Chapter 4 - THE FAMILY HISTORY GERTRUDE ERASED
There had been four.
Gertrude’s mother died of colon cancer.
Her older sister, Elaine, died of endometrial cancer at fifty-two.
A maternal uncle died of colon cancer in his forties.
And another aunt had what Gertrude called “female cancer” before sixty.
Nicole did not diagnose a hereditary syndrome from a family story.
She knew better.
But the clustering mattered enough to deserve genetic evaluation.
Brandon had never heard any of it accurately.
His grandmother supposedly died from “intestinal problems.”
Aunt Elaine supposedly had “complications after surgery.”
The uncle was rarely discussed.
Gertrude’s version of family history had been edited until every frightening pattern became isolated bad luck.
Dr. Shah recommended that the gastroenterology team complete Gertrude’s diagnostic workup first.
If a tumor was found, appropriate pathology testing could help determine whether genetic counseling was indicated.
Gertrude hated every word.
“You’re all talking about me like I’m already dying.”
Nicole answered carefully.
“No one said that.”
“You’re thinking it.”
“I’m thinking we need facts.”
Gertrude laughed bitterly.
“You always need facts.”
Nicole heard the insult.
She also heard the envy beneath it.
Facts were exactly what Gertrude had spent years escaping.
The colonoscopy took place the next morning.
Nicole stayed in the waiting area with Brandon.
Rosie was with Nicole’s sister.
For forty minutes, Brandon barely spoke.
Then:
“Did you know family history like that could matter?”
“Yes.”
“For me?”
“Potentially.”
“And Rosie?”
Nicole looked at him.
“Potentially.”
He became pale.
“Why didn’t you ever ask?”
“I did.”
Brandon frowned.
“When?”
“When Rosie was born. Pediatric intake.”
He remembered.
Nicole had asked about cancers on both sides.
Brandon wrote none known before age sixty-five.
Because that was what he believed.
“She let me give our daughter the wrong history.”
Nicole touched his hand despite being angry.
“She may have been afraid.”
“That doesn’t fix it.”
“No.”
Brandon stared down the hall.
“I defended her yesterday.”
Nicole said nothing.
He continued.
“She threw your food away and I stood beside her.”
“Yes.”
“I told you to stop accusing her.”
“Yes.”
He looked at Nicole.
“You don’t have to keep saying yes.”
“I’m not going to lie to make you feel better.”
Something in him softened.
“Fair.”
Dr. Shah entered the waiting area.
Both stood.
“We found a lesion that needs biopsy.”
Brandon’s face collapsed.
Nicole steadied herself.
“Can you tell us more?”
“It is suspicious.”
Not confirmed cancer.
Not yet.
The lesion had also narrowed part of the colon enough to plausibly explain some of Gertrude’s symptoms.
Biopsies were taken.
Additional imaging and pathology would determine the next steps.
When Gertrude woke, she saw their faces.
She knew immediately.
“No.”
Brandon sat beside her.
“We don’t know everything yet.”
“No.”
His mother started crying.
Not elegantly.
Not quietly.
For the first time Nicole had ever seen, Gertrude looked like someone who could not bully the room into becoming safer.
Brandon reached for her.
Then stopped.
Not because he did not love her.
Because love had become confused with rescue for too long.
Gertrude looked at him.
“Aren’t you going to say it’s going to be fine?”
Brandon swallowed.
“I don’t know if it’s going to be fine.”
She stared.
He continued.
May you like
“But I’m here.”
For once, he offered presence instead of a promise he could not keep.
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