At least, that’s what she told herself about the fact that Liam hadn’t kissed her again.
“Are you okay?” Liam asked now, sitting in the waiting room.
“I’m fine. Are you?”
“Yes,” he said. But the way he said it, “yes,” with his blue eyes glowing and fixed on Lily’s—well, it confused her, made her blush.
“Um, good,” she said.
“Something has changed,” he said. “And you don’t have to be afraid of it, Lily.”
“About Rose? About her tests?”
Rose had had another echo test; she was so tired now from the cumulative effect of not getting enough oxygen, she slept while the technician rubbed cold jelly on her chest. She seemed oblivious to the loud sound made by the Doppler. But the test had revealed no surprises—Rose had been stabilized by her time in Melbourne, and she was now ready for surgery.
“No,” Liam said, smiling. “Not about Rose.”
“She’s all I can think about right now, Liam.”
“I know. We’re almost there,” he said.
“We’ve been here so many times before,” Lily said—and as she looked up into Liam’s weathered face, she felt her stomach flip. They had both said “we,” and the word was apt. Liam had been with her and Rose every time. Why had Lily never let that sink in before?
“This time is different,” Liam said.
“How do you know?” Lily asked.
Liam reached for her hand. She shivered, wanting him to hold her—she felt like a tornado of emotion. She wanted him to hold her together, keep her from flying apart. She felt her skin tingling—and the length of her spine, and the backs of her legs—all from some fantastic longing that confused and shocked her and seemed like the worst timing possible. All he had done was hold her hand.
“This time is different,” he said, “because the procedure is straightforward. All they’re doing is replacing an old patch. The hole in her heart hasn’t torn or grown or widened. The only problem is the patch, and this surgery will be definitive.”
“She’s not getting worse,” Lily said.
“No. She’s not. Her symptoms are all related to the patch, and to the stenosis.”
“I can’t take it,” she whispered.
“Yes, you can,” he said, giving her hand a firm shake. “Just think it through, Lily. You know it’s going to go well.”
She watched Liam, who was watching the door through which the doctors would walk—to tell them Rose was ready. Her mind clicked through everything she knew about Rose, a laundry list of what would happen today. Although Tetralogy of Fallot included four defects, only two were of supreme importance today. Pulmonary stenosis—the outflow passage, where Rose’s right ventricle and pulmonary artery connected, was narrow and blocked; and the large ventricular septal defect—the patch had become brittle, allowing blood to freely mix between the two ventricles.
Rose’s severe stenosis meant that less blood reached the lungs with each heartbeat, causing her to turn blue. Her surgery today would involve removing the thickened muscle beneath the pulmonary valve and replacing the old worn-out patch with some brand-new felt Gortex. It all sounded so simple—yet Lily felt that she herself might not survive another minute of stress.
Now the doctors came out, wheeling Rose alongside. Prepped for surgery—groggy, hair held back by a paper cap, hooked up to monitors and an IV—she managed to lift her head slightly, searching for Lily. Only, the person she called for was Liam.
“Dr. Neill,” she said.
“I’m here, Rose.”
“Remember what I said.”
“I do remember. I never forget.”
Lily saw the looks pass between them, and felt that mysterious stomach drop—not knowing what they meant, but realizing it was important.
“Did you find her again? Nanny?”
“Yes,” Liam said, crouching down, face-to-face with Rose. “I did. It’s so unbelievable, but you know where she is?”
Rose shook her head, eyes rolling back as she tried to stay awake. Lily touched Liam’s back—partly for support, and partly because they were all together in this.
“Tell Rose, Lily—”
“Honey,” Lily said, hardly able to believe it herself. “Nanny is swimming south from Nova Scotia. While all the other whales are migrating north, we think she’s coming to Boston, to find you—”
“Will she be okay?” Rose asked, looking worried.
Lily nodded. “Yes.” The moment shimmered between them. “Nanny will be fine,” she said. “And so will you, my darling girl.”
