by Liam Durcan
He thought that seeing his father die would have granted him some immunity, something, some understanding or coping mechanism, but the opposite had happened. Every case had that point on the horizon, the approaching end, and every death became a cause for deep, festering panic. There was no disputing it; his patients smelled it, and no amount of washing could get rid of something like that.
He tried to take off his clothes, shivering through the act, having to concentrate on his fingers as they stumbled blindly around the buttons of his shirt. He clattered a hand through the minibar and found a couple of the small bottles of scotch whose contents he shook into a plastic cup. After downing it, a tablet of Valium followed, and then two more and after fifteen minutes the man coiled on the asphalt of the Prinsessegracht wasn’t there at all but instead he was safe in a hospital bed, somewhere in Den Haag, the hard work done, the broken bones set and the haemorrhaging staunched, months of hard work ahead of him, yes, but alive. It was with this thought, of a man hovering above his injuries, floating toward a distant but certain recovery, that Patrick fell asleep. He drifted through stages of sleep, surfacing as the last suppressive traces of benzodiazepines disappeared from his system and the loop of images from the Prinsessegracht began its relentless play. He saw the face on the grey plane of asphalt, the open eye and the last breath of the man escaping, drifting up to a white plane that he thought must be the sky or maybe heaven, but which was really only the ceiling.
Patrick finally awoke in a quiet and amniotically dark room. The tremors had stopped and slowly he was able to gather himself enough to get to the window where he separated the curtains to reveal the latticework of Den Haag streets below. On the Prinsessegracht he had that unassailable certainty that he could do anything, go to any lengths, for a man dying in front of him. Wrong as he had been, he thought of Hernan, and felt he understood him clearly. He understood how a man could have believed in the righteousness of one’s actions for so long. Patrick had felt it too. But he had neither Hernan’s faith nor skill and so the delusion lasted only for a moment and brought him no place more incriminating than the pavement of a Den Haag street. He understood. If there was no coercion needed to get Hernan to Lepaterique, then he must have wanted to go. And if Hernan was not a man filled with hate, then what, if not a sense of duty, could have brought him there, could have misled him so? In the tribunal, Hernan had come face to face with the people he thought he’d helped, listened as they gave testimony that demolished his notion of innocence. For the first time, Patrick thought he understood the silence at the trial, understood that the judgment Hernan had evaded for years–since the initial charges, since the death of his wife–had finally been rendered. The only problem was a life that continued, a heart that kept beating in its cell ten blocks away.
It then occurred to Patrick Lazerenko that his friend and mentor Hernan García, right there in front of everyone, was trying to kill himself.
TWENTY
It was his heart. Hypertrophic cardiomyopathy. A condition characterized by an obstruction to the normal flow of blood out of the left ventricle due to an overgrowth of muscle in the dividing wall, or the septum, of the heart. A congenital condition, affecting less than 0.5 per cent of the population referred for cardiac ultrasounds, it has what is called a bimodal peak of occurrence, meaning that the initial clinical manifestations–as innocuous as fainting spells, as catastrophic as heart failure or sudden death–are most likely to occur in adolescence or in the sixth decade. Symptoms are most reliably brought on by the strenuous beating of the heart; vigorous exercise causes pressures generated in the left ventricle to rise dramatically and arrhythmias ensue: v. tach, v. fib, asystole. Individuals may be completely without symptoms until they are stricken. It is the typical cause when an otherwise ludicrously fit soccer player falls to the pitch in mid-match, dead.
