Louisa told her that she needed to rest, to save some energy for the baby. Louisa even said to Alix, ‘You don’t want anything to happen to the baby, do you?’
‘I don’t know,’ Alix replied.
So Louisa didn’t ask her about it again because she hoped that if Alix didn’t think about it, then I don’t know would not become yes. That Alix would remember the baby was what she had left of Dan.
And running occupied Alix’s mind with thoughts other than the baby. As she ran she concentrated on the composition of her footsteps over the familiar path. Days of high tides were full of puddles and mud, so she had to turn around and go back when pounding through the water in the cold was more than her feet could bear. Low-tide summer mornings were strewn with beer cans, food wrappers, cigarette butts and trodden grass. Summer afternoons were families and lovers eating ice-creams, ferries and boats passing by on the water. Weekend evenings were carefree, drinks all round, backless dresses, a bite to eat, and sunlight till late so it always felt early and no one ever seemed tired. Winter afternoons were as cold as death, the path bare of lovers and families, no boats, no ferries, only the drip of tears falling and her shoes squeaking in mud and leaf and soil.
AUSCULTATION
(Plaster, 40x44cm. One of very few works by the artist that includes elements other than the human body.)
The first week after Dan died was a series of telephone calls.
Telephone call number one: would Alix be the guest of honour at a retrospective of Dan’s work next year?
No. It was not that she had anything against the looking backwards to the past implied by the word retrospective. It was the implication that there could be some kind of survey or representation of his life’s work. That Dan was complete, finished. Which of course he was not.
Telephone call number two: would she come to dinner at Louisa’s that night?
No. To go to dinner by one’s self was to admit that she was by herself. Whereas opening the fridge seven times before she went to bed and removing an apple or a piece of cheese or a tub of yogurt and eating them while walking around the house was something she often did if he was away or out or working late.
Telephone call number three: Louisa again. Was there anything she needed?
No. How else to answer a question to which the answers were infinite? Was there anything she needed? There were a great many things that she needed but the real question was: how was it possible to open the plaque at the cemetery and take out what she needed when she knew he was not there, merely his leftovers.
Telephone call number four: would she fill in at work tonight for Ian who’d had to go home?
Yes. Because then the phone calls would stop.
When she arrived at work she completed her rounds quickly and competently; she might be grieving but others were dying. Her stethoscope was her constant companion, a little like her big toe in that it was always attached to her but she didn’t notice its presence. She used it thoughtlessly, not the way one uses an index finger, with pointed intent, but without thinking, caught in that unconscious space between sleeping and alertness that is so easy to fall into on a long drive.
It was not an expensive stethoscope and she’d had it since university. But its beauty lay in its ability to deliver auscultation. She’d told Dan about auscultation back when they used to sneak into the anatomy lab at night and he’d made a sculpture around that time of a stethoscope pressed against a heart in an open chest. He’d been struck by how the folded-back skin of a chest looked like the pages of a book and so the chest had been sculpted to look like a book and Alix had always thought the stethoscope had the appearance of an eye.
At first this made her frown, because a stethoscope was like a third ear; it didn’t transmit the sounds that beat below the skin, it heard them: lubdub, lubdub if listening to the heart; he-haaa if listening to the lungs; and sssssss if listening to the stomach. But then, she thought, auscultation was dialogue, so it could be read. As in a novel, it had exposition: the lubs, the haas, the ssss. It had subtext. That was the thing she was listening for, the slightest nuance in the rhythms, the merest disturbance in the expected patterns of those hidden sounds of the body.
If she could not have Dan’s conversation, then auscultation was the only other talk she could tolerate.
‘Matthew’s biopsy shows moderate rejection.’
Alix sighed, not because of what the cardiologist had said but because she had to take her stethoscope out of her ears. She calculated quickly. ‘He’s a week post-transplant isn’t he?’
The cardiologist nodded.
‘Have you spoken to him yet?’
‘I thought he’d want to hear it from you.’
Alix paused for only a moment. A moment long enough to savour the victory. That the cardiologist had not simply bypassed her and gone straight to the patient. That he must, at last, be thinking of her as a heart transplant surgeon. Asexual. Not a woman any more.
So she and the cardiologist went to ICU together to tell the patient. The first sound they heard was Matthew’s monitors screaming. He was in cardiac arrest. Adrenalin, the defibrillator, compressions; these tools had all been used, Alix could see, but none had worked. So Alix jumped on the bed, straddled Matthew and took over compressions, shouting, ‘Let’s get him to the OR. We’ll open him up, massage his heart and work out what needs fixing.’
A nurse unlocked the bed brake, another threw the IV bags, defibrillator and portable monitors onto the bed and the cardiologist pumped the ambu-bag as they began to move.
‘Get the fuck away from that patient, Nurse.’ The intensivist had arrived and was referring to Alix.
She didn’t bother to answer because saving a man from dying was more important than wheeling out the oft-repeated line, I’m a doctor.
The cardiologist did it for her. ‘That’s Dr...’
But he didn’t finish. Because the intensivist, who knew exactly who Alix was, had sidled up next to Alix and was whispering in her ear, just loud enough for Alix and the cardiologist to hear, ‘You can straddle me like that later, when I fuck you.’
