Page 12 of Adult Onset


  She had also known enough to realize she might not wake up. “That’s a virtual impossibility,” her father had reassured her with his incredulous chuckle. At fourteen, however, Mary Rose did not like the “virtual.”

  As she lay recovering, Dolly would breeze in, all Broadway in her leopard print tam and matching coat. Everyone else, even her father, made Mary Rose very tired. She would smile and make it okay, but Mum would sweep in, call the nurses by name and get fresh sheets under her. Dolly found the bedsores forming on Mary Rose’s heels and elbows and got her to sit up. “That’s it, now rotate your feet around your ankles, open and close your fists, that’s right, keep moving.” It was possible to get gangrene from lying still. Dolly got her to breathe deeply so she wouldn’t get pneumonia. “That’s it, take a big drink of air. Now let it all out again.” It was possible to die of lying down.

  The nurses loved Dolly, she was one of them, and they were nicer to Mary Rose as a result. Except for the night nurse, who hadn’t met her mother.

  Last fall when the pain in her arm failed to go away, the thing that was bothering her at the back of her mind came to the fore: she began to wonder if her parents had known something about her arm that they had never told her. What if they had not been benign pediatric bone cysts? What if she had actually had pediatric bone cancer and her parents kept it from her because everything had turned out fine? She needed to know, because what if it recurred? She needed to know, because … it was her story, and if it was being held hostage by her parents, she had to get it back. So no sooner had she made the appointment with Dr. Judy, than she redialled and asked the receptionist to requisition her medical records from Kingston General Hospital, where she had undergone both bone grafts.

  It was a Tuesday morning, just like today, a child-care morning early last fall, when she sat in Dr. Judy Farber’s examination room, averting her gaze from anything too clinical such as swabs and hypodermics, focusing on the cheery oven mitts bedecking the stirrups. Still, her stomach went cold as she watched Judy open the large brown envelope and scan the few photocopied pages before reading aloud, “ ‘Benign pediatric bone cysts.’ ”

  “That’s all?”

  “What were you expecting?”

  “Cancer?”

  Hypochondriac. Think of all the people with actual cancer, meanwhile here she was sniffing about for tumours like a toxic truffle pig.

  “Definitely not.”

  This was, of course, good news and she tucked her tail neatly between her legs and rose to depart Judy’s office, conscious of her debt to that mythical beast, “the taxpayer,” who had funded her flight of fancy, chastening herself for overdramatizing like the flaky artist-type she was. Wanting her special arm to be that much more special.

  “Wait, what about the pain?”

  “Oh yeah, I forgot,” said Mary Rose.

  “That’s why you’re here.”

  Judy had her remove her top, and palpated the arm, the bone … a creepy feeling but not exactly painful.

  “Can they come back?”

  “Of course not.”

  “Good.” Nothing is more reassuring than having your fears scoffed at by a physician.

  But Judy added, “Why am I saying that? I actually don’t know for sure. If you’re worried I can refer you to an orthopaedic surgeon.”

  “Are you worried?”

  “No. But I err on the side of caution.”

  Dr. Judy referred her to a specialist, and one balmy October morning a few Tuesdays later, she left Maggie with Candace and headed off on her bike. This time she cycled down through rapidly gentrifying Kensington Market to Toronto Western Hospital on Bathurst Street across from Balloon King, where jaunty skeletons cavorted with witches and pumpkins in the window. She locked her bike outside Emergency and removed her jacket. “Unseasonably warm.” When would we dispense with denial? As though Earth were merely having a bad hair day.

  She waited in Radiology, but she had brought a book, The Brain That Changes Itself, and naturally her arm felt perfectly fine.

  She lay on the slab for the X-ray. The technician asked, “Is there any possibility that you are pregnant?”

  You’ve got to be kidding. But she said, politely, “No.”

  She had to admit she was pleased, in the way a thirty-year-old is pleased to be carded at a bar. He entered the glassed-in nuke-booth in the corner, then re-emerged instantly. All done. There was no cashunk sound as in the olden days.

