The First Time (14 page)

“We’re separated.”

“He should be here.”

“But he isn’t, is he?” Mattie buried her head in the still-bandaged palm of her hand, hearing the unpleasant echo of her muscle going pop.

“Look,” Lisa said, regaining control of her voice and adopting the same tone Mattie often took with Kim when trying to convince her daughter to do something she didn’t want to do. “Let Jake be your chauffeur. Nothing more. If you don’t want him in on the discussion, you can decide that when you get here. But at least this way, somebody will be here to drive you home. Please, Mattie. Do this for me.”

“Jake’s a busy man,” Mattie said, her thoughts translated into words. “He just can’t take off first thing on a Monday morning. What did you say to him, Lisa?”

“Just that I thought it was very important for him to be here.”

“A matter of life and death?” Mattie heard herself say.

Lisa said nothing.

“Am I dying?” Mattie asked.

“It’s complicated,” Lisa said after a pause that lasted several seconds too long, and for the first time Mattie heard tears in the measured cadences of Lisa’s voice. “Please, Mattie. Let Jake pick you up. We’ll talk when you get here.”

Mattie nodded, hanging up the phone without another word, trying to keep her growing panic at bay. Complicated, she thought. Why did things always have to be so damn complicated? She checked her watch against the two clocks in the kitchen, discovering it was five minutes faster than the later of the two. “Which means I have even less time than I thought,” she said, fighting back tears, grateful that Kim was at school and not here to have to deal with this. Kim already had too much on her plate, Mattie thought, leaving the kitchen, wandering up the stairs in a daze. She reached her room, pulled back the blue duvet, and crawled into the freshly made bed fully clothed.

She was still lying there thirty minutes later, the duvet pulled tightly up around her chin, when she heard the doorbell ring, followed quickly by the sound of a key turning in the lock and someone opening the door.

“Mattie?” Jake called from the front hall. “Mattie, it’s Jake. Are you ready? We should get going.”

Mattie pushed herself off the pillow, fluffed out the dark blond hair that was flattened against her left cheek, tucked her green silk blouse into her black pants, and
took a long, deep breath. She’d have to ask Jake to return his key, she thought. “I’ll be right down,” she said.

Five minutes later, sitting on the side of the bed and listening as Jake’s footsteps bounded up the stairs, she realized she hadn’t moved.

“You have something called amyotrophic lateral sclerosis,” Lisa was explaining, her voice breaking, as Mattie sat rigid next to Jake in one of Lisa’s small examining rooms.

“Sounds serious,” Mattie said, refusing to look at her friend, staring at the eye chart behind her head.

“It is,” Lisa whispered.

“Why haven’t I ever heard of it?” Mattie demanded, as if this made some sort of difference, as if, by knowing something about it, she could have prevented getting it.

“You probably know it by its more common name, Lou Gehrig’s disease.”

“Oh, God,” Mattie gasped. Beside her, she felt Jake slump in his chair.

“Are you all right? Do you want a glass of water?”

Mattie shook her head. What she wanted was to get out of here. What she wanted was to be asleep in her bed. What she wanted was her life back. “What does that mean, exactly? I mean, I know Lou Gehrig was a famous baseball player. I know he died of some horrible disease. And now you’re saying, what? That I have this same disease? How do you know?”

“Dr. Vance faxed me the results of the electromyogram first thing this morning. They’re quite conclusive.” Lisa offered Mattie the pale manila folder
containing the results. Jake took the folder from Lisa’s shaking hands when Mattie failed to do so. “He asked me if I wanted to be the one to tell you—”

Don’t tell me, Mattie thought. “Tell me,” she said over the loud ringing in her ears.

“The test showed extensive denervation—”

“Speak English,” Mattie snapped.

“There’s irreversible damage to the motor neurons in the spinal cord and brain stem.”

“Meaning?”

“The nerve cells are dying,” Lisa explained softly.

“The nerve cells are dying,” Mattie repeated, trying to make sense of the words. “The nerve cells are dying. What does that mean? Does that mean
I’m
dying?”

There was absolute silence. No one moved. No one breathed.

“Yes,” Lisa said finally, her voice barely audible. “Oh, God, Mattie. I’m so sorry.” Tears filled her eyes, threatening to spill down her cheeks.

“So, wait,” Mattie said, jumping to her feet, pacing back and forth in the small space between the examining table and the door. “I don’t understand. If I have this amyotrophic whatever-the-hell-it-is, how come it didn’t show up on the MRI? The MRI said everything was fine,” she reminded them.

