The Heart

13

They held hands as they followed Thomas Rémige, and, deep down, the reason they accompanied him, walking once again through this maze of corridors and sterile zones, waiting patiently as they entered each new level, holding doors open with their shoulders, in spite of the black meteor that had just crashed into their lives, in spite of their obvious exhaustion, the reason they did all this was because of the look in Thomas Rémige’s eyes — that look which kept them in the land of the living, that look which already seemed priceless. And so, as they walked, the two of them moved closer, interlacing their fingers, touching together the fleshy pads of their fingertips and their bitten nails edged with dead skin, brushing their dry palms, the rings on their fingers, and they did it without thinking.

* * *

Yet another part of the hospital: a place styled after the living room of a sample apartment, light and airy, with elegant if unexceptional furniture — an apple-green couch in a synthetic fabric that feels like velvet, and two stuffed vermilion chairs — the walls bare apart from a color poster for a Kandinsky exhibition — Beaubourg, 1985—and, sitting on the coffee table, a green plant with long, thin leaves, four clean glasses, a bottle of mineral water, and a small potpourri dish that smells of orange and cinnamon. The curtains stir gently in the breeze that comes through the cracked-open window, and the few cars that come and go in the hospital parking lot below are clearly audible, as is the screech, like sonic scratches over all of this, of seagulls. It’s cold.

Sean and Marianne are sitting next to each other on the couch, awkwardly, intrigued in spite of being so shaken, while Thomas Rémige sits on one of the vermilion chairs, holding Simon Limbres’s medical file. Even though they are sharing the same space, however, inhabiting the same time, at that precise moment, nothing in this world could be more distanced than those two beings, in their pain, and this young man who has placed himself before them with the aim — yes, with the aim — of gaining their consent for the removal of their child’s organs. Here are a man and a woman caught in a shockwave, at once thrown into the air and smashed down into a broken temporality — a continuity brutally severed by Simon’s death but which, like a headless duck running around the courtyard, keeps going senselessly — a temporality woven from pain, a man and a woman in whose heads are concentrated the whole tragedy of the world. And here is this young man in a white coat, cautious but committed, determined not to jump the gun, but highly aware of the silent countdown in a corner of his mind, knowing all too well that a body in a state of brain death quickly deteriorates, that time is of the essence — and torn between these two imperatives.

* * *

Thomas pours water into three glasses, stands up, and crosses the room to close the window. As he moves, he observes the couple carefully, never takes his eyes from them — this man and this woman, Simon Limbres’s parents — and in this moment he is undoubtedly preparing himself mentally, conscious of the fact that he is about to mistreat them, to carve into their pain with questions they know nothing about right now, asking them to think and to formulate responses when they are zombies, stunned by pain, hurtling through black space. In all probability, he prepares to speak the same way he prepares to sing, relaxing his muscles, regulating his breathing, aware that punctuation is the anatomy of language, the structure of its meaning, visualizing his opening phrase as a sound line, weighing the first syllable he will pronounce, the one that will break the silence, slicing instead of cracking the eggshell, quick and precise as a blade stroke rather than a fissure that meanders slowly up the wall when the earth trembles. He begins slowly, reminding them methodically of the context of the situation: I think you understand now that Simon’s brain is being destroyed; nevertheless, his organs continue to function; this is an unusual situation. Sean and Marianne blink in acknowledgment. Encouraged, Thomas goes on: I’m aware of how painful this is for you, but I have to broach a delicate subject — his face is haloed by transparent light and his voice becomes imperceptibly louder. It sounds absolutely clear when he declares:

We are in a context where it would be possible to consider the donation of Simon’s organs.

* * *

Wham. In that instant, Thomas’s voice hits the right frequency and the room seems to resonate like a gigantic amplifier. It is a high-precision delivery, as perfect in its timing as the wheels of a jet landing on the flight deck of an aircraft carrier, the paintbrush of a Japanese calligraphist, a tennis player’s drop shot. Sean lifts his head, and Marianne jumps, their eyes capsizing in Thomas’s calm gaze — they are beginning to comprehend, with terror, what they are doing here, sitting in front of this handsome young man with his classical features, this handsome young man who continues speaking in a composed voice: I would like to ask you if your son ever talked to you about this, if he ever expressed his views on the subject.

