Page 27 of The Devil You Know
He reaches up and grabs the box from the top shelf. It’s clearly quite heavy based on the contents, but he doesn’t even grunt when he lifts it. But I do see the muscles in his biceps bulging as he lowers the box to the floor.
I’m embarrassed how thrilled I am to find a stash of paper rolls in there. I pick out three of them, thinking I’ll stash two of them away for when I’ll almost certainly have to do this again in the future. Ryan just looks at me and shakes his head.
“That’s how things work at the VA,” I say defensively.
The phone in Ryan’s pocket buzzes. He picks it up with a gruff, “Yeah?” He listens for a minute, then says, “I’m not coming down to the OR until the patient is completely prepped and ready to go…….. Yeah, too bad…… Well, call me back when you’re ready for me to cut.”
He shoves the phone back into his pocket and winks at me. “And that’s how it’s done, Jane. You don’t let them boss you around.”
That might work for a hotshot vascular surgeon. Not for a dime a dozen internist.
“What are you doing here, anyway?” I ask him as I walk back to the examining room to switch out the rolls. I have some unknown number of patients waiting to be seen, so I don’t have time for chitchat.
“Just wanted to give you a heads up on one of my patients you’re seeing today,” he says. “His name is Donald Maloney. I’m doing a fem-pop bypass on him next week.”
I make a face at him. “You really had to come all the way here to tell me about that?”
He grins. “No, not really.”
I start fiddling with the metal bar holding the empty paper roll in place. “Well, thanks for your help and all.”
Ryan watches me struggling to get that damn empty roll off. The metal seems rotted into place. I know it must have been changed relatively recently, but this seemsimpossible. After a minute of fumbling, Ryan shoves me out of the way.
“Let me do it,” he says. “This is painful to watch.”
I’d been looking forward to watching Ryan fumble with the roll the way I did, but amazingly, he slides it right out like he’s been doing it his whole life. Like all surgeons,he’s good with his hands. His are so steady—I’ve always admired that about him.
“How is your dad doing?” I blurt out.
Ryan looks up sharply. An unreadable expression comes over his face. “He died. A few years back.”
“Oh,” I murmur. “I’m so sorry.”
“I’m not.” Ryan snaps the new roll of paper into place. “He’d been declining for so long… he wasn’t even… I mean, it was time. More than time.”
His blue eyes avoid mine. When I first met Ryan way back when I was an intern in a medicine residency, I happened to run into him at a nursing home where his father was living. Ryan tried to make up some story about the whole thing, but the truth eventually came out. His father was sick. Very sick. With a disease called Huntington’s Chorea.
Huntington’s Chorea is an affliction that usually hits people in their late thirties and early forties. It causes jerky, random, uncontrolled movements in the arms and legs known as “chorea.” It also causes difficulty with balance and eye movements. Eventually, patients have trouble speaking and swallowing. With time, their cognitive abilities are affected as well, and they decline into dementia.
The other important thing about Huntington’s Chorea is that it’s not just random. It’s caused by adominant gene. One that can be passed down from parent to child with fifty percent frequency. A coin toss.
Ryan has two older siblings. He has a sister who was tested for the gene and found to be negative. He has a brother who was tested and found to be positive, and it ruined his life. Ryan decided he didn’t want to know.
Not knowing allowed him to move on with his career and not become an alcoholic living in his car like his brother. But he decided that it would be irresponsible to ever marry and have children, knowing what could happen to him in the near future, and what he might pass on to a son or daughter. At least, not until he knew that he was in the clear.
Early in our relationship, I accepted that he didn’t want to get tested. But the longer we were together, the more it infuriated me what he was doing to himself. I was sure that he would have wanted to get married and have children if not for his fear of getting sick. If he was going to live his life like he had Huntington’s, why not just get tested? Not only was it affecting his life, it was starting to affect mine as well. I wanted him to bite the bullet and get the test.
But no. He was adamant. He didn’t want to know.
So I left.
“How is your brother doing?” I ask him. His brother is several years older than he is, likely in his fifties by now or close.
Ryan sighs. He hasn’t told many people about his family illness. I was the only person in residency who knew, which also meant I was the only person he could talk to about it. Most of the time, he liked to pretend it didn’t exist, but there were other times when he needed to talk. And I’d listen.
“Nick’s awful,” he says quietly. “I had to get him twenty-four hour care just to keep him out of a nursing home. He can’t… he can’t walk anymore. I mean, he can, but he just falls, so we can’t let him.”
“Jesus,” I murmur.
