The Law of Bound Hearts (4 page)

In the workshop, Lee was fairing the mahogany planking of his current project, a twenty-foot ketch, which was nestled in cradles. He was building it from scratch. It was commissions like this that enabled him to take on the restoration jobs.

“Relief arrives.” She held the six-pack aloft.

He put aside his sandpaper and embraced her, leaving sawdust on her shoulders. He kissed her neck, inhaling her scent. “Ummmm. Sugar and chocolate. My weaknesses.”

She kissed him back, hungrily. He smelt of raw wood, epoxy, sea air. “Does that mean you want to eat me?”

His smile could have sent her straight to a cardiologist. “Count on it.”

“I am,” she said. Her belly was heavy with longing. She pressed against him, felt his breath on her cheek, turned her face up for his kiss.

He kissed her softly, then pulled back and studied her. “Is everything all right?”

“It's been a long day,” she said, avoiding his question. One of the cats brushed against her leg, then settled down beside the wood-stove. “Want a beer?” She uncapped a Beck's, pushed a wedge of lime through the opening, handed him the bottle, opened one for herself. “Shall I order pizza now or wait?”

“I've got about fifteen more minutes here. If you can wait, I'll take you to Vic's.”

“An offer I can't refuse.” She moved a wooden mallet out of the way and sat on a sawhorse, happy to watch him. The thing was, he made her feel good inside.

She finished the Beck's, opened another. Lee was still working on his first. She felt the beginning of a buzz coming on. The sound of sandpaper rubbing wood lulled her. It was quieter than usual, even with the CD going. She reached over and stroked the cat. “A funny thing happened today,” she heard herself say. She had not planned this, had not considered or prepared for the complications, the explaining it would give rise to.

“Yeah?” Lee concentrated on the fairing.

“My sister called.”

He looked up. “Your sister?”

“Uh-huh.” She continued to caress the cat. It stretched beneath her hand. She had always wanted a kitten. A white Angora would have been her choice, but their mother had been allergic.

Lee swiped wood dust from the mahogany. “I didn't know you had a sister.”

She took another swallow of Beck's, attempted a laugh. “Yes, you did.”

“Sam,” he said, looking straight at her. “This is the first time I've ever heard you mention any sister.”

“I told you,” she said, forcing herself to meet his eyes. Shit. Why had she started this?

“Not to put too fine a point on this,” he said, “but you've never told me you had a sister.”

“Of course I did.” Too late to recant now. She took a deep swallow, unable to maintain eye contact.

He returned to the sanding. “I know you have a brother,” he said after a minute. His tone was reasonable; they could have been talking about anything. Plans for the weekend. Weather forecast for tomorrow. Anything. “His name is Josh, he's forty-eight, married to his second wife, Cynthia, a woman you're not particularly fond of. He's the father of two sons and coaches high school hockey.” He stopped and took a swallow of his beer, set it by his feet. “They live in Colorado.”

“Up yours,” she said.

He stared at her and, under his steady gaze, she flushed.

He lifted an eyebrow, waited a beat, and when she remained silent, returned to the work. With any other man, she would have been out of there.
Don't screw this up,
a wise voice counseled. She forced herself to remain. An awkward silence stretched between them.

An ache began somewhere in her insides. She wanted to explain, to apologize, but the words wouldn't come. (Sam's stubborn as a mule in mud, her father used to say.) Lee sanded the final coat of epoxy, put his tools away, shut down the damper on the stove, fed the cats. When he had finished up, they drove to Vic's.

In the restaurant, Sam headed for their favorite booth. Instead of sliding in next to her, Lee sat on the opposite bench. She wasn't the only mulish one. She hated the tension but was too proud to apologize first, although she knew she must eventually.

Andrea, Vic's youngest daughter, came over and handed them menus. “Whaddaya want to drink?” she asked Lee. Usually the girl's obvious crush on him amused Sam, but tonight she found it irritating.

They decided to stick with beer.

“What's tonight's special?” Lee asked.

“The mushroom, onion, and sausage.”

Lee didn't eat red meat. “Can Vic make mine without the sausage?”

“No problem. You?” she asked Sam.

“I'll have the same,” she said. “
With
the sausage,” she emphasized. She was being childish. Lee didn't have a problem with her choice of food or the politics of her choice.

“How about splitting a Caesar?” he asked her. “That okay with you?”

“Fine.” Her voice was careful. She missed the easy way they usually had with each other, realized suddenly that they had never fought, not in all the months since that first dinner at Alice's. Someone had carved a diamond into the maple tabletop and she traced the design with her forefinger, wondering not for the first time what urge led people to mar a perfectly fine surface, what desire to deface.

Andrea brought their beers and the salad.

