Kingdom Come
by Mihangel
Chapter 3
I could see David's brain getting to work on that.
"He's a senior consultant," I explained, "at the Great Ormond Street Hospital for Sick Children. He works on secretions from glands. Which are behind things like diabetes. And his speciality is growth and sex hormones. Which are behind short stature and delayed puberty."
"But what can he do about it?"
"A lot, with luck. Probably replacement hormone therapy to get things going. Testosterone or gonadotropin."
"I've heard of testosterone." He was beginning to be interested, thank God. "But what's . . . the other thing?"
"Lord, it's complicated. Look, David, how much you know about puberty? About what happens, and when, and why?"
"Bugger all, not having being through the bloody thing."
He was becoming quite animated now, and using good earthy language such as I did when with friends. That was encouraging. What was more, he was looking at me.
"And because I don't play games," he went on, "I never see boys naked in the shower. Only their hairy legs when they wander around in shorts. Bigger boys, that is."
"But haven't you been to, um, porn sites? To see what puberty does to your body?"
He blushed and looked down at his lap. Noticing that he was still exposed, he pulled his pants and trousers up. That was a relief, because the sight had been somehow disconcerting.
"They block them," he said.
"Or searched for information on the web? Wikipedia, say?"
"No. I'm a coward. I'm scared of what I might find."
"Have you been to a doctor?"
"Yes. The nincompoop here. Last year and the year before. Both times he said there's nothing to worry about. Yet. Come back when I'm twenty, he said, if my balls haven't grown by then. Nothing to worry about! " He actually blew a raspberry. " Twenty! "
How depressing. I knew that in theory the nincompoop had a point. Puberty could kick in surprisingly late, of its own accord, and run a normal if delayed course. But in the meantime, the sense of inferiority, the psychological damage . . . Adolescents are desperately sensitive if they seem to be lagging behind their peers, if their bodies don't conform to the norm. I had had no problem myself – puberty had struck at the usual sort of time. But I knew that if it had been delayed I would have been mortified and ashamed. And if that were underlined by snide remarks from the unthinking . . .
"Are you ribbed about it?"
But I already knew the answer.
"What do you expect? My uncle – my guardian – just thinks I'm a nuisance and doesn't give a toss. He lives in Bermuda, and I go there as little as I can. But whenever I do, his darling daughters laugh at me. 'Haven't you grown up yet, little boy? All our friends your age, their voices changed years and years ago'." He was obviously imitating them. "And whenever I go through immigration there are strange looks . . . suspicion . . . is it really my passport?"
Words were tumbling out, now.
"And here at Dorcic it's been getting worse as time's gone on. Nothing to my face, but then nobody talks to me anyway. But behind my back they jeer. I hear them, even if I'm not meant to. And that boy last year . . . he said straight out he expected to share with someone his own age, not an infant cry-baby. And on top of that, he'd found out . . ."
He stopped short, biting his tongue. That other problem was raising its ugly head again, and it seemed to be even more painful than the first.
"But I know I am retarded," he picked up. "My voice. My height . . ." He paused.
"Peter" he asked forlornly, "what is supposed to happen? Hair . . . semen . . . everything else . . . And when? And how does it all work?"
"Well, it's horribly complex. Like everything that goes on in your body. I'm no sort of scientist, but I do know something about it. Not just because I've been through it, but because of my Dad. You see, when I was a kid, when I was about . . ."
Oh God, I'd almost said when I was about your age .
"When I was ten or eleven, he started telling me about growing up, so that I knew what was coming and wouldn't be caught by surprise. After all, he's an expert. He knows everything there is to know about it, and all the latest advances.
"At first he kept it very simple, but got more detailed later, though he never drowned me in technicalities. And he only brought it up occasionally, to tell me what was going on inside me, and what the next step would be. Of course he couldn't say exactly when it was going to happen, only that it would happen, and why. He was marvellous. He made it so interesting it got me quite excited about it. So when I first, um, ejaculated, I told him, because I was proud of myself, and chuffed that he'd got it right. And when I got hair under my arms, and things like that. And it's stuck in my head. Do you want a run-down?"
"Yes. Please."
One thing that I already approved of in David was that, unlike almost all boys of our age, he said yes , not yeah .
"Right. Though my version will be even simpler than his, and no guarantee I'll get the longer words right. Give me a moment to think."
I ran through the outline in my head to refresh my memory. This was going to be quite a lecture.