The walls dance, the floor rolls. Marianne and Sean are in shock, their mouths agape, eyes staring emptily at the coffee table, hands writhing, and the silence that fills the room is thick, black, vertiginous, a mix of panic and confusion. A chasm has opened up, here, in front of them, a chasm that they can only imagine as “something,” because “nothing” is unthinkable. They struggle with this, facing that black hole, together, even if they are not feeling the same emotions or posing the same questions — Sean has become solitary and silent over the years, combining clear-headed unbelief with a sort of lyrical spirituality, based in the myths of Oceania, while Marianne had her first communion in a flowered dress and tennis socks, wearing a crown of fresh flowers on her head, the host stuck to the roof of her mouth, she prayed for a long time each evening in the bunk bed she shared with her sister, kneeling on the upper bunk, saying the words out loud in those pajamas that made her itch, and even now when she enters a church, she explores the silence as if it’s the texture of a mystery, seeks out the little red light shining behind the altar, inhales the heavy odor of wax and incense, observes the daylight filtering through the rose window in colored rays, the wooden statues with painted eyes, but remembers the intense sensation that ran through her in that moment when she removed the halter of faith from her neck. The two of them conjure visions of death, images of beyond, postmortem spaces deep in eternity: it’s a gulf hidden in a fold of the cosmos, a black and rippling lake, it’s the kingdom of the believers, a garden where beings move, their flesh resuscitated by the hand of God, it’s a lost valley in the jungle where forsaken souls flutter aimlessly, it’s a desert of ashes, a sleep, a diversion, a Dantean hole at the bottom of the sea, and it’s also a hazy shore reached in a delicately worked wooden canoe. They are leaning forward, arms crossed over their stomachs, nursing the shock, and their thoughts converge in a funnel of questions that they do not know how to ask.

Thomas starts again, trying a different tack: Was your son on the national organ donation refusal registry? Or do you know if he’s ever expressed his opposition to the idea, if he’s against it? A complicated question; their frowns deepen. Marianne shakes her head, I don’t know, I don’t think so, she stammers, while Sean suddenly moves, his dark squarish head turning slowly toward Thomas, and says, his voice muffled: Nineteen years old — he inclines forward and gathers together these poorly articulated words, spoken without really opening his mouth — are there any nineteen-year-olds who make the necessary arrangements regarding, for that sort of, does that even exist? “Necessary arrangements”—his voice is menacing, contained, the S’s sinisterly snakelike. It can happen, Thomas replies softly, sometimes. Sean swallows a mouthful of water, bangs the glass back on the table: Maybe, but not Simon. And so, stealing in through what he identifies as a breach in the dialogue, Thomas asks, in a slightly louder voice, why “not Simon”? Sean chews silently: Because he loves life so much. Thomas nods, I understand, but does not give up: Loving life doesn’t mean he never thought about death; he might have talked about it to his friends or family. Filaments of silence are spliced together, and then Marianne reacts, foggily, the words tumbling fast: Friends, family, yeah, I don’t know, actually yes, his sister, yes he really loves his little sister, Lou, she’s seven, they’re like day and night but they’re really close, and his friends, well, there’s his surf buddies, Johan, Christophe, and his high school friends, but, I don’t know, we don’t see them very often, but friends and family, yeah, I don’t know, well there’s his grandmother, his cousin who lives in the United States, and there’s Juliette too, his first love, and there’s us.

* * *

They are talking about their son in the present tense; not a good sign. Thomas continues: I’m asking you these questions because if the deceased — in this case, your son, Simon — has not made known his refusal, if he has not expressed his opposition, we need to think about what he would have wanted: Would he have consented? “The deceased — in this case, your son, Simon.” Thomas had raised his voice and distinctly pronounced each word of this phrase, hammering in the final nails. Consented to what? It’s Marianne who asks the question, lifting her head, but in truth she already knows the answer; she wants to hear those final nails go in. Thomas replies: Consented to the removal of his organs, for transplant operations. He has to use these brutal phrases, unfolded like slogans on banners; he has to utilize their heavy impact, their blunt power; Thomas knows all too well how much suffering can be caused by ambiguity, misplaced subtlety, in these kinds of interviews.