Patrick took a crash course over the next few hours, gathering specific signs and symptoms of the condition from the dozens of medical Web sites, matching each one with what he knew of Hernan: that first time they met, when he seemed on the verge of fainting after chasing him down, the sound of his heart–he had listened to his heart!–with the second heart sound splitting and the murmur roaring as Hernan held his breath. But Patrick had missed it all, heard the murmur blowing like a hurricane but failed to understand the cause. A person would know all this if he was a cardiologist, he’d know how to manage his illness and have the credentials to know how to keep the details quiet. A man with Hernan’s training and standing would be able to convince others of the surrogate diagnosis–“No need for an EKG, I should know my own heart, Dr. Bolodis, just a touch of angina”–and the need for nitroglycerin, a drug that dilated the coronary blood vessels and eased the pain of angina. It was, however, a drug that had other effects, reducing the filling pressure in the ventricle, and in hypertrophic cardiomyopathy causing a precipitous drop in blood pressure and increasing the probability of the heart stuttering into a final, fatal arrhythmia.
As Patrick ran down Johan de Wittlaan in the direction of the tribunal building, he thought about all the times he had seen Hernan take nitro, all the little leaps. There had been no cabs at the hotel, and he had been too impatient to wait. He surprised himself by keeping up a good pace for someone who had had only a few splintered hours of sleep between checking and rechecking the possibilities of what Hernan was doing and leaving middle-of-the-night messages for Bolodis.
Patrick passed through security and asked a young woman at the tribunal’s information desk to have Dr. Bolodis paged, pointing to his face, only too happy to resort to it as an all-access pass. She replied, with serene indifference, that emergencies before ten were typically referred to the hospital and offered him directions. They had a map, she said, and when she looked up to give it to him, he was gone. Down the corridor, the doors of Courtroom One had been swung open, and the crowd, already gathered like bargain hunters of human depravity, entered and were headed directly for their favoured seats. Roberto was the only García in the gallery, taking a seat in one of the middle aisles. He looked up at Patrick, standing beside one of the seats at the back, and tilted his chin up, the Roberto equivalent to a wave. Across the gallery, Elyse Brenman, star student, was already at her desk, fixing her gaze on the proceedings and preparing to create that day’s narrative. God, he thought–acknowledging that, whatever her motives, she’d been right about so much, seen the Democratic Voice clearly and understood the compromise that he was getting himself into–I’m such an asshole.
The teams of lawyers assembled, and a few minutes later Hernan was ushered in and shown to his seat behind the glass. Patrick knew it was probably projection, the effects of the realization the night before or just sleep deprivation, but Hernan was a ghastly, pre-impending-death grey. He could imagine Hernan working the nitropump all weekend, every shot nudging him closer, feeling his heart trill and kick toward a new morning. Did he think about Fernandez or any of the others when he did this? Was this a reparation, his way of repayment for what he’d done or was it nothing more than a desire to escape? Hernan put the nitropump to his mouth, and it could just as well be a pistol for the way it made Patrick wince. He couldn’t watch this, he told himself. The justices entered and the trial restarted without much ceremony, indifferent to García’s heart or Patrick’s billowing alarm. He couldn’t watch this, he told himself, but he couldn’t look away. Hernan lifted the container of medication to his mouth again and suffered another ebb tide and all Patrick could think about was that behind the glass partition, in full view of the tribunal gallery, was the only time Hernan wasn’t medically supervised, the only time he had the opportunity. Bolodis wasn’t in the gallery to see this, Bolodis didn’t know. Below, di Costini began shredding the partial, halting recollections of witness C-189. Hernan raised his eyes and looked out into the gallery, running his gaze over the first few rows until it met Roberto. A smile from Hernan, more conspicuous than one would expect, but brief nonetheless. Patrick couldn’t tell if it was r
eturned.
Patrick told himself that this was Hernan’s right, his life. Perhaps Hernan was aware of all the manoeuvrings, all the plans that were being mapped out, and this was his veto, his declaration of sovereignty. And if he wished to end it, to escape the continued hauntings of José-Maria Fernandez and the others who died in his presence at Lepaterique, then Patrick had no right to stand in the way.
