Eden's Eyes

by Sean Costello

  "You've got to stop them! Stop them now!"

  Bert shook his head, tears still blearing his eyes. "It's too late—"

  "It is not too late!"

  Forsaking him, Eve wheeled sharply away, down the hall to the small back kitchen. Uttering prayers mixed with bitter condemnation, she reached down the phone and dialed in the flickering light of the range lamp.

  "Oh please God I beg You damn this killing heathen and hasten him on his hellbound path, wield your Holy armor and deflect the fiery darts of the fallen angel save my boy Your servant blessed issue—"

  And then her whole demeanor changed. In a cadenced, controlled voice she said into the phone: "Give me the ICU please."

  Bert rose to his feet, his face a stinging agony where Eve had gouged him. He moved to stop her, meaning to grab the receiver away. . . then thought better of it. Let them tell her, he decided. Perhaps the shock would settle her once and for all. He didn't regret what he had done. The boy had been his, too. It was a good thing. Good from bad. Couldn't she see that?

  He started into the stairwell, shutting out Eve's voice as she made her demands into the phone. At the top landing he paused and glanced into his son's bedroom, lit eerily now by the grinning Mickey Mouse night light Bert had bought for him some twentyfive years ago.

  It was a child's room still—stuffed toys with blackbutton eyes, stacks of dogeared comic books, water-marked rockinghorse wallpaper, a football dimpled from lack of air. . .

  Bert pulled the door shut, suddenly nauseated by the room's musty breath. He slouched down the hall to its far end, to his own room—Eve had shut him out of the master bedroom years ago—and lay down in the dark. Far away, Eve's voice railed on.

  After a while, he got up and locked the door from the inside. For the first time in their long lives together, Bert Crowell was afraid of his wife.

  Once the guy was on the ventilator again, and receiving enough anesthetic to relax his muscles and dampen any reflexes that might otherwise occur, there was precious little for Ed Skead to do. Ed had been in practice for nine years now; during that time, he'd been involved in procedures like this on perhaps a dozen occasions. But as he stood and watched Dr. Hanussen preparing to remove the donor's eyes, he decided that even a hundred such cases would fail in making the process any more pleasant to witness.

  In the fashion of all accomplished surgeons, Hanussen had arrived with an entourage, each member of which would later assist him in the laborious process of grafting in the eyes. Terse without being impolite, he had swept quietly into the room, nodded his greetings without inviting conversation, and set straight about his business.

  The first thing Ed noticed was the color of the donor's eyes, a most striking shade of blue. Like Paul Newman's eyes, he thought. So clear and so blue they were almost silver.

  He watched with sickened fascination as the surgeon set about his task, slender gloved fingers moving with deftness and speed.

  The lids of the left eye were propped open using a tiny metal retractor. Then the conjunctiva, the membrane encapsulating the eye, was split and stripped away, making Ed think of peeled grapes. Next, the tiny red muscles responsible for the movement of the eye were transected and folded back. Finally, the major vessels and the trunklike optic nerve were neatly severed.

  The left eye, freed of its mortal tethers, was plopped into a fluid-filled jar. The jar was tightly capped, then lowered into a bowl-shaped thermos. The pirated socket, welling blood, was packed with cotton batting.

  Suddenly, the oscilloscope atop the anesthetic machine registered a jump in the donor's heart rate, from ninety to a hundred and twenty-three. Noting this, Ed adjusted the anesthetic up a notch.

  On the opposite side of the surgical drape, a nurse prepared the donor's abdomen with a brownish iodine solution. At the sinks outside of the door, Ken Tucker and his assistant scrubbed their hands.

  Without ceremony, Hanussen started in on the opposite side, glancing up only once to note the time. With similar ease he dissected and freed the right eye. He said something in German, and a second jar was opened. The eye went in with a plop.

  Ed felt his stomach do a deliberate rollover.

  Now Ken Tucker strode into the operating room, soapy water dripping from his elbows. A nurse helped him gown and glove. He nodded to Hanussen as the man skinned off his own gloves and left the OR.

  Just like that, Ed thought unpleasantly. Just like that.

  He looked down at the donor's unknowing face. A scarlet streamer of blood issued from the corner of the left eye-socket. Cotton batting protruded from the wet slits.

