Change of Heart

by Jodi Picoult

  "Really?" Dr. Gallagher said. "How strange. At Oxford it meant your roommate was inside having sex."

  "Maybe we should go," I said quickly, hoping he didn't notice that I was blushing fiercely, or that I lived alone with a rabbit, or that my hips were so big that they probably wouldn't fit into the seat of the little sports car he'd parked in my driveway.

  He opened the car door for me and didn't turn the ignition until my seat belt was fastened. As he sped off, he cleared his throat. "There's something I'd like to get out of the way before we go any further," he said. "I'm Christian."

  I stared at him. Was he some kind of fundamentalist who limited his extracurricular conversations to people of the same faith? Did he think that I harbored some secret desire to elope, and was he giving me the lay of the land? (All right. So maybe that last one wasn't far off the mark.)

  Well, whatever. I'd been eating, sleeping, breathing religion with Shay's case; I was even more sensitive now about religious tolerance than I'd been before I took up this mantle. And if religion was so vitally important to Gallagher that he had to bring it up as the first point of conversation, I could give as good as I got. "I'm an atheist," I said, "but you might as well know right now that my father's a rabbi, and if you have a problem with that I'm sure I can find another physician to talk to me, and I'd really appreciate it if you didn't make a joke right now about Jewish doctors."

  I exhaled.

  "Well," he said, and glanced at me. "Perhaps you'd rather call me Chris?"

  I was pretty sure Emily Post wouldn't have covered this topic, but it seemed more discreet to wait until after we were served our main course to start talking about how to kill a man.

  The restaurant was inside an old colonial home in Orford, with floorboards that rolled like the seas beneath my feet and a bustling kitchen off to one side. The hostess had a husky, mellifluous voice and greeted the doctor by name.

  Christian.

  The room we were sitting in had only six tables, covered with mismatched linen and dishes and glasses; candles burned in recycled wine bottles. On the wall were mirrors in every shape and size--my own personal version of the ninth circle of hell--but I hardly even noticed them. Instead, I drank water and wine and pretended that I did not want to spoil my appetite by eating the freshly baked bread they'd served us along with dipping oil--or by talking about Shay's execution.

  Christian smiled at me. "I've always imagined one day I'd be forced to consider how one went about losing one's heart, but I must admit, I didn't think it would be quite so literal."

  The waiter arrived with our plates. The menu had been full of the most delectable cuisine: Vietnamese bouillabaisse, escargot tortellini, chorizo dumplings. Even the descriptions of the entrees made me salivate: Handmade to order, fresh Italian parsley pasta filled with fresh artichoke hearts, roasted eggplant, a medley of cheeses, and sweet roasted red and yellow pepper, tossed with a sun-dried tomato cream sauce. Slices of boneless chicken lined with thin slices of prosciutto filled with fresh spinach, Asiago cheese, and sweet onion rolled and served with fresh fettuccine and a tomato marsala wine reduction. Boneless breast of duck roasted, thinly sliced, served with a sun-dried cherry sauce and a wild rice pancake.

  In the wild hope that I might fool Christian into thinking my waist size was not what it seemed to be, I'd swallowed hard and ordered an appetizer. I'd fervently wished that Christian would order the braised leg of lamb or the steak frites so that I could beg a taste, but when I explained I wasn't all that hungry (a colossal lie), he said an appetizer was all he really wanted, too.

  "From what I imagine," Christian said, "the inmate would be hanged in such a way that the spine would be fractured at C2/C3, which would arrest all spontaneous respiration."

  I was trying very hard to follow along. "You mean he'd break his neck and stop breathing?"

  "Right."

  "So then he's brain-dead?"

  A couple at the next table glanced at me, and I realized I'd been talking too loudly. That some people didn't like to mix death with dinner.

  "Well, not quite. It takes some time for anoxic changes to the brain to result in a loss of reflexes ... which is how you test for brain-stem function. The problem is that you can't leave your man hanging for a great period of time, or his heart will stop, and that disqualifies him as a donor."

  "So what has to happen?"

  "The state needs to agree that the fact that respiration's ceased is enough to justify taking the body down from the noose on likely suspicion of death, then intubate him so that the heart is protected, and then test for brain death."