Sit still, he reminded himself. You have no right to interfere. Hernan could have had him arrested that very first night behind Le Dépanneur Mondial but he didn’t. He was a good man, that’s all the evidence he had of Hernan, a man who convinced him of nothing less than possibility. Another shot of the nitropump and no one noticed, his plan brilliant for its lack of deceit. But Hernan’s head tipped back, like a man trying to keep himself awake reflexively, because the body marched on, unable to accept a rationale for its own death. Hernan turned his head and pumped in another dose and Patrick could feel it in his own chest, the stumbling steps of a heart’s journey. This was Hernan’s choice, the choice of a rational man. Patrick could understand that. Patrick owed it to him to do nothing. To watch.
It became so clear, watching Hernan’s face drain of colour and his head toggle: death was the totalitarian end, in Lepaterique or his mother’s kitchen or for van der Hoeven or the man on the Prinsessegracht, it was the cancellation of all possibility, the negation of understanding and acknowledgement. Hernan was dying, and nothing could argue away the fact that death was nothing more, nothing less than annihilation.
Because Patrick was at the very back of the gallery, no one noticed when he stood up. His legs were stilts, the very act of standing provisional, and he watched as if from a great distance as his right hand raised itself in the direction of the defendant’s stand. Patrick shouted that this man was trying to kill himself, that he was using a medication to kill himself and every face became a wildly swinging gate, cycling between him and Hernan. He stood and shouted and arms were suddenly around him, a hand tugging at his shirt collar until a button sheared off and was sent pinging against his cheek and another hand now, on his right forearm and he twisted and shrugged them off and shouted out again, full-throated, his lungs great bellows, and he would not be moved and he saw Roberto, a face of incomprehension becoming something else, becoming alarm and he struggled to see Hernan, Hernan disappearing behind a field of limbs, closing his eyes and his head tilting back and that’s when someone grabbed Patrick around the neck and pulled him backwards over the seats and out of Courtroom One.
TWENTY-ONE
Even though he was expected, Bolodis was the last man Patrick wanted to see when he opened the door of his hotel room later that morning. The doctor didn’t have to say anything; from a detention room in the security offices of the tribunal–where Patrick had been taken into custody, his belt and shoelaces and cell phone taken away, all in accordance with a strict policy for dealing with such people–he had heard the sirens like everybody else. A man who introduced himself only as Kuipers–whom Patrick was later told was the chief of tribunal security–had come into the detention room and sat down opposite Patrick. He asked Patrick why he had disrupted the proceedings rather than come to his officers, and he seemed more puzzled than angry at the cause of the commotion in his courtroom. Patrick said he was uncertain, that it was only when he got inside the gallery that he realized what was happening. From there, Patrick said, it was like a reflex. Kuipers paused, and Patrick felt the man’s gaze scanning his face, sizing up the bruises and obvious evidence of lack of sleep. Kuipers got up without a word and left the room. Alone, Patrick waited another ten minutes. He listened for the sirens again, a sign that Hernan was being urgently transported. All he could think about was the paramedics arriving, how they would try to revive Hernan, maybe even start their work right there on the courtroom floor, charging the paddles for one last electric stab at a working rhythm. Then there would be CPR, that rib-cracking, vaudevillian effort to bring someone back before they got to the hospital where they wouldn’t know his history, and like any cardiac arrest, they’d shock him again before giving him epinephrine, not knowing the peculiarities of his underlying problem, not knowing that, in this case, epinephrine would only make matters worse. They’d be confused, maybe for a moment, before they’d just consider it to be a failed resuscitation and call the whole thing off. By the time Patrick had been released ninety minutes later, on the condition that he would not set foot on tribunal property again (a photocopy of his passport photo had been duly affixed to a wall behind the security checkpoint), the whole main floor had been cleared. Even the young woman at the information desk with her helpful directions to the hospital was nowhere to be seen when Patrick left the building.
Now, in Patrick’s hotel room, Bolodis sat down in the one comfortable chair and said nothing for what seemed to be a minute, a silence that would irritate Patrick under other circumstances, but turmoil shouted from the rooftop of every one of Bolodis’s gestures, and he sympathized, appreciating their common reaction. Patrick sat down on the bed opposite him.
