legged on her bed in Aberdeen Royal Infirmary, a tiny, elfin figure with a striking, delicate face that looks as if it has been gently chiselled from creamy alabaster. Her cheeks have a faint blush of pink, a physical hint of her returning health. She stands just five feet tall, but her dainty exterior belies the inner determination that has erupted through the surface of her ill-health.

"I think if you had said to me on the Friday I went for the blood test that this would happen, like some awful soap opera plot, I would have thought that I would never have coped with it."

But she has. "She has surprised me," admits Charlie, a computer studies teacher. "She has been so brilliant... strength, that's what it is... amazing strength just to carry on and do what she has to do for herself and her pregnancy and for everybody else as well. She has come to terms with so much."

Vanessa was kept in hospital that first weekend of her diagnosis. Charlie had to leave to tell the family and she was left alone with her thoughts. Her first was for her two little girls. She didn't want them to be left without a mother. In those first hours, when her life began spinning out of control, Vanessa assumed she would start chemotherapy the next week. "When you get a diagnosis like that you just think well, that's it. You have to have chemo or you don't get better."

But when she met her consultant two days later, he gave more options. Certainly, chemotherapy was one. Termination was another. The Loves knew almost immediately termination wouldn't be their choice. They have a religious faith, but while that was a factor, it wasn't the major influence. "We have a belief in God and a faith that this is going to work out for us, that we're going to get through it with His help," says Charlie. "But I don't think we had any big pro-life drama going on. It was more about looking at the options and what would be the best outcome for us as people."

As people, they were parents. They had seen the scan of their babies just days before diagnosis. It was bound to have an impact. "We discussed termination because we had to discuss everything, but we didn't spend much time on it," explains Vanessa. "We knew it was twins and there wasn't really any choice. I just had to carry on."

But which was stronger - her survival instinct or her maternal one? What if chemotherapy had been the only way to save her own life? "I don't know," she says hesitantly, "I really don't know."

When Charlie is asked what he wanted Vanessa to do, he says the most important thing was that it was her decision. "I know her really well. I think I usually know what she's going to do next. But I said to her at the time, 'This is happening to YOU Vanessa. You need to decide what you want to do. The most important thing is how you feel about it and what you can deal with and cope with.'"

But what was his gut instinct? That she would try to save both the babies and herself. "When we spoke to the hospital they said, 'We'll always try to go for the most successful outcome for you first.' They wouldn't put Vanessa at risk. So there was a bit more security in that."

Charlie smiles a lot. He looks like a man who has just left a casino after a night of slowly losing a fortune that at the last minute he won back on the final turn of the roulette wheel. It's not straightforward happiness; there is relief in there and more than a little wonder, even bewilderment.

Vanessa says it's easier to cope with disaster when it's happening to you, that she could not have coped had it been one of her family. "I couldn't have coped if it had been you," she tells her husband. Charlie just smiles, reaching out one finger from where he leans on her bed to gently stroke her knee.

Vanessa's decision to take ATRA instead of chemotherapy was a leap of faith. "We were in limbo for an awful long time." The first test was done six weeks after taking the drug. "The first bone marrow aspiration showed the leukaemia cells had lessened but were still present. I think we were both hoping that I would take the tablets and that would be it. A miracle.

"It was another six weeks till we got another test but we just had to keep going. The next one showed the cells were leukaemia free and that was great. It wasn't very long, but it seemed like a long time and that was the worst time for me."

The treatment worked exactly as doctors planned. The drug would put Vanessa into remission until the babies were born, and afterwards she could then begin a course of chemotherapy. But, naturally, the Loves still had worries about the possible impact of ATRA on the babies. Low birth weight was one potential side effect. The plan was to try to get to at least 34 weeks before delivery. Nature, however, had other plans.

On Friday, May 13, Vanessa was taken into hospital complaining of severe pain. She was kept in hospital for tests and by Monday it was apparent that there was a problem with her bowel. One baby was lying on each side of her stomach but her bowel sat in a band across it, and was so heavy it was like carrying a third child. She was taken straight from X-ray to theatre. "I didn't have much time to think about it which was probably good. I just remember the mask going on and thinking, what next?"

