Strangely, by the time they were all seated at the kitchen table, Beth had stopped seeing the lumpen flesh and Sicily’s not-real nose. The girls’ long-lashed eyes were dazzling, made up as if for the runway. Layer upon layer of subtlety, intended to look like nature’s gift but that probably took twenty minutes to apply, had gone into those eyes.
“I’m sorry for staring,” Beth finally said. “You have the most beautiful eyes I’ve ever seen.”
“Especially given the rest,” said Sicily. The cold had affected her skin, turning the already patchy texture liverish.
“No,” Beth said, and then gave a nod. “Okay, yes, especially given the rest. I’m sorry. My father spoke highly of your dad. My father used to be the fire chief in Parkside, and I’m afraid he’s started to be a bit of an old fire horse who hangs around all the stations.”
“Everyone likes Chief Kerry,” Sicily said. “I’ve met him. And thank you about Dad. It was a long time ago.” And then she cut to the chase. “My aunt Marie came here with me for moral support. I’m sure Eliza has told you—”
“Eliza can’t tell me anything about patients.”
“Of course,” Sicily said. “But I know she told you something about my face.”
“How do you know that?”
“You said it with your face when you opened the door. I’m a candidate for a full-face transplant. And I would like you to photograph it.”
“Eliza didn’t tell me that specifically. So. Photograph it—photograph what? Why? And why me?”
“All of it. The before and after. The surgery. Not as a medical record but as a historical document. Because I’ve seen your portraits and your news pictures. The photo of my mother at my father’s funeral. The book of kids all walking away. So I thought I could say something to you that some other people might think is crazy.”
“Not just some,” Beth said. “I don’t know if I could do that, Sicily. I don’t know if I have the stomach.”
“Well, here’s the thing,” said Sicily. “I’m a medical illustrator. And people think that is gross. Like, why do I want to paint pictures of the Swiss cheese removal of liver tumors? But the body is so fascinating and resilient that even stuff that’s gross to other people … Like, do you know that Jacqueline Kennedy, who was the wife of President John F. Kennedy—”
“I’m aware of that,” Beth said, smiling honestly.
“When her husband was shot, a portion of his brain—I’m not saying ‘rain’—”
“Brain, I understand you.”
“It was exposed when the skull was shattered. And Mrs. Kennedy noticed how extraordinarily beautiful that tissue was. Even in her greatest moment of shock,” Sicily continued, as Beth went quiet, weighing that detail. “You don’t know what you’re going to feel. But once you’re caught up in it, even if you’re afraid, it might be oddly beautiful. Eliza told me that there could be dozens of men and women in Chicago who fit the requirements for having a full-face transplant, but they don’t know it. They’re too afraid to find out. I want them to see.”
“See what?” Beth asked.
“What I’ve gone through. Not for the hospital, because the surgeons have people photographing every stitch so they don’t put my nose on top of my head or something. I want everyone to see that before I had this face, I had an identity. And if I want to make it easier for the world to love me, it’s not because I don’t love myself. It’s because I do.”
“I get that,” Beth said.
“People who are not disfigured will have to know more than they ever knew about how people like me feel. And they’ll have to admit that, beneath this face, I’m exactly like they are.” Sicily paused.
“No one thinks that about disfigured people. They feel sad.”
“No, they don’t. They feel scared,” Sicily said. “They think that I am a thing. I was never a thing.”
“But how can I …?”
“You can make this art.”
Beth said, “Art.”
“Yes. Think of a photo you remember.”
Beth thought of the John Filo photo of the sobbing teenager kneeling next to the body of a college student shot during a Vietnam War protest at Kent State University.
“We remember pictures of people in pain. They’re real. They’re beautiful. Like fire is beautiful, and see what it did to me.”
“I thought of the photo of Kent State.”
“Kent State?”
“A Vietnam War protest that … before your time. I’m flattered and intrigued. But I can’t. I’m really sort of retired. And this sounds like a substantial time commitment.”
“It would be,” Sicily said. “That’s why, if you’re really sort of retired, you have the time.”
Beth couldn’t help but grin. She had to hand it to this kid.
