An Open Heart (14 page)

Jace fed more money into the machine and pushed the buttons again. “Here,” he said, “take one back to your dorm room for tomorrow.”

“Big spender,” she said.

They walked slowly across the lawn in front of the administration building, a red-brick monstrosity with three-story white columns in front. Jace touched her shoulder. “Do you ever feel like you don’t fit in your own country?”

Heather’s response was fast. “All the time!” She studied him for a moment, wishing she hadn’t responded so fast.
I’ll scare him away,
she thought.

Jace smiled, easing her fear. “I carry an American passport. But I’ve lived most of my life in Africa. When the guys talk about cars and football, I feel like I’ve landed on another planet.”

“Exactly.”

“I remember,” he said, “when we first got back, my father said he was going to take me to McDonalds so that we could experience American culture.” He laughed. “But I was so embarrassed. He tried to order chips and the lady behind the counter didn’t understand he meant fries.”

Heather nodded. “I did the same thing.”

They walked quietly. The grass was wet and she saw that they both wore flip-flops. Not the expensive leather variety, but the kind you can buy at the Dollar Store. “What do you miss?”

“Rugby.” They sat on the concrete steps. “You?”

“I used to help the young women in my village by applying a traditional white paste mask. Once they taught me how to do it, they thought it was fun to have me do it for them. It was made by mixing crushed bark from a bush with water. They thought it would lighten their skin.”

“And make them look like the beautiful American?”

Heather felt herself blush. She let his comment pass. “Okay. There has to be something else besides rugby.”

Jace looked away, and she watched as his lower lip began to quiver. He quickly pressed his fist to his mouth. “I miss my sister,” he said.

“Tell me.”

“My twin,” he said. “Died.” He hesitated. “And it was all my fault.”

Back in Kijabe, Jace found his intern in the HDU sitting behind the nursing station desk, a chart open in front of him. He was dressed in a pressed white lab coat and wearing a tie that barely came halfway down his lengthy torso. He looked up with surprise. “Dr. Rawlings. I’ve been paging you all day.”

“Sorry, Paul. I’ve been in Nairobi.” He lowered his voice. “It seems one of your politicians is playing games with me. I may need your perspective to help me understand.”

The intern nodded.

“First tell me about our patients.”

They walked to Beatrice’s bedside. She was off the ventilator and breathing oxygen from a facemask.

“Habari?” Paul asked. How are you?

“Nzuri.” Fine.

Jace understood the interchange, and understood also that the answer to
Habari?
was always
Nzuri
, even if the patient was taking her last breath. He needed specifics. “How is your breathing?” he asked.

“Better.” With her accent, it came out sounding “Bettah.”

“Do you have an appetite?”

“They won’t feed me.”

Paul explained. “I wasn’t sure what you would want.”

“If she’s hungry, feed her. We need to maintain her nutrition so that she can withstand an operation.”

The patient’s eyes widened. “An operation?”

“Perhaps,” Jace said. “We still need to do a lot of preparation.”

“You are the doctah,” Beatrice said.

Jace smiled at her accent and her attitude. Letting the doctor be in control was an attitude Americans had abandoned in the last decade in search of patient autonomy.

“Would you like me to talk to your parents?”

“My mother,” she said, looking down. “But she is poor, unable to come here.”

“How about your father?”

“I don’t have a father.”

Jace frowned. “Everyone has a father.”

“Of course,” she responded, folding her arms in a protective posture across her chest.

Subconscious body language? She is protecting herself from my knife.

Beatrice continued. “I’ve had biology in school, Dr. Rawlings. I know I have a father.”

“Do you know him?”

“My mother has had many customers. It could be anyone.”

Wow,
Jace thought. Beatrice had pulled herself into a protective cocoon. She spoke of her unknown parentage as if she were reporting the evening news.

He looked at the line of her jaw, her lanky frame, the long legs and fingers. He could see the imprint of the man claiming to be her father.
Her father is rich, easily able to pay for her operation, and she doesn’t know.

Jace rested his hand on her shoulder. “You have to have some idea.”

“Ideas disappoint. I’m doing all right on my own. I’m going to school. I want to be a nurse.”

Jace smiled in admiration. This one was strong. A tree tested over and over by life’s wind. Instead of dying, she’d sunk her roots deeper in response to suffering. “You’re going to make it.”

“You will help me.”

He swallowed.
I hope so.

He nodded, trying to convince himself. He walked away with his intern, hoping he could live up to his patient’s expectations.

The duo finished rounds. Jace was particularly pleased that Michael Kagai, his bowel-perforation patient, seemed to be recovering. There was no fever, and he had even taken sips of chai without problems. And for the first time, Kagai didn’t wrap his arms around his chest at the sight of his surgeon.

Jace opened his chart and looked at a lab result. HIV positive. Dave Fitzgerald had been correct. Predictably. Jace pointed the result out to the intern and asked, “Have you discussed this with the patient?”

