art by Liz Clarke
by Ian Nichols
It's always difficult to tell someone they're going to die. They know there's something wrong with them; that's why they've come to see a doctor. You treat the symptoms, and make them feel better for now, but you take the samples and send them off for testing. Then you wait, the results come back, you call them and ask them to make an appointment. That's when they know. They know when you want to discuss the results in person.
They come to your office and sit in the chair opposite you, not the one alongside where you usually seat them. There aren't going to be any tests this time. No pulse, no temperature, no blood pressure, none of it. The tests are all done, the diagnosis is in.
Milton Cowall was ordinary. Middle-aged, married, one kid and one on the way. Clerk in a big firm and, dare I say it, something of a loser. Hadn't moved up or out for a decade. He sat facing me with that odd look that people get when they know they're going to hear bad news; half-frightened, half defiant, and just a little stunned.
"How are you feeling, Milton," I asked.
He swallowed a lump in his throat before he answered. "Fine. That treatment really worked. I feel like I'm a kid again."
He was lying. I'd prescribed some pills to curb his nausea, more for the dizziness, and recommended some basic exercises for the soreness in his legs. That didn't address his basic problem. I'd give him another prescription today, stronger drugs, and set him up with a physiotherapist to help with the muscle spasms that would come. It was all treatable, and I could treat his symptoms right up to the day he died. I couldn't cure him, but I could make him as comfortable as possible.
"That's good," I said, and looked down at his case file on my desk.
He must have seen the expression on my face. "What's the verdict?" he said with a brittle smile.
I took a deep breath. "It's bad," I said. "Milton, you're dying."
He went pale and licked his lips. He tried to speak, but nothing would come out.
"I've done all the tests I can think of, and duplicated them as a precaution. They all say the same thing." I looked him in the eye. "You've developed a nanocyte intolerance syndrome." I opened up the file "Wright's disease. It's very rare. Your body is gradually rejecting your nanocytes, so that toxins are building up, your immune system has to take up the slack, the telomeres aren't being replaced, cholesterol is building up, your body is just wearing out. I'm sorry."
This is when they reject the findings. It can't be true, they think, we can do something about it, there's a cure. This is the hardest part.
"So, what can we do?"
I looked back down at the file, as though it had something to say that I didn't already know. "Boost the immune system, manage any infections as well as we can, palliative care for the pain and the degeneration."