Open Heart

by A. B. Yehoshua

  “So what?” she answered. “He won’t do the operation, but he’ll decide on the surgeon, and naturally he’ll supervise him during the surgery.”

  This report from Tel Aviv, instead of reassuring me, only increased my agitation. I say agitation and not anxiety because what was there to be anxious about? If they decided on bypass surgery—with one, two, or even three or more bypasses—this was a routine operation in good hands, with a mortality rate of less than one percent in healthy men who had never suffered a myocardial infarction. My inner agitation therefore stemmed from moral rather than medical concerns. Since we now had only one month left before our return, and Sir Geoffrey insisted that I take the last two weeks as vacation due to me, I decided to ask Michaela, as tactfully as I could, if we could go home two weeks earlier than planned so that I could be present at Lazar’s surgery. At first she couldn’t believe her ears, and demanded that I explain my reasons again and again. After she had begged me to extend our stay, if only by a month, I was now asking her to move the date up by two weeks. She was stunned. For the first time since our wedding one year before, we began a confrontation that almost turned into a real crisis. Although the argument was conducted in cold and ironic tones, it was fierce and even cruel. Because of the cooling off in our sexual relations, we did not try, as a more passionate pair might have, to take our revenge on each other in bed. Free of any overtones of sexual aggression or calculation, our argument might have seemed to an outside observer calm and civilized, if sharp and penetrating. I did not try to lie to Michaela and invent excuses for my wish to return, but spoke frankly about my concern for Lazar and my need to be there to support him and his wife during the surgery. Since I could not yet admit, even to myself, the true, deep source of my anxiety and agitation, in order to persuade Michaela I had to transfer part of my impossible love for Dori to Lazar himself, as if he had become a beloved friend during the trip to India, even a kind of father figure, to whom I owed my support. “You really think he’ll be short of people to support him there? To the extent that you have to go running from England wagging your tail like a puppy?” said Michaela bitterly, narrowing her big eyes as if she could already see in the distance a miserable little dog slinking into the hospital gates and wagging his tail ingratiatingly. “You’re right,” I admitted frankly, “he won’t be short of people there. But how can I explain it to you? I’m not going for his sake but for my own.” In the end she grew tired of struggling against my obscure desires and vague arguments and cut short the argument with a surprising suggestion. If I was so desperate to attend Lazar’s operation, I could go alone, and she would come later, on the date we had previously agreed on, or even, why not?—a sly, unfamiliar smile suddenly dawned on her face, while her eyes widened again in enjoyment—perhaps she would come later, for if I allowed myself to go home two weeks early, by the same logic, and according to the principles of justice and equality, she could allow herself to come two weeks late. “And the baby?” I asked immediately. “What about Shivi?”

  “The baby?” she repeated thoughtfully, with the cunning smile still on her face. “Maybe she’ll be the only one to go back on the original date. We’ll divide Shivi between us. Fair’s fair. I’ll find someone here to take her back to Israel, and you’ll have plenty of time to organize things for her there, or maybe you can give her to your mother for a while, to give me the pleasure of remaining completely on my own.”

  And so it was. But after I had advanced the date of my flight by two weeks and the travel agent had warned me that I wouldn’t be able to change my mind, because all the flights at the beginning of September were already full, I came to my senses and asked myself why I was doing it. It was as if only then I discovered how warm and pleasant London was, and how full of friendly tourists, and realized how my eagerness to snatch as many opportunities as possible to operate on drunken Englishmen smashed up in road accidents or Asiatics taken sick in the middle of the night had prevented me from enjoying the wealth of cultural opportunities in the great city. Although tickets to the theater were usually beyond our means, there were plenty of other interesting events, such as lectures by famous people, including, to my surprise, Stephen Hawking, who was due to appear at a public question-and-answer session about his cosmological theory in the Barbican two days before my flight. And even though I knew that the hall would be packed with people, I decided to try and push my way in, in order to compensate myself for this premature return which I had imposed on myself in some uncontrollable impulse, as if something important were going to happen at Lazar’s operation, or as if by actually looking inside his body I would be able to discover something about myself. I invited Michaela to join me at Hawking’s lecture, even though the baby had been restless for the past week, as if the new tension between her mother and me was affecting her mood. But Michaela took no interest in the cosmos from a scientific point of view, only from an emotional one, and since there was a rehearsal of the neighborhood choir in which she sang on the same evening, she suggested that I take Shivi with me to the lecture, on the assumption that the polite British audience would show their consideration for someone, especially a man, carrying a baby and give me a seat. And indeed, little Shivi, strapped to my stomach in her sling, did help me to find a seat in the hall, which was full but not as overcrowded as I had imagined it would be.

