by LM Ardor
‘Tom is probably doing his own research. He is, well—different; on the spectrum as they say. But functional, and smart.’ Dee was compelled to defend Tom from Adam’s casual put-down. It was useless but she couldn’t let it go by. ‘The obsessional qualities are an advantage rather than a detraction in his work. He’s a “white hacker”.’
Adam blinked twice. ‘What’s a white hacker?’ Dee remembered the double blink was a sign that he was disconcerted. It was rare.
‘Tom tries to hack into computer systems to check that they’re safe. Anyway, he is a true obsessive. I’m sure when they come back he’ll know all about what you offer and be ready with lots of smart questions.’
‘Good. There’s so much we can do for them; we can even check for risk of being on the spectrum. The possibilities are expanding exponentially. It’s expensive though. All the tests are offshore. China has the big sophisticated labs—the only place we can get all the information quickly.’
‘How about costs? They aren’t wealthy. Leah’s a student.’
‘Somewhere between $10,000 and $20,000 out of pocket per cycle with the extra tests. Not much for the guarantee of a perfect healthy child. We do offer donor insemination if they can’t afford PID.’
‘Leah loves Tom; she wants his baby, not some donor’s. You have no idea how people work, do you?’ Dee was tired. It normally wouldn’t have popped out.
There was a group gathered around them waiting for a chance to rub shoulders with success.
Adam smiled with brilliant, even teeth. ‘It’s always refreshing to be reminded that ideals still exist.’
‘Good to see you, Adam.’ Dee picked up her bag. She left the GenSafe showbag on the floor.
He took her hand, ‘Thanks, it’s been too long,’ and dazzled her with another flashbulb smile. He turned to the group gathered for his attention.
Why was he so sensitive to what she thought? Dee wondered as she headed for her car. And why was he trying to get her attention?
4.
The last time Dee had seen Tom was two weeks before the day of his missed appointment. She’d wondered why he’d come in. According to the most recent peak flow charts he’d sent her, his asthma seemed good and it was too soon for the results of the genetic tests to be through.
Perhaps he was sick? His reaction to echinacea had put him in hospital a few years ago. The cone flowers were in full bloom in the park now and the reaction could start very quickly. Maybe he wanted to talk about the visit to Adam Fairborn—and Leah. If it was just him, she’d find out more about what was going on there.
He was sitting alone in the waiting room. Dee called him into the dim liminal space of the surgery and watched him fold his long limbs to fit the chair beside the desk.
‘Morning.’
‘Morning, Doc.’
Dee sat facing him across the corner of the desk, her hands open in her lap. Both of them looked at the same spot. Tom jiggled his knee, moments passed; Dee held her tongue. It was good to see him well, but why was he here?
He sat up straight in the chair and opened his briefcase. ‘I printed these out for you but you’ll also have them in my email to import into the file.’
He handed her his peak flow records for the previous month. The simple test, a measure of how much air he could push out of his lungs, was an objective tool in his own management of his asthma. The sheets were mounted in a manila folder, held in order with binder clips. Every reading for the past three months was meticulously charted. Medications and atmospheric conditions, pollution levels and his activities were entered across the bottom and different coloured highlighters identified days when he had changed his medication in response to a low reading. Ventolin was green, his long-acting bronchodilator was blue and the steroid was orange. The red he used for steroid tablets was absent. He hadn’t needed oral medication since winter.
She noticed with satisfaction that he had recorded the flowering of the echinacea in the local park and noted he had changed his route to the bus stop to avoid them. She was glad she didn’t warn him—and expose the interfering mother he triggered in her.
‘These look perfect, as usual.’
There wasn’t much to comment on. Tom hardly needed to see her for these regular reviews but he insisted on his three-monthly visits. She suspected the trauma of his emergency trips to hospital as a child meant he still needed the reassurance of regular check-ups.
‘I notice last Friday your peak flow was normal but you started extra steroid then?’
‘Yes, Saturday I clean the flat, and the dust stirs up the asthma. You can see I usually need more by Saturday night so I’ve started anticipating and initiating the extra doses on Friday. See, no dip on Saturday evening.’
If only every patient followed instructions less people would be sick. She might be out of a job.
‘Perfect. Tom, you’ve done well. Just go on as you have been and we’ll review you in three months. These charts are great. Would you mind if I used them as examples for other patients, de-identified of course?’
‘You’ve asked me that before. That’s why I made paper copies of these; if you want, use them. All the information is in my email to make it easier to put them in my file.’
Something was going on. Tom was excited, smiling, fidgeting with the sleeves of his jacket.
‘You will remember to do it though?’
Resistance was useless. Dee made a few keystrokes, found Tom’s email, scanned the attachment and imported it into his clinical notes as an excel file.
‘So you virus-scanned them first?’
‘Of course, that’s automatic.’ Dee still didn’t know why he was really here today but it was always quicker to wait till Tom got to what he wanted. His mental template of the encounter had to be followed or they got nowhere.
‘So the security is all okay?’
Dee nodded. Tom had worked for, and recommended, the company she had used for the surgery set-up. Raj, the head of the security company, and formerly Tom’s boss, was now a friend.
