That totally sucked. Katie’s face is flushed hot, and her heart is beating as if she’s in a full sprint. Beating. B. Damn it.
You don’t have HD, but we did diagnose you with STUPID. Sorry, there’s nothing we can do for that.
“All right, Kathryn. It was nice to meet you. I’m going to leave you now with Eric. Do you have any questions for me before I go?”
“Wait, uh, yeah. What just happened?”
“You had a neurological exam.”
“To see if I’m showing symptoms of Huntington’s?”
“Yes.”
Katie examines Dr. Hagler’s face, trying to discern the answer to the terrifying question blinking in her head like a neon sign without having to verbalize it. Dr. Hagler and her infuriatingly impassive face are standing by the door. Katie can’t let her leave without knowing. Did she pass or fail? She closes her eyes.
“Am I?” asks Katie.
“No. Everything looks normal.”
Katie opens her eyes to Dr. Hagler’s smiling face. It’s the most reassuring, honest-to-God smile Katie’s ever seen.
“Okay, then. Take care.” And Dr. Hagler is gone. Namaste.
Eric raises his eyebrows and claps his hands together.
“Shall we?” he asks.
She’s not sure. To be honest, she’d really like to lie down. She’s not showing any signs of HD. All that time studying herself in the mirror, tormenting herself over every nervous fidget, or that major full-body twitch she sometimes gets just before falling asleep, hunting for Huntington’s. She can stop. She doesn’t have it. For now. This is really good news. But that neuro exam was like surviving fifteen rounds in a boxing ring. She’s been declared the winner, but she still got knocked around. She’s not sure she’s ready for anything more than a nap.
She nods.
“So your father has HD and your oldest brother is gene positive. I have your family’s medical history from JJ, so we don’t need to go through that again. Let’s talk about why you’re here. Why do you want to know?”
“I’m not sure I do.”
“Okay.”
“I mean, sometimes I think living with the constant uncertainty is worse than knowing that I’m going to get it.”
He nods. “So how’ve you been dealing with the uncertainty?”
“Not that great.”
The questioning, the stress, the anxiety are always there, like an annoying radio station playing too loudly in the background that she can never turn off or completely tune out. She becomes gripped with panic many times a day—if she loses balance in a standing pose in class, if she drops her keys, if she forgets her phone, if she catches herself jiggling her foot. Or for no reason at all. It can simply be that there’s enough time and space for her mind to wander—waiting for class to start, waiting for her tea to steep, watching some inane commercial on TV, trying to meditate, listening to her mother talk. Her thoughts beeline to HD. She’s like a teenager with a mad crush on a bad boy, or a junkie fantasizing about her next hit of meth. She can’t resist her new favorite yet destructive topic and obsesses about it every chance she gets. HD. HD. HD.
What if she has it now? What if she gets it later? What if all of them get it?
“Are you feeling depressed?”
“That’s kind of a ridiculous question.”
“How so?”
She sighs, annoyed that she has to spell it out for this guy.
“My dad and brother have a fatal disease, and I might have it, too. This isn’t exactly the happiest time in my life.”
“Your brother has the gene. He doesn’t have the disease yet.”
“Whatever.”
“It’s an important distinction. He’s the same guy he was the day before he found out his gene status. He’s a perfectly healthy twenty-five-year-old.”
Katie nods. It’s so hard for her to look at JJ now and not see him differently. Doomed. Sick. Dying young. HD. HD. HD.
“And you’re right, it’s totally normal to feel a bit depressed with all that’s happening. Have you ever been depressed before?”
“No.”
“Ever been to see a psychiatrist or psychologist for any reason?”
“No.”
“Are you on any medication?”
“No.”
One of the symptoms of HD is depression. Some people with HD begin with the physical symptoms, the movement changes she was just tested for by the neurologist, but some people begin with the psychological symptoms years before any of the chorea sets in. Obsession, paranoia, depression. She can’t stop thinking about HD, she’s convinced that God has cursed her whole family with this disease, and she’s sad about it. Is her less-than-bubbly mood of late the first sign of HD creeping through the cracks, or is it what any normal person under these totally abnormal circumstances would feel? Which comes first, the chicken or the egg? It’s a circular mind fuck.
“I’m pretty sure I have the gene,” says Katie.
“Why’s that?”
“JJ looks exactly like my dad, and he has it. I look like my dad’s mother, and she had HD.”
“That’s a pretty typical assumption, but there’s absolutely no truth to it. You can look exactly like your dad or your grandmother and not have inherited the HD gene.”
She nods, not buying one word of it.
“This might be a good time to go over some basic genetics.”
Eric walks over to a white board on the wall and picks up a black marker.
“Uh, do I have to write this down?” She didn’t bring a pen or paper. JJ didn’t warn her about any of this. She wishes Meghan had gone first. Meghan would’ve told her everything.
“No, there’s no quiz or anything. I just want to help you understand how the inheritance of HD works.”
He writes a list of words on the board.
Chromosomes. Genes. DNA. ATCG. CAG.