* * *

The tension has very quickly risen at this point on the earth’s surface. The plant’s leaves seem to tremble, the water in the glasses to ripple; the light in the room seems to grow suddenly brighter, making them blink, and the air to vibrate as if the motor of a centrifuge was slowly turning above their heads. Thomas is the only one to remain completely immobile, to show no emotion. Keeping his gaze steady on their pain-creased faces, ignoring the tremors of their jaws, the shaking of their shoulders, he goes on unflinchingly: The purpose of this interview is to discover and formulate the expression of the dead person’s wishes — Simon’s wishes; we are not here to consider what you yourself would do in this situation, but to think about what your son would have wanted. Thomas holds his breath, assessing the stealthy violence of these words, words that force a radical distinction between their bodies and the body of their child, words that create a distance, but which also, at the same time, allow them to think clearly. In a weak drawl, Marianne asks: How can we know?

She is asking for a method. Sean watches her, and Thomas reacts unhesitatingly. In that moment he wonders if Marianne might be, in the words of an expression he learned at a seminar, the “resource person”; in other words, the person who might create a wake effect. We are here to think about Simon, he says, about the person he was; the removal process is always connected to a unique individual, to our reading of his existence; we have to think about this together; for example, we can ask whether Simon was religious, whether he was generous. Generous? Marianne repeats, stunned. Yes, generous, Thomas confirms, how he was in his relationships with other people, whether he was curious, whether he liked traveling; these are the kinds of questions we need to ask.

Marianne glances over at Sean; his face is haggard, muddy skin and black lips, his eyes focused slantingly on the green plant. She can’t see the link between the nurse’s questions and organ donation. Finally, she whispers: Sean, was Simon generous? They look away, unsure how to respond, the two of them breathing heavily. She puts an arm around the neck of this man with thick, black hair like her son’s, pulls him toward her, their heads touch, and he lowers his while a yes slides from his dry throat — a “yes” that, in all honesty, has little to do with their son’s generosity, because, when it came down to it, Simon was not especially generous: he was more catlike, lighthearted and selfish, grumbling with his head inside the fridge Jesus don’t you have any Coke in this house? rather than a young man of lavish gestures and kind thoughts. This “yes” is more a description of Simon as a whole, lifting him up to let him shine, a modest, direct boy who devoured the intensity of his youth.

Suddenly Marianne’s voice breaks through in a rush of breath, the words coming out in jolts: There is something — we’re Catholics — Simon was baptized. She stops dead. Thomas waits for her to continue, but the silence lengthens, so he asks her — a life buoy thrown in the sea — Was he a believer? Did he believe in the resurrection of the body? Marianne looks at Sean, though all she can see of him is his profile, leaning forward, then bites her lips, I don’t know, we don’t go to church very often. Thomas is tense — last year, a dead girl’s parents refused the removal of any organs from their daughter’s body on the basis that they believed in the resurrection of the flesh and considered this a mutilation that rendered any other form of existence impossible, and when Thomas gave them the Church’s official position — in favor of donation — they replied: No, we don’t want her to die a second time. Marianne rests her head on Sean’s shoulder, then starts to speak again: Last summer he read this book on a Polynesian shaman, the coral man or something, he was planning to go there to meet him, you remember? It was a book about reincarnation. Sean nods, eyes closed, and adds in a barely audible murmur: Simon had so much energy, he liked to exert himself, he was a physical being, that’s it, that’s how he was, living in his body, that’s how I see him, natural, living in nature, he wasn’t afraid. Marianne waits a few seconds and then asks, uncertain: Is that what it is, being generous? I don’t know, maybe. And now she is crying.

