“I’m not doing that,” she says when the tests arrive.
“But don’t you want to know if you’re going to get something?”
“No.”
“But . . . but . . .” I have no good argument to present her other than that I paid almost a hundred bucks for the kit, not the most persuasive tactic when trying to convince somebody to learn if she will one day develop Alzheimer’s.
The “would you rather know or not know” question is one of those increasingly common dilemmas with which all of us must wrestle. On the one hand, knowing may give us the kick in the pants we need to take preventative measures. On the other, what good is knowing if there is nothing that can be done, especially because genetic testing rarely gives binary yes/no answers, offering instead a range of likely outcomes? Just because you have the BRCA1 or BRCA2 genes does not mean you will definitely get breast cancer, although it greatly increases your odds. Angelina Jolie, for example, discovered herself to be a BRCA1 carrier and lopped off her breasts via a preventative double mastectomy. Perhaps that was a sound decision, but she also carried a vial of Billy Bob Thornton’s blood in a locket around her neck when they were married, so I think it’s fair to question her judgment.
Martha’s attitude does not dissuade me from opening my own test box. I’m not sure what I expect to find inside, but I assume there will be an assortment of science gizmos including: a hypodermic needle, a high-speed centrifuge, a DNA sequencer, safety goggles, and a tabletop laser. Not so. The box contains exactly one (1) plastic spittoon and one (1) mail-in envelope. I shake out the box, but that’s it. Hm. Shouldn’t the process for untangling my personal double helix be a bit more Star Treky than filling a plastic cup with spit?
It takes ten minutes of effortful expectorating to fill the cup. When I finish, I hold it up to the light, the way schoolkids do conducting experiments on pond water. Somewhere in that watery goop is my fate. I seal up the envelope and mail it off to the future.
A couple weeks later, I receive an e-mail informing me that my results are ready for viewing. On the website, I find a tremendous amount of information broken down into four categories: “Health Risks,” “Drug Response,” “Inherited Conditions,” and “Neanderthal Ancestry.” Whoa, whoa, whoa. Neanderthal ancestry? Everything else would now have to wait. Nothing is—or ever could be —more important than finding out my Neanderthal ancestry.
Here’s the deal: I am 2.9 percent Neanderthal. That may not sound like a lot, but it is a full .2 percent above the norm. In other words, I am nearly 10 percent more Neanderthal than the average person! This was the manliest thing that had happened to me since getting hit in the eye with a pitch during Little League. For somebody as insecure about his masculinity as myself, learning I am basically a full-blooded Neanderthal felt incredible. My overabundant arm hair, which I’d always found vaguely embarrassing, now seemed primal and raw. Erotic, even. I rush to tell Martha the good news.
“I’m a Neanderthal!” I tell her, showing off my test results. I expect her to whip off her clothes and start humping me then and there.
“That explains why you look like that,” she said.
“Like what?”
“You have a Neanderthal brow.”
She’s right. I do have a heavy brow. It overhangs the rest of my skull like a buzzard on a tree limb. How did she manage to transform my cool genetic idiosyncrasy into a jab about my physical appearance? Damn her and her more highly evolved Homo sapiens brain. Well, the joke’s on her—she’s the idiot who married me.
Deflated, I return to the website, turning to my lines of ancestry, which are a total letdown. As it happens, I am exactly what I have always believed myself to be: 100 percent Ashkenazi Jew. The Ashkenazi branch of Judaism is characterized by our European roots, our long history traced to the original Israeli tribes, and our love for National Public Radio. It did surprise me to learn that we Ashkenazis are considered our own distinct ethnicity, owing to the fact that there has been so little marrying outside the faith over the last five hundred years (which, I’m sorry, is a little gross). In fact, according to Wikipedia, I am genetically more similar to an Ethiopian Jew than I am to a European gentile.
No ethnic wild cards exist in my lineage. No Native American or East African or Pacific Islander. This is disappointing. I would like to be at least a little Maori. But no. I am a bland mélange of Eastern European shtetl dwellers. I’m borscht. At least my kids have a tastier genetic makeup because I had the good sense to marry a Viking.
