We Pick Our Battles



The thick mahogany desk was covered with a thick sheet of plastic. It was as if the doctor wanted to protect the surface of this desk – probably a reproduction, definitely not an antique.  The plastic had little white plastic snaps that attached to each corner, like a Tupperware container. I stared at the plastic. In my peripheral vision, I saw a mug of cups, the same red drug trademark swooshing across the plastic. Remicaid.

“So it looks like you have Crohns disease, Francesca,” the doctor said. His white hair fell to one side of his face, framing it unevenly. His glasses were slightly askew on his nose, making his entire being just a little off center.

“What does that mean?” I managed to croak out, though I thought I knew. My friend’s dad had Crohns when we were growing up. Long stays in the hospital, feet of his intestines removed, white, white skin, bloodshot eyes, yellow fingernails. Toenails too.

“Well, it means that a piece of your intestines is inflamed. And when you eat something, it irritates it. Think of it as a canker sore in your stomach.”

That sounded about right. And also not as severe as I knew it to be.

“So what do I do about it?” I asked. It was hard for me to translate this new information from my head to my body, even though I had felt so terrible for so many years my body probably knew it already.

“You are in luck!” The doctor said, and pushed his silky white hair back onto his red flakey forehead one more time. “There are some new drugs, immunosuppressant and infusions, they have had great results so far in trials.”

“Trials? What are the side effects? How long have people been taking this medicine?” I looked straight at the mug full of Remiciad pens, their green plastic casing pressed hard up against each other, like they were trying to escape. The green went blurry in my line of vision and I could no longer make out the words scrawled on each spine.

“What is it called?” I added, knowing the answer.

The doctor sat back in his chair, leaning the way your teacher tells you not to lean when you are in seventh grade.

“Remicaid has had some amazing results.”

I nodded, at this point in my life unable to disagree with men older than my father.

“It will make me better?” I asked.

“Yes, it will. And the side effects are unproven. Some people, very very few have linked it to lymphoma, but honestly I think it is not a statistically relevant finding.”

“So I can have severe stomach pain, with the urgent need to go to the bathroom, or I can die of cancer?” I can’t remember if I said that out loud if if it played in my head. But I remember what he said next.

“We pick our battles, Francesca,” he said and re-crossed his legs, straightening the plastic casing that covered his desk, staring somewhere up over my head, up and out the window.

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