The flood of the Internet was pouring into my living room. I forced myself to eat something with carbohydrates because soon I would need the energy—a street fight can exhaust a person in as little as thirty seconds and reaction times are faster in humans when they are nutritionally balanced. I needed to restore the glucose levels in my body so I’d have readily available energy for the fight.
Another street-fighting tip: choose a weapon that would not generate suspicion or violate any local, state, or federal laws.
I also found that survival guilt is treated professionally when a therapist makes clear alternative, hopeful views of a given situation. These views then make the sufferer believe that the death was not their fault, and they can mourn and continue with life. Simple enough. Who needs a mental-health professional when one can Google the answers and self-medicate?
The alternative to loneliness is to not be alone. The hopeful view of my situation is that because I have little to lose, I am the perfect person to carry out this mission.
I went into the kitchen and took the brand-new toaster out of the box. This was my weapon. I put a note on the fridge.
The next time you read this, you will be a hero.
* * *
Harold answered the door. Black hair, wet from a shower, stuck to his forehead.
“Is Raeanna home?” I asked, wanting his twisted mind stained with suspicion, the best kind of torture I could imagine for a man of his ilk.
“No,” he said. If she was right and he had seen us together, he didn’t recognize me. His eyebrows dropped and his face tightened. “Who are you?”
Harold was a tall but not imposing man, his skin pale and slack, the sagging flesh below his eyes the color of storm clouds. We might have had a competitive scrap, but the element of surprise is too great an advantage. Another advantage is that I have been hit before, so the threat of violence held no fearful sway over me.
And I had a weapon. I swung the toaster by a thick handful of wound cord. The corner of the toaster crashed into his cheek first, a blunt cutting edge that inflicted maximum damage, dropping him to the floor. He clutched the wound, blood spurting between his fingers. I stood over him as he recoiled, then took another swing. The flat side of the toaster mashed the top of his head, sending toaster parts flying, leaving me holding nothing but a frayed cord.
Harold cried out, curled in the fetal position, muttering “Please” through his blood-stained hands.
I knelt down and drove a hard fist into his midsection. Instinct caused him to drop his hands down to protect his middle, and I looked into his ravaged face. The cut went from ear level to an inch above his chin. Blood decorated the room in glistening, abstract squirts.
“You won’t find this toaster test in Consumer Reports, will you Harold?” I punched him in the lung to let him know an answer wasn’t necessary.
“Two things,” I said in a harsh whisper. “Never touch her again, and when you go back to work and people ask what happened to your face, tell them you fell.”
I backpedaled toward the door, keeping my eye on him in case he mustered the energy to jump up and mount a reprisal. I backed right into the coffee table in the middle of the living room, and heard the telltale rattle of pill bottles. Lots of them. They rolled around at my feet. Was Rae sick?
Harold was still moaning, clutching his broken face.
I stooped, picking up two bottles in my right hand, looking at them just long enough to see the name of the medication, something with an x in it, which wasn’t very helpful. All medicines seemed to have x’s, y’s, and z’s in the name. I turned the bottles until I saw Harold’s name, but the more interesting name was right above it—Dr. A. Venhaus.
I thought of taking the bottles, but stealing prescription meds was an unnecessary risk. I dropped them and headed out the door, breaking into a sprint. My movement was covered by dusk. I ran long and hard, waiting for my muscles to spasm and my lungs to burn. It never happened. I maintained my full sprinting speed all the way to my car, which I’d left in the Wal-Mart parking lot. I had sweat and I felt the lactic acid of a long run, but it never hit me hard enough to slow down. I didn’t know if it was the adrenaline or if my regeneration assisted with endurance.
