Change of Heart

by Sally Mandel

  They put her in special isolation and kept everyone out except the transplant staff. The immunosuppressive drugs helped deactivate her body’s antigens, preventing them from attacking the alien tissue of the new heart But as a result she was vulnerable to infection from every stray germ. Even the common cold virus could prove deadly during this critical period of her recovery. Along with the elaborate equipment in her room, someone from the transplant staff remained with her at all times.

  She hadn’t awakened from the anesthesia, but she could be watched through an observation window. Mary MacDonald stood next to Brian, peering at Sharlie’s companion, who, at the moment was Nurse Wynick.

  “Goddamn cowboys, who the hell do they think they are?” Mary muttered, her substantial body quivering with indignation. “I ought to know something about isolation, for Christ’s sake.”

  Brian put his arm around her waist, enjoying the bright-pink fury of her face and the muscular girth under his hand. Nurse Wynick glanced at them, frowning slightly.

  “Bitch,” Mary said, then sighed. “Ah, well, I suppose I’d do the same if they stuck their freckled California noses into Saint Joe’s, be sure I would.”

  Brian leaned his forehead against the cold surface of the window. “I hope she never finds out about the donor,” he whispered, as if Sharlie might hear him through the glass.

  “We’ll just have to make sure she doesn’t,” Mary said. “Come on, let’s go get some coffee.”

  Sitting in the cafeteria, Brian said, “I barely recognized her. She looks so withered.”

  “Oh, you’ll get your pretty girl back soon enough, if all goes well,” Mary said, cupping her hands around the styrofoam mug. “It’s a miracle what happens to some people when they get their new hearts. So much misery they’ve had, and suddenly they feel brand new.”

  “Let it happen to her,” Brian said. Then he went on, guiltily, “Besides, I shouldn’t give a damn what she looks like as long as she’s okay.”

  “You going to get married?”

  “She’s been talking to the psychiatrist about it.”

  “They got the shrinks after her now, do they? Well, that’ll screw her up for fair.”

  “Gee, thanks,” Brian remarked morosely, and Mary laughed.

  They sipped their coffee in companionable silence for a moment. Then Brian said, “Mary, have I told you how glad I am you’re here?”

  “Mmm,” she replied. “You mentioned it.”

  “I wish you could have been around through the whole damn thing.”

  “What about the Converses?”

  Brian just smiled at her, and suddenly Mary was sputtering again. “That woman, she’s a cold fish if I ever saw one. I don’t think she gives a flying frog if her daughter lives or dies. Just fancying around in her lah-dee-dah clothes and her false eyelashes—”

  Brian interrupted delightedly. “She doesn’t really wear false eyelashes, does she?”

  Mary looked away. “Well, maybe she does and maybe she doesn’t, but she’s the type, all right. This California trip’s a great excuse to go out and buy herself a whole new wardrobe.”

  “She cares about Sharlie,” Brian said.

  Mary sniffed into her paper cup.

  Brian hesitated, then said slowly, “I’m going to tell you something you’re going to find tough to believe.”

  Instantly Mary’s eyes bored into Brian’s face.

  “You hang around hospitals long enough, you get to know people,” Brian continued. “They start telling you things they probably shouldn’t.”

  “Go on,” she said impatiently.

  “A couple of days ago, before they found the donor, Margaret Converse tried to persuade Diller to use her own heart for the transplant.”

  Mary’s face didn’t change, her stare just stiffened. “I don’t believe it,” she whispered.

  He nodded. ‘True.”

  “Jesus Mary,” she breathed at last, then, after another moment of thinking it over, muttered, “Well, all right, but she’s still a cold fish.”

  Brian sent Mary back to her motel with an obliging nurse who was going off duty and would be driving that way. Then he went back upstairs to watch Sharlie some more. He waved at the nurse now on duty, a stranger, and leaned against the window to gaze at the lifeless figure amid the hardware—electronic ticking and whirring beside the dehumanized lump that was once his warm, beautiful girl. A shrunken face, an emaciated body with wires and tubes sticking out of her flesh like tentacles.

