The Heart

22

Another call. Another telephone trembling on a table and another hand picking it up — this one has a large, dark gold ring on one of its fingers, ribbed with spirals. Another voice succeeding the electronic growl — this one sounds nervous, and we understand why when we see the name on the cell phone’s screen: “Harfang surg.” Hello? And then another announcement — we can read the contents of this one on the face of the woman who is listening to it, emotion rushing beneath her skin, and then her features contracting again in furls.

“We have a heart. A compatible heart. A team is on its way to remove it. Come now — we’ll do the transplant tonight. You’ll go into the OR around midnight.”

* * *

She hangs up, breathing heavily. Turns toward the room’s only window and gets up to open it, both hands leaning on the desk as she struggles to her feet, walking the three steps with difficulty, and then grunting as she forces the latch. Behind the window, winter is massing: a hardened landscape, glacial and translucent. The cold turns the sounds of the street to glass, each one isolated like the murmur of evening in a provincial town; it neutralizes the screech of the elevated railroad car as it comes to a halt at the Chevaleret station; it muzzles the air’s odors and presses an icy film over her face. Shivering, she looks slowly over toward the other side of Boulevard Vincent-Auriol, to the windows of the building, directly across from where she stands, that hosts the Cardiology Department of the Pitié-Salpêtrière hospital. She had been there, three days earlier, for exams that showed her heart to be in a state of severe deterioration, enabling the cardiologist to request she be put on the priority list of recipients at the Biomedical Agency. She thinks about what she is living through, now, at this second. I’m saved, she thinks: I’m going to live. Someone, somewhere, has died suddenly, she thinks. Now, this evening, she thinks. She experiences the full force of the announcement, thinking that she doesn’t ever want the spark of this present moment to fade into the past, into the realm of memory: she wants it to endure, sharp and new. I am mortal, she thinks.

She takes a deep breath of winter, eyes closed: the bluish planet is drifting through a fold in the cosmos, suspended in silence amid gaseous matter; the forest is starred with straight-lined gaps; red ants are writhing under trees in a sticky frost; the garden expands: mold and stones, grass after rain, heavy branches, palm tree claws; the lidded city incubates the masses; children in bunk beds open their eyes in total darkness; she imagines her heart — a chunk of dark-red flesh, oozing and fibrous, pipes running in all directions — this organ riddled with necrosis, this organ that is failing. She closes the window. She has to get ready.

* * *

It is nearly a year since Claire Méjan rented this one-bedroom apartment without having even seen it — the mentions in the ad of the Pitié-Salpêtrière and its second-floor location being enough to make her sign a check, then and there, for the exorbitant sum demanded by the guy at the real estate agency. It’s a small, dirty, dark place, the balcony on the third floor obscuring the view from her window like a helmet visor. But she has no choice. This is what it means to be sick, she thinks — not having a choice. Her heart has left her no choice.

It’s myocarditis. She found out about it three years ago, during a cardiology consultation at Pitié-Salpêtrière. Eight days before that, she’d stayed at home with flu, poking the crackling fire in the hearth, a blanket over her shoulders, while outside in the garden, snapdragons and foxgloves cowered in the wind. She had gone to see a doctor in Fontainebleau and told him about the fever, the aches, and the tiredness, but she had neglected to mention the short-lived palpitations, the pain in her chest, and the breathlessness she experienced during exercise, ascribing these symptoms to weariness, winter, the lack of light, a sort of general exhaustion. She left the doctor’s office with a prescription for flu medicine, and decided to stay home and work from bed. A few days later, dragging herself through the streets of Paris to see her mother, she collapsed in shock: her blood flow decreased dramatically, her skin became pale, cold and clammy. She was taken to the ER in an ambulance, sirens screaming — like she’d found herself in an American soap opera — and they resuscitated her, then began the first tests. Blood analysis confirmed the existence of an inflammation, so they examined her heart. After that, she underwent a series of exams: the electrocardiogram detected an electrical anomaly; the X-ray showed her heart to be slightly enlarged; then, finally, the ultrasound established heart failure. Claire stayed in the hospital. She was transferred to the coronary care unit, where more specific exams took place. The coronary catheterization was normal, reducing the likelihood of it being cardiac arrest, so they decided to carry out a heart biopsy: Claire received an injection in the cardiac muscle via the jugular. A few hours later, the results concluded with a hostile-sounding nine-syllable diagnosis: myocardial inflammation.

