Hold Tight

Dante interrupted. “I want to be the one.”

“Excuse me?”

“I want to give Lucas a kidney.”

“You’re not a match, Mr. Loriman.”

Just like that.

Mike kept his eyes on Susan Loriman. Now it was her turn to play neutral.

“Oh,” Dante said. “I thought the father . . .”

“It varies,” Ilene said. “There are many factors, as I think I explained to Mrs. Loriman during her previous visit. Ideally we want the HLA typing to have a six antigen match. Based on the HLA typing, you wouldn’t be a good candidate, Mr. Loriman.”

“How about me?” Susan asked.

“You’re better. You’re not perfect. But you’re a better match. Normally your best chance is a sibling. Each child inherits half his antigens from each parent and there are four combinations of inherited antigens possible. Put simply, a sibling has a twenty-five percent chance of being an identical match, a fifty percent chance of being a half match—a three antigen—and a twenty-five percent chance of not being a match at all.”

“And which is Tom?”

Tom was Lucas’s younger brother.

“Unfortunately, the news is bad there. Your wife is the best match we have so far. We will also put your son on the cadaver kidney transplant bank, see if we can find a better candidate, but I would call that unlikely. Mrs. Loriman might be considered good enough, but frankly she is not an ideal donor.”

“Why not?”

“Her match is a two. The closer we are to a six, the more likely your son’s body will not reject the new kidney. You see, the better the antigen match, the less likely he will have to spend his life taking medications and doing constant dialysis.”

Dante ran his hand through his hair. “So what do we do now?”

“We have a little time maybe. Like I said, we can put his name on the list. We search and keep working with dialysis. If nothing better comes along, we use Mrs. Loriman.”

“But you’d like to find better,” Dante said.

“Yes.”

“We have some other relatives who said they’d donate to Lucas if they could,” Dante said. “Maybe you could test them.”

Ilene nodded. “Make up a list—names, addresses, and exactly how they are blood related.”

Silence.

“How sick is he, Doc?” Dante spun around and looked behind. “Mike? Be straight with us. How bad is this?”

Mike looked at Ilene. Ilene gave a little go-ahead nod.

“Bad,” Mike said.

He looked at Susan Loriman when he said it. Susan looked away. They discussed options for another ten minutes or so and then the Lorimans left. When Mike and Ilene were alone, Mike took the chair Dante had been in and raised his palms to the sky. Ilene pretended to be busy putting files away.

“What gives?” Mike said.

“You thought I should tell them?”

Mike didn’t reply.

“My job is to treat their son. He is my patient. The father isn’t.”

“So the father has no rights here?”

“I didn’t say that.”

“You took medical tests. You learned something from them that you kept from a patient.”

“Not my patient,” Ilene countered. “My patient is Lucas Loriman, the son.”

“So we bury what we know?”

“Let me ask you this. Suppose I found out from some test that Mrs. Loriman was cheating on Mr. Loriman, would I be obligated to tell him?”

“No.”

“How about if I found out that she was dealing drugs or stealing money?”

“You’re reaching, Ilene.”

“Am I?”

“This isn’t about drugs or money.”

“I know, but in both cases it is irrelevant to the health of my patient.”

Mike thought about that. “Suppose you found a medical problem in Dante Loriman’s test. Suppose you found out that he had a lymphoma. Would you tell him?”

“Of course.”

“But why? As you just pointed out, he’s not your patient. He’s not your concern.”

“Come on, Mike. That’s different. My job is to help my patient—Lucas Loriman—get better. Mental health is part of that. Before we do a transplant, we make our patients go through psychiatric counseling, right? Why? Because we worry about their mental health in these situations. Causing tremendous upheaval in the Loriman household will not benefit my patient’s health. Period, end of story.”

They both took a second.

“It’s not that easy,” Mike said.

“I know.”

“This secret will weigh heavy on us.”

“That’s why I shared it with you.” Ilene spread her arms and smiled. “Why should I be the only one with sleepless nights?”

“You’re a great partner.”

“Mike?”

“Yes?”

“If it was you, if I ran a test like this and found out that Adam wasn’t your biological son, would you want to know?”

“Adam not my son? Have you seen the size of his ears?”

She smiled. “I’m trying to make a point. Would you want to know?”

“Yes.”

“Just like that?”

“I’m a control freak. You know that. I need to know everything.”

Mike stopped.

“What?” she said.

He sat back, crossed his legs. “Are we going to keep avoiding the elephant in the room?”

“That was my plan, yes.”

Mike waited.

Ilene Goldfarb sighed. “Go ahead, say it.”

“If our first credo is indeed ‘First do no harm’ . . .”

She closed her eyes. “Yeah, yeah.”

“We don’t have a good donor for Lucas Loriman,” Mike said. “We’re still trying to find one.”

“I know.” Ilene closed her eyes and said, “And the most obvious candidate would be the biological father.”

“Right. He’s our best chance now for a solid match.”

“We need to test him. That’s priority one.”

“We can’t bury it,” Mike said. “Even if we want to.”

They took that in.

“So now what do we do?” Ilene asked.

“I’m not sure we have much of a choice.”

BETSY Hill waited to confront Adam in the high school parking lot.

She looked behind her at “Mom Row,” the curb along Maple Avenue where the moms—yes, there was the occasional dad but that was more the exception that proved the rule—sat in idling cars or gathered to chat with other moms, waiting for school to let out so they could shepherd their offspring to the violin lesson or the orthodontist appointment or the karate class.