Harvesting The Heart Part 26

I glance at the Faberge egg on the mantel, the Civil War Sharps carbine rifle hanging over the fireplace. "Necessity makes strange bed-fellows," I say.

I wind the telephone cord around my ankles, trying to find a safe route for conversation. But there is little I have have to say, and so much I to say, and so much I want want to. I take a deep breath. "Speaking of rumors," I say, "I hear Mom called." to. I take a deep breath. "Speaking of rumors," I say, "I hear Mom called."

"Aye."

My mouth drops open. "That's it? 'Aye'? Twenty-one years go by, and that's all you have to say?"

"I was expectin' it," my father says. "I figured if you had the fortune to find her, sooner or later she'd return the favor."

"The favor?" favor?" I shake my head. "I thought you wanted nothing to do with her. I thought you said it was too late." I shake my head. "I thought you wanted nothing to do with her. I thought you said it was too late."

For a moment my father is silent. "Paige," he says finally, "how did you find her to be?"

I close my eyes and sink back on the leather couch. I want to choose my words very carefully. I imagine my mother the way she would have wanted me to: seated on Donegal, galloping him across a field faster than a lie can spread. "She wasn't what I expected," I say proudly.

My father laughs. "May never was."

"She thinks she's going to see you someday," I add.

"Does she now," my father answers, but his thoughts seem very far away. I wonder if he is seeing her the way he did the first time he met her, dressed in her halter top and carrying her practice suitcase. I wonder if he can remember the tremor in his voice when he asked her to marry him, or the flash across her eyes as she said yes, or even the ache in his throat when he knew she was gone from his life.

It may be my imagination, but for the breadth of a moment everything in the room seems to sharpen in focus. The contrasting colors in the Oriental carpet become more striking; the towering windows reflect a devil's glare. It makes me question if, all this time, I haven't really been seeing clearly.

"Dad," I whisper, "I want to go back."

"G.o.d help me, Paige," my father says. "Don't I know it."

Elliot Saget is pleased with my gallery at Ma.s.s General. He is so convinced that it is going to win some kind of humanitarian Best of Boston award that he promises me the stars on a silver platter. "Well, actually," I say, "I'd rather watch Nicholas in surgery."

I have never seen Nicholas truly doing his job. Yes, I have seen him with his patients, drawing them out of their fear and being more understanding with them than he has been with his own family. But I want to see what all the training is for; what his hands are so skilled at. Elliot frowns at me when I ask. "You may not like it very much," he says. "Lots of blood and battle scars."

But I stand my ground. "I'm much tougher than I look," I say.

And so this morning there will be no picture of Nicholas's patient tacked to his door. Instead I sit alone in the gallery above the operating suite and wait for Nicholas to enter the room. There are already seven other people: anesthesiologists, nurses, residents, someone sitting beside a complicated machine with coils and tubes. The patient, lying naked on the table, is painted a strange shade of orange.

Nicholas enters, still stretching the gloves on his hands, and all the heads in the room turn toward him. I stand up. There is an audio monitor in the gallery, so I can hear Nicholas's low voice, rustling behind his paper mask, greeting everyone. He checks beneath the sterile drapes and watches as a tube is set in the patient's throat. He says something to a nearby doctor, youngish-looking, his hair in a neat ponytail. The young doctor nods and begins to make an incision in the patient's leg.

All of the doctors wear weird gla.s.ses on their heads, which they flip down to cover their eyes when they bend over the patient. It makes me smile: I keep expecting this to be some kind of joke costume, with googly eyeb.a.l.l.s popping out on springs. Nicholas stands to the side while two doctors work over the patient's leg. I cannot see very well what they are doing, but they take different instruments from a cloth-covered tray, things that look like nail scissors and eyebrow tweezers.

They pull a long purple spaghetti string from the leg, and when I realize it is a vein, I feel the bile rise in my throat. I have to sit down. The vein is placed in a jar filled with clear fluid, and the doctors working on the leg begin to sew with needles so small they seem invisible. One of them takes two pieces of metal from a machine and touches the leg, and I can swear I smell human flesh burning.

