by LM Ardor
She waited for him to start. With Tom it was always quicker to do things his way.
‘Sorry to bother you, Doc, but the life insurance company want some forms filled in.’
‘Life insurance?’
Tom was a child; why would he need life insurance?
‘Just in case, you know. If something happened to me …’ Tom paused. He hadn’t said why. Was it for his younger brother Charlie; to help Skye with his care?
‘I have to pay extra because of the asthma but they still want a report and examination.’
Dee glanced at the form. It was very comprehensive.
‘How much are you being insured for?’
‘Hopefully five hundred grand if you decide I’ll live a few more years.’ He pushed at his curls and blinked as if dazzled by headlights.
It was a large amount. With his history of life-threatening asthma attacks he would have to pay a hefty extra premium.
‘Tom, are you sure about this? Insurance salesmen can be very pushy. You know they get a commission for life from your premiums?’
‘I want to make sure Charlie has security if anything happens to me. Mum’s got nothing and she’s not going to last forever.’
The form required a thorough exam, referral for respiratory function tests and a summary of his history. That meant trawling through two thick volumes of handwritten notes, which could take hours.
‘You haven’t had a serious attack since you were seventeen.’
‘Yeah, when I finally saw the light and started doing what you told me. But you never know for sure what can happen. You know I’m a belt-and-braces kind of guy.’
Dee nodded. Half an hour wasn’t much time for such a detailed report. Everything was to be sent directly to the company. She showed him what she was sending.
It wasn’t like Tom to be guarded. Dee was curious. There was something he wasn’t telling her.
Vague anxiety gnawed at her as she walked him back down the corridor.
‘Bye, Tom. Take care.’
*
It was only a week before she saw him again.
The morning was clear in her memory. As usual she was pleased to see his name pop up, plus it was a chance to find out what was really going on with him. She called his name. He stood up and the woman next to him stood as well.
‘Doc, this is Leah. Can she come in too?’
Dee’s ‘Of course’ was automatic. Her flash of disappointment that she didn’t have her baby to herself wasn’t reasonable. She swallowed it. Tom was a patient. The consultation was for him; not to make her feel good.
The monotone young woman had beige skin the same colour as her dreadlocked hair; even her large eyes were the same dirty sand colour. She held Tom’s hand. Her dress was an old heavy satin negligee in a brownish pink that blended into the overall effect. She was almost an apparition, Dee thought. Her natural habitat would be the edge of a forest clearing, ready to escape into the perfect camouflage of tree trunks and bush.
Leah gave a brief shake of her head and looked down at the floor as Dee ushered them into her surgery. She sat in the chair closest to Dee and Tom sat in the second chair beside hers. In the dimmer light of the consulting room, Leah seemed more at ease. Tom did all the talking.
‘Leah and I … we want to have a baby.’
‘Well that’s big news’ was all Dee could say for a moment. The insurance application suddenly made sense.
They were both so young. Leah’s face had the smooth even fullness of a baby’s. Dee resisted the urge to say ‘But you’re just a baby yourself’ like she would have with one of her own kids. Perhaps that’s why her relationship with Tom was better than that with her own three?
‘Do you mind if I ask how old you are, Leah?’
‘Almost twenty,’ said Leah simultaneously with Tom’s ‘She’s nineteen’.
‘And you’ve been together for a while?’
‘Sort of,’ said Tom. ‘Leah doesn’t believe people should possess each other.’
He touched Leah’s arm. His eyes and hands constantly returned to the not-quite-there girl beside him.
Dee left a pause for Leah to respond but she sat, hands folded on her lap, eyes narrowed as though about to dematerialise with a flick of her long, matted dreads.
‘Okay, so you’re thinking about babies?’
‘Yeah, well, maybe; Tom shouldn’t be taking all those chemicals.’
Dee decided to pass that over for the moment. ‘Leah, are you in good health? Are you taking folate tablets? Are your vaccinations and pap smears up to date?’
