“Must be drugs then. Your playing is off. I’ve seen the shakes hit when you think no one’s looking. I’ve seen how cops drink. Cleaned up after their other vices. What’s that man gotten you into?”
“Nothing,” I snapped, hating that he blamed Ryder.
His face creased with concern, and I reined in my temper. I might be an adult, a physician used to making life-and-death decisions, but to my family, I would always be the twelve-year-old girl whose poor judgment got her father killed.
I placed a hand—non-trembling, thanks to the meds I’d just taken—on his arm. “I’m fine. Really.”
He clapped his hand, large enough to swallow mine twice over, on top of mine and squeezed. “Then why did the ER let you go?”
“They didn’t.” From his expression, he didn’t believe me. “I wasn’t fired. I resigned. Thinking of moving. Trying something, someplace, new.”
There. I’d lit the fuse. The explosion would come after he passed the word down the family grapevine and it reached my mom, Patsy.
“Move?” His hand fell away from mine. “What nonsense is that? You can’t leave—you’ll break your mother’s heart.” The “again” remained unspoken.
The bar’s front door blew open, a gust of cold wind and a spark of sunshine casting aside the gloom. My younger sister, Evie, was carrying a cardboard box. Jimmy ran to help her while I shut the door against the December cold.
“Good, you’re both here,” she said, shaking her strawberry curls. “I was hoping to catch you.”
“I’m on my way to court,” I said. It was much too early to deal with Evie’s eternal cheeriness.
“This won’t take long,” she said. Jimmy set the box on the bar, and she opened the top. “Mom wants twinkle lights for the Christmas party.”
Our family celebrates Christmas Eve with an all-night party in the bar, open to everyone, filled with nonstop music, drink—and apparently this year, twinkle lights. Jimmy picked up a handful and grimaced. “I’ve already hung the evergreens she wanted, decked the halls with boughs of holly, even replaced the Christmas tree when she decided against the blue spruce,” he protested. “But I draw the line at fairy lights. Next thing you know, she’ll be wanting glitter on the damn taps.”
My mom, Patsy, was the youngest Kiely sister, but she ruled the clan. She always got what she wanted—but that didn’t mean she got it without a fight. Sometimes I think the Kielys lived for bickering, reconciling, and beginning the cycle all over again. I never understood it or learned how to play the game.
Now Evie? She was a master. She beamed at Jimmy, stood on her tiptoes, and kissed his cheek. “Do it for me, Jimmy? They’ll look so pretty hanging from the rafters.”
He blushed and nodded. Then she turned to me, handing me a piece of stationery with Patsy’s elegant printing. “Here’s the playlist Mom wants to start the party. She thought you could give it to Jacob.”
Jacob is my ex. We were married two years, divorced for almost four. My family conveniently refuses to acknowledge the divorced part, as Jacob is an integral member of the family ceili band. Can’t say I blame them. There have been plenty of times when Jacob and I also conveniently forgot we were divorced.
I dutifully pocketed the playlist. Jacob worked for the public defender’s office, so we’d be on opposite sides today as he defended Tymara’s rapist. Maybe I’d wait until tomorrow to give him Patsy’s list.
I turned to leave. “What time will you be home?” Evie called after me.
“Not sure.”
“But you
are
coming home?” With my back to her, it was impossible to tell Evie’s voice from my mom’s, they sounded so much alike. “Angela, you aren’t in trouble, are you? We’re worried.”
“I’m fine,” I lied and walked out the door, closing it on their suspicions and unvoiced accusations. Jimmy and Evie were only the first hurdle and by far the easiest. But sooner or later, I would have to face my mom.
Tahiti never looked so good.
LOUISE MEHTA IS
my neurologist. She’s also my best friend. Used to be, any time the two of us got together, it involved good wine and bad jokes. You have not heard a dirty joke until you’ve heard it told by a middle-aged, meticulously dressed Indian woman with a faint upper-crust British accent.
Only, it’s been weeks since I’ve heard Louise joke about anything. Telling your friend she probably has a one-in-a-hundred-million, rare, always-fatal disease pretty much kills any punch line.