Martha is a tall Minnesotan blonde, a statuesque descendant of Norwegians and Irishmen, with a sprinkling of Luxembourgian thrown in as genetic bling. Or so she claims. Until she spits into the cup, I don’t trust a word she says. If her ethnic claims are one day confirmed, it will mean our two kids are a rich brew of nearly the entire European continent minus Italy, which is just as well, because the Italians are savages.
Next, I turn my attention to the subject I have been dreading: “Health Risks.” Clicking the link, I expect to find a giant blinking nuclear hazard symbol informing me that I am already dead. Instead, the page lists a long column of diseases, along with my approximate odds of contracting each.
The disease I am most likely to develop is not, as I believed, colon cancer, but something called “atrial fibrillation,” which I learn is basically an irregular heartbeat. That doesn’t sound like a big deal. I mean, how bad can an irregular heartbeat be? If you’re going to be at high risk for something, it might as well be for something as innocuous as a heart that looks bad on the dance floor. Out of an abundance of caution, I do a little more research into the matter. Big mistake. Although the Mayo Clinic website assures me that “episodes of atrial fibrillation can come and go” without too much cause for concern, the American Heart Association wants me to know that “AF” can lead to “stroke, clotting, heart failure, and death.” Death does not sound good. Stupid heart.
I am also three times more likely than the general population to develop “venous thromboembolism,” which is a fancy way of saying blood clots. As it happens, I already knew this, because my aunt nearly died from a venous thromboembolism of her own. Had she not admitted herself to an emergency room after experiencing persistent pain in her leg over the course of several days, her doctors said, she likely would have been dead within twenty-four hours. After her scare, she contacted Eric and me to get tested. I scheduled an appointment and got the test. It came back positive, now confirmed by my DNA test. Stupid clots.
My doctor said there isn’t much I can do about it other than take a daily baby aspirin, get exercise, and make sure I walk around when flying long distances, all of which I now do, except for the part about getting up and walking around when I fly, and exercising.
Some other stuff I am at elevated risk for: gallstones, chronic kidney disease, rheumatoid arthritis, macular degeneration, and, most distressingly, lung cancer. Lung cancer??? My lung cancer number is legitimately scary: 11.6 percent. That’s a lot of percent. How can it be that high? I have never used any tobacco products. I don’t smoke cigarettes or cigars or pipes or chew tobacco, although I do confess to thinking that hookahs look kind of cool. Can admiring hookahs elevate my risk of lung cancer?
Panicked, I take an online “lung cancer risk test” that asks me a bunch of questions, primarily about my smoking history (none), whether I have ever worked with asbestos (no), and if any work I do or have done with mustard gas was performed with adequate protection (yes, all of my mustard gas work was done with adequate protection). After I submit my answers, the test informs me I have a “much below average” risk of contracting lung cancer. Further research tells me the genetic component of lung cancer is far less of an indicator than environmental factors. Phew. Mentally, I adjust my odds of getting lung cancer from the 11.6 percent figure to 0.0 percent, because of all the medical strategies known to mankind, denial is the most effective.
But wait—where is colon cancer? I’m supposed to get colon cancer. Mom said so. Nowhe
re on my “elevated health risk” list does it mention anything about colon cancer.
After working my way through the elevated-risk column, I explore my “decreased risk” section, where I learn I am at lower risk than the general population for contracting, among other things, prostate cancer. That’s good news. After all, the prostate and the colon are physically very close to each other. I think they may even share a cubicle. If I’m at decreased risk for one, I must be at decreased risk for the other.
The last list is “average risk,” where I finally find my colon and rectum. Despite a lifetime of dark portents from my mother, it turns out I am almost exactly average in terms of risk for colorectal cancer. Average risk! This is a huge relief. My colon is run-of-the-mill. Boring, even. It’s the kind of colon you wouldn’t even look twice at if you passed it on the street. All those years of worry for nothing. Well, not nothing. I mean, I do have an average risk for colorectal cancer, which is 5.6 percent. But still, that’s a considerable reduction from total certainty. Bad genes, my ass. Or, more precisely, average genes: my ass.
