‘They’ll look after him Alix,’ Helen replied.
‘Not the way I want them to. Even when Dan was using tools for etching or carving, his hands seemed to be whispering to the plaster, coaxing lines to appear on the surface. Lines that opened beneath the soft voice of his fingers.’ Alix laughed. ‘Listen to me. I sound like an exhibition catalogue.’
Helen shook her head. ‘You sound like someone who’ll miss her husband.’
‘I used to hate the sound of his rasp. Until he told me it was like the tongue of a cat, skimming off the slightest imperfections. When he finished with the rasp, he’d have revealed something new, something that I could never have imagined lay beneath. It was like resuscitation, giving life to what had been just a paste of powder and water.’
Helen did not reply because what could she say to that? So Alix kept talking, saying things that were in her mind, things that she would never have believed, just yesterday, could be in her mind. ‘How many times can a person die?’
‘What do you mean?’ asked Helen, confused at the turn the conversation had taken.
‘Just that Dan will die twice if I give his heart away. Because he is dead now, apparently, but he will die again when they remove his heart on the operating table.’
‘Alix.’ Helen hugged her then because they were friends as well as colleagues and Alix was asking questions that no one, not a friend, not a colleague, not even a priest, could answer.
That was when Alix remembered something she had learned and forgotten, that the Japanese resist the idea of organ transplantation because they understand that to remove a part of the body leaves a person’s spirit trapped between life and death. That is where Dan is now, Alix thought, and she didn’t know which was the better choice to make: to consign him to an absolute death or to have him always in this liminal space where she could not quite let go, nor could she quite hold on.
After Helen left, Alix picked up the consent forms. If she signed them, said yes, then the anaesthetist would administer a muscle relaxant and then a cut would be made along the midline of his abdomen. Alix ran her finger down the line the surgeons would make and rested her hand on his stomach as she imagined his abdomen excavated, then his sternum opened, the heart and lungs paralysed, the blood from his heart clamped and stopped, the ventilator shut down, the heart and lungs removed, his now-cold heart afloat in a bag, prostheses inserted to replace his missing eyeballs and then his body stitched, and washed and dressed. Evisceration as opposed to resuscitation.
She woke later from another sleep in the chair by the bed needing to find something that she read in a book Dan gave to her. The book was by Rilke, about Rodin’s plaster sculptures, and Dan gave it to her when he was trying to explain why he used plaster as a medium, rather than a passing phase between clay and bronze.
She knew the drive home would take only five minutes so she got in the car and sped, going too fast down suburban streets, running lights that were no longer orange but a distinctly bloodish shade of red.
In Dan’s studio it didn’t take her long to find the book. It took her longer to find the quote, so she sat in Dan’s chair behind his desk and scanned through pages until there it was. ‘A hand laid on the shoulder or limb of another body is no longer part of the body to which it properly belongs: something new has been formed from it and the object it touches or holds, something ... which is nameless and belongs to no one.’
What good did that do, she thought. If I give Dan’s heart away, does he then become nameless, does he then belong to no one?
She put the book down, closed her eyes and tried to see him. To defy Rilke by owning Dan with her mind’s eye. She began with his face. Dan’s face. No one else’s. An arrangement of bones, nose, teeth and muscle that made him recognisable as him, that made him the person he was.
As she thought this, she understood for the first time the impulse for art. That it was her turn to sculpt. He was the subject now. Not her.
She’d watched Dan cast enough plaster to know that speed was required: not the desperate rush of surgery to fix a massive embolism but the calibrated haste of a transplant. She told the nurses that she did not want to be disturbed and knew they would obey her because she was a doctor. Then she closed the door to his room and stood beside his bed, seeing, for instance, the true colour of his eyelashes; they were blonde at the roots and dark honey at the tips. A detail the wax would not capture. A detail only her mind could preserve and she had almost missed it even though she’d seen those eyelashes almost every day for two years.
