by Aqua Allsopp
“Good morning brother!” Jergen said as Nathaniel entered the barn to help groom the horses. “How was your first night in the new house?” Jergen asked with a wide grin.
“One day, you’ll know this kind of happiness little brother,” he said as he ran his thumbs along the inside of his suspenders, puffing up his chest like a gamecock. “There’s nothing like being alone with your wife in your own home to make a man come into his own.
“But you’ll know that soon enough. Your Sarah is a sweet girl, in fact, she was up early to come around and bring a breakfast basket to us this morning. You couldn’t ask for a prettier and more kind in spirit girl than Sarah.”
“But that’s just it, don’t you think Sarah behaves too much like a girl to marry? Don’t you think she needs a little more time, a year perhaps, to grow up?” Jergen asked.
“Brother you and Sarah are the same age, and besides Sarah and Rebecca are so much alike that it’s remarkable, considering they are not twins, and you love Rebecca,” Nathaniel replied.
“Yes I do love Rebecca, and I love Sarah too, but when I see her giggling and giddy, I just see a sweet little girl, not a woman to marry,” Jergen said.
“Would you prefer to take a wife who’s so serious that she looks like she’s sucking on a lemon all of the time like Mrs. Mueller?” They both laughed.
“No, but I think Sarah needs more time. Now if she were more like Mary Johns, I’d marry her tomorrow!” Nathaniel said with excitement.
“Brother, you’ve seriously thought about this haven’t you? Are you considering not marrying Sarah?” Nathaniel asked, standing toe-to-toe with his little brother, his face demanding a serious response.
Jergen straightened himself up to show that he was a man willing to stand by his words. When he spoke he said, “Yes brother, I’ve given it a lot of thought, and I’ve decided to wait until after Sarah’s next birthday to marry. I’m not seriously thinking about Mary; I only wish that Sarah were more like her.”
Nathaniel looked as if he were gut-punched by his brother’s words. “Have you told anyone your plan?” Asked Nathaniel.
“No, and God help me, Nathaniel, I dare not breathe a word of it. Everyone will be so disappointed, especially Sarah. I don’t want to lose her, but I don’t want to raise my wife either. When she comes to me, I want her to be a woman grown, not a child in a woman’s body, playing house. Please don’t tell anyone what I’ve told you., I suppose it’s cowardly of me, but I’m not ready to face the community’s wrath. In a month or two, they’ll all be looking to me to make a move, I hope I have the courage to speak by then.”
“I think you’re making a mistake, Jergen. My wife has the same temperament as Sarah, and we are very happy. I think you are going to cause a lot of pain just to put off something for a few months that you plan to do anyway. It seems unwise to me, but it is your life, brother, not mine.” Warned Nathaniel.
Jergen said nothing, he only lowered his head in deep thought and mindlessly groomed the horse before him.
*****
“Thank you brother Rikard for inviting me to speak to your community this morning,” Dr. Hedulund said, giving the man an enthusiastic handshake.
“Thank you, Dr. Hedulund, for caring about our community’s health,” replied Pastor Rikard as he stepped to the side of the room to allow Dr. Hedulund to have the gathering’s attention.
“Good morning everyone, before I get started I’d like to introduce my colleague,” Dr. Hedulund said as he motioned for Marilyn to come to the front of the room.
As Marilyn began to walk forward, she could feel the eyes of the audience upon her. Suddenly, she felt terribly inappropriate in her crisp white blouse, Celtic green cardigan, and navy blue boot-cut slacks. “Why didn’t I close another button on my blouse, or wear a black dress for that matter?” Marilyn asked herself. She thought her platform heels sounded like the boots of an SS Officer on the wooden floor. That, and the sound of her beating heart were the only sounds that she heard as she made her way to the front of the room, only to find that when she turned around to face the audience they all had pleasant smiles on their placid faces.
“Some of you know me already, I am Dr. Thomas Hedulund, and this is my colleague, Doctor Marilyn Richardson. We attended medical school together and have done work similar to what I’ve been doing in your community all over the world. Dr. Richardson, would you like to say a few words?”
