Andrea Allen, a 10-year-old girl with a brain tumor, didn't want to undergo surgery this morning at Johns Hopkins Hospital, but she finally agreed to the dangerous procedure after being promised a visit with a very special friend.
The friend is a "hearing ear/mobility" dog named Pepper who was specially trained to help Andrea get around despite disabilities. Earlier surgery on the tumor left Andrea with weakened legs and hearing, and speech difficulties.
Renewed growth of Andrea's tumor was found to be inoperable by her doctors in Rochester, N.Y., and she was referred to surgeons at Johns Hopkins Hospital.
Her mother, Susan Allen, said Andrea had been "very depressed" about the return of her cancer and about the prospect of traveling to Baltimore without Pepper. But Andrea brightened like a Christmas tree yesterday when she spotted her dog across the lobby of the Johns Hopkins Children's Center.
"Pepper! Baby!" she squealed.
The two reunited with hugs and wet kisses. "This is the best she's looked in a month," Mrs. Allen said, wiping tears from her eyes.
Pepper, a gentle, 3-year-old mixed retriever, and her trainer, Beverly Underwood of Canine Helpers for the Handicapped Inc., were flown from Rochester to Baltimore Tuesday. Larry Wine, of Honeoye Falls, N.Y., provided the $1,500 air fare after he reading about Andrea's situation.
Andrea and Pepper were to have a visit this morning before her 9 a.m. operation. That was part of the agreement Andrea reached with her mother in consenting to the surgery.
The cancer on Andrea's brain stem was discovered shortly before she was 2. Radiation stopped its growth but surgery to remove part of it left her with disabilities that require her to attend special education classes in Rochester. She walks with leg braces and uses a hearing aid.
Dr. Benjamin Carson, the pediatric neurosurgeon who was to lead today's eight-hour operation, said the tumor "has started growing quite rapidly. . . . So, the way I look at it, there is very little to lose and a tremendous amount to gain by going in after it again."
Dr. Carson's job will be to get inside the tumor with micro-neurosurgical tools and reduce the mass from the inside out. The goal is to destroy the tumor without damaging the surrounding nerve fibers.
"I think we have at least a 50-50 chance of being able to get in and remove all or most of it," he said.
"It will be difficult to get to it, but, with God's help, we'll get there," he said. "Say some prayers for her."
Radiation or chemotherapy may be needed later, but, unless the tumor has changed to a more sinister form since her last surgery, Dr. Carson said, "there is a reasonable chance that if we can remove it, it will be gone."
Andrea is overdue for a miracle. Her parents are divorced, and her mother has breast cancer. Mrs. Allen determined to find a trained dog that could help Andrea live more independently, helping to steady her uncertain steps, open doors and switch on lights.
After being turned down by several dog trainers who regarded Andrea's youth and handicaps as too great a challenge, Mrs. Allen last year found Miss Underwood at Canine Helpers in Lockport, N.Y.
Andrea and Pepper were fast friends and, last August, after the two graduated from eight months of training, Pepper went home to live with Andrea. The girl and the dog became inseparable, and last fall began going to school together.
But last winter, Andrea's tumor began to grow again. She grew moody, with memory problems, and her control over Pepper became erratic.
As the stress on Andrea and her family grew, the dog, too, became "stressed out" and confused, Miss Underwood said. In March, when Pepper's behavior became a problem at school, her trainers took her back for several weeks of retraining.
Pepper was ready to go home to Andrea around Easter, Miss Underwood said, but she felt the child was too busy with medical tests to take responsibility for the dog.
But "not having the dog with her for what she was facing" was devastating the child, Mrs. Allen said. So she hired an attorney in a bid to get Canine Helpers to return the dog immediately.
The adults finally agreed to a brief reunion before Andrea left for Baltimore, and then Mr. Wine's gift permitted three more visits at Hopkins before today's surgery. But Pepper was to fly back to Rochester today, and a permanent reunion will have to await Andrea's recovery.
What mattered to Andrea yesterday was the brief visit with her "best friend."
"Kiss?" Andrea asked Pepper in a game they played over and over. Pepper responded with a flurry of licks to Andrea's face, which she answered with a wipe of her hand and a loud "Yeeeeuck!"
Then it was time to go. "Say, 'See you later, Pepper,' " her mother prompted as she lifted Andrea into her arms and began to walk away.
"I'll miss you, Pepper. Bye Bye," Andrea said.
Pepper sat up, her ears cocked toward Andrea, and whimpered.