Then Nicholas moves to the center of the patient. He reaches for a knife-no, a scalpel-and traces a thin line down the orange area of the patient's chest. Almost immediately the skin is stained with dark blood. Then he does something I cannot believe: he pulls a saw out of nowhere-an actual saw, like a Black & Decker-and begins to slice through the breastbone. I think I can see chips of bone, although I can't believe Nicholas would let that happen. When I think I am surely going to faint, Nicholas hands the saw to another doctor and spreads the chest open, holding it in place with a metal device.

I don't know what I was expecting-maybe a red valentine heart. But what lies in the center of this cavity once the blood is mopped away looks like a yellow wall. Nicholas picks a pair of scissors off a tray, bends low toward the chest, and fiddles around with his hands. He takes two tubes that come from that complicated machine and attaches them to places I cannot quite see. Then he picks up a different pair of scissors and looks at the yellow wall. He begins to snip at it. He peels back the layer to reveal a writhing muscle, sort of pink and sort of gray, which I know is the heart. It twitches with every beat, and when it contracts it gets so small that it seems to be temporarily lost. Nicholas says, "Let's put him on bypa.s.s," to the man who is sitting at the machine, and in a quiet whir, red blood begins to run through the tubes. Below his mask, I think I see Nicholas smile.

He asks a nurse for cardioplegia, and she hands him a beaker filled with a clear solution. He pours it over the heart, and just like that, it stands still. Dear Jesus, Dear Jesus, I find myself thinking, I find myself thinking, he's killed the man. he's killed the man. But Nicholas doesn't even stop for a moment. He picks up another pair of scissors and moves close to the patient again. But Nicholas doesn't even stop for a moment. He picks up another pair of scissors and moves close to the patient again.

All of a sudden a spurt of blood covers Nicholas's cheek and the front of another doctor's gown. Nicholas's hands move faster than I can follow as he reaches into the open chest to stop the flow. I step back, breathing hard. I wonder how Nicholas can do this every single day.

The second doctor reaches into the jar I've forgotten about and takes out the vein from the leg. And then Nicholas, sweat breaking out on his brow, pulls a tiny needle repeatedly through the heart and through that vein, using tweezers to place the point and to retrieve it. The other surgeon steps back, and Nicholas taps the jellied heart with a metal instrument. Just like that, it starts to beat. It stops, and Nicholas asks for an internal defibrill-something. He touches it to the heart and shocks it into moving again. The second doctor takes the tubes from the top and bottom of the heart, and the blood stops coursing through the machine. Instead, the heart, still on display, begins to do what it was doing before-squeezing and expanding in a simple rhythm.

Nicholas lets the second surgeon do most of the work from that point-more sutures, including wire for the ribs and thick st.i.tches through the orange skin that make me think of a Frankenstein monster. I press my hands against the sloped gla.s.s wall of the gallery. My face is so close that my breath clouds the window. Nicholas looks up and sees me. I smile hesitantly, wondering at the power he must feel to spend every morning giving life.

chapter 39

Nicholas.

Nicholas remembers having heard once that the person who has started a relationship finds it easier to end it. Obviously, he thinks, that person did not know Paige.

He can't get rid of her. He has to give her credit-he never thought she'd take it this far. But it is distracting. Everywhere he turns, there she is. Arranging flowers for his patients, wheeling them out of surgical ICU, eating lunch across the cafeteria. It has reached the point where he actually misses her when she isn't around.

The drawings have got out of control. At first he ignored them, tacked crudely to his office door like kindergarten paintings on a refrigerator. But as people started to notice Paige's talent, he couldn't help but look at them. He brings the ones she does of his patients to their rooms, since it seems to brighten them up a little-some of his incoming patients have even heard of the portraits and ask for them at the pre-op exam. He pretends to throw out the ones she does of him, but in fact he has been saving them in the locked bottom drawer of the desk. When he has a minute, he pulls them out and looks at them. Because he knows Paige, he knows what to look for. And sure enough, in every single picture of him-even the ridiculous one of him singing in a bowling shirt-there is something else. Someone, actually. In the background of each drawing is a slight, barely noticeable portrait of Paige herself. Nicholas finds the same face over and over, and every time she is crying.