The treatment was two-pronged: the first dealt with the heart failure (the organ no longer pumping efficiently), and the second the rhythm disorder. Claire was ordered to rest — no physical strain whatsoever — and to take antiarrhythmic drugs and beta-blockers, while she was implanted with a defibrillator in order to prevent sudden death. At the same time, the viral infection was treated with powerful immunosuppressants and anti-inflammatories. But the disease persisted in its severest form: it spread into the muscle tissue, the heart grew even more distended, and every second the risk of death hung over her. The organ’s destruction was now considered irreversible: she needed a transplant. A new heart. The heart of another human implanted in the place of her own — the doctor’s gestures seemed to mime the surgical act. In the long term, this was, for her, the only solution.

* * *

She goes home that evening. Her youngest son came to fetch her from the hospital; he will be the one who drives her back there. You’re going to agree, aren’t you? he asks quietly. She nods mechanically — she feels overwhelmed. Arriving at her house on the forest’s edge — this fairy-tale house where she now lives alone, her children having all grown up — she goes straight to bed: lying on her back, staring at the ceiling, fear pins her in place, infects all her future days with no possible escape. Fear of death and fear of pain, fear of the operation, fear of the postoperative treatments, fear that the organ will be rejected and she will have to start over again, fear of a foreign body intruding in hers, fear of becoming a chimera, of no longer being herself.

* * *

She has to move. She’s taking a risk, living in that village fifty miles from Paris, a long way from any main road.

Claire feels an immediate loathing for her new apartment. Too warm, in both winter and summer; the need for lights even in the middle of the day; the noise from the street. A final airlock before the operating theater, she envisages it instead as an antechamber of death, thinking she will die here because — even though she isn’t bedridden — she feels trapped in this place: she can’t leave it without what seems a superhuman effort, climbing the stairs gives her pain, each movement making her feel as if her heart is separating from the rest of her body, slipping from its perch inside the thoracic cage and falling to pieces. This feeling turns her into a shaky, limping creature, on the verge of a breakdown. Day after day, the space seems to close in around her, limiting and reducing her gestures, restricting her movements, narrowing her entire world, as if she has a stocking or a plastic bag over her head — something fibrous that stifles her breathing — as if her feet are caught in quicksand. She grows somber. To her youngest son, who comes to see her one evening, she admits that it disturbs her, the thought of waiting for someone to die so she can have their heart: It’s a strange situation, you know, and it wears me out.

* * *

To begin with, she is reluctant to really move in. What’s the point? Live or die, she won’t be staying here long — it is temporary, no matter what. But she doesn’t let her fears show — she acts tough. Her first weeks in this apartment alter her relationship with time. It’s not that it changes speed — slowed down by paralysis, by the dread of her suspended sentence, by her debilitating circumstances — nor that it stagnates, like the blood in Claire’s lungs stagnates; no, time seems rather to disintegrate in a bleak continuity. Partly due to the unending darkness of the place, the alternation of day and night soon loses its distinction: all she does is sleep, with the excuse that she is channeling the shock of this forced move. Her two eldest children gradually come to regard Sundays as her visiting day, a fact that makes her sad without her really knowing why. Sometimes they reproach her for her lack of enthusiasm: across the road from the hospital, it could hardly be better, they say to her straight-faced. The youngest, on the other hand, turns up at any time and gives her long hugs. He is a head taller than her.

