Paris Twilight (39 page)

It had been years since I cupped a heart in my hands. It was like holding a newborn, a tiny miracle ready to kick like hell. Odile had inherited a lovely, bright, eager little heart, I could feel how game it was, and ready to go, as though it were imbued with mission and warmed by its own anticipation.

And I thought:
Warm
.

At first what I felt through the latex was what I anticipated, the warehouse chill of a well-packed icebox heart. Oddly, the cold ran only surface deep, like the skin-chill of a child who's been playing too long in the snow, and within a dozen seconds it had burned off like hoarfrost, or as though my touch (though my touch was statue still) had chafed the rose back into a chill-bit cheek, and then the infernal thing kept warming and warming, was warmer than the room, was warmer than Odile, and I had a moment's irrational alarm that it might keep on heating up and heating up, might combust inside her like a coal in a brazier. I looked up in panic. I expected the astonishment of a gallery of wide-eyed onlookers, but my comrades were all busy at their tasks, oblivious to the alchemy playing out right in front of them.

“Solution!” I demanded, and someone gave her a dose of cold Wisconsin, but the little furnace still felt like it was coming alive in my grasp. And as it did, as it divulged its secret heart to hand and I absorbed through my fingers what it had to say, I sped through confusion, through disbelief and terror and revulsion, and felt the tears start sharp behind my eyes, and immediately I had to stanch them, for to weep into this open chest would be as deadly to Odile's prognosis as would any shift of stance or posture before they wrapped up the sewing-in. With a strain of effort I immobilized my panic to immobilize myself, and I braced my knees against the side of the table to keep them from buckling under me and braced my mind against hatred.

Oh, Daniel, the news, once it came, came from everywhere. It poured out of every vacancy, from every lack I'd willingly overlooked, the absence of his usual restraint as Willem cut out Odile's heart so quick, the absence of relief when the new one arrived like clockwork. Clockwork, Daniel: the absence of allowance for the sloppiness of scheduling of a transport between two hospitals down French backcountry lanes, and what other hospital could it possibly have come from? The absence of any hospital near enough to this one, that a heart from there would still be so warm on arrival.

Willem and me, our collaboration was like this: a room where every time you've entered it for twenty or thirty or fifty years, a lamp has stood on its place on the shelf, but this time when you enter it's not there, and you derive from its absence the whole slow enormous fact of things, the future foretold in the missing crystal ball. The new heart had arrived and Willem had lifted it out of its cooler and plunked it into her chest with less than his usual sizing-up and turning-over, as though he already knew what he had to work with. He'd made his first three running sutures and tugged them to snug the newcomer into place and set about his tailoring immediately, the slicing and snipping, the edgework of artery and atrium that would permit the two parts of this hybrid to precisely coincide without any pursing or bunching or stretching out of shape at the stitches, and that's how it worked, one soft tissue adjusted to fit another. But with all the leeway the softnesses allowed, there were still so many reasons why one heart might be restless in another heart's nest; even the best of hearts was sometimes unsuitable, for reasons you couldn't anticipate—Hatfield and McCoy stuff, stuff like that, incompatible families.

That too: the absence of incompatible families. I expected Willem to do as he always did, to tumble this newcomer over in his hand, interrogate its heft and take its measure, apprise the cut before he paid the butcher, but he hadn't, or hadn't sufficiently, not quite as much as he used to do. The curiosity and the superstitious fidgeting, checking for injury or imperfection, for the congenital puncture between the two atria that is so common and so easy to repair (at this point) with a single stitch, settling the interloper this way and that to see how it fit the pit, almost the way a gardener plants a tree, musing how the roots should go this way and the branches that—all that procedure was absent, absent.