“You still going up to Scituate tomorrow?” Sam asked. There was a customer there who wanted to talk to Lee about constructing a yacht, a thirty-six-foot ketch based on a Herreshoff design. A dream commission.

“We had to reschedule. For next week.”

“Disappointed?” She nudged a crouton to the side of the salad dish. He reached over and speared it.

He shook his head. “If it's meant to happen, it will happen without me pushing the river.” He said things like that,
pushing the river,
old hippie sayings that would have driven her mad if anyone else said them.

Andrea brought their pizza. Sam ordered another beer. She was already over her limit, heading from lightly buzzed to the next stage, not exactly drunk but warming up. She would probably have a headache in the morning. She couldn't drink as much as she used to. God, in her twenties she could polish off an entire six-pack and walk, draw, or sing a straight line, no problem.

“Hey,” he said. He reached over and entwined his fingers with hers.

“Hey, yourself,” she said, and suddenly things were all right again.

She told him about the coming weekend, the three weddings, just the thought of which was now making her slightly panicked. He offered his help—purely moral support, she knew, for the delivery and last-minute on-site assembling and decorating weren't something that could be delegated. Still, she was warmed by his offer. For the first time since they left the boatyard, Sam felt as if she could fully breathe.

“So what did she want?” he said after a while.

“Who?”

“Your sister.”

She disentangled her fingers, withdrew her hand. “I don't know.”

He waited.

“She left a message. She asked me to call her.”

“And you haven't.”

“No.”

“Are you going to?”

“I don't know.”

He reached across again, reclaimed her hand. “Sam,” he said. “Are you going to tell me what this is about?”

Her throat ached. “I don't think so.” She wished he were sitting next to her instead of opposite her, but she couldn't bring herself to get up and move to his side.

He shrugged, withdrew his hand, picked up another slice of pizza, ate it.

Finally she said, “Her name is Libby.”

He nodded, waiting.

“It's been a while since we talked. We had a falling-out.”

He waited a moment and when she didn't go on, he said, “A falling-out?”

“Yes.” The words sounded so simple—a minor tiff, a quarrel over a borrowed sweater.

“That's it?”

She nodded.

“Do you want to talk about it?”

“Not really.”

He studied her for a moment. “Okay,” he said. “Whenever you're ready.”

“Are you ready?” Libby's arm is around Sam's waist, holding her close. They
perch on the edge of the webbed lawn chaise. Thigh to thigh, skin to skin, their
legs are bound together by three of their mother's silk scarves.

Libby

I'm dying.

Such an overdramatic statement was utterly unlike her. She abhorred histrionics. She looked around to see if anyone had heard, but no one was in sight, thank God. The prairie was vacant, except for the hawk overhead, and whatever rodents lurked hidden in the grass. And, she now noted, a spider—black with yellow stripes. Richard had told her the name but she'd forgotten. It sat in the center of a large web latticed on stalks of grass, a huge web really, nearly two feet across. She was grateful that only the spider and the other prairie creatures had been witness to her ridiculously maudlin and melodramatic statement, one verging on martyrdom, something to which she had sworn she would not succumb.

She was
not
dying. She was ill. Although the disease was not curable, there was treatment, she would live. So why was she sitting here on a bench in the prairie acting like a soap opera heroine? It was the isolation. Illness set her apart from others. Everything had changed. She could no longer take the ordinary workings of her body for granted.

In truth, she had to admit, she was responsible for a large part of the isolation. She had shut herself off from Richard, shut out their friends, most of whom didn't even know that she was sick although Richard urged her to tell them. He believed that if people knew, a network of support and sympathy would rise up, along with casseroles and offers for drives to appointments. She had refused, unwilling to be the recipient not only of their chicken pies and cookies but of the satisfying pity of which even she herself had been guilty in the past: the head tilted slightly to one side to indicate sincere concern, the voice pitched softer and higher than normal.
How are you doing,
dear? I'm fine. No, how are you really?
All the time grateful it was someone else's turn at bat for cancer or betrayal.

She thought of Joyce Latch and her breast cancer, the lymph node involvement. Or that pathetic Mary Hudson whose husband ran off with a counter girl from Starbucks—really, a counter girl.
How
are you doing, dear? I'm fine. Fine.
But clearly Mary was not fine. She was eating herself into oblivion; at the rate she was going she would have to be buried in a piano case.