‘Sorry, I know I’m obsessional but I also know that security protocols aren’t always followed.’
‘Tom, you taught me well. Raj’s company did a great job—have you tested us out?’
‘Aw, Doc, that was only once and I didn’t open any files, you know that.’
Dee waited.
‘Okay, okay—I did a test raid and got nowhere … as I expected. The system’s good. The only way anyone can get into the files is through a person.’ Tom’s eyes were fixed intently on her face. ‘The most perfect system can’t protect you against someone giving away their passwords.’
Was this it? Why did he want to check their security again?
‘That’s hardly likely. All the staff know how important security is. And I’m the only one with administrator status. How’s that?’ She turned the screen around so Tom could see his peak flow charts on the screen. ‘Now, scripts?’
‘I’ve got four repeats left for everything except the prednisone tablets. They were out of date so I got a new bottle last week. Give me one of those, I always have a spare, like you told me.’
When patients quoted her own words of wisdom back at her she was uncomfortable. It made her remember her own mother’s interfering version of caring.
Dee saw from the screen that he was correct. She shouldn’t be surprised, Tom remembered everything. It was a good idea to make sure he had a spare. She printed his prescription.
’How did your visit to Professor Fairborn go?’ Dee asked.
‘Do you know him?’
‘Yes, I knew him at university.’ She paused to look at him. He was sitting forward, knee jiggling, keen to tell her something. ‘Some people find his manner a bit off-putting but he is the top geneticist around. Was he okay?’
‘Yeah, he comes across as rather grandiose but he might be useful.’
‘The most brilliant scientists aren’t always the most skilled in dealing with people.’
There was som
ething different about Tom. He was usually straightforward, concrete in his responses.
He sat on the edge of his seat, head down, both knees jiggling. When he looked at her again it was with sideways eyes.
‘But, personally, is he a friend or anything?’
Tom probably already knew the answer to his question. Dee could dismiss it as not his business but there was something odd going on. She wanted to know the reason for the last fifteen minutes of palaver. She needed to answer carefully.
‘What’s up?’
‘You graduated from UNSW in the same year, I thought you might be friends.’
It was so long ago. No one would remember their affair and it wasn’t a memory Dee wanted to revisit.
‘No, Tom, we aren’t friends. Does that matter?’
Dee waited. Eventually Tom spoke.
‘There are a couple of things I’m following up.’ He smiled, almost a smirk. ‘Could be interesting but I don’t know yet, I’ll keep you informed.’
‘Okay.’ Dee wanted to know what was going on but she knew there was no use pushing.
‘Leah didn’t like him.’
Leah didn’t like me either, thought Dee. On the one occasion when they’d met she’d barely looked at Dee.
‘This is about you and Leah not about me or Adam Fairborn. Say whatever you want. It helps me if I know how the specialists I refer people to perform. I can send you to see someone else, someone with more people skills.’
‘I’m the last one who should criticise someone for a lack of people skills.’
‘So what is it?’ Dee asked.
‘Nothing right now—we still have to wait for some results. It’s very expensive.’
‘I thought you just wanted to know about the risk of autism?’
‘He tried to up-sell us on the idea of preimplantation diagnosis.’
‘That means IVF though,’ said Dee, surprised. ‘You’re both young—there shouldn’t be any trouble conceiving.’
‘The prof said that IVF could tell us for sure about autism or asthma. He hinted that there were techniques that could predict height, intelligence, even hair colour—all for a price.’
Dee opened her mouth but closed it again without saying anything.
‘Yeah, I was shocked too,’ said Tom.
‘What do you think about it?’ Dee asked.
‘The rooms are impressive, discreet. Big tasteful arrangements of leaves with spot lighting on them. It doesn’t even smell medical. The computer security at the front desk is totally slack though. You stand right over the receptionists as they’re logging in and entering data.’
‘Please don’t tell me you’ve been doing anything illegal. You know if there’s a danger to others it trumps my obligation to confidentiality.’
‘Normal journalistic techniques like research from public records is okay though?’
‘You know the law. Anything on the public record is fine but hacking into private medical records is illegal. I can’t condone that.’
‘Doc, no one does that except in movies and cheap thrillers. All the Wikileaks information was from insiders. The information Bradley Manning copied onto CDs was all stuff he was cleared to access. Edward Snowden’s revelations were of info he had security clearance for and took out on portable disc drives.’
‘Tom, I’ve known you since I listened to your heartbeat in the womb. Whatever you’re doing, no matter how justified you think it is, if it’s illegal, be careful. Anyone you talk to is a security risk and you’re putting them at risk from the police and other criminals as well as yourself. Sorry, I know you’re a grown-up …’
It was a lie. When she looked at Tom, Dee still saw the little boy with blue lips sitting up on the side of his bed, chest puffed with stale air he couldn’t get out of his lungs. His neck muscles like ropes as they strained to force the air past narrowed airways to empty his overinflated lungs.
She shook her head to break up the image. ‘Lecture over. Do you have any results yet?’
‘But you just said not to tell you.’