And now her pictures are all over the entrance hall of Ma.s.s General. The whole staff treats her like some kind of Pica.s.so. Fans flock to his office door to see the latest ones, and he actually has to push through them to get into the room. The chief of staff-the G.o.dd.a.m.ned chief of staff!-ran into Nicholas in the hall and complimented him on Paige's talent.

Nicholas does not know how she has managed to win so many people to her side in a matter of days. Now, that's that's Paige's real talent-diplomacy. Every time he turns around, someone is mentioning her name or, worse, she is standing there herself. It reminds him of the ad agencies' "block" strategy, where they run the same exact commercial at the same exact time on all three network stations, so that even if you flip channels you see their product. He can't get her out of his mind. Paige's real talent-diplomacy. Every time he turns around, someone is mentioning her name or, worse, she is standing there herself. It reminds him of the ad agencies' "block" strategy, where they run the same exact commercial at the same exact time on all three network stations, so that even if you flip channels you see their product. He can't get her out of his mind.

Nicholas likes to look at the portraits in his drawer just before he goes down to surgery-which, thank G.o.d, is the only place Paige hasn't been allowed into yet. The pictures clear his head, and he likes to have that kind of directed focus before doing an operation. He pulls out the latest drawing: his hands poised in midair as if they are going to cast a spell. Every line is deeply etched; his fingernails are blunt and larger than life. In the shadow of the thumb is Paige's face. The drawing reminds him of the photo his mother developed years before to save her marriage, the one of her own hands folded beneath his father's. Paige couldn't have known, and it strikes Nicholas as uncanny.

He leaves the portrait on the desk, on top of the scrawled sheets of a.s.sets he is supposed to be preparing for Oakie Peterborough. He has added nothing since the day he met the lawyer for lunch, a week ago. He keeps thinking that he must call to set up a consultation, but he forgets to mention it to his secretary and he is too busy to do it himself.

The operation this morning is a routine bypa.s.s, which Nicholas thinks he could do with his eyes closed. He walks briskly to the locker room, although he is not in a hurry; he changes into the soft laundered blue scrubs. He pulls on paper booties and a paper cap and winds a mask around his neck. Then he takes a deep breath and goes to scrub, thinking about the business of fixing hearts.

It's strange being the chief of cardiac surgery. When he enters the operating suite the patient is already prepped and the easy conversation between the residents and the nurses and the anesthesiologist comes to a dead halt. "Good morning, Dr. Prescott," someone says finally, and Nicholas can't even tell who it is because of the stupid masks. He wishes he knew what to do to put them all at ease, but he hasn't had enough experience at it. As a surgical fellow, he spent so much time clawing his way to the top, he never bothered to consider whom he was crawling over to get there. Patients are one thing: Nicholas believes that if someone is going to trust you with his life and sh.e.l.l out $31,000 for five hours' work, he or she deserves to be listened to and laughed with. He has even sat on the edges of beds and held his patients' hands while they prayed. But doctors are a different breed. They are so busy looking behind them for an encroaching Brutus that everyone becomes a potential threat. Especially a superior like Nicholas: with one written criticism, he has the power to end a career. Nicholas wishes he could look over the blue edge of a mask just once and see a pair of smiling eyes. He wishes Marie, the stout, serious OR nurse, would put a whoopee cushion under the patient, or set rubber vomit on the instrument tray, or play some other practical joke. He wonders what would happen if he walked in and said, "Have you heard the one about the rabbi, the priest, and the call girl?"

Nicholas speaks softly as the patient is intubated, and then he directs a resident, a man his own age, to harvest the leg vein. His hands move by themselves, making the incision and opening the ribs, dissecting out the aorta and the vena cava for the bypa.s.s machine, sewing up and cauterizing blood vessels that are accidentally cut.

When the heart has been stopped-an action that never loses its effect for Nicholas, who holds his breath as if his own body has been affected-Nicholas peers through magnifying spectacles and begins to cut away the diseased coronary arteries. He sews on the leg vein, turned backward, to bypa.s.s the obstructions. At one point, when a blood vessel begins spurting blood all over Nicholas and his first a.s.sistant, Nicholas curses. The anesthesiologist looks up, because he's never seen Dr. Prescott-the famous Dr. Prescott-lose his cool. But even as he does so, Nicholas's hands are flying quickly, clamping the vessel as the other doctor sews it up.

