We Own the Sky(67)

When the doctor entered from a side door, he looked younger than I expected.

His face had a healthy crimson hue, a mustache hiding the remnants of a hare lip, and he was wearing a tailored white coat, with his initials, Z.S., embroidered on the left breast. There was something vaguely plastic about his complexion, a waxy variegation of his skin, as if parts of his face were coated with TV makeup.

“Mr. Coates, how are you?” Dr. Sladkovsky heartily shook my hand, and his hand felt unusually dry.

“And you must be Jack. Hello, Jack.” Jack smiled weakly and huddled closer to me on his chair.

“Do you like ball pits, Jack?”

Jack nervously nodded.

“Well, that’s good. Because we have an amazing one out there. Do you want to go with Lenka? She might even give you some candies.”

I looked up, and a tall blonde woman had appeared through a side door. Lenka smiled and held out her hand, but Jack stayed in his seat, unsure whether to go.

“It’s okay, Jack,” I said. “Why don’t you go and play with the nice lady?”

Jack cautiously slipped off his seat and put his hand in Lenka’s.

“Thank you for coming, Mr. Coates,” the doctor said, when Jack and Lenka

left the room. I noticed for the first time his Slavic accent. There was something avuncular about it, like an elderly Polish watchmaker.

“We are so very glad to have you with us. Thanks for sending me everything.

I’ve looked through Jack’s notes and scans at length and, while his disease has progressed quite far and looks to be aggressive, I think it would be worth trying some treatments.”

He smiled, and I noticed just how thin his top lip was when it wasn’t hidden under his mustache.

“I assume you have an idea of our treatment here, Mr. Coates?”

“Yes,” I said, “I’ve read a fair bit and Nev—his son, Josh, was treated here for a brain tumor—has told me a lot about it.”

“Ah, yes, Josh. Such a nice little boy. Last I heard he was doing very well.

They always send me his scans,” Sladkovsky said. I noticed that he hissed on certain words, the remains of a lisp, studiously curtailed over the years. He scratched his chin and looked down at his papers.

“As I think you discussed with one of our practitioners on the phone, in Jack’s case, we would offer you a complete course of immuno-engineering. We would also want to do more extensive genetic testing, to see what additional treatments he could be given. We have had some good results with patients like Jack.”

“When you say good results, what do you mean? Could Jack be cured?” I

said.

“Yes,” he said quickly, holding my eyes with his. “Cured.”

“You mean children with glioblastoma?”

“Yes.”

“But high-grade glioblastoma, like Jack’s.”

“Yes, of course.”

Dr. Sladkovsky looked at me, so intensely I thought he was going to grasp my hand across the table.

“Look, Mr. Coates, for all the time I do this job, I don’t ever find these consultations easy. Your little boy, he is certainly very ill. I would say it breaks my heart, but no, because I don’t let it. I try to keep the professional distance, but it’s hard sometimes because I also have children.” He clasped his hands together, and I noticed a large signet ring on his right hand.

“So if I will be honest with you. I have had children come to me with

glioblastoma and survive. And I have had many who have not. I offer you no guarantees of a cure for Jack. It would not be ethical for me to do so. However, other oncologists will, how you say, write off their patients, but I won’t do that.

So all I can say—and please forgive me my English—is if you decide that Jack would undergo the treatment with us, then I could offer you no promise, but we could at least give you chance.”

“Can I ask you something?” I said.

“Of course.”

“Would you treat your own children with immuno-engineering? I mean, if

they had cancer.”

“Yes,” he said. “In a beat of my heart. I would push them to the front of the line. They’re my children, and I would do anything for them. Who wouldn’t?”

Sladkovsky tapped his pen lightly on the desk. “Is it just you? Is Jack’s mother here, as well?”

“Not yet. But she’s coming. Her mother is very ill at the moment.”

I felt a prickle of sweat on my back, imagining Anna coming home to find the note on the hall table.

“Okay. Please think on it. If you decide that Jack will undergo treatment with us, then we would like to start as soon as possible. Just so you know, this consultation is at no charge, should you choose not to stay with us...”

“Will it hurt?” I said suddenly.

Sladkovsky furrowed his brow. “The immuno-engineering, the treatments you mean?”

“Yes. Jack has gone through so much, the chemo, the recovery from the

surgery. I don’t want him to be in pain.”

“Well,” the doctor said. “I will be truthful with you. It affects people in different ways. Some patients have almost no side effects, and with children we often find that is true. But according to medical ethics, I must tell you that in perhaps 30 percent of our patients, they do experience side effects, some of them severe. Vomiting, sweating fevers, much of what you might see on chemotherapy. But I would add that we are very used to controlling these side effects. We have many, many new drugs. Was Jack scheduled for more chemotherapy in the UK?”