Truth, by Omission Read online

  “I didn’t expect them to come back good,” I say.

  “They’re not good at all,” said Mark. “He’s got spots all over his lungs. He’ll need biopsies right away, but that’s just a formality.”

  I reach across to take the report from him. “I’ll call his mom this morning.”

  “Alfred, we all thought that maybe you’d want one of us to handle it. We don’t mind helping out.”

  I know what he means, they are trying to spare me the pain of reliving my experience with Stephanie so soon after her illness and passing. They are great colleagues; they really care about the patients—and me.

  “That’s all right, Mark. I can do it. I’m feeling a lot better than I was a few days ago. Besides, who better to help a parent facing this than one who’s been through it?”

  “Are you sure?” he asks. His concern is sincere. “We don’t mind at all.”

  “I really appreciate that, Mark. I might have Rosa come in, though; my Spanish isn’t good enough to trust with something like this.”

  “Sure, no problem.”

  “Oh, Mark, one other thing, while you’re here. I’m going to take your suggestion and take some time off. Anna and I are going south for a few weeks. We thought right after Christmas, if that’s okay with you and Brie and Luis. If no one else was planning on being away.”

  “Excellent,” Mark says. “I’m glad. You both need it. Take a whole month off. Go crazy.”

  “Anna’s organizing it. I doubt it’ll be a month. I might really go crazy if I were off that long.”

  “Alfred, why don’t you slow down on the hours a bit for the next month? At least until you get away for that vacation. We’ve all been worried you’re going to burn out and then we’ll lose you permanently.”

  I smile at him. “Anna’s been saying the same thing. And I’ve already promised her I’ll do that. Thanks, Mark.” I reach across to shake his hand. “I appreciate the support.”

  After taking a look at Ricky’s file, I decide that if I call right now I might get them both at home, before Ricky leaves for school and his mother for her job. As soon as Rosa gets in I’ll ask her to make space on my schedule later this afternoon for the Nunezes, and I’ll see if she can sit in with me just to make sure everything is translated properly.

  Languages have always come easy to me. We spoke three in my village before I was taken. Bufumbwa was the first language of the village, a dialect really, and spoken by some neighboring villages as well. Kinyarwanda is the national language of Rwanda, so we all spoke that. It was the language of our early schooling, and Swahili was the common language of the greater area of central Africa. People from our village typically conversed in Bufumbwa. School and any official dealings or interactions with the government were in Kinyarwanda. And general trade and commerce were conducted in Swahili. I learned all three by the time I was five. I picked up several more dialects before leaving Africa. These were mostly variations on the languages I already spoke, and a keen ear made it easy for me to learn them. For a period during my older schooling in Kigali, and then again for four years in the refugee camp, I honed my French and got a good start in English. French was the colonial language of Rwanda under its Belgian rule, and many people still considered it a necessity for advancement. And in the UN camp English was the common language of choice for the staff and volunteers. Once I got to Denver to do my residency, I understood why Anna had learned Spanish during her youth; it was the second language of Colorado. I practiced it a bit during residency but got serious about it when I joined the clinic. For most of our patients Spanish is their first language, and for many it’s all they speak.

  Late in the afternoon Rosa pops into my exam room right after my last patient has left. “Pina Nunez is here,” she says. “Do you want to see her right now?”

  “Sure. Send her in please, Rosa. And you’ll sit in, too?”

  Pina Nunez hardly seems old enough to have a son of fourteen; she’s not yet thirty herself. And she has four other boys, the youngest five. The sunken eye sockets and pockmarks on her face give away the tough battle she has waged with drugs over the years. As far as I know she’s clean now, but that could change at any time. I’m worried that the news I’m about to give her could push her in a bad direction again.

  “Buenas tardes, Pina. Gracias por venir,” I greet her.

  “Hello, Dr. Olyontombo. I’m fine in English if that’s better for you,” she says and smiles.

