Herbert S. Heineman, M.D.

FOURTEEN

Normally blood solidifies (coagulates) in minutes once it leaves the vascular system. Simple as it sounds, coagulation is far more complicated than drying out by evaporation. It involves a complex cascade of chemicals (“coagulation factors”), each activated in turn upon completion of the previous step. Hemophilia comes in shades of severity, depending on the extent to which a coagulation factor (factor VIII most commonly, sometimes others) is lacking. In that respect Chris was lucky. His condition was designated clinically “mild,” meaning that it took significant trauma to make a joint bleed. The football-related injury was enough, but use of the knee for walking and running caused him no trouble before or after the event.

C.J.’s attitude toward Chris softened once the diagnosis was clear. He apologized for his ungracious behavior on the night of Chris’s injury and thereafter spared no effort to be a protective older brother.

His father was another matter. It was more than having a son of limited physical ability. After all, his first-born was everything a sports-loving father could have wanted, and he ought to be satisfied. So what if Chris became a poet, or a philosopher, or a homosexual — God forbid. A father can’t have everything he wants. His mind went back to his own youth, his backyard football, his aplastic anemia. Jill. How could he ever forget that sweet soul? How different his life might have been if she had lived.

In his impulsive teenage years he had fantasized being married to Jill — recovered from leukemia, of course — and she would have been the mother of his children. Now, in his more mature thirties, he realized that this fantasy was without basis beyond his obsession with her vulnerability and courage, and, yes, his pity. But if there hadn’t been time and further acquaintance to nurture his love, neither had there been time and further acquaintance to allow it to die naturally. So he treasured the memory even as his life moved on.

In any case, with Jill he would not have had a son with hemophilia. If he’d learned anything from the doctors, it was that Debbie was the vehicle. And so was Debbie’s mother. Josh, like C.J., had gotten off scot-free, on the right side of statistics. And Chris was the unlucky one, the black sheep of not one but two generations.

On a purely intellectual level, he couldn’t blame Debbie. She didn’t know what her genes were hiding. But intellectual justification was no match for his disappointment at Chris’s disability. Con was angry at his son’s bleeding disorder, at the Indian doctor who first diagnosed it, and at the checkers-and-chess-playing black doctor who had taken over Chris’s care. And he was angry at Chris himself for not excelling at sports. The litany of justifications for his anger kept repeating itself.

But Chris was an innocent child, victim of the injustice fate had perpetrated on him. He had done nothing to deserve his father’s anger, and Con admonished himself to show Chris understanding. The doctors were doing their best, which was limited by what medicine offered at the time. They didn’t deserve Con’s anger either. They had earned status in their professions and Con was hardly competent to judge them.

He felt like a tightly wound spring on the verge of tearing loose from its attachment. It was only a matter of time, unless he could find a way to relieve the tension. He said to Debbie:

“We need to tell our parents about Chris, don’t you think?”

“Absolutely,” she answered without hesitation. “I can imagine how your dad will take it. He’ll find a way to blame me.”

“So, would he be wrong?”

For a few seconds there was total silence, and the air between them seemed charged with electricity. Debbie tried to control her voice, but it shook nonetheless.

“Do you blame me?”

“I didn’t say that.”

“Then what did you say?”

“Just what I said.”

Debbie shook her head. “Don’t you distinguish between what I was born with and what I’m to blame for? Don’t you know that if I’d known about my genes — which I didn’t — there wasn’t a thing I could do about it except refuse to have children? That’s the kind of reasoning I’d expect from your father, but not from you. I thought you’d emancipated yourself.”

She’d never expressed herself like that about his father, and she expected a harsh response. But luckily he took himself in hand.

“No need to insult my father,” he said quietly, “nor me either. I know you’re not to blame, but you can’t deny that you carry that gene, and that you transmitted it to him.”

“I don’t deny it, and I feel terrible about it. But I don’t want to quarrel with you about it. We both love him and we have to work together to give him what he needs. And it’s time our parents, yours and mine, knew what’s been going on. I’ll take it up with mine while you’re at the convention. And you’ll take care of your end; I don’t have the courage — your mother maybe, but your father, no way.”

“OK, okay!! Soon as I get back.”