Once home, my fleeting confidence gained traction. I pulled out my revolver and checked the chamber. Six bullets. Blood had dried black on my hands, almost matching the gunmetal. I removed one shell, my reward for delivering justice to Harold Stillson. A tiny chance of survival. Six bullets felt so final, having that one out, earning that empty chamber would make it much easier to eat the muzzle and let ’er fly if the time came. But that time felt further away, blurry even. I spun the chamber. Why stop? There were five more chambers to go. I put a note on the fridge: The meaning of life is practicing the will to live.
THIRTEEN
You shouldn’t negotiate in enemy territory, but there I was, sitting at the kitchen island at Doc Venhaus’s house. We drank beer out of frosted glasses. Earlier in the evening, I met his wife, Lucille. He sold me as some local college student job-shadowing for a semester. Lucille was about ten years younger than he was, with a fake rack but a legitimate smile. I sensed both love and concern when she spoke of her husband.
His daughter, Samantha, was a couple years younger than me, blond and good-looking enough to have me staring at my shoes to avoid eye contact.
Doc grilled on the patio. We ate chicken and potatoes and corn on the cob. Samantha had that youthful distraction of having better things to do, not wanting to spend time at the dinner table. I had only witnessed this type of behavior on television, and seeing it in person plucked a string of regret inside of me. Jell-O came to mind. I’d eaten some Jell-O at Mom’s deathbed. I kissed her good-bye with red lips and cherries on my breath, the last thing she ever smelled before the last bit of life and soul smuggled themselves out of her, riding a long, final exhale that wouldn’t have blown out a candle.
After dinner, Sam’s friends picked her up. She said bye to “Dad” and bye to “Lucy” so I knew then that Lucille was a stepmother.
After some customary post-dinner small talk, Lucille said she was going to bed to read for a spell. She actually said “spell.” I wondered if maybe they were all putting me on, trying to show me some wholesome family that deserved the fame and fortune that would come with Dr. Allen Venhaus’s amazing discoveries, thanks to my miracle tissue and the thing he was presumably looking to score that evening—my cooperation.
To be fair, I liked the guy and I’d accepted the invitation knowing damn well I might have to tell a man who could have been my friend to fuck off. He had an earthy appeal to him. He talked like a guy, peppered in the occasional swearword, and he was plain about things. He was the proverbial “kind of guy I’d like to have a beer with,” so there we were, testing it out, one beer at a time.
The sun went down. We wandered outside to the patio, where I could smell the aromatic, fatty smoke from the now-cool grill. A swarm of insects danced around the patio light. We sat in wicker chairs with crickets chirping in the distance. Humidity clung to the beer glasses. Lightning bugs winked around us.
The black outdoors, waiting to be filled with the words of men. I thanked him for dinner.
“Have you thought it all through, son?” he said.
So here it was. Small talk had smoldered for days, and he was done with it.
“Nice night out here,” I said. “I like your place.”
“So let’s say I take out your kidney and it comes back. Like your tonsils. What then?”
“A fire pit would be sweet out here.”
“I’m not offering to do it. I’m just asking,” he said.
“You lived here long?”
He took a long, slow drink of his beer. Three gulps, each one sounding a hollow chirp I could hear in the dark silence.
“Some people think things happen for a reason. You one of them?” he asked.
“No. Things happen because of a reason.”
“A ca
use-effect man. Explain your little gift to me then.”
“Nature fucked up,” I said. “Some kids get three arms or a cleft palate. I got a superpower,” I said.
“You hit the birth lottery then, kid.”
“Sure,” I said, and finished my beer. “Can I get another one?”
“Not yet.”
We sat drenched in quiet for a long time.
“I don’t want to be a guinea pig,” I said. “No experiments. I don’t want to be some missing link. I just want to know if my kidneys will grow back.”
“To sell one,” he added. “Right?”
“No. To sell a bunch of them. To get the fuck out of here and take someone with me.”
“Where?”
“Wherever she wants to go. Wherever’s safe.”
“You’re quite the idealist.”
He got up and went inside, and came back with two more beers. No glasses. Presentation time was over. We drank straight from the can.