  Ed looked away.

  Live fast.

  “How's he doing?" Ken said, accepting a scalpel from the scrub nurse.

  Is he trying to be funny? Ed wondered briefly. But there was no trace of jest in the surgeon's eyes. He glanced again at the oscilloscope. The heart rate had settled back to eight-eight.

  "Stable," Ed replied.

  Party hard.

  Ed caught the scrub nurse averting her eyes as Ken's knife traced with brutal precision a line from breastbone to pubis. White at first, the line quickly flashed red. The incision was deepened using surgical cautery, a concentrated arc of electrical fire that spewed sterile white smoke smelling of cooked fat and incinerated muscle.

  Die young.

  Ken extended the incision laterally, creating the illusion that a giant letter "I" had been painted in red along the man's belly. Using metal clips, he turned back and anchored a full-thickness flap at each corner, causing the abdomen to gape like a hideous, viscera-filled mouth.

  Again the nurse looked away.

  Disturbed himself, Ed glanced uneasily around the brightly lit OR, his eyes pausing briefly on the clock over the doorway.

  Twenty to four. . . Jesus.

  The room was too quiet, Ed realized as, he settled into his chair and began his flow sheet. There was none of the late-hour banter they normally engaged in, none of the tasteless jokes or the endless gossip they habitually exchanged in an effort to buoy morale in the face of exhaustion. It was this damned case, Ed knew. This obscene, mutilating case. It was creepy, plain and simple, even for those inured to death, as health professionals inevitably became. All of Ed's carefully cultivated instincts were meaningless in this situation. . . because the patient was not intended to survive the intervention. It was for a worthy cause, true but Ed disliked it just the same.

  Against his will, Ed's gaze drifted back to the donor's face. The guy was sweating now, great fat beads of the stuff blooming on his brow, his cheeks, under his nose. Ed's hand itched to crank up the anesthetic. In a normal situation sweating indicated a too light level of anesthesia—he reminded himself that it didn't matter, and the itch went away.

  The cotton batting in the eyes. That part bothered him.

  That—

  Slowly, deliberately, the donor's head rolled ten degrees to the right.

  "Jesus!" Ed shrieked, hopping to his feet and spilling the chart to the floor. Jesus Christ!" The hackles were up on his neck.

  "What is it?" Tucker asked calmly, peering over the drapes.

  "His head just moved!"

  The circulating nurse appeared at Ed's side, her eyes fixed expectantly on the donor's head.

  "You mean like this?" Ken said, dark mirth narrowing his jade-green eyes.

  The donor's head moved again, and this time Ed saw Ken's fingers through the drapes, nudging the donor's chin.

  "You sick bastard," Ed accused over Ken's paroxysm of laughter. "You twisted sonofabitch!"

  Ken's assistant, a taciturn G.P. by the name of David Wong, joined Ken's crowing, letting out a series of spastic, high-pitched chuckles. Nervously, the two, and finally Ed himself, took up the chorus.

  For a moment the tension slackened.

  Then: "The Ottawa team is here."

  Ed turned to the sound of the voice and saw the nursing supervisor standing in the doorway, a hand cupped over her mouth in lieu of a mask.

&
nbsp; "They're in the change-room now."

  Ken nodded and the laughter abruptly subsided. "Let's get moving," he said to his assistant. "Get the perfusionist in here."

  "Yes, Doctor," the circulating nurse said, then hurried out of the room to find him.

  "Ed," Ken said. "Is this guy relaxed?”

  Still red-faced, Ed touched the donor's cheek with the leads of a battery-powered nerve stimulator, a device designed to test the depth of surgical paralysis. At the start of the case Ed had infused a huge dose of muscle relaxant and expected no muscle-twitch now.

  There was none.

  "He's as relaxed as I can make him," Ed said.

  Ken grunted and returned to his dissection, freeing up the kidneys for eventual removal.

  The first of the Ottawa team entered the room, a husky resident dressed in tight-fitting greens. He greeted the Sudbury team warmly, and Ed guessed from his bright-eyed enthusiasm that his boss would be allowing him to remove the heart tonight. For a moment Ed recalled his own grueling residency without fondness. His gut still felt queasy from Ken's sick little prank.