"Here we go. There are two quite different sets of hormones involved, after infancy anyway. Both of them start with the hypothalamus, which is a bit of your brain near the bottom, deep inside here." I tapped myself just in front of my ear. "It secretes peptides – and don't ask me what peptides are because I've forgotten – which stimulate the pituitary gland, which is next to the hypothalamus, into producing growth hormones. And they're carried round the body in the blood and prod the bone and muscle and whatever into growing. All that starts in the womb, and it carries on, sometimes faster, sometimes slower, until you reach full size. That's usually when you're about seventeen, and I think I'm nearly there now.
"In your case, for some reason – and for God's sake don't take this as gospel – I suspect your pituitary stopped producing growth hormones. Maybe it can be kick-started back into production. But if it can't it doesn't matter much, because growth hormone replacement is perfectly possible. Dad does it quite often. And that would set you growing again. All clear so far?"
A hopeful nod.
"Right, the other set is the sex hormones, and they only really start up at the very beginning of puberty, which in my case was when I was twelve. It can be earlier or later, but that's about average. They're not sure yet what triggers them off. But the hypothalamus starts secreting gonadotropin-releasing hormone, which stimulates the pituitary into producing two other sorts, luteinising hormone and follicle-stimulating hormone."
I had to say those words carefully to get them right.
"They're the two sex hormones, and they go into the bloodstream too. In girls they're picked up by the ovaries, which in turn produce oestrogen, which makes their breasts grow and releases their eggs and suchlike. In boys they're picked up by the balls, which start manufacturing testosterone. Some oestrogen too, but it's the testosterone that really matters because it triggers the production of sperm. And it also triggers the visible signs of puberty. Still clear?"
Another nod.
"And would you like the details of them?"
"Please."
"Well, this is the usual order, though it can vary a bit. And here too your age can vary either way. In my case I was twelve when my balls began to get bigger. A lot, in the end.
"At thirteen things speeded up. My cock grew. A lot, in the end. I got erections much more often. I began to . . ."
I hesitated. I had said ejaculate before, but it was so clinical. And I had happily said cock and balls , so why not be blunt here too?
"I began to come. And my pubic hair started.
"Then at fourteen things speeded up even more. My voice broke – that's the vocal cords stretching – and my Adam's apple grew. My muscles sort of filled out and my growth spurt got under way – that was the testosterone at work, over and above the growth hormones. Thicker pubic hair. Hair appearing on my balls. Round my arse. On my shins. In my armpits."
I was pointing in turn to the various parts of my anatomy, and he was following intently. I had the feeling he would have liked to see for himself, but I was nowhere near ready for that.
"And at fifteen, last year, it was a matter of yet more hair. Creeping down my thighs. Climbing up to my navel. On my face – upper lip first, then sides and chin. But there's still some way to go with that – I don't yet have to shave every day, thank God. And no hair yet on my chest, either. Not everyone gets that anyway. So that's where I am now."
"And I'm not even at the starting point," he said morosely. "So my sex hormones didn't kick in?"
"Looks like it. But again, not to worry. If you don't produce gonadotropin-releasing hormones they can be injected. So can testosterone. They'd bring you up to speed."
" Oh my God! I wish! But why didn't the fool of a doctor tell me that?"
"Because he's a fool. Or more likely . . . is he old?"
"Ancient."
"Then perhaps it's because replacement therapy wasn't around when he was at medical school and he hasn't kept up to date. A lot of this is fairly new."
"And why's this happened to me ?"
"Lord knows. Dad sees lots of kids with delayed puberty, and he says the reasons aren't at all well understood. But when the cause can be pinned down, more often than not it's heredity. Do you know if either of your parents were late developers?"
"No idea."
He had a guardian. Did that mean no parents? But I had to enquire.
"Um, could they be asked?"
"My Mum's dead." His voice was subdued, and had a break in it.
"Sorry about that. But your father's still alive?"
He took an age to answer. "Yes," he said at last, in the same low voice. "But you can't ask him."
That sounded final. An empty silence followed. Before it could become too painful I carried on.
"Well, all right. But I remember Dad saying there can be environmental factors like malnutrition, which delays things. That can hardly apply to you. And then there's often an ethnic factor – in some groups kids mature earlier than the average, like Mediterranean types, and in others they mature later, especially at high altitudes like Tibet. But that hardly applies either.
"And there can be psychological factors. Wartime refugees, apparently, tend to hit puberty late. Malnutrition might play a part in that, of course. But it's most likely stress."
