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Instead of riding the team bus, he'd driven his own car; he planned to stay an extra day for a med school interview at Georgetown—and to look up an old friend, a student at Johns Hopkins. He arrived early and found the number in the Baltimore phone book: his old Pearse roommate Matthew Stone.

"Sure," Matthew said when Billy invited him to the game. Billy picked him out immediately in the stands. He was thinner than Billy remembered, with a different haircut. He wore a diamond stud in his right ear. Maybe because of the earring, Matthew now looked
gay.

And on Matthew, gay looked very good.

They greeted each other warmly, clumsily—the pumping handshake, the shoulder thump—Billy wondering all the while what his teammates were thinking, how he and Matthew looked.
We were at Pearse together
, he explained to no one in particular, as though an explanation were required.

They went back to Matthew's place, in a neighborhood where Billy hesitated to park his car. Matthew's building looked ready for demolition, but his apartment was spacious and interestingly furnished—a curving, asymmetrical sofa, an Eames chair. Matthew tossed him a beer from the refrigerator, and before he had a chance to open it they were in Matthew's bedroom.

What happened there was nothing like sex with Lauren, which, at its best, had been a tense experiment. With Matthew there was no effort involved, no concentration, no calculation. Matthew knew exactly what to do, how and where to touch. His body was intensely familiar—from the long-ago nights at Pearse and the many times since, when he had visited Billy's imagination, Billy alone in his room.

"That was incredible," Billy said afterward, breathing heavily.

"I've practiced," said Matthew, and Billy felt a stab of jealousy.

Crazy of course, to hope that Matthew had waited for him. "What, you haven't practiced?"

Billy thought his guilt would choke him. Until that moment, he'd forgotten there was a Lauren.

The next weekend he drove to New Haven in a downpour. He had begged off the party at her sorority.
Let's go somewhere, just the two of us. It's important. I need to talk to you.

He picked her up at her dorm. The rain fell in icy sheets. He had parked a block away; by the time they reached his car, Lauren's coat was soaked. She'd made a dinner reservation at the Rose Room, the sort of place Yale students took their parents at graduation or homecoming. The food was good—expensive, a little fussy—the drinks exceptionally strong. Billy drank two martinis before the salads arrived.

"I've been thinking," he began, the speech he'd rehearsed on his drive from Princeton. He was drunk enough to get through it, as long as Lauren didn't cry. "Things are getting crazy, what with med school decisions. We won't have a lot of time to see each other."

Lauren frowned. "It's almost summer. We can go to the Cape with my parents. We can see each other every day, if we want."

"Sure," said Billy."The Cape would be great. Only—" Oh Jesus, how did people do this? He thought fleetingly of his parents, who'd dissolved a fifteen-year marriage over the course of a few months.

How did anyone have the courage? How did you even begin?

The waiter arrived with their dinners. Billy looked down at the plates, his stomach clenching like a fist. There was no way he could eat a bite.

He looked over at Lauren, shivering in a sleeveless dress. It was pale green and silky, a dress he didn't recognize. Pearls at her throat, her blond hair dark from the rain.

"You look beautiful," he said with feeling.

She tucked a strand of hair behind her ear, revealing a pearl earring. Billy thought of Matthew, the diamond stud in his right ear.

"I'm going to be sick," he said.

In the men's room he leaned over the toilet. The gin washed up from his stomach in a sour wave.
Quality
, he thought. Running away from the table to hurl: that was quality behavior. When he returned to the dining room, Lauren was staring out the window, her dinner untouched.

"I'm sorry," he said."I drank too much."

"This isn't how I thought it would be."

"What do you mean?" He stared at her, genuinely mystified.

"I thought there was something you wanted to ask me."

And finally he understood: the new dress, the Rose Room."Oh, Lauren."

Her face looked ready to crumble, crushed with disappointment.

It was almost more than he could bear, Billy who'd never disappointed anybody in his life.

"I don't understand," she said, her voice vibrating, and he saw there was no avoiding it: she was clearly, inevitably, about to cry. "Is it—just tell me. Is there someone else?"

The question hung in the air. Lifetimes passed. Their wedding at the church in Concord, Lauren in his grandmother's wedding gown; summers in Truro, their children playing in the surf. Billy and Lauren growing old and tender, the way his parents hadn't.

She got up quickly from the table, grabbed her handbag, and rushed for the door.

"Lauren, wait!" He reached for his wallet and laid bills on the table, fifty, a hundred, more. He felt the plastic tag in his jacket pocket.

