Second Nature (12 page)

“What would you tell me to do if I were your sister?”

“I’m telling you what I’d tell my sister.” The two of us finished our meal in as much of a thoughtful silence as Kit and I had ever spent together. Kit made one lame joke about spending a hundred and fifty bucks on a meal that wouldn’t provide enough leftovers for lunch the next day. I just sat there, sort of drifting, as though I clung to a pendulum that swung equal distances over two substantial chasms. The pendulum was the only safe place. I could swing forever. If I didn’t choose now, with the healing ballast of youth on my side, would I ever choose? If I could have asked my mother, she would have tried to forbid me. If I could have asked my father, he would have told me to measure the risks, the way you do when you assess a fire or an accident scene. Dad considered foolish risks the worst kind of disrespect for life. He considered life without risk undeserving of respect.

How many times had I begun to dial the digits of Eliza’s cell-phone number before I did? How many times had I tried to pray, to look for signs like a tracker? How many stacks of medical literature had I read in three straight days at the UIC Medical School library? This would have to be the first decision I made entirely alone (with the consent of about three dozen doctors). So it must have seemed like an impulsive plea instead of a considered pleading I made that day to Eliza at Lotta Latte. It was, however, good practice at convincing people of things they were conditioned not to believe. That would be a skill I would need for things I never imagined sooner than even I would have believed.

I offered Eliza a latte, a tea, or a sandwich. She accepted ice water. She certainly knew what I was going to say. But she couldn’t stop her eyes from saucering up (I would learn that her compendium of eye-language symbols rivaled my own) when I told her, “Eliza, I’ve changed my mind. I do want a face transplant.”

Calmly, as though I’d suggested I might want contact lenses, Eliza said, “This is not an unexpected visit. This is a reaction to your grief. Slow down. The clinic is not going anywhere.” I could have left then, to convince everyone that I could act normal, to pretend to think over what I’d already considered and reconsidered. Instead, I presented my first argument.

“There’s no reason it shouldn’t be a reaction to the grief. I considered it when you raised the subject, but I had no need for it. Now I feel I have to make changes in my life. It would make it physically easier too. I do have challenges. I can live with them, but it’s very, very demanding.”

Eliza said, “That’s true for every candidate. And still, everything you said—about your reservations, about the risks and the immunosuppressant drugs—was true. Those things still matter. You need to give this time, maybe months, to think it over.”

“You didn’t say that last Christmas. You didn’t want me to think about it for a year. Am I put on a waiting list? How does that work? Is it patient by patient? Is there a pool of donors? Is there one for me?”

Eliza glanced around her as though she feared being overheard. “Yes,” she said. “There may be.… Uh, the guardian has to make a choice for the recipient.”

“Then I would be that recipient.”

“I can’t guarantee that, Sicily! I can’t guarantee anything! I’m not in charge of any of this.”

I was determined. I was scared—who would not have been scared?—but didn’t want the traditional wagonload of ifs and buts that always attend a major life transition, especially one that carries a significant risk.

“You’ve thought about children,” Eliza continued. “You would most likely have to adopt your children or store your eggs in advance, although there is a time element. The effects of the drugs on a pregnancy aren’t really known.…”

“That’s fine,” I said. For me, having children had never felt urgent, not as it had for Eliza, who’d become a mother at the age of twenty-two. I’d had other things on my mind at that age. “But I was adopted and so were you, even though it wasn’t when we were babies.”

“Being adopted makes you long for the genetic connection, maybe even more so if you were not a baby when you were adopted and you remember your mother.” Why the hell hadn’t Eliza become a psychiatrist? I suggested we cross the street together and that she at least give me a packet of forms to fill out and an informational sheet, just as she had wanted to do last December. Then I would take the time that seemed necessary to consider the decision. There would have to be several psychological evaluations in any case. If I was trying to hide behind a new face for pathological reasons, surely somebody would be able to tell. As we walked, I continued my reasoned arguments, in a low, not-hysterical voice. Finding out about the way that Joey betrayed me, even though he had not meant to do that, made me consider my own life more, in terms of what I could do.

