by Tara Conklin
It came to Caroline then, the memory: One Easter, Aunt Claudia sent Noni an old Skinner family recipe. It was German, or maybe Austrian, a cake that called for a pound of butter, heaps of cinnamon, almonds, raisins, powdered sugar dusting the top. Noni doled out careful slices. Everyone ate slowly, reverently. The cake was very good. After we finished, Joe sat for a moment, agitated, a finger tapping the table, and then he pulled the cake plate toward himself. He picked up his fork and pried off an enormous piece, opened his mouth as wide as he could, and stuffed it in. “I love it,” he said, only his mouth had been full: “I wuff it” was the sound. He kept eating the cake as quickly as he could, and Noni began to laugh. Joe had powdered sugar all over his face and hands, even in his hair. She laughed and laughed, and we did, too, laughing until we cried as Joe ate the entire beautiful cake.
With the memory Caroline began again to laugh: Noni had been right after all. She bent over in hysterics. She could barely breathe. Her eyes filled with tears. And suddenly Caroline longed to see her sisters. The desire hit her with a whack to the chest, strong enough to make her stumble. She could no longer recall the details of her fight with me or why Renee had reacted so vehemently against the search for Luna.
Start small.
Caroline wandered again between the tables, to the flower beds, which were lovely and messy. Dirt gathered in her flip-flops, gnats at her neck, the trodden-down grass and discarded sprinkler hose and the long-forgotten sandbox that was now choked with weeds and smelled distinctly—even from this distance—of cat piss. All this earth and wood, the house rising from the mossed and molded foundations, spreading itself wide. All the small items dotting the lawn—old Lego blocks, paper fans, tennis balls, a bath towel, a wooden spoon, a ruler—that spilled from the doors and windows like a fat woman who’s discarded the wrappers of her eaten bonbons. All these things she should tidy up—the party, the party!—but instead Caroline admired each with a vicious ache. She loved this house, this yard, this rusting swing set and decaying apple core, her son’s teeth marks visible on the flesh. She loved this life, but did she love him? Caroline inhaled sharply. Could it be possible that she was not in love with Nathan? Maybe she did not love him at all?
Loving Nathan required so much of her. She’d never thought of it before, not exactly. The frogs, the faculty potlucks, the research trips, his eternal search for publication, for validation. And what about loving Noni, loving the kids, loving Joe—even more now that he was gone? It all required so very much of her. What would happen if she put the sack down? Maybe carrying all these people around wasn’t strictly required of her. The twins were nearly teenagers, Louis now in high school. Noni had bought hiking boots for her trip and foldout maps of each city they’d be visiting.
Caroline stopped in the shadow of the house, the neighbor children’s voices reaching her, glad shouts and then some crying, and she realized that it had never occurred to her to try another way. To try not loving Nathan. To try loving herself. What would happen? It had never before occurred to her, but now—yes, now it did.
Chapter 16
Renee first met Melanie Jacobs at a Monday-morning intake appointment, one of the first in her new office at New York-Presbyterian Hospital. Renee and Jonathan had recently returned from their travels, Renee to accept a permanent position as a transplant surgeon, Jonathan to focus on private commissions for the retablo pieces he’d first developed in Chiapas. This was nearly four years after Joe’s death, during the time Renee, Caroline, and I weren’t speaking. Did Renee miss us? Later she told me no, she didn’t think about us; she was too busy to miss anyone, and that was precisely her objective.
Melanie was one of Renee’s first new patients, a twenty-seven-year-old woman with cystic fibrosis, already on the lung-transplant list. A sprite of a thing, barely five feet tall, married to a longshoreman named Carl who towered over his wife. Shoulders nearly as wide as Melanie was tall. Dark hair receding in a sharp widow’s peak. A kind, gentle smile.
As they entered Renee’s office, Carl held the door for Melanie and pulled the portable oxygen tank behind them. Clear tubes ran from the tank over Melanie’s ears and into her nostrils. Melanie held out a hand to Renee, the long fingernails painted a brilliant aqua blue. “Matches the hospital gowns,” she said. “I’ve got mascara the same color, too.”
Renee laughed.
