Open Heart

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Open Heart Page 45

by A. B. Yehoshua


  It was breaking every rule in the book to leave the operating room now, but I knew that if I could find Dr. Vardi, Hishin would be able to go upstairs, and with his courage, his resourcefulness, perhaps he would be able to save Lazar’s life. But the wing was empty except for a couple of nurses in the intensive care unit. Suddenly the twilight turning red around me intensified my feeling of dread, and in the absolute silence I could sense my heart beating. Hishin was absorbed in the woman’s stomach, and nobody was watching the anesthesia machine. But I pressed the button of the main door of the wing nevertheless and hurried out into the bustling corridor to see if I could find some other surgeon to take Hishin’s place. In the distance I saw Nakash’s brown suit. He was on his way home, but the minute I told him what was up he hurried back into the surgical wing with me, although he wouldn’t enter the operating room itself in his ordinary clothes. In my absence there had been another phone call from Levine. “But what does he want?” cried Hishin, his face gray. “How can I leave the operating room now?” In the meantime the rumor of the administrative director’s deteriorating condition had apparently spread through the hospital like wildfire, and two doctors from cardiothoracic surgery had already hurried upstairs, as Dr. Levine called desperately for help in all directions. With a pang I saw that Hishin’s hands were trembling again. He stood still for a moment, closed his eyes in concentration, and then returned to work at the proper tempo, refusing to give way to the temptation to hurry things up.

  The quiet, fresh-faced young nurse, who had not yet opened her mouth, could no longer restrain herself and asked, “Who’s Lazar?” Hishin didn’t answer, but I began to tell her much more about Lazar than her innocent question warranted, as if I wanted by my words to strengthen his soul as it hovered between life and death. The telephone rang again. It was Nakash, who announced that he had succeeded in persuading Levine to bring the still unconscious Lazar down to the cardiothoracic surgery intensive care unit, which was close to us in the surgical wing. Hishin nodded his head. The hour of his most terrible test was upon him, under the watchful eyes of the entire medical staff of the hospital. Would he really be able to save his friend? But he went on cauterizing the blood vessels to prevent bleeding. From time to time he would offer his forehead to the nurse for her to wipe away the perspiration. The sound of loud, excited voices reached us as Lazar was brought into the wing, but Hishin didn’t budge from his place and he signaled me too not to move. Nakash came into the room, wrapped in the green operating room uniform, a plastic cover on his head and his face hidden behind a mask. In his quiet, noble way he offered to help so that Hishin could leave as soon as possible. All he could tell us about Lazar was that his heart was still fibrillating in spite of the electric shock he had received. Suddenly Levine burst into the room in his ordinary clothes, with a strange, rather mysterious expression on his face, looking as if his psychiatric leave had already begun. But Hishin stopped him immediately. “For God’s sake, David,” he said in a stern tone, “let’s try to keep our heads here. I have to finish the operation. And this young woman too deserves to get everything we can give her.” He bent over the gaping stomach, steadily continuing his work, and when it was all over and she was ready to be sewn up again, I could no longer hold back and offered to complete the suture for him. Hishin gave me a hard look, his little eyes burning in his pale face; he thought for a minute, and then he said, “Right. Why not? Nakash can take over the anesthesia.” He put the scissors down on the tray, held out his hands to the nurse for her to remove his gloves, and hurried from the room.

  I began stitching the big incision, straining my ears to hear what was going on in the intensive care unit, even though I knew that the heavy doors would prevent any sound, encouraging or otherwise, from reaching us. I suggested to Nakash that he pop out to see what was happening, but he waved a dark hand in firm refusal and said, “No, Benjy, let’s wait. We don’t want to disturb them now,” as if he too were afraid to see what was happening next door. And so I continued neatly and carefully suturing the surgical wound, doing my best to ensure that the scar on the young woman’s stomach would be as unnoticeable as possible.

  At last I was able to give Nakash the signal to bring our patient around and to ascertain from the state of her pupils, before he got dressed and hurried home, whether she had indeed returned to the land of the living. Outside in the corridor I felt the full weight of the weariness and the anxiety that had accumulated inside me. I decided to sit down for a moment on one of the little chairs, to fill in the anesthesia form and to ask the nurse with the face as pure as an angel’s to find out what was happening in the intensive care unit at the end of the corridor. She came back immediately and said, “I’m sorry, Dr. Rubin.” I jumped up and hurried there myself. My eyes were immediately drawn to the bed crammed between the various instruments, between the respirator and the big old defibrillator. His body was covered with a white sheet, but over his face there was a green sterile cloth, which for some reason brought back in a flash the picture of the two of them in the textile bazaar in New Delhi, standing next to a stall selling silk scarves, where she’d tried on one scarf after another and he’d watched her with an expression of weariness and boredom and had tried to move on; and then she’d held out a green silk scarf, and before he could resist, she’d put it on his head and adroitly tied the ends under his chin, like a granny’s handkerchief, and stepped back to contemplate his embarrassed and amused expression before bursting into peals of jubilant laughter, in which she was momentarily joined by the passersby. And now he was dead. The pain clutched my heart. And his good friends Hishin and Levine would not be able to escape the duty of going, stunned and eaten up with guilt, to give the terrible news to the woman who couldn’t stay a single day by herself. Nakash was now standing beside me in his suit and tie. For a moment he hesitated, and then his curiosity got the better of him and he went up to the dead body lying between the medical instruments and lifted the green cloth off, to look at Lazar’s face and perhaps to say good-bye to him too. In spite of everything Nakash had come to us from the East, and despite his great expertise in anesthesiology and his thorough knowledge of medicine, in the depths of his soul he remained a fatalist, and when death descended on someone close to him, he accepted it completely, without question, without complaint, and above all without trying to blame anyone.

