Chapter Eight
eight
Lanie
Five days later, Gran’s GP, Dr. O’Hara, sat at his desk, his mouth downturned, as Lanie and Gemma flanked their grandmother. Lanie had rescheduled her flight home to be there.
Dr. O’Hara’s face was grave as they sat across from him. “So,” he started, settling further into his wingback chair and flipping through pages in a file. “Tulip told us that she has one that’s getting her PhD and one that’s getting married?”
Lanie grimaced. Her grandmother never stopped bragging about her or hoping she’d change her mind even a full five years after Lanie stopped pursuing her studies.
He looked between the two cousins, clearly unsure of where his eyes should land. “So, who’s getting married?”
Yes, because that one is the real achievement .
“That’s me.” Gemma raised her hand tentatively, like calling out an answer in a class.
Lanie kept her hands in her lap because she wasn’t doing either of those things.
“Congratulations are in order, then!”
Gemma giggled like a pageant queen appreciating her audience. “This June.”
A June bride. What a cliché. Not to mention the wedding vendors that would be seeing dollar signs because they weren’t waiting the prescribed year.
Lanie sealed her mouth shut, having already made that argument...and lost.
“Lovely.” Dr. O’Hara gave a perfunctory smile as if the exchange was part of a script and he could now check that box. “A very nice thing to look forward to, yes?”
Gran nodded, reaching out to pat Gemma’s hand. “Yes, our Gemma is marrying a nice boy. A barrister.”
Gemma beamed at their grandmother’s clear approval. And Lanie bristled. There was far more to Jonah than his job, and not for the first or second time she hoped that her cousin realized that.
“Oh, lovely,” Dr. O’Hara said again, absently.
As Lanie had become begrudgingly accustomed to over the years, doctors here spoke to her grandmother alternately as if she was a hard-of-hearing, doddering old woman or like a three-year-old that had gotten into a cookie jar before dinner.
“Well, we’re here today for some test results, aren’t we?” He flipped through more pages, then frowned.
Gran and Gemma nodded as Lanie shifted uneasily in her seat.
“They’re a bit more concerning than we thought, I’m afraid.”
Gran clutched her purse straps in both hands. “What does that mean? Exactly?”
“Well.” He puffed out a sigh, laying his forearms on the desk before him in a way that made Lanie’s heart skip a beat and her stomach sink. “Originally, we were concerned about your kidney function. Your creatinine levels are a bit high. While you were in hospital, they did a twenty-four-hour urinalysis. And now we’ve received the results and found that your albumin to creatinine ratio—we call it an ACR—is elevated.”
“Is that very bad?” Lanie’s stomach continued its roll. Her mom was a nurse; she knew enough to understand that those words didn’t mean anything good.
“Well, it would have been infinitely better if we’d recognized it sooner. Mrs. Turner, you and I have spoken over the phone, but I believe this is our first face-to-face meeting since you joined our surgery. Isn’t that right?”
Lanie cast her grandmother a sidelong glance. The older woman looked shamefaced. She should. They weren’t supposed to be there. Her grandmother used to be conscientious about her health.
“Had we,” Dr. O’Hara went on, pressing his point, “we might not be here today.”
Gran wound her purse straps around her fist, her polite smile faltering. Lanie frowned at his tone but caught herself. It wasn’t as if he was wrong.
“We haven’t even had all our televisits, I’m afraid. Have we, dear?”
Lanie refrained from rolling her eyes at the condescension and laid a supportive hand on her grandmother’s forearm. But that seemed to startle Tulip, like she only just realized that they were still sitting beside her.
“After your collapse this weekend, we became concerned about your insulin resistance and wanted to rule out renal failure.”
Lanie felt her grandmother tense up.
“No worries there though.” Dr. O’Hara glanced up from his papers to give them an unconvincing smile. “What a relief, yes?”
He has to be fucking kidding with this. Lanie groaned audibly.
Gran gave her the same look she used to give them as children cutting up in the church pews during mass. Lanie tried not to fidget.
“However, that doesn’t mean we’re in the clear,” he continued as Lanie’s knee began to bounce. “Unfortunately, through further testing, we’ve discovered some serious trouble with your liver.”
Lanie’s grandmother gasped, a short but loud intake of breath that might have included a sob. Lanie grabbed one of her hands as Gemma took hold of the other. Then they glanced at each other, the animosity of the past few days momentarily forgotten.
Lanie was grateful. Admittedly, in the emergency room, she’d been bossy, taking charge and making decisions on her grandmother’s behalf as if Gemma wasn’t even there. But it wasn’t because she’d previously believed her cousin couldn’t do it; it was because Gemma had shown herself to be doing a terrible job of handling things now. Judging by the fact that their grandmother had gotten sick and no one noticed anything until she literally collapsed. So, Lanie had said that.
Just that way.
