CHOICES

by Soledad

Rating: General, for this part

For disclaimer and background facts see Part 1.

PART 4

"You need what from me?"

It didn't happen all too often that Dr. Calvin Kavanagh was too shocked for coherent speech. His rants were famous and much feared within the scientific community of Atlantis. At the moment, however, he felt like a fish out of water, opening and closing his mouth several times before blurting out that less than intelligent question. His reaction would have been funny, had his shock not been so obviously deep.

"I need to know whether you would be willing to father my child," Teyla said calmly. "I would prefer a permanent bond, obviously. But as I am not with my own people anymore, I am willing to make… allowances."

Kavanagh shook his head in disbelief.

Surely you must be kidding. Why would you want to have anything to do with me? Nobody ever did."

"Your wife did, once," Teyla reminded him.

"Yeah, and we both know in what a spectacular failure that ended," Kavanagh said, the old pain audible in his dry voice.

"True," Teyla admitted. "But just because you had to suffer such misfortune once, it doesn't mean that you would not deserve a second chance."

"I appreciate the sentiment," Kavanagh said, still not at all convinced. "I'd still like to know how you came to ask me, of all people. I'm not exactly Mr. Popular here, and not the best husband material, either."

"You could be both, with some effort," Teyla replied. "But I believe you secretly enjoy being disliked. That saves you the effort to be nice to people – and the pain of a possible rejection."

"Don't be ridiculous," Kavanagh tried to laugh, but it didn't sound very convincing. And Teyla didn't laugh with him at all.

"Why else would you choose to be alone?" she asked. "You are an intelligent, good-looking man. Even though your manners are not always pleasant, you could have found suitable mates long ago. Not everybody is easily intimidated."

"Nobody is intimidated by me, save perhaps Miko," Kavanagh snorted. "They just hate my guts, plain and simple."

"Well, you do not make it easy for them to like you," Teyla pointed out. "And after tonight, I believe I understand some of your reasons. You do not wish pity and you do not tolerate weakness. I can see why. But I do not understand why are you so adverse to my proposal. I am not one of those who 'hate your guts', as you so eloquently put it."

"You don't understand shit," Kavanagh spat, for her poking and prodding made him feel vulnerable – a feeling he hated more than anything. "I've already abandoned two children; even if it was for their own good. I'm not a prize father – and I could easily turn into the same cold-hearted bastard as my old man."

"True," Teyla had; she had no illusions about him. "But this is an excuse, not a reason. I thought you were an honest man, Calvin."

"I am," he protested.

"Then stop lying to me," Teyla demanded, "and tell me the true reason why you wouldn't father my child."

"I can't," Kavanagh whispered in such clear anguish it frightened her.

"Why not?" she asked gently.

"Because I am the reason for Tommy's… condition," Kavanagh shoulders slumped as if under a burden too great for him to bear anymore. "The cause for it is a genetic dysfunction – one that I've passed to him."

"I don't understand," Teyla said. "You are healthy; you must be, or else they wouldn't have accepted you for this expedition."

"I'm a carrier," Kavanagh explained tiredly. "It's most likely a new mutation of the disorder known as Fragile X syndrome. Usually, carrier males pass the permutation – a dysfunctional gene – to all their daughters but none of their sons. The doctors can't explain how could I have transmitted it to Tommy. It was supposed to be impossible – and yet it has happened. I can't risk that to happen again."

"What kind of illness is this?" Teyla asked.

"A development disability," Kavanagh replied in a strangely practiced manner, as if he had explained it to too many people in the past already. "Basically, the dysfunctional gene shuts off the production of a special protein in the human brain. A protein that's needed for normal cognitive development…"

Teyla raised a hand. "You are losing me. Can you say it simpler? Without all the scientific terms? I'm not a doctor, remember?"

"Sorry," Kavanagh grinned ruefully. "It means that the child with the syndrome will never learn normally, despite extensive therapy and rehabilitation."

"And you are absolutely certain that you do have this dysfunctional gene?" Teyla asked.

Kavanagh nodded. "I've been tested, after Tommy turned out to have the syndrome."

"What about your wife?" Teyla asked.

"She ran away shortly thereafter," Kavanagh shrugged. "But does it really matter? We knew that I have been the transmitter."

"Are you sure?" Teyla said. "If your wife has never been tested, how can you know that she is not a carrier, too?"

Kavanagh frowned. The thought had apparently never occurred to him before.

"I don't know it," he finally admitted. "But how high could the possibility be that we both have the same dysfunctional gene?"

"I can't even guess," Teyla shrugged. "Perhaps we should ask Doctor Beckett."

"No," Kavanagh said promptly, without thinking.