  He also did not want to hear my diagnosis, but calmly took his leave of Lazar and of me and went home, switching off the light behind him with his usual economy and casting the entire wing into gloom. I decided not to change my clothes but to hurry as I was to the emergency room, not only because my shift had already begun but also because I was sure that somebody there would be able to tell me what had happened. But the two young surgeons I found there, who had been with Hishin and Levine and the others when they tried to resuscitate Lazar, were still so stunned and upset that despite their eagerness to explain and interpret everything, as eager young doctors will, it was difficult to get a clear picture from them. All I learned was that after Lazar had been declared dead, Levine and Hishin had rushed off to treat Einat, who went into shock when she heard of her father’s death. At first they had wanted to co-opt me to join the delegation bearing the bad news to his wife, but since I was still busy in the operating room, they had called on Lazar’s secretary instead, who went into hysterics and began to scream and cry. Again, unlike the usual practice, the young doctors did not try to blame anyone. Not even Levine, who had been with Lazar when the fibrillation began. Nobody could have expected it—only two hours before an EKG had yielded completely normal results. Arrhythmia was characteristically elusive—it came and went as it pleased. I decided to keep my peace, since nobody could possibly know just how deep my ties with the Lazars went, and I busied myself with the work of the emergency room, which was particularly intensive, with the knowledge of the death of the hospital director breaking over us in wave after stunning wave as we worked into the night. At two A.M., I was called to the surgi
cal wing to assist with a local anesthesia. As soon as it was over I went into the little instrument-packed room again, as if to be certain that the body had indeed been transferred to the hospital morgue, where I had for some reason never been before.

  “How do you get there?” I asked the man at the information desk in the entrance lobby, who told me what I wanted to know but insisted that at this hour of night the place was locked and there was nobody there. “Don’t talk nonsense,” I said angrily, “people die at night too,” and I went down to the basement. On the stairs I met three doctors, whom I immediately recognized as Dr. Amit, deputy head of cardiothoracic surgery, Dr. Yarden, the anesthetist who had taken part in Lazar’s operation, and the elderly pathologist Dr. Hefetz. I knew that they were coming from the place that I was going to. To my surprise, they not only recognized me but did not seem surprised to see me there, as if it were only natural that I should be going down to the morgue at two in the morning. “Were you there when it happened?” they asked immediately, as if looking for someone to blame. “No,” I said, “but ever since the operation I haven’t been able to stop thinking about the possibility of ventricular tachycardia.” Dr. Amit shook his head. He didn’t agree with me; perhaps the immediate cause of death had been the arrhythmia, but he suspected that the deterioration in Lazar’s condition stemmed from an infarct caused by an occlusion in one of the bypasses. All three of them seemed very depressed by what had happened. “This death won’t do the reputation of our hospital any good,” pronounced Dr. Hefetz, who agreed to come down with me and show me the body. “But there isn’t much left to see,” he warned me as he turned back down the stairs—for Lazar, like the rest of us, had donated his organs to the hospital research laboratories. It seemed strange to me that the pathologist agreed without any hesitation to my request, as if he, too, understood that I had some special rights here. Had he heard about the trip to India? He opened the door leading to the two adjoining basement rooms. In one of the corners stood a large refrigerator with rows of big iron drawers. He pulled one of them out. I saw a smaller, shrunken Lazar, crudely stitched up after the removal of his internal organs. “Did they take his heart too?” I asked. “Of course not,” Dr. Hefetz answered in surprise.

  I suddenly felt calm and wide awake. I knew that I shouldn’t wake my parents at this hour of the night, but I felt that I had to share my feelings with them. I called them up and told them about Lazar’s sudden death. Like all kindhearted people on such occasions, they were shocked and saddened. Again and again they wanted to know how and why it had happened, as if from their home in Jerusalem they could understand what important professors at the hospital like Hishin and Levine had failed to understand. Suddenly I wanted to console them and tell them not to grieve, for Lazar’s soul had already been reincarnated in me, but I knew that they would think my sorrow had driven me out of my mind, and so I only asked them for my aunt’s telephone number in Glasgow so I could get in touch with Michaela. I took a beeper from the emergency room, switched it on, and stole into the administrative wing, which I was sure that the secretary had forgotten to lock up in the commotion. I was right. The door to Lazar’s office was open, and I didn’t even have to put on the light, because there was enough moonlight for me to see the numbers on the telephone. I found Michaela and Stephanie with my family in Scotland. I told Michaela about Lazar’s sudden death and asked her to cut her trip short and come home. There was a silence on the other side of the line. “Look,” I said aggressively, “I know you’re entitled to another week in Britain, but it wouldn’t be right to leave me to cope with the baby alone now in the new situation that’s arisen.”

