He was passionate about his profession. He believed in its power to heal and transform. He believed in his company, Twenty-Two and You, as the guiding hand of this transformation. He believed in himself. He was a doctor, and his job was nothing more or less than helping those in need.
He knew Ellen's story before he entered the room. He had read the history she had provided. With minor variations it was the same history and story of every patient who came to Twenty-Two and You. A bad gene, or genes; an uncertain future. He had no need to hear it again, yet hear it again he did, sitting in a chair opposite her, folding his hands in his lap, meeting her eyes and listening patiently without interrupting as she laid it out for him.
When she was done, he asked some simple questions designed to draw her out further, to allow her to express and unravel, at least a little, the complex knot of her feelings. She hadn't expected this, had assumed he wanted it cut and dried and to the point, and was taken by surprise. Her feelings? What manner of doctor was this?
"It's late," she said. "Are you sure you want to know? Do you have time?"
It was an honest question but also a warning, disguised as a little joke. It could get messy, she was telling him. Emotions could fly. Much was bottled up inside. Was he prepared for what might happen when the bottle was uncorked? More to the point, could she trust him enough to let down her guard?
He glanced at his watch, then slipped it off his wrist and into a drawer. Then he settled back in his chair.
"We'll talk. First you, then me. We'll put our cards on the table. We'll make time."
He had an easy manner and spoke with an accent. Eastern European…Balkan maybe. Something that from other lips could have come out guttural and harsh. From his, almost embarrassingly gentle.
She drew a breath, then began. A fistful of wadded-up, tear-soaked tissues later she wiped her nose, heaved a sigh and was done. She hadn't meant to cry. Doctors were either uncomfortable with tears or else they treated you like a child. But there it was. He'd asked for it.
Everett sat beside her. Midway through her unburdening he'd taken her hand and continued to grip it tightly. She was grateful for his presence. She could have done it alone, but he was a rock. Together, they waited for the doctor's response.
He began by thanking her for being open and candid with him. Anger, fear, frustration, and all the rest were natural. Hope was natural, too. Not that she'd mentioned it, but he knew it was there. Why else would she be sitting in this room?
"Now I'll be candid with you. There is hope. More than hope. We'll fix this gene. If you like, we'll turn around your future."
"I like," she said.
He held up a hand. "Please. You need to understand the full picture.
"This gene of yours is part of a constellation of genes. Like stars, but close to each other. Like a family. They live together in a big neighborhood. A shtetl. You know what a shtetl is? Like that. This family, they visit each other. They work together. They separate, then come together again. Maybe they actually join and make a new family. Maybe they have offspring. Whatever happens, everybody knows about it. Big family, small town, word gets around. If one member makes a change, the news travels fast. Some in the family could care less. They go about their business. Other members—now we'll say genes—they change, too.
"Change makes change. You fix a tire, your car runs better. You fix TESS 233, you run better. Cancer-free is always better. But maybe you run differently. Maybe you experience another change."
"Like what?"
"Maybe you do, maybe you don't. Change creates a ripple, a ripple creates change. You see what I'm saying? A ball in a box is a ball. You take the ball out and kick it, or throw it, you put it in motion. This motion starts a chain of events. Your ball takes on a life of its own."
"You're saying there's a risk," said Everett.
"There's always a risk. With any treatment."
"She could end up not cured?"
"This is unlikely. We have an outstanding rate of success. Close to one hundred percent. We'll fix this gene of yours. We'll break it apart and sew it back together like new." His eyes swung back to Ellen. "You'll have a healthy gene. You'll be a healthy person. You can have all the little ones you like. They'll be healthy, too. Free of TESS 233. We'll eliminate that from the picture. We'll make another picture. A valentine for you. Health. Happiness. Family. Your heart's desire. We'll put ourselves out of business."
He smiled. "I joke. It's an old joke. A doctor's joke. We do our job well, we'll never see you again. For us, this is not a problem. We have plenty of work. For other doctors—oncologists, rheumatologists—the future is not so rosy. We engineer genes, we engineer their demise. It's sad to say, but what can you do? Progress is a god. A great god. God of the impossible. But not a god of mercy."
"You said I'd change," said Ellen. "How? Please be specific."
"I said maybe. The chance is roughly fifty-fifty."
It was a substantial risk. He watched her closely to see how she'd react, then swiveled in his chair, opened a drawer in the desk, and pulled out an eight-by-eleven-inch laminated card. On it was a busy diagram with an oblong shape in the center surrounded by similar but smaller shapes connected to it and to each other by bidirectional arrows. The large shape was labeled TESS 233. The other shapes, he explained, represented genes and gene products that interacted with it. Each could have been at the center of its own diagram. Start anywhere, and you could get anywhere else. From the smallest gene to the largest, from a single molecule to an entire cell. All paths were joined. In the end there was only one path, and that was the body.
He called her attention to one of the small oblong shapes colored a royal blue and labeled DMTF, 18p5.7. The 18, he said, referred to the chromosome number. The p, to its short, petit, arm. The 5.7, to the gene's location on that arm. DMTF stood for Dynamic Memory Transcription Factor, DYMETRA for short.
