7
We did not speak in the taxi to Harley Street nor in the waiting room. Anna sat upright in her chair. She did not move, or read or check her phone. A woman, covered by a burka, was sitting opposite us. I knew she was ill. I could tell by the way she gently rubbed her thumb and forefinger together, the way her husband paced, his prayer beads wrapped round his knuckles.
The secretary called our name and led us through to Dr. Kennety, a small man sitting behind a large desk, like a child wearing his father’s clothes.
“Hello, Mr. and Mrs. Coates,” he said, clearing his throat as we sat down. “Thanks for coming. Did you come from far?”
“No, just Hampstead,” Anna said softly.
“Oh, lovely, I live quite close.” He looked at us and then down at his papers. “So let’s talk about Jack’s scans. Before we start, please bear in mind, I am just one doctor. Another doctor may well see the situation differently, and I always advise my patients, and the parents of my patients, to get a second opinion.” The doctor looked at us, raised his eyebrows, and I didn’t know if he expected a response. “So that’s my usual preamble. Now, from looking at the scans, it does seem clear that Jack has what we call a glioma, which is a type of brain tumor.”
I could hear a car alarm, hushed talking in the waiting room. Out of the window, a pigeon walked along a shit-splattered sill. The doctor paused, waiting to see if we would react, but we were still, silent. It was as if the doctor’s words were being spoken to someone else, as if we were watching a drama unfold on the stage. I stared at a Disney World paperweight on his desk that contained a photo of a child wearing a Finding Nemo T-shirt.
Dr. Kennety looked up from his papers, a stray hair protruding from one nostril. “Should I give you a minute?” he said.
I tried to speak, but my throat wouldn’t open, as if it was clogged with soot. I didn’t know what Anna was doing. I could only feel her stillness, the sound of her breathing, next to me.
“I’m sorry,” the doctor said. “I’m sure this is quite a shock. However, it does appear—and this is the good news—to be slow growing.”
I managed to sit up in my seat, to catch my breath again.
“Now, some of these tumors don’t grow. They are essentially benign and just sit there for years, and you’d never know about it. On the other hand, some of them start off benign and can then turn nasty. In Jack’s case, it does appear to be in the early stage, but we would want to take it out, to prevent it from growing into anything unpleasant.
“Here, look,” Dr. Kennety said, taking a scan of Jack’s head out of his folder. Anna and I both leaned in. “Can you see this lighter part here?” We bent over and nodded. I had expected the tumor to be more spherical, better defined, but it was just an amorphous shadow, as if a photograph had been overexposed.
“It looks like Jack has a tumor called an astrocytoma, and his more specific type is called a pleomorphic xanthoastrocytoma. Quite a mouthful I know, so we call these PXAs.”
The room started to spin and I wanted to rewind, to play the doctor’s words back, because nothing he was saying made any sense.
“Let’s talk about the next steps,” he said, writing something on his pad. “Now, I do want to focus on the positives—and there really are many positives here.”
Dr. Kennety pulled a plastic model of a brain out of a desk drawer. “So,” he said, putting it down in front of us. “Here are the two temporal lobes on the side. And here on the left side is where Jack’s tumor is. Now, the harder-to-reach tumors are much deeper in the brain, but that doesn’t appear to be the case here. That means it will be much easier for the surgeon.”
“So he will need to have an operation?” Anna asked, the first words she had spoken.
“Sorry, yes. I’m jumping ahead of myself here. Yes, surgery to remove the tumor.”
“And would that be it?” I said. “He wouldn’t need any more treatment?”
“Hopefully, that would be it, yes,” the doctor said. “In the cases where there is a complete resection—meaning where the surgeon manages to get out all of the tumor—we’re looking at a cure rate of 80 or 90 percent.”
Eighty or 90 percent. One in five, one in ten.
“And if the surgeon doesn’t?” Anna said, her voice clinical and clear.
“Well, that gets a bit trickier, but let’s not think about that now,” he said, clasping his hands together. “From the scans, it looks like it would be no problem getting it all out.”
“That’s good,” I said, and it was, but the words still felt like razor blades in my throat.
“I know the waiting is horrible,” Dr. Kennety said, “but we’ll know so much more after the operation.”
We both nodded because what else could we do?
“I’m going to book you an appointment with a neurosurgeon. Her name is Dr. Flanagan, and she’s really the best in the business. Of course, you’re welcome to do your research and find someone else, but this is who I would recommend. And I will of course need to see Jack to give him a thorough neurological exam.”
Dr. Kennety looked from side to side, demonstrably making eye contact with us. “Okay then,” he said softly, and I watched his hands, small and childlike, pecking at his keyboard like a hen.
* * *
We walked quickly down Harley Street toward Oxford Street. I crossed the road without looking, powering ahead of Anna. You didn’t normally notice life going on