“You will,” Liam said.
“It’s time to go now,” Dr. Garibaldi said. “When you see Rose again, she’ll be as good as new. She’s told me all about this Nanny character—and she’ll be back in Nova Scotia before the week’s out, and by August, she’ll be swimming with all the whales she wants. We’re going to put on the best, strongest patch in the world, and this will be Miss Rose Malone’s last surgery for a long, long time. Now come on—let’s go.”
Lily and Liam bent down to kiss Rose, and that was that—they wheeled her away. Lily’s own heart nearly gave out, watching her go into the elevator. She felt Liam’s arm come around her, she let him lead her to the chairs in the waiting room. There was a television on—there was always a television on—and a pile of magazines, and that morning’s papers. But Lily just put her head in her hands and tried to hold herself together.
“You heard the doctor,” Liam said. “He sounded so positive—he said Rose will be home by the end of the week. Lily—that’s six days.”
“I know,” she said.
“Six days, Lily. We’ll be back in Cape Hawk. Rose can have her summer.”
Lily let him hold her. There were times when she couldn’t talk, couldn’t even really think. There were aspects to life nine years ago that were so traumatic, she had developed a fight-or-flight response. Her body would flood with adrenaline, and she would go totally numb. She was right there, right now.
Rose’s father had created so much terror back then. He had been so angry about the pregnancy—and his behavior had gotten so much worse. Lily, not getting it, had tried every way possible to reassure him that she would love him as much—or even more—after the baby was born. But he was unmoved by her promises.
“Promises,” she said now.
“Which promises?” Liam asked.
Lily was almost in a trance—her baby was about to be hooked up to the heart-lung machine. The idea was so terrifying, all Lily’s old trauma was being reactivated. She started to tremble, and couldn’t stop.
“I made promises to Rose’s father,” she said to Liam now. “I promised that we would stay together, that I would love him as much or more after the baby was born. I promised that she wouldn’t take up all my time—that I’d still have plenty of time for him. More, I said. Because I was going to stop work and stay home …”
“Lily, what are you thinking of him for?” Liam asked. “You know he doesn’t deserve your words or thoughts.”
That’s right, Lily thought. She had told Liam about him that very first night—when she was nearly crazed with pain—both physical, from giving birth, and emotional, from having run for her life from Rose’s father. She gulped back a sob.
“And he doesn’t deserve your tears,” Liam said, leaning over to kiss her forehead, her cheek, the corner of her mouth.
“I used to drive myself mad,” Lily said. “Wondering why.”
“Why?”
“Why Rose? Why did she have to have these problems? We don’t have heart disease in our family—the only person who ever had a heart attack was my great-grandfather, and he was ninety-one. I ate a healthy diet during pregnancy—gave up caffeine. I’d given up wine even before I got pregnant… . I didn’t smoke. I exercised, but not too much. Why?”
“I don’t know, Lily,” Liam said, kissing her hands, looking into her eyes.
“The doctors didn’t know either. They say Tetralogy of Fal
lot isn’t hereditary. It just happens—and it’s random. There’s no knowing who gets it.”
“Lily, don’t do this—”
“It should be so simple—it is for other children. Air and blood meet in the lungs, and then the heart pumps the blood through the body. Why can’t it work for Rose? It’s so simple… .”
“But it does work for Rose,” Liam said gently. “She’s had some challenges, that’s true. But I believe the doctors. They say that this will be her last surgery for a long time.”
“A long, long time,” Lily corrected.
“Right. A long, long time. And we’re going to hold them to that.”
We. That word again.
“There are mysteries about Rose, it’s true,” Liam said. “We don’t know why. We might never know why. But there are other whys we might never know either. Such as why I went to your house that night, the night Rose was born. Why I had to take the books back to you that exact night. And why, once I walked through that door, I never wanted to walk out again.”
“Liam,” she whispered, remembering the promises he’d made that night, and for the first time, wanting him to keep them.
