“It’s just my lips.”
“All right, then. Keep your clothes on. The doctor will be with you in a minute.”
And he is.
“Dr. Ratner? You’re never on time.”
He smiles. “And I’m not today. If you were the patient who cancelled, we’d be starting fifteen minutes late. Why don’t you come sit down here on this chair?”
I perch on the very edge of the chair.
He sits by the little desk and scoots his chair out to face me. “So, Sep, what’s the problem?”
“My lips are white. Under this lipstick.”
He opens a drawer and hands me a little foil package.
I read: Makeup Remover. I go to work on my lips.
Dr. Ratner hands me a small mirror.
I finish up and hand it back to him.
Dr. Ratner studies my lips. “Well, you’re right. White lips.” He pulls out a notebook and picks up a pen. “I’m going to ask you a lot of questions. If you give an answer and then later you want to change it, just change it. I’m fishing. And I need to know as much as possible. Don’t be afraid to tell the truth.”
Fishing. That’s what Devin asked me if I was doing.
“I won’t keep anything back. I want to know what’s wrong with me.”
“How’s it been in the bathroom? Any blood in your stool?”
“No.”
“Anything odd? Pus in your stool? Loose stools?”
I’m shaking my head.
“Anybody in your family have colitis?”
“I never heard of it.”
“Crohn’s Disease? Colon cancer?”
“Not that I know of.” He said cancer. I feel nauseated. I think I’ll vomit.
“Have you been tired lately?”
“Not especially.”
“Here, let’s just be sure. A little iron test, okay?” He goes to a counter and pours clear liquid into a small flask. Then he jabs my finger with a teeny tiny needle and holds the thinnest glass tube I’ve ever seen against the bubble of blood. The blood goes up the tube, and he puts a drop into the flask. It sinks quickly. “Good, no anemia. Lost any weight lately?”
“No.”
He takes one of my arms and examines it all over. Then the other. “Stand up and hike your skirt up.” He looks up and down and around both legs. “Okay, you can drop your skirt. Any lesions on your trunk?”
“Lesions?”
“Sores, spots, bruises, anything?”
“No.”
“How about your joints? Any pains in your knees or shoulders or hips?”
“I just went to jazz dance yesterday. But I’m sore in my muscles, not my joints.”
“How about nausea? Cramps?”
“I got my period yesterday. I had cramps. But just normal.” I don’t tell him I almost spewed on him when he said cancer.
He takes a little flashlight out of a drawer and shines it in my eyes. “No inflammation. All right.” He puts the flashlight away. “Do you smoke?”
“No.”
“And you’re not obese.” He looks at my chart. “Your blood pressure is normal. And you already told me you dance, so you get regular exercise, right?”
“Right.”
“Stick out your tongue.”
I stick it out.
“Nothing sore?”
“No.”
“Insomnia?”
“A little last night, worrying about seeing you today.”
“Constipation? Flatulence? Sense of fullness?”
“Nothing beyond period junk.”
“Any pain when you urinate?”
“No.”
“Sit down. Trouble seeing?”
I sit. So does he. “No.”
“And you don’t live near a nuclear power plant,” he mutters. “How much soy do you eat?”
“I like Chinese food, if that’s what you mean. We have it maybe once a month.”
“How about soy bean curd?”
“It’s too bland.”
“Do you take any medications?”
“You know I don’t.”
“No. I know I haven’t prescribed any. But do you take any? Like lithium?”
“No.”
“Do you eat a lot of raw broccoli or cabbage or kale or anything like that?”
“I’m not sure what ‘anything like that’ means, but we cook our vegetables. Except salad stuff. And carrots.”
“Does anyone in your family have thyroid disease? Diabetes? Addison’s Disease?”
“No to all of them. At least if we’re talking about Dante and my parents. Beyond that, I don’t know.” I’m starting to feel unreal. The questions come too fast.
He palpates my throat, playing his fingers around the bump of my larynx. “Ever had an asthma attack?”
“No.”
“Ever taken Prednisone or another glucocorticoid hormone?”
“I never take medications.”
“Are you dizzy when you stand up?”
“Sometimes I’ve felt dizzy lately. Mostly when I think that maybe I’m dying.”
“You’re not dying, Sep.”
“Promise?”
“Just about. I’ll give you some tests so I can say yes for sure. But my guess is ninety-nine point nine percent sure. Do you crave salty foods?”
“I always love salty foods. But I love all foods. My mother cooks Italian.”
“Are your periods irregular?”
“They’re like clockwork.”
“Are you irritable or depressed?”
“Irritable? You’d have to ask my family. Depressed—I think today I’ve been sad. I’m really afraid.”
“You’re not dying, I told you.” But he doesn’t say it’s nothing. He doesn’t say he’s ninety-nine point nine percent sure it’s nothing. “Do you have any lower back pain? Abdomen pain? Leg pain?”
“No for all.”