Since Melanie’s diagnosis, her doctors had managed the disease, but her condition had worsened in the past year, and she came to Renee for a new evaluation to move her position up the transplant waitlist. Because of Melanie’s small size—105 pounds at the height of good health—her potential donors were limited: a man’s lungs, for example, would not fit inside her chest.
“My heart is so full!” Melanie told Renee. “My rib cage just doesn’t know it.”
Renee advised her to keep exercising, to be ready to come to the hospital at any moment, to travel no more than an hour from the city, to stay healthy, to eat well. They’d shaken hands again at the door, and Renee felt vitality in the warmth and press of Melanie’s palm.
Over the course of the next six months, Melanie Jacobs grew sicker and sicker. After she was admitted full-time to the hospital, Renee would find herself lingering in Melanie’s room, talking and laughing with her. On paper the two could not have been more different. While Renee was graduating magna cum laude from college and pursuing her medical degree, Melanie worked as a receptionist at a Toyota dealership, as a packer at a vegetable-canning facility, and as a waitress. She met Carl when she served him a piece of chocolate cream pie and he offered her a bite. But like Renee, Melanie had been raised by a single mother. Like Renee, she’d worked her way through college, though Melanie had stopped one semester shy of graduation after another hospital stay.
Month by month Melanie’s name rose higher and higher on the national transplant list until finally Melanie Jacobs was the sickest lung-transplant patient in the country.
“A dubious honor,” she croaked to Renee, who had seen her diminish from the bright, blond smart aleck to this, a frail shell beneath a sheet. Carl would arrive every day straight from work with Thai food and DVDs or a People magazine or a thriller that he would read aloud to her. After Melanie fell asleep, he would leave and then return the next day to do the same thing all over again. His union provided excellent benefits, Carl told Renee. The work was punishing, the shifts long, but he couldn’t quit now. Not until Melanie was better.
“We’re having a kid when this is all over,” Carl told Renee one afternoon as she conducted a routine exam. By now Melanie had been waiting ten months for a lung donor.
“I just want one,” whispered Melanie through the oxygen mask. “Boy or girl, doesn’t matter. I’m going to spoil that kid rotten. Carl’s not a carrier, so we won’t pass on the CF, thank God.” Here she crossed herself over the sheets. “I’ve got good eggs in a freezer. We were getting ready for liftoff before things turned bad.”
Later Renee couldn’t remember how she had responded to this information. Good luck, she had probably said. My mom had four, and let me tell you, we were a handful.
The call came at 2:00 a.m. Renee immediately jolted awake; Jonathan, accustomed to her call buzzer, slept soundly beside her.
Car accident, the nurse said. A twenty-two-year-old Caucasian woman, five foot five, slight, small-boned, blood type O. A fit.
Slipping into her clogs and coat in the kitchen, Renee called Carl’s cell.
“It’s time,” she told him.
At first the surgery appeared successful. It had taken nine hours, and Renee felt the exhaustion in her bones and core as though wet, heavy clay had been pumped inside her. She’d briefed Carl, telling him that Melanie was already out of the recovery room and in the ICU, that he should go home and get some sleep. Renee herself had gone home, remembering only from Jonathan’s note on the kitchen table—See you tomorrow, love you—that he had meetings in L.A., and fallen into bed.
Five hours later she woke to the buzzin
g of her phone. Ten missed calls flashed on the screen. Never before had Renee slept through a call buzzer. She cursed herself as she stumbled through her apartment, trying to reach the on-call attending, pulling on jeans and shoes. A thickness rose in her throat. A dread.
Heart failure was the official cause of death. Melanie had lasted three hours in the ICU and then unexpectedly crashed.
Renee found Carl alone in the hospital’s small chapel room. He’d already been told, but Renee wanted to see him, ask if he needed anything, if there was anyone she could call. If there was anything she could do, anything at all.
“Melanie was simply too weak to recover from a surgery of this magnitude,” Renee explained. These were words she had said before, but for the first time she felt the true weight of their delivery. “The team did everything they could to save her, but her heart wasn’t strong enough.”
