Peter James - Perfect People

‘I sure as hell hope you are right,’ Naomi said. ‘I find it just a little too weird.’

The paediatrician showed them both to the door. ‘I’ll call you just as soon as I know. Meantime, don’t worry.’

Dr Otterman telephoned two days later. The tone of his voice scared Naomi. He suggested that she and John should come to see him as soon as was convenient, on their own if possible.

The consulting room seemed to have changed in the three days since they were last here. On Monday morning, with its yellow walls and huge window, the room had felt light and bright. Now it was dark and oppressive. Naomi and John sat in front of the paediatrician’s desk. Dr Otterman was outside, dealing with some enquiry from his secretary. Panes of glass rattled in the wind. Naomi watched rain lash the street, an autumn equinox gale asserting itself on the town, the countryside, the sea.

A cold wind blew through her. She shivered. Nature had so much in its damned arsenal. Hurricanes, tornadoes, earthquakes, volcanoes, tidal waves, floods, meteorites, asteroids. Disease.

She reached out and took John’s hand. He squeezed back, and half turned to her as if he was about to say something. Then Dr Otterman came back into the room and closed the door. ‘Sorry about that,’ he said.

They both watched him anxiously, as the paediatrician eased himself behind his desk. As he sat down he peered at something on his computer screen, then plucked a pen from the black mug in front of him and rolled it backwards and forwards between his fingers. ‘Thanks for coming in,’ he said. ‘I felt it was better for you to hear this in person because – well – it’s a very unusual condition – not life-threatening, but it does of course give rise to concern.’

Naomi and John waited for him to continue.

‘It – well, how can I put it – it affects a very small percentage of all children born in the world. We’re going to need an electroencephalogram to make absolutely sure, but I don’t really have much doubt at all.’

Into the tunnel, Naomi thought bleakly. We’re going back into that damned, bloody tunnel we were in with Halley. Tests. Hospitals. More tests. More specialists. More hospitals.

He put the pen back in the mug, deliberated for some moments, then retrieved it again, his eyes darting between Naomi and John. ‘This bleeding – I didn’t want to give you my diagnosis until I was pretty sure. Now I have the results from the pathology tests and they are still not conclusive. Phoebe is presenting some symptoms of a variant form of a condition known as McCune-Albright syndrome.’

John and Naomi exchanged a puzzled glance. Then John said, ‘I’m sorry, I’ve never heard of this – MacEwan-Albright syndrome?’

‘Yes,’ Dr Otterman said edgily. ‘That’s right, yes, McCune-Albright syndrome.’ His face reddened. ‘It’s also known as precocious puberty.’

‘ Puberty, did you say?’ asked Naomi.

He nodded. ‘It’s a congenital abnormality that causes varying forms of early sexual maturity in children, as well as other physiological changes.’

Naomi raised her voice in disbelief. ‘Sexual maturity? What exactly are you saying? Phoebe’s not even two years old – are you telling us she’s sexually mature?’

The paediatrician stared back with a helpless expression. ‘I’m afraid what I’m saying is exactly that. Extraordinary though it may seem, Phoebe is having her first period.’

In the car afterwards, Naomi and John sat for some moments in stunned silence. John put the key in the ignition but did not turn the engine on; instead he rested his hands in his lap. The car shimmied in the wind.

Precocious puberty.

Naomi shook her head, staring at the rain-crazed windscreen.

Bone age will be advanced and serum oestrogens will be in the pubertal or adult range. Oestrogen halts growth. Many children with this syndrome are likely to end up with stunted growth. Early development of breasts. Untreated, a five-year-old girl will have the sexual maturity of a teenager.

‘The pills will work,’ John said. ‘Don’t worry.’

‘He said they might work. They might slow down this syndrome, but they won’t cure it, John, that’s what he said. Sometimes it helps, that’s what he said. Sometimes. ’

‘At least it’s not life-threatening.’ Then, after some moments, he added, ‘And – everyone is telling us how big they are for their age. Phoebe wouldn’t be this big if she had stunted growth.’

‘And Luke? Why is he so big?’

‘I don’t know. I don’t know why either of them are.’

‘Dr Otterman said the children have physiology closer to three – even four – years old, not two.’

‘But he did say their rate of growth will probably slow down.’

‘And if it doesn’t?’ she asked.

‘I’m sure it will,’ John said.

‘What makes you so sure, John? The integrity of Dr Dettore? That fills you with confidence, does it?’

He said nothing.

‘I want the children to have every possible medical test,’ Naomi went on. ‘I want to find out just what other surprises we are in for; what else that madman has done to them.’

John started the engine and began manoeuvring the Saab out of the parking space. He spoke quietly. ‘Dr Otterman said this won’t affect her, and she will be able to lead a normal life.’

‘For most women, John, leading a normal life means having children. Do you have any idea how she is going to feel when she reaches her teens and all her friends are entering their prime? When she starts dating? What happens when she falls in love? How is she going to explain to someone in twenty years’ time, Oh, by the way, I had my first period when I was not quite two years old and went through the menopause when I was fourteen? ’

‘He didn’t say that, hon. He said this condition doesn’t affect the menopause, that she wouldn’t have an early menopause.’

‘He didn’t know, John. He said he would know more after the scan. He said no two cases were ever exactly the same.’ She rummaged in her handbag, pulled out a pack of tissues and blew her nose. ‘ Stunted growth. That’s great. After telling Dettore we wanted our son to be tall, our daughter is going to be a dwarf.’

‘You’re worrying at the moment that she’s too big for her age. She’s not going to be a dwarf.’

‘How do you know?’

‘Look, there will be a lot of advances in medicine over the next twenty years – if we find out that-’

‘Sure,’ she said, interrupting him. ‘And Phoebe is a victim of one of them. Great to know that our daughter is a guinea pig – and a freak.’

‘I think freak is a strong word. She’s not a freak.’

‘So what is she? What euphemism would you like? Maturity challenged? Vertically challenged? Perhaps it’s a little too realistic a word. But that’s what she is, John, that’s the reality we have to face. Courtesy of Dr Dettore, our life savings and loans from my family, we have produced a freak. How does that make you feel?’

‘Would you rather she hadn’t been born? That neither of them had been born?’

‘I don’t know. I don’t know what I feel. Tell me what you feel – I never know what you are thinking.’

‘All I ever wanted was-’ He lapsed into silence.

‘Was what, John? What was it you wanted? Tell me, I’m all ears. And you ought to put the wipers on, might help you see where we’re going.’

He put the wipers on then pulled out into the street. ‘I don’t know,’ he said, after a while. ‘I don’t know what the hell I wanted. I guess, just the best for our kids, for you and I, I just tried to do the best for us.’

‘Is that what you’d like to think?’