“Why,” he began, but stopped himself. His lips moved against her skin, and she felt rather than heard him say “Why I love you both so much.” But then she realized that he had just kissed her neck—he hadn’t said anything at all. Of course he hadn’t—they were in the middle of the waiting room—with nurses and doctors and other parents walking in and out.
She held his hand tighter, listening to him—feeling herself materialize more in her own body, no longer numb and floating up in the air, a traumatized ghost.
“We love you too,” she wanted to say, but didn’t. She wanted to tell him that, because it was finally washing over her—the reality, that this man had been with her and Rose, right by their side, since the very first day. He was like Rose’s father. Rose’s real father was nothing to them—nothing at all. Liam was one reason why Rose felt so loved, one of the reasons why she thrived.
“You’re right,” she said. “There are a lot of whys.”
“And they’re not all bad,” he said.
“I know,” Lily said, just smiling. But she looked up at the clock and saw that it was ten o’clock—the time that surgery was going to start. Open-heart surgery never took long. Generally sixty minutes at the most. So much could happen during that single hour. A life and death could pass before a family’s eyes… . Oh God, Lily prayed, closing her eyes. Help her through this hour… .
Liam opened his laptop, hoping Lily would take pleasure and comfort in watching the green light that represented MM122 tracking ever closer to Boston Harbor. But Lily seemed unable to watch anything but the clock and the door through which the doctors would emerge postsurgery.
It was ten-fifteen. Liam tried to hide his own nervousness. He had sat beside Lily through Rose’s other open-heart surgeries. Because of Rose’s aortic valve stenosis and her ventricular defect, the very wall of the heart had to be opened.
To keep the blood flowing to other vital organs, Rose had to be hooked up to a heart-lung machine. Liam had studied up on it, spoken to a friend from McGill who’d gone into cardiac surgery in Vancouver. He knew that Rose was under deep anesthesia. Dr. Garibaldi would have gone in through her breastbone.
Catheters were draining blood from the veins in the right side of her heart into the heart-lung machine—which, in a pumping rhythm, was passing the blood over a special oxygen-containing filter, sending the oxygenated blood back into Rose’s body through a catheter in her aorta.
Her heart itself was now without blood—and the doctors were working fast. The operating room was very cold, so Rose’s heart and brain would require less oxygen. Liam tried to imagine what was going on, but he—like Lily—was now watching the clock. Ten thirty-five.
“Her last operation took forty minutes,” Lily said. “The doctor will be out anytime.”
“Yep,” Liam said. “Any minute now.”
“They’re just going to remove the blockage and replace the patch.”
“Right,” Liam said. “Dr. Garibaldi has done this exact surgery hundreds of times.”
“But not on Rose,” Lily said. “He’s never operated on her before. It was Dr. Kenney before. And then he took that position in Baltimore, at Johns Hopkins. We could have gone to Johns Hopkins.”
“Boston is fine, Lily. It’s the best. Dr. Garibaldi is the best.”
“But we could have gone to Baltimore… .”
“I know. But Boston is closer to home. You like this hospital, and Rose feels comfortable here.”
“That’s right,” Lily said, staring at him earnestly, as if he were telling her something she’d never heard before. “You’re right. That’s why we chose Boston—because it’s so good, and because Rose feels comfortable here.”
Ten-forty.
“She’s been under for forty minutes,” Lily murmured. “I think that’s as long as she’s ever been on the machine before. I’m not sure, but I think so.”
“It’s not too long, Lily. The doctor will be out in a minute.”
“It’s just …” Lily said. “They have to make sure the blood and oxygen mix properly. I never understand how a machine can do that. But it’s been done before—lots of times before. Rose has always been fine afterwards. Except that time she got the bacterial infection—”
“She won’t get one this time,” Liam said, reaching for Lily’s hand. But she wouldn’t let him hold it. As if remembering that terrible time when Rose had contracted a virulent staph infection—she had survived the surgery but nearly died from the infection—Lily jumped out of her seat and began to pace. She went to the window, rested her forehead against the glass.
