Death Spiral

by Janie Chodosh

  “What do you mean the genetic form?” I snort, studying her face for any clue that she’s making up a genetic form of the disease as a way to deflect attention from the RNA 120/IPF connection. I’m not a human lie detector machine, though, and there aren’t any obvious lying clues like shifty eyes or a nervous tick. What I see is pity. Pity is for stray dogs and orphaned babies. I ball my hands into fists and look away.

  “There’s the idiopathic form of this disease, which means nobody knows how you get it. The pathology isn’t understood,” she explains. “That’s what’s in the autopsy report. But there’s also a dominant genetic mutation that causes the disease. That mutation also causes the skin condition like she had.”

  I’ve studied enough genetics to know that the word dominant and disease in the same sentence isn’t a good thing. “So if it’s dominant you only need one bad copy of the gene to be screwed,” I say in a flat voice.

  “Right. One bad copy and, as you put it, you’re screwed. You get the disease.”

  At that moment, a smiling kid with a mullet, wearing a brown tie, matching vest, and a big circular badge that says, “My name’s Kurt. I’m here to help” appears and asks if there are any shoes we’d like to try on. I’m trying to act normal, so I say yes and hand him the first thing I see and ask for size eight.

  Smiling Kurt dashes off to find the shoes.

  “We know the gene where the mutation for this disease occurs,” Dr. Monroe says the second he’s gone, “so to find out if your mother had the mutation, all we need to do is pull out a few hundred nucleotides on either side of the mutation position and then sequence. That sequence will tell us if the mutation is present or not. I have the tissue sample from her lungs, so it would be easy to do.”

  Mutation. Sequence. DNA. Nucleotides: Greetings, Earthling! Welcome to the planet Yurgon. I will be your host and genetic counselor.

  An Asian woman with a screaming child who’s waving the broken head of a doll stops beside the bench and reaches into her purse. The woman pulls out a lollipop and offers it to the girl. The deal is a good one, and the kid stops crying, grabbing for the lollipop and dropping the doll’s head in the process.

  I pick up the disembodied head once the kid and woman have moved on and stare into the big, blue unblinking eyes. “And what about Melinda?”

  “What about her?”

  “You think she and my mom both could’ve actually had the same mutation?”

  “We don’t even know Melinda had IPF.”

  “Well, she sure looked the same as my mother,” I say, running my finger over the doll’s tiny upturned nose, the white porcelain skin, the blond hair.

  Dr. Monroe’s expression doesn’t change. She keeps the same detached look she’s had since she first sat down, but there’s a tension in her body, unnoticeable if you weren’t looking for it, but I am looking. I see the flex of her wrists as she presses her ringless fingers down against her knees, the strain of her ankle as she arches her foot.

  “Looking the same doesn’t mean she had IPF, idiopathic or genetic,” she explains, her crisp voice a veiled attempt to cover the tightness in her words. “They shared some symptoms that could’ve been caused by anything. I’ve told you, Faith, heroin use can cause a whole battery of health problems. Melinda could’ve had a skin rash. We have no reason to believe she had IPF.”

  “Fine,” I say, turning back to the doll. “So say Mom did have some mutation, and her sickness didn’t have anything to do with side effects from your drug. You said it’s a dominant condition. That means I have a fifty-fifty chance of having inherited it from her. Those aren’t exactly great odds. Is there any way to treat this disease?”

  Dr. Monroe shakes her head as if to say you’re-shit-out-of-luck, but she doesn’t speak because what is there to say? That we could look into Mom’s genes and find the cause of her death, which possibly means finding out I have the same fatal condition that has no cure? I stare at that broken doll head. Someone help me please! My head is no longer attached to my body. Call 911!!

  I think back to the debate in science class that first time I met Jesse, exactly a week ago. I’d been so sure of myself then, so sure I’d want to know the secrets hidden in my genes, that I’d want to peek inside and know what was coming down the pike. But I never considered the idea of knowing you had some fatal genetic condition there was no treatment for. Having to live with the knowledge of your early death. It seemed like science fiction then, not reality. Once you’ve opened this Pandora’s box there’s no turning back.