Alix didn’t listen. Instead she was glad that, unlike in Dan’s sculpture, hearts could not be read, that no one could flip open her chest and read the things printed inside. She remembered her first day as a surgical intern when she, the only female, was selected to stick her hand into another man’s chest and perform open heart massage while the other interns took bets on how long it would be before she puked or passed out. Later, she discovered that the female change rooms servicing the operating theatres were labelled Nurses, whereas the male change rooms were labelled Doctors. She’d lost count of the number of times a patient asked her to leave and send in a real doctor. But the thing that made her change her name, become Alix instead of Alixandra, was when a surgeon brushed his hand along the side of her breast every time he asked her to step in closer so he could teach her. Consultants who didn’t know her might look at a list and call for a Dr Alix, but no consultant ever called for Dr Alixandra if they could help it – certainly not if all they required was assistance with a patient.
She had stopped noticing the taunts when she met Dan because being in love was more powerful than harassment, insult and abuse. Now it was time to become someone else all over again.
After she had finished assisting in an operation that should have been hers to run with, Alix ordered a repeat biopsy on Matthew. She went with the cardiologist while he conducted the biopsy and watched as he put a cannula through the jugular vein and took out a piece of Matthew’s heart muscle with a bioptome.
‘Severe rejection,’ the cardiologist said to her later as he handed her the results.
Severe rejection. A term that really meant an inflammation of the heart. Alix tried to shake the thought of a heart inflamed out her head. ‘He needs another new heart,’ she said, diverting to the practicalities.
But then the image of the bioptome’s teeth, nipping at Matthew’s heart, took over from the previ
ous unwanted picture. She began to think, unscientifically, about what it must feel like to have a biopsy of your heart. Would Matthew love any less because of the void left by each nibbled off piece? And then the segue to Dan’s sculpture of the woman biting into her heart. The woman who had lost not just a piece of her heart, but her whole heart, and was alive, regardless. That there might be other people walking around – here in the hospital perhaps, or out at the park, down by the harbour – with a chunk of their heart missing had never occurred to her.
After dealing with Matthew, Alix went to get coffee and watched as a row of male surgeons turned, almost imperceptibly, to present her with their backs, removing from view any part of their faces, anything that could be misconstrued as a welcome.
But she could hear them talking as she stirred her coffee, about the latest divorce. The older her colleagues became, the more they divorced. What wife, what family would put up with, willingly, the hours of a transplant surgeon? Having to leave anything, even the birth of a child, if the call came through that a heart was available. Dan didn’t care, he would just work whenever she did and take time off whenever she was home.
‘I knew she had the shits with me,’ one of the surgeons recounted. ‘So I told her to go out shopping for a new outfit then I bought some prawns because she loves prawns and I cooked them on the barbie. I even lit a dozen bloody candles. Had a bottle of French fizz. All set to show her I knew she was pissed off with me for being here all the time when the bloody phone rang. Course that’s when someone decides to go ahead and die and give their fucking heart to one of my patients. When I got home later she’d packed her bags. Cleaned the place out.’
None of the other surgeons spoke. Alix wasn’t sure if it was because they were uncomfortable from the sharing of too much information or whether each of them could well imagine the same thing happening to them.
Then he spoke again. ‘It’s bloody lonely without her.’
And Alix did not know what made walk over to him, did not know what made her say this. ‘It’s your fault,’ she said. ‘I’m lonely too. But that’s not my fault.’
The surgeon stared at her and she saw that he was yet another person who’d lost a piece of his heart except the difference was that he’d given his away.
‘Fuck off,’ he said and she walked away because she did not want to look at another abandoned person, reminding her that there would be no more love for her, reminding her that she was just one more in a team of doctors who were married to a ward full of people whose hearts were slowly dying.
The first contraction came early, at thirty-six weeks into the pregnancy. But it was like a false start because, after that, the baby took a long time to be born. It seemed to not want to come out as much as Alix wanted it to stay inside. ‘Can I have an epidural,’ was the first thing she asked the midwife when she arrived at the hospital.
‘Are you sure? You’re only one centimetre. Why don’t you see how it feels?’
‘I don’t want to feel any of it.’
Ten hours passed by somehow, but she was only dilated four centimetres and she couldn’t get out of bed because of the epidural, which she’d had topped up every time she even imagined she could feel her toes. She’d read her magazines, eaten her lollies, drunk all the lemonade. And so it went for eight more hours: contractions, a slow dilation, more lollies – one of the midwives had gone downstairs to buy more for her, clearly feeling sorry for this woman whose husband had died – more epidural.
Sleep, they said to her, but how was it possible to sleep with a baby shoving its way out of her and into the world? She did not sleep. Then it was time to push but she was too tired. She did not push once. She could not understand what they were saying to her, to push as if she was having a poo. She was having a baby, not something that she could flush away down the toilet.
Her obstetrician put her legs up in stirrups and he cut her so he could fit the forceps inside and he pulled, hard; she could see his arms straining the one and only time she looked down at what was happening to the other end of her body.
