If I Should Lose You

by Natasha Lester

  If it had been Dan sitting opposite her she would have been able to tell him about the way she had viewed the heart that she’d held in her hands today just before she had slid it into her patient’s chest cavity. She would explain to Dan that Matthew’s body had rejected the first heart and so he was being re-transplanted. That she’d trimmed the heart to fit its new home and was preparing to stitch it in when she felt the heart retract. She’d dismissed the idea and continued to move her hands into the mediastinum when she felt it happen again.

  This time the movement was more definite; the heart had recoiled. I am unhinged, she thought. This cannot happen. A heart taken out of a body does not move by itself. It is an illusion caused by the physiological disruption to the body as a result of grief.

  She pushed the heart forward and performed that operation with her eyes; she shut off all sense of touch. She saw what needed to be done and her fingers became tools attached to the palms of her hands which performed according to her mental instructions.

  She asked the perfusionist to turn the flow down and then calculated; the heart was on ice for four hours. It had to be left in Matthew’s body to recover for fifteen minutes for every hour it was on ice. Then she speared the left ventricle with her scalpel. Blood shot out through the opening she had made, taking the pressure off the heart.

  Every five minutes of the resting time felt like five hours. But then, as the perfusionist dialled down the heart-lung machine, the heart pumped away. Alix told herself she had imagined the recoiling and asked the perfusionist to begin loading up the heart, to wean Matthew off the heart-lung machine. The heart didn’t blow up. Nothing went wrong while she was watching. So she asked for another one hundred millilitres of blood.

  Then it was time to close up. She wanted to leave the theatre and hand him over to one of the residents. But she knew that even putting the wires into the sternum could cause the heart to arrest. So she finished the job.

  After six hours of surgery she washed her hands, threw away her scrubs and told Matthew’s family that he was still alive. Then she walked down to the park on the south side of the building where no one ever came to sit because it was too cold and dark and where the stone benches were always damp, always waiting for the sun that never came to wring them out.

  It seemed that she hadn’t grieved properly, hadn’t let the grief out and now it was altering her perception of things, so she screamed, into the wind, to dilute the sound. If she screamed long enough and hard enough then she would move on to the next stage, which she believed was called acceptance.

  When she returned to the hospital, she was paged within the hour to run to Matthew’s bedside. All she could do was watch while the heart that had tried to warn her, died.

  Alix started the conversation with Jack with small talk because anything small was manageable, or so she had thought until she’d encountered that rebellious heart. ‘Did you enjoy the exhibition?’ she asked.

  Jack did not respond until the waiter had finished with their drinks order and moved away and then he said, ‘Yes. Your husband understood plaster in the way I wish all artists understood their medium. He knew when to let the plaster speak and when to make sure it was impenetrable.’

  Alix felt as though she was in an art lecture. Gone were the intuitive comments of the evening before and in their place was something more like a lecture and as impenetrable as the plaster he was speaking about. So she changed the subject. ‘I haven’t been here before,’ she said, gesturing to their surrounds. ‘Lovely view.’

  ‘Water views are generally considered to be lovely.’

  He thought she was being banal and she was but a certain degree of banality had to be tolerated in order to get to know someone, didn’t it? Or had the rules changed while she’d been married? She remembered that there was little in the way of banalities on her first date with Dan but then why was she comparing the two scenarios unless she thought she was on a date? Suddenly it became very important to understand exactly what his intentions were, as if that would help her to find her way through the evening. ‘Is this a date?’

  He laughed. ‘I’d hoped so. You?’

  ‘I wanted to talk more about what you said last night. I’d just had a sense of something and then you described it. But maybe that conversation was specific to that time and place.’

  ‘Doesn’t work in a restaurant with white tablecloths and harbour views?’

  ‘No.’

  ‘So where does that leave us?’

  The waiter brought their entrees over, deposited them almost invisibly onto the table, then vanished.

  ‘There’s always food,’ she said with a slight smile.

  They began to eat and were silent while they did, Alix unwilling to launch into any further banalities and Jack seemingly intent on his meal. It was when she was opening her mouth to put her fork in and of course a piece of lettuce decided to stick on her bottom lip that he looked at her and said, ‘Your hair is a shade that a painter could never mix.’

  After she had rescued the lettuce and closed her mouth she tried to deflect the comment. ‘I thought orange was just a matter of combining yellow and red.’

  ‘It is. But your hair’s orange in the same way that a heart is red. In a cliché.’

  She put down her fork and stared at him. Why the comparison to hearts? She could almost feel the ghost of the flinching heart dance down the middle of the table. ‘Excuse me,’ she whispered as she stood, napkin dropping to the floor, and left the restaurant to cross the lawn in front and stand by the water.

  He didn’t rush straight out to follow her; he left her alone for a good five minutes during which she imagined he’d paid the bill and left. But then he appeared, strolling across the grass as though he’d simply stepped out to take some air. He stood near her but not next to her and pointed to the same albatross she’d seen when she walked into the restaurant. ‘Another shade that’s hard to replicate. The exact white of the feathers.’

