Harvesting the Heart

by Jodi Picoult

  Nicholas and his father parked the car on a side street and got on the Green Line of the T. When the trolley swung to the left, Nicholas's shoulder grazed his father's arm. His father smelled faintly of laundry detergent and ammonia, smells Nicholas had come to associate with the hospital, just as he connected the pungent film-developing chemicals and the hazy red lights of the darkroom with his mother. He stared at his father's brow, the fine gray hair at his temple, the line of his jaw, and the swell of his Adam's apple. He let his eyes slide down to his father's jade polo shirt, the knot of blue veins in the hollow of his elbow, the hands that had healed so many. His father was not wearing his wedding ring.

  "Dad," Nicholas said, "you're missing your ring."

  Robert Prescott turned away from his son. "Yes," he said, "I am."

  Hearing his father speak those words, Nicholas felt the swell of nausea at the base of his throat ease. His father knew he was missing the ring. It wasn't on purpose. Certainly it was a mistake.

  They slid into their wide wooden seats minutes before the game began. "Let me sit on the other side," Nicholas said, his view blocked by a thick man with an Afro. "That's our seat too, isn't it?"

  "It's taken," Robert Prescott said, and as if the words had conjured her, a woman appeared.

  She was tall, and she had long yellow hair held back by a piece of red ribbon. She was wearing a sundress that gapped at the sides, so that as she sat down, Nicholas could see the swell of a breast. She leaned over and kissed his father on the cheek; he rested his arm across the back of her chair.

  Nicholas tried to watch the game, tried to concentrate as the Sox came from behind to crush the Oakland A's. Yaz, his favorite player, hit a homer over the Green Monster, and he opened his mouth to cheer with the crowd, but nothing came out. Then a foul ball tipped off by one of the A's batters flew directly toward the section where Nicholas was sitting. He felt his fingers twitch in his glove, and he stood, balancing on the wooden chair, to catch it as it passed. He turned, stretched his arm overhead, and saw his father bent close to the woman, his lips grazing the edge of her ear.

  Shocked, Nicholas remained standing on his chair even when the rest of the crowd sat down. He watched his father caress someone who was not his mother. Finally, Robert Prescott looked up and caught Nicholas's eye. "Good God," he said, straightening. He did not hold out his hand to help Nicholas down; he did not even introduce him to the woman. He turned to her and without saying a word seemed to communicate a million things at once, which to Nicholas seemed much worse than actually speaking.

  Until that moment, Nicholas had believed that his father was the most amazing man in the world. He was famous, having been quoted in the Globe several times. He commanded respect--didn't his patients sometimes send things after operations, like candy or cards or even once those three goslings? His father had known the answers to all the questions Nicholas could come up with: why the sky was blue, what made Coke fizz, why crows perched on electrical wires didn't get electrocuted, how come people on the South Pole didn't just fall off. Every day of his life he had wanted to be exactly like his father, but now he found himself praying for a miracle. He wanted someone to get coshed in the head with a stray ball, knocked unconscious, so that the manager of Fenway would call over the loudspeaker, "Is there a doctor in the house?" and then his father could come to the rescue. He wanted to see his father bent over the still body, loosening the collar and running his hands over the places where there were pulses. He wanted to see his father be a hero.

  They left at the top of the seventh, and Nicholas sat in the seat behind his father on the T. When they pulled into the driveway of the big brick house, Nicholas jumped out of the car and ran into the forest that bordered the backyard, climbing the nearest oak tree faster than he ever had in his life. He heard his mother say, "Where's Nicholas?" her voice carrying like bells on the wind. He heard her say, "You bastard."

  His father did not come in to dinner that night, and in spite of his mother's warm hands and bright china smiles, Nicholas did not want to eat. "Nicholas," his mother said, "you wouldn't want to leave here, would you? You'd want to be here with me." She said it as a statement, not a question, and that made Nicholas angry until he looked at her face. His mother--the one who taught him that Prescotts don't cry--held her chin up, keeping back the tears that glazed her eyes like a porcelain doll's.

