I laugh.
‘Nuh, it was that what you see is what you get. You were totally unpretentious.’
Isn’t this Hugh’s checklist?
‘Excuse me, Kate? Cameron? I’ve got some results we need to talk about.’
All the romance comes crashing down around us, falling into a splintered pile at the doctor’s feet. She’s petite and serious, with a dark pixie cut and black-rimmed glasses, wearing Docs. Sensible footwear for walking along hard hospital floors all day, changing people’s lives, one way or the other. I know from the expression on her face that she’s about to change ours, and watch as she switches on a lightbox and pulls some printed films out of one of the enormous envelopes she’s carrying.
‘Okay.’ Doctor Wilson sighs, as if she’s centring herself in this moment, in this room, in our lives. ‘As I said yesterday, the structural imaging didn’t show up anything that might explain the symptoms. No tumour that we can detect. No stroke. No trauma to the brain. So, I think we can confidently rule out those causes.’
This is good news, surely? They’re the main things to be terror-stricken about. The things that kept me awake all night, worrying.
‘The bloods came back clear for thyroid disorders or vitamin deficiencies, which can sometimes play havoc with cognition.’
I have a feeling she’s about to get to the punch line.
‘Now, because those tests came back clear but we’re still observing symptoms, we ran some functional imaging,’ she says, pulling the results out of the next envelope. It’s like she’s about to announce Best Actor at the Oscars. She sets up the scan on the lightbox and checks it, as if to confirm what she’s about to say. ‘This is where we can measure things like glucose metabolism and the amyloid deposits in the brain. Tests like this can be useful in cases where memory and cognition have been impacted quite quickly, and at a relatively young age, when there’s no other obvious explanation.’
We’re both silent. Cam’s grip on my hand loosens, but I pull it back. I won’t allow him to let go. Not even to think of letting go.
‘We’ll need to do more testing, including a battery of neuropsychological tests, but we’re confident enough at this stage to give you a possible diagnosis, and I’m sure you’re keen to know our thoughts.’
‘Keen isn’t the right word,’ I mutter.
The doctor smiles bleakly. She looks like she’s about to hand down a death sentence. ‘Look, I’m sorry to break this news, Cam. I suspect what we’re dealing with here is early and rapid-onset Alzheimer’s.’
We’re stunned.
‘I’m so terribly sorry,’ the doctor says, met with our blank stares.
This can’t be happening. This isn’t even possible, surely, at his age!
‘Prognosis?’ Cam asks. I don’t recognise the clipped tone in his voice, and I want to run out of the room before I hear the answer.
‘It’s a bit of a “how long is a piece of string” question. You’re young and fit and otherwise healthy. Some patients live another fifteen or even twenty years.’
‘And others?’
I wish he would shut up.
‘In cases of rapid onset of the disease, and that’s what I suspect you may have, Cameron, it can be two or three years.’
All I’m hearing now is white static, as the ground gives way and my severed heart haemorrhages all over our beautiful life.
‘There’s nothing you can do?’ I think it’s me who asks this, but everything is swimming.
The doctor sighs. It’s not good. ‘I’ll refer you to a specialist neurologist in Sydney,’ she explains. ‘What I’ll recommend is that we hook you up with a social worker who can help you access services to navigate this. I know it must feel overwhelming.’
Overwhelming? I was prepared for a brain tumour. But this totally untreatable, galloping monster arriving several decades before it’s due seems so much worse.
‘Cam is only thirty-eight!’ I argue with the doctor. ‘He’s a father! I’m pregnant! There must be some mistake!’
She refuses to accept any of my arguments, and my heart breaks again as the sickening thought descends that Charlie is going to lose the rock-solid centre of his world. How will we ever break this to him? As for the baby, I don’t even want to think about the implications. They might never remember their dad at all.
Wave upon wave of unbearable realisation crashes over me, the more people I imagine being swept into this juggernaut. This will break Cam’s parents. You’re not supposed to bury your child. Not at any age. And they’re too frail to travel here from the UK now. They were so ecstatic about our baby news two nights ago, and now this.
‘It’s hard to accept, I know,’ Dr Wilson says. ‘The earlier you’re armed with information, the better for you. In the meantime there are some drugs we can try. In some cases they slow the progression of the disease. We’ll need more tests before we start those.’
‘But the drugs don’t cure it?’ I ask, already knowing the answer. My grandmother died from Alzheimer’s, as grandmothers often do. She was ninety-two. It was horrendous.
It’s so stuffy in here. I get off the bed and start pacing and fanning myself. Breathing too fast.
The windows won’t open. I need air. And a healthy husband who isn’t going to lose his fucking memory before he’s forty.
‘Katie,’ he says, with altogether too much grace. ‘We’ll get through this.’
And that’s when I lose it. Only one of us will be getting through this, and that person is me. Why does it have to be Cam who is sick?
I get an impeccably timed text from Grace. ‘Any news?’
I look at Cam, who I promised to love until death parted us, assuming we meant some time in our eighth or ninth decades. Not this decade. Our baby hasn’t even been born yet, and one of its parents is . . . well, he’s . . . I can’t even say it.
‘SOS, Grace. It’s fucked.’
16
Our first instinct is to adopt a ‘business as usual’ approach. No admitting defeat. No brooding. We’ll keep ourselves active and distracted while all of this sinks in.
Complete denial, in other words.
‘Alzheimer’s?’ Mum probes, when I call in to break the news.
‘Early onset, obviously,’ I explain. ‘You can get dementia at any age.’
A chilling fear rises within me that it’s something that could strike Charlie, too. He could well be genetically predisposed. And not just Charlie. The baby.
Would we have so carelessly conceived if we’d known?