The way Willem had always been, he wasn't, quite, and the absences gathered to accumulate to a certainty. I couldn't admit it then, couldn't have accepted what I already knew without bringing on general catastrophe, so I did what I had to with my every nerve immobilized, and my only advantage was a great one, that what I was attempting not to think was wholly and entirely unthinkable. As soon as I had been freed from my rigid duty—“That will suffice, Miss Anselm,” Willem said, quoting again, jocular; he had no idea I'd caught on, no inkling of the emergency storming my brain—I checked Odile's vitals on my display and gave the nurse a nod and excused myself from the room. It was a traditional time for the anesthesiologist to leave things with an understudy and grab a swift break, if needed. Soon they would take Odile off the bypass machine and it would be time for redoubled vigilance as they reventilated the lungs and extracted themselves, retracing their steps, drawing her breastbone closed with heavy lengths of stainless alloy wire like closing a boot with a lace, then hammering the twisted steel pigtails flat to the bone with the side of the pliers and basting her fascia shut over them, and then her skin, and there she would be again, orange and unremarkable, restored.

I excused myself calmly and pushed out through the swinging doors into the recovery area, the central reservoir into which all the ORs emptied. No one was about; no other procedure was scheduled for the day, another incriminating absence. I looked around at the several sets of doors, their portholes darkened, indecisive. Then it occurred to me: of course. It occurred to me in Mahlev's remembered voice.
I directed you to the wrong room:
Mahlev that day in his dither. With a somnambulist's sureness, I stepped to the middle door and entered.

OR 3 wasn't completely dark; someone had left the light on in the light box for viewing x-rays. I stood just inside the door awhile, letting my eyes adjust to the dim glow and preparing my mind for what it was about to confront. How thoroughly that confrontation has haunted me since!—hounded my thoughts and bludgeoned all my dreaming into a single, inescapable dream.

In the dream, I walk not slow, not fast to the table in the center of the shadow of the room. They haven't removed him yet. They are waiting for everyone to vacate the ward. I imagine the harvest team is already on a plane. He is covered with a sheet. He is nothing now but a shape in a shroud. I go up and stand beside the shape, blue cloth bluer in the gray light from the light box. I lay my hand on his chest, on the cloth where the rise of his chest is, and let it rest for a minute there, consoling him or me. Then, with a surge of strength or will—it's the last bit of usable anger in me—I punch him hard in the sternum with my fingers, and the drape plunges into the open slit, and as the hollow sucks my hand into its absence, the hem of the cloth retreats to reveal dark hair and a forehead, then a noble nose, and his busted lip, and then I awake, my bedclothes twisted around me like a truss. In my dream, whoever put him under taped his eyes.

And maybe it would have been better if that's how it had been. Maybe it would have settled me to see Emil, to have found some certainty to accompany what I knew. Horror can be a useful paralytic, administered in sufficient dosage. The hysteria in my skull would still wail for a lifetime. Just maybe it might not be so shrill, so unabating, if I'd found him before they could whisk away the evidence. If I could have been granted that confirmation.

Instead, I flipped the wall switch and the light erupted onto emptiness. The table smiled back without subtlety or shadow and was hard and chilly when I laid my hand against it. The room was absent not only Emil, but everything, every sign of any past at all:
not even a ghost
. The tile walls gleamed innocently, and the floors; the light box held no films. The normalcy of everything ridiculed my suspicions.

Maybe it would have been better for me if I'd found him, but I was so, so relieved not to, so very relieved to be wrong, to be spared the worst, if only for a while, so willfully glad for the precious gift of just enough illusion to last me through the day.

In gratitude, I returned the room a favor. Before leaving, I stepped over and darkened the x-ray panel. I'd flipped the light-box switch and turned back to head for the door before I saw it. I noticed it just as I turned to exit, the little flat coin flat on the floor, lurking there directly in my path. I stopped and stared at it in utter perplexity, this little daub, this crimson dime on the spotless tile floor. My perplexity was that I knew right away what it was and what it meant, recognized immediately what a grievous debt this dime would cost me, even before I knelt to inspect it more closely and extended my arm slowly and tentatively to tap it with the tip of a finger. Yes, it was wet, still as wet as it was red. A single fresh drop of blood.