Leah raised her eyebrows and gave Tom a look.
Tom spoke. ‘I’m worried about autism. I told Leah we had to come because of Charlie. Leah hasn’t met him. She doesn’t understand how difficult it is to have an autistic child.’
‘Nature has its own wisdom,’ said Leah. ‘Every experience can help us grow. Tom is Aspi and I love him.’
Dee knew Tom referred to himself as ‘Aspi’ or ‘on the spectrum’. It was a popular self-reference for IT workers. His obsessional nature fitted with Asperger’s syndrome but his awareness of others and his ability to emotionally connect were not typical.
‘Charlie’s condition is very different. Perhaps you should meet him, Leah?’
Charlie was fourteen and required full-time supervision. He didn’t speak or respond to speech and spent his days in repetitive rocking movements, hitting himself or banging his head against the wall if loud noises or a change in routine stressed him. Skye’s whole life was spent caring for her second son.
‘We’ll see them soon—Mum doesn’t know much about Leah yet.’
Yes, Skye and Leah, that could be difficult, thought Dee.
Tom turned back to Leah. ‘It does matter. I want us to know what the chances of our baby having autism, or even Asperger’s, are before we go ahead.’
‘Asperger’s is a much broader category,’ Dee said, ‘which includes people with no serious disability apart from mild obsessiveness and minor social awkwardness. These days it’s considered a normal variant. Society functions better with some people who make sure things are done right.’
‘Yeah, Doc, I’m okay with it but isn’t there an increased risk of autism in children of Aspis?’ Tom asked.
‘Probably, but my information is from years ago. I usually send people to see Professor Adam Fairborn for this sort of advice. He’s Australia’s top geneticist—a lot of the original research is his. You need up-to-date information. It’s all changing so quickly.’
Dee glanced at Tom and Leah’s faces to check they were with her. ‘I can give you a referral if you like?’
Leah looked up at Tom. She raised her flattened palms and pursed her lips to fend off Dee’s suggestion. Tom laid his hand over hers and settled them back in her lap.
‘Yeah—that would make me feel better. The information on the internet is too inaccurate, all biased to prove some point. I just want to know the risk before we go ahead.’
Dee wrote the referral. She asked Leah if she had discussed pregnancy with her own doctor and if it was all right to contact the doctor for her records. The girl did not answer.
‘Let me know how it goes,’ Dee addressed Tom. ‘Professor Fairborn will write to me about it all and I can help if there’s anything you don’t understand. Let me give you a leaflet about planning for pregnancy. It explains how folate reduces the risk of spina bifida.’
Leah glared at Dee as Tom took the referral and pamphlet.
‘I’m vegan so I don’t think folate deficiency will be a problem.’
‘Good. You’re obviously concerned about health. It was good to meet you, Leah.’
Dee stood and opened the door. The three of them stepped into the corridor.
‘Do have a talk with your own doctor—sometimes vegans can have B12 deficiency.’ Leah scowled and pulled Tom towards the front door. ‘But I’m sure you know all about that.’
Dee made herself stop. He’d be a good dad. He had t
he dad jokes onboard already. His baby would be the first ‘practice grandchild’.
She walked back to her room with the next patient, still thinking of Tom. She should have warned him the echinacea in the park were in flower. No, it was okay—he was an adult, about to be a father. He’d remember.
3.
Three weeks after she had given Tom and Leah the referral, Professor Fairborn was the speaker at a medical education meeting at Rozelle Hospital. Dee really wanted to go but it was seven o’clock when she put down the phone after sorting out the last urgent call-back of the day. She would be late. Briefly she considered going home, a surprise for the kids, share their takeaway Thai, but she wouldn’t be good company tonight—she’d had to give Tracey O the news that there was only palliative care now for her cervical cancer. Let them have a night without cranky Mum.
She tried to support any educational events, like the ones at Rozelle, that weren’t sponsored by drug companies. And it was the last meeting till Feb next year. She wondered if Tom and Leah had had their appointment with Fairborn yet. She hadn’t heard from them or the clinic. It would be good to be up with the latest when Tom came back to see her.
