All the Ways the World Can End

by Abby Sher

  I tried adding some antibacterial gel and scrubbing with that. I turned on the hot water until it was steaming. The faucet was the loudest thing in the room.

  “Lenny,” Mom said over the roar, “do you have any questions for Dr. Lowenstein?”

  I turned the water down and faced him straight on.

  “Questions, questions. Oh yeah, here’s one,” I spit. “Are you giving up?”

  Out of the corner of my eye I saw Mom suck in her breath. Dad held his hand out to me and said, “Honey, we’re not giving up. We’re doing everything we can. There’s just not much else to do.”

  I hated that Dad was sticking up for this schmuck. I dumped the water pitcher again and pumped some more soap into it. “Dr. Ganesh said that there were a few trials available. There’s also a ton of drugs being tested on brain lesions, like Durvalumab or that other one … Pembrolizumab? Which is on the list of immune modulators.”

  Lowenstein looked astonished by my medical knowledge for maybe a millisecond. Then he said, “I’m familiar with that drug as well, but it would be too much on his system.”

  “His?” I said, pointing to Dad. Lowenstein nodded. “You mean my father? Because he’s still in the room and he’s still very much alive and if you’re just going to say, ‘Oh well,’ then maybe you should address him directly.”

  “Lenny—” started Mom.

  I stood in front of her to block all interruptions and kept talking directly into Lowenstein’s face. “Here are a few more things you may want to know, because he’s a person, not just one of your statistics. His name is Jeremy Reuben Rosenthal-Hermann. He’s forty-nine and a half years old and he was the first Jew to make partner at his law firm and he’s the proud father of two daughters and used to be in a band called the Mermen and plays racquetball and can do five-digit long division in his head.”

  Lowenstein looked a little queasy from nodding and fake smiling at me. Which only made me talk louder. I told him about when Dad and I went on a Girl Scout father-daughter trek through the Catskills and Dad filleted a fish with his bare hands. I told him about how he taught me to ride a bike and whistle and sing in French.

  “Did you know that he played guitar professionally for a year? And he has a notebook by his bed at home where he collects good jokes. Here’s a G-rated one for you. What’s brown and sticky?”

  Mom stood up and said, “Okay, Lenny, let’s give Dad some time to—”

  “A stick!” I shouted. Then I cackled pretty maniacally.

  Lowenstein was being too important to laugh. He opened his manila folder again, which I was now convinced had porn inside because he was so excited by it.

  “Forget it,” I snorted at him. “No offense, but you’re a little bit useless. This is why we’re facing mass extinction today, you know. Because each life counts and each life is part of the global survival. So if you can’t do anything helpful or even humane for my dad, then just tell me where Dr. Ganesh is. Please.”

  Mom scowled at me. “I’m so sorry, Dr. Lowenstein,” she said. “I think we just all need to process this.”

  “Of course,” he said. “And please feel free to reach out if you have any questions.”

  “Yeah—my question is, where is Dr. Ganesh?” I repeated. I knew no one was going to answer me, so I marched out to the nurses’ fortress. “Where is Dr. Ganesh? Excuse me, where is Dr. Ganesh?”

  There was obviously an epidemic of deafness going around the floor. I charged behind the counter. It was actually ridiculously easy. But it got everyone’s attention.

  “Sorry, but you can’t do that.”

  “Sorry, but I just did. Who is going to tell me where Dr. Radhakrishnan Ganesh is?”

  “He’s not on the floor today.”

  “Is he in his office on Seventy-First Street?”

  “We’re not allowed to give out that kind of information.”

  “Well then what kind of information do you give out?!” No one answered. “I’ll be right here until someone answers me! Is Dr. Ganesh expected today or is he in his office?”

  Saffi—the beautiful nurse with braids from the first night I’d brought Dad in—spun toward me on her chair slowly. Calmly. She didn’t say anything. She just found my eyes and nodded.

  Office? I mouthed. She nodded again. I ran to the elevator bank and used my elbows to press all the arrows pointing up (an escape trick I’d memorized from some heist movie, though no one seemed to be following me). Then I opened the door to the stairwell and slipped in extra quietly, running down the ten flights on my tiptoes. I got a sick thrill from hearing my mom at the top yelling, “Lenny? Lenny, wait!”