She spread a sheet over the floor, took a bucket and poured in some water, filtering plaster dust through her fingers until it floated in small mounds on the surface. Then she placed her hands in the bucket and stirred. She tore up another sheet into strips, dipped the strips into the plaster and wound them over his face. She scooped up fistfuls of plaster and smoothed it over the fabric, making sure the eyelashes were coated, the lines on his face filled in and the nostrils opened. His lips were stretched and bruised by the ventilator, a detail she did not want to keep so she reshaped the plaster to copy his mouth the way she remembered it.
She sat and waited while the mask set, watching it cool and harden, watching it trap his face in a way that memory could not, watching it claw back what little she could keep of him. Then she cut grooves into the plaster, moistened it a little and carved out the curls of his hair, the fineness of his eyebrows and the shape of his pupils as they would be if his eyes were open. It was time to sit and wait again, to watch the plaster solidify and the drops of water weep over this new layer of skin as the air drew the tears he could not shed from the plaster shell.
Alix did one more thing, in a toilet cubicle near ICU, before he was taken away. She used the pregnancy test kit that had sat unopened in her bag since the day of Dan’s accident. Then she went to his bedside to tell him.
‘We did it this time,’ she said. She took his hand and placed it on her stomach wondering which force was the strongest: the instinct of the baby to live and grow or the instinct of her husband to die and disappear. She felt a pressure, like magnetic opposites repelling, and concluded that both forces were even.
CAMILLE
EIGHT
I am looking after a DCD case, a donation after cardiac death. The patient has suffered an unsurvivable brain injury but she isn’t brain-dead. The intensivist has made the decision that if we withdraw cardio-respiratory support, her heart will stop within a short time. The family have agreed to this. They have also agreed to donate all the organs that they can after she dies.
She needs to die within sixty minutes or her organs will suffer too much damage and be useless. Only if she dies within thirty minutes can we use her liver. We have explained to the family that they will have five minutes with her after time of death is declared, then they must stand down. If they cannot, donation will not go ahead.
Everyone is tense. The tiniest thing can destroy the uneasy equilibrium that exists at this time between us and the patient’s family. We have to respect the patient as they die. We have to respect the family as they sit and watch. Lastly, we have to respect the organs that will help someone else live. The needs of the family and the needs of the organs are really incompatible. The organs require haste. A speedy death. A speedy retrieval. The family need time.
We move the patient to the operating theatre which has been set up for the retrieval surgery. The family cry and wait. I continue ECG and blood pressure monitoring so I know when the irreversible cessation of circulation occurs. I continue to administer analgesia for pain.
Thirty minutes passes. She is still alive. We have lost a liver. I call the retrieval team and the transplant team and the patient who’d been prepped for a new liver receives the news. The liver was incompatible, is what he’ll be told and he’ll know that this could mean anything from the family changing their mind at the last minute to the liver being damaged in some way. Forty-five minutes. ECG shows continuing circulation. Fifty minutes. N
o change. After one hour she is still not dead. The lungs, kidneys and pancreas are now incompatible. We lose our last remaining hope.
We take the patient back to ICU. I talk to the family, offer my support but they do not want anything from me. They would prefer not to donate tissue now. They have had enough.
I prepare to leave. The patient is not going to be an organ donor so she is not my case any more. Another nurse takes over.
‘Sorry,’ the family say.
You didn’t tell us she was such a stubborn old bitch, is what I don’t say.
I am home in time to read Rosie a book before her afternoon sleep. She chooses Addie and the Bad Fairy. We read it three times until I close it and say, ‘Time for bed.’ I have a pile of bills to pay, laundry to fold, dozens of emails from friends that I need to reply to, not to mention an exhibition to curate, and the sooner I get Rosie into bed, the sooner I can begin. ‘Let’s put your sleeping bag on.’
‘Fairy one,’ Rosie says.
‘The fairy bag is dirty. You spilt milk on it last night. What about the one with pussy cats on it?’
‘Fairy one,’ Rosie repeats, as if I have not even spoken.