  Shivi was quiet for most of the evening. Perhaps because she spent so much time strapped to Michaela, who ran around all over with her, she saw her mother as part of herself, whereas I was a separate being, who aroused her interest and in whose arms she could also relax. So it wasn’t on her account that I found the evening so frustrating. Although there were some bona fide astrophysicists in the hall, there were also many laymen, interested readers of A Brief History of Time, for whom the public evening was intended. But Professor Hawking’s hollow, disjointed voice coming from the speech synthesizer mounted on his wheelchair was not as comprehensible to me as it was to the native English-speakers in the audience, and the ease with which I usually understood spoken English, especially after my year in London, failed me now, to my great disappointment. Maybe it wasn’t only my trouble in understanding the artificial voice that prevented me from enjoying the evening, but also the fact that it was conducted for some reason in a general spirit of levity and impish humor full of puns and hidden meanings, as if the entire universe, with its black holes and big bang from which everything had begun, and the big crunch in which everything might end, including the poignant question of whether God had a choice when He created this universe, and therefore whether He exists at all—all the theories with which I had grappled that stormy winter day in my old Tel Aviv apartment, wearing my pajamas and waiting for Dori’s mother to call me—had turned here in London, on this fine summer evening, into a matter for the amusement and diversion of the stiff-backed Englishman sitting next to me, glancing indulgently at the baby on my lap. And it may have been my serious and agitated state of mind, because of Lazar’s impending heart surgery and Michaela’s new hostility toward me, that prevented me from sitting back in my chair and trying to smile like everyone else. Accordingly, when Shivi, who had been lying quietly in my lap for a long time, suddenly burst into loud wails—which for some reason gave rise to much mirth in the audience, and led Hawking to make some witty remark—I rose to my feet and hurried out of the hall without having dared to ask a single shy question about the spirit shrinking the universe.

  So in spite of all the surgical experience I had accumulated in the emergency room of St. Bernadine’s, I left London in a mood of depression, to which was added the unexpected pain of leaving the baby, even though at the end of two weeks I would be seeing her again when I went to meet her at Lydda airport, where she would be accompanied by two English friends of Michaela’s, who had gladly agreed to take care of her on the way, and two weeks after that I would be back at the airport again to meet Michaela. I myself was met at Ben Gurion by my friend Amnon, who had been living in our apartment all this
time and who had decided when he heard that I was returning two weeks early to borrow a van from the company where he worked as a night watchman in order to help me with my suitcases and various other items of luggage, such as Shivi’s crib. I was naturally delighted to see him, but I immediately noticed that he had gained weight and grown his hair and that his whole appearance was sloppy in the extreme. For his part, he was surprised to see that I was wearing a jacket and a tie, as if I had forgotten the end-of-summer heat. As we loaded my luggage into the old van, I noticed that he had adopted a new style of talking, cynical and almost nihilistic—Amnon, of all people, who had always been the most pure-hearted and naive of my friends. This worried me, and as we left the airport and began crawling along in a traffic jam on the Ayalon highway—which made me long for my defunct motorcycle—I began ruthlessly questioning him about the state of his doctoral thesis. He told me that he had changed the subject slightly, or rather expanded it in a more philosophical direction, and he now had an additional supervisor, from the institute for the philosophy of science. The confused ideas I had confided in him that night on our way back from Eyal’s wedding were still floating around in his head. “You won’t believe it, but I’m still thinking about that nonsense of yours and trying to make something of it from a scientific point of view,” he said, with a smile but also a hint of resentment. I told him about the evening with Hawking, and he listened eagerly to every detail, laughing loudly when I repeated one or two witticisms that I had succeeded in grasping. He questioned me again about the reasons for my early return. He couldn’t understand how I could leave Michaela, of whom he was so fond, alone in London. “Have you two had a fight?” he asked, with a mixture of concern and hope. When he heard my explanation he seemed surprised, but he accepted it, as I hoped everyone would, at face value. “Nice of you to be so worried about Lazar,” he said, half seriously, half cynically. “If you keep on like this you’ll end up as the hospital director yourself one day.”

  The apartment was not as neglected as I had feared, but since Amnon had taken the liberty of switching the furniture in the two rooms around, its whole nature had changed. The big double bed on which I had made love to Dori was now standing in the middle of the living room, covered with the same brown bedspread. Amnon had discovered that from this vantage point he could see the strip of sea beyond the chaotic roofs of Tel Aviv as he fell asleep, and argued that this improved the quality of his sleep. I had to share the apartment with him for a week, while he got himself settled in his new place, but since he worked nights we hardly saw each other, for after a brief and businesslike visit to my parents—from whom I received my father’s old car—I spent all my time at the hospital, with the secret aim of getting myself into Lazar’s open heart surgery, as a participant or an observer. To this end I went first to Dr. Nakash, to find out what he knew, even before I presented myself to Hishin or Lazar. It turned out that Nakash didn’t know yet if he was going to be the head anesthetist at the operation, whose team was being assembled by Professor Hishin. Although the hospital had a cardiothoracic department, headed by Dr. Granoth, a man of about forty who had recently returned from a long fellowship in the United States and was regarded as a gifted surgeon, Hishin, and apparently also Levine, did not see him as the ideal man to perform Lazar’s surgery. Perhaps they were afraid that if he operated on Lazar, he would gain the right to a special relationship with the director and threaten the exclusivity of their own deep friendship. In any case, they decided to invite a close friend from one of the big hospitals in Jerusalem, a man of their own age who had gone to medical school with them—Professor Adler, the bypass expert—to perform the operation under their supervision. At first Lazar protested at the idea of bringing in a surgeon from outside for him, as if he himself lacked confidence in the top cardiac surgeon of his own hospital. But Hishin and Levine, working together smoothly and secretly, succeeded in dragging things out and putting the operation off until Granoth would be at a conference in Europe, at which point they would be free to call in their friend from Jerusalem with no hard feelings.