  "Intubating him isn't the same as resuscitating him, then?"

  "No. It's the equivalent of someone brain-dead being on a ventilator. It preserves the organs, but there won't be any brain function once that spinal cord is severed and hypoxia sets in, no matter how much oxygen you pump into his system."

  I nodded. "So how do you determine brain death?"

  "There are multiple ways. You can do a physical exam first--check to make sure there are no corneal reflexes, no spontaneous respirations, no gag reflex--and then repeat it twelve hours later. But since time is of the essence, I'd recommend a transcranial Doppler test, which uses ultrasound to measure blood flow through the carotid arteries at the base of the brain. If there's no blood flow for ten minutes, you can legally declare brain death."

  I imagined Shay Bourne--who could barely string together a coherent sentence, who bit his fingernails to the quick--being led to a gallows. I pictured the noose being drawn tight around his neck and felt the hair stand up on the back of my own.

  "It's brutal," I said softly, and put down my fork.

  Christian was quiet for a moment. "I was a resident in Philadelphia the first time I had to tell a mother her child had died. He was the victim of a gang shooting--eight years old. He'd gone to the corner store to get a quart of milk, and was in the wrong place at the wrong time. I will never forget the look in her eyes when I told her we weren't able to save her son. When a child is killed, two people die, I think. The only difference is that his mother still had to suffer a heartbeat." He looked up at me. "It will be brutal for Mr. Bourne. But it was brutal for June Nealon first."

  I sat back in my chair. This, then, was the catch. You meet a well-educated, intensely gorgeous, charming Oxford-educated man, and he turns out to be so right-wing he's nearly pointed backward. "Then you're in favor of capital punishment?" I asked, trying to keep my voice level.

  "I think it's easy to take the moral high road when it's all theory," Christian said. "As a physician, do I think it's right to kill someone? No. But then again, I don't have children yet. And I'd be lying if I said that when I do, this issue will still seem crystal clear to me."

  I didn't have children yet, either; at the rate I was going, I might never have them. And the only time I'd seen June Nealon, face-to-face, we'd been at the restorative justice meeting and she had been so filled with righteous anger that I found it hard to look at her. I didn't know what it felt like to carry a child underneath my heart for nine months, to feel my body give way to make room for hers. I didn't know what it felt like to hold an infant and rock her to sleep, to find a lullaby in her breathing. But I knew what it was like to be the daughter.

  My mother and I hadn't always argued. I could still remember wishing that I was as glamorous as she was--trying on her high-heeled shoes, pulling her sheer satin slips up to my armpits as if they were strapless dresses, diving into the wondrous mystery of her makeup bag. She had, at one point, been the person I wanted to grow up to be.

  It was so damn hard to find love in this world, to locate someone who could make you feel that there was a reason you'd been put on this earth. A child, I imagined, was the purest form of that. A child was the love you didn't have to look for, didn't have to prove anything to, didn't have to worry about losing.

  Which is why, when it happened, it hurt so badly.

  Suddenly, I wanted to call my mother. I wanted t
o call June Nealon. I was on my first date since the dinosaurs had roamed the planet, a date that was really just a business dinner, and I felt like bursting into tears.

  "Maggie?" Christian leaned forward. "Are you all right?" And then he put his hand on top of mine.

  Arrest all spontaneous respiration, he had said.

  The waiter appeared at the side of the table. "I hope you've left room for dessert."

  I had nothing but room; my appetizer had been a crab cake the size of my thumbnail. But I could feel the warmth of Christian's skin on mine, and it was like heat at the tip of a candle--only a matter of time before the rest of me melted, too. "Oh, I couldn't," I said. "I'm stuffed."

  "Right," Christian said, and he slipped his hand away from mine. "I guess just the bill, then."

  Something had changed in his features--and there was a chill to his voice that hadn't been there a moment before. "What's the matter?" I asked. He shook his head, dismissive, but I knew what it was: the death penalty. "You think I'm on the wrong side."

  "I don't think there are sides," Christian said, "but that's not it."

  "Then what did I do wrong?"