Liam ached with helplessness, so he forced himself to focus on science. He turned up the brightness of his computer screen—it wasn’t like sitting in the dark with Lily, in his truck by the lighthouse, with the night so black, and the screen showing every dot, with his arm around Lily, and her skin soft against his. It wasn’t like that here.
He peered at the screen. There she was—Nanny, MM122—blinking off Gloucester. She had swum her amazing journey in one and a half days—from Melbourne, slanting across the Atlantic to the Gulf of Maine, passing Matinicus and Monhegan, Christmas Cove, Boothbay Harbor, Yarmouth, Portland, swinging past the Isle of Shoals, down the coast of Massachusetts.
Here she was, right on Boston’s North Shore, speeding south. Liam wanted to call Lily over, to show her, but something in Lily’s posture told him that she couldn’t take hearing about Nanny just now. Liam’s own stomach dropped a little.
MM122 was way out of her range, out of the normal geographic areas where beluga whales were found in July. What if Nanny did have some mystical connection to Rose? What if her coming here was some sort of harbinger—living in Cape Hawk, the whale could certainly say hello to Rose any time she wanted to. What if Nanny was coming to Boston to say goodbye?
Liam refused to think that. Gazing at Lily across the room, he pushed himself up. The clock now read ten fifty-five. Rose had been under for five minutes shy of an hour. Liam tried to think of the things he could say to Lily: maybe the doctors got started late, maybe the operating room wasn’t ready, maybe …
This wasn’t the time for speculation. Liam was an oceanographer, and he knew: it was a time for science. He walked across the big space to Lily—a distance that seemed interminable. He was reminded of the first time he saw his mother, after Connor had died, and after Liam had had what was left of his arm amputated. His mother had been looking out a window then. Liam had called her name, and she didn’t turn around.
“Lily?” he said.
When she wheeled at the sound of his voice, he felt so much relief, he felt his eyes fill.
“What?” Lily asked.
“I wanted to tell you something,” he said, blinking back the tears. He wanted to come up with something factual, scientific, indisputable, and wise. But the thing was
, he really had nothing to say. All he could think of was Rose.
“You were talking about the mix before,” he said. “Blood and oxygen.”
“Yes …”
“I was thinking back to grad school,” he said, struggling for something that would comfort her. “We learned a lot about that in a marine biology class. Whales are mammals, as you know, and our professor was teaching us about the cetacean circulatory system.”
Lily nodded, listening. She seemed to notice that his brow was sweating—she reached up and brushed his damp hair back from his forehead. Her smile was very gentle, as if encouraging him to go on.
“In the earliest days of medicine,” Liam said, “dating back to the sixth century B.C., on the Greek island of Ionia, doctors had the idea that when air and blood mingled in the lungs, the blood gained a ‘vital essence.’ But it took many centuries until they realized that the vital essence was—”
“Oxygen,” Lily said, and Liam smiled, knowing she probably knew more about the process than most scientists.
“Right,” he said. “I still remember reading William Harvey’s famous treatise—I think it’s from 1628—on blood flow and circulation. Of course, my class was on whales, not humans.”
“Hearts are hearts,” Lily whispered, watching the time click to eleven o’clock.
Liam watched the blood drain from her face. She began to tremble, and he knew she was losing it. He put his arm around her, tried to hold her tight. She was shaking so hard, grabbing his arm, burying her face in his chest.
“Where are the doctors?” she asked.
“They’re coming,” he said.
And before they could look up, they heard Dr. Garibaldi’s voice. “Lily, Liam?” he asked.
“How’s Rose?” Lily asked. She lurched toward the doctor. Liam looked around—as if it was possible Dr. Garibaldi could have rolled Rose out with him, into the waiting room. Then Liam looked at the doctor’s pale, deep-set eyes, and he knew what he was about to say, before he even spoke.
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