Mend the Living (25 page)

Claire unpacks her things, places her toiletries in the bathroom, plugs in her phone charger, puts the phone on her bed; she personalizes the place. Calls her sons – they’re running on the pavement, down the hallways of the metro, she hears the echo of their steps in the corridors, we’re on our way, we’re coming, they pant in distress. They want to reassure her, to support her. They are mistaken: she’s not scared of the operation. It’s not that. What torments her is the idea of this new heart, and that someone had to die today in order for all of this to happen, and that he or she could invade and transform her, change her – stories of grafts, cuttings, fauna and flora.

She turns in circles in the room. If this is a gift, it’s certainly a strange kind, she thinks. There’s no giver in this exchange, no one intended to give a gift here, and likewise there is no recipient, because she doesn’t have the choice of refusing the organ, she has to receive it if she wants to survive, so what then, what is it? The release back into circulation of an organ that’s still usable, carrying out its job as a pump? She starts undressing, sits on the bed, pulls off her boots, her socks. The meaning of this transfer that she has the luck to receive, through unbelievable chance – the amazing compatibility of her blood and genetic code with those of a being who died today – all of this goes hazy, out of focus. She doesn’t like this idea of undue privilege, of a lottery, feels like the stuffed animal grabbed by the claw from the jumble of things behind glass at the fairground. And above all, she will never be able to say thank you – that’s just it. It’s technically impossible – thank you, these radiant words, whispered into the void. She will never be able to show any form of gratitude toward the donor and his family, or make a reciprocal gift in order to free herself from the infinite debt, and she’s shot through with the thought that she will be ensnared forever. The ground is frozen beneath her feet, she’s scared, everything retracts.

She goes to the window. Figures hurry along the paths to the hospital, slow cars circulate between buildings that draw the anatomical map of the human body in the night, organ by organ, pathology by pathology, separating children from adults, grouping together mothers, the elderly, the dying. She would like to be able to kiss her sons before putting on this paper tunic that floats without covering her and gives her the feeling of being naked in a gust of air, keeps her eyes dry but struggles to break down the enormity of all that’s happening, and her in the midst of it, places her hand there, between her breasts, feels its rhythm, always a little too fast despite the medication, always a little unpredictable too, and says its name out loud: heart.

Even after hours of interviews with the doctors in charge of her psychological evaluation when the transplant was first proposed – assessment of her emotional attachments, measure of her degree of social integration, survey of her comportment in the face of fatigue and anxiety, of her willingness to face post-op treatments that would be difficult and long – no one could tell her what would happen to her heart, afterwards. Maybe somewhere there’s a junkyard for organs, she says to herself, taking off her jewellery and her watch, a landfill of sorts, and hers will be tossed there with the others, carried away from the hospital through the service doors in big garbage bags; she imagines a container for organic matter where her heart will be recycled, returned to a state of indistinct matter, compost of remodelled flesh that the boundlessly cruel Atrides would serve to their famished rivals in the palace dining room, galettes or steak tartar, feed given to the dogs in large dishes, bait for bears and marine mammals – and maybe these creatures would be transformed after ingesting the substance, their scaly skin sprouting platinum hair like her own, maybe they would grow long velvety eyelashes.

A knock and then he enters the room directly without waiting for a reply, it’s Emmanuel Harfang. He plants himself before her, says the heart will be harvested around eleven o’clock, the organ’s specs are impeccable, then he grows quiet, observes her: you wanted to talk to me. She sits on the bed, rounds her back, places her hands flat on the mattress and crosses her ankles, her feet are ravishing, her nails are painted bright purple, they explode in the chlorotic room like foxglove petals, yes, I have some questions, questions about the donor, Harfang shakes his head as though he thinks she’s pushing it, she knows the answer. We’ve already talked about this. But Claire insists, her blond hair forming hooks against her cheeks, I want to be able to think about the person. She adds, persuasive: for example, where will this heart be coming from, if it’s not from Paris? Harfang stares at her, frowns, how does she even know that much? then consents: Seine-Maritime. Claire closes her eyes, accelerates: male or female? Harfang, tit for tat, male; he heads for the door that’s open onto the corridor, she hears him heading off, opens her lids again, wait, his age, please. But Harfang has already gone.

Her three sons arrive together moments later, looking awful; the eldest, terribly anxious, won’t let go her hand, the second whirls about the room and repeats over and over everything’s going to be fine, the youngest has brought a pack of heart-shaped candies. Harfang’s an ace, the best in his field, seventy heart transplants a year, and the best team, you’re in good hands, he tells her in a small, trembling voice. She nods mechanically, observes his face without really listening, I know, don’t worry. It’s harder with her mother who can’t stop snivelling that life is unfair, that she wants to take her place under the knife – saying it’s more natural, more conceivable, that she be the one to die, or at least the one to risk her life first – Claire grows impatient, but I’m not going to die, I have no intention of dying – and the boys, incensed, speak sharply to their grandmother, that’s enough! they’re all foundering here. The nurse comes back to the room, taps her watch face and hurries things along, everything is in order, you need to get ready now. Claire kisses her sons, caresses their cheeks, murmurs to each of them, see you tomorrow, my love.

Later, naked, she steps into the shower and washes herself for a long time with Betadine, spraying her entire body with yellow liquid and rubbing herself vigorously. When she’s dry, she pulls on the sterile tunic, and then begins to wait again.