Louise loves routine, likes everything to follow a precise order. Her favorite thing is to check items off her many lists—lists of questions to ask patients, lists of articles to read, lists of groceries to buy. She’s governed by bullet points.
I’m not. As an ER doc, chaos is my constant companion. Lists and practice guidelines, standard operating procedures, paperwork in triplicate—they all give me hives. I like being flexible, juggling a bunch of ideas—many contradictory—all at once, playing devil’s advocate.
“Good morning. How are you feeling?” Louise’s gaze was fixed on my chart as she entered the exam room where I waited. Trailing after her was a dark-haired man in his early thirties, his white coat brimming with tools, including the longest reflex hammer I’d ever seen. The tablet computer clutched in his hands was a match to the one in Louise’s pocket.
“Resident,” was my diagnosis. I restrained an eye roll. Amazing. I’d gone from attending physician to lab rat in a matter of days. Guess I knew what my tests were going to show if Louise was putting me on display for her neurology residents.
She glanced up, surprised I hadn’t returned her greeting. Never mind that it was the kind of greeting you gave a patient, not a friend. She saw me staring at the man. “Oh, sorry. This is Tommaso Lazaretto, a visiting neurofellow from Penn. Tommaso, this is Dr. Angela Rossi. Tommaso has done some work in prion diseases, so he’s very interested in your case.”
I transferred my stare to her and arched one eyebrow. I felt an illicit rush of satisfaction when she flushed. “Tommaso, why don’t you wait outside? Angela and I have a few things to discuss.”
To his credit, Tommaso stepped forward and took my hand. “I’m so pleased to meet you, Dr. Rossi.” He had the faintest of Italian accents. “I’m sorry it’s under such unfortunate circumstances. I look forward to working with you.”
I gave him a lukewarm handshake, having no patience for niceties. Not when Louise held my future in that file in her hands. Tommaso left, carefully closing the door behind him. Leaving me and Louise and my unnamed diagnosis trapped inside the tiny room.
Louise leaned against the closed door, looking down at where I sat on the swivel stool traditionally reserved for the physician. I’d taken it by habit and, once on it, couldn’t bring myself to move to the patient exam table.
I drew in my breath, steeling myself. Didn’t even give her time to take the other chair and sit down. “What did the DNA results show?”
Her face told me everything I needed to know. “We were able to isolate your father’s DNA from the sample you brought in.” I’d stolen my dad’s old straight razor from my mom’s stash of his keepsakes. “The results confirmed my suspicions. Although there are some abnormal genetic markers, your father tested positive for Fatal Familial Insomnia.”
Her voice was steady, clinical. I was glad. If she’d shown emotion, I don’t think I could have handled that.
She sank into the chair beside me as I processed this new reality. A strange fog of relief swirled through me, leaving me with goose bumps in its wake. “Do you think—could he have had symptoms already? Back then? I mean…” My voice trailed off, a breathless sigh of hope.
Could twenty-two years of family lore be wrong? Because if fatal insomnia, with its muscle spasms, hallucinations, and sudden fugue states—episodes that left a person catatonic for a period of time—had caused my dad’s accident, then I wasn’t to blame. For the first time in my life, I could forgive myself for being the reason why he was out on the road that stormy night, coming to pick me up after yet another afterschool detention. Maybe the rest of the family would finally forgive me as well.
Louise didn’t have to check her notes. “Yes. It’s definitely possible that he already had symptoms. I’d love to learn more about his family, especially anyone else who died young.”
“Sorry, there’s no one. His mother brought him here from Italy after his father died, and she died—cancer—before I was born.” The facts helped distance me from the emotional tug-of-war raging in my mind. If Dad had fatal insomnia, then the odds I had it were fifty-fifty. Not just me, but my little sister as well. How the hell was I going to break it to Mom and Evie that she was at risk?
“And me?” I asked, sucking in my gut, preparing for the one-two punch.
