by Karin Aharon
“Listen,” I said to Jonathan as I stepped outside, and into the crowded street, “if the results are positive, they’ll call to schedule a meeting, because they don’t give them over the phone. They send a letter only if they’re negative.”
“Great,” he replied, as if it had nothing to do with him.
“Mom’s mutation is not as dangerous. But still, it increases chances for other types of cancer. Did you know that men can also get breast cancer?” I tried making him realize that he needs to be cautious about it. It wasn’t something he could just brush aside.
“Are you implying that I’m fat? It’s not breasts, it’s all muscle.” As usual, he was trying to joke around and avoid any form of serious conversation.
“Hardly muscles,” I mocked him.
“I don’t think I’ll take the test for now, it doesn’t seem that urgent.”
“As you wish.” I gave up. I didn’t understand how he took this so lightly. I always had the need to know everything. “I’ll talk to you later.” I decided to leave Jonathan with mom. In any case, he would only listen to her, so if someone could convince him, it was only her.
***
The next day, I met Sarah in the small kitchen.
“You won’t believe the guy I met yesterday, he was stunning.” This explained her insanely large cup of coffee. “So, how was the test yesterday?” Sarah put the milk back in the fridge and leaned against the kitchen counter, while I was contemplating what tea I would have.
“They took some blood, and now we wait.”
“Great. Fingers crossed that the results are negative.” Sarah cupped her coffee mug and tried warming up. I really can’t understand why these offices are always freezing. “But, what do you do if you have the gene?”
“Once you’re done having children, you have an oophorectomy to remove your ovaries. There also these crazy women who remove their breasts so they don’t get breast cancer.”
“Wow, that’s pretty extreme. Ok, let’s hope yours are negative, and that’s it.”
“I don’t think so. When it comes to me, anything that can go wrong – goes wrong.”
“Don’t think like that, sweetie. See what gorgeous kids you have. It’s not all bad. Come on, I can hear Nathan coming. Let’s pretend we’re working, so that things don’t get really ugly. Chinese today?” she yelled while heading to her office, and then disappeared.
I went back to my room, the same one I had after coming back from my maternity leave, and took comfort in knowing I could close the door and drink my tea in silence. At home I hadn’t drunk hot tea in a long time.
Chapter 15
It was my twenty-ninth birthday. Michael came home early from the office and we took Adam and Ariel to a jungle gym at the mall, a typical outing for a young mom celebrating her birthday. We had already strapped the kids in their car seats, and had sat in the car when the phone rang. An unknown number was never a good sign. I answered and the call connected to the car speakerphone.
“Shirley Moshe?”
“Yes?”
“We’re talking from the genetics clinic,” I felt my pulse rise by the minute. “I’m calling to schedule an appointment for you with our team of health consultants.”
“OK,” I didn’t get any letter in the mail, I thought. The results were positive. I felt my heart pulsing and I couldn’t breathe.
“Wednesday, two weeks from now at five thirty, does that work for you?”
“OK…” I looked at Michael like a sad puppy, I think he understood what my look meant. Adam started shouting “tele bubbies, tele bubbies”, and Michael tried looking for the CD in the glove compartment box.
We didn’t speak all the way. Michael probably didn’t know what to say, and I was too shocked to speak. But there was one thing I did want to say – why me? Why was I dealt this screwed up hand? I woke up healthy on my birthday, and now I will end the day knowing that horrible disease is coming my way. However, I kept quiet since Adam was old enough to understand. I just wanted us to park, so I could get out of this cage.
When we arrived, I left Michael at the jungle gym and went to the bathroom. It was the only place I could have some privacy. On my way I looked at the other people, walking around without any worries. I just wanted to scream. I could barely hold the tears in, until I found an empty stall and closed the door behind me. Although I knew there was an actual chance it would happen, I couldn’t believe the results were positive. Couldn’t they have waited until tomorrow? They simply had to call on my birthday. They have my date of birth on file, for god’s sake, how insensitive can they be?
I leaned against the door and cried quietly. I could hear behind the door a couple of women casually talking about different discounts and sales they just had to go to. At that moment, it sounded like they were having the silliest conversation in the world.
And then I thought about mom. How would I tell her? How could I break her heart like that? It was obvious she would blame herself. I decided that my birthday wasn’t the right time to tell her that I too would probably have to face this terrible disease. I knew that mom would have a hard time hearing such a thing. Ariel was the next thought that crossed through my mind while standing in that reeking bathroom stall. What would I have done if I had known before? What do I do if the terrible gene has passed on to her too? How could I live with myself?
“Are you OK?” Michael sent me a text, bringing me back to reality. I didn’t have a choice, I had to get out of my hiding place and go back to being a mom.
“No,” I honestly replied, and tried pulling out some tissues from the annoying dispenser that would produce only one square at a time, “but I’m on my way.”
***
“What does that mean, exactly?” Michael asked when the kids fell asleep and we could speak without being disturbed.
