Authors: Maylis de Kerangal
Tags: #Fiction, #Medicine, #Jessica Moore, #Maylis de Kerangal, #Life and death, #Family, #Transplant, #Grief
At one thirty, the urologists put down their tools, lift their heads, exhale, pull down their masks, and leave the O.R.; they take the kidneys with them. The only ones remaining are Thomas Remige and Cordelia Owl, who seems to stay standing under the effect of a residual tension – she hasn’t slept for nearly forty hours and she has the feeling that if she stops even for a second she’ll fall over, collapse on the spot. She begins the work of the end. Takes an inventory of the instruments, fills out the labels, notes numbers on printed sheets, writes down the hours, and these administrative formalities, carried out with the rigour of an automaton, leave her mind free to ramble, for flashes to blaze in her brain, cross-fades linking fragments of bodies, snippets of words, portions of places – the hospital corridor opens onto an alleyway of exquisite stenches, the lock of hair trembles above the lighter flame, the orange streetlamps undulate vertically in the eyes of her lover, the sirens with green hair stir on the body of a van, her phone finally vibrates in the night – porous continuum onto which Simon Limbeau’s face is etched, the one she cleaned this afternoon, that she examined and caressed, and this young woman, body sprinkled with brown hickeys – a panther’s skin – thinks suddenly of the time it will take for these hours to decant, for her to be able to filter out the violence, clarify the meaning – what did I just live through? Her eyes mist over, she looks at her watch, lowers her mask, I have to go back up to the department for a bit, the intern is alone upstairs, I’ll be back. Thomas nods without looking up, it’s fine, I’ll finish up, take your time. The girl’s steps recede and the door of the O.R. closes behind her. Thomas is alone now. He scans the place with a slow circular sweep of his eyes and what he sees makes him shudder: the place has been laid to ruin, chaos of materials and electrical wires, displaced screens, used tools, sullied cloths piled up on work tables, the operating table soiled and the ground splashed with blood. Anyone who stuck a head in would blink their eyes against the cold light and then form an image of a battleground after the onslaught, an image of war and violence – Thomas shivers, and gets to work.
Simon Limbeau’s body has become a corpse. What life leaves behind when it has slipped away, what death leaves on the battlefield. It’s a violated body. Frame, carcass, hide. The boy’s skin slowly turns the colour of ivory, it seems to harden, haloed in this raw light that falls from the scialytic lamp; it seems to become a dry carapace, a breastplate, a suit of armour, and the scars across the abdomen are reminiscent of a mortal blow – the lance in Christ’s side, the sword-strike of the warrior, the knight’s blade. And whether it’s this act of sewing that recreates the bard’s song, the song of the rhapsody of Ancient Greece; or whether it’s Simon’s face, the beauty of this young man risen from the ocean wave, his hair still full of salt and curled like the manes of Ulysses’s companions; who knows whether it’s this that unsettles him, or his scar in the shape of a cross, but Thomas begins to sing. A fine song, barely audible to those who might find themselves in the same room with him, but a song that synchronizes with the actions that make up the last offices for the dead, a song that accompanies and describes, a song that deposes.
The material necessary for preparing the body before it’s taken to the morgue is laid out on a crash cart. Thomas has pulled a disposable apron over his shirt, pulled on single-use gloves, gathered towels – they too are single use, one time only, for Simon Limbeau – and soft cellulose compresses, a yellow garbage bag. He begins by closing the boy’s eyes, using a dry eye pad, and then, to close his mouth, he rolls two pieces of cloth, places one beneath the occiput to flex the neck, the other beneath the chin, pressed vertically against the thorax. Next, he removes everything that invades the body, threads and tubes, drips and catheter, he takes out everything that criss-crosses it, enlaces it, obstructs the view of it – he frees it and then Simon Limbeau’s body appears in the light, suddenly more naked than naked: human body catapulted outside humanity, troubling matter drifting in the magmatic night, in the unshaped space of non-sense, but an entity to which Thomas’s song confers a presence, a new meaning. Because this body that life has shattered becomes whole again beneath the hand that washes it, in the breath of the voice that sings; this body that has undergone something extraordinary now becomes part of the greater death, the company of others. It becomes the subject of praises, it is embellished.
