The room began to revolve slowly; it was almost comical, reminding me of the teacup ride at Disneyland, the room’s occupants at first curious, white, extravagantly dark-eyed, ovoid, their half-raised champagne flutes blinking gold and blue like stained glass, Beth, tears streaming sooty trails through her makeup, picking her camera up from a side table and beginning to shoot, then the people’s jaws thickening, stretching, spreading, connecting like a border of faces—AngeloPatRosieBenChiefBlissElizaBenAngelo …
“Are you dizzy?” the paramedic asked, and before I could answer, she said, “We need to go.”
“I’m ready,” Aunt Marie said.
“She wants me,” Vincent put in. “She’s not a child.”
“Nonsense,” said Eliza. “Ben, I will go with her in the ambulance. You two can stay here and fight like fools.”
My aunt grabbed a swag of garland draped over the long curved banister and jerked it, setting the lights bouncing. “He’s here by … accident!”
“Accident, accident! Life is all an accident,” Eliza said loudly. “My mother is my mother because the little girl she saw in the picture died of influenza, and when she came to bring home her child, they give her Maria Agata and say it is Maria. We are all Maria. Vincent has a right here too. Now we’ll go, Sicily. You come when you aren’t drunk.”
And there we went, past the neighbors, who were all outside, red-faced with drink and shivering in their finery. The carolers stood next to them, the teenager holding the carriage lamp overhead to light the progress of the cot down the walk and out into the street.
Ambulances speed along with such authority and dispatch that you’d think it would be comfortable in one, but it isn’t. It’s like being a package in the back of an ice-cream truck. The drivers are hot dogs, and if there weren’t rails on the beds, you’d be on the floor. As we shrieked along, through the quiet neighborhoods and onto the expressway, I felt as though I had the vantage of St. Nicholas, high above clusters of identical houses, all four walls frosted in racing lights and rugged blinking lights and ethereal LED lights, ice-blue and green and silver lights in the shape of icicles and oversize tree ornaments and chili peppers, and it was impossible for me to put away from my mind the story Renee Mayerling told me all those months ago, about the silent ride through the dark afternoon bravely illumined by outdoor mangers and gables festooned with candy canes—from Engine Company 3 to the chapel at Holy Angels.
When we arrived, the doors were open in the bay and the doctors and nurses surged out. I knew from years of hospital habitation that they’d had time to do what they called their preps, from throwing down a sour cup of coffee to washing their faces to a stolen thirty seconds of yoga breathing. And then they were all around me and I was, for better or worse, home again.
Dr. Park and the senior resident, whose name I could never remember, did not ask me to pause at the desk to register. Up to the ninth floor we went, where my new obstetrician, Dr. Helen Setnes—who’d replaced Dr. Gloomy Glass—came hurrying down the hall, pulling on her lab coat over a red velvet Christmas dress. At the huge triangular central station, nurses were gathered, singing … what child is this? Around the corner of the desk came Dr. Livingston, as the medics lifted me onto the bed. In the hall. “What is this with our Sicily?” he said, and I felt my blood pressure swoop right, left, and settle to center.
“I’m sick,” I said. “I don’t know what’s wrong with me.”
“The vascularity and the beginnings of a pattern of tracery beneath the skin of her upper left cheek …” Eliza said.
“That’s just right,” Dr. Livingston said. “Spot-on. You’ve never seen an episode of rejection.” Eliza got an A-plus. What did I get?
“Will my face slough off tonight?” I asked. “Will it start with layers? Bits? Like sunburn?”
“Sicily, no, of course not. Now, you know that we can bring this under control.” I was in a room by then, the transplant nurses helping me out of my black silk and into sprigged blue cotton and the pair of bottoms to a set of surgical scrubs I’d asked for. “Everything will be fine.”
“Hey, Sicily,” said Dr. Setnes. “I didn’t expect to see you until next month.” A sonogram tech was wheeling in a portable machine. “Let’s have a look and see what’s going on in there before I give you over to the supersleuths here.” The tech, a sweet-faced blond young woman wearing an elf hat, rolled down the band of the scrubs and gelled my belly. And I didn’t notice that my aunt and Vincent were at the foot of the bed until the little alien appeared on the screen, displaying the palm of one perfectly formed miniature hand. My aunt gasped and Vincent swore softly, but when I looked up at him, his face was thrilled and agonized, his eyes squeezed nearly shut, his lips compressed.