  “English is still a little better for me, but I am working on my Spanish,” I say.

  “You’re doing well, Doctor.”

  “Do you mind if Rosa sits in with us, just in case you have any questions?”

  “That would be good. Thank you.”

  “Where’s Ricky?” I ask her. “Is he coming?”

  “He has to work at the restaurant. He’s afraid he’ll lose his job if he asks for time off.”

  “He should be here for this, Pina. I have the results from the tests we sent him for last week, and they’re not good.”

  She tenses visibly, as if she is about to be hit—and she is, with the news I’m going to deliver. I remember hearing these words myself as a parent not long ago. Anna and I had each other to hang on to; Pina has no one, so I take her hand. Not wanting to make it melodramatic, I just get on with it.

  “Pina, Ricky has cancer. The swelling in his testicles is a tumor, and the CAT scan tells us it’s in his lungs, too. We won’t know exactly how advanced it is until we do an MRI. And we have to biopsy everything to be one hundred percent certain before we can confirm malignancy. But we should expect it. There are things we can do, and we’ll get on it right away.”

  She sits frozen in her seat, staring at me. I’m not certain if she hasn’t heard me or perhaps doesn’t understand me. “Pina, do you understand? Do you need Rosa to explain?”

  “Is this like your little girl had, Doctor?”

  “Not quite the same, Pina. But similar.”

  “Is my Ricky going to die, too?”

  “We’re going to start on treatments as soon as we can. I know exactly the pediatric oncologist we’ll get Ricky in to see. He’s the best in Denver.”

  “Is my Ricky going to die?”

  I don’t want to lie to her, and Ricky’s prognosis is a little better than Stephanie’s was. I wouldn’t have wanted anyone to lie to Anna and me, but we obviously had the advantage of me being a physician. I resort to my well-practiced truths, or perhaps, lies by omission.

  “He’s young, and he’s strong, and he’s otherwise healthy; he has a good chance to fight this.”

  The emotion overwhelms her now, and she breaks down into gasping sobs. Moving closer I put my arm around her, and Rosa takes her other hand. We let her cry for a minute, let her process this news in her own way. I know that Pina has no family in town, her parents are in the US as illegal immigrants and they both work as ranch hands south of here in Alamosa.

  “Pina, where are the other boys? You’ll need someone at home with you. Do you have a friend you can call?”

  “The little ones are next door in the community center, Doctor.”

  “What about a friend to stay with you at home for tonight, maybe a few days? Could your mother come up?”

  “Mama will come. She’ll stay with us.” Pina is still sobbing but she manages to get it out. “I have to go get my boys, Doctor.”

  “How are you getting home, Pina?”

  “We’ll walk. I don’t want to go on the bus like this.” She wipes away tears with the back of her hand.

  “I’m going to drive you, Pina. We’ll get the boys and I’ll drive you all home. What about Ricky? When is he home?”

  “His shift is done at eight. He’ll be home after that.”

  I grab a few things and tidy up while Pina waits with Rosa. She’s managed to stop crying but her face and body language sho
ut distress.

  “Rosa, would you mind waiting a few minutes longer with Pina? I’ll go next door and get the boys.”

  The door to our clinic is right beside the door to the community center. After exiting one, and before going into the other, I pull out my cell and call Anna, getting her voice mail. “Anna, something’s come up, I won’t be home until after nine, I’ll call you when I’m in the car. Love you, honey.”

  A sixteen-year-old attendant greets me as I enter the community center. “Hi, Dr. Alfred.”

  “Hi, Mercedes. Do you know where the Nunez boys are?”

  “I think the two older ones are in the gym and the younger two are probably in the art room upstairs. Do you want me to get them?”

  “No, I’ll go get them. Thanks, Mercedes.”