Around ten o’clock, the anaesthetist comes into the room, everything all right? She’s a tall woman, narrow shoulders and hips, a swan’s neck, pale smile, she has long cold hands that brush Claire’s own when she holds out a first dose of medication – to relax you – and Claire lies back on the bed, suddenly exhausted even though she’s wound up like never before. An hour later, the O.R. porter comes in, takes hold of the handles on her bed, they’ll operate on you on the table and bring you back to your bed afterwards, and then he transfers her without a word. They travel along metres and metres of corridors, she doesn’t know where to rest her eyes, sees the dull ceilings file past, and sinuous electrical wires like river snakes. Her heart accelerates bit by bit as they reach the O.R., pass through airlocks and coded double doors. The space becomes further isolated, then she is brought into a small room where she’s told to wait. They’ll come get you. Time dilutes, nearly midnight.

Behind the door to the O.R., the anaesthetist checks the equipment setup for the patient’s monitoring: places electrodes for cardiac monitoring, inserts arterial catheter lines to read the blood pressure continuously, and this apparatus that pinches the end of the finger to check oxygenation of the blood. She administers the intravenous, hangs the pouch of translucent liquid, checks the seals – simple gestures, modelled on thirty years’ experience, perfectly executed – okay, we’re good to go, is everyone here? But everyone isn’t quite here, the team is getting ready in the change room, pulling on sky-blue scrubs, short-sleeved shirts and long-sleeved jackets; each one puts on at least two plastic caps to be sure to cover the entire scalp, and two masks over their mouths. Shoes, shoe covers, sterile gloves in multiple pairs that will be changed several times over. Thorough washing in plenty of water, forearms soaped up to the elbows with disinfectant, nails cleaned, once, twice, three times. Then they head into the O.R. Indistinct bodies take their places, check the machines, but although the faces have disappeared, the aura, the build, the body language, and the eyes remain to form another language within this enclosure. Present are a perfusionist, an O.R. intern, two dressing nurses specialized in packing the organs, and two anaesthesiologists – Harfang’s been working with this pair of old girlfriends for thirty years; he did his first transplant with them.

And here he is now, looking like he’s just set off on a race. He’s put on a high-coverage surgical gown that slips on from the front and is knotted at the back, one sleeve attached to the thumb by a ring – its half-calf length is reminiscent of butchers’ aprons that narrow the hips. He comes over to Claire for a last word: the heart will be here in thirty minutes, it’s gorgeous, it was made for you, the two of you will get along just fine. Claire smiles: but you’ll wait until it’s in the O.R. before taking this one out, right? Harfang, taken aback: are you serious?

Claire is anaesthetized. Images begin to appear behind her eyelids, plastic gush of soft shapes and warm tones, infinite metamorphosis of surfaces, kaleidoscopic spreading of cells and fibres as the nurses make her head and body disappear beneath large sheets of yellow plastic, covered in turn with sterile surgical drapes: only a small perimeter of skin remains visible, pale beneath the lamp beams, poignant, this area they’re going to carve into. Harfang makes the first movements, he inscribes the line of the incisions to come on her thorax with a sterile pencil, takes note of the precise places for small openings – tubes carrying a system of cameras will be slid inside the body. Then the anaesthetist, glued to the O.R. telephone, turns and says: okay, they’re on their way.

A
nother operating room in a nocturnal estuary, but this one emptying now, the order of departure of the teams inverse to the order of organs recovered, the last ones to lean over Simon Limbeau are those who retrieve the kidneys – the urologists, they’re always the last. And they are the ones responsible for restoring the body, for making it look whole again.

Thomas Remige is there too, face shining with fatigue, cheeks flat, and even though these are different hours that are beginning – flaring out toward the end of the process, hours watered down in a temporality that is at once slower and of a softer texture – his presence grows sharper, more intense. Each one of his actions, even the most imperceptible, expresses the idea that it’s not over, no, it’s not over yet. Of course he exasperates the others as he cranes his neck over their shoulders, as he anticipates the movements of the surgeons and the nurses. It would be so easy to let go a little now, to let a point or two slide, to expedite the final procedures, to close out the thing, in the end what would it change? But Thomas silently resists, countercurrent to the general exhaustion or the urgency to close up shop, he lets nothing slide: this phase of the retrieval, the restoration of the donor’s body, cannot be trivialized: they have to mend, now, mend the damage. Put that which was given back together, the way it was given. Otherwise, it’s just barbaric. Around him, eyes roll, people sigh: don’t worry, what do you expect, we won’t botch anything, everything will be done as it should be.

Simon Limbeau’s body is hollow, the skin appears to have been suctioned out from the inside in places. It didn’t have this atrophied appearance when it entered the O.R., it screams mutilations endured, it’s a violation of the promise made to the parents. They have to fill it. The practitioners quickly make a lining using surgical pads and compresses, crude stuffing that they must model as best they can to correspond to the volume and shape of the organs that have been recovered, then position them inside. Hands busy themselves and the actions performed are those of a restoration: it’s a matter of giving Simon Limbeau back his original appearance, so that it’s him, and this image of him, that may be archived in the memory of those who will see him tomorrow at the funeral home, so they might recognize him as the person he was.

They are closing up the body now – over its emptiness, its silence. The running-stitch suture – sewn with a single thread, knotted at each end – will be delicate, careful, the practitioner’s needle, fine and precise, tracing a straight dotted line, and what’s striking is that the act of sewing, this archaic gesture sedimented in human memory since the eyed needles of Paleolithic times, could reach the operating room and be the conclusion to an operation of such technological advancement. Also, the surgeon works with absolute intuition, totally unconscious of his movements, his hand carrying out regular loops above the wound, short and identical loops that will lace up and close the skin. Before him, the young intern continues to observe and learn – it’s the first time he, too, is present at a multiple-organ retrieval and he probably would have liked to do the suture himself, probably would have liked to bring his hand, too, to the donor’s body in order to join the collective gesture, but the density of the operation has saturated his perceptions, and black butterflies of fatigue or nervousness flutter in his field of vision, he stiffens, tells himself he didn’t flinch when the blood poured out into the pail, at least that’s something, and that the main thing is to stay standing until the very end.