  The technician, a lugubrious former East Bloc citizen—no doubt a brain surgeon barred from practising in Canada due to bureaucracy—seemed to have forgotten she was there. She felt sheepish; there was nothing wrong with her. Paging Dr. Freud!

  She waited for the komrad to hand her the X-ray so she could schlep it over to the specialist’s office, but when at length he looked up, as though surprised to find her still there, he merely muttered, “Digital.”

  Not only was she a hypochondriac, she was a dinosaur … No one toted around actual X-rays anymore. She nodded at his instructions on how to get to the Orthopaedic Clinic, “western wing, northeast elevators” … second star on the left, straight on till morning …

  She wandered off past a supply cupboard stacked with Phisohex, past doors that afforded unlooked-for glimpses of lumpy bedspreads, trying not to breathe too deeply of hospital smells, past the nursing station where no one so much as glanced at her. What if I were a maniac, here to murder helpless patients? Past the Emergency Eyewash Station, past a laminated chart illustrating the degrees of “Hazardous Waste,” until she found the elevator. She emerged into a sky-lit nexus on the fifth floor where a plump volunteer with a name badge told her to follow the white footsteps. “White for bones!” she chirped.

  She found a seat in the waiting room—it was still warm from the previous occupant and she shuddered at the vinyl exhalation as she sank into the roomy ass-print. Her eye was drawn, like a moth to a flame, by the muted television mounted in a corner of the ceiling, its “live eye” tracking traffic on the Don Valley Parkway while across the bottom of the screen, a band of news text unspooled like a postmodern novel, its content neither sequential nor linked to the words a female commentator was mouthing, which appeared as closed captions in a band across the top and which could not possibly be accurate, “… WHAT IT MEANS TO BE A HUMAN BEAN IN THIS DANE AGE …” She tore her gaze away, opened her book and read about a girl who’d been born with half a brain.

  “Mrs. MacKinnon,” announced the brusque West Indian receptionist.

  Mary Rose looked up—Mrs. MacKinnon’s my mother, dude!—and stood meekly.

  Dr. Ostroph turned the computer screen on his desk to face Mary Rose—gone were the days of the shadowy X-ray in the light box. Just as shadowy, but on a computer screen now, was the long bone of her upper left arm in all its forensic glory. Her humerus.

  He pointed with a pencil—some things don’t change—at the various, to her indiscernible, old fracture sites. “… you can see where the bone healed here, here, here and …” She noted that Dr. Ostroph was pale but had excellent bone structure. She determined to be the best patient he had seen that day, the most informed, the least needy. He had golf clubs on his tie. He talked fast, she talked faster, out-brisking the specialist, “So an injury that wouldn’t harm a normal bone causes a bone cyst bone to break,” she said, helpfully paraphrasing in case he had not understood himself.

  “It’s called pathological fracture.”

  “Right,” she said.

  Like the frozen puddle.

  “Bone cysts go undiagnosed a lot of the time because they’re asymptomatic unless there’s a fracture.”

  Like the skating rink.

  “Sorry, what?”

  He spoke slowly—did he think she was stupid? “You don’t feel the cysts unless the bone is broken.”

  Like the airplane swing.

  And because she still must have been presenting with all the facial cues of a carp, he added, “It hurts. That’s your first clue.”
br />
  Like … every time it was sore.

  He was saying something. She wondered if he knew who she was—perhaps his kids or his wife had her books and he’d twig to it when he got home this evening, Hey, you’ll never guess who walked into my clinic today … He stopped talking. She blinked. “I beg your pardon?”

  “I said, where are you on the pain scale?”

  “What’s the pain scale?”

  “One to ten, one being low.”

  She came clean. “At the moment I’m not on it.”

  “You had pain, though, recently.”

  “It comes and goes.” Like the Looney Tunes frog in top hat and tails that would sing and dance so long as no one was watching. She chuckled.

  “From one to ten?”