When it is all over and Nicholas steps back to let his a.s.sistant close, he does not feel as if five hours have pa.s.sed. He never does. He is not a religious man, but he leans against the tiled wall and beneath his blue mask he whispers a prayer of thanks to G.o.d. In spite of the fact that he knows he is skilled, that his expertise comes from years of training and practice, Nicholas cannot help but believe a little bit of luck has been thrown in, that someone is looking out for him.

That's when he sees the angel. In the observation gallery is the figure of a woman, her hands pressed to the window, her cheek flush against the gla.s.s. She is wearing something loose that falls to her calves and that glows in the reflected fluorescent light of the operating suite. Nicholas cannot help himself; he takes a step forward and lifts his hand a fraction of an inch as if he might touch her. He cannot see her eyes, but somehow he knows this is only an apparition. The angel glides away and disappears into the dark background of the gallery. Nicholas knows that even if he has never seen her before, she has always been with him, watching over his surgeries. He wishes, harder than he has ever wished for anything in his life, that he could see her face.

After such a spiritual morning, it is a letdown for Nicholas to find Paige in all his patients' rooms when he is doing afternoon rounds. Today she has pulled her hair away from her face in a braid that hangs down to her shoulder blades and moves like a thick switch when she leans over to refill a water pitcher or to plump pillows. She's not wearing makeup, she rarely does, and she looks about as old as a candy striper.

Nicholas flips over the metal cover of Mrs. McCrory's chart. The patient is a woman in her late fifties who had a valve replacement done three days ago and is almost ready to go home. He skims a finger across the vitals recorded by one of the interns. "I think we're getting ready to kick you out of here," he says, grinning down at her.

Mrs. McCrory beams and grabs Paige's hand, which is the nearest one. Paige, startled, gasps and almost overturns a vase of peonies. "Take it easy," Nicholas says dryly. "I don't have room in my agenda for an unscheduled heart attack."

At this unexpected attention, Paige turns. Mrs. McCrory eyes her critically. "He doesn't bite, dear," she says.

"I know," Paige murmurs. "He's my husband."

Mrs. McCrory claps her hands together, thrilled by this news. Nicholas mutters something unintelligible, amazed at how easily Paige can ruin his good mood. "Don't you have somewhere else to be?" he says.

"No," Paige says. "I'm supposed to go wherever you go. It's my job."

Nicholas tosses the chart down on Mrs. McCrory's bed. "That is not not a volunteer's a.s.signment. I've been here long enough to know the standard rounds, Paige. Ambulatory, patient transport, admitting. Volunteers are never a.s.signed to doctors." a volunteer's a.s.signment. I've been here long enough to know the standard rounds, Paige. Ambulatory, patient transport, admitting. Volunteers are never a.s.signed to doctors."

Paige shrugs, but it looks more like a shiver. "They made an exception."

For the first time in minutes, Nicholas remembers Mrs. McCrory. "Excuse us," he says, grabbing Paige's upper arm and dragging her out of the room.

"Oh, stay!" Mrs. McCrory exclaims after them. "You're better than Burns and Allen."

Reaching the hallway, Nicholas leans against the wall and releases Paige. He wanted to yell and to complain, but suddenly he can't remember what he was going to say. He wonders if the whole hospital is laughing at him. "Thank G.o.d they don't let you in surgery," he says.

"They did. I watched you today." Paige touches his sleeve gently. "Dr. Saget arranged it for me, and I was in the observation room. Oh, Nicholas, it's incredible to be able to do that."

Nicholas does not know what makes him more angry: the fact that Saget let Paige watch him doing surgery without his consent, or the fact that his imagined angel was really just his wife. "It's my job," he snaps. "I do it every day." He looks at Paige, and that expression is back in her eyes-the one that probably made him fall in love with her. Like his patients, Paige is seeing him as someone who is flawless. But he has a sense that unlike them, she would have been just as impressed if she'd watched him mopping the hospital's halls.

The thought chafes around his neck. Nicholas pulls at his collar and thinks about going right back to his office and calling Oakie Peterborough and getting this over. "Well," Paige says softly, "I wish I I were that good at fixing things." were that good at fixing things."