“I want to do it in a way that means something,” Sicily went on. “This surgery changes my whole future. I might become good-looking or just plain. I might get married someday. Someday I might have children. Or maybe not, because of the drugs. You can freeze your eggs, but that takes time, maybe several cycles of stimulation and harvesting the ova. In my case, there’s not the luxury of time. The donor they’ve found for me … well, it’s a delicate situation. She’s been on life support for a long time. That’s a horrible thing for her—for her guardian, who wanted to choose a certain kind of recipient. So I can’t get pregnant now unless I wait. I have to agree to have a shot at the hospital every month for the first year so I don’t get preg—conceive a child. They won’t trust you even to take your own birth control. Some of the medicines cause defects, and others they’re not sure of. I have to take, like, six of them every day. All my life, I’ll have an increased risk of infection. All my life, I’ll have to think that I could be more likely to get leukemia and wonder if it was worth it. Some people say a face transplant might take five or ten years off your life, because of all that medication.”
“And you’re still willing to do it?” Beth watched as Sicily’s eyes smiled. “It’s a face. Not a heart. You have to have a heart to live. You don’t have to have a face to be alive.”
“Define alive,” Sicily said. “We’re talking now. You’re not scared of me. But you were. You didn’t mean it. No one wants to be heartless.”
Beth stood up, put her hands in the back pockets of her ratty jeans, and peered out her kitchen window. The girl had a point. And yet why would Beth want to do this? She wasn’t especially squeamish, but the whole idea sounded like a long, exacting, drawn-out bad dream—potentially both boring and disturbing. In her life, Beth had had quite enough of upsetting, drawn out, and disturbing.
“Consider this before you decide: You know how it feels to lose the way you thought your life would go. And then have it again. But not the way it was.”
Beth sat back down at the table and placed her hands flat on the surface. “I need to think about it,” she said. “I need time.”
“There is no time,” said Sicily, leaning forward, which had the effect she certainly knew it would, of forcing Beth to sit up straight.
Got me
, Beth thought,
you little brat
.
“The tests are done and the doctors are ready and there’s a donor.…”
“You’re determined,” Beth said. She glanced at Marie Caruso, with a look that would have said,
Hey, call off your dog here
. But Marie had taken a sudden and concentrated interest in the contents of her coffee mug.
“I would want you to take pictures of the donor too,” said Sicily.
“What do you think I am? If they have a donor, she’s dead,” Beth objected. “She’s brain-dead. On life support.”
“She’s in a coma, what’s called PVS, a persistent vegetative state. She does have a breathing tube in her throat rather than a mask on her face because they don’t want to damage her face with pressure and they need a way to get to a donor’s face, for measurements and so forth. She can’t ever wake up because the brain is the one organ that can never be healed. Emma can’t ever be healed. And my face is considered healed. Isn’t that amazing? I haven’t seen Emma, although, well, I’ll see her and meet her mother in two weeks. Two weeks from today exactly, actually. But they say she looks like any other cute teenager, like a sleeping angel. I look like a walking nightmare. But she can’t get better and I can. That’s the mystery. You know? Even if the one to document this isn’t you, it would have had to be someone like you …”
“Isn’t the donor stuff all a secret?”
“Yes, it is,” Sicily said. “You see what I mean, though, don’t you?” Beth’s head thrummed.
“One thing at a time,” Beth said. “There are ethical considerations here.”
“Of course. They really do matter. Other things matter more right now, though.”
Beth felt suspended, as though she floated in some bright liquid among her silvery kitchen appliances, with the huge eyes of these two women turned on her like twin searchlights. Grim images flashed through her mind, none making this project more appealing. Beth glanced down at an imaginary watch and then up at the kitchen clock. Surely they would notice and leave. They noticed and did not leave.
“Listen,” Beth said. “I have to get something to eat. I forgot to eat dinner last night. I have to jump in the shower and change.”
“I’ll go get something. I saw that little place down around the corner,” Marie said, and she briskly took orders, while Beth wondered how somebody could convincingly fake a sudden-onset migraine.
When Marie left, Sicily said, “It’s for her too. It’s for my aunt.”
“Sicily, excuse me, but that should have no part in it.”
It was Sicily’s turn to get up and look out the full-wall windows that ranked across Beth’s kitchen. From the back, the girl was exceptionally lovely—her hips high and level, her posture so erect she was nearly retroflexed.
