Herbert S. Heineman, M.D.

TWELVE

A lifetime of trouble. . . . progressive disability. . . . crippling arthritis.

The words buzzed like an angry bee inside Debbie’s head. Doctor Prasad had been quite clear about the urgency of treatment — wanted to give it on the spot, in fact — but how good was it?  . . . prevent most of it, . . . relatively low risk. Exactly what did most and relatively low mean? Was she hedging, in case things did go wrong, so she wouldn’t be accused of inspiring false hope? Or was there genuine solace in those words? 

Maybe Con was right: . . . for him it’s a hundred percent. She couldn’t think of it any other way.

Then there was the matter of Doctor Prasad herself. Debbie tried to be respectful of and toward everybody, especially doctors. She had never met an Indian one, though, and the experience took her by surprise. Except for her slight accent, Doctor Prasad had spoken just like other doctors she had known, down to earth and kindly. Being female wasn’t that bad; Debbie’s obstetrician had been a woman. Still, a surgeon — with saws and hammers, and screws . . .  Debbie didn’t know what to make of it. At least, Chris didn’t mind Doctor Prasad. But he was too young to know about foreigners.

Debbie was proud of her children. The first had been healthy and had done well if not brilliantly at school and — thank the Lord — stayed out of trouble. Maybe he would eventually get into college on a football scholarship.

Chris was her baby. If that alone wasn’t reason enough to spoil him, how could she avoid it now? His bleeding disorder wasn’t all. She worried about his mental as well as his physical health. She’d have to find a way to rein in her anxiety and still oversee the precautions his disorder required, to make his childhood as normal as she could. To take the over out of overprotectiveness. Yes, that catchphrase would be useful; she would measure important decisions against that standard. Then she thought about Con. The signs were clear already: he couldn’t deal with it. Chris hadn’t cared about playing football even before he twisted his knee, but Con had been determined to fit him into the only mold he recognized as a man  — in her mind, a jock. She wondered what was going through Con’s mind as he drove back to Edison. She’d wanted him to come home with them, but he’d made excuses about a couple of other fellows being out. She knew the real reason. He had to get away — to deal alone with the shattering news. He might also be thinking about some of the things he had said in Doctor Prasad’s office. Debbie wished he weren’t so prejudiced, or at least not so open about it. And why should she, Debbie, be surprised? Hadn’t she expected that the values he learned early from his father would surface under stress? And there was no shortage of stress in the present situation.

Chris came back into focus. How often would he have to take injections? Who would give them? Was this for life, or would he outgrow it? Did “a lifetime of trouble” mean if his condition was neglected, or even if it was treated? There was no end to the questions. Suddenly she realized she knew next to nothing about hemophilia. And here was Chris, just starting school and about to mingle with boys who were bound to involve him in rough play. She’d never feared that prospect before, but now everything was changed. She hadn’t even asked Doctor Prasad what he was and wasn’t allowed to do. Poor child! She was sure life would never be the same for him. Nor for the rest of the family. The rest of the family! Who else had it? And where had it come from? It had come from her, Debbie. She was the carrier. Doctor Prasad had said as much.

And where had she got it?

❖❖❖❖❖

His eyes were on the road, but unrestrainable thoughts strewed the neural pathways within his brain. Somewhere between the retinal image of the stop sign and the reflex application of his brakes communication hit an obstruction. He was almost halfway into the intersection before he heard the screech on his left. Had not the other driver, who had the right of way, been more alert than he, both Con and his car might have been totaled. Behind the other windshield he saw an elderly woman, her complexion ashen.

“Fuck you!” he yelled at her, pounding the accelerator. He reached the end of the next block before looking in his rearview mirror, where he saw the other car still stopped, two men standing at the open door. Maybe I gave her a heart attack, he thought, turning the corner. He broke into a cold sweat and his hands began to tremble.

The near miss forced him to step outside himself, however briefly. It all came down to anger. Anger at the disease hemophilia; anger at Chris for being stuck with it and scotching his father’s ambition for him; anger at the little female Indian doctor for her smug pronouncement; anger at himself for his intemperate remarks and his resistance to having Chris treated. If only Debbie had insisted on following Doctor Prasad’s urgent advice, he could be angry at Debbie too. He was angry at her, but for a reason more ominous than her willingness to expose Chris to hepatitis and God-knows-what, not to mention chiding her husband for telling the truth about those fags! That was bad enough, but it would eventually be forgotten. What could not be forgotten was that Debbie had brought the whole thing on them. OK, so she didn’t know she was a carrier. But she was a carrier, and that’s why Chris was a hemophiliac. How was Con going to deal with her? He couldn’t accuse her outright; reason told him that much. But he knew his feelings would show, one way or another, maybe when he least expected them to. His resentment cried out for a scapegoat, and he could think of no other.

At least they were lucky in one respect: they had no daughters. Imagine! One generation of girls after another could carry that gene without showing it, and only time would tell whom they’d passed it to: further generations of asymptomatic daughters, or hemophiliac sons. But Chris was a boy, and this much he knew: boys at least were straightforward in their genetics. Honest, that’s what boys were; not sneaky, like girls. No stowaway genes among boys. Chris could pass it on to his daughters, to be sure, if he ever got a girl pregnant, but at least he wouldn’t hide it. If he had any sense, he wouldn’t get a girl pregnant.

By the time he got back to Edison he was calmer. Next he had to deal with an important practical question: who would treat Chris over the long haul? He expected, and hoped, that Rick Harmon would recommend a hemophilia specialist.

Debbie thought Rick was perfectly competent to take care of Chris. After all, he’d been the family doctor for decades. But Con was half expecting that a specialist would know of a cure that Rick was unfamiliar with and offer Chris a way to play football safely. Debbie, unafraid of that possibility, was willing to grant Con his wish. He needed this victory. As it happened, Rick had already decided that a hematologist should be consulted and he referred the Flynns to a man with whom he’d worked many times in the past.

“I’m going to ask a very competent hematologist to take a look at Chris,” Rick said as parents and child sat in his office. “His name is O’Leary, and the receptionist will give you his card. I’ll have her write a referral. You may have to wait a few weeks for an appointment, because he’s very much in demand.”

“Great,” Con said. “Only the best for my boy! Definitely worth waiting for.” His unspoken source of satisfaction was more specific: O’Leary. At last a real doctor. A real man. An American, probably got his degree in the U.S., or perhaps in Ireland. His pleasure showed so clearly in his expression that Debbie was happy to go along without question.

“Actually,” Rick continued as he too saw how pleased Con was with the referral, “O’Leary subspecializes in bleeding disorders, including hemophilia. So he fits your needs exactly.  By the way, did Doctor Prasad order plasma?”

“No.”

Rick frowned. He didn’t want Con and Debbie to think Amaya might have overlooked something so important, but he was surprised. Better say nothing, and maybe ask her about it in private sometime.

On their way out Con was in a better mood than he had been for days. 

“O’Leary,” he said with relish. “I like that.”

Debbie laughed. “I guess it’s nice to be in the hands of a white man, especially an Irishman. I hate to admit my own prejudices, but I really liked Doctor Prasad. She seemed to know what she was about.”

“Give me O’Leary any day,” he said. Debbie laughed again and took his arm.