“Not yet. I’ll do it in the morning. I need time to discuss starting him on antiretroviral therapy. I can’t just drop this bomb on him and move on.”

“He’s married?”

Paul nodded. “Two wives.”

“They will need to be counseled as well.”

“Of course.” Paul shook his head. “I’m sure he didn’t get it from them.”

Jace looked up in response to the sound of boots. One of the guards from the front entrance approached. “Dr. Rawlings, there is a truck out front. They say they have a delivery for you.”

Jace smiled. “Yes,” he said. “Come on, Paul, we’ve got a heart program to start.”

The parking lot of Ukrop’s grocery was the last place Heather expected someone to show off their surgical scar, but she was a surgeon’s wife, after all, and that put her at risk for listening to and looking at all manner of scars of Richmond’s finest patients. She was struggling to get the overloaded shopping cart to travel straight ahead in spite of the weight and a sticky wheel, when a bleached blonde in a low-cut dress came to her aid.

The woman, who appeared to be about Heather’s age, grabbed the front of Heather’s cart without asking. “Let me help,” she said. “Where to?”

“Just over there,” she said, pointing to a silver Chrysler minivan. She shrugged sheepishly. “Thanks. This is just too heavy today.”

Together they wrestled the uncooperative cart to the back of the van. The woman turned. “OMG!” she exclaimed, actually voicing the initials of a popular texting phrase. “You’re Dr. Rawlings’s wife. I recognize you from your photos on his desk.”

“Yes, well, I—”

She lifted a pair of gaudy sunglasses from her face to reveal lashes thick with mascara above brilliant blue eyes. “Honey, you’re way more gorgeous than your picture.”

Heather was about to respond, but the woman barged ahead.

“Your husband saved my life!” At that, she grabbed the front of her dress and pulled it even lower, revealing a red lace brassiere.

Heather glanced around the parking lot before settling her gaze on the woman’s ample cleavage. Blushing, she noted a fine scar that began at the notch above her breastbone and plunged further south than Heather was comfortable inspecting.

“Go on,” the woman coaxed, “look closer. You can barely see it anymore.”

Heather cleared her throat and straightened, cautious to position herself on the opposite side of the cart lest her newest acquaintance pull her face forward for an up-close and personal view. “Wow,” she muttered. “I wouldn’t have noticed.”

“I had a heart transplant,” the woman beamed, opening her arms and allowing her hands to flop outward as if to say “ta-da!”

Before Heather could respond, the woman continued. “My two-year anniversary with my new heart is next week,” she bubbled. Then, placing her hand on her hip, she added, “Since my transplant, my fashion sense is entirely new. Before I got this heart, I would have been wearing a blue business suit.”

She paused just long enough for Heather to muse that a conservative suit might have been more appropriate.

“I’ve always had the goods to wear something like this,” she said, cupping her breasts quickly before smoothing the front of her dress over her hips. “But I wouldn’t dare.” She winked. “Now that my new heart has given me a new lease, I don’t care what anyone thinks.” She leaned across a bag of dog food. “What’s Dr. Rawlings like at home? It must be so exciting married to a heart surgeon. And I’ll bet he keeps you in the finest clothes.”

Heather clutched at the collar of her plain white blouse and cleared her throat. She opened the back of the van. Maybe if she started loading the groceries, her husband’s patient wouldn’t dump any more of her story.

The woman grabbed a bag of dog food.

“You don’t need to do that.”

“The point is that now I can. But you should have seen me before your husband’s knife. I couldn’t walk across the room.”

Heather quickly emptied the cart and slammed the door a little harder than she’d meant. “Thanks again. Excuse me,” she said, wheeling the cart away to a cart collection area a few spaces away.

She tried to not make eye contact with the woman, hoping to avoid hearing more of her story. But when Heather returned, the amazing-scar transplant woman stood behind her van, smiling. As she opened her mouth to speak again, Heather raised her voice and said in one breath, “I’m so sorry, but I’m late for an appointment, thanks again for your help.” She practically jumped into the minivan and started the engine, checking the rearview mirror for her assailant. Thankfully, she had moved on.

As she drove slowly across the lot and then out into traffic, Heather found herself on the verge of tears.

Is this my only identity now? The wife of the famous heart surgeon?

She sniffed.

What did I expect? Who else am I? The dog-walker?

Who am I without Jace?

She’d fought being swallowed into Jace’s identity, but in Richmond, wherever she was recognized, it was the same. She was the surgeon’s wife.

And with Jace gone, where did that leave her?

That evening, Jace spent two hours examining the equipment. But he didn’t understand. In addition to his cardiopulmonary bypass pump and a few monitors, there was a new endoscopic ultrasound device, arterial line monitors, two new pulse oximeters, an entire box of unopened Swan-Ganz pulmonary artery catheters, a portable suction machine, and a cardiac defibrillator with small paddles for intraoperative use directly on the heart muscle. He looked at Paul. “I packed this, this, and this,” he said, touching the boxes. “The rest of this, including this endoscope and ultrasound equipment, has been added by mistake.”