She had forgotten her coat.

He found her in the parking lot, sodden and crying. "Here," he said gently, wrapping her in her coat. They drove back to campus in silence, Billy sober finally, and shivering in the cold. He thought of the long wet drive back to Princeton, the long arid years of a life without her.

 

And for a long time, love, the possibility of it, seemed lost to him.

It was the cold reality of his condition. He could want another man, he could touch and be touched, fuck and be fucked; but this was not love. Was, rather, a terrible parody of it, somehow comical, somehow grotesque. Love was the movies of his adolescence, John Travolta strutting and preening, twirling the girl in the Lycra dress. Billy couldn't name the actress, couldn't even recall her face; but still he'd absorbed the lesson: it wasn't love unless someone was wearing a dress.

Sex, now: sex could be had. When he started med school that fall, he sensed its presence in the streets, in the dance clubs where he occasionally ventured, New Order playing so loud he couldn't hear a thing, only feel it in his chest.
How does it feel to treat me like you do?

Boys in boots, in peg-legged jeans, eyed him brazenly from across the room. The night-owl complexions, the hollow cheeks: to Billy, who'd spent his adolescence crushing on Bowie and Mick Jagger, they could hardly have been more seductive. But in the fall of 1984, they were also suspect. The virus had been identified, a name assigned. Still, the obituaries in the
Times
were full of code words:
of pneumonia, after a long illness.
Suddenly nobody looked healthy, and suddenly this mattered a great deal. For the average gay man, getting laid was a scary business. For Billy McKotch—coming off a tough first semester at Columbia, knowing more than he wanted to about virology and epidemiology—it was simply impossible.

So to hell with women; to hell with men. He would live like his sister Gwen, outside that dizzying and treacherous game. Med school consumed him; he studied, went to lectures, slept when time allowed.

And when he wasn't sleeping or studying, he ran. Each day, awake before dawn, he passed the same lean strangers in the park, a ghostly fraternity darting through the half light. They exchanged glances, the curt runner's nod, and Billy thought of the other ghosts who still inhabited the city, the young men evaporated by
a long illness
, felled by a chronic condition. The men who were like him.

He finished the New York Marathon in three hours and sixteen minutes—six minutes too slow to qualify for Boston, but next year that would come. Crossing the finish line, he thought of Lauren McGregor, who'd made him faster and better. Afterward, his hands shaking from adrenaline and fear, he called her number in Connecticut. A machine answered:
I'm not here now. You know what to do.

He called again and again, saying nothing, just to hear her voice.

 

1998

the cure

 

chapter 4

 

Gwen packed her gear carefully. The duffel bag was narrow and lightweight, just large enough to hold her mask and fins and snorkel, her regulator and buoyancy compensator vest. As always, she worried that the airline would lose her luggage. Snorkels and regulators were easily replaced, but the BC had been custom-made to fit her perfectly. No dive shop in St. Raphael—in the entire Caribbean—would have one in her size.

Which was short and square. Sort of, but not exactly, small.

She has never explained herself to anybody. She has been asked, but not in a way that required a response.

What's your problem, Bitsy? Why are you such a freak?

Or:
Describe any way(s) in which your Turner's syndrome has affected your psychosocial development.

The second question is worse, being unanswerable. She has never been anyone else, anyone normal. Beyond the obvious—the breasts, etc.—she has no clue how they develop. And of course psychosocial isn't about breasts.

I am not a psycho
, she'd written on the questionnaire as she was waiting to see the doctor,
nor am I very social.
The doctor, if he actually read this, would take it as a symptom of something. Her whole life was considered a symptom of something.

Unanswerable.

It wasn't as if something had happened to her, an accident or injury, an illness that struck overnight—she is thinking of tuberculosis or the other one, the spinal one—and left her crippled, a clear case of cause and effect. No. She'd been a child, normal, healthy.

Then.

Then nothing, not a single thing, had happened.

Instead things had
failed to happen.
And how do you explain what has failed to happen? Gwen did not change. Other girls did. She can't know what they are like inside, their internal weather. What they are that she is not.

In her teens she devoured science fiction novels, full of alien invaders, the more fantastic the better. And it was to these creatures, visitors from another galaxy, that she imagined explaining herself.

I am small
, she would tell them.
This is why I am small.

They would have noticed her size, of course, in relation to her fellows; but to them, large headed and possibly without working lungs, it would seem a minor point. She would describe the metamorphosis humans typically went through—the sudden increase in size, the subtle changes in shape. The visitors would listen incredulously, the whole process as foreign to them, as bizarre and random sounding, as it had always seemed to Gwen.

