“I remember every-shing.” Roy blinked and tried to clear his eyes.
“There’s only one thing I need you to do.”
“Wash that?”
“You need to stay sane, Roy, for your sake as much as mine. Remember, brain health before all else.”
Roy narrowed his eyes and tried to focus on the doctor. Brain health? Sane? Why would you say that? If anyone is insane, it’s you—cutting off people’s heads, chopping them into pieces …
* * *
The fluorescent lights of the home gym’s new glass atrium glowed bright under the trees.
Roy said, “Stay sane; stay sane.”
He rocked back and forth.
“Stay sane.”
He was sitting cross-legged in the grass out by the shed. Out in the backyard. A bowl of what smelled like mushed cat food in his hand. He blinked and looked around. How did he get here? A second ago, he was at the Chegwiddens’ house, and now he was sitting in the dark, out by his shed. He staggered to his feet.
The sound of a patio door sliding open. “Roy, are you out here?” Penny’s voice.
He looked at the bowl of food in his hand. “Yeah, I’m just … I came out to find the cats. Is everything okay?”
“Everything is fine,” his wife replied. “Those cats have been gone for weeks. Come back in. It’s cold. You’ll catch your death.”
12
The meeting was in Hell’s Kitchen, in the basement of the Church of the Sacred Heart of Jesus, a red-brick megalith towering over the two- and three-story apartments on West Fifty-First Street, a few blocks over from Times Square.
The location alone—in a church—was almost enough to send Roy back to the subway the moment he arrived, but Sam had scoured the message boards for him. It wasn’t easy to find a support group for transplant patients, harder still to find one that focused on body dysmorphia issues.
That was what Sam said he had: issues concerning his perception of his own body.
Roy couldn’t disagree, and he didn’t have any better ideas. Something was better than nothing, and the support group was run by Dr. Kenneth Brixton, a renowned British transplant surgeon. Sam said maybe Roy could get a second opinion on what was happening to him, or something like that.
“Just sign here, and print your name here with a phone number,” the woman said in a singsong Caribbean accent. A pudgy index finger pointed out the correct spots.
Roy hesitated, then went ahead and filled in his real name. What was the point of faking it?
He had talked to Penny about the dinner party, and she said he was just drunk, but he hadn’t had that much. Two drinks? Maybe three? The more he told his wife, the more she wanted to keep him under lock and key. So he didn’t tell her everything.
He was scared.
He had gotten up yesterday morning and decided he needed to heed Sam’s advice and go to a support group, talk to some people who shared his experience or at least some part of it.
The receptionist was a big woman, and proud to be, in a flowing orange sari with floral lace fringe and great, dangling silver tiger’s-tooth earrings. Dark-skinned with a broad, smiling face, and long straight black hair pulled back in a ponytail, she radiated a readiness for work and business. Her gap-toothed smile was infectious.
“We are glad to have you, Mr. Roy,” the woman said. “My name is Fatmata Johnny.” She held out her hand to shake. “I run the support groups for Dr. Brixton. I’ll tell him you’re new here to the group if he comes up.
“This way,” she said, leading Roy toward the stairs down. She had scribbled “Mr. Roy” onto a sticker, and she gave it to him.
“Everyone, this is Mr. Roy,” Fatmata announced. Then she whispered under her breath to Roy, “One of our group died this week. And you might speak to Mr. Mario. He had a double hand transplant. I’m just trying to be helpful.”
Eight men and three women sat around a circle on metal folding chairs. They all said hello and introduced themselves. The scene was as depressing as Roy had feared. Two men wore identical blue T-shirts with the message, “Don’t take your organs to heaven; heaven knows we need them here!”
Roy could already feel the sweat trickling down his back, and not because of the turtleneck shirt. Just leave, his inner voice told him.
I can’t, he replied to himself. It wouldn’t be polite.
Screw polite. Get out of here.
He took a chair from the stack against the wall, unfolded it, and joined the circle.