  Now four other members of the Ottawa team entered en masse, setting about their preordained tasks with practiced efficiency, and Ed felt a glow of admiration. These guys flew all over the nation, Ed knew, gentlemen farmers, late-night harvesters of man's most precious crop—human organs.

  Maybe it was the fatigue, but Ed found himself recalling a Monty Python movie he'd see a few years back, a gruesome little flick entitled Meaning of Life. . .

  Two guys in dirty-white lab coats appear at this rummy's front door and one of them says, "We've come for your liver."

  And the rummy says, "But I'm not done with it yet. . ."

  "Doctor, could you give the patient a gram of Solu?"

  Ed whirled as if slapped. "Sure he said to the tall, imperious-looking fellow who had just stepped into the room. The head honcho, Ed guessed from the man's demeanor.

  "Evening, Ken," the man said, peering over the drapes into the operative field.

  "Hi, Ozzie!" Ken replied with genuine pleasure. "I didn't expect to see you up here."

  "Oh, I like to make the trip every now and again."

  "I'll be out of your way in just a few minutes," Ken said. The right kidney's shot—big subcapsular hematoma—but the left one looks fine." He chuckled." Oh, Ozzie. Have you met Dr. Skead?"

  Turning toward Ed, the heart surgeon shook his head.

  "Oswald Harrington," Ken said. "Meet Ed Skead, our weary gas man."

  Ed shook the man's hand, surprised at its gentleness.

  And all at once things sped up to triple-time, diverting Ed's attention from the dead man on the table and his own enveloping fatigue.

  Ken stepped back from the table, dipping his bloody gloves into a water-filled basin but keeping them sterile. Once the heart was ready he would have to finish his job, extracting the one viable kidney as quickly as possible.

  Now, under Harrington's supervision, the resident took over, extending Ken's incision up to just below the chin. Years removed from cardiac surgery, Ed stood at the head of the table and peeked over the drapes, his sleepy psyche easily entranced by the busy hands in front of him.

  In a single slick stroke the incision was taken down to the breastbone. Next, a pressure-powered jigsaw rasped through the sternum with liquid ease. Again the odor of cooked tissue wafted up on gray-white smoke.

  Noting an abrupt increase in the donor's heart rate, Ed glanced again at the oscilloscope. He's feeling that, he thought, even though he realized it was merely a brainstem reflex and not a conscious awareness. It spooked him just the same.

  Now the pericardium, the lubricated bag in which the

  heart tapped out its living beat, was incised and reflected away.

  Bared to the world, the donor's heart thumped in earnest, rolling slightly to one side with each separate systole. Draped in a kind of apron of fat, it made a rather unimpressive sight in the white-hot glare of the overhead spots. No romantic associations here, Ed thought. Just a thick, muscular pump, jetting blood through myriad conduits in a frantic, suddenly pointless rhythm.

  "You can take over now, Ken," Harrington said, stepping away from the table. "We're all set here."

  While Tucker cut the kidney's final linkups, another Ottawan prepared a cold, potassium-rich solution which would later bathe the heart, paralyzing it in midbeat and facilitating its removal.

  "Jesus, Ed," Ken said with annoyance. "Are you positive this guy is relaxed?"

  Ed tested him again. "He's flat out, Ken. Really."

  "Well then maybe he just doesn't want to part with this thing. I'm having a hell of a time here."

  Tiring of Ken's complaints, Ed fired in another dose of relaxant. He failed to see, considering the size of the hole in the donor's belly, how Ken could be having any trouble—but he'd learned years ago that it was better to coddle than to clash, particularly with surgeons.

  "Shit!" Ken said. "He's hemorrhaging!" An instrument clattered to the floor. "Clamp!" he snapped at the nurse.

  Curious, the Ottawa surgeons stepped in for a closer look.

  Ken’s hands moved with swift precision, delving into the wound and probing blindly. There was a sustained moment of tense silence, then a sound like a foot pulling free of a thick bed of mud.

  "There," Ken breathed with obvious relief. "Got it."

  He lifted out the small, purplish organ and carried it like a dripping newborn to the perfusionist, whose job it was to bathe the kidney in a preserving solution until the time of transplant. By now the recipient would be on the table in Ottawa, where this organ, along with the heart, would be going by helicopter very shortly.

