The funny thing was that Nora wasn’t nervous when she went in to meet with Dr. Niles. She could admit she might have been a little obsessed with WebMD when it first hit the Internet, but she liked to think she channeled her hypochondria for good now. Using a combination of the Mayo Clinic Symptom Checker, the NIH, and the CDC, she’d successfully diagnosed her friend Lily’s onset of Bell’s palsy and Ellie’s whooping cough. She was good at diagnosing the difference between a cold and the flu (it was usually a cold). She had all the markers of perimenopause: breast tenderness, urinary urgency, fatigue. Her period had been five days late last month, and the PMS had been horrible. Always driven to clean while premenstrual, Nora had taken down the ceiling fans—actually uninstalling each one—to swab each blade with her homemade vinegar–tea tree oil cleaner. (Her column “Does Green Really Clean?” had gone viral the year before, getting more than four million reads and pushing When Ellie Was Little back onto the bestseller list, and now, even if she’d wanted the industrial strength of 409, she wouldn’t have been able to justify buying a bottle of it.) She predicted the doctor would tell her to start thinking about HRT (she wasn’t interested), and then she’d get back to work on the column that was giving her fits, the one on how working from home could be just as productive as working from an office. In annoying irony, she kept wandering away from the computer, forgetting to finish it.
Dr. Niles’s office could have doubled as a hotel lobby, full of healthy potted plants and watercolor paintings of boats and bays. When Nora was done filling out paperwork, the tan receptionist handed her a box of Valentine hearts with a conspiratorial smile. The pink Be Mine tasted like a preschool chalkboard might, granular and sweet. While she chewed her way through the small box, she played with the piece of beach glass she’d chosen that morning—pure, clear blue, and perfectly round. It was a good worry stone, made for a doctor’s office. She put it back in her pocket when she started to put it in her mouth, almost confusing it with the candy heart in her left hand.
The doctor herself was as pretty as the office, with a blond bob and a manner so warm Nora thought she might have missed her calling as a preschool teacher. She could picture Dr. Niles bending down to stick a SpongeBob Band-Aid on a six-year-old, receiving kisses that smelled of peanut butter. She would be careful with germs and keep one of those tiny plastic bottles of Purell in the front pocket of her adorable smock, which she’d wear un-ironically. Ellie’s preschool teacher, when Nora thought about it, had been someone who should have been a doctor. Mrs. Finchly’s posture had been so rigid Nora had sometimes wondered if she wore a brace under her plain dresses. She’d smiled at the kids, but Nora had never seen her squat on the playground, arms wide open, like all the mother-helpers did. Mrs. Finchly took her job seriously. Much more seriously than the teacher in the other preschool class did, the one who was always wandering around with Play-Doh on her dress and her arms filled with finger-painted maracas and flutes made of bamboo. Yes, Mrs. Finchly would have inspired more trust as a doctor than as a teacher.
In Dr. Niles’s office, Nora asked her, “Did you ever teach?”
The doctor shuffled a paper, pushing it underneath a brown manila folder. Was that where the answers were? The nerves Nora hadn’t been feeling rushed in to fill their familiar place. She wanted to reach forward, grab the folder, and run. In her car, she would read the words that would tell her why they’d taken so much blood, why the phlebotomist with two-almost-three children looked at her so strangely the last time she’d sat in his ergonomically correct chair with the armrests made for tired elbows. If she didn’t understand the words, she’d google them on her phone. She was a trained reporter, after all. She knew how to do research.
“Not really. When I was premed, I was a TA for a couple of classes. Once I had to teach a semester of childhood development but I wasn’t that good at it.” She smiled. A dimple darted into her cheek and then ducked away. “Why?”
“Do you have kids?”
Gamely, she said, “Not yet.”
“But you will.”
“I’d like to.” Dr. Niles held out her left hand and looked at it as if the small, sparkly diamond still surprised her. “I haven’t been married that long, actually. We do want kids. Someday.”
“The sooner the better.”
The doctor looked at Nora again with that sweet gaze. “You were young when you had your daughter?”
“Not too young. I was twenty-eight.” Could this woman be any more than twenty-five? She was a doctor—was it even possible she could be that young?
Dr. Niles pulled out another sheet of paper. “You just have the one child, is that right?”