Thomas washes the body, his movements calm and loose, and his voice draws upon the corpse so as not to falter, just as it dissociates from language in order to grow strong, frees itself from earthly syntax to reach that precise place in the cosmos where life and death meet: it breathes in and breathes out, breathes in and breathes out; it escorts the hand that revisits the contours of the body one last time, recognizing each fold and each span of skin, including the tattoo across the shoulder, this emerald black arabesque inscribed in his skin the summer he told himself his body was his own, that his body expressed something essential about him. Thomas applies pressure now to the puncture points where tubes have pierced the epidermis, and dresses the boy in a change of clothes – he even arranges his hair so that his face becomes radiant. The song grows louder still in the operating room as Thomas wraps the body in an immaculate sheet – this sheet that will be knotted at the head and the feet – and watching him work, funerary rituals come to mind, ones that conserve the beauty of the Greek hero come to die with intention on the battlefield, these rituals created to restore his image, to guarantee him a place in human memory. So that societies, families, and poets will be able to sing his name, commemorate his life. It’s a good death, la belle mort, it’s the song of a good death. Not an elevation, a sacrificial offertory, not an exaltation of the soul that clouds in ascending circles toward Heaven, but an edification: this song reconstructs the singularity of Simon Limbeau. It causes the young man to rise up from the dune, surfboard under his arm, run along the shore with others beside him; it makes him fight over some insult, hopping from foot to foot with fists up by his face and elbows in tight; it makes him thrash and jump in the mosh pit at a concert, wild, and sleep on his stomach in the bed he’s had since he was a child; it makes him spin Lou around – little ankles fluttering above the kitchen floor – and sit down at midnight with his mother who’s smoking in the kitchen, to talk about his father; it makes him undress Juliette, and hold out his hand so she can jump down from the seawall; it propels him into a post-mortem space where death doesn’t reach, a space of immortal glory, of mythography, of song and literature.
Cordelia reappears an hour later. She’s made the rounds of the department, she’s pushed open the doors, has looked in on the patients in the recovery room, she’s checked the vitals in the private rooms, the flow of electric syringes and diuresis, she’s leaned over the beings that sleep there, over their faces that sometimes twist in suffering, she’s observed their positions, listened to their breath, and now she goes back to see Thomas. She catches him singing, hears him even before she sees him because his voice has grown strong now, and she freezes, deeply moved. With her back flat against the door to the O.R., hands at her sides, head thrown back, she listens.
Later, Thomas lifts his eyes. Good timing. Cordelia approaches the table. The white sheet covers Simon up to his neck, throwing his facial features into relief, the grain of his skin, the transparency of cartilage, the flesh of his lips. Does he look handsome? Thomas asks her; yes, very, she answers. And then their eyes meet, deliberate, full, and they lift the body together, which, in spite of everything, is still heavy; they stand at either extremity to slide him onto a stretcher, in a shroud, before calling the funeral home. Tomorrow morning, Simon Limbeau will be brought back to his family, to Sean and Marianne, to Juliette and Lou, to the people close to him: he will be given back
ad integrum
.
T
he plane lands in Bourget at 00:50. Time sharpens. A car is waiting for them, impeccable logistical coordination. This is no taxi, but a specialized, thermally regulated car for just this type of mission – the inscription on the doors says: Priority Vehicle, Organ Transplant. A profound calm reigns inside: although the tension is palpable, there is no hint here of a staged emergency scene, a re-enactment for a televised report on the glory of transplants and the heroic human chain, no hysterical pantomime with a red stopwatch running in the corner of the screen, no blue lights or motorcycle squadron with white helmets and black boots leading the way, armada of stiff thumbs and impassive faces, jaw muscles clenched. The process unfolds in a controlled manner and traffic on the highway is clear for the moment, the flow of Sunday-evening return trips already diluted: before them, Paris rises beneath a dome of corpuscular light. A call from the O.R. when they’re passing Garonor: the patient is here, we’ll begin preparations, where are you? Ten minutes from La Chapelle. We’re on time, Virgilio murmurs, and looks at Alice; her profile of a night bird – the concave of her forehead, her beak-like nose, her beautiful silky skin – alights on the fur collar of her white coat. She sure does have a Harfang face, he thinks.