  The waiter sidled over with the bill, tucked into a leather folder. Christian reached for it. "My last steady girlfriend was a principal dancer for the Boston Ballet."

  "Oh," I said feebly. "She must have been ..." Beautiful. Graceful. Skinny.

  Everything I wasn't.

  "Every time we went out for a meal I felt like some sort of ... glutton ... because I had an appetite, and she never ate a damn thing. I suppose I thought--well, hoped--that you'd be different."

  "But I love chocolate," I blurted out. "And apple fritters and pumpkin pie and mousse and tiramisu and I probably would have eaten everything on this menu if I didn't think it would make me look like a pig. I was trying to be ..." My voice trailed off.

  "... what you thought I was looking for?"

  I focused my attention on the napkin on my lap. Leave it to me to ruin a date that wasn't even really one.

  "What if all I was looking for," Christian asked, "was you?"

  I lifted my head slowly as Christian summoned back our waiter. "Tell us about dessert," he said.

  "We have a creme brulee, a fresh blueberry tart, warm peach puff pastries with homemade ice cream and caramel sauce, and my personal favorite," the waiter said. "Chocolate French toast with a thin pecan crust, served with mint ice cream, and our own raspberry sauce."

  "What shall we try?" Christian asked.

  I turned to the waiter. "Maybe we could skip back to the main course first," I said, and smiled.

  "This is my simple religion.

  There is no need for temples;

  no need for complicated philosophy.

  Our own brain, our own heart is our temple;

  the philosophy is kindness."

  --HIS HOLINESS THE 14TH DALAI LAMA

  June

  |||||||||||||||||||||||||

  As it turned out, in spite of the deathbed promises, I didn't tell Claire about her potential new heart when she first awakened after the episode that had brought us back to this hospital. Instead, I made a hundred excuses: When she wasn't running a temperature. When she had a little more energy. When we knew for sure that a judge was going to allow the donation to happen. The longer I put off the conversation, the more I was able to convince myself that Claire would have another hour, day, week with me in which to have it.

  And in the meantime, Claire was failing. Not just her body, but her spirit. Dr. Wu told me every day that she was stable, but I saw changes. She didn't want me to read from Teen People. She didn't want to watch television. She lay on her side, staring at a blank wall.

  "Claire," I said one afternoon, "want to play cards?"

  "No."

  "How about Scrabble."

  "No thanks." She turned away. "I'm tired."

  I smoothed her hair back from her face. "I know, baby."

  "No," she said. "I mean I'm tired, Mom. I don't want to do this anymore."

  "Well, we can take a walk--I mean, I can take a walk and push you in a wheelchair. You don't have to stay in bed--"

  "I'm going to die in here. You and I both know it. Why can't I just go home and do it there, instead of hooked up to all of this stuff?"

  I stared at her. Where was the child in that sentence, the one who had believed in fairies and ghosts and all sorts of impossible things? But we're so close to fixing that, I started to say, and then I realized that if I did, I would have to tell her about the heart that might or might not be coming.

  And whose it was.

  "I want to sleep in my own bed," Claire said, "instead of one with stupid plastic sheets and a pillow that crackles every time I move my head. I want to eat meat loaf, instead of chicken soup in a blue plastic cup and Jell-O--"

  "You hate when I serve meat loaf."

  "I know, and I want to get mad at you for cooking it again." She flopped onto her back and looked at me. "I want to drink from the orange juice container. I want to throw a tennis ball for my dog."

  I hesitated. "Maybe I can talk to Dr. Wu," I said. "We can get your own sheets and pillow, I bet ..."

  Something in Claire's eyes dimmed. "Just forget it," she said, and that was how I realized she'd already begun to die, before I had a chance to save her.

  As soon as Claire fell asleep that afternoon, I left her in the capable hands of the nursing staff and exited the hospital for the first time in a week. I was stunned to see how much the world had changed. There was a nip in the air that whispered of winter; the trees had begun to turn color, sugar maples first, their bright heads like torches that would light the rest of the woods on fire. My car felt unfamiliar, as if I were driving a rental. And most shocking--the road that led past the state prison had been rerouted with policemen on traffic detail. I inched through the cones, gaping at the crowds that had been cordoned off by police tape: SHAY BOURNE WILL BURN IN HELL, read one sign. Another banner said SATAN IS ALIVE AND KICKING ON I-TIER.