I’m going to live forever! I celebrate my good news by not getting a colonoscopy.
A few months after receiving my test results, I read a newspaper article saying the Food and Drug Administration has forbidden my genetic testing company from continuing to sell their product, expressing concerns about the “validity of their results.” How can that be? The validity of their results is the only thing separating them from a company that sells overpriced spittoons. Maybe everything they told me is a lie. Maybe my genes really are bad. Maybe I am right back where I started, fretting about the future, convinced of my own imminent demise. Maybe, but I’m not going back to worrying about that stuff. I can’t. It’s too exhausting. I’ll just do what I can do. I will get my colon checked out—soon, I promise. I will continue taking my daily baby aspirin. I will also continue taking my hair medication, which has nothing to do with any of this, but I thought it prudent to reassure readers of this book that my hair will always look cool. But one thing I will no longer do is get freaked out over a future I cannot control. Because I am a Neanderthal. And we Neanderthals Do. Not. Give. A. Fuck.
Chapter Three
What they are thinking is this: “Dad sucks”
A few months after her time-out in the hot room, Mom returned to the oncologist for a routine follow-up. It was supposed to be a quick howdy-do and a lollipop on the way out. Instead, he found a mass right near the area where her cancer had been. “A big mass,” Mom emphasizes to me.
The doctor didn’t mince words. “I’m really sorry,” he said, “but I don’t see any way that it’s not terminal.”
One day in the distant future, when I receive my own death sentence, I like to think I will accept the news with solemn grace. I like to think I will nod once or twice, take a moment to gaze out the window at this good, green earth, then rise to shake the doctor’s hand. In a vaguely British accent, I will tell him not to feel too bad, old boy, it’s been a good show. Then I will spin on my heel and take my leave, fading into nothing as he bangs his fist against his desk shouting, “Damn it! Damn it all to hell!”
That’s not how Mom took it. She says she felt like she’d been punched in the stomach. She says she felt terrified and angry and hopeless. Her doctor said they would do what they could, which is, of course, what they always say. It’s what they’d told her father years before. The oncologist made plans to remove the growth. Maybe they could get enough of it that they could start chemo. Maybe they would get lucky. Maybe. But he made it clear to Mom that he didn’t think so. In the meantime, he instructed Mom to “get her affairs in order,” a phrase I didn’t think existed outside of movies. Mom staggered from his office, ordered her affairs, and prepared to die.
And that’s where the story gets a little weird.
A week or so later, as Mom and Sandy drove to the hospital on the morning of her surgery, Mom heard a voice. Or maybe it would be more accurate to say she heard A Voice, deep and male, the kind of 1950s Paramount Pictures voice that once commanded Charlton Heston to part the Red Sea. Like Moses, she alone heard the Voice, which delivered its message unto her and departed as inexplicably as it had come, taking with it the terror she’d felt since receiving her diagnosis, leaving in its place an abiding calm.
She turned to Sandy. “I just heard a voice,” she said. “I don’t know if it was God or who it was, but the Voice told me the tumor isn’t malignant.”
Sandy’s reaction was basically, “Whatever you say, Jill.”
Mom had her surgery. Afterward, the doctor entered her recovery room with news: To his shock, the tumor had turned out to be benign. Mom thanked him for the update but tells me she didn’t feel surprised. She’d already known.