  The gym is really just the old main factory floor area from the bindery, but it serves the purpose well. It has a high ceiling and new lighting was installed overhead. Only problem is, it’s still got the original concrete floor, not ideal, but workable. It gives the kids a place off the streets, out of the weather, and away from the miscreants who wait to corrupt them. Twice a year the gym is used by the county health department when they send out public health nurses to provide immunizations and general checkups for the young and elderly alike in the neighborhood. On those days Luis, Brie, Mark, and I all pitch in to offer free examinations and advice to anyone who wants to drop by.

  A pair of movable basketball hoops are set up at the far end, and some of the older boys have a game running. This end is occupied by boys and girls playing a game of dodgeball. I spot the two Nunez boys, laughing and having a good time. I wave to them just as the ball flies into my vision. Ducking quickly, I look around to see who threw it. Two girls about Stephanie’s age laugh and shout, “Come play with us, Dr. Alfred.”

  I know several of the kids in the gym, a few of them are my patients and others I met just dropping in to play with them.

  “Yes, Doctor, play on our team,” someone else shouts.

  “Another time, girls.” I wave again for Marcus and Adrian Nunez, and they come running over.

  “Is Mom waiting for us, Dr. Alfred?” Marcus asks.

  “She is, Marcus. I’m going to give you a lift home tonight. Would you mind running upstairs and getting your brothers?”

  Marcus runs off leaving Adrian to ask, “How come you’re going to drive us home, Doctor?”

  “Your mom just needs a hand for a bit. And I want to see Ricky when he gets home,” I answer.

  The two younger boys come down the stairs dragging their jackets. When Ronny, the youngest, sees me, he drops his coat and runs right to me, jumping into my arms. “Dr. Alfred, you’re driving us home?”

  None of the boys know their fathers, and they crave male attention. Ronny is the most affectionate of the brood and still wants to be cuddled. I carry him next door with the others in tow; we collect Pina and all load into my SUV.

  They live in one of the older tenements, two bedrooms for the whole family, the three eldest boys in one and the two younger in the other with Pina. The living room and kitchen are both cramped, but the boys are happy to show me their home and have me as a guest. Pina and Adrian set to making supper while the other boys entertain me. Ronny sits on my lap and at one point, with the brashness of youth, leans back and asks, “Dr. Alfred, what happened to your face?”

  “Stop it, Ronny,” Marcus says. “You’re not supposed to ask him that. Mom’s told you before.”

  “But I want to know,” his little brother responds.

  “An accident with a machete, Ronny,” I say.

  “What’s a machete?”

  “It’s like a sword, stupid. Don’t ask him these questions,” Marcus says.

  “Were you in a sword fight?” Joe asks. “Like a pirate?”

  “Can I touch it?” Ronny asks.

  “Ronny!” Marcus shouts.

  I smile at them. “Sure, go ahead and touch it.”

  Ronny reaches out to trace the line of the scar, starting at my forehead, following it across my eyebrow and down the side of my face to my jaw. Joe reaches up for a turn. “Does it hurt, Dr. Alfred?”

  Hmm. No one has ever asked me that before. It does hurt, actually. It hurts to wear it every day, as a reminder of a previous life, a life I’ve now spent nearly two decades trying to erase—or at least make up for. But instead of admitting to the pain I reply, “No, Joe, it doesn’t hurt.”

  After dinner Pina can’t thank me enough for staying around until Ricky gets home. I am still not sure how to handle this, how to give the news to Ricky. When he finally arrives a little after eight o’clock he sees me as soon as he comes in the door. “Dr. Olyontombo? What are you doing here?”

  “Hi, Ricky.” I want to force a smile but none will come out. It’s just as well, he takes my cue.

  “Something’s wrong?” he asks, cocking his head slightly and looking from me to his mother. He sees her trying to look composed, but she’s snuffling and her eyes are wet. She looks older than she did when she came into my office just four hours ago. I know how this ages a parent. I also know it’s only just starting for her.

  I inhale deeply. “Yes, Ricky. I have your CAT scan results. A few things have come back as problems.” Ricky is silent. He looks again to his mother, who steps in to hug him, and I continue. “Ricky, it looks like there are some tumors on your lungs. We need to do some more tests.”