  "I don't know," Nicholas said, and he went to bed still hungry. He huddled under the cool sheets of his bed, shaking. Hours later, in the background, came the muffled splits and growls that he knew were the makings of an argument. This time it was about him. He knew more than anything that he did not want to grow up to be like his father, but he was afraid of growing up without him. He swore that never again would he let anyone make him feel the way he felt right now--as if he was being forced to choose, as if his heart was being pulled in two. He stared out the window to see the white moon, but its face was the same as that of the baseball lady, her cheek smooth and white, her ear marked by the brush of his own father's lips.

  "Wake up, Sleeping Beauty," one of the residents whispered into Nicholas's ear. "You've got a heart to connect."

  Nicholas jumped, hitting his head on the low roof of the helicopter, and reached for the Playmate cooler. He shook the image of his father from his mind and waited for a surgeon's reserve of energy to come from his gut, pulse into his arms and his legs, and spring to the balls of his feet.

  Fogerty was waiting in the operating suite. As Nicholas came through the double doors, scrubbed and gowned, Fogerty began to open Alamonto's chest. Nicholas listened to the whir of the saw slicing through bone as he prepared the heart for its new placement. He turned to face the patient, and that was when he stopped.

  Nicholas had done more than enough surgeries in his seven years as a resident to know the procedure cold. Incisions, opening the chest, dissecting and suturing arteries--all these had become second nature.

  But Nicholas was used to seeing a patient with wrinkled skin, with age spots. Under the orange antiseptic, Paul Alamonto's chest was smooth, firm, and resilient. "Unnatural," Nicholas whispered.

  Fogerty's eyes slid to him above the blue mask. "Did you say something, Dr. Prescott?"

  Nicholas swallowed and shook his head. "No," he said. "Nothing." He clamped an artery and followed Fogerty's instructions.

  When the heart had been dissected, Fogerty lifted it out and nodded to Nicholas, who placed the heart of the thirty-two-year-old woman in Paul Alamonto's chest. It was a good fit, a near match, according to the tissue analyses done by computer. It remained to be seen what Paul Alamonto's body would do with it. Nicholas felt the muscle, still cold, slipping from his fingers. He mopped as Fogerty attached the new heart just where the old one had been.

  Nicholas held his breath when Fogerty took the new heart in his hand, kneading it warm and willing it to beat. And when it did, a four-chamber rhythm, Nicholas found himself blinking in time with the blood. In, up, over, out. In, up, over, out. He looked across the patient at Fogerty, who he knew was smiling beneath his mask. "Close, please, Doctor," Fogerty said, and he left the operating room.

  Nicholas threaded the ribs with wire, sutured the skin with tiny stitches. He had a fleeting thought of Paige, who made him sew loose buttons on his own shirts, saying he was better at it by trade. He exhaled slowly and thanked the residents and the operating room nurses.

  When he moved into the scrub room and peeled off his gloves, Fogerty was standing with his back to him at the far side of the room. He did not turn as Nicholas jerked off his paper cap and turned on the faucet. "You're right about cases like that, Nicholas," Fogerty said quietly. "We are playing God." He tossed a paper towel into a receptacle, still facing away from Nicholas. "At any rate, when they're that young, we're fixing what God did wrong."

  Nicholas wanted to ask Alistair Fogerty many things: how he'd known what Nicholas was thinking, how come he'd sutured a certain artery when it would have been easier to cauterize it, why
after so many years he still believed in God. But Fogerty turned around to face him, his eyes sharp and blue, as splintered as crystal. "Seven o'clock, then, at your place?"

  Nicholas stared for a moment, dumbfounded, and then remembered that he was giving his first dinner party for his "associates"-- Alistair Fogerty, as well as the heads of pediatrics, cardiology, and urology. "Seven," he said. He wondered what time it was now; how long it would take him to change gears. "Of course."

  Nicholas had been having nightmares again. They weren't the same ones he'd had when he was in medical school, but they were every bit as disturbing, and Nicholas believed they stemmed from the same source, that old fear of failure.

  He was being chased through a heavy, wet rain forest whose ivy vines dripped blood. He could feel his lungs near bursting; he pulled his legs high from the spongy ground. He did not have time to look back, could only brush the branches from his face as they lacerated his forehead and his cheeks. In the background was the banshee howl of a jackal.