Clutching at the front of her lab coat to close it, Dr. Richardson nervously took a step forward and began to speak. “Thank you for allowing me to come and work here in your community. I look forward to offering whatever medical support, research, and information you may need, thank you.” She took a step back to stand alongside Dr. Hedulund.
Prior to arriving, the doctors had discussed a sort of tag team approach to delivering today’s message. They wanted to show the community that Dr. Hedulund trusted and respected Dr. Richardson as an equal, that he was not her boss, she was not his nurse, but they were a team of doctors.
Marilyn was grateful for the respect and consideration her colleague gave her, since this was not always the case with other male peers. She appreciated not having to fight with him to be treated as a respected equal, which only deepened her unrequited affection for Thomas Hedulund.
Marilyn had wished for some way to make Thomas notice her as a woman ever since they met in medical school. Their nine-year age difference didn’t matter to her, but Thomas always seemed to gravitate to women who were just a little younger, prettier, and less of an intellectual challenge than Marilyn.
She knew she had no chance with Thomas, but she couldn’t make herself fall out of love with him.
“Glutaric acidemia type 1 (GA-1) comprises several different disorders. It is an autosomal recessive disorder, one of the many ways that a trait, disorder, or disease can be passed down through families,” said Dr. Hedulund.
“An autosomal recessive disorder means two copies of an abnormal gene must be present in a body in order for the disease or trait to develop,” Dr. Richardson explained.
“The accumulation of GA-1 in the body of an affected patient can make the brain atrophy or shrink, or a person can experience macrocephaly. I know that’s a mouthful, but it simply means that a person could have what is sometimes called large head syndrome. They can also experience acute dystonia, which is sustained, often very painful, muscle spasms that can look like a seizure,” said Dr. Hedulund.
“Some children don’t have any symptoms until a triggering event like a childhood infection with fever between six and eighteen months of age,”
Seeing the wide-eyed stares, open mouths, hands covering throats and mouths, and red faces in the audience, Dr. Richardson was quick to interject, “But there is no cause for a loss of hope. There is a treatment, and that is why we are here today, to make you aware of the issues, what to look for, and to encourage you to bring children to the clinic for testing as soon as they are born, and as soon as possible for your older children.
“This way, you will have an excellent chance of preventing any long-term disabilities,” Dr. Richardson said.
“Therapy consists of carnitine supplementation to remove glutaric acid, a diet restricted in amino acids, and prompt treatment of childhood illnesses. Fairly simple treatment, right? We’re here to help you and to keep you and your children healthy.” Dr. Richardson wrapped up the speech.
Feeling relieved that she survived such a stoic audience, she busied herself on her tablet, preparing to schedule appointments after this powerful, and what she presumed was a frightening information session, but no one came forward.
Dr. Hedulund was at the opposite end of the room with a matching tablet, and aside from the folks who walked by and thanked him for coming to their community, he didn’t have anyone schedule an appointment with him, either.
After half an hour, Dr. Hedulund and Dr. Richardson headed to the clinic to prepare for her next training session, but it would have to be postponed. Over
the next six hours, a steady stream of single men and women, couples, and families with small children showed up timidly to the clinic to receive genetic testing.
“Rebecca, I’m so happy that you and Nathaniel decided to get tested. I fear mother and father would not have allowed me to be tested if Nathaniel had not agreed to come with us,” said Sarah.
“Well it was Jergen’s idea, he said that he beat the doctors to the clinic by taking the shortcut, making him the first to be tested in the community.”
“Next please!” The nurse called out. Sarah stepped up to the desk and began the intake process, in four weeks they would all know what sort of risk they had for passing on GA-1 to their children.
*****
Marilyn Richardson enjoyed working with the Amish and became very committed to the community’s health. Her interests may have originally been to try to spark a flame with Dr. Hedulund, but those concerns went out the window as soon as Dr. Richardson met with the community that first day. The questions of the women, the health of their offspring, and their futures became important to her almost instantly.
