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So when the doctors pile into the cabin a few minutes later, I don’t bother trying anything. It takes all my strength to sit slumped against Alexei’s side, supported by his arm wrapped around me, and not beg for some painkillers for the migraine splitting my skull open.
My head hurts so bad that I don’t notice at first how grave the doctors’ faces are. Alexei does, though. His body turns to stone next to mine, and that’s what clues me in that something is very wrong.
The neurologist—whose name I finally learned is Dr. Kressler—looks particularly grim. “Madame Leonov,” he says, his brows furrowed and his French accent more pronounced. “I’m afraid I have some bad news.” He takes a deep breath. “The MRI showed a mass on your frontal lobe.”
I stare at him, uncomprehending. “A mass?”
“A tumor,” he clarifies. “I can’t give you a definitive diagnosis without a biopsy, but I suspect it may be a type of glioma—possibly an oligodendroglioma, a type of brain tumor that develops from glial cells called oligodendrocytes.”
A brain tumor. As in, cancer. In my brain.
Alexei’s arm tightens around me, making it hard to breathe. Or maybe I just can’t breathe because the words coming out of the doctor’s mouth wrap around my throat like a fist. My mind is blank in a buzzing sort of way, as if my brain has been filled with static. Is that the tumor’s doing? No, that wouldn’t make sense. A minute ago, I could still think, even with the splitting headache. A tumor can’t act that fast… can it?
Alexei’s voice, harsh and tight, reaches me as if from a distance. “What can be done? Can you cure it?”
“There’s no cure as such,” Kressler begins and turns pale—likely at whatever he sees on Alexei’s face. Quickly, he amends, “But there is treatment, of course. The course of the treatment will depend on the exact diagnosis, including the grade of the tumor. All I can tell you for sure is that it will involve surgery, during which we will remove as much of the tumor as possible and biopsy it. If it’s a slow-growing—i.e. low-grade—tumor, that may be all that’s required. But if it’s anaplastic—high-grade and fast-growing—which I suspect it might be, given its appearance on the scans, radiation and chemotherapy will also be required.”
Surgery. Radiation. Chemotherapy.
Each word falls on my ears like the blow of an executioner’s axe, hacking away at the buzzing static, breaking through the shock keeping me paralyzed in place.
“The prognosis…” Somehow, my voice is perfectly calm. “What is the life expectancy if it is a high-grade oligo-something? How long do I have?”
Kressler swallows visibly, his gaze to the right of me, presumably on Alexei’s face. “Every case is individual, so I can’t tell you for sure. There are so many factors that go into it—the age of the patient, the exact location of the tumor, whether there is a co-deletion of 1p/19q—”
“Your best guess then,” Alexei says, his tone so sharp that I nearly flinch—and everybody else in the room does flinch.
“A low-grade oligodendroglioma has a five-year survival rate of about seventy percent,” Kressler says after a tense moment. “For a high-grade oligodendroglioma, it’s about thirty percent.”
So I have either two-in-three or one-in-three odds of making it to my thirtieth birthday. And to think that hours ago, my biggest health worry was my lack of prenatal vitamins.
I don’t know whether to laugh or cry at a fate that seems determined to fuck with me.
“I guess I’m not pregnant then,” I say, rather dumbly. Because of course I am not. All the symptoms that I ascribed to early pregnancy are due to something far more malignant than Alexei’s baby.
I’m addressing Kressler, but it’s a female voice that replies in Russian-accented English.
“Actually, Alina Vladimirovna”—Bureva’s tone is still cool and detached, even as naked pity fills her gaze—“you are. While it’s too early for the HCG to be detectable in urine, a blood test is more sensitive. Your HCG levels are still quite low but in the range that indicates a developing pregnancy. If your estimate of your last period’s start date is correct, you are roughly three weeks along.”
Chapter 29
Alexei
When I was seven years old, I fell down a cellar in an old shack on my father’s summer retreat in the Ural Mountains. I spent two nights there with a broken arm and a twisted ankle, feeling spiders and rats crawling over me, convinced that I would be eaten alive before I could be found.
Up until today, that was the most terrified I’d ever been.
And the most furious.
“Say that again.” Even to my ears, my words sound like the snarl of a rabid wolf. “The part about the survival rate.”
“Mr. Leonov…” Kressler’s voice shakes a little. “I understand that you’re upset. I hate to be the bearer of bad news, believe me, and besides, every case is so individual. For instance, age plays a factor, and your wife is quite young. Also, the frontal lobe location is a favorable clinical prognostic factor. So there’s really—”
