Free So Much for That by Lionel Shriver Page A

comprised the value of his Merrill Lynch portfolio increasing by $23,400 without his lifting a finger. Their son finally passing second-year algebra. Randy Pogatchnik playing hooky at some golf resort, so that for three days working at Knack would be, if not quite the same as the olden days, at least collegial. Glynis being in a playful, indolent mood he could barely remember now, and up for watching an old episode of The Sopranos . Now on a dime he was expected to enter a world in which “good news” comprised his wife’s abdomen coursing with vicious “epithelioid” cells rather than the even more vicious “sarcomatoid” kind and this information was meant to cheer him.
    “As for where we go from here,” said the doctor, “you may want to commission a second opinion. It’s always possible that other specialists will recommend an alternative approach, but I thought I’d prepare you for the standard course of treatment for epithelioid mesothelioma. Assuming the diagnosis is confirmed, Mrs. Knacker, you’ll probably be scheduled for debulking surgery as soon as possible. This is to remove as much of the cancer as can be reached. We’ve located three patches of diseased tissue in the peritoneum. I’m afraid that the surgeons I have consulted concur that one of those patches is inaccessible. Both to shrink the little bit we can’t reach and to discourage further malignant cell growth, chemotherapy will almost certainly have to follow once you’ve recovered from the operation. To that purpose, a thoracic surgeon will install two ports in your abdomen. This way we can deliver intraperitoneal infusions of heated cisplatin that will wash over your organs, rather than administering chemotherapy through your bloodstream. Unpleasant side effects with this direct application should be markedly less pronounced.”
    “Does that mean I won’t lose my hair?” asked Glynis, reflexively touching her crown, as if to make sure her hair was still there.
    A shadow crossed the oncologist’s face, a sadness, a pitying, into which Shep could read that such a small damage to his patient’s vanity was bound to be the least of Glynis’s problems. “Patients react differently to treatments,” he said gently. “There’s no way to predict.”
    “Besides, it grows back, doesn’t it?” said Shep. This was the role. He was supposed to be upbeat.
    A second shadow, and this time one that Shep could not decode. “Yes, once treatments are completed, it certainly does,” said Dr. Knox, seeming to rouse himself. “Some patients find it grows back in even more thickly than before.”
    Shep had the sudden impression that this visit, if not the whole song and dance from the X rays and the CAT scan to all the scalpels and “abdominal ports” and vile medications to come, was a farce, a macabre charade. As helpful and soothing as this doctor was trying to be, Shep felt distinctly humored. In turn, he also felt co-opted into a collusion with the doctor, whereby together they were humoring his wife. The joke was on Glynis. It was a wicked joke, a despicable joke, for which she would pay with every fiber of her being. He did not want to be a part of it. He would be a part of it.
    “But before we go any further?” the oncologist continued. “Because this is such an unusual cancer, I have limited experience with the disease. Phelps Memorial has seen only two cases in the last twenty years. However, there’s a specialist in internal medicine at Columbia-Presbyterian, who works in tandem with a skillful surgeon. They both have extensive clinical experience with mesothelioma, and have a terrific reputation.”
    “Are you trying to get rid of us?” said Shep with a strained smile.
    Dr. Knox smiled back. “You could say that. Mesothelioma patients come to Philip Goldman from all over the world. You’re lucky, because for you two he’s effectively right next door. Now, he doesn’t come cheap. It’s likely as well that he’ll be