by Jodi Picoult
Suddenly I really believe that if I stick it out long enough, Nicholas will understand. It's just a matter of time, and I have a lot of that on my hands. "I'm a volunteer at the hospital now," I tell my mother proudly. "I work wherever Nicholas works. I'm closer than his shadow."
My mother pauses, as if she is considering this. "Stranger things have happened," she says.
Max wakes up screaming, his legs bent close to his chest. When I rub his stomach, it only makes him scream harder. I think that maybe he needs to burp, but that doesn't seem to be the problem. Finally, I walk around with him perched on my shoulder, pressing his belly flush against me. "What's wrong?" Astrid says, her head at the nursery doorway.
"I don't know," I say, and to my surprise, uttering those words doesn't throw me into a panic. Somehow I know I will figure it out. "It might be gas."
Max squeezes up his face and turns red, the way he does when he's trying to go to the bathroom. "Ah," I say. "Are you leaving me a present?" I wait until he looks as if he's finished, and then I pull down his sweatpants to change his diaper. There is nothing inside, nothing at all. "You fooled me," I say, and he smiles.
I rediaper him and sit him on the floor with a Busy Box, rolling and turning the knobs until he catches on and follows. From time to time he screws up his face again. He seems to be constipated. "Maybe we'll have prunes for breakfast," I say. "That ought to make you feel better."
Max plays quietly with me for a few minutes, and then I notice that he isn't really paying attention. He's staring off into space, and the curiosity that flames the blue in his eyes seems to have dulled. He sways a little, as if he's going to fall. I frown, tickle him, and wait for him to respond. It takes a second or two longer than usual, but eventually he comes back to me.
He's not himself, I think, although I cannot put my finger on what the problem really is. I figure I will watch him closely. I tenderly rub his chunky forearms, feeling a satisfied flutter in my chest. I know my own son, I think proudly. I know him well enough to catch the subtle changes.
"I'm sorry I haven't called," I tell my father. "Things have been a little crazy."
My father laughs. "I had thirteen years with you, lass. I think your mother deserves three months."
I had written my father postcards from North Carolina, just as 1 had written Max. I'd told him about Donegal, about the rye rolling over the hills. I told him everything I could on a three-and-a-half-by-five-and-a-half-inch card, without mentioning my mother.
"Rumor has it," my father says, "you've been sleepin' with the enemy." I jump, thinking he means Nicholas, and then I realize he is talking about living at the Prescotts'.
I glance at the Faberge' egg on the mantel, the Civil War Sharps carbine rifle hanging over the fireplace. "Necessity makes strange bedfellows," I say.
I wind the telephone cord around my ankles, trying to find a safe route for conversation. But there is little I have to say, and so much I want to. I take a deep breath. "Speaking of rumors," I say, "I hear Mom called."
"Aye."
My mouth drops open. "That's it? 'Aye'? Twenty-one years go by, and that's all you have to say?"
"I was expectin' it," my father says. "I figured if you had the fortune to find her, sooner or later she'd return the favor."
"The favor?" I shake my head. "I thought you wanted nothing to do with her. I thought you said it was too late."
For a moment my father is silent. "Paige," he says finally, "how did you find her to be?"
I close my eyes and sink back on the leather couch. I want to choose my words very carefully. I imagine my mother the way she would have wanted me to: seated on Donegal, galloping him across a field faster than a lie can spread. "She wasn't what I expected," I say proudly.
My father laughs. "May never was."
"She thinks she's going to see you someday," I add.
"Does she now," my father answers, but his thoughts seem very far away. I wonder if he is seeing her the way he did the first time he met her, dressed in her halter top and carrying her practice suitcase. I wonder if he can remember the tremor in his voice when he asked her to marry him, or the flash across her eyes as she said yes, or even the ache in his throat when he knew she was gone from his life.
It may be my imagination, but for the breadth of a moment everything in the room seems to sharpen in focus. The contrasting colors in the Oriental carpet become more striking; the towering windows reflect a devil's glare. It makes me question if, all this time, I haven't really been seeing clearly.