  He was getting impatient with her. What was the right answer—what was the question? “Uh, three. Eight?”

  His eyebrow flickered.

  “I have a high pain threshold,” she said.

  “Pain is subjective.”

  “Have they come back?”

  “No.”

  “Could they?”

  “I know of no research to support that.”

  “Is it, are they, is it from adhesions?” she asked. “Like old scar tissue?”

  “Is what?”

  “The … soreness.”

  “All that would have resolved long ago.”

  “Okay. So there’s nothing I should or shouldn’t be doing.”

  “Don’t jump in front of an oncoming car.”

  “Ha-ha.” He wasn’t annoyed with her after all. “It’s hard to know, with kids, though, if they have a broken bone, right?”

  “In very young children it’s called a green-stick fracture and no, you might not know.”

  He was typing something into his computer. Probably billing the government at that very moment. Was this her cue to leave?

  “Especially if you weren’t aware of anything actually having happened to them, unless they cried or complained.”

  He looked up. “Why wouldn’t they complain? My kid complains about everything.”

  “Do I have cancer?”

  He did not crack a smile. “I see no indication of that.”

  “Thanks, I only ask because I’m here at the urging of my partner and my family physician, so they’ll be glad to know …”

  He was already turning the screen away and she was halfway to the door when he said, “What about the pain?”

  “Well obviously it’s in my head.” She smiled. She wasn’t going to let him be the one to say it.

  “Well, yeah, that’s what pain is, information.”

  “Absolutely.” Brain plasticity. She brandished her book. “I’ve just been reading about—”

  “Messages.”

  “Exactly, neurological—”

  “You get an old pathway kicks up in the brain, it’s literally ‘remembered pain.’ ”

  She flashed on an illustration from her childhood Treasury of Fairy Tales, of a prince hacking his way through brambles on an overgrown path beyond which could be glimpsed the castle of Sleeping Beauty. She mirrored Dr. Ostroph’s clipped tones, “So you shut down the pain pathway with what, like with what, surgery?”

  “Doesn’t usually work.”

  “So …?”

  “Antidepressants.”

  “Really?” Had she missed something?

  “I can’t prescribe those.”

  “No, that’s fine, I don’t want them, although that is quite fascinating—”

  “Here.” He scrawled something on his prescription pad and handed it to her.

  Tylenol 4s.

  “Oh.”

  “You want fives?”

  “No, no, this’ll do, I’m sure.”

  “We’re talking bone pain, right?”

  “Yup, I just don’t like to take a lot of drugs, you know?”

  He bent over his pad once more, tore it off and handed it to her, saying, “This one’s right in the building.”

  She thought he was talking about the pharmacy, and figured the second script was for a lower dose of Tylenol.

  “Thanks.” She retraced the bone-white footsteps to the elevator, crossed the echoey food court toward the pharmacy—might as well have something on hand in case the pain came back—her own “nice mother” pills. It had given her pause to learn that her arm had been in a state of chronic friability throughout her childhood—was, in fact, broken sometimes. Several times. Often. But what did it change? It was in the nature of bone cysts to fracture without fanfare—witness the airplane swing at four, which would account for one of the heres at the end of Dr. Ostroph’s pencil … how many heres were there? The swing was the first to result in a sling but may not have been the first fracture. Still, if her arm was injured enough to merit a sling, why did it not merit an X-ray? Because no one thought it could possibly be broken because bone cysts cause bones to break and no one knew she had bone cysts—which came first, the chicken or the egg? Her mother provided her with a sling because it seemed Mary Rose had pulled a muscle. Seen from this perspective, Dolly was very attentive indeed—all that fuss for a mere muscle. If Mary Rose had made it clear her arm really hurt—if she had cried—she might have got an X-ray and been spared the ensuing saga. It was her own fault.

  She handed over the second prescription and the pharmacist was already turning toward his dispensary shelves when he stopped and handed it back.

  “This not a prescription,” he said in his Chinese accent.

