Mend the Living (3 page)

P
ierre Revol had started his shift at eight in the morning. He’d scanned his magnetic card at the entrance to the parking lot as the night turned greyscale – pale, still sky, vaguely turtledove, a far cry in any case from the grandiloquent choreographies that had given the clouds of the estuary their picturesque reputation – driven slowly across the hospital grounds, snaking between buildings connected according to a complex plan, slid into the place reserved for him, parked his car nose first, a petroleum-blue Laguna, a vehicle in decline but still comfortable, leather interior and good radio, the preferred model of taxi barons he says with a smile, then he’d gone into the hospital, crossed the enormous windowed nave toward the north hall, ground floor, and, walking fast, arrived at the hyperbaric medicine and intensive care unit.

Now he passes through the department door, pushing it open with the flat of his hand so firmly that it bangs several times in the emptiness behind him, and those who are at the end of the night shift, men and women in white or green shirts, all of them done in, dishevelled, brisk movements and bright eyes, febrile grins on their tense faces – tambourine skin – these ones laughing too loudly, or coughing, frog in their throats, voiceless, these ones bump into him in the corridor, brush past him or on the contrary see him coming from far off, cast a glance at their watches and bite their lips, think, good, finally, in ten minutes I can get out of here, in ten minutes I’m off, and at that moment their features relax, change colour, turn pallid, and circles trace themselves all at once, bronze spoons beneath their blinking eyelids.

Calm strides, constant speed, Revol reaches his office without deviating from his path to respond to this sign someone is already making, these papers someone is already holding out, this intern who’s already hot on his heels; takes his key out in front of an ordinary door, enters, and proceeds to the daily gestures of arriving at work: hangs his coat – a tan trench coat – on the peg nailed to the back of the door, pulls on his white coat, turns on the coffee maker, the computer, absently taps the paperwork that plasters his desk, surveys the stacks classified in order of importance, sits down, opens his email, sorts the messages in his inbox, writes one or two replies – no hello or anything, all words emptied of their vowels and no punctuation – then gets up and takes a deep breath. He’s in good shape, he’s feeling good.

He’s a tall man, skinny, thorax hollowed and belly round – solitude – long arms long legs, white leather lace-ups, something slender and uncertain in him that matches his juvenile mien, and his coat is always open, so that when he moves the front panels swell, spread, wings, revealing jeans and a shirt, also white, and rumpled.

The little diode glows at the base of the coffee maker, then the bitter scent of the electric hotplate heating empty fills the air, and on the desk, the dregs of coffee cool in the glass pot. Although minuscule – five or six lousy square metres – this private space is a privilege at the hospital and so it’s surprising to find it this impersonal, chaotic, of a questionable cleanliness: swivel chair that’s comfortable despite the high seat, desk where forms of all sorts pile up, along with papers, notebooks, notepads, and promotional pens palmed off by pharmaceutical companies in embossed plastic pouches, a bottle of San Pellegrino gone flat and, in a frame, a photo of a Mont Aigoual landscape; punctuating the clutter, three objects placed in an isosceles triangle may testify to an urge to add a personal touch – a glass paperweight from Venice, a stone turtle, and a cup for pencils; against the back wall, a metal shelf holds disparate folders and boxes of files numbered by year, a good layer of dust, and a small handful of books whose titles you can make out if you get closer: the two tomes of
The Hour of Our Death
by Philippe Ariès,
La sculpture du vivant
(The Sculpture of the Living) by Jean Claude Ameisen from the Points Sciences collection, a book by Margaret Lock with a two-tone cover showing an image of a brain and titled
Twice Dead: Organ Transplants and the Reinvention of Death
, an issue of the
Revue neurologique
from 1959, and the crime novel by Mary Higgins Clark
– Moonlight Becomes You –
a book Revol likes, we’ll find out why later. Otherwise no window, hard fluorescent, the bare light of a kitchen at three in the morning.

Within the hospital, the ICU is a separate space that takes in tangential lives, opaque comas, deaths foretold – it houses these bodies situated exactly between life and death. A domain of corridors and rooms where suspense holds sway. Revol performs here, on the reverse side of the diurnal world, the world of continuing, stable life, of days that irrupt in the light and file toward future plans; he works in the hollow of this territory the way you’d rummage inside a heavy coat, inside its dark folds, its cavities. And he likes his shifts, Sundays and nights, has liked them since his residency – you can imagine Revol as a slender young intern seduced by the very idea of the job, this feeling of being needed, at work and autonomous, called upon to ensure the continuity of the medical gesture within a given perimeter, invested with vigilance and endowed with responsibility. He likes their alveolar intensity, their specific temporality, fatigue like a surreptitious stimulant that gradually rises in the body, speeds it up and makes it sharper, all this erotic turmoil; likes their vibratile silence, their half-light – devices that blink in the dimness, blue computer screens or desk lamps like the flame of a candle in a La Tour painting –
The Newborn
, for example – and again this physicality of the work, this climate of an enclave, this watertightness, the department like a spaceship launched into a black hole, a submarine plunging into a bottomless chasm, the Mariana Trench. But Revol has also been getting something else from this work for a long time: the stark consciousness of his own existence. Not a feeling of power, not a megalomaniac exultation – exactly the opposite: an influx of lucidity that regulates his movements and sifts his decisions. A shot of cold blood.