“So you haven’t thought this through,” he said. “How much do you anticipate earning for a kidney?”
He knew the answer. I played along. “I’m thinking six figures,” I said.
“A medical center would give you that and more to simply study and test you, and it would be far safer. It’s a better deal for you.”
“So you got divorced?” I asked.
He drank to this, then glided past it.
“Plus you would be helping people. One kidney saves one person. There’s sixty-three thousand people on the waiting list. Most of them are going to die waiting.”
“The person I’m wanting to save isn’t on that list.”
“Kill two birds with one stone, then. They’ll pay you. Start a bidding war if you want. Get an agent. Get confidentiality in writing. Whatever’s going on inside of you is pure hope. You get that?”
“Whatever is inside of me only seems to wake up when I get cut or beat on. If that’s hope, hope can go fuck itself.”
“Sling your organs then. You heal, but you hurt. Organ removal isn’t a wet kiss, and you want to repeat it … how many times?”
Being hospital property seemed like I was selling not only my body, but control of it. Living in a sterile room with chrome and that God-awful powder blue. “I still have to find out if my body can pump out a kidney.”
“To hell with your kidney,” he said. “For the record, I think things happen for a reason. I think God sent you to help a lot of people. Including me.”
The moon played hide-and-seek behind fast-moving wisps of cloud. On the far horizon, blinks of lightning, but no thunder. Not yet.
He told his story without interruption. He talked slowly, carefully, a surgeon’s talk, as if he could linger at the moment his life changed and make it different. The pieces of his story stacked up just-so, blocks of the unlikely building up, tearing out bits of his life to make room for their rise. But I was the most unlikely of all. I was the one who could make things right again.
* * *
After his residency, Doc settled down in Minnesota. He didn’t say it was rural, but it felt that way—I imagined snow and wind and icy lakes and chains on everyone’s tires. He was the only surgeon for miles around, and worked everything from car-crash trauma to tonsillectomies.
He got married. He had Samantha. He helped people get better, and people who knew him called him Doc. A doc is a friend—a doctor is a guy who does not appear to give a shit. I tabbed him as a doctor at first, but he was about as doc as a medical professional could be.
Then came the inevitable Big Regret that all men of a certain age seem to have, the girl with the bad gallbladder, Angie, twenty-two, skinny, with a whole cliché-filled life ahead of her. Gallbladder problems made me think of old, fat men, but it turns out that girls are six times more likely to get gallstones. Birth control increases the chances, as do multiple pregnancies, or rapid weight loss. Angie was a trifecta—pregnant, scared, lost the baby, went on birth control, crash dieted to lose the weight. Doc talked about her as if she were vibrant and perfect, as any older guy perceives someone in their golden twenties, I’m sure.
Gallstones are typically harmless, but Angie got a stone caught in her cystic duct. This is a cause for at least one-fourth of gallbladder removals.
“It was my job to know this,” he said, and I knew the fuck-up was coming.
He had removed a gallbladder as a resident, but none since, and this surgery, this story, is what he invited me over to hear, I was sure of it. He talked about the surgery like Mack would have talked about one of his historic home runs—the kind of moment that nestles in and stays. The memory that you can smell and feel, it’s not just runny paint on the canvas of a bored mind. It’s there, whole, and can be delivered into your reality just like a newborn.
I could see the blue smock, the steel, the drapes and scalpels. I felt the cold, brown coating of disinfectant slathered on Angie’s stomach. His scalpel blade blew through flesh and yellow fat, but dissected no farther. Modern medicine is not about the blade anymore. It’s about cameras and vents and ports and carbon dioxide, and all the other white-noise details that he talked about, reciting them to himself more than me. I could barely follow until he slowed down and talked about the major risk—the main bile duct. The gallbladder and liver are quite the tag team. The bladder itself is tucked under the liver. Severing the main stalk to remove it means treading carefully around the main bile duct.