  He had participated in her humiliation, urging his reluctant lover into this awful arena of pain and degradation. Couldn’t he have let her die with her beauty and humor and humanity still intact?

  He looked down at his hand, now wrapped lightly in an elastic bandage. How many more bones can I break? he wondered.

  As he was about to turn away, Sharlie’s head moved on the pillow, and she looked him full in the face. He stared back at her stupidly, not knowing what to do with his eyes to hide his dismay. She began to smile and then rolled her eyes at him, making a small grimace with her mouth in the familiar way that said, Can you believe what I’ve gotten myself into this time? And suddenly he was grinning like a fool, waving and laughing and calling for everybody to come and see.

  Diller attended Sharlie with the same kind of protective paranoia he reserved for his hands. No one else, except Jason Lewis, of course, was allowed to interpret her tests. She was his consuming passion, and he hovered at her bedside, fidgeting and fussing.

  Margaret watched him with curiosity and amusement. Over the years she had come to realize that the surgeon’s special interest in Sharlie focused more on Walter’s wallet than on Sharlie’s chest cavity. But now his absorption had become personal. Margaret wondered if Diller was bewitched by his own instant celebrity.

  Since the transplant the waiting room had been crowded with newspapermen and television cameras. Sharlie’s plight had come to the attention of a reporter in New York soon after the donor’s demise on a dismal street in Queens. The writer, an ambitious young woman, discovered that frantic arrangements were underfoot to ship the body to California. She sensed exploitability in the story and began a series of articles describing the beautiful young woman on the brink of death awaiting a donor. She wrote about Martin Udstrom, how he had spent his short life attempting to make a splash in New York’s criminal underworld, and traced his journey from petty larceny to assault and finally his graduation into homicide with the brutal murder of a shopkeeper in Jackson Heights. The story captured national attention—the hardened heart of a criminal implanted in the chest of a fragile girl—and the public eagerly devoured every word. The media hordes, pencils poised and cameras whirring, gathered daily for Diller’s news bulletins.

  Today Margaret encountered Diller outside the waiting room where he generally held court. This morning he would be taped for national broadcast, and he muttered to Margaret that the press with all the cameras and paraphernalia was getting in his way and wasting his time. He was fed up with newsmen underfoot all day every day. But she noticed that before he stepped into the room, he was careful to straighten his tie and brush his thick, gold-streaked hair back with his hands.

  Margaret watched from the doorway as a jaded Los Angeles reporter asked, “When do we get to see the patient?”

  Diller allowed himself a cool smile and turned his best side toward the camera. “I can’t tell you that now, gentlemen. She’ll be in partial isolation until we’re certain she’s past any danger of infection.”

  “Is she conscious?”

  “Yes,” said Diller. “We hope to take her off IV today.”

  The New York reporter broke in, “What’s the publicity doing to your career, Doctor? Do you see yourself becoming another Christiaan Barnard?”

  Diller smiled at her ingratiatingly. “Oh, I’m not interested in notoriety. I just want to do my job.”

  “But I understand you’re due for several television
appearances and speaking tours. Those things have to …

  “I’m sure you understand,” Diller interrupted, “that all I want is to continue the work I’m doing. However, I do feel that the public is entitled to information about the kinds of strides being made in coronary surgery, and despite the sacrifice of time away from my patients, I believe I’m obligated to enlighten people who may benefit from these advances.”

  Margaret heard suppressed snickers behind her and turned around. Three of the eighth-floor nurses were enjoying Diller’s performance from the safety of the doorway across the hall. Diller, meanwhile, dismissed himself for the day, saying he was needed for follow-up on yesterday’s surgical cases. He nodded his head graciously at the expressions of appreciation from the reporters and left the room. He touched Margaret’s shoulder briefly, then stopped at the group of nurses who were red-faced with the effort to remain properly sober.

  “Find out when they’re showing that tape, will you?” he murmured, then went off down the hall. Margaret smiled at the nurses but then stared at Diller’s retreating figure, wishing him, in her gratitude, a best-selling autobiography and a starring role opposite the actress of his choice.