* * *

They are speaking in the past tense now, the father and the mother. They have begun the story. For Thomas, this is a tangible step forward, the signal that the idea of the death of their child is slowly crystallizing. He places the case file on the table, rests his hands flat on his thighs, and opens his mouth to continue speaking. But then, without warning, everything is up in the air again: Sean leaps to his feet and begins pacing around the room, agitated, abruptly declaring this is bullshit, all this crap about generosity, I don’t see why Simon being generous or liking to travel should give you the right to think he’d want to donate his organs, that’s too easy, and anyway, what if I said he was selfish, would that be the end of it? He stops pacing around, approaches Thomas, and whispers in his ear: Just tell us if we can say no, go on. Marianne, shocked, turns to him and cries out Sean! But he doesn’t hear her, he is striding around the room again, his pace increasing. Finally he leans against the window, his back to the glass, his silhouette black and huge against the daylight: Go ahead, just tell us the truth, are we allowed to refuse or not? He is snorting like a bull. Thomas doesn’t blink; his spine stays straight, his clammy hands remain glued to his jeans. Marianne stands up and walks toward Sean. She holds out her arms but he turns away, walks three paces along the wall, spins on his heels, and punches the wall with all his might: the window shudders above the Kandinsky poster, then he groans: Fucking hell, I don’t believe this! and, devastated, turns to face Thomas, who is now standing up, white as a sheet, frozen, immobile, and announces in a decisive tone: Simon’s body is not just a box of organs that you can help yourself to.

The process is suspended if the attempt to discover the deceased’s wishes, carried out in tandem with his loved ones, ends in refusal.

* * *

At last, Marianne grasps Sean’s hand. Fantastic, she whispers, stroking it, that’s just what we need, then leads him over to the couch, where the two of them sit down, take deep breaths. There’s a lull. Marianne and Sean each drink a glass of water; neither is particularly thirsty, but they need to buy time, to keep moving, rediscover the right frequency so they can speak again.

At this point, Thomas thinks the whole thing is screwed. Too tough. Too complex, too emotional. The mother maybe, but the father … there’s no way back, it’s all going too fast. They’d barely had time to realize their tragedy before they had to decide about organ removal. He sits down too. Picks up the file from the coffee table. Does not insist, or seek to influence them, manipulate them, use his authority. Does not act as the agent for a silent but oppressive game of emotional blackmail, a pressure that is all the more powerful on Simon’s parents because young, healthy donors are so rare. He does not, for example, tell them in no uncertain terms that French law prescribes the principle of presumed consent in the absence of membership in the national organ donation refusal registry. Spares them the tortured question of how presumed consent can be the rule when the donor was dead and could no longer speak, could no longer consent to anything. Spares them the legal fact that, by never having said anything on the subject to his family, Simon has effectively said yes, another rephrasing of the dubious dictum silence implies consent. Yes, in the end, he keeps quiet about those texts that would so easily have undercut the meaning of this dialogue, making it a mere formality, a hypocritical convention, when the law as a whole suggested something more complex, based on reciprocity and exchange: as each person is considered a potential organ recipient, is it not logical that each person should also be considered a potential organ donor after his or her death? Once the conversation takes this turn, he will only mention the legal context to people who are neutral on the question of donation, or in order to comfort families after they have already agreed, using the law like a handrail to support them as they move forward.

He closes Simon’s file and rests it on his knees again, signaling to Sean and Marianne Limbres that they may quit this dialogue if they desire and leave the room. They’ve refused — it happens. There has to be a place for such a decision: the possibility of refusal is also the condition for donation. He should shake hands and say goodbye now. The interview has failed, and he has to accept that fact. Thomas’s principle is absolute respect for the wishes of loved ones, and he also understands the indisputable nature of that which makes the body of the deceased sacred for those who loved him. It’s his way of preventing an approach that risks becoming — supported legally and ethically by the letter of the law and the shortage of transplant organs — a steamroller. His gaze sweeps the walls of the room: from behind the window, a bird is watching them. A passerine. Seeing it, Thomas immediately wonders if Ousmane will drop by his apartment to feed Mazhar, the goldfinch, fill its trays with clean water and organic grains, those multicolored grains grown on a balcony in Bab El Oued. He closes his eyes.

* * *

Okay, what would you remove? Sean asks this, head down, eyes to the ground, and Thomas, surprised by this change of course, frowns and then instantly adjusts to this new tempo: The heart, the kidneys, the lungs, and the liver; if you agree to this, you will be kept fully informed and your son’s body will be restored. He lists the organs unwaveringly, a symptom of the urge he always feels to favor dry precision over evasive vagueness.