  I open my eyes and glance at Dr. Monroe, sitting with her hands folded in her lap, waiting patiently for me to return to planet Earth and say something.

  “Look, Faith, if we found out your mother had the mutation there are a lot of facts for you to consider,” she tells me when I don’t speak. “You wouldn’t have to decide anything for yourself right away. Maybe you’d want to know if you had the mutation and maybe you wouldn’t. There’s no right answer.”

  My thoughts are still too jumbled to respond. If what she says about the dominant mutation is true, I’m the fallout, the casualty. She’s a professor, not a miracle worker. What could she do if I have the mutation, dig my grave? I feel around my pockets for candy or gum, even a cough drop, anything to take away the bitter taste on my tongue. Just lint.

  “Okay,” I say when I’ve found my voice again. “Imagine living every day knowing some morning I’m going to wake up and my skin’s going to start peeling off my face and then as an added bonus I won’t be able to breathe and I’ll die.”

  “There’s also the chance you wouldn’t have the gene. Don’t forget that. Fifty-fifty isn’t a guarantee.”

  I feel like we’re at a casino talking about our betting odds in a game of blackjack. “And while we’re on the fact of the genes I’ve inherited from my mother, what about addiction genes? Am I going to find that out, too? That not only might I have some horrible mutation that’s going to kill me, but maybe I got really lucky and inherited her addict genes as well? Great. Maybe I can be just like her, a junkie with a fatal lung condition.”

  Dr. Monroe jumps to her feet and steps in front of me, transforming into this she-beast professor. It’s not hard to imagine her standing in front of a room full of hungover undergrads and commanding their attention.

  “All right, let’s slow down,” she says. “One thing at a time. First of all, we’re sequencing one tiny part of a gene, not your mother’s entire genome, and even if we did sequence that, inheriting a dominant mutation for IPF is a lot different than this idea of some junkie gene. Addiction doesn’t come from one gene, Faith, like you either have it or you don’t. It comes from a lot of interacting genes and it’s not just genes, either. There are environmental factors to consider.”

  “Great, like being raised by a heroin addict? Somehow that doesn’t make me feel any better.”

  Smiling Kurt who’s here to help arrives at just that minute with two shoeboxes in his arms. “We didn’t have your size,” he tells me. “I brought a seven and a nine instead.”

  I thank him for his help and pretend to show great interest in the shoes. He lingers for a second in case I require further assistance. I assure him I can tie the laces on my own. He smiles and darts off to help another customer.

  “Okay, fine, so I might not be an addict like her,” I concede. “But still, I might end up the same anyways, dead from some fatal lung thing. If I have the mutation, our destinies really won’t be that different in the end.”

  “This is hard stuff, Faith, I know,” Dr. Monroe says, sitting back down. “But right now I need your permission to look for the mutation in your mother’s gene. If I find the mutation I’ll know that she had the genetic form of the disease and that my drug in no way caused it.”

  For the first time since Mom died, I stop and ask myself what she would’ve done, because occasionally even my mother had common se
nse. She knew how to stay calm in emergencies, and she always zippered her coat and wore a hat when it was cold—she had the basics covered at least. Would she tell me to find out? No matter how hard I search, I can’t find her answer.

  “And what about Dr. Carlisle?” I say, remembering the other nightmare, the one where the medical examiner was just killed. “Say you find out my mother did have this mutation, then what? We still don’t know who was bribing Dr. Carlisle to lie about her death or who killed him or what they were trying to cover up.”

  Dr. Monroe stares at me. “What makes you think someone killed him? It was an accident. They say there was a drunk driver, and Dr. Carlisle’s brakes failed when he swerved.”

  “Oh, come on! You think it was an accident? The same day I overhear the phone call, his brakes just happen to fail and he just happens to drive off a bridge?”

  Dr. Monroe protests and tries again to make me see the connection between my stress and my imagination, but I stop listening. The picture of Dr. Carlisle’s car plummeting into the water—his bloated corpse being fished out of the river, the mutation, Mom, the Rat Catcher, the heroin—it’s too much to take in. I’m no longer in my body. What sits on the bench is molecular Faith. The DNA, blood, and guts part of me. The soul part of me drifts, watches all this happening from someplace else, Hawaii, maybe. The moon.