This is exactly the kind of story I would normally dismiss out of hand when told to me by somebody else. Yeah, yeah, you heard a voice. Go play with a crystal. But it’s harder to do that when the person involved is your mother. I know her to be a rational person and, aside from her love of country music, a person with reasonable mental faculties. She’d never heard voices before, never communicated with the Great Beyond, never professed any great spiritual fervor. After Susan was born with Down syndrome, my mother even dropped her belief in God. Not because of Susan’s health issues, but because the rabbi refused to conduct a naming ceremony in the temple for a child with mental retardation. So Mom didn’t seem to be the most likely candidate for otherworldly intervention. Yet, when it happened, she accepted the event with a strange nonchalance, relating the story to me with the indifference of somebody describing an unspectacular episode of The Good Wife. I can’t decide if her blasé attitude indicates a healthy, open mind or a complete psychotic break. I know that my reaction would have been considerably different. First, I would have torn off all my clothes and run into traffic. Then I would have sought out the only spiritual advisor that matters, but who knows if Oprah would even take my call?
My own spiritual problems are profound. I don’t believe in God but I also don’t don’t believe in God. The usual term for people like me is agnostic, but I hate that word because it gives people an intellectual dodge, a way to feel smug about their own ignorance: “Well, I can’t prove there is a God, but of course, I can’t prove there isn’t a God, either.” Well, la-dee-dah for you, smart guy. But a paradox isn’t a philosophy.
Better to take a stand. Better to know what one believes. Except I have no idea, finding myself caught between wanting to believe in God but unable to allow myself to do so. I’m a devout believer born into the body of an atheist. There is no word for people like me, so I made one up: praytheist, which I define as, “Somebody who prays to a god in which he doesn’t believe, hoping to find evidence for God’s existence, which, if found, he will then dismiss.”
It was easy enough to keep my spiritual struggles to myself until we had kids. But Martha is Catholic, and once we found ourselves in possession of a couple of pliable minds to mold, she wanted to send them to Sunday school. I objected for reasons I had a tough time articulating.
“I don’t want to do that,” I said when she broached the idea.
“Why not?”
I had hoped just me saying I didn’t want to do that would have settled the matter, since I wasn’t prepared to actually defend my position with, you know, reasons. Again, my wife was outmaneuvering me with that damned Homo sapiens brain of hers. But even old Homo neanderthalensis can occasionally pull a card from his sleeve. “Because I’m not Catholic.”
Game. Set. Match.
She responded that she was Catholic, and that since I was not a practicing Jew, she didn’t understand why I should mind the kids learning about her religion. Moreover, she would not object if I also wanted to send them for Jewish instruction. I told her I didn’t see why they needed any religious education whatsoever. Again, she wanted to know why not. But this time, I had my answer prepared.
“Because I don’t want them to.”
My argument, su
ch as it was, boiled down to this: Why should we force-feed our kids some made-up story as truth just because their mom was brought up with that story, a story she’s not even sure she believes; and also, isn’t it better to let our children arrive at their own conclusions about religion in their own good time instead of giving them answers to questions they haven’t yet even thought to ask; and also, shouldn’t their father’s gnashing existential angst/low-grade chronic depression serve as a shining example of how to conduct one’s spiritual life?
Martha’s response boiled down to this: because I want to, no, and no.
After months of back-and-forth, I finally relented, for two reasons. The first is because giving them some religious training was ultimately more important to Martha than not giving it to them was to me. But the second, far more important reason, was that she volunteered to get up early and drive them every week, which, honestly, constituted most of my objection to the idea in the first place.
So each Sunday, the kids trooped off to Catholic class, where they colored and filled out biblical worksheets and sang about Jesus loving them, this they know. After a couple years, their formal religious education concluded with a confirmation ceremony involving two hundred dollars’ worth of new clothes they would never wear again. Ruthie had to don a creepy white veil, which I guess signified a holy union with the Church, but which veered uncomfortably close to child-bride territory for my taste.
All in all, harmless enough, but I don’t think Jesus really worked his way into their open and trusting hearts. Now that Sunday school has ended, they don’t talk much about God, or pray, or do any of the Jesus-y things I would expect from true believers. For example, neither has ever offered to wash my feet or tithed to me their birthday money. The kids do sometimes attend church with Martha, but when I ask them what they got from the service, what they most often mention are the free doughnuts.
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