She remembered an appalling joke Amadeo had brought home from school when he was nine. Do you have HIV? Are you positive? She’d whirled on him, her own son, breezily bringing such terrifying, hurtful words into her kitchen. “Never, ever joke about that,” she’d said, and his smile had vanished at the urgency of her tone. “People die from that.” She’d known the word die would frighten him, and she was glad to see his stricken expression. “But not you, right, Mom? You’re not going to die?” Amadeo had asked, and she’d relented. Of course not, she’d said.
Behind Dr. Mitchell, the med student had removed his stethoscope and was now occupied with stretching the headset wide, then bringing the ear tips to meet each other, over and over.
Dr. Mitchell inhaled. “Based on the presentation, my guess is that this is a glioblastoma multiforme.”
The med student stopped fiddling with his stethoscope and looked up, alarmed.
“Are you sure there isn’t someone who can be with you?”
Yolanda shook her head tightly.
Dr. Mitchell nodded once. “Well. This is a serious diagnosis. Glioblastoma is aggressive. It’s uncommon, maybe one in every fifty thousand people, but when it hits, it works quickly.”
Yolanda forced a laugh. “One in fifty thousand. Wish I’d been so lucky at the slots last night.” She’d never given much thought to her brain. When she thought of organs, Yolanda thought of her stomach usually, with its seething acids, or of her heart, always straining, always ready to be broken. Not her brain. “Can’t you just take it out? Don’t they have real good surgeries now?”
“Given the location, total resection probably isn’t an option—it would almost certainly damage the brain tissue. I recommend we remove part of it to reduce pressure and buy you time, but glioblastomas have deep roots.” These roots, Dr. Mitchell explained, were tapping into the blood her brain needed. Yolanda imagined her tumor like a squatter siphoning electricity from neighbors with extension cords. She imagined the blood vessels thickening, tightening into a wicked net, choking off her poor brain until it spluttered and twitched. “They almost always come back.”
There were, unfortunately, no good options, he explained. Treatments included radiation and chemo.
Yolanda had heard on some commercial or other that humans only used five percent of their brain’s capacity. “What about that? What about my other ninety-five percent?” Wasn’t that enough to keep her alive?
Dr. Mitchell smiled sadly, as if she were making a joke. But she wasn’t joking—she wasn’t!
“So what does this mean?” Yolanda asked.
“It means you’re dying.” He said this simply, gently, and Yolanda was grateful for his clarity. This was the one thing she truly understood since this whole rigmarole started. “With surgery and treatment, median duration of survival for aggressive tumors like this is a year, fifteen months.”
“And without treatment?” Yolanda’s voice sounded very dry and calm to her ears, and she was proud of her composure.
“No one knows the future, of course, but we could be looking at as little as five months.”
Yolanda slumped, the paper crinkling beneath her. “I’m not good at games of chance. Last night I lost two hundred dollars in twenty minutes.”
Dr. Mitchell smiled sympathetically. “Keep that sense of humor. It’ll be a blessing to you.”
So: brain tumor. That was how she was going to go. No one in her family had ever died of such a thing. People in her family either lived forever, growing smaller and crankier, still baking and cleaning and hauling wood—take Tío Tíve, for example—or they died in some preposterous and untimely way: car accidents （Anthony）， falls from roofs （Yolanda’s second cousin）， overdoses （Elwin）。 These were idiotic, wasteful, hapless deaths, and they could, in certain retellings, be darkly funny. Never anything so bland and dreary as a body turning against itself, of resilient, inventive cells dividing industriously, spreading and conquering as in a game of Risk. These cells were the American Dream. They were the Sam Waltons of cells, the Starbucks, starting small and taking over vast swaths of territory, leaving destruction and foreclosures and empty storefronts in their wake.