  “Yes it is, I just got it from Dr.—”

  “Dr. Ostroph, yes, no, not for drugs, miss, look.”

  She looked. It was a referral to a psychiatrist.

  “Thanks,” she said, and left empty-handed.

  That night, Hil brought a tray of nachos, salsa and two glasses of wine down to the basement rec room. She was wearing her fuzzy mauve dressing gown that sounds dowdy but is sexy—Hil has a way of turning a tea towel into a seventh veil. She bent and her shingle of dark hair fell forward to graze Mary Rose’s cheek as she administered the very married kiss that said, I love you and I know we’re both too tired, so let’s just watch TV, and said aloud, “So what did the doctor say?”

  “He said there’s nothing physically wrong.”

  Mary Rose was kneeling in front of the DVD player. “Which disc were we on?”

  “What about the pain?”

  “There’s no pain unless it’s broken.”

  “But if it only hurts when it’s broken—”

  “Yeah, no, it’s not broken now, the pain I’ve got now is called ‘remembered pain,’ it’s like a neurological thing, are we going to watch?”

  “What?”

  “Sopranos.” Mary Rose put in disc five.

  “No, if it only hurts when it’s broken, then—”

  “It isn’t hurting, I thought it away.” Throb.

  “Then that means when you were a kid, it was broken every time it hurt.”

  “You can’t know without an X-ray. What episode were we on?”

  “I think we were halfway through three.”

  Mary Rose pressed play.

  Hil said, “Why didn’t they get you an X-ray?”

  “They did, eventually.”

  “Why didn’t they before?”

  Mary Rose pressed pause, somewhat irked—this was their one chance to re-watch a whole episode before they fell asleep from exhaustion or Maggie woke up. “Because no one thought my arm could be broken, that’s the point.”

  She fast-forwarded, chuckling as the familiar frames jerked past.

  “But it hurt,” said Hil.

  “Yes, but I was stoic, so they couldn’t know.”

  “Even your brother knew it hurt.”

  Mary Rose pressed pause again.

  “Okay, my darling, my mother was busy, bereaved, okay? Angry, pregnant, whatever, I don’t know, she had a hard childhood, I must’ve looked perfectly fine by comparison.”

  “She was a nurse.”

 
“Exactly, the children of health professionals rarely get a Band-Aid, look at you with your dad. He didn’t even give you an Aspirin the time he sewed up your finger on that fishing trip when you were eight.”

  “He’s a psychiatrist.”

  “All the more reason.”

  Play. Tony Soprano settled himself into an upholstered chair—

  “How many times did your mother make a sling for you out of an old scarf? She must have known something was wrong.”

  Mary Rose sighed. “Three times, and it was usually a new scarf, are we going to watch?”

  Hil’s bathrobe had fallen open slightly—seductive, in a 1950s housewife kind of way. Mary Rose pictured her bending over to clean the oven … in G-string and garters. “What’s a nice girl like you doing in a place like this?” Enter, woman with tool belt, here to lay tiles. “Hey, can I give you a hand? …” Hank is right, she should be writing erotica—which is what women say when they don’t want to say “porn.”

  “Sorry, Hil, what did you just say?”

  “I didn’t say anything.”

  Hilary was a human authenticity-detector. The little lies that allow so many marriages to float, if not merrily, then at least gently down the stream were provocations to Hil. Not that Mary Rose was lying. In Hil’s gaze now was the mixture of curiosity and concern that Mary Rose recognized as the signal that she was starting to listen “behind the words.” This was good news and bad. It meant that Mary Rose was about to be understood whether she liked it or not.

  “Look, Hil, what you have to understand is, that was a different era.”

  “The era of what, stupid people?”

  “Please!”

  “I’m sorry—”

  “It’s okay, just—I don’t have cancer, okay? I don’t have bone cysts, I’m not beating my child.” She chuckled.

  “What’s that got to do with it?” Hil’s lovely blue eyes narrowed unattractively along with her mouth. “Are you telling me you’ve hit the children?”

  “Of course not.”