Dee tutted loudly.
‘Oh you mean the tests. We’re still waiting for the full genomes and the sperm freeze tests. I just wanted to get some more background before we went back. There were a couple of things I was worried about. Everyone goes through the same process no matter what they’ve come in for. The sperm test straight up was a surprise. Now they have my sample it’s easy to push us down the high-tech path. The professor does have an impressive record of research. He said he could help but I’d like to do some background research of my own.’
‘Tom …’
‘No, nothing too illegal but sometimes it’s important to have all the information, not just what you’re told.’ Tom dropped his head and looked at Dee through his long black lashes.
She rolled her eyes.
‘Don’t worry. I know the company who did their security, on the cheap. It’s so full of holes it’s practically an invitation to come in and look around. And no one will know I’ve got in. I’ll let you know how it goes. Thanks, Doc.’
‘Is everything else all right?’ Dee wanted to know what was up with Tom. ‘Leah’s okay?’
‘She’s good, not keen on the idea of IVF though.’
‘How about Skye and Charlie?’
‘The same. Charlie wears Mum down. I try to spend time there but Glen and I don’t exactly enjoy each other’s company.’
He stood up and was gone. Dee wondered what to write in the notes as the reason for the consultation. She would have to wait till the results came back to see him again and to find out what was going on.
That was the last time she saw him alive.
5.
Dee asked Janelle to send Tom a text; then to try the number of the company she thought he was working for at the moment and to send him an email. Briefly, she considered a call to his mother. Tom was an adult; a call to his mother was an invasion of his privacy. And Skye would be useless, her hysteria a hindrance rather than a help. Dee had enough trouble reining in her own need to interfere in Tom’s life.
‘Don’t say where you’re from,’ she told Janelle, ‘just that you want to speak to him.’ Janelle rolled her eyes. ‘Sometimes people forget that sort of stuff. I’d rather say it and make sure.’
Dee took in her next patient, an attractive and very fair young woman with a tiny spot on her upper lip. It had been there for a couple of months and was getting bigger. With good light and magnification, Dee knew the spot was a skin cancer, a basal cell carcinoma.
The young woman, Stella, worked in the arts, was in her mid-twenties, stylish with perfect skin and ash-blonde cropped hair. Dee delivered the diagnosis as gently as she could. Stella rocked back and forth between shock and disbelief. Cancer wasn’t compatible with her competent in-charge self.
The rest of the consultation was a balancing act for Dee. The cancer wasn’t highly malignant but it would continue to grow slowly and relentlessly in the local area unless removed. She tried to reassure Stella that she would be okay without letting her think that the tiny spot could be ignored.
Dee was used to the inevitable reactions: ‘I’m too young’, ‘I haven’t done the wrong thing’ and ‘why me’. Most people, the lucky ones, got to believe in their own invincibility until middle age or longer. Whatever age it came, the first knowledge of one’s own vulnerability threw people off any solid foundation onto uncertain ground that could give way with any step. Dee had learned to sit with people when they became irrational or incapable of thought till they had time to process the threat. Stella seemed well balanced. Dee knew she would cope in time.
The lesion needed to be removed by an expert plastic surgeon. Dee could remove it herself but in that position, on the junction of the lip, it would take expert work to avoid a disfiguring scar.
Stella agreed to return once she had thought through the issues. The delicate task took all Dee’s concentration.
By the end of thirty minutes she had forgotten about Tom.
Dee walked out to reception thirty-five minutes behind. She couldn’t let a beautiful young woman ruin her looks without making her understand the danger.
‘Dee, I rang where he was working but he hasn’t been in, not yesterday either.’ Janelle had followed her to the back room to tell her. The dread flooded back.
‘Have you tried the girlfriend?’ Dee asked. Her mouth was dry and her chest tight.
‘No, no number for her. She wasn’t ever officially a patient. Do you want me to check with his mother?’
‘Thanks, but no.’ Dee knew Skye’s reaction would be less than helpful.
6.
Mid-morning and the patient was on the couch in position, legs spread. Dee lubed the speculum and gently put it in place. With her head inches from the vulva she manoeuvred the device until the cervix popped into place between its jaws.
‘Good. Everything looks normal. Is that comfortable?’
The phone started to buzz. Why did it always ring when she was in the middle of a pap smear? Janelle knew only emergencies or calls from other doctors should be put through. No matter who it was they would have to wait.
‘Do you need to get that?’ her postnatal patient asked.
‘No, no, it’s fine. Relax, we’ll be done in a minute.’
‘It’s fine, the baby’s with his father for once—this is the first chance I’ve had to have a rest for a week.’
‘You’re sure?’
‘Sure, I’ll still be here.’
Dee removed the speculum, peeled off her gloves and picked up.
‘Sorry,’ Janelle said, ‘but it’s Tom Harris’s mother. She’s hysterical. I think you need to speak to her.’
Dee’s stomach plummeted. Her body knew—something had happened to Tom. She sat down. Then tried to be rational. The phone call didn’t have to mean something bad. Skye Harris had only two default moods: blissed out or hysteria.