I said, “I’m not sure, at my age, that I’ve done everything I want to do. Personally. Maybe even professionally.”

“You like your job.”

“I do, but I might want more.”

“Your face as it is now doesn’t bar you from other professions.”

“I was thinking of fashion modeling,” I said. “No, I’m serious. I would have a wider circle of friends. That’s a support system, not only more dates. I would have a layer removed between me and the world.” I realized what I’d just said. “You know what I mean.”

Eliza nodded.

“The impulse is a strong one.”

Eventually we got to the clinic, where I met Polly Guthrie, who was the coordinating psychologist on the face-transplant team. I wondered why there was a team and was surprised to learn that, at UIC, under Dr. Hollis Grigsby, there was the transplantation of a full or partial face nearly every week; hands and legs and feet from cadaver donors were transplanted more often that that. “It’s not common,” Polly Guthrie said. “It’s not rare either, the way it was ten years ago.” Having made an appointment with Polly for my first interview—and after basically swearing on a stack that I
really understood
there were no promises—I asked for the photographic record of the surgery so that I could study it in depth.

“There are individual before-and-after photos of two or three people,” Eliza said. “We can show them to you, but you can’t take them out of the clinic.”

“I mean of the whole process.”

“There are line drawings that show a sort of general set of images of the process, like what you do in your work,” Eliza said. “Like that series in your binder.”

“Yes, but I don’t mean drawings that take out all the gore, which is what I do. I want to see the whole thing, with the mess, the musculature in color. I’m talking about the photos of the surgery.”

“The surgeons take those only for their own use during the procedure,” Eliza said. “They photograph every step so that they’re absolutely certain to place and reattach—”

“There’s no photographic record?”

“Patient privacy issues,” Eliza said. “The face is a very intimate part of the body. Perhaps the most intimate.”

“So is the vagina. But you have pictures of babies being delivered.”

“It’s not possible, Sicily.”

But that made no sense. It was possible.

“What if a candidate waived the privacy provision to make a photographic record, as … well, as for science and art? So people understood more about the procedure? Isn’t there still a sort of
Phantom of the Opera
thing about this?”

“There is,” Eliza said. “But people are sensitive to issues about their faces. It’s only recently that there have been documentary films of cosmetic procedures, Sicily.”

“It shouldn’t be a mystery,” I said. “It shouldn’t be a joke.” Eliza nodded patiently when I told her that, during my own preliminary research, I found gimmicky photos of how it would look, for example, if the lower half of a movie star’s face was swapped with that of a gorilla. “It’s not funny. It’s not science fiction. Right? I’m just surprised that no one has asked to have this process preserved.” Eliza was watching me attentively, which made me hope I was being convincing despite the fact that I was utterly winging it. This thought had not entered my head until I stepped through the bright celery-colored double doors of the clinic. And yet it wasn’t too big a reach. This was not a necessary surgery. I could survive without it. It was not a notion born of narcissism either. If I could invest it with more meaning—more service—I could further my quest for I-wasn’t-sure-what. So I said, “If I have this procedure, I would like to have my surgery documented for a public forum.”

“That’s not possible,” Eliza told me promptly. We sat there for another half hour while they tried to explain why I could not violate my own privacy. I raised the subject of the significance and poignancy of the exhibit called
Bodies
that had toured the United States some years before. The bodies were real human bodies. They were Chinese people, preserved—in states of strength and weakness, movement and stillness, sickness and health—with a polymer process. Even children who saw it were not, after the initial surprise, horrified. People were instead rapturous, intrigued, deeply moved to care for their own remarkable bodies in a way that no drawing could have inspired.

“Yes, and some were outraged,” Eliza countered. There was considerable controversy about the provenance of those preserved people—questions raised about how they had died. Some of them were young men and women who had been in Chinese prisons or national hospitals. They very likely hadn’t given their permission to have their cadavers flayed and displayed to illustrate muscle groups or lung function.