"Dad," I whisper, "I want to go back."
"God help me, Paige," my father says. "Don't I know it."
Elliot Saget is pleased with my gallery at Mass General. He is so convinced that it is going to win some kind of humanitarian Best of Boston award that he promises me the stars on a silver platter. "Well, actually," I say, "I'd rather watch Nicholas in surgery."
I have never seen Nicholas truly doing his job. Yes, I have seen him with his patients, drawing them out of their fear and being more understanding with them than he has been with his own family. But I want to see what all the training is for; what his hands are so skilled at. Elliot frowns at me when I ask. "You may not like it very much," he says. "Lots of blood and battle scars."
But I stand my ground. "I'm much tougher than I look," I say.
And so this morning there will be no picture of Nicholas's patient tacked to his door. Instead I sit alone in the gallery above the operating suite and wait for Nicholas to enter the room. There are already seven other people: anesthesiologists, nurses, residents, someone sitting beside a complicated machine with coils and tubes. The patient, lying naked on the table, is painted a strange shade of orange.
Nicholas enters, still stretching the gloves on his hands, and all the heads in the room turn toward him. I stand up. There is an audio monitor in the gallery, so I can hear Nicholas's low voice, rustling behind his paper mask, greeting everyone. He checks beneath the sterile drapes and watches as a tube is set in the patient's throat. He says something to a nearby doctor, youngish-looking, his hair in a neat ponytail. The young doctor nods and begins to make an incision in the patient's leg.
All of the doctors wear weird glasses on their heads, which they flip down to cover their eyes when they bend over the patient. It makes me smile: I keep expecting this to be some kind of joke costume, with googly eyeballs popping out on springs. Nicholas stands to the side while two doctors work over the patient's leg. I cannot see very well what they are doing, but they take different instruments from a cloth-covered tray, things that look like nail scissors and eyebrow tweezers.
They pull a long purple spaghetti string from the leg, and when I realize it is a vein, I feel the bile rise in my throat. I have to sit down. The vein is placed in a jar filled with clear fluid, and the doctors working on the leg begin to sew with needles so small they seem invisible. One of them takes two pieces of metal from a machine and touches the leg, and I can swear I smell human flesh burning.
Then Nicholas moves to the center of the patient. He reaches for a knife--no, a scalpel--and traces a thin line down the orange area of the patient's chest. Almost immediately the skin is stained with dark blood. Then he does something I cannot believe: he pulls a saw out of nowhere--an actual saw, like a Black & Decker--and begins to slice through the breastbone. I think I can see chips of bone, although I can't believe Nicholas would let that happen. When I think I am surely going to faint, Nicholas hands the saw to another doctor and spreads the chest open, holding it in place with a metal device.
I don't know what I was expecting--maybe a red valentine heart. But what lies in the center of this cavity once the blood is mopped away looks like a yellow wall. Nicholas picks a pair of scissors off a tray, bends low toward the chest, and fiddles around with his hands. He takes two tubes that come from that complicated machine and attaches them to places I cannot quite see. Then he picks up a different pair of scissors and looks at the yellow wall. He begins to snip at it. He peel
s back the layer to reveal a writhing muscle, sort of pink and sort of gray, which I know is the heart. It twitches with every beat, and when it contracts it gets so small that it seems to be temporarily lost. Nicholas says, "Let's put him on bypass," to the man who is sitting at the machine, and in a quiet whir, red blood begins to run through the tubes. Below his mask, I think I see Nicholas smile.
He asks a nurse for cardioplegia, and she hands him a beaker filled with a clear solution. He pours it over the heart, and just like that, it stands still. Dear Jesus, I find myself thinking, he's killed the man. But Nicholas doesn't even stop for a moment. He picks up another pair of scissors and moves close to the patient again.