  World War III

  Approximate Number of Operational Nuclear Warheads

  Chapter 14

  SMALL TALK(ING)

  Linda with the yarn-story sweaters looked up so lovingly from her desk that I almost broke down before the door closed behind me. I really just wanted to bury myself in the acrylic sunset that was spread across her pillowy chest.

  “Darling!” she chirped. “How is that wonderful dad of yours? And is it nippy outside? I brought a windbreaker but I don’t want to presume.”

  “Pretty warm out actually.” I tried my hardest to sound cheery. “Is Dr. Ganesh here by any chance?”

  “Yes, but he’s booked solid until the end of the day. And I’m heading out at two, otherwise I’d try to slot you in. So sorry,” Linda said. She pulled off her clip-on earrings and placed them by her phone. Then she started shutting down her computer, mumbling things like, “Exit application” … “Save changes” … “Yes, and quit.”

  “I know it’s Friday afternoon and it’s getting late. It’s an emergency, though.”

  She stopped humming along to her easy-listening radio station and snapped to attention. “Is your father here?”

  “No. He’s in the hospital. Which is why I need Dr. Ganesh to…” I wasn’t sure how to finish that sentence. I needed Dr. Ganesh to change Lowenstein’s mind and convince him that the drug trial would be miraculously efficient. I also needed Dr. Ganesh to change the progression of time and reverse the racing reproduction of cells in my dad’s body and tell me we could do this. We could find an opening somewhere. A bunker in the sky or at least in my brain where we’d be safe. Plus, I needed to apologize for sending him dirty pictures.

  Linda was waiting for me to explain.

  “I just need to talk to him. Please?”

  “I’ll tell him you’re here,” she said. “Rosenthal-Hermann, yes?”

  “Yes. First name—Ey. Leah. Nor,” I said weakly.

  Linda waddled down the hall and knocked on Dr. Ganesh’s door. I could picture him at that desk with the photo of him and his parents. His parents who’d lost a child and the wise son who had pledged to find a cure.

  I heard his trademark “Helloooo!” and then Linda mumbling something with the door closed. When she came back, I pretended to be reading a pamphlet on endocrine health.

  “Okay, darling, you’re in luck,” Linda sang. “I guess he has a few more patients coming in, so if you can be back a little after five, he’ll be finishing up then. I won’t be here, but you just press two-zero-two-eight at the security door, twist the lock to the left, and come on up. Same code for the office door.”

  “Thank you thank you thank you thank you!” I sounded like a cat’s squeaky chew toy. Linda opened the door and ushered me out.

  I had a little too much hope walking away from that moment. Enough hope to go to the drugstore and pull out Mom’s emergency credit card again and charge up forty dollars’ worth of eye shadow, hand sanitizers, tweezers, a thank-you card with a frog on it, and six bottles of some pink wine cooler.

  It wasn’t that I wanted to get drunk with Dr. Ganesh, but I needed something to unknot this night. I had very little prior experience drinking. I’d taken a few sips of my dad’s beer over the years. And last summer at our cousin’s wedding, Emma made me try vodka, which was horrible and amazing all at once. My mouth was on fire and I
was doing a rubbery chicken dance that made me feel taller than the clouds. The next day was rough, though. I vowed that this time I would sip slowly.

  Pregnant Sheena at the cash register clearly did not remember me. Or was willfully trying to forget.

  “Hey! How’s it going?” I practically screamed at her.

  “Fine thank you and how are you,” she said in her dreary monotone while scanning my items. She stopped at the wine coolers and shot me a look. “ID?” she asked.

  I did a very dramatic impersonation of someone looking through her pocketbook for a piece of identification. Then I shook my head and said, “This is ridiculous, but I seem to have left all my ID at home. But I swear—”

  She cut me off. “Do you want to save a life and donate a dollar for AIDS?”

  “Whoa, who’s for AIDS?” I asked, trying to crack her. I didn’t know why I needed this girl to like me so much, but I did. I kept thinking how I couldn’t trust any of my so-called friends and she was about my age and there wasn’t that much separating us except maybe social stratification and income inequality and I could help her bring up her baby if she was all alone because I needed to do something more meaningful than nosedive into this vat of self-pity.