“I didn’t expect it to look so real now,” Vincent said. “Yet, I mean.”
“Well, this is a very early pregnancy,” said Dr. Setnes. “These are features that—”
“It’s my baby,” said Vincent. “That is my baby.” Vincent reached down and touched all there was of me within his field, one of my stockinged feet.
As I stared at the slip of printout that Dr. Setnes had first handed me, Dr. Ahrens explained that what was happening to me was understandable, an undesirable blip, but not necessarily a failure of the new protocol. “We might expect a period of adjustment as the body … well …”
“Is she going to be okay?” Vincent asked.
“The baby?” said Dr. Setnes.
“Sicily,” he said. “Is Sicily going to be okay?”
Dr. Setnes shrugged. “I wish I knew, let’s hope.” To me, she said, “What we have to decide now, Sicily, are two huge things. And deciding right now is critical. One, there is still plenty of time to reconsider your decision to terminate the pregnancy in light of this event. The other issue is the alternative protocol. Do you want to continue? The human-subject group for this protocol, with a face transplant, is one.”
Dr. Ahrens said, “Human hands aren’t human faces, although there are striking similarities. And the face-transplant animal studies are extraordinarily promising, but they are animal studies. Essentially, if we go ahead, you know that this would be a drug trial with a single subject, for which the hospital ethics committee has given its approval, considering the nature of the circumstances. But you didn’t start this drug protocol right away. We don’t know what the earlier protocol did to this fetus, and we don’t know what this one will do.”
“You don’t know if it will work.”
“I think it will work. But, no, I can’t be sure,” said Dr. Ahrens.
“And if I have the pregnancy terminated?” I looked up at Dr. Ahrens instead of at the shape of the tiny hand.
“Well, we’ll put you back on standard levels of the commonplace immunosuppressive drugs we’ve always used for the first year after transplant, and you’ll be out of here in a couple of days.”
“That would straighten you out immediately,” Dr. Setnes said.
I breathed in and held it. Could I let this baby soul go, this inconvenient child, and lasso it again someday later, in a child I adopted, in a child another woman gave birth to using some likely donor’s sperm mixed with my egg? This baby now seemed to slip away from me. This had all seemed possible for me to do—sustaining the pregnancy, being a single mother—but now I saw the full gruesomeness of a face that would not even be patched on carefully, as my previous topographical mash had been over months and years, but slapped on to keep life in and infection out. There would be hanks of cultivated skin and strips torn in haste off my back and my buttocks, which would leave not the tiny snail-trail scars that lurked under this discreet fold and that but raw, red, raised, welted ridges. My beautiful body. My one vanity, transformed by urgency into a hell of stinging striped scrawls, a bombed field seen from the air—and for all of this nothing saved but my life, a changed and solitary life, my apartment a place to crawl back into. I wouldn’t come out again. I wouldn’t. Swathed and long-sleeved, I would receive my newspapers and work correspondence from Angel, my takeout from a series of acne-stippled boys. Or perhaps I would no longer work. There would be no more brave interviews with new clients. No one would want to hire the grotesquerie I would be—the girl who lost her face, twice. I might subsist on disability. My apartment was paid for and was my own.
And my child would live with me, in that dimly lit world. If he turned out to be a mutant like me, we might be boon companions. If he was a normal child, I wouldn’t be able to go to baseball games, kindergarten graduation, parent–teacher conferences, to the zoo, and … to ride on the teacups at Disneyland. He would love me, as the grandchild of the woman I’d drawn in my art class loved her. And as soon as he could, he would flee, to college, to the world, where torment meant losing a job or a girl. There would be no pictures of me in his dorm room, no pictures of me holding him triumphantly in the birthing room, at the baptismal font, helping him put together his wooden train under the Cappadoras’ lavish Christmas tree.
I might live for thirty years, for fifty years, for sixty years, long after Aunt Marie was dead and my grandparents were dead.
Long after Vincent was married and a father.
That was if I lived at all.
The baby and I might die together—him with quick and blessed unawareness. I would go slowly and in pain, as the hospital staff pulled out all the stops to save me.… To save me for what?
Or maybe, if everyone on this crack team I’d so abused acted quickly, my face would be just fine and, after counseling—lots of it—I would no longer feel as though my heart was a gourd filled with sand.