* * *

Sinister winter, cruel spring (she cannot see the greenness returning to the forest, the pure colors bursting forth again, and she misses the undergrowth: the golden stumps and the ferns, the light probing in vertical rays, the multitude of noises, the foxglove scattered in semishade behind flower beds, on secret paths), hopeless summer. She is withering away (you need some sort of structure, meals at fixed times, a daily routine, repeats everyone who comes to see her, finding her depressed, distracted, vague, even a little creepy, her blond-haired black-eyed beauty altered, corroded by anxiety and the lack of fresh air), her hair is dull, eyes glassy, breath sour, and clothes shapeless. Her two eldest children try to find someone who can look after her — a home helper who can take care of the housework, the shopping, monitor her intake of medicine. When she learns about this plan, anger brings her back to life — are they trying to hack away at the little freedom that remains to her? White-faced and bitter, she rants about being under house arrest, no longer able to bear healthy people’s opinions about sickness.

* * *

The first call comes on the night of August 15. The window is open: it’s 8:00 p.m. and the room is suffocatingly hot. This is the Pitié, we have a heart for you, tonight, now — always the same phrasing. She’s not prepared. Putting her fork back on her untouched plate, she looks at her family, gathered around her, reunited for her birthday — you have to celebrate your fiftieth — they all stand with their arms dangling at their sides like birds’ wings: her mother, her three boys, the young woman who lives with her eldest and their little boy, all frozen except for the child with his garnet-colored eyes, all listening: I’m going, I have to go, chairs shoved backward, champagne flutes trembling, spurting, spilling, a bag packed with toothpaste and eau de toilette, the stairs descended with that rushed slowness that makes people trip and yell at each other — we forgot the sorbets in the kitchen, forgot the medical card, forgot the cell phone — then the sticky asphalt, the smoky sky, people leaning through open windows, a shirtless guy walking his dog, the little boy running on the sidewalk, grabbed by his mother, the tourists checking their maps as they emerge from the metro, and at last the hospital, ringed with little lamps, the admissions process, the newly scoured room where she waits again, sitting on the edge of the bed that she will never open because, finally, there is movement in the corridor, the sound of heavy footsteps, and Harfang appears. He stands before her, thin and pale, bags under his eyes: In the end, we decided to refuse the organ.

She listens as he explains his decision, her face blank: The heart wasn’t good, too small and poorly vascularized, there’s no point taking a risk like that, we’ll just have to keep waiting. Harfang imagines she must be in shock from the disappointment, her hopes dashed, but in fact she is stunned, stupefied, and soon she has only one thought in mind: to get away from here. Her feet hang in the void, her backside slips insensibly off the edge of the bed, and she lands softly on the floor, then stands up — I’m going home. Outside, her sons kick bushes that instantly give up clouds of burning dust, her mother bursts into tears, comforted by her youngest son, the eldest son’s girlfriend keeps running after the little boy, who refuses to go back to the house, and everything falls apart. The group crosses the road in the opposite direction, no longer feeling hungry: it seems impossible to start eating the meal where they had left it. But they can still drink — a pink champagne served in bubble-glass flutes — and Claire ends up lifting her full glass above the table, arm outstretched and smiling, looking beautiful now: Come on, put your heart into it! You’re not funny, you know, her youngest son mutters.

* * *

After that, the nature of time changes — it regains its shape. Or, rather, it takes the shape of waiting: hollow and stretched out. From that point on, the only purpose of hours is to be available during them, knowing that the transplant operation could suddenly become reality, a heart might appear at any moment: I must stay alive, I must be ready. Minutes become supple, seconds ductile, and finally fall arrives, and Claire resolves to bring her books and lamps to this tiny apartment. Her youngest son installs Wi-Fi for her, and she buys an office chair, a wooden table, gathers together a few objects: she wants to start translating again.