“Yes.” Nora’s blood chilled, as if she’d plunged her wrists into ice water. “Why?”
“And you’re not married?”
“Divorced.”
“Are your parents still alive?”
“We never really knew our father. Our mother died in a car crash when she was forty-four.” Her age. God. She hadn’t thought of that till right now.
“She never had these kinds of episodes that you’ve been dealing with? Memory loss or confusion. Any kind of mood swings?”
Nora frowned. “Mom was a little volatile, I remember, just before the crash, but she was still working two jobs and her boyfriend had also just moved out. She was tired. It just happened.” What was the doctor implying? That if her mother hadn’t died young, she would have had something? Had what?
“What about your sister? You’re a twin, right? Identical?”
“Fraternal.” Nora was confused. “Are you asking if she’s married?”
“Does she have children?”
There was so much more under her voice, things that Nora didn’t understand. Fear tugged at the base of her neck.
“No. Just my Ellie.”
Dr. Niles nodded and leaned back in her chair. She steepled her fingers. In an older doctor, it would have come across as pensive. Knowledgeable. Instead, she looked like a child playing in a leather chair too big for her small body.
“You came by yourself today?”
“You’re scaring me,” Nora said with a smile. Maybe this would make the young doctor laugh and realize she was being too serious. Oh, sorry! I didn’t mean to frighten you. It’s really no big deal at all, nothing to worry about.
“We’ve found something.” The words were blurted out rapidly, as if the doctor didn’t know what else to do with them. “You have early-onset Alzheimer’s disease.”
Nora laughed at the words, relief soaking her like warm water. It was just a mistake, then. “I’m forty-four. Not old.”
Dr. Niles’s voice was tight as she said, “Early-onset is a different beast, I’m afraid.”
“I don’t understand. I don’t have Alzheimer’s. I’m forty-four. You can’t get it that early.” She would tell the doctor her job. That was always a good idea.
Dr. Niles reached forward, touching her papers again. Nora’s papers. Her tongue darted out and wet her lips, and Nora realized the doctor was nervous. Maybe even more so than Nora was.
“In some unfortunate cases, it can start as early as midthirties. I hate telling you this. I’ve actually never run across it in my practice, and I’ve been up the last two nights at home, researching it.”
Nora pictured her, propped up in bed with her laptop. She would wear a peach negligee, something sheer enough to please her new husband but decent enough to wear to the kitchen to make coffee. Nora used to have one like it, in cream. Dr. Niles would sit in bed, distracted by the sound her husband made gargling mouthwash. She would read about Nora, about what was apparently in her blood, her body. She would read about how to get it out.
“What’s your first name?” Nora asked her. It was suddenly incredibly important that she know what her husband called her in the middle of the night when he rolled over and found her ear next to his lips. Nora must have known it, must have heard it when she first introduced herself, but it had dropped out of her mind.
It had dropped all the way out.
“Susan,” the doctor said. Her eyebrows came together and her mouth wobbled for a split second.
Her husband called her Susie. Nora knew he did.
Nora picked up her purse, which she’d left thoughtlessly at her feet. As if she wouldn’t need it. She took out her Moleskine and her favorite pen, the burgundy Montblanc fountain pen she’d bought herself the first time her book hit the New York Times list. She would make particular, careful notes, and then this young doctor would fix it. Not a problem. “What does this diagnosis mean for me, Susan?”
To Nora’s horror, Susie’s mouth wobbled harder. She pressed two fingers against her lips. “Oh, god. I’m so sorry. This has never happened to me before.” She spun in her huge leather chair so she was completely hidden. A child playing hide-and-seek, only Nora, the seeker, was more goddamned terrified than she’d ever been in her life.
Ten seconds later, when the doctor spun back around, she was normal again, the only telltale sign of any emotion a slight glassy sheen in her cornflower eyes. Her lips were steady. She placed both hands flat on the top of the papers on her desk. She looked directly at Nora, sizing her up. Nora made a reckless, unnecessary line on the blank page as if she had something to note.
“It means you have an incredibly rare, familial, incurable, fatal disease that we hate to diagnose in anyone.”
Nora wrote the unacceptable words slowly. One by one.
Rare.
Familial.
Incurable.
Fatal.
“I’m so sorry,” pretty Susie said.