“As I think you discussed with one of our practitioners on the phone, in Jack’s case, we would offer you a complete course of immuno-engineering. We would also want to do more extensive genetic testing, to see what additional treatments he could be given. We have had some good results with patients like Jack.”
“When you say good results, what do you mean? Could Jack be cured?” I said.
“Yes,” he said quickly, holding my eyes with his. “Cured.”
“You mean children with glioblastoma?”
“Yes.”
“But high-grade glioblastoma, like Jack’s.”
“Yes, of course.”
Dr. Sladkovsky looked at me, so intensely I thought he was going to grasp my hand across the table.
“Look, Mr. Coates, for all the time I do this job, I don’t ever find these consultations easy. Your little boy, he is certainly very ill. I would say it breaks my heart, but no, because I don’t let it. I try to keep the professional distance, but it’s hard sometimes because I also have children.” He clasped his hands together, and I noticed a large signet ring on his right hand.
“So if I will be honest with you. I have had children come to me with glioblastoma and survive. And I have had many who have not. I offer you no guarantees of a cure for Jack. It would not be ethical for me to do so. However, other oncologists will, how you say, write off their patients, but I won’t do that. So all I can say—and please forgive me my English—is if you decide that Jack would undergo the treatment with us, then I could offer you no promise, but we could at least give you chance.”
“Can I ask you something?” I said.
“Of course.”
“Would you treat your own children with immuno-engineering? I mean, if they had cancer.”
“Yes,” he said. “In a beat of my heart. I would push them to the front of the line. They’re my children, and I would do anything for them. Who wouldn’t?”
Sladkovsky tapped his pen lightly on the desk. “Is it just you? Is Jack’s mother here, as well?”
“Not yet. But she’s coming. Her mother is very ill at the moment.”
I felt a prickle of sweat on my back, imagining Anna coming home to find the note on the hall table.
“Okay. Please think on it. If you decide that Jack will undergo treatment with us, then we would like to start as soon as possible. Just so you know, this consultation is at no charge, should you choose not to stay with us...”
“Will it hurt?” I said suddenly.
Sladkovsky furrowed his brow. “The immuno-engineering, the treatments you mean?”
“Yes. Jack has gone through so much, the chemo, the recovery from the surgery. I don’t want him to be in pain.”
“Well,” the doctor said. “I will be truthful with you. It affects people in different ways. Some patients have almost no side effects, and with children we often find that is true. But according to medical ethics, I must tell you that in perhaps 30 percent of our patients, they do experience side effects, some of them severe. Vomiting, sweating fevers, much of what you might see on chemotherapy. But I would add that we are very used to controlling these side effects. We have many, many new drugs. Was Jack scheduled for more chemotherapy in the UK?”
“Yes, next week.”
“Believe me, it will be no worse than that.”
The phone on Sladkovsky’s desk rang. “Sorry, I will be one minute. I’m afraid I have to take this.”
He picked up the receiver and, after saying a few words in Czech, pulled out a notepad on his desk. I watched as he listened, nodding, occasionally touching the end of his pen to his lips. I remembered someone on Hope’s Place calling him Dr. Sleaze. They said he tried too hard with the smart suits and doctorly bow ties, his attempt at an English upper-class accent. But as I watched him now, writing down numbers on a blank page, professorial in his trim white coat, he radiated nothing but composure.
“So you have decided?”
“When can we start?”
Dr. Sladkovsky looked at me and scratched his chin. “I’m glad you would like to go ahead with the treatment, but we do have to take a few steps to check that Jack is eligible.”
“Of course,” I said.
“This is standard practice,” he said. “Nothing to worry about. We are bound by European medical law to make sure that we are doing Jack no harm.”
“Yes, of course, I understand.”
I followed Dr. Sladkovsky out of the office and down a corridor until we reached an atrium with a glass ceiling where we found Jack throwing a ball back and forth with Lenka.
“Hello, Jack,” the doctor said, but Jack didn’t smile back and clung to my trouser leg.
“So I’d like to take Jack for his checks. Is there a suite free now, Lenka?” the doctor asked the receptionist.
“Of course,” Lenka said, and smiled.
“Jack,” she said, “do you want to come with me?”
“Am I having the medicine?” Jack asked.
Lenka paused, not knowing what to say.
“No, Jack,” I said, putting my arm around him and guiding him out of the atrium. “Just a couple of tests. Nothing that will hurt, I promise.”
“Okay,” Jack said. “Is there a TV?”
“There is,” Lenka said. “A big TV.”
Lenka led us into a private room, and Jack lay down on the bed. A nurse came in and checked Jack’s heart rate and then took some blood. I held his hand when they put the needle in, but he didn’t even flinch. As we waited for the doctor, I remembered the checks we went through before Jack’s operation in London. The questionnaires, the endless medical tests and pre-op assessments. There was nothing like that here. It was all so quick. Could they really gauge his fitness from a quick blood test?
After a little while, Dr. Sladkovsky came into the room and looked at Jack’s charts and then asked to see me outside. I felt a familiar sense of dread, a shiver as I