David's head shot up, and his mouth was open. Was this a clue to pursue?
"David," I asked as gently as I knew how, "have you ever been through stress? Bad stress?"
The head dropped. "Yes," he mouthed.
"How old were you?"
"Eleven," he muttered. "Just leaving primary school."
I waited for elaboration, but in vain. So I continued.
"And since then you haven't grown at all? Like grown out of clothes?"
"No. Some of my clothes are five years old. Or more."
"But before that, was your growth rate normal?"
"I think so. I was just like other kids. Then."
I could see he was putting two and two together. I certainly was. We were still sitting side by side on the bed. I put my arm back round his shoulder, and tried to say it simply and tenderly.
"David, it seems pretty obvious that your problems go back to when you were eleven. And that you went through something dreadful then. I don't know what, and I'm not going to push you. But think about spilling the beans. Please. Tell me if you like. I'm here to help, because I'm your room-mate, and because I like you. Better still, tell my Dad, because he's the one who can help you with treatment."
He looked at me, tears back in his eyes. "Thank you, Peter. I'll think about it. But I can't talk to your Dad. Not yet. I don't know him. But," he added touchingly, "I think I know you. Now."
"Fair enough. But do you mind if I talk to my Dad, and tell him what you've told me so far? He's already concerned about you."
"How do you know?"
"He said so."
"When?"
"As we were saying goodbye."
"But he'd only seen me for a few seconds!"
"He's an endocrinologist, remember. Once glance was enough."
David's reply was to fall back on the bed. He raised his head long enough to get out a choking "Yes, tell him," and fell back again. This time I left him. No time like the present.
I went into the bathroom for privacy, closed the door, sat down on the loo, and fished out my mobile. Four o'clock, it said. I never normally phoned Mum or Dad at work because they were busy people, but this was different. And it was hit-and-miss too – while Dad would have got to the hospital hours ago, he might be in his office or he might be out in the wards. But I was in luck. I spoke to his secretary, whom I knew, and she put me through at once.
"Peter! Didn't expect to hear from you so soon. How's it going? How do you like the place?"
"I've hardly seen anything of it, Dad. But from what I've heard, it's worse than we thought from the blurb. It sounds a real dump."
"Oh dear. Does that mean you want to pull out already?"
"No way. I'm sticking it out. I've promised."
"Promised? Who?"
"David. We've been talking the whole day."
"Ah! And?"
"You're damn right, Dad. He does need help. Any amount of it. Here's the current state of play. He wasn't clued up at all about hormones and stuff, so I passed on what you've told me, and he understands now. From what I've gathered, he was perfectly normal until he was eleven. Then something happened, something intensely stressful. He won't say what, though I hope he will. But I think it involved his father, who's out of circulation somewhere, and his mother, who's dead. Since then he hasn't grown at all, and puberty hasn't even started.
"Sounds to me like his growth hormones stopped dead and his sex hormones didn't kick in. And he's ridiculed for it, all round. He's shunned. He doesn't have any friends. His guardian's unsympathetic. His GP's an ancient pill-pusher who tells him not to come back till he's twenty, for God's sake. There's nobody on the staff he can turn to. He's as bright as they come, but he's desperately unhappy. Inside, he's tearing up."
"God! That's evil! And because he needs friendship you've promised you won't abandon your dump and abandon him?"
"Well, more or less, yes."
"I said this morning I'm proud of you, Peter. I'm even prouder now . . . Did you tell him about replacement therapy?"
"Yes. He hadn't heard of it, not even from his pill-pusher. At the moment he's crying. With relief, I think. Or at least with hope. Dad, what do we do?"
"You, just keep up the friendship. Me . . . well, my first step is to see if your diagnosis is right."
Typical Dad. No debate about whether to get involved. Just the knowledge that he could help, and therefore that he would help.
"And the first stage of the first step, before we move on to the more complicated stuff, is straightforward blood and urine tests. Best do that through the school nurse. There is one, isn't there?"
"Two."
"Can you find out their names and if they've got any qualifications?"
"Hang on a mo."
There had been a sheet in my folder about medical matters. I nipped out and scrabbled for it. David was still face-down on the bed and still heaving, but this was currently more important. Back to the bathroom.
"Here you are, Dad. The senior one's called Sister Thwing. She's an SRN."
"Brilliant. Qualified to take blood. Like a vampire. I suppose I can get her through the school switchboard. I'll phone right now and tell her what I need."