“Okay. Here’s what we’ll do. One big cause of loss of pigmentation is Addison’s Disease. You don’t have any other symptoms of it. But we’ll take a blood sample and test you anyway. Another is thyroid disease. Again, you don’t have any other sign of it, but we’ll do a few tests on that blood. Another is diabetes. Again, no other sign—but we’ll test your blood for that, too. Then there’s pernicious anemia, but I know you don’t have that. Still, we’ll test your blood. And there’s ulcerative colitis. I’ll send you home with a little packet so you can take stool samples and bring it back for us. But you don’t have that, either.”
“So what do I have?”
“Let’s get the blood results before we discuss it at length. And I want you to do a small thing for me. Anyone in your house have dandruff?”
“Dante.”
“How’s he doing?”
“His lips are normal color.”
Dr. Ratner smiles. “How about the rest of him. Is he okay?”
“As okay as Dante ever is.”
“Does he use Selsun Blue?”
I give a half smile, this feels so weird. “Yes.”
“Okay, good. Smear Selsun Blue on your lips and go sit in the sun in the backyard.”
“My lips don’t have dandruff.”
He laughs. “There’s a slight chance you have a fungus under the skin. If so, that will kill it. But don’t stay out too long. I don’t want you to get burned. A half hour at a maximum, okay? Just once. And I don’t think it’s a fungus, anyway. Let’s just cover all the bases, though. And Selsun Blue is a cheaper way to rule that out than a Kott prep test.”
“What do you think it is?”
“I don’t like to make guesses without more information.”
“But you already have. You said you don’t think it’s a fungus. So what do you think it is?”
He sighs through his nose and looks at me and I can tell from his eyes that this is not going to be good news.
I feel myself crumbling inside. I swallow. But I keep my eyes on his.
“It might be vitiligo.”
“I neve
r heard of it. Do you die from it?”
“I told you, you’re not dying. No one dies from vitiligo. It doesn’t affect your health, only your appearance.”
Vitiligo. Vitiligo. Vitiligo. “What is it?”
“It’s an autoimmune disease. Your immune system has made a mistake and is attacking you. In vitiligo the pigment cells get destroyed and white patches form on the skin.”
“It starts at the lips?”
“It can start anywhere. Did you have a blow to your lips recently?”
“No.”
“Then I don’t know why it started there. Limbs often show it first. And usually the patches are irregular. You’re kind of lucky that your lips are wholly white—and both of them.”
There’s pressure on my inner ears. Like I’m underwater. Like my eardrums are about to break. Like my head will explode. Vitiligo. Vitiligo. Vitiligo. “So now other white patches will come?”
“I don’t know.”
I look at him hard.
“Probably. Some people have mild cases. A few spots that appear suddenly and that’s all. For other people there are more and more spots.”
“So I’m turning into an albino?”
“No. It never goes that far. Your eyes won’t change. It’s just patches on the skin. Rarely, but sometimes, in the hair, too.”
“Little patches? Like the opposite of freckles?”
“Or big ones. Your skin is dark, so it could be… noticeable.”
“Is there a cure?”
“No. But there are some treatments that have had variable success. We can talk about them. Let me get the blood test and stool test back first. And you try the Selsun Blue. And then we’ll talk. In a week.”
“Can’t we do it sooner?”
“The tests take time. We don’t want to schedule an appointment and then not have all the information we need. Anyway, I’ll send you to a dermatologist if you’re going to try any of the therapies.”
“Why not just send me to a dermatologist right away?”
“Let’s take it one step at a time, okay, Sep?”
I’m blinking hard. “How did I get it?”
“No one knows. It’s nothing you ate. Or did. Sometimes stress can make it worse, but we don’t think stress causes it in the first place. Don’t blame yourself. It’s not your fault. It just happens.”
“Who does it happen to?”
“More people than you think. I’ll gather you some information on it for next week. Make an appointment after the nurse takes your blood. One vial will do for all the tests. In the meantime don’t drive yourself crazy on the Internet.”
“You know I will. Vitiligo, vitiligo, vitiligo.”
“Yes, I know you will. But promise me you won’t panic. There’s things we can figure out together if it’s really vitiligo.” His eyes are steady. And they’re sad. How often does he have to deliver bad news?
OhmyGod—this is bad news.
MAMMA IS WAITING FOR me as I come out of the lab room. She touches the Band-Aid on the inside of my elbow, from where they took my blood.
I make an appointment for next Thursday, with Mamma silent at my side.
We get into the car. She starts up the engine and backs out of the parking place. She’s not asking me anything.
“Did you already talk to Dr. Ratner?”
She nods. “He took me aside while you were getting your blood drawn.”
“Can we go to the college library and see if they have a book on it?”
Mamma glances over at me. “Good idea.”
I use the little mirror on the back of the sun visor in front of the passenger seat and reapply my lipstick. And I used to think this mirror was pointless.
We spend the next hour at the library, finding nothing worth checking out. Mamma talks with a reference librarian, who tells us to try a medical school library. The closest is in Philadelphia.
We’re back in the car.
“Can we stop at the mall? I need something.”
“All right.”
“And I want to go get it alone.”
“All right. I’ll pick up some boxer shorts for your brother.”
“Get him something embarrassing.”