Carl did not meet Renee’s gaze. “Her heart was strong,” he said. “It was her body. And the fucking transplant list. Why did she wait so long?”
It was a question that Renee had been asked before. The lung-transplant list operated on a system of need and perceived chance of recovery and pure dumb luck, she explained now to Carl. It was a complicated calculus, imperfect and unjust, but it was the system they had. Some people were saved. Some had to wait too long. Some died waiting. There weren’t enough donors, it was that simple.
Carl listened. He nodded, dry-eyed. He’d already done his crying, he said. “Thanks for everything, Dr. Renee.” Into his pocket he stuffed the thriller he’d been reading to Melanie before the surgery, and then he left the hospital.
* * *
Renee didn’t hear from Carl for seven months. Every so often she thought of him, but she had new patients, all with their own families and stories, and the memory of Melanie Jacobs faded. A smart aleck. Brightly painted fingernails. The only child whom one day she’d spoil rotten.
And then Carl knocked on Renee’s door at New York-Presbyterian. It was an unseasonably warm day in April, and Renee had her lab coat off, her shoes off beneath her desk. It was near the end of her workday, but the door was open, and she waved him in.
“Carl,” she said, surprised at how glad she was to see him and also how the sight of him alone, no oxygen tank, no Melanie, shifted a weight in her chest. Rising from her desk, Renee hugged him.
Renee took Carl down to the hospital cafeteria, where he insisted on paying for their coffees. They sat at a small table overlooking a paved courtyard where fat pigeons fluttered and clucked. It was 4:00 p.m. The cafeteria was empty and overheated, smelling of pasta water and Windex. Across the room one lone window was open, and brief, tantalizing bursts of fresh air washed over them. With each one Renee breathed more deeply.
“Dr. Renee, you ever want kids?” Carl asked her.
Melanie would often ask Renee personal questions—What’s your favorite movie, Dr. Renee? Do you ever smoke pot?—but Carl never had, and for a moment Renee was taken aback. She sipped her coffee and considered Carl’s question. Had she ever wanted kids? She remembered a discussion with Jonathan not long after they’d met. This was shortly after Joe’s engagement party, still almost two years before the accident. Jonathan’s no to kids was as emphatic as Renee’s own, though she admitted to him one point of ambivalence. On a practical level, she liked the idea of creating newer, fresher, better Skinners. Our mortality weighed on Renee. Given our father’s example, it seemed any of us might disappear at a moment’s notice. With our bad luck and genetics, how would the Skinners continue? The pressure had lifted a bit with Caroline’s three, but those children were Duffys, not Skinners. It was clear even then that I was unlikely to become a mother, so it had to be Joe or herself, Renee, keeping her maiden name, procreating with a certain degree of independence or an extremely understanding partner. When she explained this to Jonathan, he had smiled and said, “Joe is a born father. Look at him. I bet he’ll have three wives with two kids each. At least. Don’t worry. We’re off the hook.”
Renee had laughed, but she’d also felt relief. Jonathan was right: the Skinners would endure.
But now, here in the institutional hush of the empty cafeteria, sitting across from her dead patient’s husband, Renee realized with a small, terrible shock: Joe will never have children. Renee felt loss again, not of Joe, her brother, but of possibility. Of the future.
Renee still had not answered Carl’s question. She was forty-two years old. It was no exaggeration to say that she and Jonathan had everything they’d ever wished for.
“No, I’ve never wanted kids,” Renee answered at last. “Not really.”
Carl shifted in his chair, gripped the coffee cup but did not drink. “Well, Melanie wanted me to give you her eggs. That’s what she said. She said she wanted to donate them to you. She didn’t have any sisters. And her friends—it’s hard to maintain friendships when you’re in the hospital for so long. She admired you, Dr. Renee. She cared about you.”
Carl’s phone began to beep. “Oh, shit,” he said. “I’m late for work. Overnight shift. Dr. Renee, think about it, okay? You and that boyfriend of yours. Kids. I’m not having any, not without Mel around, but she’d love it if a part of her was tumbling around the playground. Or learning how to play the violin or be a doctor or whatever. I’d really love it, too. I wouldn’t bother you. We could make whatever kind of legal agreement you want. Anyhow, I gotta go. Think about it, Dr. Renee. Just think about it.”