The babies were only 30 weeks, a crucial four weeks short of the hoped-for delivery. The Loves were desperately hoping surgery could be done without prompting delivery. But the surgeon made clear to Charlie that was unlikely.

"A peace came over me straight away when he said we were not going to have any choice," recalls Charlie. "That was fine. That was going to happen." There was an element of relief. "She was in such pain, such agony. She was exhausted and I was so worried about her. I didn't know what they were going to find." Was he preparing to lose her? He pauses. "I think I was actually. I think I was."

He was in a room next to theatre when the babies were delivered. Someone kept sticking their head out of the door to update him. Then he saw Blake lifted out. The baby was wheeled past him in an incubator to a waiting ambulance. Doctors had expected a birth weight of over two pounds. But Blake was 3lb 9oz. Rohan followed one minute later.

"I could see immediately he was smaller," says Charlie, though even he was 3lb 5oz.

Vanessa remained in surgery. Her bowel condition is one which develops in the womb; she was the oldest presentation of it that doctors had seen. She had gone to surgery not knowing what doctors would find, or what would happen to her babies. When she woke, her first thought was of the change in her body. "I really had the sensation of oh gosh, they're not there." Wired up to various tubes, she had to wait three days before undergoing a painful wheelchair journey to a separate building where the babies were.

When Vanessa was diagnosed, Charlie recalls the list she made of things she hadn't done in life yet. Joined a gym. Travelled. They had both been to Venice separately but she wanted to go together. They are hopeful they will one day make that journey.

"The chances for Vanessa are really good," says Charlie. "Things are really positive." She will start her chemotherapy in two weeks. "The drug put her in remission but it doesn't cure the cause of the leukaemia. Hopefully, chemotherapy will flush the problem away."

Vanessa thinks their relationship has changed a little. "Charlie was always a bit stronger than I was. I think that's maybe shifted a little." And what does Charlie think? "I just love her to pieces," he says. "I always have."

Unaware of just how hard their two baby brothers have been fought for, Amber and Megan Love are less than impressed by the family additions. "Are they still boys?" Megan asked after one scan, hopeful that some miracle might have transformed male chromosomes into female ones.

Miracles seem not impossible in the Love household. A 10-minute walk from Vanessa's room, Blake and Rohan Love lie in the special-care unit. Vanessa has been told she can go home, but the twins will remain here at least another six or seven weeks. Until then, life revolves around the hospital.

They are in separate rooms in the unit, Blake already stronger and less dependent than Rohan. Blake is tiny, pink, beautiful in his miniature perfection; but it is perhaps Rohan who stabs most keenly at your heart. Rohan with the concert-pianist fingers, who lies asleep in just a nappy, his matchstick legs bare. Periodically he starts from sleep, his arms and legs kicking out as though an imaginary current has passed through him. It is like looking into a glass nest at a tiny, unfeathered bird, fragile as cracked eggshell.

It makes you think of his mother, that delicacy, and if you wish anything for Rohan as you look at the ventilator helping him breathe, it is that he has been gifted even half of her fighting spirit.

HOPES GROW OF FINDING A CURE

LEUKAEMIA is a cancer of the blood which occurs when too many white cells are produced.

Around 21,500 people are diagnosed with leukaemia in the United Kingdom every year and it is still fatal for more than half of those diagnosed with it.

But in the past 20 years there have been a considerable number of breakthroughs in finding a cure.

In the mid-1980s researchers working in Shanghai found that ATRA, an oral vitamin A derivative that had previously been used for off-the-shelf treatment for skin cancer, was a potent drug against acute promyelocytic leukaemia (APL), a rare blood cancer that up until then had been uniformly fatal.

But scientists found that high dosages of ATRA could cause APL cells to 'age' quickly and die without causing bleeding problems. The advent of ATRA therapy revolutionised the treatment of APL and markedly improved patients' outlook.

But there are serious potential side effects of ATRA treatment, including fever, respiratory distress, and abnormally low blood pressure.

ATRA is therefore used in combination with chemotherapy including an anthracycline drug.

Survival is better with the combination of ATRA and chemotherapy than chemotherapy alone.