The Morning Star

by Karl Ove Knausgaard

  Quite fearless, it stood there. Then, after a moment, it lowered its head, turned and slipped away through the hatch into the barn.

  * * *

  —

  As the bath slowly filled with water, I undressed, folded my clothes and put them on top of the laundry bin. Standing there naked, I considered myself in the mirror. It was seldom I ever did, but now I wanted to see what I might look like to others.

  My thighs were white and round, my hips broad. My stomach was soft and crumpled into folds when I bent forward.

  I smoothed my hands over my hips. It looked awkward, as if all of a sudden I felt uncomfortable with myself.

  I’d spent my twenties and thirties reconciling myself with my body. Now, everything I’d eventually come to accept then had changed, and it seemed like I could start again.

  Eww.

  It was so much better not to have a man to please. There was no need to think about it then.

  I turned the tap off and stepped into the bath. The water was red-hot, but I persisted, lowering myself gently until I was sitting down.

  My skin prickled agonizingly for a few seconds, requiring all my resolve to stay where I was. And then it was good.

  I leaned back and the hot water assailed my upper body, but again the agony subsided and I closed my eyes.

  After the gushing water from the tap, the room was completely still. I heard only the murmur of the television in the living room, the faint rush of the waterfall in the dell.

  The dripping tap, droplets gathering and releasing, one after another.

  I smoothed a hand over my brow, drew my fingers through my damp hair and was just about to pick up the soap when my mobile started ringing.

  It was an infernal invasion. I reached over the edge of the bath, pulled my trousers toward me, extracted the phone from the pocket and saw that it was the hospital calling.

  It’ll be Inge, I thought. He’ll have had a hemorrhage.

  But it wasn’t Inge, it was Ramsvik, he was on life support and a transplant team was on its way from Oslo.

  I dried myself quickly, put the clean clothes on that I’d laid out for tomorrow, and went in to check on Mum.

  She opened her eyes when I stopped at her bed.

  “Aren’t you asleep?” I said. “Is anything the matter?”

  “No,” she whispered.

  “Good,” I said. “I’m afraid I’ve got to go back to work again. Will you be all right?”

  “Yes,” she whispered.

  “Do you want me to make you a sandwich?”

  “No. Line . . .”

  “I’ll tell her,” I said. “She’s all right. Don’t be afraid to ask her if you need help!”

  * * *

  —

  Everything was quiet as I closed the door behind me and went over to the car. The fjord light and filmy, the fell heavy and silent, the sky clear.

  Thank goodness it wasn’t Inge!

  The thought had been coming back to me all day, that suddenly he would be lying there, his eyes big and black and dead, his brain full of blood.

  It happened now and then.

  I backed out onto the gravel track, fastened my seat belt, put the car into gear and drove off down the hill, faster than I usually did.

  Farther down by the gate, an animal was standing in the middle of the track. At first I thought it was a dog, but as I got closer I realized it was a fox. Probably the same one, I supposed. I didn’t slow down, presuming it would bolt to one side and run away. Only it didn’t.

  I braked in front of it.

  It looked at me.

  I blew the horn, revved the engine, but it didn’t budge.

  Not until I opened the car door and made to get out did it turn and slink away into the pasture, disappearing a moment later in the tall grass.

  Someone must be feeding it, I reasoned, and carried on my way. It was nearly tame. It was a shame, what were people thinking? Wild animals were wild and ought to remain so.

  There were hardly any cars out, and I drove as fast as I dared along the narrow roads. On the other side of the fell, where the road into town swung west and the landscape flattened out, I saw the star again, shining low over the peaks. It was almost as if I’d got used to it already, and I savored the splendor that was all around. The bluish, night-silent landscape, the star shining so brightly and so vividly in an otherwise empty sky.

  In Oslo I’d worked as an operating theater assistant at Rikshospitalet. I loved the job, but the intensity it required, the stress that went with it, wouldn’t accord with living here, I’d told myself when I decided to make the move back. Sometimes, though, if it was a major operation, they would call on me to assist. I didn’t mind, the money was good and occasionally it felt like there was too much administration in my normal work.

  Everything was about life and death in the operating theater. And everyone who’d ever worked there wanted to go back.

  Even tonight, I thought as I passed through the stillness of the valley, was about life and death. The patient was dead, but his organs were alive and were to live on inside other patients.

  To shield myself from the next thought—that it wasn’t just a patient, but Ramsvik—I ejected the CD that was in the player and inserted another.

  Eurythmics, “Here Comes the Rain Again.”

  How I’d loved that song.

  It occurred to me that I could look in on Inge while I was there. There’d be nothing odd about that, he was a patient on my ward. If I was lucky, he’d be awake too.

  Around me the farms segued seamlessly into detached houses, scattered at first, gradually clustering until they at last became a city that lay twinkling below. Passing over the plain after crossing the river, I saw a helicopter coming in low overhead. That would be the team from Oslo, I thought, pulling into the car park in front of the hospital at the same moment the chopper landed on the platform on the other side. The thought of Ramsvik, which had long been a kind of shadow in my mind, now loomed large as I hurried through the car park, entered the building and descended into the basement.

