I glance over to find a knowing smile on her lips, her sparkling emerald eyes crinkling at the corners as she studies me. Either I’m being painfully obvious, or mother’s her intuition is better than I realized. I’m hoping it’s the latter.
“Oh, um… no one.” Even if I wanted to tell her, it feels weird when we’re en route to her oncology appointment. Not sure how she’d take the news that I’m living with the guy I’m crushing on, either.
“Sure seems like someone.”
“Just a guy I’ve been talking to. It’s not even a thing.”
And at this rate, it never will be.
“Mrs. Carter?” A petite nurse in pink scrubs stands in the doorway, scanning the waiting room until my mother stands up. “The doctor can see you now.”
My heart races as I follow my mother and the nurse down the wood-paneled hallway into Doctor Wilson’s office. With a sprawling glass desk and two leather guest chairs, it looks more like something I’d expect to find at a law office rather than a medical practice. But he’s one of the best oncologists on the East Coast, so that might explain the decor.
The first half of the appointment involves a lot of medical jargon, some of which I didn’t fully understand, but I ask questions and take ample notes because the chemo gives my mom brain fog and she likes to be able to re-read things later. I relax slightly as Doctor Wilson explains that they expect her to respond well to the protocol they’ve designed, and her overall prognosis is excellent. For her type and stage of cancer, the rate of survival is nearly ninety percent with early aggressive treatment like she’s receiving. Probably even better in her case because she was in such good health before. All things considered; she’s doing great.
While everything has been encouraging until this point, the mood in the room shifts markedly when he mentions something about genetic testing, reaching for a folder on the tray next to his desk. My nerves skyrocket again, and I hold my breath, waiting for him to continue. Did they find something else wrong with her?
He clears his throat. “As we discussed, we conducted a comprehensive genetic testing panel during the diagnostic process. The results have come back, and you’re positive for the BRCA-1 mutation. It’s helpful that your daughter is here with you today; when a patient has a positive result, we recommend testing all immediate relatives since there’s a fifty percent chance they’ve also inherited it.”
My vision tunnels, and the room turns sideways on me.
BRCA.
Fifty percent chance.
I try to make sense of what he just said, but I’m lacking critical information. I don’t know what it means other than it’s something bad, and I might have it too.
Mom reaches over and covers my hand with hers, giving it a squeeze. “I know it sounds scary, sweetheart, but it’s better to get tested and find out. If you’re negative, it’ll be a weight off your shoulders.” Despite her reassurance, her expression is tight, and there’s fear beneath the brave face she’s putting on for me. She looks more upset than when she told me about her diagnosis.
“Why? What does it mean if I’m positive?” I ask, trying to hide the wobble in my voice.
“Sera, let’s not get ahead—” she starts.
“No, tell me. Please. If you don’t, the first thing I’m going to do when I get home is Google it, and that’ll be worse.”
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.