  “Fine,” I hear molecular Faith says. “Do what you need to do. Sequence my mom’s DNA. Get your proof. How long will it take?”

  “Three days,” Dr. Monroe says rising to her feet and grabbing her purse. “I’ll have the primers by tomorrow, amplify the section, and then get on the sequencer. I’ll call you when I get the results.”

  ***

  I wander out of the store and enter malltopia. It takes a second to adjust to the hip-hop music blaring from Hot Topic, the smell of pizza, fudge brownies, and corndogs emanating from the food court, the flashing neon lights advertising sales on useless crap. The whole thing is an exercise in attention deficit disorder, but slowly my soul reunites with my body. As I pass the sunglasses cart and ear piercing station, I start wishing I’d never heard any of this. I wish Melinda had just left me alone, and I’d taken Aunt T’s advice: Don’t go looking for problems when there aren’t any. But it’s too late to turn back now.

  I stop for a piece of pizza, then sit on the bench next to the merry-go-round to watch the little kids on their wooden horses. Maybe if I sit here long enough, some of their happiness will diffuse into me. The longer I watch, though, the worse I feel. Nothing can penetrate the cell membrane of my anxiety.

  As I nibble around the pockets of bubbling grease, my thoughts bounce around like a ball in a pinball machine. PING! Genetic disease, lose ten points. PING! Murder and bribery, lose another ten. It’s with Dr. Monroe that the ball sinks into the gutter. Is she making up this stuff about genetic IPF? Is she trying to hide something? What about Melinda and her symptoms? Did she just happen to have the same mutation?

  I press my fingers against my eyelids and push the world into blackness until my thoughts settle. Then I toss my napkin into the trash and leave the mall to head back to school. The one place where life still resembles normal.

  ***

  A layer of frost covers the windshield of Aunt T’s car when I get to the parking lot. I start the engine and crank the defroster. I might as well wait for the glaciers to melt. If I want to make it back to school in this geologic era, I’ll have to scrape. I manage to clear a notebook-size patch of glass before my fingers go numb. Good enough. I get into the car and start back to school.

  I decide to take the back road. It’s faster. Bio starts in ten minutes, and the threat of Mrs. Stratberry hangs over me. I’m a few blocks from campus when a squirrel darts into the road. Slamming on your brakes to avoid smooshing a small rodent is one of those no-no’s they teach you in driver’s ed, but what I know and what I do when the life of a small, fluffy creature is at stake are two different things. I hit the brakes.

  The car doesn’t stop. The wheels flatten the squirrel with a sickening thump. I brake again as I zoom toward the intersection. Still nothing. I have the red, and the light’s getting closer. I pump the brake, but the pedal is soft. It’s then I see a car coming the other direction. I punch the horn and swerve hard to avoid a collision.

  I don’t know if it’s minutes or seconds that I’m sprawled across the steering wheel, but when I blink open my eyes and find my view angled to the tops of the trees, I know something’s wrong. For one concussion of a moment I think there’s been a tectonic event, but then the truth hits me like my head must’ve hit the wheel: I crashed Aunt T’s car. I don’t have a license. I’m in a ditch.

  I sit up, my head pounding, and turn the key, hoping by some cosmic miracle I can get out of the ditch as easily as I got into it. The wheels just spin with a helpless whir. As I rub my right shoulder, throbbing beneath the gray band of seatbelt, I see a dude in a denim jacket running from the top of the embankment and stumbling down the berm toward me. He reaches the car and jerks open the door. The smell of pot wafts off him. I cough and slowly sit up.

  “Hey, man, you okay?” He’s staring at the angle of Aunt T’s car, and there’s panic in his eyes. “Should I call for help?”

  “No!” The strength of my response makes my head pound even more, and I slide back down into the seat. A picture of tow trucks, blinking lights, and cops runs through my mind, followed by the fact of having “borrowed” Aunt T’s car and driven without a license. “I’m fine. Really.” I open the door and wobble to my feet. The edges of me feel blurred. I reach to the hood for balance. “Don’t call anyone.”