  ‘What do you paint?’ she asked as she studied the wings of the albatross, wings that she’d thought before were the same colour as plaster but now she could see they were not so perfectly white.

  ‘People. Bodies mainly. Sometimes heads. Sometimes whole bodies.’

  ‘Like Dan.’

  ‘A bit.’

  ‘Why are artists so interested in bodies?’

  ‘It’s not just artists.’

  ‘No.’ She smiled. ‘I suppose a walk through Kings Cross will tell you that.’

  He laughed. ‘Not what I meant but you’re right.’

  ‘But why take note of the colour of the albatross? You don’t paint birds.’

  ‘Because it’s the same as the colour of the inside of your wrist.’

  The way she reacted was not, she supposed, normal. She didn’t smile or blush or try to dismiss the remark, because she heard it as truth rather than flirtation and she wanted, with her surgeon’s eyes, to see what he meant. She lifted her wrist closer to her eyes and looked at the skin. She saw that, in one spot, the striations of her veins did stain her pale skin the same colour as the wings of the bird on the water.

  She remembers how to kiss a man. She remembers what desire feels like. That is what she thought when she woke the next morning.

  They did not return to the restaurant, they did not eat their dinner. They bought an ice-cream from the kiosk and walked home. On the way they did not talk about sculpture or art but they talked about magnolia trees and Iris Murdoch and Moscato.

  She laughed. Her hands moved as she talked. She didn’t think about Camille or organs. She turned to him when they reached her front gate and he was already moving towards her as if he knew that she was about to disappear. Before she could, he caught her lips against his, not softly, not gently, not slowly, not even leaving a piece of time for thought. She didn’t know how long they stood like that, kissing and kissing and kissing, but it was the first time that she felt unconscious, or thought-less, empty minded of all but sensation.
/>   CAMILLE

  TWELVE

  What a thing to read and then to write when you are sitting beside your desperately ill daughter and the dead body of an unloved baby is lying in the next bed down. That your mother bought pills with which to kill herself.

  I snap my notebook shut and watch as they wheel away a bed that is covered with a sheet; it looks empty but has the slightest mound in the middle, a ripple really, insignificant, reflecting in death what had been the child’s plight in life.

  In contrast, Alix’s gesture was so dramatic, suitable for film or stage but not for the muckiness of life with a baby. I can see her, as she would have watched herself, thriving on the spectacle of what she thought she could do to show everyone just how much she was grieving. I am glad that Louisa has never told me about it, that she refused to give Alix’s performance the attention it didn’t deserve. False dares and Louisa and wanting to dwell on Dan were the things that pulled Alix back and I pick up Addie’s hand and whisper to her, ‘Mummy’s here,’ wishing Alix could see me now, could see what it is to promise to your child that you will always be here.

  Suddenly, surprisingly, Paul arrives and after he leans over to kiss Addie’s head and before I can say, I wasn’t expecting you today, he says, ‘I’m here to do the work-up. See if I’m compatible.’

  Surprise and suppressed tension rush out of my mouth with a whoosh. ‘Thank you,’ I say and I almost cannot quite believe it when my feet push my body up out of the chair and propel me over to my husband’s side so that I can kiss him on the cheek.

  His smile is wry. ‘So that’s what I’ve got to do for affection.’

  I laugh. ‘Imagine what I might do if your liver’s compatible.’

  I can hear him laughing as he leaves to have his tests.

  Paul comes back to see me after his tests are complete. ‘Why don’t you go home and be with Rosie tonight. Give her a bath. Addie won’t wake up now she’s on vanc and the doctor said it’ll be forty-eight hours before it starts to work. I’ll come here after work and stay the night.’

  ‘Thanks,’ I say and I kiss him again before he leaves for work. Then I ring Rosie and tell her I will be home later to give her a bath and put her to bed.

  ‘Bubbles,’ she says to me and I say, ‘Yes darling, we can have bubbles in the bath.’ She squeals because bubbles are almost as good as kisses at making things better.

  I pack up my bag at a quarter to six and watch the minutes tick by until six o’clock. I give him the benefit of the doubt; it is okay to be five or ten minutes late. Then my phone rings and it is Paul.

  ‘I’m with the lawyers. We’re in court tomorrow. I’m not going to make it in time.’

  I hear the sound of Rosie’s joy bursting like the bubbles in her bath but I am too tired to yell so I just say, ‘Are you going to be an hour late or four hours late?’

  ‘Probably the latter.’

  More answers I cannot control. At that moment I hate my husband. I wish I could pour that feeling into Addie’s IV tube because I know it is stronger than staph, stronger than vanc, stronger than anything a human could make or imagine, stronger even than death.

  I rummage through my handbag, searching for a tissue. Then my phone beeps. It is Paul, I think, he is coming, it’s all okay, we will be fine. But it is Sarah. She has attached a copy of the invitation to the opening night of the exhibition. My name is there, in the centre, next to my father’s name. And Jack’s.

  I send Paul a text to tell him that he’ll have to stay with Addie on that night. Because I will be too busy. Being a Curator. Of Art.