I walk to her room and return with a sleeping bag covered in frolicking kittens. ‘This one is especially cuddly.’ I reach out for her but she runs away and stands on the other side of the room, watching, waiting.
‘I’m not chasing you today. Time for bed.’ I wait with the bag on my lap but she does not move so I walk over to her.
She runs off, giggling.
‘Rosie! No. Time for bed.’
She stops running and waits. I know that if I move towards her, she will run away again.
‘Okay.’ I put the bag down on the ground. ‘Mummy will have to go if you can’t come here and put your bag on. I’m going to count to five. One, two...’ I make it to five and she stays where she is, grinning.
‘Off I go then.’ I walk towards the door. She doesn’t relent. I open the door. Nothing. I step outside and close it. It is only when I begin to walk up the path that I hear her cry out and run towards the door. I wonder what I am going to do if she ever realises that I have no intention of going anywhere, when this trick stops working.
I walk back inside, squat on the floor with the bag and put her on my lap. She arches back and pushes away from me. I hold her, firmly, pushing her arms through the holes. Her legs kick and I struggle to hold her down and connect the zip.
‘No, Mummy, no,’ she cries, kicking and pushing and arching.
I get one leg in the sleeping bag but she jerks it straight out as I reach for the other. She thrusts her head up and knocks my teeth into my lip. ‘Ouch!’ I shout and as my hand moves instinctively to my mouth Rosie pulls her arm out of the armhole. I scrabble for her limbs. The zip breaks. I shove her off my lap and onto the floor.
‘Happy now?’ I yell. ‘You’ve broken it. What a waste of money.’ As if she has any idea what I mean. What is it, to an eighteen month old, to waste money? She doesn’t even know what money is for. But I can’t stop. ‘You’re a naughty girl. I should put you to bed in just your pyjamas. If you don’t care about being cold, neither do I.’
My voice gets louder and louder. I am standing over a baby who is sitting on the floor in a broken sleeping bag, crying, ‘Mummy fix,’ as she points at the zip.
‘Mummy can’t fix. If you’d just lie still while I put on your bag it wouldn’t have broken. I don’t know why you have to make something so simple be so hard.’ I am tall and loud and mean. She is tiny and sad and my daughter. I want to smack her. I pick her up instead. Sing ‘Hush Little Baby’ over and over. Imagine all the other things I could be doing. Having a cup of tea. A bath. Going for a run, feet hitting the pavement, moving fast and far away.
‘Do you pray for a drowning? Or for a mother to take her eyes from the road long enough to smile at her child and swerve to the wrong side of the road?’
‘Of course not.’
Paul and I are lying in our bed, backs facing one another and separated by a space that could accommodate at least another person.
‘I do,’ I say.
Paul rolls onto his back and stares at the ceiling. I wonder what he sees. The geometric plaster patterns of the deco ceiling rose, perhaps. In a certain light, it looks as though each of the arrowhead sides is pulling away from the centre, straining to separate from the unity of image they create. Tonight, though, the rose looks at rest; it is simply a piece of decorative art, inert, coming to life only in the imagination of its viewer.
As my eyes adjust to the dark, I realise that Paul’s gaze is lowered; he sees neither inertia nor activity in the rose but simply the shape of his own thumbs, pads pressed together, betraying a tension that his fingers, which rest on his chest, are better at hiding.
He says, ‘We don’t want another child to die just so Addie gets a liver. For some other parents to have to bury their child instead of us.’
‘Of course we do. You just don’t like to say it.’
‘Is that such a bad thing?’
‘Yes. If we don’t want it enough we might not get it.’
‘Wanting it and saying it are two different things.’
‘And pretending not to think it is better? Lets you sleep at night?’
‘Yes.’
He is so fucking placid, lying there in the bed with his morals, that all I want is to provoke him, to make him yell, so it’s not just me shouting at someone who looks as though he is already defeated. I say, ‘Tonight I pray to God for a kid to fall off the monkey bars and hit their head hard, really hard, on the concrete.’