Even then it was not quick; it was still labour, still work, still a relentless quaking and shuddering from just below her breasts right through to the muscles of her thighs, and no, she did not want the mirror, did not want to see where to push, did not want to see exactly what it looked like when an oversized pair of metal pliers had disappeared within oneself to extract something that was perhaps better off left inside.
Then the baby was out. ‘It’s a girl,’ the obstetrician said as he plopped the slimy baby with blue feet and hands on her chest. Alix waited for it to cry but it did not. Instead it stared at her with the blue eyes it had taken from its father and it hardly seemed to blink. It was waiting for Alix to declare her position, perhaps: to renounce the baby or claim her. Alix could do neither because she could not look away from those eyes until eventually the midwife came to take the baby, to weigh it and put a nappy on it and to listen to its heart with a stethoscope.
‘Can I?’ Alix asked, gesturing at the stethoscope. The midwife nodded and passed the baby to Alix and from then on all that Alix could hear was auscultation, the sounds behind the closed doors of her baby’s skin and the look of her father caught and held within her baby’s eyes.
CAMILLE
TEN
Paul has rung to say he can’t stay with Addie at the hospital today. He has a meeting. With real, live people. So he has to attend. Whereas I am supposed to be at work with people who can be called neither real nor alive. So I have to cancel. I ring my boss and apologise. Because Julie has uni today, Louisa is ill and Paul’s mother and sister are at Palm Beach for a long weekend. No one at the hospital complains when I call, how could they? But that is not the point. It’s not that I don’t want to stay with Addie. It’s that I want Paul to not cancel something that you shouldn’t cancel. A three year old cannot stay in a hospital room by herself.
When I arrive I look at Addie and forget about Paul. If she remains stable, we can take her home in a couple of days. We can wait there in comfort for her liver until she gets sick again and we come back, thus getting a little bit closer, both to the top of the list and life and a liver, and also to death because to be at the top of the list is to be about to fall over to the other side.
I lie down with her on the bed, not caring about it being daytime and busy and forbidden, because we are leaving soon and I don’t need to be nice to anyone any more. I run my hand over her fat little tummy, not round and soft with baby fat but bloated and swollen from the portal hypertension. She looks like a World Vision child with skeletal limbs and a pregnant belly. I pick up her tiny hand, which has never been plump like a little girl’s should be; it is like a transparent glove pulled tight over bone and vein. It is bruised and purple from too many cannulas and I kiss each livid spot.
‘My sleeping love,’ I whisper and am reminded of Pygmalion and his ivory Galatea, clothed and adorned in jewels, kissed every night but always cold and hard and unresponsive. Where is the divide, I wonder, between the clinical and the artistic body, between the brain-dead cadaveric donors I work with every day and my daughter? When does one become the other, when can a mother stop responding to her daughter and see only corpse?
Addie is not cold but she is cool, her skin is not hard but it is bony and she is not unresponsive but merely asleep. I clasp my hands and for the first time I pray to whomever, to Aphrodite or God or some other power, that they bring my work of art back to life.
Addie’s life has been an unending experiment, partly because she was our first child.
The Breastfeeding Experiment: a constant guessing game as to whether she was getting enough milk, was the first breast empty and should I move her on to the second breast, and how could such a small mouth accommodate such a large nipple without ‘grazing’, which is what the midwives in the hospital called the blistering sores that I did not want anybody to touch, let alone suck on. Six weeks later, when the option to breastfeed was taken away by t
he biliary atresia, I would have done anything to have those blisters back.
There were experiments with formula to improve her poor weight gain. Experiments with vitamins to give her body the things that the biliary atresia took away. Experiments with naso-gastric tubes. Drip feeds of Liquigen and Monogen, a kind of liquid fat, every afternoon and every night. Visits to the hospital almost weekly in winter as a constant snotty nose caused her to knock the tube out. Each time that happened, we would have to drive to Emergency, wait to be triaged, and wait again for a nurse to have the time to reinsert the tube. Three or four hours would pass us by. I bought the girls a portable DVD player because what else can you do with a one year old and a two-and-a-half year old in a hospital for five or six hours nearly every week?
Sleep, though, was the biggest experiment of all. I remember Addie cried every night from midnight until at least three in the morning for the first six weeks of her life. We rocked the bassinette, patted her bottom, swaddled her, fed her, sang to her, walked with her and, the first night we took her home, I tucked her into bed beside me as she howled, thinking that the feel of her mother beside her, holding her close, loving her, would be enough. It wasn’t. I was so shocked at this discovery. That hugging and loving did not stop tears. That being a mother did not stop tears. It was not the magic wand I’d thought it would be.
Paul arrives after work. ‘Sorry,’ he says as he brushes past and kisses Addie’s cheek. ‘A defamation suit’s been threatened over one of my articles. I had to go through everything with the lawyers. It took forever.’
‘Yes,’ I reply as I gather my bag. ‘I can imagine how slowly time might move in a boardroom full of lawyers as distinct to the brisk pace at which it moves right here.’
‘Go home. See Rosie. I’ve got it.’
‘I’ll get you something from the cafeteria and then I’ll go.’
‘I can go down and get something. She’s asleep.’
If I Should Lose You Page 9