Nicholas turns and walks down the hall to see another patient, a transplant recipient from last week. When he is half inside the room, he glances around, to find Paige at the door. "I'll "I'll change the d.a.m.n water," he says. "Just get out of here." change the d.a.m.n water," he says. "Just get out of here."

Her hands are braced on either side of the doorway, and her hair is working its way out of her braid. Her volunteer uniform, two sizes too big, billows around her waist, falls to her shins. "I wanted to tell you," she says, "I think Max is getting sick."

Nicholas laughs, but it comes out as a snort. "Of course," he says, "you're an expert."

Paige lowers her voice and peeks into the hallway to make sure no one is around. "He's constipated," she says, "and he spit up twice today."

Nicholas smirks. "Did you give him creamed spinach?" Paige nods. "He's allergic."

"But there aren't any welts," Paige says, "and anyway it's more than that. He's been crabby, and, well, Nicholas, he just isn't himself."

Nicholas shakes his head at her and takes a step into the patient's room. As much as he doesn't want to admit it, when he sees Paige standing in the doorway, arms outstretched as if she is being crucified, she looks very much like an angel. "He's not himself," Nicholas repeats. "How the h.e.l.l would you know?"

chapter 40

Paige.

When Astrid hands Max over to Nicholas that night, something still is wrong. He has been crying on and off all day. "I wouldn't worry," Astrid says to me. "He's been a colicky baby." But it is not his crying that bothers me. It's the way the fight has gone out of his eyes.

I stand on the staircase while Nicholas takes Max. He hoists the diaper bag and some favorite toys over his free arm. He ignores me until he reaches the door, about to leave. "You might want to get a good lawyer," he says. "I'm meeting with mine tomorrow."

My knees give out under me, and I stumble against the banister. I feel as if I have been swiftly punched. It isn't his words that hurt so much; it is knowing that I have been too late. I can run in circles until I drop, but I cannot change the course of my life.

Astrid calls out to me as I pull myself up the stairs to my room, but I do not listen. I think about phoning my father, but he'll only lecture me on G.o.d's will, and that won't give me any comfort. What if I don't happen to like G.o.d's will? What if I want to keep the end from coming?

I do what I always do when I am in pain; I draw. I pick up my sketch pad and I draw image after image on the same page until it is nothing more than a dismal black knot. I flip the page and do this all over again, and I keep on doing this until little by little some of the rage leaves my body, seeping through my fingertips onto the page. When I no longer feel I am being eaten alive from the inside, I put down my charcoal and I decide to start over.

This time I draw in pastels. I rarely use them because I'm a lefty and they get all over the side of my hand and make me look strangely bruised. But right now I want color, and that is the only way I can think of getting it. I find that I am drawing Cuchulainn's mother, Dechtire, which seems natural after thinking of my father and the whims of the G.o.ds. Her long sapphire robes mist around her sandaled feet, and her hair flies behind her in a sleek arc. I draw her suspended in midair, somewhere between heaven and earth. One arm reaches down to a man silhouetted against the ground, one arm reaches up toward Lugh, the powerful G.o.d who carries the sun.

I make her fingers brush those of her husband below, and as I do it I get a physical jolt. Then I lengthen her other arm, seeing her torso twist and stretch on the page as she reaches into the sky. It takes all the effort in my fingers to make Dechtire's hand touch the sun G.o.d's, and when it does I begin to draw furiously, obliterating Dechtire's porcelain face and the solid body of her husband and the bronze arm of Lugh. I draw flames that cover all the characters, erupting in fiery sparks and bursting across the sky and the earth. I draw a blaze that feeds on itself, that shimmers and flares and sucks away all the air. Even as I cannot breathe anymore, I see that my picture has turned into a holocaust, an inferno. I throw the scorching pastels across the room, red and yellow and orange and sienna. I stare sadly at the ruined image of Dechtire, amazed that I have never before seen the obvious: when you play with fire, you are likely to get burned.