  In the morning when I stand up I feel in my muscles the cliché: I got out on the wrong side of bed. Although bed is now a chair and breakfast is two slices of toast cooked in the Parents’ Room, a cubby-hole jammed with tired mothers hovering over a fridge, a kettle and a toaster.

  The newcomers are easy to spot. They have notes in pen on their hands, complicated words that describe what is wrong with their children, words they have inscribed on themselves so they can Google them later when the doctors have moved on to the next bed. They flip through the single-serve jams and vegemite looking for butter. Most mornings I open the fridge and extract the hospitality-sized tub of wet, white paste that is labelled margarine and pass it to them.

  ‘Thank you,’ they say. They are so grateful until they open the lid and stare at what is inside. I eat dry toast with jam.

  Some of the mothers are competitive: My son’s been in for a whole week. He’s had two operations and won’t be going home for at least five more days. Until they speak to me. All I need to say is liver transplant and they are silent. Or another mother says coma. They are silent then too. There is always someone worse off.

  This morning I pass on the toast and go straight to coffee. It doesn’t help, even though I try copious amounts, wishing it would produce a hallucination – a daytime dream.

  I go back to Addie’s bedside and the staph is still there and it is too early to tell if the vanc is working. Her blood pressure is stable so there is no sepsis. She hasn’t vomited blood for twelve hours. I hold onto small details like these now because the larger picture of taking out her liver and replacing it with another has become too abstract to imagine.

  The next day I work a night shift at the hospital, timing it so I can be back at Addie’s bedside at the critical forty-eight hour mark. Paul stays with her; the court does not sit through the night so he has no excuse.

  I have only been at work a short while, enough to notice a new neuro-consultant noticing me, when I’m told of a brain-dead boy in ICU. He’s crashed his motorbike, as eighteen year olds are prone to do. I meet the new neuro by the boy’s bed.

  ‘I’m Nick,’ he says to me.

  ‘Camille,’ I reply.

  Nick comes into my office a short time later. I’ve just finished checking the organ donor registry. Nick is holding two cups of coffee and he hands one to me. ‘I noticed you inhaling these earlier. Thought you might need another.’

  ‘Thanks.’ I take a sip and then ask, ‘Which hospital have you come from?’

  ‘I’ve just moved down from Brisbane.’

  ‘Stranger in town.’

  ‘Yep.’ His mobile rings and he looks at it, says, ‘Duty calls,’ then leaves.

  The consultants have spoken to the boy’s family and now it is my turn. The boy is brain-dead: a corpse generating reusable parts I once heard a transplant surgeon say. The boy is listed on the organ donor registry but his mother wants more time to make a decision. More information. She didn’t know that her son wanted to be an organ donor and she has the final say, regardless of her son’s wishes. And it seems she isn’t sure whether or not she wants to save someone else’s life with a perfectly working, only eighteen year old heart.

  I sit down next to her and introduce myself. I do not get any further.

  ‘He’s still breathing,’ the mother, Stephanie, says.

  I understand she has not accepted the intensivist’s explanation of brain death, or, if she has, she does not think it applies to her son. So I need to start there, before I can even begin talking about the fact that organ donation is a gift of great value. I hope she is not deeply religious or uneducated because both of those factors will make it harder.

  I look directly at her, which is something I know neurologists are not good at doing, and say, ‘The ventilator is breathing for him. It’s stimulating his heart and keeping the blood flowing around his body. That’s why he’s warm and pink.’

  ‘He’s warm and pink because he’s alive.’ She turns away from me and looks at her son. ‘It’s all right honey, I know you’re still alive. I won’t let them turn anything off. Or take anything from you.’

  I know that these words, far from being directed at her son, are directed at me. But I also know that if she’s decided not to donate then I need to leave her be; I am not allowed to persuade people to change their minds. I provide information and support, she makes a decision and then we all live wi
th it.

  So I say, ‘I understood from the doctor that you wanted some more information about organ donation to help you make a decision. Is that right?’

  She shrugs. ‘Maybe. I don’t know.’

  ‘Would you like some more time with your son before I speak to you?’

  ‘No, go on. Say whatever it is you’re supposed to say.’

  So I speak clearly and calmly, some would say dispassionately, because I have to explain something that is almost impossible to understand with emotion, that can only be understood with logic. ‘He will never regain consciousness. His brain has stopped working. The haemorrhage...’

  Stephanie actually begins to scream. To scream like a two year old who has lost a toy. I sit beside her and let her scream, knowing it will exhaust her. She stops after a few minutes and sits and stares at her son’s face, holding his hand as if she were the one breathing for him, keeping him alive.

  It is always the family who most fear death because they can see it; they begin to know something that had previously been impossible to imagine. The patient is the one without fear and for that I think he is lucky.

  I try another approach. ‘Your son would have thought this through when he decided to become an organ donor.’

  ‘He’s too young to know what he’s doing.’

  I understand that she wants to recast her son, to change him back into something she can make sense of, not this body in a bed who looks like her son but isn’t, not any more. She wants to remake him as her child, as her baby, with a flimsy, dependent body, a body that she owns because it is a body that cannot work without her. But she doesn’t own his body. And neither does he, now that he has gone.