Libby was
not
dying. Carlotta—Dr. Carlotta Hayes—had emphasized that. Just as Carlotta had reassured her that it would have made no difference if Libby had gone for a checkup when she first noticed symptoms, symptoms she hadn't even recognized as significant. If there had been pain, she might have been troubled, but there had been only the swelling, a slight puffiness in her face and hands and ankles, similar to what she'd experienced when she was pregnant with the twins. Salt retention, she'd thought, or maybe an odd and early sign of menopause. Pain—backache or headache or even the slightest tenderness—would have been a definite sign of something amiss, but not a little edema. Even the first time she saw foam in the toilet bowl after peeing, she wasn't particularly alarmed. Startled, certainly, but not panicked. She explained that away too, telling herself some food had caused it, the same way beets turned your pee red, or asparagus made it smell. Still, it
was
odd. And it persisted, even after she increased her fluid intake. When she finally mentioned it to Richard, she was resolutely casual, saying it was probably something she'd eaten. What, he said, you've been eating soap? He insisted she set up an appointment with Jack Dixon, their family physician. She postponed making the call. (Once, at a cocktail party, she overheard Jack complaining about the women needing nothing more than attention who filled his waiting room. He said more than sixty percent of the patients who came to see him didn't really need to be there.)
There wasn't any pain.

When she finally phoned Jack's office, she emphasized that it wasn't an emergency. The day of the appointment, she went shopping first and even made a date with Sally Cummings for lunch. That was how certain she was that there was nothing seriously wrong.

Jack listened to her symptoms and took her blood pressure, which was unusually high, 170 over 115. He frowned at the reading. (One year earlier, according to his records, it had been 115 over 70.) He checked her lungs and heart and palpated her abdomen and then sent her off with one of those little waxy cups to get a urine sample, that humiliating part of the routine exam: squatting splayed-legged over the toilet, haunches trembling from the effort of keeping her flesh from touching the toilet seat, the too-small cup clutched between thumb and forefinger, so nervous she couldn't relax her sphincter muscles, whistling to release the flow—her mother's trick—hoping the patients in the waiting room couldn't hear. After she finally managed to pee, she checked the sample, half expecting to see it perfectly natural and foam-free. Didn't that always happen? You made an appointment at the dentist's, but when you got there the tooth-ache was gone. Or you frantically carted a toddler to the pediatrician but no sooner walked through the door than the temperature that had been spiking all night dropped to normal.

After she dressed, Jack came back into the examining room, avoiding her eyes for a moment. In that second, the first tendril of fear curled in her belly. There is elevated protein in your urine, he told her, which—with the high blood-pressure reading and the edema— was cause for concern. On the plus side, there was no blood or sugar and this was certainly a good sign. She grasped at these words.
No
blood or sugar. A good sign.
He wanted more tests. Full chemical and renal panels. He made out a prescription for the lab and told her to cut back on salt, to eliminate it as much as possible, see if they could get a start on bringing her hypertension under control.

At home, while she waited for the results of the blood work, Richard researched kidney diseases on the Web. He reported that since Jack had detected no sugar in the dipstick test they could pretty much eliminate diabetes. He also thought they could reject polycystic kidney disease, which, more than ninety percent of the time, was inherited. They could rule out congenital abnormalities and trauma, as well. Finally she had to tell him to stop, he was driving her crazy.

When Jack called, he suggested Libby and Richard come in together. That was
not
a good sign, but Libby clung to her hope line.
There was no pain.
Surely nothing could be seriously wrong if there wasn't pain. On the drive, Richard put a Fauré composition for cello, a deliberately lighthearted selection, on the Volvo's CD player. Whatever it is, he said, we can handle it. We'll get through this together. He drove with his left hand, his right holding hers. She knew he was thinking
cancer.

Jack wasted no time. “Your BUN and creatinine levels are abnormal,” he said, reading from a lab report.

“What's BUN?” Richard asked, but before Jack could answer Libby said, “What does that mean?”

“You're experiencing kidney failure,” he said.

She stared at him, uncomprehending. Impossible. A mistake in the blood tests. She barely listened as he listed the diseases that could directly or indirectly cause renal failure. Lupus, diabetes, hepatitis B and C, HIV. He talked about the need for additional tests. An MRI, more blood and urine work. A kidney sonogram. Tests to obtain a more accurate picture of what was going on. He was referring her to a nephrologist—a kidney specialist, he explained—and had his secretary set up an appointment. The best in the Midwest, he said.

Richard wanted to tell the twins right away, but Libby persuaded him to wait until they had more information. Why worry them needlessly? She was still hoping there had been a mistake. Lab results mixed up. It happened.

She watched the spider weaving its web, the zigzag pattern in the center. Its name came to her now: garden spider. Innocuous name for such a large insect. Part of the macrocosm of the prairie. Which was one of the things Richard appreciated about this place. The order of it. Everything playing a part. Even things like fire, he'd told her, things that seemed like devastation, were a necessary part of the overarching plan, which was why each year, in early spring, a part of the prairie was set aflame, whole swatches of grass and plants reduced to nothing more than charred stubble. The fire prevented trees from encroaching on the grassland, he had told her. It returned nutrients to the soil.