“The MRI tests for other things.”

“It tests for multiple sclerosis,” Mattie argued. “It showed I didn’t have that, and it’s a sclerosis.”

“ALS is different,” Lisa explained patiently, pronouncing each letter individually.

“ALS?” Mattie demanded.

“It’s short for—”

“I know what it’s short for,” Mattie snapped. “I’m not an idiot. My brain cells aren’t dead yet.”

“Mattie—” Jake said, then stopped.

“The disease won’t affect your mental faculties,” Lisa said.

“No?” Mattie stopped pacing. “So, what exactly will it affect?”

“Maybe you should sit down.”

“Maybe I don’t want to sit down, Lisa. Maybe I just want you to tell me what’s going to happen to me, so I can get out of here and get on with the rest of my life.” Mattie almost laughed. The rest of her life, she thought. That was a good one. “How long do I have?”

“We can’t know exactly. It’s unusual for ALS to strike someone your age—”

“How long, Lisa?” Mattie insisted.

“A year.” The threatened tears began tumbling down her cheeks. “Maybe two,” she added quickly. “Possibly even three.”

“Oh, God.” Mattie felt her knees buckle, her body disappearing under her, so that her head felt like a giant lead balloon spiraling through a stormy sky, about to crash into the ground below. Both Lisa and Jake jumped from their seats, caught Mattie before she hit the floor.

“Take deep breaths,” Lisa urged, as worried hands secured Mattie in her chair. Mattie heard the sound of water running, felt the pressure of a glass at her lips. “Sip it slowly,” Lisa instructed, as Mattie tasted cold water on the tip of her tongue, mingling with the warm salt of her tears. “Are you okay?” Lisa asked after several seconds.

“No,” Mattie said softly. “I’m dying. Haven’t you heard?”

“I’m so sorry,” Lisa cried, holding tightly onto Mattie’s hands.

Mattie noticed that Jake was leaning against the door, looking as if someone had kicked the air out of him. What’s your problem? Mattie wanted to ask. Upset because you can’t work your magic here? Upset because you can’t save me from the death sentence a higher court just handed down? “A year,” Mattie repeated.

“Maybe two or three,” Lisa said hopefully.

“And what happens to me during that year or two or three?”

“It’s impossible to predict the exact course of the disease,” Lisa said. “It affects different people in different ways, and even on an individual basis, there’s no symmetrical evolution.”

“Please, Lisa. I don’t have a lot of time.” Mattie smiled, and Lisa laughed sadly, despite herself.

“Okay,” Lisa said. “Okay. You want it straight? Here it is.” She paused, swallowed, took one deep breath, then another. “ALS is a debilitating and ultimately fatal condition that leaves its victims mentally acute but increasingly unable to control their own bodies,” she recited, as if by rote, accompanied by a steady stream of tears. “As it progresses, you’ll lose the ability to walk. You’ve already begun feeling the tingling in your legs. You’ve started falling. It will only get worse. Eventually, you won’t be able to walk at all. You’ll be in a wheelchair.” She took another deep breath, as if she were dragging on a cigarette. “You told me you sometimes have trouble fitting keys into
locks. That’s an early symptom of ALS. Eventually your hands will be rendered useless. Your body will start contorting in on itself, even as your mind stays sharp and focused.”

“I’ll be a prisoner of my own body,” Mattie acknowledged quietly.

Lisa nodded, making no move to wipe away her tears. “Your speech will become slurred, difficult. You’ll have trouble swallowing. At some point, you’ll probably require a feeding tube.”

“How will I die?”

“Mattie, please—”

“Tell me, Lisa. How will I die?”

“You’ll start gagging, choking. In the end you’ll suffocate.”

“Oh, God.” Mattie recalled her panic inside the MRI. Forty-five minutes of feeling as if she were being buried alive. And now she was expected to endure up to three years of the same sensation. No, it couldn’t be. She felt perfectly fine. She couldn’t be dying. There had to be some sort of mistake. “I want a second opinion.”

“Of course.”

“But no more tests. I was fine till I started having all these tests.”

“No more tests,” Lisa agreed, swiping the tears from her eyes. “I’ll talk to Dr. Vance. Get his recommendations.”

