Inside the O'Briens

Katie nods. Eric waits. The air between them swells with a sticky silence.

 

“One thing we didn’t talk about last time when we went over the genetics that you should know. Remember we talked about the expanded HD gene. Thirty-five or fewer CAG repeats is a negative result and means you won’t get HD. Forty or more CAG repeats means you will definitely get HD. Well, the test isn’t completely black-and-white. There’s a gray area.”

 

Eric pauses. Katie’s stomach tightens, and she braces herself. She has no idea what he’s about to say, but her intuition is sounding every alarm.

 

“If you have thirty-six to thirty-nine repeats, it’s a result I can’t interpret. This is called a reduced penetrance allele. This is the gray area. With thirty-eight or thirty-nine, you probably have a ninety percent chance of getting HD in your lifetime if you live long enough. It’s probably around seventy-five percent if you have thirty-seven CAG repeats and fifty percent for thirty-six repeats, but none of this is exact. We can’t really say for sure when the number is between thirty-six and thirty-nine.”

 

He waits, exploring Katie’s face for how this new information is landing in her. It landed like a fuckin’ drone attack. She never saw it coming. It was a big fat lie of omission. A bait and switch. She’s so pissed, she can’t even find the words. She takes a deep breath. There they are.

 

“So let me get this straight. I could take the test and get an answer that’s not an answer.”

 

“Unfortunately, yes.”

 

She can’t believe it. This can’t be right.

 

“So I could go through all this bullshit, decide I want to know, and then if the result is gray, I’ll essentially still be at fifty-fifty.”

 

“Yes.”

 

“Well, that fuckin’ sucks.”

 

“It does. But it’s the best we have.”

 

“You should’ve told me on our first date.”

 

She hears what she just said. She’s too pissed to blush.

 

“I mean appointment.”

 

“I know. I’m sorry. Sometimes, I find it’s too much information to lay out on the first visit. Has any of this helped?” asks Eric.

 

It did right up until everything went gray.

 

“I dunno.”

 

“You don’t have to decide anything today. But if you want, we can walk down to the lab, have your blood drawn, and sent for the test.”

 

“And then I’ll find out if my CAG count is black, white, or gray.”

 

“Yes. And in four weeks, if you still want to know, you can come back, and I’ll tell you your results. Here’s how that visit will go down if you decide to go through with it. You and the person you bring to support you will be called in from the waiting room. I won’t know your results before you come in, so whatever my face is doing when you first see me means nothing. If I smile or look distracted or whatever, it doesn’t mean anything. I’ll ask you whether you still want to know. If you say yes, then I’ll open your envelope, read your results, and then tell you the news.”

 

She tries to picture them in this same office in four weeks. Eric has a white envelope in his hand. He opens it. And the winner is . . .

 

“So what do you want to do? Do you want me to escort you to the lab for a blood draw?”

 

Truth or dare, little girl. What’ll it be?

 

“Hope is the thing with feathers

 

That perches in the soul

 

And sings the tune without the words

 

And never stops at all.”

 

“Fuck it. Yeah, let’s do it.”

 

 

 

 

Lisa Genova's books