She should go.
*
In the park-like grounds of the old hospital there were no streetlights and there was no moon. Dee drove through darkness, the world narrowed down to the intimate tunnel of her headlights. Colonial sandstone buildings were separated by wide lawns nourished by 150 years of history. The delusions, the dramas of the asylum for the insane were over. The sweat-soaked earth was quiet.
She parked away from the big sodium lamp that lit the car park. There wasn’t enough time to sit and pack away the day. She got out and let herself in through the back door.
The buzz of voices meant they had broken for dinner. There was probably nothing left now. The light was bright and the crowd were milling around the bain-maries at the side of the large room. Dee dumped her bag on a vacant chair at the back.
The topic for tonight was ‘an update on genetics and advances in reproductive technologies’. Cardboard booths in the tasteful grey, light blue and white of GenSafe IVF lined the walls. They held glossy promotional material and pamphlets. Those who arrived early had plastic models of the female reproductive system covered with the GenSafe logo. At the front was Adam, a glamorous star surrounded by dowdy GP fans. It was always easy to pick the speaker at these functions. Their grooming, expensive suits and confident air of superiority stood out. They existed in a higher socio-economic stratum, much more than peers. Dee looked down at her own outfit. Definitely in the GP category.
The GPs wore cheap clothes, pilled cardigans. Their haircuts were cheap and a statistically excessive proportion of the men were bald. Dee knew many of them. They were mostly good doctors who worked long hours for low fees and gave up their evenings to keep up to date.
Adam scanned the room, nodded when his eyes lit on her, then went back to his fans. Involuntarily Dee’s hand went to the white streak at the front of her hair. She bent down to her bag to hide her blush. Her time with Adam at university seemed a thousand years ago. Still when he cast his eyes at her she felt a spark. He was handsome, tall with pale olive skin and thick wavy brown hair. He had a trick, a tic almost, of allowing the hair to fall over his face so he could flip it back and come up with a flutter of his lashes to look you in the eye. It was an animal movement, a connection that was fatally effective. Few could resist if he turned it on them.
Dee saw through the illusion now. His sensuality was more self-regard than an indicator of his qualities as a lover. In return for services, such as admiration and practical help with the tasks of daily living that Adam was too busy for, Dee had been allowed to call herself his girlfriend for half a year while they were at university.
He split with her because ‘she was genetically unstable’ and not suitable as a mother for his children. This came soon after they’d started to study genetics in second year. After three lessons he had decided that the white streak in her flame red hair was evidence of a translocation at the end of her chromosomes for hair colour and an indicator of genetic imperfection.
The hurt had mostly gone now. It had taken some time but eventually she’d realised she’d had a lucky escape. Relating to a narcissist was a spectator sport.
Adam had never married. The girl he had been engaged to in their fourth year at medical school drowned. After that, he never had a long-term partner; although that might have changed in the thirty or so years while Dee had been absorbed in her own life—the practice, babies and a divorce.
The woman manning the booth with handouts had her eyes all over him but he hadn’t glanced her way—must be a secretary or nurse—a wannabe, not a lover.
The food was mostly gone. Curling dry crusts of lasagne and three slices of beef rejected for their gristle were all that was left. Dee settled for a bread roll filled with the cherry tomatoes and snow pea sprouts that had garnished the beef. With weak tea in a polystyrene cup, she sat down in the last row. Her mouth was full so she didn’t have to talk to anyone.
Adam dimmed the lights for his slides. His work was impressive. His group had pioneered IVF in Australia and they were still the leaders in reproductive technology. It was a field where everything changed so quickly. Dee was glad she’d come. He showed a film of the latest technique, PID, or pre-implantation diagnosis. When an embryo was only eight to twelve cells, hours from fertilisation, a few cells were removed, cultured and their genes analysed in the laboratory. This meant only embryos free of disease or with the desired qualities were selected to be put into a womb to become a baby, a new human being.