"This plays a crucial role in the brain," he explained. "It's the hub of memory maintenance. I think of it as the jealous sister in the family. She's used to being center stage. If TESS gets a facelift, DYMETRA's going to know about it. Half the time she lets things be and goes about her business. But half the time she makes a fuss. Floods the brain with her transcript. Shows how important she is."
"What happens then?"
"The brain is a plastic organ. Memory is the most plastic of all. It's like rubber. DYMETRA recruits other genes in the family. Some turn on, some off. Memory gets reshaped. It's a small change usually. A small effect. Most of the time it's barely noticeable. Sometimes not noticeable at all."
"Like what?" asked Ellen. "Give me an example."
"Maybe you forget a face. Or forget something you said. Or where you put something. Things like that."
"Is it permanent?"
"How do you mean?"
"Do you ever get the memory back? Or do you get it but keep forgetting over and over? Does the process stop?"
"We've only been offering this treatment for two years. We don't have long-term results. In the short-term, sometimes yes, sometimes no."
"It doesn't sound so bad," said Everett. "Hell, I'm forgetful now. We could handle it, El."
"It sounds like Alzheimer's," she said.
Stanović shook his head. "No. Alzheimer's is a different beast."
She imagined how it might be, forgetting things. It was always annoying when it happened. Frustrating at times. She could see how it could get embarrassing if it happened a lot. But life-altering? It would depend on the degree.
She asked him about that. "You said the effect is usually small. Have you seen a large effect? How often does that happen? What's it look like?"
"One time," he said, raising his index finger as though it required emphasis. "A patient of ours, a man, forgot his wife. It was a difficult situation. Very troubling for all concerned."
"What do you mean, he forgot her?" she asked. "Like what? Completely?"
Stanović nodded.
"How awful."
"We tried many different things to help. Called in experts. Hired consultants. Sent counselors to their home. We took it very seriously, I assure you."
"And?"
"After six months his wife moved out. There was nothing we could do."
"She deserted him?"
"She was a young woman. And extremely unhappy."
"That's horrible," said Ellen. "How could someone completely abandon someone they love like that?"
Stanović did not point out the obvious, that the wife had been abandoned as well, and first. "It was very sad."
"It's not going to happen," said Everett.
She turned to him. She was shaken. "What? I won't forget you, or you won't move out?"
"Neither."
She stared at him.
He stared back, then left his chair and crouched in front of her.
"Take my hands," he said. "Now look at me. Now tell me: do you think you can forget me? Do you possibly believe you ever would?"
He had the most beautiful eyes. In every way he was a beautiful and memorable person. What could she do but shake her head?
"Now tell me: do you think I'd ever leave you? Ever?"
A slightly harder question, only because you could never know someone else's mind as well as your own. Except maybe in this one case.
"No," she whispered.
He turned to Stanović. "How many times has something this extreme happened? Remind us. Out of how many treatments?"
"One time. Only one. Out of twenty-three treatments. As I explained, small effects are much more common. But listen. There's more to the story. A new development. Do you have time? Would you like to hear?"
"Yes," said Everett, then glanced at Ellen, who wasn't so sure. But curiosity got the better of her, and she nodded.
Stanović leaned back in his chair. He was pushing the envelope a little of what it meant to be a doctor. Stories of other patients weren't usually told in such detail, though this one could easily be justified from the point of view of full disclosure of risk. And he had to admit, he enjoyed telling it.
"The wife moves out. Time goes by, and he forgets her again. He loses her memory, as it were. He goes back to work. He's living alone, a young man, and he wants to meet women. He goes to a bar one night and sees someone he likes. Pretty face, nice figure. She's talking to the bartender and doesn't notice him. The room is crowded, and he pushes his way toward her. The closer he gets, the more he likes what he sees. He feels something inside. Chemistry? Would that be the word?"
"Chemistry takes two," said Ellen.
He shrugged and continued. "The woman turns, and who do you think it is?"
"His wife. What did she do?"
"Told him to go away. Leave her alone."
"Poor guy. So now he wants her again, but she doesn't want him." She pitied them both. "Or are you saying something else? That he knows her. He remembers."
"He knows something. Chemistry, memory, two pods of a pea."
"That is such a sad story."
Everett felt differently. He took it as affirmation that certain things could never be forgotten. This seemed a fact of life, powered, as facts could be, by the twin engines of love and youth.
But Stanović was not finished. There was more to the tale.
"She told him to go away, but he didn't. He bought her a drink. Then another. And what do you think happened next? They went home together."
"I like that," said Everett.
Ellen did too, though she also knew that a woman, if drunk enough, would do many things she might regret the next morning.
"And now?" she asked. "Are they back together? Is he still forgetting?"
The results on that, he said, were not yet in. Although the man's memory, it seemed, was stabilizing.
"What did he have?" Everett asked. "To begin with? What was wrong with him that needed to get fixed?"