  “I think it’s awesome what you’re doing,” I told her.

  “What am I doing?” she asked. I nodded at her belly. “Oh yeah,” she said, looking more angry than excited. “You want this stuff in one bag or two?”

  I still had over three hours until I could buzz Dr. Ganesh’s office again. I signed a few petitions on the street—mostly to save dogs and get rid of oil rigs. Then I walked down to the old Park Avenue Armory building and wandered through the room with all the knights in chain mail.

  “You guys look ridiculous,” I told the mannequins. There was something so pitiful and enraging about their dusty steel collars and gauntlets. They looked like oversize toys. At least we didn’t waste all that time forging iron for shields and swords anymore. Everything was electronic or invisible to the naked eye. The next world war was going to start from somebody’s robot’s second drone once removed.

  “Can’t have that in here,” said a small woman in a blue smock. She had glasses taking up most of her face and flashed a badge that said ARMORY DOCENT at me. Then she pointed at my cell phone, which kept buzzing in my hand from Mom calling repeatedly.

  “Sorry,” I said, trying to turn it off at the same moment that she called again. “I’ll just … yeah.” Back out on the street, I answered just in time to hear Mom midsoliloquy.

  “… do a loop with the car but we can’t file a missing persons report until it’s been at least three hours I think.”

  “Mom!” I shouted. “I’m right here.”

  “Aaaah! Aha!” she yipped. Then I couldn’t tell whether she was laughing or crying. Dad took the phone from her.

  “Okay, okay. Hey, Lenny, hon. I’m sorry this is so hard.”

  “It’s not your fault. Please stop saying sorry.”

  “Fair enough. Where are you?”

  “I’m—I’m fine.”

  “But where are you?”

  “I can’t tell you.”

  Dad conferred with Mom, then came back to the phone.

  “Listen, honey, we won’t ask any questions, but we really need you to come back. Mom’s going out to the bus stop in a little while to pick up Emma. She says she can swing by wherever you are. Just give us a corner or a coffee shop and she’ll meet you there.”

  “Sorry, Daddy,” I said. I could feel a sob caught under my ribs and I really didn’t want it to get out. Once I started, I didn’t know if I’d ever stop. “I’m safe. I’ll check in again soon.” I hung up before he could offer another solution and went into the nearest bake shop so I could at least sit down. I chewed on some ice and ordered a croissant that sort of devolved in my hands into a fistful of French dust. Then I sat in my pile of crumbs and wrote a list of all the things I needed to say to Dr. Ganesh, including:

  1. Pembrolizumab is listed in both colorectal and brain tumor trials. Coinkidink or brilliant sign of possibilities?

  2. Cancer should be put on the list of catastrophic pandemics so we can get federal and even international support/funding for research.

  3. FYI my dad’s band once played to a sold-out crowd at Jones Beach.

  4. Those pictures I sent were a huge joke with a side of mistake wrapped in a burrito of ugly.

  I rewrote it twice to look neat but not overly formal, in case Dr. Ganesh asked to see my work. I also used my phone to look up where the phrase “good Samaritan” appeared in the Bible, because it had been bugging me since Oscar had said it the other day. It wound up being in a parable Jesus told about someone getting beat up on the road to Jericho and all the people who walked right by him before the Samaritan stopped.

  I walked by people who were suffering every day. Most of the time I backed away if someone looked particularly troubled or contagious in any way. I wondered how many people I’d passed just today who might not make it until tomorrow.

  I had a half hour to go until five o’clock when I put in the secret code at Dr. Ganesh’s security door. I used the empty lobby as a dressing room, pulling out some of my new makeup compacts to pluck a few stray eyebrows with my tweezers and smear on some lavender sparkle shadow. Then I took the stairs to the eighth floor instead of dealing with elevator germs. Adrenaline always helped rescramble my neurons at least a little.

  When I got into his waiting room, I heard Dr. Ganesh walking down the hall explaining how his new running sneakers made him feel like a grasshopper and also how caffeine could be therapeutic but he didn’t understand why Americans paid so much for drinks made with cold coffee.

