Because the cancerous mass was so close to Sam’s brain, they decided to take him to a place where he could get specialized treatment — Memorial Sloan Kettering Cancer Center in New York City. Doctors put a catheter in Sam’s skull, allowing chemotherapy to bypass the blood-brain barrier and go directly into his brain and spine. Tony and Sam commuted to and from New York and Dallas. Whenever Sam wasn’t getting treatments, an organization called Candlelighters of New York arranged special activities, like a personal tour on the Hudson.
Around Christmas in 2019, when Tony’s family was in town, the Pampels noticed Sam seemed to have particularly low energy.
Then on Jan. 2, Sam woke up screaming in pain again. They went to a Dallas hospital and learned he had bacterial meningitis. The port in his head, which was allowing medication to treat the cancer, had become infected.
That began Sam’s longest stay in a pediatric ICU. Doctors administered antibiotics and put a shunt in his head to allow fluid to be expelled from his brain, which wasn’t properly balancing the correct amount of cerebrospinal fluid.
One day, Tony was at the hospital with Sam and the neurosurgeon, who was meeting with them to discuss how the shunt was working. But there was something else.
“He showed me where the cancer was making a very, very aggressive return,” Tony says. “And he also explained to me that because of the damage caused by the bacterial meningitis, all of our treatment options were blocked, and that there was nothing further they could do for Sam.”
Sam had maybe weeks, probably days left to live. Tony and Maude initially hoped to take him home, but they realized it wasn’t possible, and they were transferred to a different floor, out of the ICU. Sam had the biggest corner room, with two beds pushed together, familiar faces in the nurses caring for him and every day, a view of the sunset.
“I think you start to change your mind, and you realize as you walk through it the best decision for your family and for him, what was going to be the best,” Maude says.
The family spent the next six days with Sam. Though he was receiving a lot of pain medication, he was coherent. He ate only one dish, crunchy pudding — chocolate pudding with Honey Nut Cheerios — and was always making jokes.
Once, when everyone thought Sam was asleep, he popped up, held open his eyelids (because he lost the ability to open his eyes normally after the surgery) and said: “Hey, dad. What did the nacho say to the taco?”
“I don’t know, buddy,” Tony replied. “What did he say?”
“That’s nacho cheese.”
Another time, a priest came to the hospital to deliver last rites. As he was putting chrism oil (holy anointing oil) on his forehead, Sam said: “Not yet.”
Sam died Jan. 23, 2020.
At his funeral service, the cathedral at Church of the Incarnation was “packed to the gills.”
“I wish we could find a way for every kid that was dealing with this and every family that’s supporting them to have that level of support,” Tony says.
In September 2020, to honor his son, mark National Pediatric Cancer Awareness Month and raise money for Alex’s Lemonade Stand, Tony decided to make a daily 3/4-mile walk around the neighborhood. It’s the same distance he and Sam walked every day while they were in New York from the Ronald McDonald House, where they were living, to Memorial Sloan Kettering Cancer Center and back.
Armed with a selfie stick and needing a way to share his story, Tony live-streamed the neighborhood walks. He talked to Facebook followers about Sam, his family’s experiences and the organizations that helped them.
On one of the last days of the month, Tony walked out of his house and saw about 20 friendly faces waiting to walk with him. As they headed to the alley, where the walk began, another 50 people were there to join them.
“We received so much from the community, people we didn’t even know …” Tony says. “Community became just such a huge part of our life and helped us in so many ways.”