She hesitated. “Indeterminate.” That was the problem with testing for a disease that only hit one in one hundred million people. “We’ll repeat it, of course. But given your symptoms, with him testing positive, I don’t see any other possibility for a diagnosis.”
Louise was the smartest person I knew. And the best doctor. If she had ruled out every other possibility, then that was that. The disease that had killed my father and let me off the hook for his death was also the disease that would kill me.
Okay.
Okay
. Now I knew what the enemy was—a microscopic protein known as a prion—the same thing that caused mad cow disease. A nasty, traitorous, crumbled clump of tissue had contaminated my brain, turning it into Swiss cheese.
She reached a hand toward my shoulder. Toddler that I was at times, I pushed hard with my feet, propelling the stool out of range of Louise’s comfort so fast I ricocheted off the exam table and knocked over the empty metal waste can with a clatter. It rolled across the floor, landing at Louise’s feet. She looked at me. At the can. Then she tilted her face toward me, a quirky half smile creasing her eyes. She gave me a quick nod as if agreeing to an unspoken conspiracy and kicked it soccer-style.
Her aim was perfection, careening it against the corner and back to me. I raised my foot and stomped down so hard the empty metal can caved in with a satisfying crunch. The perfect explosion of petulant, childish rage.
It felt good. Damn good. If not for the fact that the stupid, cheap tin can crumpled around my foot and I had to balance against the exam bed to shake free of it. Flushed, I turned to Louise. She waited for my response as I wavered between tears and laughter. Laughter won out.
I sat again on the stool, wheeled my way around the crushed can, and rejoined her at the desk. “Put that on my bill.”
“You know they’ll mark up that piece of essential medical equipment until the insurance company thinks you destroyed an MRI machine.”
“Not like I’ll be around to pay for it,” I shot back. That sobered us both. But it was the truth, no sense in avoiding it. I released my breath, my stomach caving in. “So…Tahiti it is.”
“Tahiti?” she asked, confused. I let it hang. Louise was smart enough to figure it out for herself. It only took a beat, and her expression turned fierce. “Angela Rossi. Are you that selfish? To abandon your friends, your family—”
“I’m trying to spare them, and you damn well know it.”
“You’re a control freak. Brassed off that finally there is something beyond your control,” she retorted.
“What do you want me to do? Lie there, helpless, awake and aware of everything, while the people I love wipe my ass for me? How’s that for a final memory to haunt them the rest of their lives?”
Louise crossed her arms, hugging the chart to her chest. Inhaled and blew out her breath, lipstick feathering into the creases around her mouth. “It doesn’t have to come to that. I can help.”
I stared at her, surprised. She’d lose her job, her license, maybe even go to jail. “I can’t ask you—”
“You didn’t.” She released the chart from her grip and set it between us. “I’m offering. It can be here or…Tahiti. But promise me, whatever you decide, you’ll say good-bye first. Your friends and family deserve that at least.”
Images of the band filled me. Of Jimmy’s bar, music soaring, spinning out of control, as laughter filled the air and people danced: Mom, Evie, Uncle Jimmy, my two obnoxious cousins, Jacob—my ex—Louise and her family, my colleagues from the Advocacy Center and ER. And Ryder. It was the last that made me nod my agreement. The way Ryder looked at me when I played my fiddle, as if I were the only woman in the entire universe. Who could resist the chance to see that one last time?
Except…I looked away. “Ryder. It’s not fair. He never signed up for this.”
“Don’t you think that’s his choice?” Louise’s infamous
you’re screwing up again
glare said it all. It was the one she gave me every time I hooked up with Jacob for one of our on-again, off-again flings. Of course, she needn’t worry. Jacob and I were never going to happen again. Not after Ryder. He’d be my last. And, in so many ways, my first. First time I ever needed, ever wanted a man in my life—no, that was wrong—first time I ever wanted to be part of a man’s life, instead of solely living my own.
“Ryder deserves to know,” she said.
“He deserves a lot more than that. Which is why I can’t drag him into this.” My words hung between us. Then I dared to ask the question I’d been avoiding. “How long?”
“There’s been speculation that some alternative therapies may—”