The heart? Marianne asks. Yes, the heart, Thomas repeats. Simon’s heart. Marianne is dazed. Simon’s heart — clusters of blood cells merge in a little sac to form the first vascular network on the seventeenth day; pumping begins on the twenty-first day (very weak contractions, but audible on highly sensitive equipment designed expressly for heart embryology); the blood flows through the growing vessels, nerves form in tissue, veins, tubes, and arteries, the four chambers develop, and by the fiftieth day everything is in place, if unfinished. Simon’s heart — a round belly rising gently at the bottom of a portable crib; the bird of night terrors flapping distraught inside a child’s chest; the staccato drumbeat syncopated with Anakin Skywalker’s destiny; the riff under the skin when the first wave rises — feel my pecs, he said to her one evening, muscles tensed, monkey face, he was fourteen years old and in his eyes she could see the new glow of a boy taking possession of his body, feel my pecs, Mom — the diastolic melt when he saw Juliette at the bus shelter on Boulevard Maritime, stripy T-shirt dress, red Doc Martens, art portfolio tucked under her arm; held breath on Christmas Eve, the surfboard unwrapped in the middle of the freezing warehouse, opened with that mixture of meticulousness and passion, the way you slice open an envelope containing a love letter. The heart.

But not his eyes — you don’t take his eyes, do you? Her scream stifled with a palm held to her own mouth. Sean shudders, instantly shouts no, never, not his eyes. His groan dies to silence and Thomas looks at the ground, I understand.

This is another area of turbulence, and he shivers, swims through it, knowing that the symbolic significance differs from organ to organ — Marianne reacted only to the idea of removing her son’s heart, as if removing his kidneys, liver, or lungs was more conceivable, and she refused the removal of the corneas, which, like the muscle tissue and the skin, are rarely the subject of the family’s consent — and understands that he must compromise, make an exception to the rule, accept their restrictions, respect this family. It’s empathy. Because Simon’s eyes were not only his nervous retinas, his taffeta irises, his pure black pupils in front of the natural lens; his eyes were his gaze, the way he looked at you. His skin was not only the mesh of his epidermis, his pores, it was his light and his touch, the living sensors of his body.

* * *

Your son’s body will be restored.

It is a promise and it is perhaps also the death knell for this dialogue — who knows? Restored. Thomas looks at his watch, makes a quick calculation — the second thirty-minute EEG will take place in two hours — would you like some time alone? Marianne and Sean share a glance, both nod. Thomas stands up and adds: If your son is a donor, it will enable other people to live, other people who are waiting for an organ. The parents pick up their coats and bags, their movements slow even though they are in a rush to leave this place now. So he wouldn’t have died for nothing, right? Sean lifts the collar of his parka and looks Thomas in the eye: We know, we know all that, transplants save lives, the death of one person can give life to another, but Simon is our son, don’t you understand? I understand. As she walks through the doorway, Marianne turns and she too looks Thomas in the eye: We’re going to get some fresh air, we’ll be back.

* * *

Left alone in the room, Thomas collapses into a chair. He rests his head in his hands, runs his fingertips through his hair, massaging his skull, and exhales a long breath. No doubt he is thinking how tough his job is; maybe he too would like to talk, to punch walls, throw things at wastepaper baskets, break glasses. Maybe it will be a yes, more likely a no. It happens — a third of interviews end with a refusal — but for Thomas Rémige, a clear-headed refusal is better than an agreement torn from confusion, extracted with forceps, and regretted two weeks later by people ravaged with remorse, people suffering with insomnia, drowning in grief. You have to think about the living, he often says, chewing the end of a matchstick, you have to think about those who are left — in his office, on the back of his door, he has stuck a photocopy of a page from Platonov, a play he has never seen, never read, but this fragment of dialogue between Serguey Voinitzev and Nicolas Triletzki, seen by chance in a magazine he’d found at the local Laundromat, had thrilled him the way a kid is thrilled when he discovers some glorious treasure: a Charizard in a packet of Pokémon cards, a golden ticket in a chocolate-bar wrapper. What shall we do, Nicolas? Bury the dead and mend the living.