“You can give him embarrassing boxers for his birthday if you want. I’m his mother. I’m getting what he likes.” She pulls into a parking spot. “Meet me back here in a half hour?”
“Fifteen minutes is enough.”
I walk into the department store at the east end and go straight to the cosmetics counter.
“Good. I was hoping you’d be here.”
Slinky turns to me and blinks. “Hey, it’s you again. That burgundy looks good.”
Her smile of recognition lit her up. I didn’t notice it before because of the dyed hair and black clothes and all, but she’s totally juicy. “Actually, I botched it up with the pink this morning. I tried to mix them. So if you really think it looks good, it’s only because you picked the color.”
“So now you’re a shrink?” Slinky tilts her head, almost coquettishly. “They’re all certifiable—true psychos, you know. You don’t seem the type.”
“I want blue lipstick.”
She slaps the counter. “That answers it.”
“And green. Lime green.”
“Green is in. But for blouses and purses. If you put green on your lips, it makes you look like you’re standing under a neon light. People might stop and offer to give you blood. And even out in the sun, with your skin… I don’t know.”
“My skin is changing.”
“Oh yeah? That’s a good trick.”
“I doubt it.”
Slinky looks at me thoughtfully. “How about this moisturizing lip color?” She opens a skinny tube.
“It looks like mud.”
“Brat.”
I throw up my hands in mock offense. “There’s no need to call me names.”
“That’s the name of the color. Hard to believe, huh? The company should fire their marketing division. Anyway, I picked it because last time you said you wanted brown.”
“And you treated me as though I was a moron.”
“I was new on the job. Now I know better. The customer is always crazy. That’s our motto.” Her hand searches through the merchandise. Her fingernails are purple. For an instant I think of Devin. Devin loves nail polish.
My chest goes pang. I miss Devin right now. I miss her so much. I can hardly believe I haven’t told her anything—not about my lips, not about Joshua Winer. I’ve never kept a secret from her before. What kind of person keeps two secrets from her best friend for three whole days?
“How about this lip pencil in Cocoa Lights?” Slinky holds up the pencil. “If you use gloss and then pencil over it, it gives a sheer look.”
“I hate it.”
She takes a deep breath and protrudes her lips in thought. “Express tubes, that’s the answer. They’re lipstick and liner in one. It saves time. Here, look at these: Rush Naked, Coffee Run, and Racy Raisin.”
Do I need to save time? My heart seems to flutter at the thought. I feel out of breath. “Do I look like a swift to you?”
“A swift? You mean a bird?”
“Or a tuna?”
“You mean a fish?”
“Do I look like I’m in a rush—running—racing?”
She stares at me. “Okay, let’s go back to blue.” Her eyes are nervous. We’ve been joking so far and she’s been quick on the repartee. But now I can see she’s afraid that this isn’t just a little game—she thinks maybe I’m really psycho. “You’re right,” she says sweetly, “you could pull off a gray-blue. Like this lip color here. Silver Plum.”
“Do you have anything in hazelnut?”
“Yes.”
“Yes?” I practically shriek.
“That brings us back to brown tones, though. But here.” She rolls a tube across the glass counter to me. “This one is right for you. Why do you want hazelnut?”
“It’s my mother’s favorite flavor.
And my mother loves me.”
“She’s not the only one.”
“How do you know that?”
“Jesus loves you.”
Oh my God. I’d be offended if I wasn’t so stupefied. For all she knows, I’m Buddhist or something. “And here I thought you were a classic alternative type.”
“Don’t judge a book by its cover.”
I stare at Slinky—at her dyed black hair and purple lipstick. “How old are you?”
She smiles. “Older than you. I have a son.” Her whole face softens. “Take the Hazelnut. Then come back and tell me how it worked.”
“I’ll take both.” And I don’t believe she’s much older than me. A son, huh? Wow. On an impulse, I add, “And some purple nail polish, please. The color you’re wearing.”
“Hazelnut lipstick with purple nail polish? Crazy. But, hey, that’s how we got our motto.”
I DO MY HOMEWORK between sneaking looks at pictures of people with vitiligo on the Internet. I’m using Dad’s computer—so I won’t even think about IM-ing. And I put my cell in a drawer. No distractions. Vitiligo. It’s awful how many pictures there are.
Some are of naked people, but none of them are erotic. Vitiligo makes you look so ugly, no one could get turned on. A lump forms in my throat, so big my ears ache. I’ve been telling myself vitiligo is just lack of coloring, so no matter how far it goes, it can’t look that bad. But it does. I can’t understand how—but it does. It’s revolting. A little shiver hums inside me, elusive and eerie.
Normally, I would be ashamed of myself for thinking this way, for being such a shallow jerk. In fact, I’m pretty sure I wouldn’t think this at all. Normally, I would have empathy. If it weren’t me, I could look and be kind, charitable. But it is me.
My head is muck.
I’m not prepared for this.
Well, who could be?
Only I’m the girl who’s always prepared. I work at it. I want to be ready for whatever’s coming next. I always just assumed what was coming next was good.
But it isn’t.
I can’t deal with this right now. I can’t deal with anything.
I go to the kitchen phone and punch out the numbers.
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