“I heard what you did in the tribunal, what you were shouting about,” Bolodis said. “I didn’t get your messages. I didn’t know this about his heart.”
“I just figured it out myself last night.”
“He said it was a little angina. I took his word for it,” Bolodis said, smiling but unable to hide the fact that he was seeing his own future collapsing, the letters of official inquest arriving, already smelling the hallways of a clinic in Groningen. “A little angina. Oh, fuck.”
“He’s dead,” Patrick ventured, an inflection between question and declaration. Testing the words for their road-worthiness.
Bolodis shrugged and stood. “They took him to the hospital. I thought you’d want to come.”
On the car ride to the hospital, Patrick had the urge to tell Bolodis to stop and drop him off somewhere. He needed to walk, to take his time before he saw Hernan’s shrouded body pulled out of one of those stainless steel man-sized filing cabinets they have in morgues. But Bolodis was on the phone, speaking in Dutch, and they arrived before Patrick could put the thought into words.
They walked through the hospital, Bolodis leading the way. With each floor up, each corner turned, the hallways became increasingly depeopled. Patrick readied himself for the scene in the morgue and for a tableaux of Garcías: Celia weeping and Roberto now stuck in the neutral gear of silence and Nina, wielding her practicality like a shield, thinking about the forms that needed to be signed to ship a body back home, all around the cold metal tablescape of Hernan, and that’s when he heard the beep and shush of an automatic door being swept back to reveal not a morgue, but an intensive care unit. The incessant digital bips and respirator chuffs, the official soundtrack to his every anxiety back when he was in this world, now sang their hallelujahs as he followed in Bolodis’s wake, every face a hero’s for having saved Hernan, every hand an engine of technique and wonder. Hernan was here, in a bed, and Patrick wondered if he would be angry with him for thwarting his efforts. Agitation at the thought of this affected his stride, increasing his pace so that he had to restrain himself from overtaking Bolodis. As he walked, he scanned the unit for signs of Hernan’s presence, but saw only a repeating, disorienting sameness to it, a coral reef of medical equipment. In one of the rooms off the main unit he saw a flash of colour, an electric blue fish darting away, recognizing it only after turning away as the same colour as the young woman’s hijab from the Prinsessegracht. But he was walking too fast and had passed too far to take a second look.
Bolodis stopped at the desk, catching the attention of a nurse, who then turned to the big board behind her where the patients’ names were listed. She pointed to another corner of the unit and the room that awaited there. The last corner, they’d run out of corners, and here, as if needing witnesses to the spectacle of being confronted by reality, he found a nurse and a respiratory technologist talking to each other, sharing a joke perhaps, both stopping when he and Bolo
dis entered, all of them standing over an immobile Hernan García.
The chief of intensive care came into the room a short time later with his white-coated entourage. When Bolodis introduced Patrick as a doctor and a friend of the family, the chief gave a nod of collegial recognition–a complex gesture in itself, an alloy of relief and wariness–and went on to explain that it was most likely an arrhythmic event, the heart tripping into an ineffectual pattern of pumping causing a prolonged period of circulatory compromise. Hernan was intubated, ventilated, canulated, and paced, said the doctor, pleased at his accomplishments, like a man rounding third after hitting an ICU home run. Of course, Hernan was comatose. No, no, coma was too broad a term, too generous; the chief of intensive care looked at his residents and asked, “Does he have brain stem reflexes?” and one of the residents shook her head. No.
Hernan García was dead, after all. Patrick saw Hernan’s chest rising and falling with machine regularity. He touched Hernan’s arm, fingering the scar that ran down his forearm, looking like an ill-tailored seam. The chief of intensive care, thinking these two doctors in front of him would find a solace in the facts that they could not find in the body, called them out of the room to look at scans of Hernan’s injured brain.
