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She woke up, marched to the training center, and applied for any program that would earn her enough money to legally go off contraception. It took her three years of fourteen-hour days, but she managed it. Enough money for both a licensed child and the donation of germ plasm that would help begin my life. She said that it was her choice to purchase sperm from a trading house that gave me my intelligence and drive, that the only fertile men in the housing complex were criminals and thugs too far outside of civilization to be on the basic rolls, and that I couldn’t have gotten it from her because she was lazy and stupid.

As a child, growing up, I used to fight back on the last point: She was smart and she was beautiful and anything good about me surely had its roots in her. I believe now she used to denigrate herself in front of me in order to hear praise from someone, even if it was only a beloved child. I don’t resent the manipulation. If intellect and focus were indeed the legacies of my invisible father, emotional manipulation was my mother’s true gift, and it was as valuable. As important.

Because I was an adolescent when it began, I did not notice her symptoms until they were fairly advanced. My time was largely spent out of the house by then, playing football at a dirt-and-weed pitch south of the housing complex, running badly designed experiments with some garage-level makers and artists, exploring my own sexuality and the limits of the young men of my cohort. My days were filled with the smell of the city, the heat of the sun, and the promise that something joyous—a football win, a good project, a transporting affair—might come at any moment. I was a street rat living on basic, but the discovery of life was so rich and dramatic and profound that I wasn’t concerned with my status in the larger culture. My social microenvironment seemed to stretch to the horizon, and the conflicts within it—whether Tomás or Carla would be goalie, whether Sabina could tweak off-the-shelf bacterial cultures to produce her own party drugs, whether Didi was homosexual and how to find out without courting humiliation and rejection—were profound dramas that would resonate through the ages. When, later, my project lead said There is a period of developmental sociopathy in every life, this is the time I thought of.

And then my mother dropped a glass. It was a good one, with thick, beveled sides and a lip like a jelly jar, and when it shattered, it sounded like a gunshot. Or that’s how I remember it. Moments of significance can make maintaining objectivity difficult, but that is my memory of it: a thick, sturdy drinking glass catching the light as it fell from her hands, twirling in the air, and detonating on our kitchen floor. She cursed mildly and went to fetch the broom to sweep up the shards. She walked awkwardly and fumbled with the dustpan. I sat at the table, an espresso growing cold in my hands while I watched her try to clean up after herself for five minutes. I felt horror at the time, an overwhelming sense of something wrong. The metaphor that came to me in the moment was my mother was being run remotely by someone who didn’t understand the controls very well. The worst of it was her confusion when I asked her what was wrong. She had no idea what I was talking about.

After that, I began paying attention, checking in on her through the day. How long it had been going on, I couldn’t say. The trouble she had finding words, especially early in the morning or late at night. The loss of coordination. The moments of confusion. They were little things, I told myself. The products of too little sleep or too much. She spent whole days watching the entertainment feeds out of Beijing, and then stayed up all night rearranging the pantry or washing her clothes in the sink for hours on end, her hands growing red and chapped from the soap as her mind was trapped, it seemed, by minor details. Her skin took on an ashen tone and a slackness came to her cheeks. The slow way her eyes moved reminded me of fish, and I began having the recurring nightmare that the sea had come to take her, and she was drowning there at the breakfast table with me sitting beside her powerless to help.

But whenever I talked about it, I only confused her. Nothing was wrong with her. She was just the same as she had ever been. She didn’t have any trouble doing her chores. She wasn’t uncoordinated. She didn’t know what I was talking about. Even as her words choked her on their way out, she didn’t know what I meant. Even as she listed like a drunk from her bed to the toilet, she experienced nothing out of the ordinary. And worse, she believed it. She genuinely thought I was saying these things to hurt her, and she didn’t understand why I would. The sense that I was betraying her through my fear, that I was the cause of her distress rather than only a witness to something deeply wrong, left me weeping on the couch. She wasn’t interested in going to the clinic; the lines there were always so long and there was no reason.

I got her to go the day before Ash Wednesday. We arrived early, and I had packed a lunch of roast chicken and barley bread. We made it to the intake nurse even before we ate, and then sat in the waiting area with its fake bamboo chairs and worn green carpet. A man just older than my mother sat across from us, his hands in fists on his knees as he struggled not to cough. The woman beside me, my age or younger, stared straight ahead, her hand on her belly like she was trying to hold in her guts. A child wailed behind us. I remember wondering why anyone who could afford to have a child would bring it to a basic clinic. My mother held my hand, then. For hours we sat together, her fingers woven with mine. For a time I told her everything would be all right.

The doctor was a thin-faced woman with earrings made of shell. I remember that her first name was the same as my mother’s, that she smelled of rose water, and that her eyes had the shallow deadness of someone in shock. She didn’t wait for me to finish telling her why we’d come in. The expert system had already pulled the records, told her what to expect. Type C Huntington’s. The same, she told me (though my mother never had), that had killed my grandfather. Basic would cover palliative care, including psychoactives. She’d make the notation in the profile. The prescriptions would be delivered starting next week and would continue as long as they were needed. The doctor took my mother’s hands, urged her in a rote and practiced tone to be brave, and left. Off to the next exam room, hopefully to someone whose life she might be able to save. My mother wobbled at me, her eyes finding me only slowly.

“What happened?” she asked, and I didn’t know what to tell her.

It took my mother three more years to die. I have heard it said that how you spend your day is how you spend your life, and my days changed then. The football games, the late night parties, the flirtation with the other young men in my circle: all of it ended. I divided myself into three different young men: one a nurse to his failing mother, one a fierce student on a quest to understand the disease that was defining his life, and the last a victim of depression so profound it made bathing or eating food a challenge. My own room was a cell just wide enough for my cot, with a frosted glass window that opened on an airshaft. My mother slept in a chair in front of the entertainment screen. Above us, a family of immigrants from the Balkan Shared Interest Zone clomped and shouted and fought, each footfall a reminder of the overwhelming density of humanity around us. I gave her ramen soup and a collection of government pills that were the most brightly colored things in the apartment. She grew impulsive, irritable, and slowly lost her ability to use language, though I think she understood me almost to the end.