None of the Above (3 page)

The ob-gyn's office smelled like an unholy marriage of baby powder and Listerine. After I found a seat, I tried to find something to read, but it was all
Better Homes and Gardens
and parenting magazines, so I just sat there and waited.

Some of the other patients were really pregnant. Like, waddling. One woman struggled so much to get out of her seat that the nurse got her a wheelchair to push her to the back hallway.

It'd been a while since I'd been religious; my dad and I had come to a mutual agreement to stop going to church in the months after my mom died. There were only so many sympathetic looks and well-meaning attempts to set my dad up that we could take. Even so, I still remembered the Sunday school classes that my mom had taught, and all I could think about that day in the OB's office was the book of Genesis—the part where Eve ate the apple and God told her he would multiply
her pains during childbirth, and that she had to submit to her husband.

A woman who didn't look quite as pregnant as the others sat across from me. She had a car seat with her and the baby nestled inside looked so happy and warm.

“Aren't you the cutest thing?” I said. I leaned over and nudged the little pink bear hanging from the car seat handle. It jingled and the baby cooed and reached up.

I got my cell phone out and played some of the different ringtones. The baby gurgled and laughed, pretty much the best sound ever, and reached for my phone.

“You mind if she holds it?” I asked. “I've got some Purell in my bag.”

“Go ahead.” The mom shrugged. “You got kids?”

I laughed. “No, not yet. I'm a senior in high school. But I'm going to be a child development major next year at State.” The day I'd signed my letter of intent and accepted my track scholarship had been one of the happiest days in my life; it was amazing to know my dad wouldn't have to worry about paying for college.

A nurse called my name, and I excused myself. She took me back to an exam room and handed me what looked like a stack of pink tissue paper.

“Dr. Johnson will be in soon. Everything off from the waist down, please,” she said. “Leave the opening in the front,” she added, and closed the door.

The pink thing the nurse gave me ended up being some kind of doctor's gown. I undressed, wincing as my bare feet touched the ice-cold linoleum. When I put the gown on and tried to tie it up, the little paper strap tore a bit. I felt like a really badly wrapped birthday present.

While I waited, I studied Dr. Johnson's Howard and NYU diplomas and her posters of the female reproductive system. Somehow, the pictures made girl parts look like an alien, with the uterus being the body, the cervix a bad hairdo, and the tubes and ovaries a pair of demented eyes.

I looked over at the exam table again. Where were the stirrups? Vee had told me about the stirrups.

When Dr. Johnson came in, she started out with a question about how high school was, I guess to make me feel comfortable. She asked me if I had a partner, and I told her that yes, I had a boyfriend.

“And are you sexually active?”

I blushed. “That's kind of why I came for all this.” I made a vague gesture toward the poster on the wall.

“Of course. I saw from your family history that your mother passed away from cervical cancer.”

It sounded like a question so I said, “Yeah.”

“That must have been difficult.”

The worst thing was that cervical cancer is so preventable. If my mom's insurance hadn't lapsed when my dad was laid off
from his last job, they might've caught it sooner. I shrugged and looked at my toes. The nail polish from the pedicure Faith had given me was already starting to peel.

Dr. Johnson didn't say anything for a bit.

“So, when was your last menstrual period?” she said finally.

I shrugged again. “I don't get my period. I train for track pretty much all year around.” Three or four of my more hard-core teammates had stopped getting their periods, too.

“Were you getting your period regularly before you started running?”

I shook my head. My aunt Carla had always said that I was a late bloomer, and it had always kind of bugged me, but then Faith would tell me how lucky I was that I didn't have to worry about tampons and maxi pads and stuff, which made me feel better.

“Hmmm. Okay.” Dr. Johnson wrote something on my chart. She asked me a few more questions about my diet and birth control and stuff, and then stood up. “Well, let's go ahead with the exam then, okay?”

She listened to my heart and lungs. Then she had me lie down and kneaded my boobs and my belly while I stared at the ceiling. She made a little surprised sound and I looked over at her.

“Are you aware that you have a small hernia? Two, actually.”

“What's a hernia?”

It shocked me that anything could be physically wrong with me. For the past decade, I'd been getting physicals from an old buddy of my dad's. Dr. Arslinsdale wouldn't even make me get undressed when he examined me—he just mashed on my belly over my clothes, said, “You're as healthy as a horse,” and offered me a sticker.

“It's a very common thing,” Dr. Johnson said. “You feel this little bump here?” She moved my hand to just above my crotch. “It's a small opening in your abdominal wall where your internal organs can come through. Give a little cough and you can feel it bulge a bit.”

I pulled the crepe paper gown over myself. “Is that a problem?”

“It's not an emergency, but things could get strangulated, or caught, in the future. I'll give you a referral for a surgeon.”

Strangulated
was definitely not a word you liked to hear in a doctor's office. As my blood pressure started to rise, Dr. Johnson reached next to my legs and pulled something out of the exam table that clanked as it unfolded. The stirrups.