Department meeting: the transmittals. The staff from both shifts are here, they form a circle, everyone stays standing, leaning against the walls with cups in hand. The team leader who oversaw the previous shift is a thirty-year-old fellow, sturdy, with thick hair and muscled arms. Exhausted, he glows. Details the situation of the patients present in the unit – for example, the absence of any notable change in the eighty-four-year-old man, still unconscious after sixty days of intensive care, whereas the neurological status of the young woman admitted two months ago after an overdose has deteriorated – before giving a longer description of the new patients: a fifty-seven-year-old woman with no fixed address, advanced cirrhosis, admitted after having convulsions at the shelter, remains hemodynamically unstable; a forty-year-old man, admitted that evening after a heart attack, with cerebral edema – a jogger, he was running on the seafront toward Cape de la Hève, luxury cross-trainers on his feet, head encircled with a neon-orange bandana, when he collapsed near the Café de l’Estacade and even though they wrapped him in a thermal blanket, he was blue when he arrived, soaked in sweat, features hollow. Where are we at with him? Revol asks in a neutral tone, leaning against the window. A nurse answers, specifies that the vitals (pulse rate, blood pressure, body temperature, respiration rate) are normal, urine output is low, the PIV (peripheral intravenous line) has been placed. Revol doesn’t know this woman, inquires about the patient’s blood test results, she answers that they are in process. Revol looks at his watch, okay, we’re good to go. The team disperses.

This same nurse lingers in the room, intercepts Revol and holds out her hand: Cordelia Owl, I’m new, I was in the O.R. before. Revol nods, okay, welcome – if he looked more closely, he would have seen that there was something a little odd about her, eyes clear but marks on her neck, swollen lips, knots in her hair, bruises on her knees; he might wonder where this floating smile came from, this Mona Lisa smile that doesn’t leave even when she leans over patients to clean their eyes and mouths, inserts breathing tubes, checks vital signs, administers treatments, and maybe if he did he would be able to guess that she had seen her lover again last night, that he had phoned her after weeks of silence, the dog, and that she showed up on an empty stomach, beauteous, decorated like a reliquary, lids smoky, hair shining, breasts warm, resolved to an amicable distance, but she was a rather
mezzo
actor, whispering distantly how are you? it’s good to see you, while inside her whole body was diffusing its turmoil, incubating its tumult, a hot ember, so they drank one beer and then two, attempted conversations that didn’t take, and then she went outside to smoke, telling herself over and over I should go now, I should go this is stupid, but he came outside to find her, I’m not gonna stay long, I don’t want to be up too late, a feint, and then he got out his lighter to light her cigarette, she sheltered the flame with her hands, tilting her head, curls falling across her face and threatening to become a wick, he tucked them automatically behind her ear again, the pads of his fingers brushing her temple, so automatically that she went weak, the backs of her knees turning to jelly – all of this, by the way, threadbare and old as the hills – and bang, a few seconds later the two of them were knocking about beneath a neighbouring porch, held inside the darkness and the smell of cheap wine, smashing into garbage cans, offering up a range of pale skin, upper thighs emerging from jeans or tights, bellies appearing beneath lifted shirts or unbuckled belts, buttocks, everything boiling and freezing all at once as their mutual and violent desire collided – yes, if Revol looked at her more closely, he would see in Cordelia Owl a girl who was curiously bright-eyed, even though she was beginning her shift on a sleepless night, a girl in much better shape than he was, someone he would be able to count on.

W
e have someone for you. A call at 10:12. Neutral, informative, the words strike. Male, six feet, 154 pounds, maybe twenty years old, car accident, head trauma, in a coma – we know who’s being summed up like this, we know his name: Simon Limbeau. The call is barely finished when the ambulance crew arrives, the fireproof doors open, the stretcher rolls in, up the central corridor of the ICU, people step aside to let it pass. Revol emerges – he’s just returned from examining the patient admitted in the night after convulsions, and he’s not optimistic: the woman didn’t receive CPR in time, the scan revealed that liver cells had died after her heart stopped, a sign that her brain cells were also affected – he’d been notified and, seeing the trolley arrive at the end of the corridor, he suddenly says to himself that this Sunday shift won’t be easy.

The doctor from emergency services follows the stretcher. He’s built like a high-alpine surveyor, bald, mid-fifties, skin and bone, a twig; he reveals pointy teeth when he says out loud: Glasgow 3! Then addresses himself specifically to Revol: the neurological exams showed a lack of response to sound (calling his name), visual stimuli (light), or pain; there were also ocular disturbances (asymmetrical movement of the eyes), and respiratory dysfunctions; they had intubated him immediately. He closes his eyes, rubbing his head from forehead toward the occiput: suspected cerebral hemorrhaging following head trauma, unresponsive coma, Glasgow 3 – he uses this language they share, language that banishes the verbose as a waste of time, exiles eloquence and the seduction of words, overdoes nouns, codes, and acronyms, language in which to speak signifies above all to describe – in other words, inform a team, gather up all the evidence so a diagnosis can be made, tests can be ordered, people can be treated and saved: power of the succinct. Revol takes in each piece of information, and plans for the body scan.

Cordelia Owl is the one who sets him up in his room, in his bed, after which the ES team can leave the department, taking their equipment with them – stretcher, portable ventilator, oxygen tank. Now they have to insert an arterial line, electrodes on his chest, a urinary catheter, and connect Simon to the monitors that will show his vital signs – lines of different colours and forms appear, superposed, straight or broken lines, cross-hatched deviations, rhythmic undulations: the Morse code of medicine. Cordelia works with Revol and her gestures are assured, her movements fluid, easy; her body seems relieved of the viscous spleen that still clung to her movements only yesterday.