“But I am giving my permission,” I said. “It’s because I am a medical illustrator that I know that what some people would initially consider frightening can be not only educational but also really beautiful.”

“You don’t even know if you’re going to have the surgery, Sicily. One decision at a time.”

I was twenty-five years old, though, and newly un-wed, hungry for substance that seemed to have left my soul a hollow seed. Eliza might as well have told all this to a dog—a dog would have paid more attention. I’d already found out that proceeding on faith could rise up and strike you down. And yet it isn’t possible, I understand now, to entirely grasp the scope of the arena you’re walking into. Most blessings, it turns out, are mixed.

As we parted, Eliza agreed to speak with the team leader, Dr. Grigsby. Then I asked her whether, if both the surgery and the documentation turned out to be possible, she knew a photographer. This was a trick question. I could read the ambivalence on her face when she said she couldn’t think of one offhand who had the training and the equipment and sensitivity.

“What about your mother-in-law?” I asked, using my eyes to hold hers.

“Right,” said Eliza. “Well … yes, Beth is between jobs right now, but I don’t see her doing this.”

“I could call her.”

“I can’t stop you from contacting her. I’m sure she’d be intrigued by it. But she’s in a weird kind of … mood right now.”

Going home on the train at sunset, I wondered if I actually would go through with it, with any of it. I wondered why I had been so insistent. The answer was embodied in the question. My stubbornness was the worst thing and the best thing in my character. But it rankled that, had I been hoping for a kidney transplant, the same ethical issues would not have applied. By the time I got to my stop, I had construed the idea of making my face history a matter of honor, my own and that of the donor. I was young. I didn’t know what I didn’t know. And I still trust that impulse. I didn’t want attention from the larger world for myself. I wanted attention from the larger world for this process—how it would change both the outside of a person and the smaller world of that person, the world within. I intended to break what I saw then as a cycle of self-centeredness. I’m older now, and I look at the price tag before I even try the coat on. Then I decide what is prudent—which is not necessarily better, but always is safer.

CHAPTER SIX

B
eth Cappadora might never have met Sicily Coyne were it not for Beth’s deeply superstitious belief that her family had been singled out by the cosmos for events that were statistically impossible. The Cappadoras had not been singled out uniquely. But they were a slender slice of a slender slice. If Beth took an angel’s-eye view of the households whose predisposition (and she knew it was predisposition) for the unimaginable was comparable to the Cappadoras’, if they were clustered before her on a tabletop like Monopoly houses, it would be a bonsai-ed universe that would fill only the palm of one of Beth’s hands.

Everything that had happened to these families also was statistically impossible. And yet it had all happened.

More than thirty years ago, Beth’s son Ben was kidnapped from a hotel lobby, standing not ten feet from his mother (statistically impossible). Nine years after that, Ben had statistically impossibly turned up, healthy and well adjusted (Beth wasn’t certain that Ben was not actually
more
well adjusted than the rest of them), living less than a mile from his parents. He grew up to marry Beth’s godchild, Elizabeth (called Eliza), the daughter of Beth’s best friend, who also was the police detective who searched for Ben for all those years. When Ben and Eliza’s daughter, now a robust first-grader, was just a baby, she had been similarly threatened, also in a hotel and also reclaimed unharmed.

Top that.

Beth could.

She kept a file, and though it was no thicker than one of Beth’s slender fingers, it was brimming with similar statistically impossible cases that had happened since: In Utah, Leslie Dorr was forced to live for two years as one of five wives of her abductor, on a farm just outside the town where her parents owned the florist’s shop. The truck driver was sick when Leslie’s own father delivered a birthday bouquet to the farm. Leslie was outside, taking towels down from the clothesline. And there was the case of Brian Ambeling, stolen after Pee-Wee League baseball practice by his coach, who turned out to be Brian’s biological father—something not even Brian’s mother knew for sure. Three years later, the mother was waiting in line with her two younger daughters at Disney World when she spotted her son.