  The news sinks in. He looks confused, and yet comprehending at the same time. He bites the side of his lower lip and nods ever so slightly as his eyes begin to water up. He’s tall at fourteen, taller than his mother, and he stands proud, hugging her to his side.

  “What do we do now, Doctor?” he asks me over the top of her head.

  “I’m going to make all the arrangements for your next tests. I’ll call you in a few days. I’ll let you and your mom know everything you need to do.”

  “What about my job? We need my job.” He gives his mom a squeeze.

  Only fourteen years old, yet Ricky is taking this like a man. He’s concerned about his family; he’s comforting his mother. He’s certainly making this easier on me. After giving him the details and making sure that Pina and the other kids are okay I get up to leave, and Ricky sees me to the door.

  “Thank you, Doctor,” Ricky says. “Thank you for coming over here and helping Mom. And me. I know you didn’t have to.”

  I sit in the SUV for a minute before starting the ignition. I feel like shit. I want to do more for this kid, more for his mom and brothers. I’d trade places with him if I could. Ricky’s done nothing to deserve this sentence. I have. I wish I were half the man that Ricky is.

  What started out as a pretty good day, making love with Anna into the early hours, plans to take our honeymoon vacation, and my resolve to move forward after a month of sulky mourning for my baby girl, is ending on a bit of a downer. Just last night I promised Anna that I’d put in a little less time at work and get home earlier in the evenings, and here it is now almost nine o’clock. I have to call her.

  “Anna, hon, I’m really sorry—”

  “Freddie, I tried calling you. There was no answer on your cell or at the office. I was worried. Are you okay?”

  “I wasn’t at the office, and I turned off the ringer for a while. I was with one of my patients and his family. He’s just a kid, Anna. A little older than Steph … almost the same thing.”

  “As bad?”

  “Not quite … yet. I’ll be home in thirty. I’ll tell you about it then.”

  “Are you okay, Freddie?” she asks.

  “Sort of. Anna, I’m sorry I’m late. I’m sorry.”

  “Freddie, I love you.”

  “I know. I know you do. Thank you, Anna. I love you, too.”

  Over the next couple of weeks I spend quite a bit of time with Pina and Ricky Nunez, ex
plaining test results and trying to reassure them that they are in the best hands possible with the oncologist that I referred them to. Because of the potential aggressiveness of Ricky’s cancer we’ve decided to hit it with chemo and radiation at the same time. He’s young and strong; it seems the best option. But we’re now at December 19, those departments run slowly over the holidays, and I don’t want him in the hospital during what might be his last Christmas. They can start the treatments first thing in the new year.

  I am a little bothered that I won’t be here for his first round; Anna has our trip all booked. And it’s not just Ricky. I hate to take off on my other patients, too. There are several of them who need ongoing follow-up. I know they’re in good hands with Mark and the others at the clinic, I just have this guilty feeling about leaving for a vacation. I know I shouldn’t feel this way, and I’ve talked it through a million times with Anna, and I try to pretend with her that I’m fine with it, but I’m not. I use guilt, I always have, as a sort of backhanded way to wallow and punish myself. I’m not sure how a psychologist might clinically diagnose this but I don’t need anyone to formally analyze it. I’m working on it … trying to, anyhow.

  On the other hand, I am looking forward to the trip almost as much as Anna. She’s got us booked for a week at an all-inclusive on Saint Martin, on the Dutch side, and then we’ll stay for two more in a rented condo in Marigot, on the French side of the island. She says the first week will allow us to decompress without having to do anything or think about anything. Then the next two weeks we can both get back to practicing our French, which we haven’t had much opportunity to use since leaving Paris sixteen years ago. I know that Anna, always a little more quixotic than me, is looking for a romantic distraction for us, however we can both most certainly use the three weeks to recharge.