Chapter 43 The Second Mutation
The morning of the appointment, a light drizzle covered the windshield. Damian wiped it with his sleeve before getting into the car. The children were strapped in, unusually quiet. Even Waffle, left behind with Rosa, seemed to understand something was different.
Rose looked out the window. "Is it going to rain all day?"
"Probably," Damian said. "We'll bring umbrellas."
We drove in silence.
Dr. Harris's waiting room was empty. The receptionist waved us straight back. The fish tank was dark, the filter off. Someone had forgotten to turn it on.
We filed into the office. The children took their usual seats. Damian stood by the window. I sat closest to the doctor's desk.
Dr. Harris opened a thick folder. "The expedited results are in. All four children have the PAI-1 mutation."
Damian's shoulders stiffened. "So they have both."
"Yes. MTHFR and PAI-1 together create a higher risk for clotting. We'll need to adjust their medications."
Lily tugged my sleeve. "Is that bad?"
"No, sweetheart. It just means the doctor knows more now."
Dr. Harris explained the new protocol. Daily blood thinners. Monthly monitoring. Compression socks for long trips. Leo asked if he could have superhero socks. Max wanted dinosaurs. Dr. Harris smiled and said she would write a prescription for both.
Rose waited until the others were done. Then she asked, "Is there anything else?"
Dr. Harris paused. The pause was longer than before.
"There can be growth effects. We'll need to track height and weight more carefully."
Damian turned from the window. "What kind of effects?"
"Mild delays in some cases. Nothing severe. But we want to catch anything early."
We left with another folder. Damian carried it like a fragile package. The rain had stopped. The clouds were breaking.
In the car, Leo asked, "Do I have to get more shots?"
"Not yet," Damian said. "Just medicine for now."
Max wanted to know if the medicine came in flavors. I told him it did. He asked for grape.
Rose was quiet. She stared at the wet streets.
When we got home, she went straight to the yellow room and closed the door.
I found her sitting on her bed, holding one of the paper stars. She had made it herself months ago, back when we first moved in.
"Rose, talk to me."
She looked up. "I'm tired of being the one who asks the questions."
"What do you mean?"
"At the doctor, I'm always the one who asks 'Is there anything else?' Everyone else asks about flavors and socks. I ask about the hard stuff."
I sat beside her. "That's because you're brave."
"I don't feel brave. I feel tired."
I put my arm around her. "Being tired and being brave are the same thing. You keep going even when you don't want to."
She leaned into me. "Will I ever stop having to go to doctors?"
"Someday. But right now, the doctors are helping us keep you healthy."
She nodded. Then she said, "I want to go to the beach again."
"We'll go. As soon as we can."
The growth specialist appointment came three days later. Dr. Morrison had kind eyes and a wall full of height charts. She measured Rose twice. Then she measured Max.
"Rose is below the first percentile for her age," Dr. Morrison said. "Max is in the fifteenth."
Damian frowned. "What does that mean for Rose?"
"It means she has a growth hormone deficiency. Likely linked to her genetic mutations."
I gripped the arms of my chair. "Is it treatable?"
"Yes. Daily injections for several years. She should reach a normal height."
Rose looked at the doctor. "How many years?"
"Three to five. Maybe less."
Rose nodded. "Okay."
That evening, we learned how to give the injection. A nurse came to the house. She showed us the pen, the alcohol wipes, the tiny needle.
Rose watched everything. She did not flinch.
When the nurse asked if she wanted to try, Rose held out her leg. "Do it."
The nurse pressed the pen. Rose's jaw tightened, but she made no sound.
"Done," the nurse said.
Rose looked at the small bandage on her thigh. "That wasn't so bad."
Damian knelt beside her. "You're incredible."
"I know."
The next few days fell into a rhythm. Morning medicine. Evening injection. Rose never complained. Lily started calling her "Super Rose." Max drew her a picture of a girl with a cape.
Leo asked if he could have an injection too, just to be like his sister. Damian explained that Leo didn't need one. Leo was disappointed.
"You can have extra dessert instead," I said.
Leo brightened. "Every night?"
"Once a week."
"Deal."
On Friday, Dr. Harris called with the bone density results.
"I've reviewed Rose's scan," she said. "There's an area of lower density in her left hip. It's not urgent, but we need to address it."
Damian put the phone on speaker. "What does that mean?"
"It means her bones are slightly weaker in that spot. We'll add calcium and vitamin D supplements. And she'll need to avoid high-impact activities until we see improvement."
I wrote it down. "How long?"
"Three months, then a repeat scan. If it's better, she can resume normal activity."
Rose was in the room, listening. She did not cry. She did not ask questions. She simply said, "No gymnastics, then."
"I'm sorry, sweetheart."
She shrugged. "I didn't like gymnastics anyway."
That night, we sat on the porch. The stars were out. Waffle chased fireflies.
"Another thing," Damian said.
"Another thing."
"But she's handling it."
I leaned into him. "She's handling everything."
We sat in silence. Then Rose appeared at the screen door.
"Mommy, can I sleep in the yellow room with the stars?"
"Of course."
She disappeared back inside.
Damian kissed my temple. "One day at a time."
"One day at a time."
Then his phone vibrated. He glanced at the screen. His jaw tightened.
"Dr. Harris again?"
He showed me the message. I've been reviewing the bone density results with a pediatric endocrinologist. There's a second area of concern. Please call me in the morning.