All of a sudden a spurt of blood covers Nicholas's cheek and the front of another doctor's gown. Nicholas's hands move faster than I can follow as he reaches into the open chest to stop the flow. I step back, breathing hard. I wonder how Nicholas can do this every single day.
The second doctor reaches into the jar I've forgotten about and
takes out the vein from the leg. And then Nicholas, sweat breaking out on his brow, pulls a tiny needle repeatedly through the heart and through that vein, using tweezers to place the point and to retrieve it. The other surgeon steps back, and Nicholas taps the jellied heart with a metal instrument. Just like that, it starts to beat. It stops, and Nicholas asks for an internal defibrill-something. He touches it to the heart and shocks it into moving again. The second doctor takes the tubes from the top and bottom of the heart, and the blood stops coursing through the machine. Instead, the heart, still on display, begins to do what it was doing before--squeezing and expanding in a simple rhythm.
Nicholas lets the second surgeon do most of the work from that point--more sutures, including wire for the ribs and thick stitches through the orange skin that make me think of a Frankenstein monster. I press my hands against the sloped glass wall of the gallery. My face is so close that my breath clouds the window. Nicholas looks up and sees me. I smile hesitantly, wondering at the power he must feel to spend every morning giving life.
chapter 39
Nicholas
Nicholas remembers having heard once that the person who has started a relationship finds it easier to end it. Obviously, he thinks, that person did not know Paige. He can't get rid of her. He has to give her credit--he never thought she'd take it this far. But it is distracting. Everywhere he turns, there she is. Arranging flowers for his patients, wheeling them out of surgical ICU, eating lunch across the cafeteria. It has reached the point where he actually misses her when she isn't around.
The drawings have got out of control. At first he ignored them, tacked crudely to his office door like kindergarten paintings on a refrigerator. But as people started to notice Paige's talent, he couldn't help but look at them. He brings the ones she does of his patients to their rooms, since it seems to brighten them up a little--some of his incoming patients have even heard of the portraits and ask for them at the pre-op exam. He pretends to throw out the ones she does
of him, but in fact he has been saving them in the locked bottom drawer of the desk. When he has a minute, he pulls them out and looks at them. Because he knows Paige, he knows what to look for. And sure enough, in every single picture of him--even the ridiculous one of him singing in a bowling shirt--there is something else. Someone, actually. In the background of each drawing is a slight, barely noticeable portrait of Paige herself. Nicholas finds the same face over and over, and every time she is crying.
And now her pictures are all over the entrance hall of Mass General. The whole staff treats her like some kind of Picasso. Fans flock to his office door to see the latest ones, and he actually has to push through them to get into the room. The chief of staff--the goddamned chief of staff!--ran into Nicholas in the hall and complimented him on Paige's talent.
Nicholas does not know how she has managed to win so many people to her side in a matter of days. Now, that's Paige's real talent--diplomacy. Every time he turns around, someone is mentioning her name or, worse, she is standing there herself. It reminds him of the ad agencies' "block" strategy, where they run the same exact commercial at the same exact time on all three network stations, so that even if you flip channels you see their product. He can't get her out of his mind.
Nicholas likes to look at the portraits in his drawer just before he goes down to surgery--which, thank God, is the only place Paige hasn't been allowed into yet. The pictures clear his head, and he likes to have that kind of directed focus before doing an operation. He pulls out the latest drawing: his hands poised in midair as if they are going to cast a spell. Every line is deeply etched; his fingernails are blunt and larger than life. In the shadow of the thumb is Paige's face. The drawing reminds him of the photo his mother developed years before to save her marriage, the one of her own hands folded beneath his father's. Paige couldn't have known, and it strikes Nicholas as uncanny.
He leaves the portrait on the desk, on top of the scrawled sheets of assets he is supposed to be preparing for Oakie Peterborough. He has added nothing since the day he met the lawyer for lunch, a week ago. He keeps thinking that he must call to set up a consultation, but he forgets to mention it to his secretary and he is too busy to do it himself.