  The dream always started with Nicholas running; he never knew what it was he was running from. But sometime during the sheer physical concentration of sprinting, of balancing and dodging thick trees, he'd realize that he was no longer being chased. All of a sudden he was running toward something, just as faceless and forbidding as his pursuer had been. He gasped; he grabbed at a stitch in his side, but he couldn't move quickly enough. Hot butterflies slapped against his neck and leaves striped his shoulders as he tried to move faster. Finally, he hurled himself against a sandstone altar, carved with the leers of naked pagan gods. Panting, Nicholas slid to his knees in front of the altar, and beneath his fingers it turned into a man, a person made of warm skin and twisted bone. He looked up and saw his own face, older and broken and blind.

  He always woke up screaming; he always woke up in Paige's arms. Last night when he had become fully conscious of his surroundings, she had been hovering over him with a damp washcloth, wiping his sweaty neck and chest. "Sssh," she said. "It's me."

  Nicholas let a choked sound escape from his throat and pulled Paige to him. "Was it the same?" she asked, her words muffled against his shoulder.

  Nicholas nodded. "I couldn't see," he said. "I don't know what I was running from."

  Paige ran her cool fingers up and down his arm. It was in these moments, when his defenses were down, that he would cling to her and think of her as the one constant in his life and let himself give in completely. Sometimes when he reached for her after the nightmares, he would grasp her arms so tightly he left bruises. But he never told her the end of the dream. He couldn't. Whenever he had tried, he'd started shaking so badly he couldn't finish.

  Paige wrapped her arms around him, and he leaned into her, still warm and soft with sleep. "Tell me what I can do for you," she whispered.

  "Hold me," Nicholas said, knowing she would; knowing, with the unswerving faith of a child at Christmastime, that she would never let go.

  Paige hadn't wanted to tell anyone she was pregnant. In fact, if Nicholas hadn't known better, he would have thought she was avoiding the inevitable. She didn't run out to buy maternity clothes; they really didn't have the extra money, she said. In spite of Nicholas's urging, when she called her father she did not tell him the news. "Nicholas," she had told him, "one out of every three pregnancies ends in miscarriage. Let's just wait and see."

  "That's only true through the first trimester," Nicholas had said. "You're almost five months along."

  And Paige had turned on him. "I know that," she said. "I'm not stupid."

  "I didn't say you were stupid," Nicholas said gently. "I said you were pregnant."

  He drove home quickly, hoping Paige had remembered this dinner party even if he hadn't. She'd have to, after the way they'd fought over it. Paige insisted the house was too small, that she couldn't cook anything worthy of a dinner party, that they didn't have fine china and crystal. "Who cares?" Nicholas had said. "Maybe they'll feel bad and give me more money."

  He opened the back door and found his wife sitting on the kitchen floor. She wore an old shirt of his and a pair of his pants rolled to the knee. She held a bottle of Drano in one hand and a glass in the other, ringed brown. "Don't do it," Nicholas said, grinning. "Or if you do, wouldn't sleeping pills be more pleasant?"

  Paige sighed and put the glass down on the floor. "Very funny," she said. "Do you know what this means?"

  Nicholas pulled open his tie. "That you don't want to have a dinner party?"

  Paige held up her hand and let Nicholas pull her to her feet. "That it's a boy."

  Nicholas shrugged. The ultrasound had said the same thing; the waitresses at Mercy said she was carrying out in front, the way you carry a boy. Even the old wives' tale had confirmed it--the wedding ring dangling from a string had moved back and forth. "Drano probably isn't the definitive test," he said.

  Paige went to the refrigerator and began pulling out trays of food covered by aluminum foil. "You pee into a cup, and then you add two tablespoons of Drano," she said. "It's like ninety percent foolproof. The Drano people have even written to ob/gyns, asking them to tell their patients this is not a recommended use for their product." She closed the door and leaned against it, her hands pressed against her forehead. "I'm having a boy," she said.

  Nicholas knew that Paige did not want a boy. Well, she wouldn't admit it, at least not to him, but it was as if she just assumed that being the kind of person she was, it was impossible for her to be carrying anything other than a tiny replica of herself. "Now, really," Nicholas said, putting his hands on her shoulders, "would a boy really be so awful?"

  "Can I still name him after my mother?"

  "It would be hard," Nicholas said, "to be the only boy in first grade named May."

  Paige gave him a smug look and picked up two of her platters.