Outside the Stade de France, they hit a traffic jam. Shit. Virgilio sits up straight, immediately tense. What the hell are they still doing here? The driver doesn’t blink. It’s the game, they don’t want to go home. Bottleneck of cars full of young guys drunk on celebration who lean out the windows in the cold, prancing the Italian flag around on long sticks, as well as charter buses for fan clubs, not to mention long-haul refrigerator trucks stuck in the euphoric tangle. They’re signalling a pileup ahead. Alice lets out a cry, Virgilio grows even more tense. Centimetre by centimetre, the driver manages to widen the gaps between cars to slip his vehicle through and reach the emergency lane where he drives at a reduced speed for nearly a kilometre, passing the nodal accident, after which the lane is empty and acceleration powerful, reflectors spaced out along the guard rail becoming no more than a long luminous ribbon in the night. Congestion again at La Chapelle. We’ll take the ring road. The points of entry are strung out along the city’s borderline to the east, from Aubervillier to Bercy, long curve at the end of which the vehicle nudges back over to the right, enters the city, and then there are the banks of the Seine, the towers of the library, a turn to the left and they drive up boulevard Vincent-Auriol, stop at Chevaleret, enter the hospital grounds, it’s here, the vehicle stops in front of the buildings – thirty-two minutes, not bad – Virgilio smiles.
In the O.R., the others barely lift their heads when they show up, bringing the treasure to the foot of the bed like a trophy to the feet of the master. Their arrival scarcely creates a stir, because the operation, here, has already begun. The team is dressed in sterile clothing, arms washed, hands disinfected – and now the only thing that Virgilio sees of Alice are her strange eyes, slow and condensed, where scattered yellows coagulate, chartreuse and honey, smoky topaz. Harfang, though, does finally toss out: so, everything went okay with the heart? And Virgilio, in the same relaxed tone, says: yeah, just a pileup on the way back into town.
The heart is placed in a basin, close to the bed. Alice climbs onto a small standing stool at the end of the table – she’ll be observing the transplant; her legs wobble a little as she pulls herself up the step, while Virgilio comes forward to take the place of the O.R. intern, just managing to hold back from taking the instruments into his own hands. Everything in him is expressing his desire to be there, beneath the three scialytic lights above the thorax, and to be there across from Harfang. They’re working together, now.
Suddenly, as he reveals Claire’s heart, Harfang whistles and exclaims that this one isn’t in the best shape, it might be time to find a new one, and around him they agree, half laughing – it’s surprising to find that he’s a bit of a crowd-pleaser in the O.R., putting on a show, while also keeping each of his team members under formidable pressure – nothing escapes him, even what’s happening behind him. The O.R. is truly the only place where he feels himself existing, where he’s able to express who he is, his atavistic passion for his work, his maniacal rigour, his faith in human beings, his megalomania, his dreams of power; it’s here that he convokes his lineage and remembers one by one those who developed the act of transplanting, scientifically – the first to perform one, the pioneers, Christiaan Barnard in the Cape in 1967, Norman Shumway at Stanford in 1968, and Christian Cabrol here, at the Pitié, men who had invented the transplant, had conceived of it mentally, had composed and decomposed the process hundreds of times before carrying it out, all men from the 1960s, workaholics, charismatic stars, media-friendly competitors who argued over who would do the first operations and didn’t hesitate to steal from one another, playboys of multiple marriages surrounded by women made up like Twiggy in mod boots and Mary Quant miniskirts, autocrats of a mad audacity, guys covered with accolades but still hungry for success.