  Once, when Claire was tiny, she'd raised the blackout shade in her bedroom window when she woke up. At the sight of the sunrise, with its outstretched crimson fingers, she'd gasped. Did I do that?

  Now, looking at the signs, I had to wonder: Could you believe something so fiercely that it actually happened? Could your thoughts change the minds of others?

  Keeping my eyes on the road, I passed the prison gates and continued toward my house. But my car had other intentions--it turned right, and then left, and into the cemetery where Elizabeth and Kurt were buried.

  I parked and started walking to their shared grave. It was underneath an ash tree; in the light wind, the leaves shimmered like golden coins. I knelt on the grass and traced my finger over the lettering on the headstone:

  BELOVED DAUGHTER.

  TREASURED HUSBAND.

  Kurt had bought his plot after we'd been married for a year. That's macabre, I had said, and he had just shrugged it off; he saw the business of death and dying every day. Here's the thing, though, he had said. There's room for you, if you want.

  He had not wanted to impose, because he didn't know if I'd want to be buried near my first husband. Even that tiny bit of consideration--the fact that he wanted me to choose, instead of making an assumption--had made me realize why I loved him. I want to be with you, I had told him. I wanted to be where my heart was.

  After the murders, I would sleepwalk. I'd find myself the next morning in the gardening shed, holding a spade. In the garage, with my face pressed against the metal cheek of a shovel. In my subconscious, I was making plans to join them; it was only when I was awake and alert and felt Claire kicking me from within that I realized I had to stay.

  Would she be the next one I'd bury here? And once I did, what would keep me from carrying things through to their natural conclusion, from putting my family back together in one place?

  I lay down for a minute, prone on the grass. I pressed my face into the stubbled moss at the edge of the he
adstone and pretended I was cheek-to-cheek with my husband; I felt the dandelions twine through my fingers and pretended I was holding my daughter's hand.

  In the elevator of the hospital, the duffel bag started to move itself across the floor. I crouched down, unzipped the top of it. "Good boy," I said, and patted the top of Dudley's head. I'd retrieved him from my neighbor, who had been kind enough to play foster parent while Claire was sick. Dudley had fallen asleep in the car, but now he was alert and wondering why I had zipped him into a piece of luggage. The doors opened and I hoisted him up, approaching the nurse's desk near Claire's room. I tried to smile normally. "Everything all right?"

  "She's been sleeping like a baby."

  Just then, Dudley barked.

  The nurse's eyes flew up to mine, and I pretended to sneeze. "Wow," I said, shaking my head. "Is that pollen count something or what?"

  Before she could respond, I hurried into Claire's room and closed the door behind me. Then I unzipped the bag and Dudley shot out like a rocket. He ran a lap around the room, nearly knocking over Claire's IV pole.

  There was a reason dogs weren't allowed in hospitals, but if Claire wanted normal, then she was going to get it. I wrapped my arms around Dudley and hoisted him onto Claire's bed, where he sniffed the cotton blanket and began to lick her hand.

  Her eyes fluttered open, and when she saw the dog, a smile split her face. "He's not allowed in here," she whispered, burying her hands in the fur at his neck.

  "Are you going to tell on me?"

  Claire pushed herself to a sitting position and let the dog crawl into her lap. She scratched behind his ears while he tried to chew on the wire that ran from beneath Claire's hospital gown to the heart monitor.

  "We won't have a lot of time," I said quickly. "Someone's going to--"

  Just then, a nurse walked in holding a digital thermometer. "Rise and shine, missy," she began, and then she saw the dog on the bed. "What is that doing in here?"

  I looked at Claire, and then back at the nurse. "Visiting?" I suggested.

  "Mrs. Nealon, not even service dogs are allowed onto this ward without a letter from the vet stating that the vaccinations are up to date and the stool's tested negative for parasites--"

  "I was just trying to make Claire feel better. He won't leave this room, I swear."