Teyla raised a tolerant eyebrow. "Why not? Don't you want to know whether you have passed the illness to your son or not? Perhaps you've been carrying the guilt with you all this time for no reason."

"Unlikely," Kavanagh said. "And for such a small chance I won't let nosy medical personnel dig around in my past. I value my privacy very much."

"So much that you would rather sacrifice the chance of having children – healthy children – ever again?" Teyla asked quietly. As Kavanagh couldn't find a prompt answer, she added. "Besides, is Dr. Beckett not bound by doctor-patient confidentiality?"

"I still don't want him to know," Kavanagh replied stubbornly. "This isn't something that would show up in my file, and I prefer to keep it that way."

"And I would prefer to know the risks I am taking," Teyla said just as adamantly.

"I can tell you the risks," Kavanagh exploded. "Even if Tommy got the dysfunctional gene from my wife, I still am a carrier. Which means I would pass the gene to all theoretical daughters I might father. And they would have a fifty per cent chance to pass it to any children they might have, male or female alike. So there. Are you willing to risk that?"

"Yes, I am," Teyla said calmly. "But not before we talked to Dr. Beckett and I have been confirmed that there are no greater risks involved."

Kavanagh shook his head in utter bewilderment again.

"I thought you were in a hurry," he said.

"I am," Teyla nodded. "But I still have ten more fertile days left. Maybe eleven. One day won't count. The question is: are you willing to do this for me? Or are you too frightened to become another damaged child?"

"I am afraid," Kavanagh admitted. "Children with Fragile X syndrome need special care, and while I wouldn't miss Tommy for the world, it's not easy to provide that care. Not even back on Earth, with special schools and specially trained personnel. How could we provide the necessary therapy and rehab here, in Atlantis, should we have a child with the syndrome?"

He broke up abruptly, realizing that he was actually considering the possibility of having a child with Teyla. Teyla smiled at him, not in triumph, which would have made him go all stubborn again, but with gentle understanding."

"You do want to do it, do you not?" she asked.

Kavanagh sighed, admitting his defeat. "Of course I do. I always wanted a large family, especially after we had learned that my sister couldn't have any children. But after Tommy, I never dared to give it a try again."

She took his hand in hers and said softly, almost pleadingly. "Let us go and talk to Dr. Beckett then, shall we?"

Unable to resist her soft persuasion any longer, he nodded slowly, hesitantly. The touch of her lips on his felt like a breeze upon the gist of the ocean – light and refreshing.

PART 5

A/N: Sorry for the simplicistic crash-curse in genetics. Beckett needed to make Teyla understand things somehow, and she didn't have any previous knowledge of such things. The details about the Fragile X syndrome were borrowed from the following website: www dot conquerfragilex dot org/.I hope I haven't misinterpreted anything.

Dr. Carson Beckett was surprised to find an urgent request for a confidential meeting with Teyla on his desk, first thing in the morning.

"She came in late in the night and asked for you," Denise, the nurse from the night shift, said. "She didn't say why, but it seemed fairly urgent. She asked if you could go to her quarters."

"Aye, I can do that," Beckett was clueless of what it could be about, as Teyla had looked all right the day before. But he'd never refused a request from a potential patient in his life. "Anything else?"

"Dr. Kavanagh called in sick," Denise replied. "He said it's a mild case of upset stomach and that he'll come by later."

Deep in a dark, very unprofessional corner of his otherwise gentle heart, Carson Beckett was amazed by the courage of the bacteria that had actually dared to attack Kavanagh. One would think that even the stoutest germs would flee in terror from such an unwelcoming host. On the other hand, the strange combination of MREs and Athosian food could upset the strongest stomachs in two galaxies. Compared with that, haggis was an easy dish to digest.

Amazed by the fact that Kavanagh might actually have something in common with human beings – and ashamed by his own reaction – Beckett looked up today's schedule. It promised to be one of the relatively easy days (although in Atlantis one could never know, of course), so that he could afford to start lab work a little later.

"Listen, love," he said to Denise, "I'll go to Teyla's quarters and see what her problem is. Call me when something happens."

"Of course, Dr. Beckett," Denise nodded. "Don't worry; I'll keep the shop running here."

No one should be confronted with a surprise and a shock on an empty stomach before work, Carson Beckett thought, after he had absorbed the fact that he'd just found Kavanagh in Teyla's quarters. The scientist and the Athosian woman were obviously having tea – unfortunately the Athosian blend that Carson, personally, couldn't get used to.

"I thought you were sick," he said to Kavanagh.

The scientist shrugged. "We needed an excuse to speak to you in private. I've been working double shifts since we got here. I think I can take one shift off. But you're free to report me to McKay, if that's what you want."

