“I catch myself. It’s not that bad. But I occasionally switch a word with another word. Child for chive, for example. Or last week I called The Grapes of Wrath “The Grapefruit Rag.” Obviously, this poses a problem in my line of work. I felt quite convinced that I was saying the right thing. My wife thought there might be an antiseizure medication that could help?”
“Aphasia,” she says. “I don’t like the sound of that.” Given A.J.’s history of seizures, the doctor decides to send him to a brain specialist in Boston.
“How’s Molly doing?” A.J. asks by way of changing the subject. The surly salesgirl hasn’t worked for him for six or seven years now.
“She’s just been accepted to . . .” And the doctor names a writing program, but A.J. isn’t paying attention. He is thinking about his brain. It strikes him that it is odd to have to use the thing that may not be working to consider the thing that isn’t working. “. . . thinks she’s going to write the Great American Novel. I suppose I have you and Nicole to blame,” the doctor says.
“Full responsibility,” A.J. says.
GLIOBLASTOMA MULTIFORME.
“Would you mind spelling that for me?” A.J. asks. He has not brought anyone to this appointment with him. He has not wanted anyone to know until he was certain. “I’d like to Google it later.”
The cancer is so rare that the oncologist at Massachusetts General Hospital has never seen a case other than in a scholarly publication and once on the television show Grey’s Anatomy.
“What happened to the case in the publication?” A.J. asks.
“Death. Two years,” the oncologist says.
“Two good years?”
“One pretty good year, I’d say.”
A.J. goes for the second opinion. “And on the TV show?”
The oncologist laughs, a noisy chain saw of a laugh designed to be the loudest sound in the room. See, cancer is hilarious. “I don’t think we should be making prognoses based on nighttime soap operas, Mr. Fikry.”
“What happened?”
“I believe the patient had the surgery, lived for an episode or two, thought he was in the clear, proposed to his doctor girlfriend, had a heart attack that was, apparently, unrelated to the brain cancer, and died the next episode.”
“Oh.”
“My sister writes for television, and I believe television writers call this a three-episode arc.”
“So I should expect to live somewhere between three episodes and two years.”
The oncologist chain saw laughs again. “Good. A sense of humor is key. I should say that estimate sounds about right.” The oncologist wants to schedule surgery immediately.
“Immediately?”
“Your symptoms were masked by your seizures, Mr. Fikry. And the scans show that this tumor is quite far advanced. I wouldn’t wait if I were you.”
The surgery will cost nearly as much as the down payment on their house. It is unclear how much A.J.’s meager small-businessperson insurance will cover. “If I have the surgery, how much time does it buy me?” A.J. asks.
“Depends on how much we’re able to get out. Ten years, if we manage clean margins. Two years, maybe, if not. The kind of tumor you have has the annoying tendency to grow back.”
“And if you’re successful removing the thing, am I left a vegetable?”
“We don’t like to use terms like vegetable, Mr. Fikry. But it’s in your left frontal lobe. You’ll likely experience the occasional verbal deficit. Increased aphasia, et cetera. But we won’t take out so much that you aren’t left mostly yourself. Of course, if left untreated, the tumor will grow until the language center of your brain is pretty much gone. Whether we treat or not, this will, in all likelihood, happen eventually anyway.”
Weirdly, A.J. thinks of Proust. Though he pretends to have read the whole thing, A.J. has only ever read the first volume of In Search of Lost Time. It had been a struggle to read that much, and now what he thinks is, At least I will never have to read the rest. “I have to discuss this with my wife and my daughter,” he says.
“Yes, of course,” the oncologist says, “but don’t delay too long.”
ON THE TRAIN then the ferry back to Alice, he thinks about Maya’s college and Amelia’s ability to pay the mortgage on the house they bought less than a year ago. By the time he is walking down Captain Wiggins Street, he decides that he cannot undertake such a surgery if it means leaving his nearest and dearest broke.
A.J. does not yet want to face his family at home so he calls Lambiase, and the two of them meet at the bar.
“Tell me a good cop story,” A.J. says.
“Like a story about a good cop or a story that is interesting involving police officers?”
“Either one. It’s up to you. I want to hear something amusing that will distract me from my problems.”
“What problems do you have? Perfect wife. Perfect kid. Good business.”
“I’ll tell you after.”
Lambiase nods. “Okay. Let me think. Maybe fifteen years ago, there was this kid, goes to Alicetown. He hasn’t been to school for a month. Every day, he tells his parents he’ll go and every day, he doesn’t show up. Even if they leave him there, he sneaks out and goes somewhere else.”
“Where’s he going?”
“Right. The parents think he must be in some serious trouble. He’s a tough kid, hangs with a tough crowd. They all get bad grades and wear low pants. His parents run a food stand at the beach, so there isn’t much money. Anyhow, the parents are at their wit’s end, so I decide to follow the kid the whole day. The kid goes to school, and then between period one and two, he just leaves. I’m trailing behind him, and finally we get to a building I’ve never been into before. I’m on Main and Parker. You know where I am?”
“That’s the library.”
“Bingo. You know I never read much back then. So I follow him up the stairs and into a library carrel in the back and I’m thinking, he’s probably going to do drugs or something there. Perfect place, right? Isolated. But you know what he’s got?”
“Books, I’d imagine. That’s the obvious thing, right?”
“He’s got one thick book. He’s in the middle of Infinite Jest. You ever heard of it?”
“Now you’re making this up.”
“The boy is reading Infinite Jest. He says he can’t do it at home because he has five siblings to babysit and he can’t do it at school because his buddies will make fun of him. So he skips school to go read in peace. The book takes a lot of concentration. ‘Listen, hombre,’ he says, ‘there’s nothing for me at school. Everything’s in this book.’ ”
“I take it, he’s Latino, by your use of the word hombre. A lot of Hispanic people on Alice Island?”
“A few.”