  “What situation are you talking about?” asked Michaela in surprise. For a moment I was angry that she couldn’t understand by herself, but I tried to stay cool. “I’m asking you, Michaela.” I spoke quietly but firmly. “It’s not only Shivi who needs you; I need you too. You’re the only one I can talk to about what’s happening to me. Because nobody else would believe that Lazar’s soul has entered my body.” There was a profound silence on the other end of the line again. But it was no longer the silence of resistance. It was a new, different silence. And I knew that what I had just told her would capture her imagination and excite her curiosity so much that she would cancel her trip to Skye and fly home.

  Sixteen

  Twice during the week of mourning I paid a condolence call to the Lazars’. The first time alone, the day after the funeral, and the second time with Michaela, who returned to the country four days after our midnight telephone conversation. I might have paid a third visit, with my parents, who vacillated between going to the funeral and paying a condolence call until I persuaded them that their relations with the Lazars did not justify either of these measures and it would be enough to send a sympathy letter, which I helped them formulate over the phone. So that I could perform the overt and covert duties imposed on me by Lazar’s sudden death, I asked my parents to keep Shiva with them until Michaela arrived. The overt duties were clearer than the covert ones, and involved the funeral itself, which was scheduled for the day after his death so the hospital administration and his many friends there could organize a dignified ceremony and try to rehabilitate the hospital’s reputation in the wake of damaging rumors about a failed operation and an incorrect diagnosis. I myself was careful at first to maintain medical confidentiality, precisely because I felt that I would be a more reliable source of information than Professor Levine, who was so stunned and grief-stricken by the death of his friend, which had taken place not only in his department but under his personal care, that he retired into a corner and delegated some of his authority to his deputy as a kind of private punishment for himself. In this way he succeeded in diverting most of the darts of criticism from himself to Professor Hishin, who had “stolen” the operation from cardiothoracic surgery and brought in an expert from another hospital. True, patients occasionally died after bypass surgery in the cardiothoracic surgery department too, but these were considered “internal” deaths, while Lazar’s was “external,” brought from outside in an act of treachery. Since I was still convinced that the cause of Lazar’s death was not connected to the surgery but stemmed from a mistaken diagnosis, when the criticism intensified I felt I had to break my silence and defend Professor Hishin from his detractors in the hospital, among them people I hardly knew—physicians, nurses, and members of the administrative staff—who began buttonholing me in the corridor the day after Lazar’s death and questioning me about what had really happened. Dr. Nakash, who happened in on one of these corridor conversations, immediately took me aside and warned me, with uncharacteristic sharpness, to stop letting my mouth run away with me. At the funeral too, which began in the plaza in front of the hospital, I sensed that he and his wife were deliberately keeping close to me and discreetly trying to prevent me from joining the inner circle of mourners, family and intimate friends now surrounding Dori, who was standing at a careful and fearful distance from her beloved husband.

  Mourners were packed into the plaza—their numbers exceeded all my expectations, and many appeared to be truly grieving, for throughout the crowd I saw tears sparkling in the eyes of men and women as they listened to the eulogy delivered by the medical director of the hospital, a gray, retiring man who began by reading in a low clear voice from the notes he had prepared about Lazar’s life history. Lazar had been born and brought up only two or three streets away from the hospital. In his youth he had studied medicine, but in his second year he had had to abandon his studies because of his father’s illness and go to work to support his younger brother and sister, recognizable in the circle surrounding Dori by their physical resemblance to their brother. From a distance it seemed that the two of them were careful not to get too close to Dori, as if they feared that this pampered, vivacious woman’s rage at being left alone by her husband might be greater and more violent than her grief. Even her mother kept her distance, standing with her grandchildren on either side of her, the three s
upporting each other. Only Hishin, perhaps by virtue of his medical authority, which in the eyes of the Lazars was absolute, dared to approach Dori and take her arm as she stood steadily on her straight legs, her left foot even at this difficult time in the lax, slightly out-turned position I always found so appealing. Hishin had honored the occasion by wearing a black suit, but instead of a skullcap he wore an old black baseball cap on his head, which gave him the air of a sorrowful bird. As someone who had stood at his side for many hours next to the operating table and learned to sense every shift in his mood, I felt even from a distance the tremendous tension in his movements, as if he were about to whip out a knife and operate on himself. I did not yet know that he had claimed the right to eulogize Lazar at the graveside and that he was going over the first sentences of his speech in his mind as his little eyes scanned the hostile audience. Dori’s eyes too wandered over the people around her, but it did not look as if any sentences, or even words, were coming into her mind. She was so stunned by the catastrophe that she didn’t even realize how her eyes, encountering the familiar faces of her friends, lit up, even at this terrible time, in the old, friendly smile, although the light was so dim and weak that I thought my heart would break.

 

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