The man Fatmata had identified as Mario said, “Victor had been waiting for his second heart transplant and died within a few days of finally getting it. He rejected his new heart.”
Roy could just see the edges of the scars on Mario’s forearms.
“But he lived two good years after the first transplant,” a woman said—Sylvia, according to her name tag. “Every day is a gift. Just because Victor died doesn’t mean it will happen to us.”
“For the first few months after surgery, I held my breath, waiting in fear for my body to reject my new organs,” said a man named Carroll, from Brooklyn. “The medical staff at the hospital tried to help, but their main priority is to fix bodies, and they didn’t have time to offer me emotional support. Talking to a psychiatrist who hadn’t experienced this wasn’t the same as talking to people who’ve been through what I have.”
Sylvia said, “One of the most difficult things is living with the guilt over the donor dying to give me what I needed to live.”
This was part of what Roy was struggling with. Sam had been right. Roy spotted a large stainless steel coffee urn on a table, then nodded to the group and went to get a cup.
“We carry guilt around the fact that we were waiting for someone to die so we could live,” he heard the man Carroll say behind him. “We have to help each other ease the guilt by reminding ourselves that these people would have died anyway. They just would have gone to their graves with their organs. When I first heard the word ‘transplant,’ my hair stood up on end. Today I’m fifty-seven on the outside, but inside I’m thirty-seven.”
“I gave this heart life the same way this heart gave me life,” Sylvia said. “That’s the way I think about it.”
“But once you take them up on their handouts,” said Mario, the guy with someone else’s hands, “they pretty much own you. Promotional functions, distributing intimate studies about you to anyone who can get hold of a lab coat. Like I’m more of a specimen than a human.”
Roy pushed the spigot on the coffee urn and filled a Styrofoam cup. He could definitely empathize with what Mario was saying. He put the cup down to stir in some creamer. Behind him, the group leader asked everyone if they wanted to take a five-minute break.
“My name’s Fedora.” The wiry man in a leather sport jacket seemed to come out of nowhere. He stood next to Roy. Right next to him. He held out his hand. “I didn’t introduce myself before.”
“Roy.” He shook the man’s hand.
Was the guy Mexican? Italian, maybe? Roy wasn’t sure. He had a black mustache flecked with gray, a tuft of a soul patch, and sideburns as long as the mullet haircut. He smelled of equal parts cheap cologne and cigarettes.
“What are you in for?” Fedora asked, his eyes narrowing. “Heart transplant? No, let me guess. Liver, right?”
“Well …” Roy sagged.
“Take your time. We’re here for healing, right?” Fedora began filling a cup.
“I’m new to this.”
“It’ll be good for you. Trust me.”
“And you?” Roy asked. “What are you here for?”
“My arm—it’s someone else’s!” He theatrically held out his fist, then snickered. “Bad joke. No, man, this isn’t just a transplant support group—it’s a body-dysmorphic thing. My problem is, I’m in the wrong body entirely. That’s a trip, right? Man, I got arrested by the cops last week for ca
rrying fake papers. Passports and everything.”
“And this is a support group for that?”
Fedora scratched the back of his head. “Maybe, maybe not. The judge let me off and said I had to go to therapy. It’s close, right?”
“If it works for you.”
“It does.”
“Is Fedora your real name?”
The guy smiled an intense grin. “It’s more like a hat I put on.”
Roy nodded, not sure what to say to that, and turned back to the circle of people, who were chatting in twos and threes. He had decided that Fedora was probably Latino, partly from the accent. Weird guy, but Roy liked him.
Maybe he should just go introduce himself to the group, say what happened. Get it out in the open. Part of the problem was that he didn’t even want to talk about it. He didn’t want to admit the freak he had become—the guilt and anger and, worse, the fear.
The pain he could deal with, but the fear seemed bottomless.
“Mr. Lowell-Vandeweghe,” said a loud male voice with a British accent. A man strode purposefully across the linoleum floor in the time it took the stairwell door behind him to swing shut. “What a bit of luck! It is you! I’m Dr. Kenneth Brixton. Do you suppose we might have a word?”