  “Hey, man, that’s cool. If you say so.” He looks relieved that I don’t want to file an accident report or call the cops to the scene. I might’ve been the one who spun off the road, but driving while baked doesn’t exactly endear yourself with the authorities. He’s a polite stoner though, and adds, “Can I at least give you a ride?”

  I agree to let him take me back to school. There’s no blood, thank god. Internal injury, maybe, but no outer damage. Nobody will know what happened. It’s the kind of pain I’m used to hiding—on the inside.

  I take one last look at Aunt T’s car. There’s already so many dents and dings on the thing, maybe she won’t notice a few more. I’ll get someone to pull it from the ditch later. I’ll have the car home before Aunt T gets there.

  One can always hope.

  ***

  Five minutes later, I’m back at school. My legs are shaky and my right shoulder throbs like a mofo, but I down a few Advil, and head to the first-floor bathroom for a quick mirror check, so I don’t enter bio looking like an extra from The Night of the Living Dead.

  As I slap my face with cold water, the day replays in my head. The medical examiner’s death. Dr. Monroe’s call. Genetic IPF. My car accident. Car accident? All other thoughts screech to a halt as I hear Anj’s voice: They think the medical examiner’s brakes might have failed. Could my accident be connected to his? Did someone mess with the medical examiner’s brakes and then mess with mine?

  I slap more cold water on my cheeks. Or did the brakes just fail? Aunt T said the car was vibrating, but she never said anything about faulty brakes. Maybe I hit a patch of ice and skidded out. I close my eyes and recall the scene. I don’t remember seeing anything but dry pavement.

  My phone buzzes. I jump and pull it out from my bag to see a text from Jesse. Where are you?

  I check the time. Shit. Class started fifteen minutes ago. I smooth my hair and head to bio doing my best impression of a normal girl.

  Mrs. Lopez asks for a pass when I walk in fifteen minutes late. I tell her I don’t have one, and she tells me to see her after class. I nod and go to my table. Anj’s seat is empty. She must still be busy with Tara and Sylvie and the Hunger Days stuff, so when Mrs. Lopez says to find a partner for today’s lab, I don’t have to worry about making up an
excuse to avoid her.

  Jesse, on the other hand, charges over to my seat the second Mrs. Lopez finishes giving directions. Before he can reach me, I turn to Raven, an emo who hardly ever talks, and ask her to be my partner. She shrugs and grunts, something I interpret as yes. I open the lab manual and pretend to read the instructions. Jesse’s not so easily cast off. He stands at my table, firing off questions about what happened and where I was during lunch and if I’m okay, until Mrs. Lopez orders him to choose a partner and get to work. I turn and swallow as he walks away. Thank god Raven’s too into her own suffering and angst to notice mine.

  I manage to get through lab without doing much of anything, and I’m attempting to sneak out at the end of the period and avoid my little after-class discussion with Mrs. Lopez when her voice stops me. She waits until all the other kids leave, then closes the door and tells me to sit. I drop my bag and take the seat closest to the front of the room. She leans against my table and folds her arms across her flowered blouse.

  “You were late to class,” she says, her brown eyes searching my face. I feel her watching me even when I look down.

  “I know. I’m sorry. I—”

  “Save it. I’ve heard every excuse possible. My favorite one was when Arnold Klint told me he was on the highest level of Angry Birds, and he had to finish the game before he could come to class.” She sounds strict, but her voice hides a smile. For the first time today, I relax a little. It’s strange to find a lecture about truancy relaxing, but after everything else that’s happened, it’s a relief to be in trouble for something so normal.

  “I want to show you something,” Mrs. Lopez says. “Come with me. You can leave your stuff, we’ll be back.”

  I start to protest, but the look on Mrs. Lopez’s face shuts me up. I leave my backpack on the floor and follow her out the door, through the empty halls, and upstairs to the art wing. The hall smells of clay, paint, and chemical fixatives. Combine that with the pizza, and my stomach is starting to turn. Mrs. Lopez stops in front of the current display of portraits without saying anything. I have no idea what we’re doing here, and I don’t care. I’m just going through the motions. If Mrs. Lopez wants to give me a course on art appreciation, I’ll be her pupil.