  Meanwhile, Harrington and his resident had already begun the final process. The removal of the heart.

  At the head of the table, Ed Skead felt his own heartbeat quicken. This was it. Once the major vessels were cross-clamped, the guy was a goner.

  It surprised Ed, the tension he was feeling. He supposed it was the presence of that old dark cousin, Mortality, that was doing it to him. That and his bone-deep fatigue. But this was a unique glimpse of death, he realized, glancing again at the donor's face.

  A favorite expression of his father's, who before his death had been a Presbyterian minister, flitted unbidden through Ed's weary mind:

  Death hath ten thousand doors for men to take their exits.

  Ten thousand and one, Ed added morbidly. We just cooked up a new one.

  The guy was brain-dead, he knew, and therefore legally dead. . . but what about the rest? Who could say with any real certainty, save for God Himself, what was going on inside him at this exact moment?

  Suddenly Ed found himself stirring up questions he hadn't touched on since medical school. . . simply because they defied answering.

  Was the guy really dead? Had his spirit, if such a mythical intangible actually existed, already fled his ruined body? Or was it still trapped in there somewhere, in some dark, untraceable cavern, festering into a gob of unsalvageable slime, unfit for eternity or reincarnation or whatever transcendence lay ahead? For Ed believed fervently in God, and therefore in some form of, if not life, then continuance after death. And all of that made this particular situation, this artificially suspended evolution from life to death, seem highly unique indeed.

  "The aorta's clamped," Harrington said mildly. "Begin the infusion."

  Ed looked up sharply from the donor's face, trying to switch his thoughts to another tack. He hoped he could get in a few hours sleep after this, because now his eyes were playing hallucinogenic tricks on him. He thought he'd seen the void, nerveless expression on the donor's face change subtly. Tighten somehow, as if. . . grimacing.

  No way.

  There was an empty stool in the far corner, and Ed found himself imagining the Reaper seated there. Not the faceless, hooded skeleton of lore, but a grinning goblin with a cobra's green eyes and a hint of impatience in the set of its curving jaw. The Reaper waited right in this
room, Ed fancied, annoyed but resigned. . . because tonight, Oswald Harrington would determine the instant of death, not the creature with the scythe.

  Ed looked up at the oscilloscope, at the electrical pattern of life gone suddenly awry. The blood pressure had dropped from one-ten over seventy to forty over nothing.

  Any moment now, Ed thought, glancing compulsively at the donor's face. Sweat oozed steadily from the man's skin, which had already adopted the dusky hue of death.

  "Cutting the aorta now."

  Quite unexpectedly, there followed a huge spike in the donor's pressure, way up over two hundred when by rights it should have slipped to zero. Ed looked on in breathless awe as blood spurted up in a great red fountain-spray, spattering both surgeons, drenching their gowns and speckling their stupefied faces. Some of the stuff even found its way over the drapes, spotting Ed's shoes in dime-size gouts.

  "What in hell was that?" Harrington erupted, losing his air of unshakable cool.

  "Freaky," Ed whispered to himself. "Fucking freaky."

  Now, as it should be, the pressure was zero. Blood welled passively into the yawning chest cavity.

  "Suction," Harrington said edgily.

  Ed thought of vampires as the length of clear-plastic tubing flashed red, and the room filled with a low rude sucking sound.

  The scrub nurse turned pale above her mask.

  Ed reached out and flicked off the ventilator, feeling like the impish demon that trips up from the Gulf at night to steal the breath, from sleeping children.

  Scissors snipped, clamps clicked. Instruments changed hands, first gleaming silver, then streaked with blood.

  Systematically, the donor's heart was taken.

  Ed's gaze drifted helplessly, downward, bleak curiosity impelling him to study the man's face for hints of his passing.

  But there were none, save for the physical.

  The skin hue deepened from bluish pink to pinkish blue to the dusky shade of a new bruise. The lips grew pale, almost ivory. The cheeks sank. The sweating stopped. The runner of blood at the corner of the left eye-socket had already begun to dry into a flaky red brush stroke.

  "Okay," Harrington said. "Got it. Mark the time."