In front of the ER doctor. And a room full of people. Including Jonah, his parents, Fatou and Les.
Naturally, afterward things had been tense. Lanie chose to keep to her room while Gemma, when she was there, moved in a disgruntled cloud, leaving a thunderous wake in every room, the televisions blaring, doors slamming, shelves buffeting bureaus and a cacophony of cabinets banging to give voice to her displeasure. The aggression could hardly be called passive in any way, save Gemma’s refusal to speak. So, Lanie was surprised to see Gemma, coat on and ready to go to their grandmother’s appointment with them that morning.
“Your chart indicates that you’ve previously told us you are not a smoker or drinker, is that right?” Dr. O’Hara continued as Lanie reflected on her terrible behavior this week.
“Yes. That’s right, Doctor.” Gran nodded. “Except a sip of Communion wine on Sundays and the occasional snifter of brandy for Christmas. Is that bad?”
“The Communion wine is grape juice, Nan,” Gemma said softly, patting her grandmother’s hand.
“Is it?”
“Don’t listen to her, Gran. Next thing you know, she’ll be saying that the Communion wafers are really Time Outs too,” Lanie quipped.
Gemma let out a single “Ha!” before catching herself. “Nah, those things are rubbish. The body of Christ is tastier than that.”
Lanie snickered.
“Girls,” Gran snapped at them both. “Blaspheme another time, please.” And in Pavlovian style, they were instantly back onside, sitting up and silent.
“Uh, yes.” Dr. O’Hara conferred with his notes again, confused by the left turn his very serious discussion had taken. “I mean no, I’m talking about habitual alcohol consumption, yes?”
“No, absolutely not.” A dark exasperation traversed Gran’s face. A look over at Gemma’s face revealed a virtually identical fatigue.
Gran barely allowed alcohol in the house. Lanie knew little about it, but she had gleaned that her late grandfather had been an alcoholic. A mean one, who had made every family member who’d had the misfortune to follow him to England miserable.
“Very good, we gathered that when we spoke to you in hospital, didn’t we?” he said before embarking on a detailed review of the results of Gran’s most recent blood work.
So then why ask again? Lanie bristled. “The diagnosis, Doctor?” she finally demanded, unable to deal with the suspense or polite dithering any longer.
“Yes, yes, of course.” He nodded. “We believe this to be a case of nonalcoholic fatty liver disease.”
“Sweet Jesus, mi cyaan manage!” The words tumbled out of Gran’s mouth in one long exhalation of air, before she grabbed her chest.
Gemma burst out crying. Lanie glared from the other side of their grandmother.
What the hell? When had Gemma become this emotionally overwrought person?
“Ladies, ladies!” Dr. O’Hara warned.
Non-what? Liver? No, this doesn’t make any sense. Is Gran dying? The idea of it unmoored Lanie. She wasn’t like her grandmother and cousin; when she panicked, she got stoic, turned inward and fell into a part of herself no one could reach. But not now. Right now, she needed answers.
Lanie put up a palm, barely wheezing the words out of her diaphragm. “Wait, what—what is that?”
Dr. O’Hara looked stricken, eyes wide. “Well, it’s a buildup of adipose tissue in the liver...”
“Adipose?” Lanie focused on the words coming out of the doctor’s mouth instead of Gemma’s hysterical weeping and her grandmother’s muttered prayers. Hanging on to every word and parsing them acted as a distraction from her growing anxiety.
“Just tell me, how serious is this?” her grandmother, who was not crying but was morbidly grim, finally asked.
“Very, I’m afraid. It’s incurable.”
Lanie felt the word like a knife but remained quiet while Gemma howled like she was the one being diagnosed as terminal. Even their grandmother regarded her older granddaughter with surprise then.
Lanie decided to take this apart like the scientist she supposedly used to be.
“What does ‘adipose’ mean?” she repeated.
“It means fatty tissue,” Dr. O’Hara replied.
“And can this tissue be treated?”
“No. It’s not possible to reverse the damage with medication.”
“Okay, so what are our next steps?” Lanie asked.
“We have diets that can potentially prevent this from becoming a far more serious problem like cirrhosis or liver failure.” He spoke over Gemma’s sobs. “There are a few more tests we’d like to run. But we’re confident that we’re onto the correct diagnosis. So right now, all there is, is just to treat it.”
Just treat it? Lanie was in a state of disbelief. Couldn’t he have started there? If for no other reason than to prevent the histrionics in his office?
“Don’t worry, Mrs. Turner, we will have you put to rights in no time, sound good?” Dr. O’Hara said, returning to his obnoxiously patronizing tone.
“Yes, see? Nothing to worry about.” Gran digested that while whispering and gathering a sniffling Gemma into her arms. “I’ll be fine.”
From the doctor’s face, you’d think he’d told them they won the lottery.