"Calvin," Teyla warned. "You promised not to antagonize Dr. Beckett right away."

"Sorry," Kavanagh said, not looking the slightest bit apologetic. "Old customs die hard."

Teyla gave him a patient smile – the one that was actually her very personal equivalent of an eye roll – and then turned to Beckett, who was still trying to accept that she was now obviously on first name basis with Kavanagh.

"I apologize for the ruse, Dr. Beckett," she said smoothly, "but as I've already said the nurse, we need to speak with you in a confidential matter. I know we can trust your discretion; however, we are not that sure about the rest of your staff."

"Hey, wait a minute," Beckett protested. "My people dinnae go against their oath!"

"I believe you," Teyla said, "but people like to gossip, and the mere fact that we would seek out your help – together – would start the rumour mill. We would prefer to avoid that."

That was true enough. Due to the almost complete lack of other entertainment sources, people had basically two kinds of amusement in Atlantis: talking shop and gossiping. And, to be completely honest, the idea of these two having anything to do with each other baffled Beckett to no end.

"I see," he said tentatively. "Well, what can I do for you?"

"We need your opinion as a doctor on a certain… disease?" Teyla looked at Kavanagh questioningly.

The scientist shook his head. "It's not a disease, Teyla, it's a condition." He turned to Beckett. "I'm a Fragile X carrier. We want to know if there's any chance I might have passed the gene to my younger son, who is heavily affected by the syndrome."

Being a geneticist, Beckett was familiar with the disorder, of course, and didn't need to think about it long.

"Not to my knowledge, there isn't," he replied. "There aren't any known cases of a carrier male transmitting the permutation to a male child."

"But is it possible?" Kavanagh pressed.

"Highly unlikely," Beckett said. "Of course, the FMR1 gene has only been detected in 1991, and I'm not exactly up-to-date with the latest research efforts. I do have the reports filed off somewhere in the medical database, though. I can look it up for you, if you want me to do so."

"How long would that take?" Teyla asked quietly.

"I cannae say for sure; couple o'hours, maybe," Beckett said, still not understanding the apparent urgency of their case. "Why are you in such a hurry?"

"There is a flight scheduled for the mainland tomorrow," Teyla replied. "If your answer is a positive one, we need to be on that jumper. Each Athosian child must be conceived upon living soil, not in a box of dead metal like this place. And my fertile cycle is nearing its end."

For an endless moment, Beckett looked from one to the other, rendered speechless.

"You… you wanna have a baby together?" he finally all but squealed. Kavanagh's only answer was a darkly amused sort, as if he'd said 'I told you so', but Teyla didn't lost her calm for a moment.

"If the risks are acceptable, yes, we do," she replied.

"Very well," Beckett said. "Let me look up the latest research. I'll call you when I'm done. And since you dinnae want the others to know about this, we should meet for lunch. All three of us. Come up with a good excuse for eating together, and I'll join you."

After several hours of shifting through medical databases – the official ones and his own extensive genetic research database – a tired and somewhat worried Carson Beckett was making his way to the mess hall. What he had found would do little to ease Teyla's mind, as it most contained theories and statistics and very little hard proof. Unfortunately, that was all he could offer them.

He found them at a table in a lonely corner. Teyla was stoically eating today's 'creative' choice of cookery, while Kavanagh, trying to keep up the ruse of a stomach problem, was staring into a cup of Athosian tea. They didn't look like a couple in love, for sure. Beckett couldn't even guess the motivation between their wish to have a child together.

"May I join you?" he asked, in the unlikely case that one of the four Marines present would watch them.

Teyla nodded. "Please, Doctor Beckett."

Beckett put down his tray, and for a minute or two, he pretended to be eating the stuff on his plate. It required considerable willpower to swallow it without gagging, but he already had much experience with that.

"Well, he said, after having ingested as much of… whatever food it was supposed to be as he was able to get down," let me tell you what I've found. I'm afraid it's not much, but…" he trailed off with a shrug.

"Please continue, doctor," Teyla said.

"Let's start with basic facts," Beckett said. "The syndrome is caused by a gene called FMR1. Individuals who are affected by it have a defect in the FMR1 gene, which shuts it down. To put it simply, the gene cannot manufacture a protein it usually makes: a special protein that the brain needs for normal cognitive development."

Teyla nodded. "Calvin has already explained me that affected children cannot learn normally. What we want to know is more about the way this… this defect is passed down to the next generation."

"That's a difficult question," Beckett replied. "Fragile X carriers, like him, do have a small defect in the FMR1 gene – we call that a permutation – without showing any symptoms of the syndrome itself."