Yet everyone experienced it: rich and poor, genius and cretin, millions of Africans and Asians speaking languages she would never understand. Years ago, as an undergraduate, she'd become fascinated with puberty rituals: the Sunrise Dance of the Apache, the Nigerian girls sequestered in fattening rooms, the bar mitzvahs and confirmations, the conferring of adult names. The local Algonkian tribe had performed the Ceremony of the Maide to initiate young girls into womanhood—a ritual deplored, and quickly outlawed, by Concord's Puritan settlers. It occurred to Gwen—nineteen then, holed up in the Wellesley library writing an exam for Cultural Anthro—that puberty was the one universal human experience. Not just for the billions of people now living, but the billions who'd preceded them. Everyone had gone through this passage. The realization shook her. She had never felt so alone.

 

She'd been a girl like any other: small for her age, but not remarkably so. She liked being small, the attention it brought her. She'd been a showoff then, a singer and a dancer. The lead in every school play. The fastest runner in her grade.

She was competitive. Coming in second had made her wild. At Pilgrims Country Day she was branded a crier, but only because she hated losing. She'd tried to explain this to her mother:
I'm not sad. I'm just mad.
Emotional immaturity, her teachers called it. For this reason, Gwen was held back a year.
She's so little
, the principal told her mother.

She needs time to catch up.

Gwen saw, in retrospect, that flunking was a blessing. It delayed the inevitable. It bought her an extra year of innocence. In the seventh grade she noticed girls changing. Not all of them, not yet; but more and more she spotted the square yoke of bra straps beneath her friends' white blouses. That summer at the Cape her cousin Charlotte had betrayed her; in the space of a year she'd become a different person, someone Gwen didn't recognize. At school she kept a mental tally: how many, like herself, still wore undershirts or nothing. As long as there were others, she didn't care. As long as she wasn't the only one.

Phys Ed, predictably, was a source of agony. Three times a week she stripped down quickly in the locker room. Naturally she didn't want to be seen. But just as urgently, she didn't want to see. She wrapped herself in a towel and headed to the shower, timing it carefully. If she moved fast, she could finish before most of the others had started. This worked, but never completely. Always she saw a pair of breasts or two.

There was no escaping it. Breasts were everywhere. Like a horny teenage boy, Gwen perused the lingerie pages of the Sears catalog.

Breasts squeezed into sweaters, peeking out the sides of tank tops, curving under T-shirts, like the pillows of a neatly made bed. When she was finally diagnosed, the other facts of her Turner's were murky abstractions—the talk of ovaries, which until recently she wasn't aware of having; the old-person worries about bones and heart disease. But her flat chest tormented her. Breasts were what she wanted, symbols of all she would never have.

Behind closed doors her parents argued—in urgent whispers, in low voices. In the end they shouted, not caring if Gwen heard.

The substance of these arguments was always the same. Her father wanted tests, doctors, X rays, hormones. Her mother wanted none of these things. Unless they were medical, Frank ignored her problems. Paulette treated her like a baby. At the Cape she refused to let Gwen bike in the dunes, insisting she take one of her brothers along.
Keep an eye on your sister
, she'd tell Scotty.
Don't let her get lost.

Never mind that Gwen was three and a half months older and had a reasonable sense of direction, while Scott couldn't find his way out of a parking lot.

Let her go
, her father would have said, if he'd ever been around at such moments.
Gwen will be fine.
Of course, he knew everything about Turner's. Nothing made him happier than telling her all the things that could be wrong with her, but weren't. A few years back, he'd phoned her sputtering with excitement: a scientist at Berkeley had identified a gene responsible for early breast cancer, the disease that killed Frank's mother. Mutations in the gene were inherited—but Gwen, thank God, had little cause for concern.

It took her a moment to understand his delight. He was giving her another reason to be grateful.
Thank God for what?
she wondered.

That I don't have breasts?

He'd spent her adolescence talking to doctors,
keeping up with the literature.
Billy, their father's actual favorite, often joked that Gwen was.

She had an unfair advantage, he claimed: there was no literature on Billy or Scott.

 

It was her father who first put a name to it, who took her for the blood test at Mass General. It was snowing that morning, the first day of Christmas vacation. Her parents had been fighting for several months. When the test results came back, it was Frank who explained what they meant. He talked for more than an hour using words Gwen didn't recognize, long words that obscured the important points.

Which were:

1. She would be short forever.

2. She wouldn't have periods, or

3. babies, or

4. breasts.