The operation this morning is a routine bypass, which Nicholas thinks he could do with his eyes closed. He walks briskly to the locker room, although he is not in a hurry; he changes into the soft laundered blue scrubs. He pulls on paper booties and a paper cap and winds a mask around his neck. Then he rakes a deep breath and goes to scrub, thinking about the business of fixing hearts.
It's strange being the chief of cardiac surgery. When he enters the operating suite the patient is already prepped and the easy conversation between the residents and the nurses and the anesthesiologist comes to a dead halt. "Good morning, Dr. Prescott," someone says finally, and Nicholas can't even tell who it is because of the stupid masks. He wishes he knew what to do to put them all at ease, but he hasn't had enough experience at it. As a surgical fellow, he spent so much time clawing his way to the top, he never bothered to consider whom he was crawling over to get there. Patients are one thing: Nicholas believes that if someone is going to trust you with his life and shell out $31,000 for five hours' work, he or she deserves to be listened to and laughed with. He has even sat on the edges of beds and held his patients' hands while they prayed. But doctors are a different breed. They are so busy looking behind them for an encroaching Brutus that everyone becomes a potential threat. Especially a superior like Nicholas: with one written criticism, he has the power to end a career. Nicholas wishes he could look over the blue edge of a mask just once and see a pair of smiling eyes. He wishes Marie, the stout, serious OR nurse, would put a whoopee cushion under the patient, or set rubber vomit on the instrument tray, or play some other practical joke. He wonders what would happen if he walked in and said, "Have you heard the one about the rabbi, the priest, and the call girl?"
Nicholas speaks softly as the patient is intubated, and then he directs a resident, a man his own age, to harvest the leg vein. His hands move by themselves, making the incision and opening the ribs, dissecting out the aorta and the vena cava for the bypass machine, sewing up and cauterizing blood vessels that are accidentally cut.
When the heart has been stopped--an action that never loses its effect for Nicholas, who holds his breath as if his own body has been affected--Nicholas peers through magnifying spectacles and begins to cut away the diseased coronary arteries. He sews on the leg vein, turned backward, to bypass the obstructions. At one point, when a blood vessel begins spurting blood all over Nicholas and his first assistant, Nicholas curses. The anesthesiologist looks up, because he's never seen Dr. Prescott--the famous Dr. Prescott--lose his cool. But even as he does so, Nicholas's hands are flying quickly, clamping the vessel as the other doctor sews it up.
When it is all over and Nicholas steps back to let his assistant close, he does not feel as if five hours have passed. He never does. He is
not a religious man, but he leans against the tiled wall and beneath his blue mask he whispers a prayer of thanks to God. In spite of the fact that he knows he is skilled, that his expertise comes from years of training and practice, Nicholas cannot help but believe a little bit of luck has been thrown in, that someone is looking out for him.
That's when he sees the angel. In the observation gallery is the figure of a woman, her hands pressed to the window, her cheek flush against the glass. She is wearing something loose that falls to her calves and that glows in the reflected fluorescent light of the operating suite. Nicholas cannot help himself; he takes a step forward and lifts his hand a fraction of an inch as if he might touch her. He cannot see her eyes, but somehow he knows this is only an apparition. The angel glides away and disappears into the dark background of the gallery. Nicholas knows that even if he has never seen her before, she has always been with him, watching over his surgeries. He wishes, harder than he has ever wished for anything in his life, that he could see her face.
After such a spiritual morning, it is a letdown for Nicholas to find Paige in all his patients' rooms when he is doing afternoon rounds. Today she has pulled her hair away from her face in a braid that hangs down to her shoulder blades and moves like a thick switch when she leans over to refill a water pitcher or to plump pillows. She's not wearing makeup, she rarely does, and she looks about as old as a candy striper.
Nicholas flips over the metal cover of Mrs. McCrory's chart. The patient is a woman in her late fifties who had a valve replacement done three days ago and is almost ready to go home. He skims a finger across the vitals recorded by one of the interns. "I think we're getting ready to kick you out of here," he says, grinning down at her.