  Chapter 34

  Nurse Wynick helped Brian on with his mask and gown and paper slippers. He stepped quickly through the glass doors and stood by Sharlie’s bedside, wondering if today would be the day she would wake up and talk to him. She opened her eyes and smiled.

  “Hello, lovely man. That’s you under all those sheets, isn’t it? Did they make me bionic?”

  Brian’s eyes smiled, and he said, “Hi.” He couldn’t seem to manage anything more.

  “Give us a kiss,” Sharlie whispered.

  Brian shook his head. “Not yet. I’ve got too many germs.”

  “Oh, come on,” she urged. She reached out a hand for him, and he backed away.

  “Sharlie, I’m not supposed to touch you.”

  “Oh,” she said, disappointed. She held up her hands as if she were grasping a hose and pretended to spray him from head to foot. “You’re disinfected. Hey, I’m injected, you’re disinfected. Pretty good,” she giggled. Brian glanced at the window where Nurse Wynick watched them. She raised her eyebrows questioningly, but he smiled and turned away so he’d be left alone with Sharlie a little while longer.

  “How’re you feeling?” he asked her.

  “Honey,” she said, grinning, “I am soo-per. Sooperb. And you know the best thing?” He waited, and she said, “All suspense, lambie-love? Really, listen, the best thing is …” She poked her toes out from under the sheets and said, “Taa-dah!”

  Brian stared at her feet, then gave her a blank look.

  “Pink toes! Can you believe it? Did you ever? I mean, who would have thunk it? No more blue feet, no more cold feet. Feel ‘em for yourself. They’re roaster-toaster warm. Hot off the old ankle. Don’t you just love ‘em?”

  “Sharlie, you’re bombed,” Brian said.

  “Ho ho! Bombed, the man says. This Pearl Harbor Day?”

  Brian started for the door, and Sharlie reached out to him. “Don’t go away. Oh, please don’t go away. I haven’t told you the most important thing, the thing I came here to tell you, all the way from Seventy-fifth Street. All this way I tramped on my little pink toes, and you go away before I get to say my little speech, all polished and practice-perfect.”

  Brian stood at the foot of her bed.

  “Okay, lush, let’s hear it.”

  She waved her hands in an effort at fanfare, then pronounced ceremoniously, “You, Myron Borgan …” She started to giggle and tried again through the snickering. “I mean, you Byron Morgan … oh, dammit, dammit, it’s no use …” She was laughing helplessly now, and Brian hurried outside.

  He interrupted Nurse Wynick’s conversation with the dietician. “She’s drunk,” he said. “Absolutely looped.”

  “Uh-oh,” Wynick said, and ran off down the hall. Brian called after her, “Hey, is she okay?” But there was no response. He went back to the observation window and saw that Sharlie was sound asleep again.

  It was Tuesday morning, and Carlton Diller looked forward to making rounds. The notoriety over the Converse transplant had attracted several prominent surgeons from out of state, one of whom worked with Michael De Bakey in Texas. Diller was eager to exhibit his prize patient, so including the entourage of students, there were more than a dozen people peering at Sharlie through the observation window at nine thirty. Diller strode to the head of the bed to stand next to the microphone. Sharlie watched her audience solemnly.

  “The patient is twenty-six years old, has suffered since birth from congenital valvular heart disease. Six weeks ago she experienced a pulmonary embolus secondary to a thrombosis from the tricuspid valve. Cor pulmonale developed rapidly. Enlargement and necrosis were severe, and the patient, upon arrival at the center, was near death.”

  Sharlie stared at the disembodied heads in the window, the faces gawking at her with undisguised curiosity. She’d seen the same expressions last summer near Seventy-second Street where an old man had been run over by a taxi. He lay crushed and mangled while a mob of pedestrians gathered to watch him gasp out his last breath on the bloody pavement.

  Diller leaned over to place his stethoscope against Sharlie’s chest. As he reached to pull back her gown, she said in a low voice, “Don’t touch me.”

  Diller recoiled.

  “What?” he said, stunned.

  “I said, don’t touch me.”

  The faces at the window began to quiver like excited insects. One of the spectators spoke into the intercom beside the door. “She’s still on immunosuppressives?”