I fall asleep fitfully that night, and when I wake, sleet is rattling against the window. I sit up in bed and try to remember what has awakened me, and I get a sinking feeling in the pit of my stomach. I know what is coming. It is like that feeling I used to have about Jake, when we were so closely connected that I could sense when he stepped into his home at night, when he thought of my name, when he needed to see me.

I jump out of bed and pull on the pants and shirt I wore yesterday. I don't even think to find socks, tying up my sneakers over bare feet. I gather my hair into a tangled ponytail and secure it with the rubber band from a bag of gummy fish. Then I pull my jacket off the doork.n.o.b and run downstairs.

When I open the door, Nicholas stands before me, a.s.saulted by the ice and the rain. Just beyond him, in the yellow interior light of his car, I can see Max, oddly silent, his mouth in a raw red circle of pain. Nicholas is already closing the door behind me and pulling me into the storm. "He's sick," Nicholas says. "Let's go."

chapter 41

Nicholas.

He watches the hands of people he does not know poke and prod at his son's body. John Dorset, the resident pediatrician on call last night, stands over Max now. Every time his fingers brush Max's abdomen, the baby shrieks in pain and curls into a ball. It reminds Nicholas of the sea anemones he played with on Caribbean beaches as a child, the ones that folded around his finger at the slightest touch.

Max hadn't gone to sleep easily last night, although that wasn't cause in itself for alarm. It was the way he kept waking up every half hour, screaming as if he were being tortured, fat clear tears rolling down his face. Nothing helped. But then Nicholas had gone to change the diaper, and he'd almost pa.s.sed out at the sight of so much jellied blood.

Paige trembles beside him. She grabbed his hand the minute Max was brought into the emergency room, and she hasn't let go since. Nicholas can feel the pressure of her nails cutting into his skin, and he is grateful. He needs the pain to remind him that this isn't a nightmare after all.

Max's regular pediatrician, Jack Rourke, gives Nicholas a warm smile and steps into the examination room. Nicholas watches the heads of the two doctors pressed together in consultation over the kicking feet of his son. He clenches his fists, powerless. He wants to be in there. He should be in there.

Finally, Jack steps out into the pediatric waiting room. It is now morning, and the staff nurses are starting to arrive, pulling out a box of Big Bird Band-Aids and sunny smiley-face stickers for the day's patients. Nicholas knew Jack when they were at Harvard Med together, but he hasn't really kept in touch, and suddenly he is furious at himself. He should have been having lunch with him at least once a week; he should have talked to him about Max's health before anything like this ever happened; he should have caught it on his own.

He should have caught it. That is what bothers Nicholas more than anything else-how can he call himself a physician and not notice something as obvious as an abdominal ma.s.s? How can he have missed the symptoms? That is what bothers Nicholas more than anything else-how can he call himself a physician and not notice something as obvious as an abdominal ma.s.s? How can he have missed the symptoms?

"Nicholas," Jack says, watching his colleague pick up Max and sit him upright. "I have a good idea of what it might be."

Paige leans forward and catches at the sleeve of Jack's white coat. Her touch is light and insubstantial, like a sprite's. "Is Max all right?" she asks, and then she swallows back her tears. "Is he going to be all right?"

Jack ignores her questions, which infuriates Nicholas. Paige is the baby's mother, for Christ's sake, and she's worried as h.e.l.l, and that isn't the way to treat her. He is about to open up his mouth, when John Dorset carries Max past them. Max, seeing Paige, reaches out his arms and starts to cry.

A sound comes out of Paige's throat, a cross between a keen and a wail, but she doesn't take the baby. "We're going to do a sono gram," Jack says to Nicholas, Nicholas only. "And if I can verify the ma.s.s-I think it's sausage-shaped, right at the small bowel-we'll do a barium enema. That might reduce the intussusception, but it depends on the severity of the lesion."

Paige tears her gaze away from the doorway where Max and the doctor have disappeared. She grabs Jack Rourke's lapels. "Tell me," me," she shouts. "Tell me in normal words." she shouts. "Tell me in normal words."

Nicholas puts his arm around Paige's shoulders and lets her bury her face against his chest. He whispers to her and tells her what she wants to know. "It's his small intestine, they think," Nicholas says. "It kind of telescopes into itself. If they don't take care of it, it ruptures."

"And Max dies," Paige whispers.