A Quick Lap Through the Family Gene Pool: Thoughts on Unwieldy Inheritances

(Originally published in my column for CF News Today)

At a recent appointment, a doctor told me something I’ve heard many times before: “You know what you should really consider? Genetic testing!”

He was scanning my chart, reading some of the details aloud, such as my father’s diagnosis at age 50 with stage 4 colon cancer. Also in the records: When my father’s eight younger siblings got tested, they all had polyps. It’s damning evidence, though as my doctor noted, I’m doing the right things: getting screened regularly, staying healthy, sticking to my decades-long vegetarian diet.

I took the pamphlet on genetic testing that he offered me, knowing I’d drop it in the recycling bin on the way out of his office. I don’t need more information. I already know too much!

Growing up alongside my sister’s cystic fibrosis has given me ample occasion to consider the toxic stew of my family’s gene pool. I’ve often explained it to myself and others with a joke: My great-grandparents came from a very small place in Donegal, Ireland. My great-grandmother’s maiden name was Mary Furey. Her married name was Mary Furey. If you live in a place with more sheep than people, you probably shouldn’t procreate with someone with the same last name. They’re probably a relative and you may end up scraping the bottom of the gene pool.

When my mom had a stroke earlier this year, the thought of genes and genetic testing popped into my head for a moment. Before we knew the stroke was a stroke, I wondered aloud to my sister, “Could it be an aneurysm?”

My maternal grandmother had an aneurysm that she survived. Her mother was not as lucky, slumped over dead in the passenger seat as her family was driving back from the Jersey shore. Her death by aneurysm was instantaneous. She was in her early 60s, a bit younger than my mother is now. When my grandmother had her aneurysm, my aunt, a nurse, noted that it was something we should all have on our radar as a potentially inheritable condition.

I was only genetically tested once, when I was pregnant with my first child, to see if I was a CF carrier. My generation of my large, extended family has diversified the gene pool more than previous generations, who mostly wed within our Irish Catholic cultural group. My husband’s part-Spanish, part-Russian-Jewish background made him an unlikely carrier; still, the doctor tested me. I learned I did not have the faulty gene.

Shortly thereafter, my older sister became pregnant and was tested. We learned that she wasn’t a carrier, either. It was a pang of well-sibling guilt for us both. I know my Punnett squares. It was statistically unlikely that my younger sibling alone would draw the short straw and inherit the mutated CFTR gene that causes CF from both parents. What’s more, CFers have an increased risk of colorectal cancer, especially if they are post-transplant like my sister.

Because of my family’s medical maladies, I tend to think of my genetic inheritance in a negative light. “Another curse of my ancestors!” my father said just the other day while getting another patch of melanoma removed. (Our pasty Irish skin also makes us susceptible to skin cancer.)

However, I find myself reframing inheritance sometimes when I look at my son. From the very moment he was born, I could see a strong resemblance to myself and my father. “He’s all Delany,” people often said when he was a baby. It’s almost uncanny, comparing photos of my father and my son at the same age. I find it touching, how much my son looks like my dad, a man I so admire.

Having grown up in a household centered around a genetic disease, it’s easy to think of genetic inheritance as an albatross around my neck — but really, it’s more than that. It’s a mixed bag and a throughline that helps us locate ourselves in time, in place, in history.

I discovered this one day while poking around online, doing some research into local political history. While on a website called Interesting People of Camden NJ, I suddenly saw a face I knew so well — so like my own, my father’s, my son’s! It was my great-grandfather, who has always been a bit of a void in my family’s history since he was killed in a car accident when my grandfather was very young.

Though the website is full of interesting people who lived in Camden, New Jersey, in the 1920s and ’30s, it was my great-grandfather’s face that drew me in, that intense spark of recognition of someone long gone, someone I did not know.

As I passed the screen over to show my husband this man who has my eyes, my lips, my nose, I joked, “I guess at the end of time there will be some version of this Delany face present.” To tell you the truth, it’s a comforting thought.