The new techniques, especially PID, saved parents from so much distress.
Dee remembered her own distress through the screening tests for chromosome abnormalities when she was pregnant with Oliver. She was late thirties and the risk of Down’s syndrome was classified as high. Amniocentesis, taking a sample of cells from the foetus, was an invasive procedure with a significant risk of miscarriage. The wait for results was protracted torture. Oliver was an active baby. His first kicks were before the amniocentesis. With every kick, Dee implored the universe to save her from the decision to terminate.
With Eleanor, she and Rob went ahead without the tests. They couldn’t face it a second time.
At the end of Adam’s presentation, the usual few had questions. Dee wanted to know more but she knew that if she waited someone else would ask her question.
A hand went up in the front row, Dee recognised the long white blonde hair over an acrylic patterned jumper. Alana, rabidly religious, took over any meeting she attended with long, rambling morally loaded questions about her own practice. A collective sigh went around the room. How long would she go on this time?
‘And what’s your policy on sex selection? Doesn’t this just make it easier? I had a case where an Indian family wanted only boys and I had to tell them that abortion wasn’t legal for that reason in Australia. It was very hard … I don’t know how many girls they got rid of before—’
Adam interrupted. ‘Thank you, an interesting question and a question we need to debate as a society. GenSafe IVF has a policy of service to the community. We provide the technology and it’s up to the community to decide how it is used. The technique of preimplantation diagnosis means less trauma and more control for couples wanting to have healthy babies.’
Alana had her hand up, ‘But I had a patient who—’
Adam stepped forward so he was directly in front of her. Her words were muffled by his body. He reached above her head to point at a bald scruffy man at the side of the room. ‘Dr Prentice, you have a question?’
‘How soon can we get appointments?’
Everyone laughed with relief. Alana’s rant was averted. There were a few more questions but all were kind. Alana had the effect of galvanising support for whomever she attacked.
‘Thanks for giving me your time tonight,’ Adam said. ‘I’ll be here to answer any more qu
estions. My practice manager has referral kits for you all.’
The blonde assistant wasn’t what Dee remembered as Adam’s type. She was tall and willowy, but nothing stood out. The girls he’d chosen at university, and in the first few years when they were residents at the same hospital, were all striking in some way. Like Dee’s red hair and green eyes. She’d so longed to be ordinary then.
The ‘referral kits’ were showbags with pens, an executive toy, referral forms and anatomical models of the male and female reproductive systems. All labelled GenSafe IVF, of course.
Adam was surrounded by the usual sycophants. There was no chance to ask him about Tom and Leah. Dee grabbed a showbag and headed past the group towards the door but Adam caught her eye. He nodded and moved in her direction.
‘Hi Adam. Do you have a moment?’
‘Of course. It’s been a long time.’ He looked directly into her eyes. The spark in Dee flickered again.
‘Thanks for the fascinating talk, I’m glad I came.’ She put down her bag. ‘I sent you a young couple recently for genetic counselling. Have they come in?’
‘Yes, interesting, a young man with a hippy girlfriend?’
‘That’s them, Tom and Leah—why interesting?’
‘Well, they wanted to know about the risk of autism. Testing for that is just becoming possible.’
‘Tom’s brother, Charlie, is autistic and needs full-time care. It’s not easy.’
‘The boy seemed a bit of an odd bod himself. They’ve cancelled their follow-up appointment.’
How dare Adam call Tom an odd bod. Dee looked at Adam and saw white teeth, good hair, a few fine wrinkles and an empty smile.
He had no idea he’d upset her. No idea he’d said something offensive. Specialists often referred to patients with casual put-downs as if doctors were all part of some privileged club of superior mortals. Diseases were moral failures, indicators of lower status. Dee didn’t want to be part of that club, dependent on others’ imperfections to feel superior. Everyone had the right to respect. Even the patients with difficult personalities had medical problems and needed care.
