Peter James: Perfect People

‘So, here’s the plan. I just want you guys to relax tonight, have dinner in your cabin.’ He held out the envelope. ‘There’s a medical history form I need you to fill out for me, Naomi, and there’s a consent form I need you both to sign. The nurse will be along to take blood samples from you both shortly. We’ve already analysed the samples you had mailed to us and have had both your entire genomes mapped out; we’ll start looking at them in the morning. We meet in my office at ten – meantime, is there anything I can do for you?’

Naomi had made a list of a million questions she wanted to ask, but at this moment with her whole insides spinning from motion sickness she had only one thought, which was trying to not throw up.

Dettore pulled a small container from his pocket and handed it to Naomi. ‘I’d like you to take one of these, twice a day with food. We know they will help epigenetically modify the foetus right at the beginning of conception.’ He smiled, then continued, ‘If there’s anything you think of you want to talk through, just pick up the phone and call my extension. See you in the morning. Have a good one.’

Then he was gone.

Naomi looked at John. ‘Has he got great genes, or a great plastic surgeon and a great dentist?’

‘What did you think of him?’ John said. Then he looked at her in alarm; her face had turned grey and perspiration was rolling down her cheeks.

She dropped the container and lunged towards the bathroom.

Naomi’s diary

Can barely write this. Thrown up twice now. It is three in the morning. My arm hurts from the third injection. Three lots of blood. What on earth did the nurse need three lots of blood for? She was v. sweet and apologetic, though. Everyone seems kind. John ordered a huge dinner then left it untouched, the smell of it making him sick – me too!

The cabin is vibrating because the ship’s engines are running. The nurse – Yvonne – a pleasant black woman, said when it is calm they usually just drift or drop anchor at night, but when it’s rough like now it’s more stable if they run the engines and keep some forward motion.

Phoned Mum earlier – very brief call (at $9 per minute!) to say we were here. Then rang Harriet. She’s really excited for us. Don’t know when we are going to be able to afford to pay back the $150,000 they lent us. John is in with a chance on one or two science awards and he’s putting together a book project for MIT press – although their advances aren’t exactly huge.

Feel like a fugitive – which I suppose is what we are. Weighing everything up over and over. Trying to find that point where medical ethics, the acceptable boundaries of science, individual responsibility and plain common sense all meet. It is very elusive.

John’s awake, unable to sleep, like me. We just had a long discussion about what we’re doing and how we feel about it, going over the same old stuff. And of course how we would feel if it doesn’t work – there’s a fifty per cent chance of failure. We’re both positive still. But the enormity does scare me. I guess I’m OK about it because it still hasn’t happened yet, and although we wouldn’t get our money back, there is still time to change our minds. We still have a couple of weeks in which we can do that.

But I don’t think we will.

On the large flat screen mounted on the wall of Dr Dettore’s stateroom office, directly facing the semi-circular leather sofa on which they were sitting, John and Naomi stared at the heading that had just appeared.

Klaesson, Naomi. Genetic defects. Disorders.

PAGE ONE OF 16…

Dettore, sitting beside Naomi, dressed as before in his white jumpsuit and plimsolls, tapped the keypad on a console mounted on the low, brushed-steel table in front of them, and instantly the first page of the list appeared.

1. Bipolar Mood Disorder

2. Attention Deficit Hyperactivity Disorder

3. Manic Depression

4. Anxiety

5. Glomerulosclerosis

6. Hypernasality

7. Premature Baldness/Alopecia

8. Cardiomyopathy

9. Optic Nerve Atrophy

10. Retinitis Pigmentosa

11. Al-antitrypsin Deficiency

12. Marfan Syndrome

13. Hypernephroma

14. Osteopetrosis

15. Diabetes Mellitus

16. Burkitt’s Lymphoma

17. Crohn’s Disease. Regional Ileitis

(Cont… page 2)

‘I have the genes for all these diseases?’ Naomi said, shocked.

There was a tinge of humour in Dettore’s voice. ‘Yes, you have some genes that predispose you for all of them. I don’t want to scare you, Mrs Klaesson, but there are another sixteen pages.’

‘I’ve never heard of half of these.’ She looked at John, who was staring expressionlessly at the screen. ‘Do you know them?’

‘Not all of them, no.’

Naomi stared down at the thick form that lay on the table in front of her and John. Pages and pages of little boxes that needed a tick or a cross.

‘Believe me,’ Dettore said, ‘you absolutely do not want to pass any of these on to your kids.’

Naomi stared at the list on the screen again, finding it hard to concentrate. Nothing ever worked out the way you imagined it, she thought, her brain swilling around inside her head, fighting yet another bout of nausea. Her throat was parched and there was a vile taste in her mouth. She’d drunk one cup of tea and managed to force down just two mouthfuls of dry toast since arriving on the ship yesterday. The sea was calmer this morning, as Dr Dettore had forecast, but the motion of the ship did not seem to be a whole lot better.

‘What is hypernephroma?’ she asked.

‘That’s renal cell carcinoma – cancer of the kidney.’

‘And osteopetrosis?’

‘Actually, I’m quite excited to see that.’

She stared at him in horror. ‘Excited? Why are you excited to see that?’

‘It’s an extremely rare congenital condition – it’s known as Boyer’s Ossification disease – that causes a thickening of the bones. There used to be a lot of argument about whether this is hereditary or not – now through genetics we can see that it is. Are you aware of anyone in your family having had it?’

She shook her head. ‘Diabetes,’ she said. ‘I know we have that in my family. My grandfather was diabetic.’

Dr Dettore tapped a key and scrolled through the next page, then the next. The list was bewildering to her. When they reached the last page she said, ‘I have ovarian cancer in my family – an aunt of mine died of it in her thirties. I didn’t see that gene.’

Dettore scrolled back three pages, then pointed with his finger.

Gloomily she nodded as she saw it, too. ‘That means I’m carrying it?’

‘You’re carrying everything you see.’

‘How come I’m still alive?’

‘There’s a big element of lottery with genes,’ the geneticist said. ‘Dreyens-Schlemmer, which killed your son, can be carried by individuals like yourself and Dr Klaesson all your lives without harming you. It’s only when you produce a child, and the child inherits the Dreyens-Schlemmer gene from both parents, that we see the disease. Other disease gene groups that you carry can be expressed by all kinds of factors, many of which we still don’t understand. Age, smoking, environment, stress, shock, accidents – all of these can act as triggers for certain genes. It is quite possible you could carry everything you’ve seen on this list all your life and not be affected by any of the diseases they can create.’

‘But I’ll pass them on to any child I have?’

‘Ordinarily you would pass some, absolutely. Probably around half. The other half of the baby’s genes would be inherited from your husband – we’re about to take a look at his list now.’