Carl left the cafeteria, but Renee sat for a while. Perhaps twenty minutes, perhaps an hour. She held on to her coffee until it grew cold.
Renee told no one about the eggs. She filed away their existence into a compartment that contained the things she did not want to think about. The man in the car. Luna Hernandez. The ring. Those bruises on the thin, fragile skin of Joe’s forearm. That night on the balcony at the party. And so Melanie Jacobs’s eggs remained frozen in a basement laboratory in New York-Presbyterian Hospital while, fourteen stories above, Renee went about her profession. She transplanted lungs and kidneys from the dead into the living, she taught medical students and residents about cross matching and pulmonary function tests. Her patients were young and old, responsible and careless, and grateful, all of them, grateful beyond words for what she and her team had granted them. Time.
* * *
I was at work when Caroline called to invite me to lunch. It was two days before an environmental conference on the Paris Accords, and I had been spending long hours at the office, writing speeches for Homer, researching our position papers. At night I was working on a new project, the Love Poem, about a man and a woman who lived in a hot climate, who in many respects appeared different in background and aspirations, but who had discovered in each other something rare.
My assistant, Hannah, put the call through. “Caroline something,” Hannah said. “I didn’t catch the last name.”
I paused. “Masters?” I said, referring to one of our major donors, heiress to a shipping fortune and, thankfully, dedicated to ocean preservation. She was fifty-five years old and looked thirty, as was the job of an heiress.
“No,” said Hannah.
I thought of other Carolines I might know.
“Duffy?” I said.
“Yes! I think that was it. Duffy.”
“Hm.” The line was blinking red; Caroline remained on hold.
“Who’s Caroline Duffy?” Hannah asked.
“She’s my sister.”
“Sister? But I thought her name was Rachel.”
“Renee. Renee is one sister. Caroline is the other.”
“Oh, two sisters! That’s a lot of sisters. You’re so lucky to have sisters! I only have a brother, and he’s younger and totally ridiculous.”
I had hired Hannah, but there were times when I deeply regretted it. “Yes, very lucky,” I said. “Okay, put her through, please.”
And then I was hearing Caroline’s voice for the first time in nearly five years.
“Fiona,” she said without pr
eamble, “I’d like to see you. Lunch, with Renee, too.”
“Oh,” I said. “When?”
“Maybe, gosh, I don’t know. Tomorrow?”
I had a meeting tomorrow at eleven o’clock, another at one that was sure to go late. In the lull before I answered, I heard Caroline’s breathing, the delicate in-out of my sister’s lungs.
“Okay,” I said. “Where?”
We met in the city, at an Italian place that none of us had been to before. Only half full on a Friday afternoon, with plastic flowers on the tables and a balding waiter who stood at the back of the room and jiggled change in his pocket. The kind of restaurant frequented by lost, footsore tourists or illicit lovers looking to hide.
I cancelled all my afternoon meetings. We stayed three hours and drank two bottles of wine.
Caroline told us she was leaving Nathan—had left him, in fact, although they both still remained in the Hamden house. He was looking for another place, but these things took time. They had told the kids, who were understandably upset but coping, she said, as best they could. There was a counselor, the school had been notified, the parents of their best friends.
“But why?” I asked Caroline. The table had been cleared; we awaited our dessert of tiramisu and affogato. Caroline’s marriage had always seemed immutable, incontrovertible as a law of physics. Till death do us part. The happily ever after.
“Nothing happened,” she explained. “I mean, nothing dramatic. No affairs. No drug habits or porn habits or anything like that. I just couldn’t become the person I wanted to be. I couldn’t even figure out who that person was. With Nathan I could only be the same old Caroline.” She took a sip of wine and then shook her head, flapped her hand to signal a change in topic. “And listen, you won’t believe it, but yesterday I saw someone who looked like Luna Hernandez. On the train platform, just as the train was pulling in. She got onto a different car, and I wanted to go look for her, but I hate stepping between cars when the train is moving.” Caroline paused. “I’m sorry we never found her,” she said.