Page 31 of Daughter of Genoa
Dr Rostan answers the door himself. He’s a short, stocky man with abundant grey hair, and he sticks his hand out for Vittorio to shake. ‘Come in, come in. You are Brother…?’
‘Vittorio. Bernardo and Silvia’s friend.’
‘So I gathered. Well, brother Vittorio, you caught me at a good time. I just came in to catch up on some work.’ He shepherds Vittorio into his office and closes the door after him. ‘Now, what’s the problem? Bernardo said that you had a bad cough.’
‘Yes,’ Vittorio says, and he outlines his symptoms: the shortness of breath, the night-time sweats, the dry cough that comes and goes, the chest pain that nags more and more. ‘I can’t even lie down to sleep,’ he says, suddenly desperate. ‘I feel like I’m suffocating.’
‘I see. And how long has this been going on? Be honest.’ The doctor fixes him with a steely blue eye.
‘It’s only been like this for a few days. But I haven’t been feeling very well for a while.’
‘And when you say a while, you mean…’
‘Weeks. Months, I suppose,’ Vittorio admits. ‘But it hasn’t been all that bad. I could manage. I’ve always had weak lungs – I seem to get any cold or flu going around, so I rather thought it was something like that. And my work… my work is stressful, and I spend a lot of time walking. I was away from Genoa for twenty years – I’m not used to hills any more.’
‘Right.’ Dr Rostan looks sceptical, but he doesn’t push any further. ‘Well, if you’d strip off – down to the waist, if you would – I can have a look at you and we’ll see what’s going on.’
Vittorio can’t remember the last time he had to strip in front of anyone. Since becoming a Jesuit, he doesn’t even look at his own body; he’s adept at dressing and undressing without touching any part of himself, as his discipline demands. The discipline he’s traducing simply by having come here. Dr Rostan is looking at him with wide eyes.
‘You’re very underweight. Dangerously so, I’d say. Haven’t you been eating?’
‘I haven’t wanted to eat much. And there was Lent, of course, and…’
‘Lent shouldn’t do this to anyone, much less a man of your age. But now we’re getting into theology, and I think we’d better stay out ofthat. Sit up on the table and breathe as normally as you can.’
Vittorio hoists himself up onto the table that stands behind him, and Dr Rostan begins examining his chest, methodically placing one hand in a particular spot and then tapping at it with the other. A memory comes rushing back, so vivid that he might be there: his childhood bedroom, sitting up in bed with his blue-striped pyjama jacket open and kindly, bald Dr Parodi, the family doctor, tapping his small chest with large, warm hands. He’d given Vittorio a big smile and said that he’d been ever so brave and it was all perfectly in order. Then he’d ushered Vittorio’s mother out of the room, and a moment later he’d heard her start to cry, a sharp, keening cry that made him feel alone and scared.
Dr Rostan is listening with a stethoscope now. The feel of the cold metal on his skin is horribly familiar. Vittorio tries to breathe, to force down the fear that’s rising up within him. The doctor must notice, because he puts a steadying hand on Vittorio’s shoulder as he removes the stethoscope.
‘All right, Father. You can get dressed now.’
Father. It doesn’t feel like a term of respect; it feels like an act of indulgence, a sop to a patient in dire straits. ‘What is it?’ Vittorio asks, pulling his clothes back on with shaking hands. ‘What’s wrong?’
‘You have a pleural effusion: in other words, your chest cavity is full of fluid. It’s pressing on your lungs and that’s why you can’t breathe comfortably. You need to get a chest X-ray and have some of the fluid drawn and analysed. In fact,’ Dr Rostan adds, ‘you should do so urgently.’
‘Why? What’s causing it?’
‘There’s no sense in my frightening you with a list of potential diagnoses. Get the tests done, and if you want to talk over whatever you find out, then you can come back and see me.’
‘But I need to know,’ Vittorio says, frantic now. ‘I’m not asking for a precise diagnosis. I just need to know what kind of thing it might be – how serious it is. I need to know what’s going to happen to me. It’s important. Please, doctor.’
Dr Rostan considers him for a moment. ‘Fine,’ he says at last. ‘You are a friend of my good friends, and so if this is an extraordinary situation – which I can only assume it is, since you’ve come to me in the first place – then I can tell you something in general terms. But I think we’d better sit down.’
18
The doctor is talking in a low, soothing voice. But the words he’s using aren’t soothing at all. Cancer – that’s one thing it could be, with the weight loss and the night sweats. Lung cancer, perhaps, or another type that’s spread to the lungs. Heart failure. Tuberculosis.
‘But it can’t be that,’ Vittorio protests. ‘I haven’t been coughing anything up.’
‘TB can take root outside the lungs,’ Dr Rostan explains. ‘It’s much less common, but it happens. When it does, it can infect more or less any part of the body – and in that case, you won’t have the classic productive cough. It’s just one possibility and not even the most likely one, but it’s something to consider. Especially given your risk of exposure. I expect you’ve done missionary work in the past? Ministered to the poor and the sick, that sort of thing?’
‘Yes, but I…’ Vittorio has to pause for breath. The fear is at his throat, strangling him. ‘I had TB as a child,’ he says.
‘Ah.’ Dr Rostand gives him a sympathetic look. ‘In that case, I’m afraid the probability is rather higher. The disease can recur, even in patients who make a good recovery. I’m sure you’re aware of that already.’
‘Yes. I knew it might come back, but I didn’t know…’ He’s been making bargains with himself all this time – stupid, wrong-headed bargains.If I cough something up, I’ll go. If I taste blood, I’ll go.
‘Well, you know now,’ Dr Rostan says. ‘So the important thing is to get the tests done, find out what you’re dealing with and go on from there.’ He reaches across and pats Vittorio on the arm. ‘You’ve asked me to tell you what’s going to happen, and so I shall be honest with you. If it’s cancer or TB, you should be prepared to hear that it’s terminal. That means you might have a few months left. If it’s heart failure, you could go on for a bit longer – an additional year or two, with good care and a following wind. But in any case, treatment can only be about managing your symptoms, not curing them. I’m very sorry, Father. I know this is hard to hear. If there’s anything I can do…’