  His two children had lost their father tonight.

  I breathed deeply a few times. Death belonged to life. Death was natural. It came all the time and took people away. This time it was Ramsvik. It was only natural. Children lost their fathers. That too was only natural.

  With these thoughts in mind, which I repeated to myself whenever death came close, I hurried to get changed and then took the elevator up to the operating theater.

  * * *

  —

  Ramsvik lay hooked up to a ventilator in the middle of the glaringly illuminated room, amid tubes and wires, surrounded by monitors. There were five doctors present. Henriksen, one of our own, stood by the operating table in conversation with the surgeon I understood to be leading the transplant team.

  Camilla had briefed me on the way in. Ramsvik had suffered a renewed hemorrhage, so massive there was nothing to be done, the damage to the brain far too considerable. He’d immediately been put on life support to keep his organs alive.

  It was impossible to comprehend that he was dead. His chest rose and fell and his heart was beating. He looked like any other patient under narcosis.

  I’d liked him. He’d been an exceptional man.

  “Good to see you, Solveig,” Henriksen said. “Everything all right?”

  His eyes smiled above his mask.

  “Mm,” I said.

  “Let’s get ready, then.”

  “OK,” I said.

  The procedure was for Henriksen to lead the operation until the life support was switched off and the heart stopped, the Oslo team taking over from there to remove the heart. Once that was done, Henriksen would step in and remove the abdominal organs.

  Normally, he’d put his music on now. His 1950s playlist—Elvis,
Jerry Lee Lewis, Bo Diddley, but also Frank Sinatra and the other crooners. All a bit silly to my mind, though I’d always liked Elvis. “Blue Moon,” especially.

  Tonight, though, everything was taking place in silence, out of respect for the deceased.

  I stepped up to Ramsvik. His cheeks had more color now than when I’d seen him earlier in the day. I began to get things ready, putting out the hypodermics that would be needed when the chest was opened, tongs, scalpels, catheters, saw, while Camilla primed the machine that would keep his blood circulating. The Oslo team stood chatting behind us with their arms folded.

  I checked the monitors. All functions normal. The heart was beating steadily, comfortably.

  Henriksen bent over Ramsvik, glancing up with a nod at Kyvik, who shut off all infusion. Henriksen then gripped Ramsvik’s index finger and pressed hard against the nail. I looked at Ramsvik’s face, which remained motionless. He wasn’t anesthetized, yet the brain registered no pain and was quite without life.

  “You can never be too sure!” Henriksen said with a chuckle before straightening up. “Right! Let’s switch him off.”

  He did so himself, and I removed the tube from Ramsvik’s mouth.

  All heads turned to the monitors. Sometimes hours could pass before respiration ceased and the heart stopped pumping. If it took more than ninety minutes, the organs would be useless. But such cases were rare.

  It wasn’t going to happen now either. The blood pressure dropped as respiration grew fainter, stopping definitively after perhaps a minute.

  The curve shown on the monitor leveled off as the heart came to a halt, and after a moment it flatlined completely. An alarm signal sounded.

  The ultrasound image showed the heart to be quite motionless.

  “Five minutes,” said Henriksen. “From now.”

  He left the room, followed by one of the assistant surgeons.

  I stared at the lifeless body that only a few seconds before had been living. For no apparent reason, the gentle guitar chords of “Blue Moon” came into my head. It was as though the song were actually playing inside me, rather than coming from memory.

  I glanced at the others in the room, and a wave of emotion washed through me. I blinked to get rid of the tears, making sure no one saw me, as together with the transplant nurse I began to get things ready for the next and most substantial part of the operation. The body would be opened, the various organs removed, a minutely detailed and time-consuming procedure with no room for mistakes, everything had to take place quickly and precisely.

  “Have you done this before?” said one of the transplant assistants, a man who seemed to be in his early thirties. He looked unhealthy, bags under his eyes, but then I supposed we all did in the glaring light.

  “I worked at Rikshospitalet a few years ago,” I said.

  “As a theater nurse?”

  “Yes.”

  “And you ended up here?”

  “It’s where I’m from,” I said. “I wanted to come home.”

  “Did you know him?” he said then, with a nod toward Ramsvik.

  “He was my patient.”

  He shook his head in sympathy. Behind us, Henriksen returned to the room.

  “Five minutes gone,” he said. “Any signs of life?”

  “No.”

  “Right then,” he said. “Let’s get started.”

  I washed the chest, abdomen and groin with disinfecting agent. Kyvik infused the anticoagulant, before Henriksen inserted the tubes of the heart-lung machine into the groin. Into one he fed a balloon that would be inflated just below the brain, ensuring that any remaining blood flow would be blocked. Then, he switched on the machine that would circulate the blood and infuse it with oxygen.

  I’d always found this disconcerting, for now the lower body was alive, while the upper body was dead. The head, neck and chest above the heart became cold, gradually turning blue, while the lower body remained living and warm.

  There was a flurry of activity around me. I drew the instrument tray with its scalpels, knives and clamps toward me, arranging them one last time before the surgeon began. Ramsvik’s corpulent frame lay motionless on the table in front of us; his face was quite white, drained of blood, with a faint tinge of blue.