Remembering the two sisters who appeared to be twins but were not, she smiled as she recalled their questions about her.
“I don’t usually speak with two patients at the same time, but since you insist on being seen together it’s perfectly fine with me. Now that you’ve been tested for GA-1, do you have any specific questions that you'd like to ask?”
“Yes Doctor, I have a question. Are you married, do you have children, are they boys or girls? Were you born in Lancaster? What’s it like to be a doctor? Do you feel called by God to do this work?” Sarah asked these questions in rapid succession without pausing for a response.
“You are curious aren't you? Sarah right?” Marilyn chuckled at the girl’s enthusiasm.
“Yes. I am Sarah, and this is my sister Rebecca, she wants to know too, but she’s too shy to ask you.”
“I’m not shy Sarah, I’m too polite to ask such personal things, and you should be too. It’s one thing to wonder about and it’s another to be so bold as to ask.”
“Oh, I’m sorry, I didn't realize. Please accept my apology for being so forward.” Sarah said with bowed head and downcast eyes.
Dr. Richardson gently touched Sarah’s arm and said, “No, please don’t apologize, it's alright really, I don't mind answering your questions. I’m not married, and I don’t have any children, but I’d like to have two someday, a boy, and a girl. But first I have to find a husband. I have a boyfriend, kind of, but he’s not ready for marriage or kids.”
“Is that other Doctor your boyfriend?” Rebecca asked with the excitement and romance of a girl her age.
“Dr. Hedulund? Oh no, we only work together. No, my boyfriend is someone else.”
“Is Dr. Hedulund married? He’s quite handsome,” Sarah said, causing all three women to giggle.
“No, he’s not married, I’m afraid Dr. Hedulund is married to his work,” Dr. Richardson said. “Now! I would love to stay and talk with you ladies all day, but I have other patients waiting, but do come back and see me anytime, to say hello, or if you have medical or personal questions,”
“Thank you, Doctor,” the sisters said as the rose to leave. The girl’s taking notice of Dr. Hedulund made Marilyn acutely aware that her biological clock was running out, her boyfriend would probably never commit in time for her to have a baby, and her true love only saw her as just a friend.
Marilyn knew that although she was five years younger than Dr. Richardson, he just didn’t see her in that way; or did he? Marilyn wondered why it seemed as if the doctor was flirting with her at times. The way that he touched her elbow or hand during the course of their work together. The way that he stood too close, moved the hair out of her face, and he always invited her to eat with him after they closed the clinic.
“Oh Marilyn, he’s just being nice, don’t read too much into this,” she told herself.
*****
“Marilyn the results are back from the lab.” Dr. Hedulund said.
“Have you looked at them, what are we dealing with?” she said, biting the side of her cheek out of nervousness.
“Yes, I did,” Dr. Hedulund said in a somber tone. “I’m very glad we had so many people to get tested. This community is really going to have to make some tough decisions about marriage and children.” At hearing this, Dr. Richardson lunged at Dr. Hedulund and grabbed the lab results out of his hand as he continued, “...and we have a couple dozen children that we have to monitor closely. Are you okay Marilyn?” Hedulund asked, as she tore the document from his hand.
“Oh my God! Nathaniel, Jergen, Rebeca, and Sarah’s lives will be changed forever. Those poor kids.”
“What, who?” Dr. Hedulund asked.
“They’re a family that I've grown close to. Sarah and Rebecca are sisters. Rebecca is married to Nathaniel, and Sarah is promised to marry Jergen. Having children could be very risky for them. Sarah and Jergen, who are so much in love, may be broken apart by the risk they run if they were to have children. Oh, Thomas, how do we tell them, how do we ruin these young people’s lives?” Dr. Richardson asked.
Standing there in the clinic hallway, Dr. Hedulund put his arm around Marilyn and she gently rested her head on his shoulder. A single tear rolled down her face as she imagined the devastation that she and Dr. Hedulund were about to deliver.
They were interrupted by Sarah, who walked into the hallway and smiled.