  His extra last patient of the day was very old. It wasn’t fair how old and alive he was. His tan pants were belted just below his chest and he wore a sailor’s cap that looked like it was attached to the rusty hair underneath. He was leaning on Dr. Ganesh while they walked. Then he thanked the good doctor and announced he was going to go home and have eggs and tomatoes. Dr. Ganesh wished him well and said they’d talk soon. He locked the door after the sailor left. When he turned around there was a smile on his face. Then he saw me on his waiting room couch, and shut his lips into a tight line.

  I stood up, but he motioned for me to sit down again, which I ignored. He sat in the chair farthest away from me. I couldn’t be deterred, though.

  “Thank you for seeing me. Not seeing me, but just using your eyes. Or whatever you’re using. Just—thank you for letting me come here.”

  “You are welcome,” he said stiffly. “Linda said it was an emergency.”

  “Yes! I mean, not the nine-one-one kind but—yes!” I’d wanted to save the wine coolers for later, but it looked like now was already desperate. I pulled out two bottles and tried to hand one to Dr. Ganesh, but he waved me away.

  “It’s sour apple passion,” I read. “I guess if you like sour apples, you must be passionate about it, huh?” I twisted off the cap and took a long swig. It tasted like carbonated caramel. “Yum,” I said, trying not to wince. I took another big gulp and felt everything start to melt. I hadn’t noticed until that moment that the labels had pictures of a couple running on the beach. I thought I should tell him it obviously wasn’t us—I’d never look like that in a bikini.

  “Is this alcohol, Ey-leah-nor?” Dr. Ganesh asked.

  “Well, sort of. I mean, it’s mostly sugar, which is unfermented alcohol, right? Or maybe it’s alcohol that’s already metabolized?”

  Dr. Ganesh either didn’t understand the question, didn’t have an answer, or, most likely, didn’t care. “Please,” he said, “you cannot have that in here.”

  “Of course not! Just a sec!” I gulped about eight more ounces of apple elixir because this was already going so poorly and Dr. Ganesh looked disgusted even though he was supposed to be the one person in the world who could accept me and offer hope.

  “Okeydoke,” I said, draining the first bottle. I needed to lo
ok at my list. Or at least recite some data. “So the emergency is—well, do you know what Dr. Lowenstein told us today?”

  “Yes, Dr. Lowenstein is my mentor. We have spoken a lot about this case.”

  “This case” really stung. I wondered if they added the number of my dad’s metastases and did long division with his life expectancy. I was part of “this case” too—the troublesome daughter with misplaced outrage, chronic halitosis, and obsessive-compulsive, continuously annoying idiosyncrasies with a dollop of Electra complex on top.

  “I need you to tell Lowenstein that we have to do the trial,” I said.

  Dr. Ganesh folded his arms.

  “Or I shouldn’t tell you what to do. Did you read that thing online about Europe approving Pembrolizumab for first-line treatment? Something like 74 percent for one-year survival, which is way better than Ipilimumab.”

  “These are PD-1 targeters,” Dr. Ganesh said glumly. “Your father wasn’t able to tolerate the BRAF inhibitor we tried.” He didn’t even acknowledge that I’d memorized some pretty hard words and statistics. Especially when the room was tipping to one side. I grabbed another cooler and opened it, taking a slug.

  “Ey-leah-nor, please,” he said. I’d never heard his voice that close to anger before. His ears pulled back a little and his whole face looked tight. I wanted to tell him that anger didn’t scare me and that I was grateful he could be this open with his feelings and that this was good for us as a couple because emotional honesty was the only real source of human potential. “Away,” he ordered, breaking into my reverie. I tucked the bottle behind me and blinked hard to refocus.

  “Right,” I said. “Okay, if you’re on the anti-pembro team, there’s another monoclonal antibody I saw mentioned a lot. Durva-something?”

  “Durvalumab,” Dr. Ganesh said. I put my fist out for a bump because we were having a conversation now! But he didn’t move.

  I stopped, stumped. Honestly, I had this list of things to tell him and lots of numbers swimming in my head but I’d envisioned Dr. Ganesh softening by now. He would say something to the effect of we were in this together and he had an enchanted loophole or had misread the charts. Plus, he had taken so long to respond to my texts because he was doing some really meditative work with his inner conscience. And now he was ready to say that he respected my mind and my heart and let’s forget about protocol and age differences and he wanted to take my whole family to India where the cure would spring up out of a saffron-scented fountain.