“Just put your heels here, scooch toward the bottom of the table so you're to the end, and lie back. I'm going to start with the internal exam. This is the speculum I'm going to use to see inside.” She brought out a contraption that looked like a metal duck bill and presented it to me in the palm of her hand the way they showed off things on QVC.

When she went between my legs I pulled my knees together and Dr. Johnson had to push them apart. I stared up at the ceiling again. There was a water stain on the corner of one of the tiles.

“Try to relax,” Dr. Johnson said.

That was pretty much impossible, but I closed my eyes and tried to think of other things. Cute puppies. Precalc. The new pair of racing spikes my dad had given me for my birthday. Coach Auerbach had told me that if I was really serious I needed three different pairs—one for racing, one for hurdling practice, and one for . . .

“Holy sh—!” It was like being torn apart from the inside. I gasped in pain and my knees came together, knocking Dr. Johnson in the forehead. I sat up and reached my hand out to apologize. “Oh my God, I'm so sorry.”

Dr. Johnson slid her stool back and looked at me. There was a sharp furrow between her eyes. “No, that's okay.” She pulled nervously at her latex gloves. “I'm sorry, I wasn't able to complete the exam. I'll have to try again.”

I took a deep breath and lay down. The poking started again, and I clenched my hand on the paper covering the table.

“Huh . . . ,” Dr. Johnson muttered to herself.

“What?”

“No, I'm . . . Was it very painful when you had intercourse for the first time?”

“Um, yeah.” It seemed so obvious that I laughed through clenched teeth.

“There are a lot of lacerations. And your vagina is unusually short.”

What the hell did that mean?

“I'm also having some trouble seeing your cervix for the Pap, so I'm going to bring over our ultrasound.”

As I stared up at the ceiling, my heart started going crazy and I could feel my throat tighten. A couple of seconds later, before I could really start to panic, Dr. Johnson came in with a machine that looked like a rolling laptop. I winced as she put some ice-cold glop onto my stomach. As she swirled a little probe beneath my belly button, another furrow formed between her eyes. She frowned twice, and pressed harder.

It seemed to be hours before she finally gave up. “I'm sorry to keep you here longer, Kristin, but I'm going to have to order some extra blood tests.”

That's when I started feeling numb, remembering how we'd take Mom to get her blood drawn after chemo and the phlebotomists would stick her again and again like she was a human voodoo doll as they filled vial after vial of sluggish, dark blood.

“What's going on?” I whispered as I got dressed.

Dr. Johnson didn't look at me at first, just tapped her pencil against my chart as if she was trying to figure out how much to tell me. Finally, she seemed to come to a decision.
“Why don't you sit down.”

I shuffled over to the plastic chair by the door, heart pounding.

“So, Kristin,” Dr. Johnson said, “in that ultrasound I just did, I wasn't able to find your uterus—your womb—at all.”

“What do you mean?” I stared at her blankly.

“I want you to think back to all your visits to doctors in the past. Did anyone ever mention anything to you about something called androgen insensitivity syndrome, or AIS?”

“No,” I said, panic rising. “What is that? It's not some kind of cancer, is it?”

“Oh, no,” Dr. Johnson said. “It's not anything like that. It's just a . . . a unique genetic syndrome that causes an intersex state—where a person looks outwardly like a female, but has some of the internal characteristics of a male.”

“What do you mean, internal? Like my brain?” My chest tightened.

Dr. Johnson's mouth opened, but then she paused, as if she wasn't sure whether she should go on. I was still trying to understand what she'd said, so I focused on her mouth as if that would allow me to understand better. I noticed that her lip liner was a shade too dark for her lipstick. “Kristin. Miss Lattimer,” she said. Why was she being so formal all of a sudden?

“I think that you may be—” Dr. Johnson stopped again and fingered nervously at the lanyard of her ID badge, and at her awkwardness I felt a sudden surge of sympathy toward her.
So I swallowed and put on my listening face, and was smiling when Dr. Johnson gathered herself and, on the third try, said what she had to say.

“Miss Lattimer, I think that you might be what some people call a hermaphrodite.”

I blinked. A distant roaring filled my head, like the sound of a seashell pressed against my ear.

“You're kidding, right?” If I opened the door, would I see Vee pressed up against it, holding back laughter? Or maybe it was one of my track teammates. They were always playing pranks, like the time they tricked Lana Weissmuller into thinking that our assistant coach had the hots for her.

But no one jumped in yelling, “Surprise!” The only sound in the room was the hum of the forced-air heating, until I heard Dr. Johnson take in a deep breath. “Kristin, I'm so sorry. This is a lot to absorb. And I don't mean to imply that this is definitely what you have, but your exam and history all point to it. . . .”

I still didn't understand what “it” was. “What do you mean?” The roaring sound grew louder, and I raised my
voice so I could hear myself. “What do you mean that I'm a hermaphrodite?” Saying the word, my voice broke off into a whisper.

Dr. Johnson winced. “I'm sorry, I shouldn't have used that term—it's quite antiquated. The better term to use is
intersex
.” She reached over to the ultrasound machine and tore off a little strip of paper with a picture that looked like a fuzzy black cloud.

