Nephrologist?
I tighten my fingers on Canon’s and try to control my breathing.
“I personally requested Dr. Okafor, Neevah,” Dr. Ansford says from the screen. “She’s the best there is in cases like yours.”
“Cases like mine?” I ask, watching Dr. Okafor warily. “What kind of case is that exactly?”
“May I explain?” she asks Dr. Baines. At his nod, she walks closer to the hospital bed, those steady eyes never leaving mine. “Neevah, when we biopsied your kidneys, we found significant scarring.”
“What does that mean?” Canon asks.
She flicks a questioning glance from him to me, silently asking if he gets to speak. If I weren’t so anxious, it would be funny to see someone question Canon, even if silently.
“It’s fine,” I tell her. “He’s my boyfriend.”
Canon glances at me, a pleased look in his eyes even in the midst of this, and I realize that’s the first time I’ve referred to him that way. This situation seems to have ripped the training wheels off our relationship. In so many ways, we’re already at full speed.
“Yes, well,” Dr. Okafor says, “the scarring on your kidneys, coupled with what we’ve seen in your blood, urine and ANA tests, indicate that your original diagnosis of discoid lupus should be expanded to systemic lupus.”
I’m already lying down, but I think I’ve fallen. There is a thud in my ears as if I’ve hit the floor. The breath whooshes from my chest on impact. Canon slips an arm around my shoulder, and I clutch his hand for dear life. Literally for life and health I’ve always taken for granted that now seems imperiled.
“I . . . I don’t understand.” I shake my head, look to Dr. Ansford onscreen. “We said it was just discoid and not . . . no. Can you run more tests?”
“Initially,” Dr. Ansford says solemnly, “your symptoms presented very narrowly, but during this flare-up, it’s apparent we’re dealing with a broader diagnosis.”
“And we could waste time running more tests,” Dr. Okafor says, “or we can start treating this now for the best results. I know it’s a lot to process, but can I tell you what we’re dealing with?”
I square my shoulders and nod.
“The scarring on your kidneys is irreversible.” Dr. Okafor’s stare doesn’t waver. “And the damage is significant.”
“No.” I bark out a disbelieving laugh. “My kidneys? It couldn’t have happened that fast?”
“It can. It does. It did,” Dr. Okafor says. “Kidney failure can be quite insidious and hard to detect until the damage has been done. And it can be accelerated if you have an aggressive autoimmune event like what you have, most likely triggered by extreme conditions.”
“You mean stress,” Canon says, his jaw sharply-edged with restraint.
“Yes.” Dr. Okafor flicks her gaze to him. “Your immune system makes antibodies to fight foreign substances, bacteria, viruses, etcetera. When your body produces antinuclear antibodies, they attack the nucleus of your healthy cells.”
“Because your disease had presented so narrowly in the past,” Dr. Ansford interjects, “and you were in conditions that could have caused similar symptoms like muscle soreness and achy joints, those signals may have been disguised until they were severe enough to present as things you hadn’t experienced in the past.”
“Like the nausea and high blood pressure you came in with,” Dr. Baines adds.
“Regardless of how we got here,” Dr. Okafor says, “we are here now. The autoantibodies have affected your kidneys to the point of failure.”
“Failure?” I ask numbly.
“I know it feels sudden to you, but it has been happening quietly in your body the last few months.” Dr. Okafor slides her hands into the pockets of her white lab coat. “And now it’s getting loud.”
“How loud?” Canon asks. “What do you mean?”
“We put kidney disease into five different stages,” Dr. Okafor says. “We’ve determined you’re in stage four. Patients in this stage will most likely require dialysis for life or will need a kidney transplant. As I said, the damage, once done, is irreversible.”
I shake my head and toss my legs over the side of the bed. I need to walk, to move. I can’t bear just lying here and taking this. Accepting this, when it cannot be right. I can dance nine hours a day. I do yoga. I eat right. I barely drink alcohol. I’m healthy.
“I know this is a lot to take in, Neevah,” Dr. Okafor says.
“Take in?” I shout, my voice loud and outraged and desperate. “It’s not a lot to take in. It’s impossible. I can’t be . . .” My words splinter into the doctors’ practiced silence. That silence, that space they make for patients to accept the news. The world tilts. I’m wavering. I stagger and Canon is there, grabbing my elbow and pulling me into his chest. I stand there, sheltered in his arms, on the outside, completely still, but inside, reeling.
Vertiginous.
Spinning and falling into a deadly new reality that I’m not sure I’m ready to face. I feel Canon’s kiss in my hair, and I cling to him like he’s the only thing keeping me afloat in this storm.