  Diller nodded. Sharlie glared.

  “Any evidence of postoperative psychosis?” asked the clinical voice.

  “Oh, lots,” Sharlie said into the microphone. “The patient is adjusting most lousily to having her heart cut out.”

  Diller arranged his face into an expression of sympathy and tried to put his hand on Sharlie’s shoulder. She shuddered and slapped at it as if it were a poisonous snake. Diller said, “Heh, heh,” with his mouth twisted into a grotesque smile.

  Sharlie looked at her fascinated observers and choked out, “Go away.”

  The faces remained until Diller turned to wave them off. They disappeared reluctantly, and he put his hand over the microphone to hiss at her through tight lips, “Quite a show, Sharon. I assume you’re proud of yourself.”

  “I’m not your prize freak, Doctor … Dalton,” she retorted.

  “You don’t have a speck of gratitude, do you?” he said contemptuously.

  Sharlie felt the waves of rage rising until they towered inside like thunderheads.

  “I’m a person, a person. Look what you did to me!” she wailed.

  Before Diller could reach the call button, Nurse Wynick appeared with a hypodermic. Diller held Sharlie’s flailing arms while the nurse plunged the needle in, and all the time Sharlie was howling, “Don’t touch me, don’t touch me, don’t touch me!”

  Chapter 35

  Sharlie lay quietly in her bed reflecting on conflicting sensations of freedom and insecurity. She had been unhooked from her last wire today. She knew she was doing well because her father had left for New York yesterday morning, and in the afternoon they transferred her into a real room with a window to the sunshine instead of the oversized incubator she’d been inhabiting. Her head felt quite clear despite some giddiness, which she attributed to the elation of functioning free of machinery. She put her hands to her cheeks. They were puffy, and she gathered from the way people looked at her that she had changed. So far, she hadn’t mustered the courage to confront herself in the mirror, even though Dr. Lewis warned her that the heavy dosage of cortisone would eventually make her face swell. But there could never have been enough preparation for the dismay in Brian’s eyes as he sat by her bed and gave her his brave smile.

  She’d lost ten pounds since
her arrival in Santa Bel, and barely required X rays to discern the skeleton under the thin layer of flesh. She sighed as her eyes skimmed over the surface of her blanket, filling her mind with the image of a pitiful scrawny body topped by a pouting cantaloupe head. Pumpkin head. She imagined herself climbing out of bed at night, slipping into her wheelchair, the mechanized horse, to careen through the hospital like a dreadful ghost from Sleepy Hollow in search of some poor Ichabod Crane in a room down the hall.

  When she was six years old, she’d contracted a severe case of the mumps. They couldn’t figure out where she’d picked it up, since she was isolated from other children. Nevertheless, one morning she had awakened with her glands ballooning out from under her ears. Margaret had held up a mirror, and her reflection made her laugh. She wore her hair short in what was known as the Buster Brown style. The texture was so fine even then that there was nothing much she could do with it except cut it in a straight line and keep it shiny clean. But with her hair perched on her bulging glands, it was as if her hairdresser had used a far too shallow bowl to guide his scissors. Margaret reminded her that one could get mumps on only one side; at least she was symmetrical.

  Sharlie lifted her hands to her cheeks again and thought perhaps they’d shrunk just a little since yesterday. She imagined Dr. Rosen sitting all night by her bedside chanting paragraphs from psychiatric textbooks to reduce the size of her swollen head. Perhaps she should give some consideration to the other end of her anatomy in hopes of cheering herself. Her feet—now there was a miracle for you.

  Hands finally unhampered by IV tubes, she pulled back the covers and gazed. Remarkable what a little healthy circulation could do for one’s digits. Her toes glowed and twinkled, robust testimony to the magical fingers of Lewis and Diller. First thing out of the hospital, she’d buy a pair of sandals so that whenever she felt the urge, she could take a quick reassuring peek. She had worried about lying in bed with Brian, imagining his body tense beside hers in anticipation of the icy implantation of her foot on his leg. She had warned him that sleeping together would require her wearing socks to bed out of compassion for his central nervous system.