“It’s not for Marie, of course,” Sicily said. “But she has given me so much. I’d like her to be happy. She’s never said anything about being sad about the way I am. But she loves me. Who wouldn’t be?”
“Are you a dancer?” Beth asked.
“Since I was four,” Sicily said. “I still take class twice a week. Of course, when you’re little, you imagine you’ll be the next Sylvie Guillem. I was way too heavy and tall for that. But I might have taught it. Choreographed. The way I am is too hard on kids.” She said it in a matter-of-fact voice, absent self-pity or melodrama. “I wouldn’t want my own kids—if I maybe adopt kids—to be scared. I wouldn’t want them to be ashamed.”
“They wouldn’t be.”
“They would be. They would have to get in fights over me. I know that, because I’ve had a chip on my shoulder since the fire. It helps, but you would rather not have it.”
Sicily drew a heart on the weeping glass. Pat, Beth reflected, kept the temperature in the house approximately the same as in a retirement facility for the tubercular. Slowly, as though the window were a mirror, Sicily raised her leg until it extended behind her, the toe pointed in an unnatural and beautiful arch, high above her head, as she gathered her arms gently at the level of her breasts. For five, ten, then fifteen seconds, Sicily was a sculpture, the body at its fine and tested best.
That was the first picture Beth took.
CHAPTER SEVEN
D
r. Hollis Grigsby was sure her patients knew that the cheesy farm picture was actually a two-way mirror.
Why were functional things so blessed ugly and obvious? Why couldn’t there be a really lovely screen that would sit lightly in front of a flat-screen TV—instead of some horror that looked like a bad toaster cover in a fishing cabin? Why didn’t someone do something about that? It was so unnecessary, as Hollis’s mother would have said. Ugliness was just not necessary. Had Mother not believed this so thoroughly, designing and making dresses for rich women to give her daughters the perks of education, propelling each girl to be her most extraordinary self through her own example, Hollis Grigsby would be what she had set out to be, a professor of anatomy, instead of the first doctor to perform a full-face transplant. It was not necessary for people, not all people, to endure a deformity.
In keeping with her new resolve to shim exercise into her every idle moment, Hollis crossed one leg behind the other and began to do calf raises.
“Does your leg hurt?” Eliza Cappadora asked. She had just come into the corridor and was removing the long scarf wound around her neck. It was spring, but Chicago didn’t seem to know that.
“I’m building long, lean, sexy calf muscles,” Hollis replied. “I’m actually eavesdropping on this young woman.”
They stood side by side—Hollis, slender and serene in her immaculate white coat, a full eight inches taller than Eliza—and listened to Polly Guthrie conduct her third interview with Sicily Coyne. In Sicily’s case, a decision was more urgent than usual, the reverse of the customary scenario. The face transplant was very important to Mrs. Julia Cassidy, the donor’s mother: A year and a half after the young woman’s MI, her mother was now ready to remove her from respiratory support. In the past, when they had tried to wean Emma from the ventilator, it had resulted in a code. Every manner of imaging, including 3-D ultrasounds, had been brought to bear to detect that stray spark of brain activity beyond the brain stem. In an elaborate journey by ambulance, the girl was ferried to the University of Illinois Chicago Circle for scan after scan.
Sicily’s tissue samples, blood type, and general compatibility with the young donor had long since been determined. They were good—better than good. Because of the Irish part of her heritage, Sicily’s skin density and tone were very satisfactory duplicates of the donor’s, if not the best Hollis had ever seen. A medical anthropologist had done age progressions of Sicily’s eighth-grade portrait and, based on those, had created a spooky life-sized bust. While Sicily mouth-breathed, an anaplastologist made molds of the undamaged musculature of her face, then of her teeth. Cardiologists measured her heartbeat as she ran on a treadmill, and pulmonologists assayed her respiration.
Except for her problems with closing her mouth and the near-constant need for humidity, Sicily radiated health.
But no one wanted a disaster prompted by a hidden mental condition. Not given what Dr. Grigsby had gone through once with that very situation. Was Sicily emotionally out of crisis after the devastation she’d endured in January? Polly Guthrie wanted irrefutable proof.