Paul stands up, throws on his robe and says, ‘I’m going to watch TV.’
He is gone before I can accuse him of preferring the safety of an American sitcom to the reality of children dying.
My thoughts prod me like the pea beneath the princess’s mattress. I get out of bed and creep down to the studio, hearing the low murmur of the TV as I pass Paul but he does not hear me.
Inside the studio, I walk over to a sculpture, the size of a doll, that sits alone on a stand. It is one of my favourites and it is not one of my father’s; it is a bronze of a pregnant woman but it is not softly curved and expectant. Instead the woman has a hand on one hip and she is leaning slightly to the left. The muscles of her legs show the strain of back pain and the impossible quest to find a comfortable position in which to stand. Her belly button is protruding and it looks as if something secret and private has suddenly been thrust into full view. The usually hidden and tucked away parts of the navel are precisely carved and strike the viewer as real, even though the viewer could not possible know – whoever sees the interior spaces of their navel?
The woman’s ankles are full of fluid and the bronze appears soft and spongy, as if you could reach out and lose your fingers in the flesh, searching for bones that are not normally so well covered. Her face shows the loss of sleep that she will never regain and the fatigue of carrying the globe of her belly everywhere, of never being able to take it off and put it away, of having to put up with the wriggling, kicking creature inside, of bearing the tightness of yet another practice contraction. Her eyes hold the knowledge that, even after the baby is born, her body will still carry an impression of pregnancy; in the small haemorrhoid that will reappear whenever she decides to eat more bread and less fruit; in the ridge of hardened skin along her perineum that will be left even after the tear has healed; and in her belly button, which will forever after be a wider hole, stretched open like a mouth ready to scream.
The door to the studio opens and Paul steps in. He is wearing a T-shirt that used to be blue and is now bleached white, and soft with age and wear. I look at this T-shirt and wonder why we have not aged into softness like that shirt.
He walks over to the desk and half-sits, half-leans against it. He is silent but it is not a closed silence; it is a listening silence. I put the sculpture back in its place and the bronze touching the wood sends a low tone into the room. It is
into this harmony of silence and resonance that I speak.
‘They’re not real.’ I stop, listen to the sound of the bronze woman fade out and then continue. ‘The donors. The bodies I see everyday. They’re like sculptures in a way, detached from life. But they’re not at all sensual; you don’t want to touch them the way you do this woman.’ I gesture to the piece I have just returned to its stand. ‘The ones at the hospital are these awful intellectual works, works without emotion, because nothing, not imagination or belief or looking upon them can change anything about them. That’s why I can wish for another one. Because they aren’t real.’
The silence continues after I finish; it is now reflective and I let it extend as Paul’s thoughts wrap around my words. He looks directly at me and I see that his eyes are still the same as they were when we met, depthless, impassable, and that I know how to dive through to the bottom, into the wreck, and that perhaps we are going there now.
‘You couldn’t do your job if they were real,’ he says.
I nod.
‘Why don’t you stop, just for now, until Addie’s better? You can’t spend every day lost within death.’
Lost within death. I had forgotten my husband’s eloquence, his ability to translate, to understand. I put out my hand and he takes it and pulls me closer, tucking my head onto his chest which is where I say, ‘I can’t stop. Because there has to be someone like me in a hospital somewhere when Addie’s liver comes in.’
And then the tears spill, into the years and the fineness of Paul’s shirt. I can feel his tears falling too, over my hair and down my cheek, tears that polish our skin like a plaster so brilliant I can see both of our faces reflected there, together.
NINE
I go back up to bed with Paul and lie down beside him. His hand reaches for mine and so do his lips. At first it feels like kissing a stranger; it feels like something I am too old to be doing, like a skill I have forgotten to practise. I can’t remember the last time we kissed with open mouths, not just a scrape of lip on cheek as we say goodbye in the mornings. I am almost shy of my body and of his, uncertain where to put my hands, unsure what it is that he likes.
If I Should Lose You Page 7