“It means that I have the gene. Just like I told you,” I rubbed it in. In fact, this time, I wanted to be wrong. I threw my clothes into the washing machine and went to bed. What a screwed-up way to end my birthday.
“So, now what?” Michael laid on the bed and looked at me.
“Now we try not to die from cancer.”
“Good idea,” he said, “and how do we do that?”
“I actually don’t have a clue, but I don’t want to talk about it right now. I want to go to sleep and be done with this terrible day.” I turned my back to Michael and turned off the light. He placed his arm around me and hugged me. We stayed like that until he fell asleep and then I gently rolled him on his side.
That’s how my sleepless night began, only this time I couldn’t stop crying. I felt as if I had been sentenced to death. That’s it. My life was cut short. In a couple of years I’ll get sick and then die. That’s all I could think of, over and over. I thought about all the things I wouldn’t get to do. I won’t see my kids growing up, won’t get to see them getting married, won’t get to know my grandchildren. And if they have the gene, what would happen to them? Who’s going to be there for them? There was nothing that Michael could say that would calm me down. It was obvious things could never go back to the way they used to be.
Now, what should I answer when someone asks: “do you have any health issues?” So far, I answered ‘no.’ But now? “No, but I have a high chance of getting cancer.”
In the morning I woke up feeling like a different person, but definitely not a better one. I felt as if I could never smile again. I came to the office with even less enthusiasm than usual. I threw my purse on the chair in my office and went to the kitchen. I stared at the kettle and completely disproved the theory that a watched pot never boils. I didn’t even feel like turning around when Sarah walked in, and by simply hearing her ‘good morning’ I could tell she had a better evening than mine.
“Morning,” I replied in a tone indicating that the word ‘good’ would not come out of my mouth today.
“Well, did you have a party yesterday? Did you go out?” “No.” She couldn’t sense the tone.
“We were at the mall with the kids. But I wouldn’t call it a party.” I poured the boiling water into the mug, but mostly onto the counter. “Oh, crap.”
“You’re such old drags.” Sarah elegantly pushed the capsule into the machine and leaned against the dry part of the counter. Her curls bounced happily from side to side. I took a rag and started wiping the puddle, but the water had already started dripping to the floor.
“The clinic called me yesterday to schedule an appointment,” I said while on my knees, without looking up at her, “it means the results are positive.”
“Why are you jumping to conclusions?”
I stood up and gave her the angriest look she had ever seen, “because they said that if it’s negative, they send the results in the mail. So, it’s not negative. What else can it be?”
“It still doesn’t mean anything. When did they schedule your appointment?” Sarah whisked the milk for her latte and I finished mopping up the floor.
“In two weeks.” I finally made some tea.
“OK, so wait for your appointment and listen to what they have to say. It doesn’t always end badly.”
“So far, your theory hasn’t really proven itself. In any case, I’m tired. I’m going to start working so I can be done with this day.” I didn’t wait for her encouraging response, and took my tea, because there was nothing she could say that would help. She couldn’t even begin to understand what I was going through.
I walked really slow holding my tea; I was too tired to mop other floors.
Chapter 16
I cried myself to sleep every night, and in the morning pretended to be a lawyer and dragged myself to the office. I wasn’t actually working, more like trying to get through the day without doing any damage. My indifference to Nathan’s comments was bordering on rude. I even lacked the patience to answer all his silly comments. Nathan kept blaming the children for my distraction and made a point to constantly mention that a lot of lawyers who are also mothers, in fact get their work done (“are they also about to die?” I wanted to ask, but kept quiet). Even Sarah couldn’t cheer me up with her usual “everything will be fine”, but at least she was now helping with some of my cases.
The only case I could somehow focus on was ALUT’s. Joel was charming and patient, but he spent his days caring for people with special needs, so it seemed inappropriate to whine to him. After all, I’m completely healthy, how can I complain?
On the day of my appointment, Joel came over to look at the depositions we wanted to submit. “God willing, everything will be fine,” he said at the end of the meeting.
“Amen.”
“Don’t forget you’re welcome to visit us and see the hostel for yourself. I thought to arrange a meeting with the parents, because they have a lot of questions.”
“Sure, I’ll talk to Nathan and we’ll put something together.”
Joel left and I quickly grabbed my purse. Natalie wasn’t available so I had to pick up Ariel from home and drive to the genetics clinic, at the afternoon rush hour. Adam had a playdate with a new friend from daycare and I was hoping that mom wouldn’t call me during my appointment.
Michael met us by the clinic’s front door and helped me carry the stroller to the second floor. In the waiting room, I sat quietly and didn’t utter a word, which was very unlike me. Ariel was playing in her stroller and I stared at her thinking about what her future might hold. Or actually what her future held because of me.
We entered the room and Dr. Gidron smiled at us as if this were another pregnancy scan.
“How are you, Shirley?” The geneticist started speaking as soon as Michael closed the door.
