The Art of Getting Stared At (24 page)

Kim and I spend an awkward few minutes making polite small talk until a white-coated woman appears beside the door and plucks my file from the wall. She's tall; her face is freckled; and she has frizzy brown hair and thick, gold hoops in her ears.

“I'm Dr. Paxton.” She strides into the room. “You must be Sloane Kendrick.”

“Yes.”

She turns to Kim. “And you must be Sloane's mother.”

“Stepmother.” Kim holds up her pen and notepad. “Taking notes in case we need to refer back.”

“Excellent idea.” Her gaze is direct, her words to the point. “I understand your hair loss has accelerated over the last couple of days.”

“Yes.”

“When did it start? Do you remember?”

How could I forget? “Exactly two weeks ago. At least that's when I first noticed it.”

“I see from your file that Dr. Thibodeau ordered some blood work when he referred you?”

I nod.

“Well, your blood work looks good.” She smiles, puts the file on her desk. “No worries there.”

My heart skips a beat. “Then I don't have alopecia?”

Instead of answering, she says, “Would you mind removing your hat and coming over to the examining table?”

I'm nowhere near bald but I feel so exposed when I take off my hat. As I slide onto the table, she pulls a portable tray close. I see disinfectant wipes, specimen jars, a tiny knife no bigger than tweezers, and latex gloves. “I'll examine your scalp, take a skin specimen for a biopsy, and then pull a few hairs.”

Lose more hair? I don't think so. “But—”

“Only two, don't worry.” She flicks on a portable light, snaps on the gloves. “I'll pull them from an area that hasn't been affected.”

Affected by what? If this isn't alopecia, then what is it?

“Bend your head for me, please.”

Her rubbery fingers comb gently through my scalp. She examines the bald patches several times, once asking me to tilt my head farther to allow her a better look.

“Here comes the little scrape.” I feel a stinging tug, like
I've pulled off a hangnail. From under my lids, I see her drop a piece of my pale, pink skin into one of the jars. “And now the hair.” She pulls. I don't even feel it. But the lump in my throat threatens to choke me when she drops the two hairs into the second jar.

“Look up, please.” When I do, she asks, “Did you bring your brow pencil with you?”

“Yes.”

“Then I'm going to rub the pencil off to take a look, okay?”

Nothing about this is okay. “Sure.” I shut my eyes.

The disinfectant is cold against my forehead. Seconds later, she says, “You can open your eyes now.”

She is so close her nose is practically touching mine. “Blink your lashes, please.”

I blink, once, twice.

She skims my right eyelashes with the tip of her finger. My eyes start to water. I blink again. She brushes something from my cheek—an eyelash?—and then tells me to look up at the ceiling. When I do, she takes a tiny flashlight from her pocket and shines it up my nose. Then she checks my ears. What the hell?

After a minute she steps back. “That's all. You can put your hat back on.”

I return to my chair while she labels the specimen jars. “Have you noticed any hair loss on the rest of your body?” she asks.

“I don't think so.”

She walks to her desk and sits down. “Your arms or your legs? Maybe when you shave them?”

I haven't shaved my legs in weeks. Because I haven't
needed to. My stomach knots. Oh my God. “Maybe a little on my legs.” My voice sounds as if it's coming from far away.

She jots something down in my file. “What about in your pubic region?”

My stomach cramp intensifies. She
has
to be kidding. “My pubic region?”

“Yes.”

“I don't know.” It's not like I'm in the habit of examining myself. “You said my blood work is good. That there's nothing to worry about. So if I don't have alopecia, what do I have?”

“The fact that your blood work is good doesn't rule out alopecia.” She drops her pen and leans back in her chair. “If anything, it helps us confirm it.”

I stiffen.

Kim looks up from her notebook. “How can that be?”

“We do the blood work to rule out an underlying disease or a thyroid condition. Something other than alopecia that could cause hair loss,” the doctor tells her. “In this case, nothing showed. Dr. Thibodeau's preliminary diagnosis was alopecia but it's always good to get a second opinion.”

Her smile is kind. Respectful. But I cannot smile back. Hate for this woman—her freckles, her frizzy hair, her calm, cool demeanour—swamps me.

“As a matter of routine, I'll send your hair and scalp sample for analysis but there's really no question in my mind that you have alopecia. I've seen hundreds of cases and yours is presenting quite typically.”

Deep down, I knew it. Even though a part of me prayed it wouldn't be true. I hug my waist. I'm suddenly freezing.
To-the-bone cold. But I am prepared. I know exactly what I want. “Let's discuss treatments.”

“Of course.” She pulls two pamphlets from her desk drawer and hands us each one.

“About Alopecia” the blue banner screams. The same brochure Thibodeau gave me. I stick it under my thigh. “I read about some treatments online and I know you have to be careful about online stuff—my mother is a doctor—but I'm talking about conventional medical treatments. Things like prednisone or anthralin or cortisone shots. I've considered them all. And I want to try the cortisone shots.”

“I don't recommend it. Not yet.”

“Why not?” Kim asks sharply, pen poised over her notebook.

“My recommendation is that Sloane wait until she's through the acute phase.”

“Until I lose all my hair you mean?”

The doctor opens her mouth but Kim cuts her off. “How long will that be? Why can't Sloane start the shots now?”

Dr. Paxton twists her silver watchband. “Alopecia is extremely unpredictable in its progress. The pattern of hair loss can take many different paths. Treatment depends on the type of alopecia we're dealing with.”

“But you said my case was typical. I've got the smooth, round spots of alopecia areata, right?”