Beth would not photograph this, my loss of face. The project was over. What combination of ego and altruism, stubbornness and arrogance, had moved me? Why the exhibit? Why, oh, my God, why the pregnancy? What a fool I was—a hateful, irresponsible, self-centered, grasping, greedy, impractical, dreamy-eyed fool.
Why had I ever met Beth? Or, worse, Vincent?
“I need to see my aunt and Vincent alone for a moment,” I said to Dr. Ahrens. “I’ll have the pregnancy terminated as soon as it’s possible. You do believe you can save me? Right?”
“I really do believe we caught this very early, Sicily, and that you will be fine.”
“How soon can I have the termination? Do I need to be conscious for it?”
“Not tomorrow,” she said. “That would just be too sad. The next day. And, no, you can be thoroughly sedated.”
“Will it hurt the … fetus?”
“Sicily, there’s a huge amount of controversy about things like that. Nothing will hurt for very long.”
“If it can be tomorrow, then I want tomorrow,” I told her.
My aunt rushed to the side of the bed, reaching down and holding me to her with a fragile strength. “Tell Beth not to open our gifts,” I said to Aunt Marie. “It’s important.”
“I gave her a first edition of an Alfred Stieglitz book from both of us,” Marie said. “Why?”
“Mine is like this,” I said, thrusting the ultrasound picture at my aunt. “From last week. I put it in a little silver frame.”
“There’s nothing wrong with that,” Marie said.
Over my aunt’s head, I studied Vincent, his pelt of thick light hair disarranged, his perfect California-guy shawl of cotton sweater hanging askew. Our baby would have gray eyes, like Vincent’s and mine, eyes as gray as the clouds reflected in a pond.
Or in a ditch.
“Did you want this?” I asked him. “Is any part of you in pain over ending it?”
“Sicily, I promised in the emails I sent to you. I would have wanted to help you support a child of mine and even know it.”
“You want to know it.”
“I mean that I want to be a father in any way I can.”
“In any way you can without being a father, really,” I said, and inhaled deeply.
“Sicily, wait. Tonight when I saw you …” He looked at Marie. “This really is private.” My aunt whirled and left the room. “I wrote to you that I wanted to try to help and support you in having this child, my child. Our child. But tonight I saw you. And when I touched you, it was different.”
“What happened? You got aroused? I did too.”
“I thought what I thought the last time. What I never got to say. Maybe we can get to know each other. Over these few months. I have a bunch of work to do with the movie coming out. But I can make time. I’ll visit. We’ll talk about what we do and what’s important.”
“What’s important this minute?”
“This emergency.”
“And you? And the baby? And me?”
“I want to be a part of this.”
“Vincent, this is a terrible question to ask anyone but one you have to consider right now. If I were to have this baby and lose the face I have, if I had to have a face that was mainly scar tissue, like my face before, would you still want to get to know me? Would you still want to know the baby?”
“I can’t think of that. I can’t. No one could.”
“If I died, would you want to raise our child?”
He stood still for a long while, head down, gripping his elbows with his arms folded across his chest.
“No,” he said. “I would want Ben and Eliza to raise the baby.” Vincent took a deep breath and shook his head. “It’s not worth the risk to you. I know you. I don’t know some unknown, unformed child.”
“It’s too great a risk to me, Vincent. I have to have an abortion.”
His eyes widened. “I’m so sorry. It’s so horrible. We’ve seen him, and he’s alive and real. You’re doing this and we just saw our child, alive and real, with hands and a little face.”
“But I’m alive and real,” I said. “And I have a face. And I need this face to face the world. I do want children someday, some way, and someone to love me, Vincent. And if I kept this baby but I lost my face, you wouldn’t be able to stomach me. I don’t blame you for that.”
Vincent pulled his beat-up leather jacket off the hook and stuck his arms into it. “You don’t know that for sure. I don’t know that for sure.” For a moment, Vincent pulled up a metal chair and sat down beside me. He took my hand, careful not to dislodge my IV. Then he said, “I do know it would scare the hell out of me, and I couldn’t be sure if what I was feeling was love or pity. And you know what, Sicily? It would scare you too. I know you had a face before that was hard to look at. But you were used to it. Now you’re not used to it. You’re used to being pretty. You don’t even know who you’d be after something like that. Or how you’d act. If I could be sure you’d be that girl I met that day at the airport … but you can’t be sure. And I can’t make that decision with a gun to my head. If I was wrong, that would be the worst thing of all.” He called to my aunt. “Do you need a ride, Marie?”