I wanted to answer that I was feeling crappy and I hated everything about this world, but I held it in. “Well, since I’m here, it seems things could have been better.”
“So, as you have probably realized by now, the test results came back positive and you’re a carrier of the BRCA1 genetic mutant,” she looked at the papers in front of her as if she needed them to give me the news. “Which means that you have an 85% chance of having breast cancer, depending on the research.”
“OK,” Ariel started whining in her stroller so I sat her on my lap. She pulled out her pacifier and started banging it on the table. Everyone turned their attention to Ariel’s big eyes and smiled at her.
But there wasn’t much of a choice and the geneticist continued. “Your chances of getting ovarian cancer are 50%, again, depending on the research. You can choose to have a preventative surgery. It won’t eliminate your chances of getting sick but it will reduce them considerably. If you remove your ovaries, you could reduce your chances of getting breast cancer by 50%. We recommend having that surgery at the age of 40. Breast amputation is also an option you could consider.”
“What does that mean exactly?” I really tried to focus, but felt that I couldn’t.
“We remove the existing breast tissue and reconstruct the breasts at the same procedure. But you should also remember that it only reduces your chances, it doesn’t eliminate them. You can choose whether or not to keep your nipples.”
“I don’t think I’ll do that.” I looked at Michael, who simply shrugged and kept silent.
“All right. I understand that you have two children. If you want more, I suggest you hurry up.”
I looked at her with shock. “Wait, these are my only options? Removing everything?”
“Look, you’ll have semi-annual checkups, and if something comes up, you’ll be treated immediately.” I looked at Michael and then at the doctor who kept talking as if reading from a grocery list. “Ovarian cancer isn’t something we can detect early, so the only solution is removing the ovaries. It’s all written down in this letter.”
Dr. Gidron nodded in consent. I remembered that a friend from law school had told me about a girl who had a preventative breast removal surgery because her mom had breast cancer. I was shocked by the choice she made, but back then I didn’t know what having this gene meant. I didn’t even know it existed.
“At the moment, I’m not removing anything. I’ll have regular checkups.” I looked at Michael again, but he was too busy picking up the pacifier Ariel kept throwing on the floor. “All right,” the doctor handed me my verdict letter, “wishing you good health.”
“Wishing you good health” was the least appropriate thing she could have said. I won’t have good health, I thought to myself. Perhaps she should have wished me good luck?
I smiled politely and left holding Ariel in my arms. A young woman held the door for Michael, who followed me with the stroller. She entered the room and closed the door behind her. We waited for the elevator in silence. I didn’t know what to say to him.
“You’ll have checkups and everything will be fine,” Michael told me as we left the building, but I think he was saying it more to himself.
“Were we at the same meeting? Because I don’t think you understood what they were saying.”
“I understood perfectly well. There is also a chance that you won’t get sick, you know?”
“So far your statistics didn’t really prove themselves. In a few years I’ll get breast cancer and die. That’s what’s going to happen.”
“You can’t know for sure. There must be women who have the gene and didn’t get sick. You’ll have checkups as they recommended and everything will be fine.”
“Stop telling me ‘everything will be fine’, Michael. Nothing is fine. You have to accept that. Besides, what do you care? You’ll be a desirable widower and you’ll find a new wife. Widowers are even hotter than divorcees.”
“You might be right,” Michael said teasingly and hugged me. “See, everything will be fine.”
“Shut up,” his hug finally helped me release the tears I had held in,
“only I’m allowed to joke about it.”
We stood there for a long time, hugging next to the green trash cans.
***
Ariel was surprisingly quiet, which allowed me to call mom on the way back home.
Mom felt guilty. As if it were her fault that I got this gene. I explained to her that it was completely the other way around. Thanks to her being sick I was able to find the gene early, take care of myself and get an early detection if something will go wrong. I told her the truth, that she had actually saved me, but at this moment I could hardly believe it myself.
We picked Adam up and went back home. We barely spoke. Michael was in charge of bath time and I made omelets.
At night, when everyone was quiet in their beds, Michael hugged me and said, “maybe they’ll find a cure for it in a few years, something genetic that will fix the deficiency. You can never know. Science is constantly evolving.”
“Maybe. But I am now entering the danger years. I don’t have time to wait for a miracle. It might be relevant for Ariel, but not me.”
“She might have not gotten it from you. Maybe she got my exquisite genes?”
“I wish. You can’t say that I didn’t try upgrading my Ashkenazi genes,” Michael laughed.
“Nothing beats the Yemenites; great genes.”
“I don’t think I’ll be able to fall asleep tonight,” I said and laid on my back. I noticed the dust on the lamp. “There are too many things bothering me.”
“So, what do you want to do? Do you want to watch a movie? We recorded some that we haven’t seen yet.” Michael looked for the remote control. We recorded the movies while I was pregnant with Ariel, and we still haven’t found the time to watch them.
