After the array of tests she endured, Bibi had been returned to her hospital room in a state of exhaustion. In spite of her concern about her condition, she wanted only to sleep before dinner. She had passed out as if she’d mainlined a sedative.
Dr. Chandra didn’t want to disturb her, and indeed he preferred to wait until the following day to sit with her and discuss what the tests had revealed, after he had more time to review the results. But although Bibi was twenty-two, no longer a ward of her parents, the doctor wished to speak with them first, and at once, “to determine,” as he put it, “the kind of girl she is.”
Nancy and Murph sat with him at a table in the break room, at the north end of the fourth floor, where at the moment none of the staff was taking a break. The vending machines hummed softly, as though mulling over some grave decision, and the unforgiving glare of the fluorescent lights did not inspire serenity.
“I’ve told Bibi only that time is needed to review all the test results, to reach a diagnosis and design a course of treatment,” Dr. Chandra said. “I’ll meet with her at ten tomorrow morning. It is always a concern to me that my diagnosis and prognosis are presented to my patient in as comforting a manner as possible. I have found that it helps to have a sense, in advance, of the person’s psychology and personality.”
Nancy didn’t like the sound of this. Good news didn’t require the careful tailoring of the words with which it would be delivered. She might have said as much, except that suddenly she didn’t trust herself to speak.
“Bibi is an exceptional girl,” Murph said. Perhaps no one else but Nancy could have detected the strain in his voice. He looked only at the doctor, as if to meet his wife’s eyes would undo him. “She’s smart, a lot smarter than me. She’ll know if you’re putting even the slightest shine on the truth. That’ll upset her. She’ll want to hear it blunt and plain, not prettied up. She’s tougher than she looks.”
Murph began to tell the physician about the death of Olaf, the golden retriever, who had passed away almost six years earlier, a few months after Bibi’s sixteenth birthday. At first Nancy was surprised that her husband would think this story had any relevance to the moment. As she listened, however, she realized that it perfectly answered Dr. Chandra’s question about the kind of girl Bibi was.
The physician did not interrupt, only nodded a few times, as though he had no other patient but Bibi for whom to prepare.
When Murph finished telling of Olaf’s death, Nancy dared to ask a question, throughout which her voice trembled. “Dr. Chandra…what kind of doctor are you? I mean…what’s your specialty?”
He met her eyes directly, as though he assumed that she shared her daughter’s indomitable and stoic nature. “I’m an oncologist, Mrs. Blair. With an additional specialty in surgical oncology.”
“Cancer,” Nancy said, the word issuing from her with such a note of dread that it might have been a synonym for death.
His dark-chocolate eyes were warm and sympathetic, and in them she saw what seemed to be sorrow. “Though I really do need to review the test results more closely, I feel certain we are dealing here with gliomatosis cerebri. It originates in the connective cells of the brain and infiltrates quickly, deeply into surrounding tissue.”
“What causes it?” Murph asked.
“We don’t know. Scientists have had little chance to study the disease. It’s exceedingly rare. We see no more than a hundred cases a year in the entire United States.”
Nancy realized that she had come forward in her chair and that she was holding the edge of the table with both hands, as though to anchor herself against some great approaching turbulence.
“You’ll remove the tumor,” Murph said, making of those words a hopeful statement rather than a question.
After a hesitation, the oncologist said, “This tumor isn’t localized like those in other forms of cancer. It has a spiderweblike pattern, filmy threads across more than one frontal lobe. It can be difficult to detect. The boundaries of the malignancy are hard to define. In certain cases, primarily in young children, surgery may be an option, but seldom a good one.”
Perhaps consoled and given hope by the fact that the glioma was not easily detected, Murph said, “Then you treat it how—with chemo, radiation?”
“Often, yes. That’s why I want to study Bibi’s test results more closely before deciding what we might do to extend her life.”
Although she gripped the table tighter than ever, Nancy felt as if she were floating away on a tide of despair as real as any flood waters. “Extend her life?”
There were lustrous depths in the physician’s eyes, and in those depths coiled a knowledge that suddenly she didn’t want him to share with them.
Dr. Chandra looked down at the table, at Murph, at Nancy once more, and said almost in a whisper, “It pains me to tell you that there is no cure. Survival time from diagnosis averages one year.”
Nancy could not breathe. Could not or didn’t wish to breathe.