Dr. Paxton's eyes meet mine and skate away. Nerves flutter in my stomach. “Alopecia areata is the most common form but given the swiftness of your hair loss to date, my educated guess is that we're dealing with either alopecia totalis or alopecia universalis.”

Oh no. No, no.
Totalis wipes out all the hair on your scalp, usually fast. Universalis takes all your head
and
body hair. Both are totally gross. I clutch my stomach. I might be sick. “Are you sure?”

“I can't be one hundred percent sure yet, Sloane. I'm sorry. But given the amount of hair you've lost in such a short period of time, and considering the loss of your eyebrows and the thinning I see on your lashes and in your nasal cavity, I suspect we're dealing with universalis.” Compassion shines from her brown eyes. “Unfortunately treatment options for totalis and universalis are minimal and the outcomes are generally poor,” she adds softly.

I'm going to lose all the hair on my head and probably all the hair on my body too. My stomach rolls and dips. I'm a fucking freak.

“Keep in mind that alopecia universalis may be acute and short-lived,” she adds.

“But it can be permanent too.” My voice is croaky. I did my research.

“True,” she admits. “But regrowth is always possible even in cases where there's one hundred percent hair loss over a period of years.”

Years. Good God in Heaven.

“One of the things you have to be aware of with AU—”

Kim frowns and stops writing. “AU?”

“Alopecia universalis,” the doctor clarifies. “And one of the things you need to be aware of is that when people lose their lashes and brows along with the hair in their nose and ears, they're more vulnerable to dust, germs, and the invasion of foreign particles.”

I want to throw up. First I lose my hair. Next I'll be invaded by foreign particles. Great.

“Are you saying there are no treatments at all?” Kim asks.

“Certainly there are things we can try. I'll see Sloane every week for the next month. By then we'll have a better idea of where she's at. We're seeing some success with topical immunotherapy, whereby we produce an allergic reaction with irritants placed on the skin. The idea being that hair can sometimes be stimulated into regrowth by irritating the follicles.”

I tune her out. I cannot believe this is happening to me. I haven't done anything to get this. I haven't abused my body. Indulged in risky behaviour. Nothing. It's so fucking unfair. There's no treatment. No cure. No way to control this.

Honestly, cancer would be better. At least I could get chemo. And people would understand. Who understands baldness?

“My nurse will give you some information on the National Alopecia Areata Foundation,” the doctor continues. “Even though you likely have a different form of the disease, the organization is an excellent resource and will be able to help you.”

“I don't need it.” I've read enough online. Too much.

“I understand this is hard for you, Sloane. Believe me, I do. Over four million Americans are affected by alopecia. And the effects are primarily emotional and social.” She pauses. “Have you shared this with any of your friends?”

“No.”

“I would encourage you to confide in someone. Those who cope best surround themselves with a support
group. Sharing is so important. The NAAF holds a yearly conference—”

Go to a freak show? No way. I look at Kim. “Can we go now? I need to get to school.”

“Not so fast,” Kim says. “There's someone else I want you to see. I thought we'd talk to her about your options.”

Options? Like I have any? “My video's due in less than a week. I need to finish it.” Before I become a card-carrying member of Freaktown and have to stay home forever. “Besides, my options are pretty clear.” I stand. “Bald or bald.”

“I don't want a wig.”

Half an hour after our appointment with Dr. Paxton, I am surrounded by hair and mirrors. My current definition of hell.

I'd been so stunned by the news from the doctor that when Kim said we had an appointment with another specialist and hustled me into a nondescript office complex off Polk, I assumed she meant another medical specialist.

Instead, I am in a windowless room lined with shelf after shelf of faceless heads topped with every kind of hair you can imagine: short, long, sleek, curly. Red, blonde, brown, black. I glance at a spiky white wig with green and pink tips. Even multicoloured.

“But—”

“No buts.” I give Kim a frosty smile before turning to Francine. She's a short, bowling-ball-shaped woman wearing a flowing red caftan. “Thanks anyway.”

Before I can stop her, Francine whips off my fedora and slaps a long, dark wig onto my head. “Sit!” She is bowling ball with attitude.

Swallowing my anger, I sit.

The two of them hover in front of me, flipping bits of hair around. I glimpse at myself in the mirror. Small white face, huge dark wig. I look like a vampire playing dress-up. A trickle of sweat runs down my back. Only vampires are never hot and I'm pretty sure they never take this kind of abuse either.

“We'll need to have it thinned,” Francine says to Kim.

“And shortened.” Kim touches my shoulder. “To about here.”

“I'll have to send it out.”

I shut my eyes, shut them out. I do not want to be here. I do not want a wig. But I don't have the energy to argue. Besides, Kim can buy me as many wigs as she wants; I don't have to wear them.

After a minute, Francine stands aside. “What do you think?”

The hair is a good colour match for my own, I mentally concede as I stare into the mirror. Even if it feels like I'm wearing a garden shrub on my head. “It's heavy. I'd rather wear a hat.”

“So I heard.” Before I realize what she's doing, Francine pops the wig off and replaces it with a denim ball cap. A cap with dark hair attached. “This is a lighter, cooler option.” She stands back and gives me an appraising look. “It suits you.”

Unlike my sage green cap, this one fits snugly. And the attached hair is so close to my natural colour, it totally blends in.

“Can you shorten the hair and maybe thin it a little?” Kim asks.

“That I can do immediately.”

“Thanks,” Kim says. “We'll take both. I'll pick up the full wig next week.”

Francine takes the cap to a table in the corner. Kim pulls her wallet from her purse. “You can wear the new hat to school right now if you want,” she tells me.

“No, I can't.” I shove the fedora back on my head.

“Why not?”

“Because I have to take my hat off in some of my classes and I'm not taking my hair off too.”