Second Hand Heart (5 page)

They screamed at each other for most of the night, and then the next day he packed up a few of his shirts and things and went to stay with his friend Moe from work, and then a few weeks later he moved the rest of the way out.

Two things I want to say about divorce.

One. They say kids tend to blame themselves. But I always have to be different, I guess. I sort of blamed my mother. It was just a motorcycle ride. I was fine. She could’ve let it go by.

Looking back, I’m sure it was much more complicated than all that. But I was four. And it seemed simple.

Also, this. Two. I read somewhere about how they’ve done studies of families after a child dies. And this huge percentage of couples get divorced. I forget the percentage, but it’s really big.

But, so far as I can tell, nobody studies the families who know they’re probably about to lose a child pretty soon.

I bet the statistics are not so hot for that, either.

On Dr. Vasquez

S
he came into my room just now, to talk to me one more time before the big event. Fortunately I’d gotten all caught up with my writing by then.

When I saw her, I knew it was getting to be time. And I felt this jump in my chest. Well, I guess I shouldn’t say my chest. That’s a little euphemistic. It was my heart that jumped. Maybe it knows its days are numbered. But really, I think it was just a simple fear reaction. You know how your heart beats faster when you get scared? Like that.

So all of a sudden I could feel my heart, and I thought, Oh my God. You can’t just cut it out and throw it away. It’s my heart! Granted, it’s not much of a heart, but it’s mine. I’ve had it all my life. It’s me. After all.

Who will I be without it?

But I didn’t say any of that to Dr. Vasquez, because she has an important job ahead of her, and I didn’t want what she was about to do to seem any weirder or more complicated than necessary. To her, I mean. Even though I knew somewhere in the back of my mind that this was probably a lot weirder for me than it was for her. She does heart transplants all the time. This is my first.

She stood by my bed and reached out for my hand, and I gave it to her.

She asked me how I was doing.

Probably seems like a simple enough question. At least from the outside of me.

I said I figured I was as close to OK as anybody could be in my position, and she smiled in a way that made me think she was actually listening. (Lots of people will ask you how you’re doing, but usually when you answer, if you pay close attention, you’ll see they’re not really listening.) She asked me if there was anything I wanted to know about the surgery. You know. Any final questions.

I said at this point I was thinking maybe the less I knew about it the better, and she laughed a little.

“Really?” she wanted to know.

“No, I’m kidding,” I said. “You can tell me.”

“Well. You know an awful lot about heart surgery already. Too much for a girl your age, really … I wish you didn’t have to be such an expert. This probably seems like a really unique surgery, and it is in some regards, but the basic sequence of events isn’t all that different from the procedures you’ve had in the past. In some ways it’s simpler. We make the same size incision. Saw through the sternum the same way, except this time we have to go through more of the wire sutures left from the last couple of procedures. And you probably know about how we use a cauterizing tip to keep the bleeding down—”

“Yeah,” I said. “I hate that thing. It smells really bad.” She looked at me, kind of curious.

“Who told you that?”

Then I knew I’d made a mistake by talking about something I promised myself a long time ago I would never talk about.

“Oh,” I said. “That’s a long story. Never mind about that.”

See, back when I had that third procedure, when I was four, I either saw or dreamed part of what happened. I have no idea which, and I probably never will.

I just know I saw myself on the table, except I couldn’t see my head at all because it was behind these blue drapes. My chest wall was pried open with that big metal separator, and Dr. Vasquez was standing there, along with one other surgeon and three nurses and the anesthesia guy and the heart-lung machine guy. Staring down at my heart. Watching it stop. She’d put a bunch of ice in there, on my heart. To slow it down and stop it. I could see the wet chunks of it filling up that cavity in my chest.

Actually, the heart-lung machine guy and the anesthesia guy weren’t looking down into my chest. They were too far away from the table for that. They were watching the monitors. But it amounts to more or less the same thing, because they were still watching my heart stop. Even a four-year-old knows what it means when that red line goes flat. At least, this four-year-old did.

After a minute she lifted out the bulk of the ice and suctioned out the rest, and I could see the two thick tubes of blood going from me to the heart-lung machine, and how the blood was a different shade of red coming and going.

While she worked, Dr. Vasquez kept stopping to use that cauterizing tip on anything that was still bleeding, and when it touched the bloody live tissue it made this little wisp of smoke or steam, and the smell was bad.

Do you dream a smell? Maybe. But probably not.

I watched her for a minute or two, from high up, and I could see really well. I could see straight down. It’s almost like I was watching from up where the lights were.

Oh, and just one other weird little detail. The radio was playing. Some kind of semi-mellow classic rock.

The thing I remember best was the weird thin medical drape they had on my body, actually stuck on to my skin. It has iodine in it, so it’s kind of reddish-yellowish, and I thought it was my skin at first, and it made me look like a corpse. It made my skin look papery and weird, like I was a hundred years old, or even like I was decomposing. It was shocking to me.

That and the cauterizing smell. It’s really hard to forget that smell.

I never checked the details with anybody after I came out of surgery, and I never told anybody what I either dreamed or saw. Because I knew it would freak my mother out. Because, if it wasn’t a dream, then it was something like being dead for a minute. I mean, if your heart isn’t beating, what’s that? Under the circumstances, hard to say.