  Since the operation had been “stolen” from the cardiothoracic surgery department and transferred to Hishin’s general surgery department, it was up to Hishin to select the members of the team. He and Levine, despite their senior positions, agreed to take a backseat to their Jerusalem friend and act as junior or even resident doctors. Naturally Hishin chose Nakash as the anesthetist, but since Lazar did not want to offend Dr. Yarden, the anesthetist from the cardiothoracic department, and insisted on including him in the team, he was invited to join Dr. Nakash, without anyone’s specifying which of the two would be senior to the other. At the same time Nakash was given the right to choose an assistant. This was exactly what I had hoped for. It was the sixth day after my arrival in Israel. Up until then I had succeeded in avoiding Hishin, and with Lazar resting at home on the instructions of his two friends, I had not met him either. Since my return to Israel I had spent all my time hanging around Dr. Nakash, in my capacity as a future colleague in the anesthesiology department, but mainly in order to persuade him to choose me as his assistant for Lazar’s operation. But Nakash, who was well aware of my professional competence, suddenly refused. “What do you need it for?” he said in his dry, quiet way. “There’ll already be two anesthetists there, and you’ll have hardly anything to do. And Lazar is in a sense a friend of yours. Why do you want to be there when his chest is being sawed open?” But I insisted. Hishin and Levine were real friends, I said, and they would not only be there during the operation but would take an active part in cutting him up. And we all had to train ourselves to maintain our composure in any situation that came along, whoever the patient was. Dr. Nakash listened to my arguments, his little coal-black eyes glittering in his dark, almost bald head and his pink tongue licking his lips, as was his habit when he couldn’t make up his mind about something. He was hesitant because he really was fond of me, in his shy, reserved way. On the one hand he didn’t want to distress me by making me watch my patron being cut open, but on the other he wanted to give me what I so eagerly insisted I wanted. In the end he decided to consult Hishin, who said at once, “Why not? What harm can Benjy do there? The more the merrier, old friends and new!”

  Maybe I was only projecting my own feverish excitement onto my surroundings, but as the day of the operation neared—it was set for ten days after my return from England—I sensed that the whole hospital was in a state of suspense. But perhaps I was simply not yet acclimated to the Israeli tension and tempo after a year of long nights in the relative peace and quiet of the ancient English hospital. After all, the kind of operation that Lazar was to undergo had become a routine matter in the hospital, and every week there were bypass operations and valve replacements in at least ten patients, as well the correction of congenital heart malformations in babies and premature infants. Nevertheless, I could feel the suspense in the air. It seemed that the clerical staff, who were closer in their daily work to the administrative director and his secretaries than the medical staff, and who were the true guardians of the spirit of the hospital, were the ones responsible for spreading rumors and drumming up suspense. The fact that the operation had been “stolen” from cardiac surgery and transferred to general surgery also added to the drama, and eventually Professor Hishin decided to schedule the operation for the quieter afternoon and evening hours, so that when it was over he and Levine would be available for the long hours of their friend’s recovery in intensive care. On the eve of the day of the operation I decided to drop in to the administrative wing and say hello to Lazar’s secretary, whom I found sitting in her office next to Lazar’s, all alone in the dark, deserted wing. When she saw me standing in the door, she uttered a joyful cry and immediately rose to her feet, offering me her rather ravaged face for a kiss. I embraced her, kissed her warmly on the cheek, and sat down to chat. First of all, she asked to see a picture of the baby and to hear about England, but I soon turned the subject to Lazar, who to my surp
rise was sitting in his office with his two chief assistants, clearing his desk before his hospitalization, which was scheduled to begin that evening. She too was in a fever of excitement and anxiety about her boss’s surgery, and her agitation pleased me and made me feel that I was not alone in my feelings. Suddenly she said, “Come and say hello to him, at least.” I felt myself trembling, and blurted out, “Why bother him now?” But she insisted, knocked lightly on the dividing door, and opened, it saying, “Dr. Rubin’s back from England—he wants to say hello to you before the operation.”