“You see this here? Usually you can see the uterus behind your bladder. But I can't see anything. And those hernias you have? I think there may actually be male gonads—testes—in them. Of course I'll have to do more labs. A karyotype—that's when we look at your chromosomes to see whether you are XX or XY—blood hormone levels and things like that. And Kristin, do you mind if I call in a family member, just so you can have someone else here with you?” She looked through my chart, where I had put my emergency contact information. “I'll have my nurses call your dad.”

I nodded, and closed my eyes, hoping that when I opened them again I would wake up, but when I did, Dr. Johnson was still there, frowning at me under the unforgiving fluorescent lights.

I closed my eyes again.

“Kristin, are you okay?” Dr. Johnson touched my arm and I twisted away, wincing at the pain between my legs as I
moved. Dreams weren't supposed to hurt, right?

But real life did. Oh, did it ever.

Dr. Johnson's nurse came in with some test tubes and a tourniquet and drew my blood. After that, I don't know how long I sat around in a daze while I waited for my father.

My cell buzzed and I looked down to see a text from Sam.

What's up? Didn't see you during lunch.

My panic rose up like a tidal wave. What was I going to tell him? What was I going to do? I could feel the muscles in my throat tighten, felt a sour taste at the base of my tongue the way you do just before you throw up.

After a while one of Dr. Johnson's nurses came in to see if I wanted a magazine while I waited. What I really wanted was to know how the fuck I was going to tell my boyfriend that I had testicles.

On the chair, my phone buzzed again. I didn't want to, but I picked it up.

You okay?
said Sam's text.

My hands trembled as I keyed in the vaguest response I could think of:

Had a Drs appt. CU later?

Okay. Love you.

For a second I was able to hold it together. Two seconds. Then all the love and guilt and the fear that things would never
be okay again overcame me, and I sobbed alone, in a cold room that smelled of antiseptic, with nothing but a crumpled-up paper gown to hold on to.

I was curled up in the fetal position when my dad came in, and I could hear him right away as he yelled in the hallway, “Where's my daughter? What's wrong with her?” and all of a sudden my brain went into overdrive. Was I still my dad's daughter, or should he start calling me his son?

I stood up when he came in. As soon as he saw me, his face collapsed with relief, like he had been worried that I'd been paralyzed or something.

“You didn't tell me you had a doctor's appointment,” he said breathlessly.

“I just had some weird bleeding, that's all.” That was the best story I had come up with while I waited.

“God damn it,” my dad groused. He got irritable when he had to deal with anything medical. “The doctor said it wasn't anything serious. But it's obviously serious if she had to interrupt my work.”

Then Dr. Johnson came in. It took her half an hour to explain things to my dad.

And that was the worst part of the whole day: seeing the parade of expressions that marched across my dad's face as he heard the news. First confusion. Then shock and revulsion. And then all the emotions seemed to neutralize each other and
he just looked empty. Shattered.

When everything was said and done, Dr. Johnson reached over to put her hand on my dad's knee. “Mr. Lattimer, I just want to reiterate: the bottom line is that Kristin is perfectly fine. And while I'm relatively certain about the diagnosis, we still need to get the results of some blood tests to confirm everything. I'm also going to send Kristin to a specialist to see whether any surgery needs to be done about those hernias.”

“Why would she need surgery?” my dad asked suspiciously.

“Well, in some cases, the gonads are more prone to developing cancer. . . .”

“Cancer?” My dad's voice cracked.

“It happens in fewer than one in one hundred people,” Dr. Johnson said, as if that were supposed to make me feel any better, “and usually only in much older individuals. But some doctors do recommend a gonadectomy, or removal of the testes.”

“If there's a risk of cancer, shouldn't we do it right away?” asked my dad. “Can we see this specialist tomorrow?”

“We'll have to check with her schedule,” Dr. Johnson said.

“What do you mean, you'll look at her schedule?” my dad said, his voice growing louder. “This is an emergency.”

“Well, it's not technically an emergency, Mr. Lattimer,” Dr. Johnson started, but when she saw my dad's face getting red, she backpedaled. “However, I'll place a call to Dr.
Cheng.” She picked up my chart and headed toward the door. “I'll be right back.”

After she left, my dad slumped into his seat, and put his hand up to his forehead. I hurried over to his side, knowing that if there was anything that could break him, it was the thought of another cancer. “It's okay, Dad,” I said, my face pressed up against his coarse brown hair.

“But what if it isn't?” His voice caught. “I couldn't handle it again, sweetie. I just couldn't.”

“She said the tumors only develop when people are older,” I reassured him. It felt weird to be the one comforting him, like somehow I was the adult and he was the teenager.

A few minutes later Dr. Johnson came back in and told us that the specialist had an appointment the next Monday at four o'clock. “Dr. Cheng will be able to talk to you about surgical options,” she said. “She'll be able to give you more details about cancer risk.”

At the
C
word, my father's face sagged again. But to be perfectly honest? Even knowing what cancer did to my mother, sometimes I think it would've been so much easier if things had been as simple as cutting out a tumor.