* * *
“So what can we do for you, Mr. Lowell—”
“Roy, just Roy.”
“Ah, yes, of course. And you can just call me ‘Brixton’; everyone does.” The doctor gave a rosy-cheeked smile through two days of stubble. His suit looked as if he’d just woken up in it. “Now, what can we do for you?”
Was this normal? Did this famous surgeon do one-on-ones with everyone who walked in the door? The guy didn’t exactly look prosperous. “I don’t know. I, uh …”
The room was to one side of the large open basement, with a dividing window wall of glass crisscrossed with embedded wire. Above the row of cast-iron radiators along the street-side wall were two half windows reinforced with metal bars. The doctor had closed the disintegrating wood-laminate door, the only way in or out. The enclosed space smelled strongly of floor polish with a faint note of mildew.
“I know who you are, Roy. We can dispense with that. And I know Dr. Danesti only too well. My question is, with all the resources Eden has at its disposal, what are you doing here, in a musty church basement west of Times Square?”
“To be honest, I don’t know.”
“I think you do.”
“How do you know Danesti?”
The doctor pressed his lips together. “A better question is, who doesn’t know him these days? Am I right? And I knew him professionally, of course.”
Roy leaned forward to rest his elbows on his knees. “I’m having trouble.”
“And who wouldn’t be, in your shoes,” Brixton murmured. “I’m sorry,” he said in a louder voice. “Look, chap, the first rule of medicine is to do no harm. You are facing some unique challenges. Honesty the best policy, and all that.”
“I’m scared shitless. That’s about as honest as I can be.”
Brixton gave him another hobo smile. “Before surgery, people are usually dying, and they’re terrified,” Brixton said. “Their main concern is getting that transplant so they have a chance to live. After the transplant, recipients realize that things aren’t perfect. They must deal with harsh realities. They have to be permanently on expensive medications that may have side effects and may play havoc with their moods. They may have to go in and out of hospitals. In essence, they’ve traded a terminal illness for a chronic illness.”
“This wasn’t my decision. I was in a coma.”
“So then you’re stuck living with the consequences of someone else’s decision.”
Roy’s stomach churned. “This was my fault, not theirs.”
“Guilt is a common reaction people have after a transplant. Patients often report thinking a lot about the donor and feeling guilty about benefiting from the donor’s death. After the procedure, some get the feeling that they had been wishing for someone else to die. And to further complicate those feelings, at what point can we really say that someone is dead? Who makes the decision to harvest organs? A tricky thing, cheating death.”
Maybe it was the church basement, but Roy suddenly imagined the undead—long curling nails, pallid skin, and misshapen fangs. “I was dead for more than an hour, they say. Maybe I should have been the donor.”
“But luckily, you’re rich.” The doctor seemed to catch himself. “Excuse me, that wasn’t fair.”
Roy leaned forward to get to his feet. “This was a mistake.”
Brixton laid a hand on his arm. “Just tell me, why did you come here?”
With a sigh, Roy eased his weight back onto the chair. “I’m getting these dreams, almost every night. The same dreams, over and over.”
“You are a body dreaming it has a head, or a head dreaming it has a body?” Brixton said. “Is that it?”
“Something like that. I don’t feel normal.”
“But what is ‘normal’? Medicine has no way of really knowing. We define it with mirror writing, by seeing our reflection. Only the limits of abnormality define normality. Deviance defines the limits of conformity. Perhaps you are the freak now, but perhaps just the first exemplar of the new normal.”
“You’re losing me.”
“I’m not sure that Dr. Danesti has fully informed you of the challenges you face. Is he keeping you confined? Away from prying eyes?”
Yeah, he is. “I’m here, aren’t I? I just need to talk to someone.”