Her editor is delighted by this news, and sends her Charlotte Brontë’s first publication, a collection of poems published under her and her sisters’ masculine pseudonyms: Currer, Ellis, and Acton Bell. She spends the fall in an icy cottage, battered by the wind, where three sisters and a brother write and read together by candlelight, communing with each other through books: feverish, exalted, tortured geniuses, inventing worlds, walking the moors, drinking quarts of tea, and smoking opium. Their intensity wins Claire over, and she gradually perks up. Each day spent working yields a slender batch of pages, and as the weeks pass she finds her rhythm, as if it’s a question of synchronizing the waiting — which becomes sharper and clearer as the state of her heart declines — with another kind of time: that of translating poems. Sometimes she feels she is replacing the painful contractions of her sick organ with a fluid back-and-forth, between her native French and the English she has learned, and that this reciprocal movement is digging a cradle-shaped crevice inside her, a new cavity. She’d had to learn a new language in order to understand her own, so she wondered if this new heart would allow her to better understand herself: I’m clearing a space for you, my heart, I’m making you a home.

* * *

On Christmas Eve, a man resurfaces, placing a bouquet of purple foxgloves on her bed. She has known him since childhood: they grew up together — lovers, friends, brother and sister, partners in crime. They are, for each other, almost everything a man and a woman can be.

Claire smiles and taps her chest: it’s not a good idea to surprise me, you know. In fact, she has to sit down and recover while he takes off his coat. The flowers are from her garden, she can tell from their scent. You know they’re poisonous? she says, pointing at them. One of those flowers that children are forbidden to touch, breathe, gather, taste — she remembers staring, fascinated, at her fingers, coated with fuchsia powder, alone in the street, and the word “poison” appearing in a thought bubble above her head while she lifted her hand to her mouth. The man slowly pulls off a petal and places it in the palm of her hand: Look at that. The petal is so brightly colored that it looks artificial, made of plastic. Trembling in her palm, it is covered with microscopic wrinkles. Actually, he tells her, the digitalin contained in the flowers makes the heartbeat stronger, slower, steadier. It’s good for you.

She sleeps with the flowers that night. The man carefully undresses her, removing the petals one by one, then placing them on her naked skin like the scales of a fish, a sort of organic jigsaw puzzle that he painstakingly perfects into a ceremonial gown, whispering don’t move from time to time, even though she has long been asleep, in a luxuriant catalepsy, nursed and ornamented like a queen. It was still night when she awoke, but the children in the apartment above hers were already running around excitedly, shouting, their footsteps hammering the floorboards, rushing into the living room to tear the wrapping paper from the presents that had appeared during the night around the ectoplasmic Christmas tree. Her friend had gone. She shook the petals from her body and made them into a salad that she seasoned with truffle oil and balsamic vinegar.

* * *

A T-shirt, a few pairs of underwear, two nightgowns, a pair of slippers, beauty products, laptop, cell phone, chargers. Her medical file — administrative printouts, latest exams, and those large, rigid envelopes containing scans, X-rays, and MRIs. She is glad she’s alone to pack her bag, to walk cautiously downstairs, to take her time outside. She crosses the road diagonally, trying to catch the eyes of drivers who slow down when they see her, listening to the hot rail tracks vibrating over her head; she would like to see an animal — a tiger, ideally, or a barn owl with a heart-shaped face, but a stray dog would be fine, and bees would be wonderful. She is more terrified than she has ever been; she is anesthetized by terror. But she should call to let people know, she thinks, as she enters the hospital grounds. She looks up her sons’ numbers and sends them a text — it’s now, tonight — then calls her mother, who must already be asleep, and lastly her foxglove friend on the other side of the world: signals sent in this very instant that stretch out a long way through time. She turns back one more time, looks at the window of her apartment, and suddenly all the hours that she has spent behind that pane of glass, waiting, are condensed into a single shard of time, converging at the base of her skull at the precise moment when she walks through the hospital gates, a lightning-quick finger snap that launches her into the enclosure, onto the asphalt ribbon that runs beside the buildings. Then, as the path bends to the left, she enters the Cardiology Institute: a lobby, two elevators — she forces herself not to think about choosing the one that will bring her good luck — up to the fourth floor and that corridor illuminated like a space station, the glass-walled workstation, and Harfang standing there, in a clean and neatly ironed shirt, white cowlick combed back off his forehead: I’ve been expecting you.