  She stuffed one into the oven and took the other into the living room, which had been turned into a dining room for the night. The tiny kitchen table was bolstered on both sides by card tables, and every chair in the house had been dragged into service. Instead of their usual dishes and glassware, there were ten places set with bright dinner plates, each one different and each with a matching glass. Painted on the surfaces were simple, fluid line drawings of diving porpoises, glacial mountains, turbaned elephants, Eskimo women. Curled in the glasses were paper napkins, each fanned in a different shade of the rainbow. The table spilled with color: vermilion and mango, bright yellow and violet. Paige looked uneasily at Nicholas. "It's not quite Limoges, is it," she said. "I figured that since we only have service for eight, this would be better than two place settings that looked entirely wrong. I went to the secondhand stores in Allston and picked up the plates and glasses, and I painted them myself." Paige reached for a napkin and straightened its edge. "Maybe instead of saying we're poor, they'll say we're funky."

  Nicholas thought of the dinner tables he'd grown up with: the cool white china from his mother's family rimmed in gold and blue; the crystal Baccarat goblets with their twisted stems. He thought of his colleagues. "Maybe," he said.

  The Fogertys were the first to arrive. "Joan," Nicholas said, taking both of Alistair's wife's hands, "you look lovely." Actually, Joan looked as though she'd had a run-in at Quincy Market: her tailored suit was a silk print of larger-than-life cherries and bananas and kiwis; her shoes and her earrings sported clusters of purple clay grapes. "Alistair," Nicholas said, nodding. He looked over his shoulder, waiting for Paige to arrive and take over the role of hostess.

  She stepped into the room then, his wife: a little pale, even swaying, but still beautiful. Her hair had become thick during pregnancy and covered her shoulders like a shining, dark shawl. Her blue silk blouse curved over her back and her breasts and then billowed, so that only Nicholas would know that beneath it, her black trousers were secured with a safety pin. Joan Fogerty flew to Paige's side and pressed her hand against her belly. "Why, you're not even showing!" Joan exclaimed, and Paige looked up at Nicholas, furious. />
  Nicholas smiled at her and shrugged: What could I do? He waited until Paige lowered her gaze, and then he led Alistair into the living room, apologizing for the lack of space.

  Paige served dinner to the Fogertys, the Russos, the van Lindens, and the Walkers. She had prepared Lionel's secret recipes: split-pea soup, roast beef, new potatoes, and glazed carrots. Nicholas watched her move from guest to guest, talking softly as she replenished the plates with spinach salad. Nicholas knew his wife well. She hoped that if she kept the plates full, no one would remember that they weren't a matched set.

  Paige was in the kitchen, getting together the main course, when Renee Russo and Gloria Walker ducked their heads together and began to whisper. Nicholas was in the middle of a discussion with Alistair about immunosuppressive drugs and their effect on transplanted tissue, but he was listening to the wives with half an ear. After all, this was his home. Whatever transpired at his first dinner party could make or break him in the political ranks of the hospital as much as a brilliant piece of research. "I bet," Renee said, "she paid a fortune for these."

  Gloria nodded. "I saw almost the same thing in The Gifted Hand."

  Nicholas did not see Paige enter the room behind him, frozen by the gossip. "It's the in thing," Gloria added, "crayon drawings that look like they were done by monkeys, and then someone has the gall to sell them as original art." Gloria saw Paige standing in the doorway and offered a tight smile. "Why, Paige," she said, "we were just admiring your dishes."

  And just like that, Paige dropped the roast beef so that it rolled onto the pale beige carpet, steeped in a pool of its own blood.

  The year that Nicholas was seven, his parents did not split up. In fact, just a week after the Red Sox game, Nicholas's life--and that of his parents--miraculously moved back on track. For three days Nicholas ate by himself at the kitchen table while his father drank Dewar's in the library and his mother hid in the darkroom. He walked through the halls only to hear the echo of his own footsteps. The fourth day, he heard banging and sawing in the basement, and he knew his mother was making a frame. She had done it before when she mounted her originals, like the famous Endangered exhibit, which hung at odd intervals in the hallway and up the staircase. She said she wouldn't trust her prints to some crackpot frame store, and so she bought her own wood, nails, and matting. Nicholas sat at the foot of the main staircase for hours, rolling a basketball over his bare toes, knowing he wasn't allowed to have a basketball in the house and wishing someone were around to tell him that.