"But doesn't it have to go through the GP?"
"If he's as fuddy-duddy as that, best bypass him completely."
"I mean, doesn't he have to refer David to you?"
"Only if the NHS comes into it. Not if David's a private patient."
"Private! But the cost . . ."
"There won't be a cost if I don't send him a bill, will there?"
" Dad! You're a star!"
"I do try to twinkle from time to time. Now get off the damn phone and let me beard the Thwing. I'll call you back as soon as poss."
I was laughing as I returned to our room. I sat down again beside David, put my arm back round him, and told him that Dad was taking him on and was already putting tests in motion.
"Oh God, that's good of him! And of you! . . . Oh God!" he repeated wistfully. "I do envy you your family."
On hearing that, I was visited with an inspiration. "What do you do at half term, David? You don't go back to Bermuda, do you?"
"God, no! I stay here and mooch."
"Then come home with me and mooch there."
That brought back his tears, of gratitude this time. From what he let slip, months later, this was the point when he really began to trust me. And then my mobile rang.
"Quick work, Dad."
"No problem. Get David down to the Thwing pronto. She's happy to do him, but she knocks off at half past four. She promises to get the specimens into the post on her way home, first class, so they should reach me tomorrow morning. With luck the results'll be through by the evening, and I'll phone again then. Sleep well, Peter. And make sure David does too. You're doing a damn good job already."
"Thanks, Dad. Love to Mum. Bye."
I turned to David. "Wipe your eyes. We're going straight to Sister Thwing, wherever she lurks."
"This very minute? Well, all right. But I need the loo first. Desperately."
"No you don't. Because she needs your pee. Desperately. As well as your blood."
He led the way to the Thwing's lair, and I waited outside. Within five minutes he was out, in his shirtsleeves, a little sticking plaster in the crook of his elbow, more comfortable, and very much more cheerful.
"At last something's being done! Do you know, Peter, it's less than six hours since we met?"
It seemed like an age.
"Do you know, David, it's less than twenty four hours since I had a drink? But I feel like one right now."
"Well," he said dubiously, "there's a kettle in our room, but the tea and coffee and milk are plastic."
"I don't want tea or coffee. I want booze."
His eyebrows rose. "And where are you going to find that? You're not allowed into pubs or the bar, and even if you were you wouldn't be served. Specially if you had me in tow."
"I know a friendly pub in S312," I said as we stepped into the lift. "It stocks all I need. You see, since I turned sixteen I've been allowed wine." He gaped at me. "In moderation, needless to say. I'm partial to sherry, and because I knew I couldn't get it here I brought a few bottles with me."
"But how did you get them?"
"Mum bought them for me, of course."
He looked wistful again. Poor blighter, with no conniving Mum to buy illicit sherry for him, or anything else. No Dad either, it seemed.
"Care to join me?" I asked.
No harm in that. After all, he was the same age as me. Then it struck me. I was offering alcohol to a pre-pubertal boy. Was I already becoming acclimatised to the contradiction that was David?
Into S312, where I dug out the sherry from my baggage.
"I've never had it before," he said. "But I'd like to try."
"Good. But only one glass each. Must conserve our stocks."
More important, mustn't overdose him. Let alone stunt his growth, whenever that might begin. But surely a modest pick-me-up could do no damage. So we had one glass each, or the equivalent in our tooth mugs. Must remember to get proper glasses. He liked it, or said he did. We sipped in companionable silence, each with our own thoughts. Then it was time for dinner, as I found it was called here rather than tea. As good as lunch, equally quiet, equally together. Not much was said. David still seemed to be thinking hard, and so was I.
Where was this leading? Towards a cure for one of his torments, with luck, though at best it would take a long time. At least he had been thrown a mental lifeline. And the other torment? Without knowing what that was, it was hard to say. But to get him on a moderately even keel was going to take a great deal of care and friendship. I begrudged him neither.
First of all, there was the plain pity which surely any right-minded person would feel, although there seemed to be nobody right-minded at Dorcic.
Then, as I had already told him, I liked him. When he was not floundering helplessly in his grief, a sharp mind showed through, and a humour. Both were in tune with mine.
Finally, I admired him. Five years of anguish without friends or family, five years of adversity with everyone and everything against him, was far outside my experience and way beyond my imagining. He was immensely vulnerable, and it showed. But he must also be immensely strong. Had I been in his shoes I doubted I could possibly have survived such odds.
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