Robin Cook - Marker

Keeping her hand over her forehead, Laurie dropped her eyes to her tray in front of her. She had hardly touched her food. Although her selections sounded appetizing when she got them, once she sat down, she realized she wasn't hungry at all. Having no appetite was not usual for Laurie. She attributed it to the stress she felt about her upcoming meeting with the social worker and the inevitable news she was about to get. In some ways, she felt humiliated about being forced to see a mental-health professional.

When Laurie had arrived at the hospital forty minutes earlier, she'd first gone to Roger's office, but he still wasn't available. One of the secretaries had told her he was closeted with the hospital president. Laurie had then gone to seek out Sue, who was graciously willing to join her for lunch on short notice.

"Getting a call from one of the genetics lab social workers doesn't necessarily mean your test was positive," Sue said.

"Oh, come on," Laurie complained. "I just wish the woman would have told me."

"Actually, by law, they are not supposed to tell you over the phone," Sue said. "With the new Health Information Privacy Act, phone reporting is frowned upon. Laboratory personnel can never be sure exactly with whom they are speaking. They could inadvertently give the information to the wrong person, which is what the new HIPA is supposed to prevent."

"Why haven't they sent you my results?" Laurie asked. "You're my official primary-care physician."

"I wasn't, technically, when the test was ordered. But you're right. I should have heard. At the same time, I'm not surprised. The walk-in genetics lab is just getting their act together. To tell you the truth, I'm surprised they didn't require you to have a session with one of their specially trained social workers before they took your blood. That was my understanding of the proactive way they were going to handle things. You don't have to be a rocket scientist to know that genetic testing is going to be upsetting, no matter the outcome."

Tell me about it, Laurie thought to herself.

"What's wrong with your food?" Sue asked, leaning over to look at it. "You haven't touched a bite. Do I have to take this personally?"

Laurie laughed and gave Sue a dismissive wave of her hand. Laurie confessed to being not hungry with everything going on in her life.

"Listen," Sue said, assuming a more serious tone. "If the BRCA1 test turns out to be positive, which obviously you expect, I want you to come right over to the clinic so I can get you in to see one of our top oncologists. Do we have a deal?"

"We have a deal."

"Good! Meanwhile, what's the scoop with Laura Riley? Did you get set up with a gyno appointment for your routine check?"

"I did. I'm set."

Laurie glanced at her watch. "Oops! I've got to get a move on. I don't want to be late. The social worker might decide I'm being passive-aggressive."

The women parted ways in the hall. As Laurie climbed the stairs up to the second floor, the right lower quadrant discomfort came back, causing her to hesitate. She wondered why stairs tended to aggravate whatever the nuisance was that was bothering her. It was like what she used to call a "stitch" when she ran too much as a child. True to form, it faded after only a minute. Making a fist with her right hand, she tapped against her back. The idea had occurred to her that it might be kidney or ureteral pain, but the tapping did not re-evoke the discomfort. She pushed in on her abdomen but felt nothing abnormal. She shrugged and continued on her way.

The reception room of the genetics diagnostics lab was as serene as it had been on Laurie's previous visit. The same classical music floated out of wall speakers and certainly the same impressionist prints hung from the walls. What was different was Laurie's mind-set. On the first visit, there was more curiosity than trepidation. Now it was the reverse.

"Can I help you?" a pink-smocked receptionist asked.

"My name is Laurie Montgomery, and I have an appointment with Anne Dickson at one o'clock."

"I will let her know you are here."

Laurie sat down and picked up a magazine, flipping through the pages aggressively. She looked at her watch. It was exactly one. She wondered if Ms. Dickson was going to humiliate her further by making her wait.

Time crept forward. Laurie continued flipping through the magazine without concentration. She found herself getting progressively more anxious and more irritated at the same time. She closed the magazine and put it back on the table with the others. Instead of trying to read, she sat back and closed her eyes. By force of will, she calmed herself. She thought about lying on a beach in the hot sun. If she tried, she could almost hear the waves lapping against the shore.

"Ms. Montgomery?" a voice asked.

Laurie looked up into the smiling face of a woman half her age. She was dressed in a simple white sweater with a single strand of pearls around her neck. Over her sweater was a clean white coat. In her left hand was a clipboard tucked against her side. She had her right hand extended. "I'm Anne Dickson."

Laurie got to her feet and shook the woman's hand. She then followed the woman through a side door and down a short hall. She was directed into a small, windowless room with a couch, two club chairs, a coffee table, and a file cabinet. Centered on the coffee table was a box of tissues.

Anne motioned for Laurie to sit on the sofa. She closed the door and then sat down in one of the chairs, the box of tissues conveniently between them. Anne consulted her clipboard for a moment and then looked up. From Laurie's perspective, she was a pleasant-appearing woman who could have been a mere college student in a work-study program rather than a person with at least a master's degree and probably extra training in genetics. She wore her straight, medium-length, brown hair parted in the middle, requiring her to frequently sweep it off her face and tuck it behind her ears. Her lipstick and nail polish were a dusky red-brown color.

"I appreciate you coming in on such short notice," Anne said. Her voice was soft with a slight nasal twang. "And I apologize again for having misplaced your folder."

Laurie smiled, but she could feel herself getting progressively impatient.

"I wanted to give you some background concerning what we do here in the genetic diagnostics lab," Anne continued. She crossed her legs and settled the clipboard between them. Laurie could see a small tattoo of a snake on the inside of her leg just above the ankle. "I also wanted to explain why you are talking with me rather than with one of our staff doctors. It's purely a matter of time: I have a lot, and they have a little. What that means is that I can be with you here for as long as you would like and answer all your questions. And if I can't answer them, I have immediate access to people who surely can."

Laurie didn't comment or change her expression while she silently ordered Anne to cut the fluff and just give her the damn results of the test. She leaned back abruptly, crossed her arms, and tried to remind herself that she shouldn't blame the messenger. Unfortunately, Anne and the situation was irking her to no end. She particularly found the convenient box of tissues patronizing, as if Anne expected her to break down emotionally, even though, knowing herself, Laurie knew it was a possibility.

"Now," Anne said after consulting her clipboard again and making Laurie feel as though she was getting a canned presentation. "It is important for you to know something about the science of genetics and how the field has all changed with the decoding of the human genome, meaning the sequence of all three-point-two billion nucleotide base pairs. But first let me say that you can interrupt at any moment if you don't understand something."