What was the role that made sense of this devastation in her body? What if one's physical order went awry?

Dr. Carlotta Hayes was a surprise. Libby had not expected the “best nephrologist in the Midwest” to be a short, dark-haired woman with the fingers of a pianist, a woman who urged them to call her by her first name and held both of Libby's hands in hers the first time they met. Libby, not charmed, had withdrawn her hands. She wanted a male doctor, someone tall and strong and with a trace of arrogance, someone to whom foreign potentates would send their ill sons, not this woman who acted like someone's grandmother.

Richard
was
charmed, especially when Carlotta mentioned that she had heard him play two years before. A violin and cello concerto with the Chicago Symphony. She was on the CSO board of directors, she told him. Then she looked at Libby.

“There's no easy way to say this,” she said. “Your kidneys are failing.”

“Okay. That's what we
do
know.” Libby tried to soften her rudeness, only an attempt to gain control, with a vestigial smile. But she
hadn't
known that. Not really. She had been hoping that the new test results would prove otherwise. She had hoped that the changes she'd made recently were all that was needed. (She'd eliminated salt, every speck; she'd
meditated,
for God's sake.)

“We'll need more tests,” Carlotta said. “And a biopsy. We'll talk about treatment when we get the results.” She left the room and was gone for several minutes.

“What a coincidence,” Richard said as soon as she disappeared.

“What?”

“Her being on the CSO board, hearing me play.”

“Yes,” Libby said, her jaw so tight it ached. “How lovely for you.”

“I'm only saying she seems nice.”

Libby didn't want nice. She wanted professional. She wanted someone to cure her.

Carlotta returned with a folder, which she handed to Libby. “I've put everything in here,” she said. “You've got an appointment tomorrow for the biopsy and I've set up a time to see you next week. By then we'll have a clearer idea of our protocol.”

The days passed slowly. Libby slept late, moved cautiously, stopped having wine with dinner. When she returned for the next appointment, she had lost three pounds.

It wasn't lupus or HIV or hepatitis.

“You have a disease called focal sclerosing glomerulonephritis,” Carlotta told her. “FSGS for short.”

Richard asked her to repeat it, to spell it for him. He wrote it down carefully, parroted back the spelling to ensure he had it right.

“We usually find it in African American patients,” Carlotta continued, “but certainly not limited to them. Caucasians can contract it, as well.”

“How long have I had it?”

“That's impossible to say. People can have the symptoms for years and years and not know. The first symptoms you would notice were exactly what you experienced: swelling in the legs, puffiness in the face and hands, foamy urine.”

“How did I get it?” Libby thought of the traveling she and Richard had done. The trip to Guatemala to see the ruins at Tikal. Snorkeling in Belize. The Yucatán. She was meticulous about what they ate and drank on these trips, even insisting they brush their teeth with bottled water, no matter what reassurances the hotel gave. She had always been so careful of everything. She had tried to do everything right.

“There are three ways we get diseases,” Carlotta said. “Bad habits, bad genes, and bad luck. With FSGS it's purely a case of bad luck.”

All that care and it came down to luck.

“What's the long-term prognosis?” Richard asked.

“FSGS is chronic, not acute.”

Hope warmed Libby's chest. “Acute” sounded serious, the word itself sharp as a knife. “Chronic” sounded like something she could deal with. Something pesky like a sinus infection or strep throat, something cured with a double course of antibiotics, but certainly not anything life-threatening. Not cancer.

“Which means?” Richard said.

Carlotta was straightforward. “Which means we can't reverse it. There are treatments, but there is no cure.”

Hope cooled and fell away. She had it wrong. “Acute,” the sharp-edged word, was the more benign. “Chronic” was the one she had to fear. Later, she realized that was the moment everything changed. The Before-and-After moment. The plane-crash moment. The dividing line between the ordinary—the blessedly ordinary life in which all the minute and unconscious workings of the body flexed and pulsed and flowed on—and the perilous extraordinary, when nothing could be taken for granted ever again.

Richard reached for her hand, squeezed it, but she was unable to respond. She felt brittle, betrayed.

“What do we do?” he asked.

“We start with medications—drugs to get your numbers lowered.” Carlotta spoke at length about chemistry levels and numbers— creatinine, BUN, blood pressure, protein—and what they signified. Libby's hand lay lifeless in Richard's.

“Long-term?” he said.

“Long-term we are looking at more dramatic treatments. Once we reach end-stage renal disease, which is without doubt where we are heading, we'll be looking at treatments to replace lost kidney function. Almost certainly hemodialysis.”

“Dialysis?” Libby said. Just the thought made her nauseous. Hooked up to machines for hours. She couldn't do it.