 

She had two chromosomes, like everyone did, but one of hers was partly missing. And these other things would be missing as a result.

Suddenly everything about her had an explanation: her size, her shape; her dramatic entry into the world, the tiny preemie in an incubator. The time she'd gotten lost in Star Market was no longer just a story; it was evidence of her
spatial difficulties
, her
nonverbal learning impairment.
Even her lousy math scores had an explanation: apparently all Turners sucked at math. That Gwen rarely did her homework, that she doodled or daydreamed or wrote letters to Shaun Cassidy instead of copying the sample problems into her notebook, did not matter.

She was no longer castigated for being lazy; she was simply taken out of Algebra and put into General Math.

Her parents argued.

After each argument her father dragged her to another doctor—an endocrinologist, a pediatric cardiologist. Blood was taken, an ultrasound image of her kidneys; X rays to see the bones of her hand.

The shots would make her grow several inches if she was lucky. Of course, being Gwen, she wasn't lucky. A year later, she'd grown less than an inch.

Gwen had Turner's.

Her parents argued.

Her father left.

 

Long after he'd moved out of the house, Frank continued to explain things. He was endlessly interested in Turner's; it was as if they'd discovered a new hobby together, like stamp collecting or golf. Yet he never told her anything she truly needed to know.

She remembered a Saturday evening in the dead of winter, the radiators hissing. They were eating take-out pizza on the floor of his apartment in Cambridge. Frank explained. Gwen listened.

Q. Daddy, why did I get Turner's?

A. You didn't get it. You've always had it. Your second X chromosome was damaged in utero, perhaps since conception.

(Then, seeing her frown) Since before you were born.

Q. So it runs in our family?

A. No, because Turner females are nulliparous. (seeing her frown) That is to say, they do not have children, and so do not pass on their damaged genetic material. Once a family produces one Turner, that line is in effect extinguished. If one of your brothers were to have a daughter, she'd be no more likely to have a damaged chromosome than any other girl.

Her questions were always simple, his answers always complicated. The more he talked, the less she understood.

 

She chose Sacred Heart for high school instead of Pearse. She did this partly to please her mother and partly to spare herself. More and more, school was a torment. An evil new nickname, Bitsy, followed her through the halls. At Pearse there would be no escape from such misery: in the evenings, on weekends, you were always at school.

The hormones came next, with more promises. Her shape would change—"modestly," the doctor was quick to caution. She would have periods—not real ones, he added hastily; but for a few days each month she would bleed.
How is that different from a real one?
Gwen wondered.

But by then she'd learned not to ask.

When she remembered that time, Gwen thought mainly of her mother. After Frank left, she and Paulette were inseparable. Her mother took her to the theater and the ballet, on picnics and nature walks, to concerts at Tanglewood and exhibits at the MFA.
He would never do this with me
, her mother often said. Of course Gwen understood who "he" was.

Her mother needed her. When Frank appeared on Fridays to take Gwen and Scotty for the weekend, Gwen claimed headaches and stomachaches. Her mother allowed this, even encouraged it. With Billy away at Pearse, Paulette was lonely. She wanted Gwen all to herself.

And Gwen wanted to make her happy. She allowed herself to be taken shopping, a chore she despised: the humiliation of department store changing rooms, the perplexed saleswomen who eyed her up and down and asked what size she
usually
wore. When her mother suggested—with embarrassing optimism—that they buy Gwen a training bra, she did not resist. She monitored her chest daily, waiting for the hormones to kick in. No kicking had occurred. Still, a little training couldn't hurt.

Most shockingly (to her adult self, the person she would later become) she acceded to an urgent demand of her mother's. It was important—essential—that Gwen attend her winter formal.

She'd listened incredulously to this request. It was as if her mother had asked her to break into flight.

"Um, okay," said little Gwen, tentatively flapping her wings.

"Don't worry about a thing," said the mother bird. "I have it all figured out. You leave everything to me."

Paulette's old friend Tricia James, it developed, had a son Gwen's age. Patrick James was a senior at the Friends School in Philadelphia and had recently applied to Harvard; he was in the process, now, of scheduling his college visits. After the glowing letter of recommendation he'd received from Frank McKotch, Patrick owed the family a favor. He could schedule his Harvard interview for the week of the formal, and enjoy a fun evening with Gwen.

The preparations began two months in advance. After a long fruitless day of shopping, Paulette gave up and took Gwen to a dressmaker. Together they looked at fabric samples, silk and satin and tulle.

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