Shutout (Rules of the Game, #2)(29)
Doctor Wilson laces his fingers together, giving me a sympathetic look. “I need to emphasize that statistically speaking, there’s an equally good chance you’re not a carrier. With that said, individuals who carry the BRCA gene are at a higher-than-average chance of developing breast cancer and are more likely to develop it at a young age. There’s an increased risk of ovarian cancer as well.”
This is more or less what I expected, but somehow hearing it out loud makes it even worse.
“Routine cancer screenings begin sooner and are conducted more frequently,” he adds. “Some patients may also opt for a prophylactic mastectomy and/or salpingo-oophorectomy to reduce their risk of cancer down the road. Even if you test positive, you have some time to weigh your options in that regard.”
“Sal-what?” I echo, not even able to process the mastectomy part that preceded it. When I came here today, I had no idea we might discuss anything in relation to me. Part of me wishes my mother had warned me in advance, but I also understand why she didn’t. The stricken look on her face says it all—she was hoping the results would be negative and that she wouldn’t need to.
“Removal of the ovaries and fallopian tubes,” he clarifies.
In other words, surgically eliminating my ability to get pregnant.
Panic claws at my throat. “How much time are we talking?” I’m in no hurry to settle down but I want to have children someday, and I assumed I had plenty of time to make that happen.
He hesitates. “It depends how aggressive the patient wants to be. Most risk reduction strategies recommend the procedures between the ages of thirty-five and forty or when childbearing is complete, whichever is sooner. The risks are incremental, and they increase with age. Statistically speaking, most women with BRCA1 develop breast cancer eventually.”
The good news is the intervention timeline isn’t as immediate as I feared. I’m almost twenty-one, so we’re talking roughly fifteen years in the future.
The bad news is that working backwards, this wouldn’t give me as much time as I thought I had to start a family.
The worst news is being a carrier would mean I’m a ticking time bomb.
My chest is so tight it aches. “I see.”
“Let’s not get ahead of ourselves,” he says, shuffling the papers on his desk. “The first step would be to book you in for testing. We can facilitate that if you’d like. After that, you can be referred out for additional genetic counseling if necessary.”
“What about men? Could Chase be a carrier?” He made me promise to message him the minute we finished, but this isn’t a conversation for text.
He nods. “Men can carry the gene too.”
“Seraphina.” My mother touches my forearm, drawing my attention to her. Her lips press into a grim line. “If you don’t mind, honey, I’d like to hold off on telling him about this for now. Just for a couple weeks. He’s got a lot on his plate to deal with, and I don’t want to add to his stress.”
I swallow the boulder sitting in my throat. “Right. I won’t say a word.”
We gather our things and I numbly trail behind my mom, my head spinning and ears ringing. When we step back into the lobby, I spot a woman standing at reception. She’s hardly older than me—well under thirty for certain—and like my mother, she’s clearly sick. A pink-and-purple scarf covers what’s left of her hair and her olive complexion is wan.
My eyes dart in her direction again. She’s beautiful, with wide dark eyes and full lips. I can’t get over how young she looks. Twenty-four or twenty-five, if I had to guess. How old was she when she was diagnosed? Did she even suspect she might get sick? Did she do the same genetic test Mom’s doctor mentioned?
Could that be me someday?
The reality of what I’m facing slams into me. People always say you have your twenties to figure everything out. I always assumed that was true, but everything seems different when you’re looking down the barrel of a diagnosis.
While I have a hazy, imprecise understanding of what I want out of life, I couldn’t articulate it if I tried. My plan for the future is vague and amorphous, filled with terms like “one day” and “eventually.” Like an apparition you see out of the corner of your eye that vanishes when you try to grab it.
I want to get married eventually—that much I know for sure. And if I’m a carrier, that has consequences for both of us, not just me. It could even impact how many children we have. What if I can’t have kids in time? Or what if I do, and then I get sick?
Deep down, I know it’s irrational to get ahead of myself before I get tested and receive the results. There’s a decent chance I’ll be BRCA negative. But what if I’m not?
I’m spiraling and I can’t help it. There are too many unknowns—and many of them are terrifying.
Fueled by a morbid sense of curiosity, I steal another peek at the young woman. A million questions swirl through my mind. I wonder how much life she got to experience before her diagnosis. Did she get the chance to fall in love? Does she have a partner to help her now? To my stepfather’s credit, he’s been there for my mother more than I expected, even picking up cooking and cleaning around the house. I’m not sure she’d be doing nearly as well without him.
As we pass, I overhear part of their conversation.
“Still with Cigna?” the receptionist asks.