It was a common question. People were naturally curious. Some found comfort in comparing themselves to others. This, too, seemed natural, though in Stanović's experience it was rarely helpful and frequently harmful, and not, therefore, a practice he condoned.
"What he had is not important. The important thing is that he came to us. And that we cured him. And that for him life goes on."
He paused to give this last thought its proper weight, and to allow his visitors to do the same. The story about the man and his wife was useful, possibly applicable, but mostly it was a detour, a digression, a mild indulgence on his part. What happened to one person should not be generalized. The case was extreme and unlikely to recur. It was time to return to the matter at hand.
"The going on, that is most important. It's why you're here. We're all in agreement on this. Yes?"
"Yes," said Everett.
A moment passed before Ellen nodded.
Stanović gazed at her. "You have reservations?"
"No," she said.
"But something else to say?"
She heaved a sigh. "I wish I didn't have to do any of this. Not this treatment of yours, not some horrible surgery, not anything. I wish I'd gotten pregnant first. That was my plan. I wish I'd stuck to it."
"Pregnancy in all likelihood will trigger the cancer. And it's a bad cancer. You may not survive."
"My mother did."
"You mother is different. She has only the TESS gene. You have TESS and more. Pregnancy is a time bomb unless we do something first. Even if you don't get pregnant, you're still at risk. But it's not so urgent a matter. We can monitor you. Watch and wait."
She knew all this. She also knew what she was going to do. But it helped to talk it out.
"I wish I didn't have to put you through this," she told Everett. "It's not what you bargained for. I'm sorry."
"Don't say that," he said. "Don't even think it."
"I wish I was normal."
"You are normal. You're better than normal. I can't begin to tell you how much better."
She turned to Stanović. "I have one request. There's a gene for eye color, right? While you're messing around in my DNA, please change mine to my husband's. Then there'll be no doubt whose eyes they're going to have. Assuming this works."
"It works," said Stanović. "Children will come. Eye color we can do. But there we stop. It's unpredictable what happens if you monkey around too much. Maybe you get a super-kid, maybe an imbecile. It's bad medicine to think we're smarter than we are."
The infusion took place in the company clinic designed for the purpose. She was warned to expect to feel sick for several days. Feverish, achy, under the weather. This was due to the vector that carried the repair sequence, a modified strain of the influenza virus. In addition, she might feel disoriented for a bit. Mentally, a little wobbly and weak in the knees. This was due to, first a down, then an up regulation in various neuronal circuits. A recalibration of the electro-molecular homeostatic mechanism. Typically, the symptoms were mild and gone in a week.
Ellen surprised everyone, including herself, by not getting sick at all. Nor, thank God, did she forget her husband. Nor her mother. Nor anyone. She felt fit before the infusion, fit during the infusion, and fit a week later.
Something, though, was different. She couldn't quite say what. It seemed important but also strangely unimportant. As if something of interest to her, of significance, had lost its power to hold her attention and possibly even affect her.
This something nagged at her, like a thorn, but every day the nagging grew less. Then one day there was no nagging. The thorn had worked its way out.
It was a huge relief. Finally, she felt normal again. She felt like herself. It was the self she most loved. The one with energy, who loved to do things. The one who didn't live under a cloud of apprehension but took pleasure in life.
One of those pleasures had been on hold for nearly a month. Too much pressure and stress. Being freed of them was like waking from a stupor.
This waking first happened in the kitchen. Everett was putting away groceries, and she went at him like a
cat in heat.
"I want you," she growled, backing him against the counter. "I lust for your body."
"I can do lust," he replied.
She licked her lips.
He grinned.
She pressed herself against him, then let herself be lifted and carried to the bedroom.
The sex was awesome. She let herself go in a way she'd never done, clawing his back, grinding her pelvis against his, screaming when she came. He responded with a low-throated roar, and a millisecond later went stiff as a board and shot himself into her.
This happened on a Sunday morning, an off day from work for them. After sex they had breakfast. After breakfast Ellen called her mother.
Mom was different these days. More open, more expressive. The cancer remained in remission. Physically, she felt good. Mentally, like she was living a dream. How could things be better? She was well. Her daughter was cured. She couldn't express in words how happy this made her. Not to mention the prospect of grandkids.
After the call Ellen waylaid Everett again. Afterward, she lay in his arms and playfully asked if she was being a nuisance.
"No way. I love having sex with you."
"It's weird," she said. "I feel so…so driven."
"Driven?"
"Horny. It's like I've been holding all this stuff inside, and now it's just busting out. It feels so good to let go. I can see how people get addicted."
He kissed her on the shoulder. "Should we tell the doctor you've become an addict?"
"I just like it."
"Yeah. Me too."
The next time they made love was that night. Ellen had the condom out, ready to roll it on, when Everett said, "How about we do it without that thing?"
She knew it was better for him. He got more excited. The sensation was heightened. He'd liked it more when she was on the mini-pill.
The condom, on the other hand, seemed like such a good idea.
It was a tough decision, but at length she agreed.
The next time, a day later, she said yes again.
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