“Injury to the main bile duct causes death twenty percent of the time,” Doc said. “The rest of the time, the bile backs up and destroys the liver. The damage is permanent.”
He didn’t have to say any more, but he did anyway. This was his penance. I waited for him to destroy the main bile duct.
He stripped and searched, trying to reveal the point of the gallbladder, which he could sever to remove it. A stem peeked.
“I stopped,” he said. “I looked at the screen. Everything was as big as boiler-room piping. I announced where I would be cutting. No one said anything, they were just ready for me to get it over with and get them the hell out of there. It was all routine, you see? Lap choles are done hundreds of times over in hundreds of hospitals. It’s batting practice for a surgeon. There was only one mistake to avoid.” We stared out into the dark together. I waited without speaking. “I struck out in batting practice,” he said finally, chilling me with the baseball metaphor.
He was just about to cut when he saw a bead of fat near the incision point. “This is not an issue unless it’s obstructing the incision angle or vision, and it wasn’t. Still, a jolt went through me that something might be wrong. But I went ahead anyway.”
That bead of fat could have saved both him and Angie—had he flicked it away, had he been completely thorough, he might have exposed the rest of the area. He might have seen that the duct that he was cutting to remove the bladder had a fork in it, that the real and safe incision point was above the fork and he was about to not only injure the main bile duct but clip it off completely.
He was telling me this story in Grayson, Illinois, because he did not see the fork. He cut off the main bile duct and with it, he extracted his wife, Minnesota, his reputation, and untold thousands of dollars from his life. In its place, he transplanted the guilt of knowing Angie would be worse after the surgery than she was going in.
Surgeons make this mistake in one out of every two hundred lap choles, one-half of one percent. But it is still a severe surgical mistake, one that lured him into the realm of lawyers and malpractice and seeing a sick and yellow girl tethered to a waiting list of over sixteen thousand people wanting new livers. And out of that list, who knows how many died waiting.
Angie’s image stood out for him among a host of Minnesota images—his wife packing, his now-empty office, the small-town talk making its rounds and coming back to him through the channels of his trusted friends. He was damaged. Marked. Broke. Malpractice insurance drying up, bank account draining, daughter getting ridiculed at school. There is no privacy
act for bad doctors. There are no heroes on television explaining that doctors make mistakes, that they are not infallible. We expect our doctors to be perfect. No mistakes. No confusion. Crucify the bad ones, and by bad … one mistake is all it takes.
His story had left him, rising and vanishing into the night air like a coil of smoke, leaving quiet behind. The night was cooler but still humid. The last swig of my beer was warm, the can sweaty. He waited.
“She died waiting for a liver,” he said. “She was young, high on the list. But she was tough to match, and rejected her first transplant. Graft-host issues.”
His cards were on the table and the hand was pity. He explained a few connections he had, old friends who could transplant organs with the lights off, guys with research credentials. But at the end of the day, this would be Dr. Allen Venhaus’s discovery—the surgeon’s mistake made right again by work the world would never forget.
In short, I had him.
“I have a connection working the black market for my kidney,” I said. “I can call him and opt out. Tell him it’s game over. Get on your team. We work on helping people, then. But on my terms, and first, I need something.”
“I don’t have any money,” he said.
“Not money. Harold Stillson. He’s a patient of yours.”
Venhaus drew back and away from me, almost shrinking, the burden of medical privacy laws and ethical dilemmas swirling around us.
“I saw a lot of medication at his place. What’s wrong with him?”
“You know I can’t talk about this.”
“You made a mistake once,” I said. “Make another one and then we’ll wipe the slate clean.”
“Dear God, why?”
“Less to do with him and more to do with his wife. She’s an old friend.”
“This isn’t going to work,” he said. “Call your crooked funeral director. Winston. It’s not a big town, you know. I know that piece of slime is who you’re talking to. You’re two of a kind.”
The Heart Does Not Grow Back Page 11