“Oh, Doctor Richardson, I was on my way to your office to tell you that my father said that I could volunteer at helping you in the clinic. He thinks it is great that I am doing something to help take care of the people in our community, but I can see that you are busy. I will come back tomorrow,” Sarah said, her face reddening as she noticed Marilyn in Doctor Hedulund's embrace. She made a hasty exit back down the hall.
Sarah didn’t quite understand her own feelings of sadness at seeing Dr. Hedulund hold another woman, especially the beautiful Dr. Richardson. She found herself running out of the clinic practically in tears and ran nearly all the way to her sister’s house.
*****
Early Saturday morning, Nathaniel, Jergen, and several other men began placing roofing tiles on Nathaniel and Rebecca’s home, getting an early start to beat the coming rain. They had been working for a few hours when the first drops began to fall. The wind picked up suddenly, followed by thunder and lightning.
“Nathaniel, we’d better call it a day for safety,” said Jergen.
“Alright then, you all head down, I’ll just finish this row of tile and will come down too. We’ll take lunch together inside. Rebecca made apple pie.”
The men all gathered their tools and climbed down the ladder one by one. Seeing the wind pick up, Rebecca came outside to see if the men were stopping their work. She saw Sarah running toward the house and gave her a little wave hello.
“Jergen, where’s Nathaniel?” Rebecca asked.
“He’s still on the roof, but he’s on his way down,” Jergen said.
Together they waited in the rain as Sarah drew closer and closer, but there was no sight of Nathaniel. Jergen began to call out to his brother as the rain poured down and the wind blew fiercely. A crack of thunder was so close that it made the women jump.
Jergen looked up at the sky, worried. “You ladies should go inside I’ll get Nathaniel to come in.”
Feeling uneasy, Rebecca turned to walk away then stopped and looked back toward the roof. Sarah dutifully stopped with her, and they listened as Jergen called to his brother.
“Nathaniel, Thaniel, Brother, please come down, it’s dangerous up there!”
“Coming brother,” Nathaniel yelled, as he raised the hammer over his head to signal an acknowledgment of his brother’s demand. Jergen and Rebecca were relieved to see Nathaniel walking towards the ladder, when suddenly a bolt of lightning struck Nathaniel’s raised hammer.
He fell from the roof. Sarah and Rebecca let out a scream as th
ey bolted to Nathaniel’s side.
“Get a doctor!” Jergen yelled. His neighbor, Daniel, bolted into action, driving Nathaniel’s buggy full of building materials wildly toward the clinic.
At the clinic, the doctors grabbed an emergency kit and instructed the nurse to dial 911, feeling confident that Nathaniel’s injuries would require a hospital visit. As Dr. Hedulund’s truck raced to the house, the two doctors traveled in silence, their minds busy preparing to assess the patient.
Seeing Nathaniel, they looked at each other and read the other’s mind.
“Unconscious for more than twenty minutes, we’re looking at some amount of brain injury, but at least he’s breathing,” Dr. Hedulund said quietly.
The ambulance arrived quickly and took the still-unconscious Nathaniel and his hysterical wife Rebecca to the hospital. Dr. Richardson drove behind them, bringing Sarah and Jergen in Dr. Hedulund’s truck.
After an interminably long wait, the doctor came to talk with Jergen, Sarah, and their parents. Doctors Hedulund and Richardson were standing alongside a third English doctor.
“My name is Dr. Siddhartha Gautama, I am the head Neurosurgeon,” he said, and offered his hand. Turning to Rebecca, he spoke softly, “Madame, your husband is receiving the best possible care. He has quite a bit of swelling on the brain. It does not appear that he was struck by lightning, it is most likely that it was an indirect strike that caused him to slip and fall off the roof, hitting his head. There is no fracture in the skull, but there is a lot of swelling of the brain. We have taken measures to stop the swelling. He has not awakened from the coma at this time, but that is okay, we are keeping him in the coma to allow his brain to heal, then we will slowly bring him out of the coma.