G
RIEF IS A SOLIDER THING
than suspicion, Daniel, solider than fear. Grief is work, and all I could do . . . all I could do was begin it. Kneeling there by the blood spot in the blameless, spotless room, that's just what I did. I ordered my tasks and began.

And that's what got me through the next two hours, barely, some oil-and-water admixture of grief and disbelief. The serious and immediate and main thing was Odile, and I stepped back into OR 5 and took up where I'd left off behind my ether screen, a presentable zombie, putting Odile through her remaining paces, alert for the last-minute danger, any reflux requiring suction, any reluctance to breathe again. How fatally reluctant she would be, did she know! And did she ever find out, she would rip her chest open with her own two hands, of that I was sure.
Before the surgery, and afterward
, I heard, and heard myself say,
I promise
.

And so I became a conspirator.

Willem alone had noted the minutes, known to make anything of them beyond a regulation break, and I could feel his quizzing eyes on me when I took up my task. I didn't say anything, wouldn't even look at him until later, when he accosted me in the stairwell after we'd gotten Odile to intensive care, when he'd try to begin to explain it all, and I would give him my verdict, straight and unadorned, that he and I would never speak again.

I fed Odile the palliative and watched on the monitor to see it counteract the anesthesia. On those rare occasions when someone doesn't make the climb, it's generally on the first step that they stumble. They refuse to do the about-face. Was that where Odile had dallied at the end of her childhood operation? What had tempted her to stay that time? I could feel myself pushing her with every wish I had. When I saw on the display that she'd turned and stepped, I thought,
Good: come
.
You're beyond the abeyance, the room is warming, wherever you've gone to, come
. Her pulse beeped steady on the oximeter, and it occurred to me,
Emil
, as though I recognized its voice.

I saw her through the finalities. She came to in the ICU and I stayed with her long enough to kiss her forehead and assure her everything had gone beautifully, to welcome her back before she drifted off again, holding her hand as though pulling her up the last yard to the surface, and when she let go, I sank.

 

For that's what I did, Daniel. Whatever the spirit was that had buoyed me most of a lifetime gave up and gave out and lost its spell and let me all the way, all the way down. The sensation wasn't, as I'd always imagined it, of slipping smoothly through a satin vortex, but of banging down stairs the rough way into oblivion, down a rotted ladder rung by rung by rung. Each rung had a name on it. I couldn't see through the dark where the ladder led; I wasn't drawn by destination. It's just that each rung had a name on it and the name was a question, and the answer to each question was the question written on the rung below, so I took the first step and asked,
What have I done?
, and embarked on my descent.
Done, w
ith all my smug prattle about the morality of things.

[Step]

Who cares? He didn't, to leave you in such a way.

[Step]

But he did care. I do. He had no choice
.

[Step]

He made a choice.

To save his sister
.

To not be with you.

He couldn't have, not for long
.

Not saying how very sick he was.

[Step]

Willem did. Willem said “pancreas.”

Afterward.

Yes, afterward. In the stairwell. Said, “Emil knew he had pancreatic cancer, knew he was dying and that death would be soon, and ugly, and pointless.” And that I was being . . .

[Step]

. . . illogical
.

Willem said that?

Said, “Look at it rationally. We've put a cancer patient's heart that no one would have accepted into a cripple whom no one would have saved. We've spared a man who was going to die anyway a few months of agony and made his end a happier one and converted a sure and purposeless death into the wondrous gift of life.” He demanded I tell him why I wouldn't call this . . .

Call it what?

My “finest hour as a doctor.”

[Step]

That's hard.

Not hard. Wrong
.

You call it wrong.

Oh yes!

And when Emil sat in kerosene beneath a wobbling candle and risked his life to save the life of a stranger, your friend, at your behest, was he wrong then too?

[Step]

Oh, but . . .

[Step]

Why not? Explain. Is it because his death then was merely possible, not certain?

That's a fine distinction
.

Though the good was merely probable too—with your Corie, it was never more than a maybe, at the best. But in Odile's case, the good was as guaranteed as all his sacrifice and all your skill could make it. Doesn't certainty of good justify certainty of sacrifice?