“Because this has to be some sort of mistake,” Mattie continued. “Just because my foot sometimes falls asleep and I have trouble with my keys—”

“Mattie’s outburst in the courtroom—” Jake began, stopped by Mattie’s angry glare.

“It’s part of what’s happening,” Lisa told him. “No one really understands why, except that sudden unexplained outbursts, laughing and crying for no apparent reason, are another hallmark of the disease in some cases.”

“I really don’t want to talk about this anymore,” Mattie said, jumping to her feet.

“Dr. Vance wants you to start taking a drug called Riluzole,” Lisa said quickly. “It’s a neuroprotective drug that prevents the premature death of cells. You take one pill a day, and there are no side effects. It’s expensive, but well worth it.”

“And what exactly is the point of taking this drug?” Mattie asked, feeling her earlier anger return. Hadn’t she already told Lisa that she wanted a second opinion? Why were they discussing medication as if any new opinions were foregone conclusions?

“It offers a few extra months.”

“Months being unable to move, months of choking, months of being mentally acute while my body caves in around me? Thank you very much, Lisa, but I don’t think so.”

“The Riluzole slows the progress of the disease.”

“In other words, it postpones the inevitable.”

“Science is discovering new ways of treatment all the time,” Lisa began.

Mattie cut her off. “Oh, please, Lisa, not the ‘wonders of medical science, miracles can happen’ speech. It doesn’t become you.”

“Please, Mattie,” Lisa said, scribbling out a prescription and offering it to Mattie, who refused it.

“I said I wanted a second opinion.”

Jake took the prescription from Lisa’s hand, tucked it in the pocket of his pinstriped gray suit. Next to his receipt for a room at the Ritz-Carlton, Mattie thought bitterly.

“What are you giving that to him for?” Mattie demanded of Lisa.

“I just thought we should have it,” Jake offered weakly.

“We? Who’s this
we?”

“Mattie—”

“No. You have no rights here. You gave up those rights, remember? I just brought you along as my chauffeur.”

“Mattie—”

“No. This is none of your business.
I
am none of your business.”

“You’re the mother of my child,” Jake said simply.

Oh, God, Kim, Mattie thought, grabbing her stomach, doubling over as if she’d been struck. How would she tell Kim? That she wouldn’t be around to see her graduate from high school. That she wouldn’t be there to see her off to college. That she wouldn’t be able to dance at her wedding, or hold her first grandchild in her arms. That she was going to slowly choke to death in front of her daughter’s beautiful, terrified eyes.

“The mother of your child,” Mattie repeated. Of course. That’s all she’d ever been to him. The mother of his child. She was pathetic, she thought, straightening up, pushing her shoulders back and her chin out. “I want to go home now,” she said, glancing at her watch, noting it was closing in on eleven-thirty. “I have a date.”

“What?!”

The look on Jake’s face was almost worth the anguish of the morning, Mattie thought. “Can I have sex?” she asked Lisa suddenly.

“What?!” Jake said again.

“Can I?” Mattie repeated, ignoring her husband, focusing on her friend.

“As long as it’s comfortable,” Lisa said.

“Good,” Mattie said. “Because I want to have sex.”

“Mattie—” Jake started, then stopped, his hands dropping lifelessly to his sides.

“Not with you,” Mattie told her husband. “Isn’t that a relief? Your services are no longer required in that department. You bailed just in time. Now nobody can accuse you of being a no-good, miserable son-of-a-bitch for walking out on your wife when you found out she was dying. Your timing is as impeccable as ever.”

“So what do we do now?” he asked helplessly.

“It’s very simple,” Mattie said. “You live. I die. Now, do you think you could drive me home? I really do have a date.”

Jake said nothing. He reached over, opened the door to the small room, sucked in a deep breath of air.

“I’ll call you as soon as I make the arrangements,” Lisa said.

“No rush,” Mattie told her, and walked from the room.

T
hey didn’t speak at all on the drive back from Lisa’s office, Mattie too numb, too angry, Jake too numbed by her anger, to say anything. Instead they listened to the radio, louder than Jake usually played it, louder than Mattie normally liked it, but today, just the right volume. The rock music blasted its way into the BMW the way water fills a car sinking into a river, seeping in from every available opening, quickly filling all empty space, drowning everything in its path. The noise of the music blocked their ears and closed their mouths, although Mattie had no idea what the singers were shouting about. That was okay, she thought, focusing her attention on the road ahead. She didn’t have to know what they were shouting about. It was enough they were shouting.