"Why is that?" Teyla asked.

"Och you can ask questions," Beckett sighed. "Well, the gender of a human being is determined by chromosomes. Females have two X chromosomes, males an X and a Y chromosome. When a child is conceived, both parents pass to it half of their genetic heritage. As the child can only inherit an X chromosome from its mother, it's always the father whose genetic stamp decided the gender of the child."

"Wait, doctor, you are getting too medical for me," Teyla interrupted. "Are you saying that women are two parts female while men are half male and half female?"

"That's an extremely simplicistic way to put it, but that's basically it, aye," Beckett nodded.

"So the child gets a female half from the mother and either a male or a female part from the father?"

"Aye, that's correct."

"And if it gets a male part from the father, it will be a boy, but if the father passes down a female part, it will be a girl?"

"Exactly."

"I understand. But how is that going to help us?"

"Well, I've double checked the research papers, back to 1991, to see if I was remembering correctly, and I was. The FMR1 gene is located on the X-chromosome… on the 'female part' of a child. A boy has only one X chromosome, inherited from his mother. There is no way he could inherit it from his father," Beckett looked at Kavanagh with a frown. "What kind of doctors have you consulted that they never explained you such simple facts?"

Kavanagh shrugged. "They weren't geneticists. When the DNA blood test identified Tommy as a syndrome child and me as the carrier, they simply sent us to the therapy center. Never bothered with explanations, except of telling me that, theoretically, I shouldn't be able to transmit the gene to Tommy."

"Well, to their defence, I had to look up the details first, too," Beckett said. "But they should have looked them up. You really thought you gave the kid the disorder?"

"I couldn't be sure," Kavanagh said, "as nobody ever bothered to tell me why it was impossible. Besides, how big could be the chance that my wife was a carrier, too?"

"Fairly big, actually," Beckett answered. "One out of two hundred and sixty women are carriers."

"Does this mean that it was definitely my ex-wife who passed down the gene to our son?" Kavanagh asked.

"There's no other way," Beckett said. "The permutation can be passed down silently through several generations in a family before a child is affected by the syndrome. Has it surfaced in your family before?"

"Not that I'd know," Kavanagh shook his head. "As for that of my ex – I can't tell. I only ever met her parents, and even that not all too frequently."

"Well," Beckett said, "as long as you have only sons, you're safe. Unless Teyla, too, has the gene. We can find out that through a simple DNA blood test."

"I'll come to the infirmary right away," Teyla said. "But let's say that I'm not a carrier and we will have a daughter. What chances would she have to be affected by the syndrome?"

"According to recent studies, one in four thousand girls are estimated to be affected," Beckett answered. "Unfortunately, statistics cannot foretell what the case would be by a particular person."

"What if she's not affected?"

"She still would be a carrier, with a fifty per cent probability to pass down the gene to her children."

"I see," Teyla contemplated the possibilities for a while. "Is there a cure for the syndrome?"

"Not at the moment, there isn't," Beckett said regretfully. "Dr. Kavanagh can tell you how education and medication can help improve a syndrome child's condition, but the sad truth is, most boys – and many girls – remain significantly affected all their lives."

"I cannot believe that with your technology there's no help for this condition," Teyla said, clearly disappointed.

"We're doctors, not wizards, love," Beckett replied. "There is a lot of research going on, back on Earth, of course. One direction is working on a gene therapy. They're trying to determine whether the mutated, ineffective gene in an individual may be replaced by inserting a healthy gene into their cells."

"That can be done?" Kavanagh asked.

"Aye, theoretically it's possible," Beckett said. "After all, have I not managed to produce a synthetic Ancient gene? The problem is, we still dinnae know enough of the FMR1 gene to risk such drastic measures. I wouldnae do this, not before an awful lot of further research."

"Is there any other way?" Kavanagh asked. Beckett nodded.

"Aye, we could try to supplement the protein a mutated FMR1 gene cannot produce from an external source. However, messing around with the protein production ain't any less risky than experimental gene therapy. And we all swore an oath that before all else, we'd do no harm, you know."

"That leaves treating the symptoms with medications," Kavanagh said, "which hasn't been very effective, so far."

"No, it hasn't," Beckett agreed. "But we are making headway all the time. And who knows, we might find something helpful in the Ancient database one day."

"That's a very long shot, doctor," Kavanagh said.

"Aye, it is," Beckett nodded and rose. "Well, I have to go back to the infirmary. I haven't done a thing about my actual work yet."

"And I'll go with you," Teyla stood, picked up her own tray and glanced at Kavanagh. "I'll contact you as soon as we have the results."

"You'll find me in the gym, same time as last night," Kavanagh replied.