The doctor leaned back and looked at the ceiling. “You know, I like to think of the human nervous system as a tree. If you invert the human nervous system, look at the pattern of nerves spreading out from the brain. It looks like a tree—but this is a tree that dreams. And the tree does not survive without the branches and leaves. What has happened to you isn’t the same as grafting a single branch onto an existing, healthy organism.”
“So you’re saying the dreams—they’re not just me?”
“The question really is, who are you now? Your conscious stream, the record of one moment to the next, is in the brain. But the bulk of your nervous system and gray matter is foreign to you. Ninety-five percent of your body is not your brain’s body. You now have two sets of DNA. You are a chimera.”
Roy remained silent, though he glanced at the door.
“Just hear me out,” Brixton continued. “While we might be able to reconnect the tissue and blood vessels in the surgery you underwent, the mind is a whole different thing. Change the body, and you change the mind. Do you ever get a ‘gut feeling’?”
“Sure, who doesn’t?” Just words were enough to knot Roy’s stomach in a churning roil, as if something were fighting to get out of him.
“You see, Roy, there isn’t just one brain in the human body. Did Dr. Danesti explain this to you? There are, in more than a figurative sense, two brains.”
“Danesti said that what made me me was in my head. He said it would …” Roy shifted in his chair, searching for words. Two brains? The walls of the room seemed to warp and bend in his peripheral vision.
“There is a secondary brain in the human body—in fact, some would even say that evolutionarily speaking, it is the primary brain. The mass of nerve cells around the gut is the vestige of our most primordial brain …”
Roy’s stomach clenched again. Painfully this time.
“Connected to the modern brain by the vagus nerve, it controls the heart, the lungs. We all began as worms from the primordial soup, and this ancient brain was the thing that made us survive, made us into the killers we are. The modern brain is a recent offshoot, and there are dozens of mini brains throughout our bodies, which provide body control and reflexes. ‘What your gut tells you’ is not just an expression, but a real thing. Your body now has two connected nervous systems.”
The pain intensified. Roy gritted his teeth. The doctor’s face ballooned cartoonishly in his vision.
“… Connecting two parasympathetic nervous systems … two different unconscious systems connected together. You are not just you anymore, Roy …”
The words became disconnected.
“Do you hear an inner voice?”
A pause in beats as the room faded in and out.
“Dementia … two brains. This is what … Are you all right? Mr. Lowell-Vandeweghe …?”
* * *
“Roy, sweetheart, is that you?”
A light clicked on. After the cool blackness of a second before, the brightness of it almost blinded him. He held up a hand to shield his eyes.
Penny squealed and scrambled back against the mahogany headboard of the bed in their spare room, her lacy nightgown up around her midsection. She almost fell out of the bed. “What are you doing!”
“What’s wrong?” Roy’s mouth felt full of molasses. He could hardly get the words out. “I was just … I’m just …”
“Don’t … don’t hurt me,” she stuttered, eyes wide.
“I’m not doing anything.” Roy wiped his face with his hand. He looked at the hand. It was covered in mud. Not just that. Something red. Blood. Still hazy, he looked at his other hand. It held something aloft.
“Put the bat down, Roy! For God’s sake, I’m calling the police.” She had her cell phone in her shaking hand now.
Roy put the weapon down on the bed. How had he gotten here? A second ago, he’d been talking to Dr. Brixton. God damn it. Another blackout. “Don’t do that. I’m just sleepwalking. I’m sorry. I’m okay. I was just sleepwalking. I thought I heard something.”
13
“Drop them there,” Del said to her partner, indicating a wooden table by the open door. Officer Coleman tramped up the last two stairs and nodded.
She wasn’t entirely sure why, but she had asked him to pick up the Pegnini files from almost two years ago. She wanted to look through them again. It was Friday, and she had spent the day filling in paperwork online, so Coleman had volunteered to pick up the boxes and some other files they were working on from storage. She pushed the image of the impaled bookie from her mind. The Pegnini case had opened a treasure trove on the Matruzzi crime family, earning her a quick promotion, but it was also something she tried to forget.
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