  His whole body, with the exception of the head, chest and abdomen, was covered up. I handed the surgeon a scalpel and he drew a long incision from the throat to the pubis. Fresh, red blood trickled out. When it was done, he returned the instrument to me. I placed it in the holder, then handed him the saw.

  I looked up at Ramsvik’s face as he began.

  His eyes were open.

  “The patient’s awake!” I shouted.

  “Don’t be silly,” the transplant surgeon said, immediately switching off the saw. “He can’t be.”

  But he too could see that the eyes were open.

  “I’ve not seen that before,” he said. “But I did once have one who shouted after he was dead. Now that was scary!”

  He started the saw again.

  But the eyes that lay open there were not dead. There was life in them, I knew it. It was as if he were looking out at the world from a place far, far away.

  Yet the heart was not beating. And the brain had been without blood for some time.

  It didn’t matter. There was life in those eyes.

  “Are we certain he’s dead?” I said. “Could there be something wrong with the balloon?”

  Both the Oslo surgeon and Henriksen looked at me in annoyance.

  “It’s just a reflex,” the Oslo surgeon said. “He is brain-dead. The heart has not beaten for ages. It’s not possible for there to be life in him.”

  “Look at the X-ray, Solveig,” Henriksen said. “And at the blood pressure. The balloon is functional.”

  “He’s as dead as a dead fish,” said the Oslo surgeon. “Now, let’s continue.”

  He leaned forward and the saw whined into life as he pressed it to the chestbone. A fine dust filled the air as he cut through the bone, and as the blade slowly made its way downwards, blood trickled forth again, fresh and red.

  Ramsvik opened his mouth.

  “Stop!” I shouted.

  The surgeon stopped the saw again.

  “Aaaaaaaaaaaa,” came a voice, barely audible, from the body on the table.

  “What the hell is happening?” said the surgeon. “It can’t be, it’s impossible!”

  I looked at the monitor. The heart had started beating again. The curve was low, but it was a curve.

  “The heart’s beating!” I said.

  He was alive.

  A kind of panic broke out. The eyes that stared out from above the surgical masks were frightened, darting about as if in search of something concrete to latch on to.

  “The definition of death is that it’s irreversible,” said Henriksen. “No one can come back from the dead. Which means that he is not, and was not, dead.”

  “Oh, good God,” said the transplant assistant.

  “What do we do now?” said the transplant surgeon.

  “We sew him together again and then scan the brain,” said Henriksen.

  “No organs tonight, in other words,” the transplant surgeon said.

  “No,” said Henriksen.

  “How can it be possible?” the transplant surgeon said, shaking his head. “There’s been no circulation in the brain for half an hour. The heart was stopped. And the balloon is functional, yes?”

  “Looks like it,” said Henriksen. “The fact, however, is that he’s alive.”

  “What will happen to him now?” I said.

  “He’ll receive no treatment,” said Henriksen. “No nourishment. So he’ll simply expire nice and peacefully. Best for everyone.”

  He lifted his voice.

  “Not a word outside this room about what’
s happened here, is that clear? Not a word in Oslo, not a word here.”

  * * *

  —

  I took off my cap, mask and gown, tossed them in the laundry bin and got myself a coffee. Henriksen, scrubbing down, turned his head toward me.

  “It can take up to twenty-four hours for the heart to stop after brain death,” he said.

  “But his heart stopped after only a few seconds,” I said.

  “Yes, yes, yes,” he said. “It’s happened before. There was a time in Sweden, years ago now, when something similar occurred. The patient had been declared brain-dead and they were busy removing his organs when suddenly he opened his eyes.”

  “I’ve heard about that,” I said. “But they must have been wrong. The patient can’t have been brain-dead at all.”

  “No,” said Henriksen.

  “But Ramsvik was dead,” I said. “We all saw that.”

  “Logically, he can’t have been,” said Henriksen. “There must have been something wrong with the balloon. It can’t have been working right. That happens too, of course. Nothing’s infallible.”

  He smiled.

  “Anyway, it’s still early. We’re off for a drink. Fancy joining us?”

  He winked at me.

  “No, thanks,” I said.

  “OK,” he said. “Some other time, then.”

  He produced a little spray bottle, sprayed three times into his mouth, wiped his lips and dropped the bottle back in his pocket.

  “Nicotine,” he said. “See you later, Solveig!”

  I waited a few minutes before taking the elevator down to the ward. Jorunn appeared from the duty room as I stepped out. She must have heard it stop.

  “Hi, Jorunn,” I said. “Everything all right? Just come to get something.”

  “Have you been assisting with the transplant?” she said.

  “Yes,” I said.

  “Poor man,” she said.

  “I’ll say,” I said, and went into my office, put an unused ring binder into a plastic bag and went out again, to Inge’s room.

  I knocked cautiously and opened the door.

  He was sitting up in bed supported by pillows and turned his head toward me as I came in. His face was pale, there were dark rings around his eyes and a shadow of stubble on his cheeks and chin. His eyes glowed.