But I’ve learned in my life that not everything that happens needs to be talked about. Some things are better left alone.

Anyway, back to my talk with Dr. Vasquez.

While I was thinking about all that stuff, she was telling me more details of the surgery, and what to expect, but I was only half-listening and I don’t remember enough to write them down now. I think a lot of it was about the heart-lung machine, though. How it’ll circulate my blood while nothing else can. As if I didn’t know that already.

“Anything else you want to know?”

“Is the heart here yet?”

“No, but it’s being harvested. Right now. They had an option on when to harvest, because the donor was being kept alive artificially. But it’ll be on its way soon.”

And I thought, Good. Maybe more time to write. “Are you going to take me into the operating room and take out my heart while you’re waiting for it?”

“We’re going to take you into the OR while we’re waiting, yes. But we won’t take you past what we call the point of no return. I think you know what I mean by that. Not until we see that donor heart walk through the door. Not that there’s likely to be any trouble. But you just never know. What if the helicopter crashed?”

“What difference does it make? I’ll die without it either way.”

“It makes a difference,” she said.

I figured she meant to her. I’m not sure how much difference it makes to me.

“Can I ask you a favor?” I said.

“Sure. Anything.”

“I know the last two times you operated on me you used those defibrillator paddles on my heart. To get it to start again.” I hadn’t actually seen that. I just knew from being told. “And that’s OK, because it was my old heart. But I read that sometimes a transplanted heart will start beating on its own. Not always, but sometimes. Sometimes you can just warm it up and it’ll start to beat. So maybe you could give this one a chance. You know. To beat on its own. Because I feel like it’s sort of a guest. In a weird sort of way. I’ll just be getting to know it, and vice versa. And I want to get off on the right foot with it. You know. Be welcoming. Treat it as politely as we can.”

She smiled, but I couldn’t tell what she was thinking. I was hoping she was listening to me with the right side of her brain, or with both sides at least, and not entirely from the professional side on the left.

“Circumstances will have to dictate that,” she said. “But I’ll keep your request in the back of my mind. We’ll be as welcoming as we can.”

“Thanks,” I said. “One more thing. It’s about my journal.”

“OK. What about your journal?”

“I want to write something about my transplant surgery in my journal. But I won’t be able to. Because I’ll miss the whole thing. So I was hoping you would.”

“You want me to write in your journal?”

“About the surgery. Yeah.”

“What do you want me to write?”

“I don’t know. Anything that seems important. Anything you want. It’ll be at the nurse’s station. I can’t give it to you now because I need to work on it some more before they come prep me. But I always leave it at the nurse’s station unless I’m awake and using it, because I don’t want my mother to read it. And I think she would, too, if I gave her half a chance. So just leave it back at the nurse’s station when you’re done, OK?”

There was a silence at that point. And she scratched her head once.

“It’s a bit of an unusual request,” she said. “Can’t say I’ve had one like it before. But I guess I can manage something.”

“Thanks,” I said.

Then she wished me the best, and all the usual stuff you say to someone in my position, and as soon as she left, I scribbled down everything I could remember about my talk with her in this journal. In a big hurry.

Dreaming About the Heart, Unless I Wasn’t Dreaming

S
o, here’s another thing that was maybe a dream and maybe not. I’m not even sure how I’m supposed to tell things like that apart.

I thought I’d written everything I wanted to write, so I drifted off into a little short nap, maybe just ten or fifteen minutes. The kind where you’re only about three-quarters asleep.

And I kept having these dreams where I saw the heart.

I mean, not the actual heart. Not the bare, finely-veined muscle of it.

More like the movement of it. The journey.

I kept dreaming I saw this medical cooler. Dangling at the end of someone’s hand. Moving fast across a parking lot. Sitting in a helicopter, holding perfectly still while the copter lifted off and sped in this direction. It was bright orange. The cooler, I mean. Sort of that highway-safety orange. And it had the words “Transplant” and “Organ” stenciled on it. It might’ve said “Organ Transplant” or it might’ve said “Organ for Transplantation.” I’m not sure because I couldn’t really see the whole side of the cooler because of the way they had it strapped in. But other than that I could see it really well. I could even see a little wisp of steam from the dry ice.

Then I woke up, and my mother was still gone, and I wondered if what just happened to me had been all dream or partly real. Maybe part of my spirit was so involved with the journey of the heart to this hospital, to me, that I got to meet it and travel along.

Only, I don’t think there would be a wisp of steam from the dry ice. I think there would be nothing until they opened it, which I guess they wouldn’t do until it was in the operating room with me, and then I guess it would be a big cloud of steam. But while they’re closed, I think those medical coolers are too perfectly sealed for that.

But I was asleep, mostly, and maybe my dreaming self could have been partly dreaming and added that little part in a dreamy sort of way.

And maybe the rest of it was some form of real.

I wish I’d had that dream before Dr. Vasquez came in and talked to me, and then I could have asked her about the medical cooler, what color it is and all, but maybe she wouldn’t know anyway, because it isn’t even here yet.