Second Nature (17 page)

“And right now I wish I had,” Brodsky said. “You call it, Dr. Grigsby.”

Dr. Grigsby nodded.

CHAPTER EIGHT

T
hey tuck you up in tons of warmed blankets when you’re waiting in an operating room, because those places are kept at the temperature of meat lockers.

I guess they are meat lockers.

If you should ever be alive on a really narrow metal bed, looking up at someone, and you want to know why your nose is cold, that person will tell you it’s to prevent infection. Which is not true. Even some OR nurses and doctors would be surprised to hear that, because they believe it. The fact is, a person who’s hypothermic for a long time gets a weakened immune system, and more people die from hospital infections than from cancer and heart attacks. I’m not showing off. But lots of people die from medical errors too, which is really why operating rooms are cold. It’s to keep the doctors and nurses from getting too hot. They have gloves and gowns and hats on over their scrubs, and the lights are merciless, as is the gradual buildup of heat from everyone else who isn’t the patient. So you balance the odds of getting an infection with the odds of a doctor having a little slipup and dropping a hemostat into your intestines—or, in my case, my sinuses.

This particular surgery was going to last a long time, like maybe up to twenty hours, and there would be at least twelve people in the room at any given time. Dr. Grigsby—whom I had begun to call “Hollis,” because she called me “Sicily”—said that there was every likelihood that doctors and nurses would be replaced by other doctors and nurses so that they didn’t become exhausted: There might be four full teams. I didn’t know she had four full teams or even that the U of I did.

“You don’t mean the second string, right?” I asked her.

“No,” Hollis said. “Everyone is the first string.”

That’s not true either, but it was probably the case that there wouldn’t be many first-year interns working on my face. I knew Eliza would be, and that was a source of strength. I had told Eliza I was willing to have a discreet wrinkle or two for the consolation of her and Beth’s presence—because Aunt Marie could not be with me. In fact, by the time my surgery was scheduled, in June, I had spent so many evenings and some days with Eliza that Kit Mulroy was saying things to me like, “Is she your new best friend? Do I have anything to worry about here?”

The blankets are a comfort. Those blankets and kind words, no matter how nonsensical, are the only comfort the nurses and doctors can offer a person who’s terrified.

And guess what?

I was terrified.

Every other time I’d had surgery, I knew that I would wake up and the doctor would say,
Hey, we really restored some symmetry here but, in fact, not much is going to change
. This time, when I woke up, everything was going to change. I would either look like a cross between myself and Emma or like a raw hamburger. And my whole future would be different.

There was a boy I had met once, in the hospital, a child, who’d had corneal transplants. The first time he opened his eyes, he could
feel
seeing. It was almost physically painful. There was too much to take in, and it was all so clear and brightly colored.

I thought that might be my own experience.

But I was pretty sure that, however I felt, it was going to splatter me all over the place emotionally.

That would be normal. Some of it, Polly and Kelli Buoté had tried to prepare me for—Polly with individual sessions both before and after I was in the hospital, Kelli with a novel’s worth of printouts about community resources. There’s no Face Transplants Anonymous, but there are body-image groups and post-surgical groups and post-trauma groups that people attend for months or years. Sometimes, friends from these groups are the only ones post-trauma patients have. Sometimes, that’s where they meet the special person they marry. The thing was, I’d been to most of them as a kid. As an adult, I’d been the speaker at some of them.

The best thing Kelli had promised to do was put me in phone contact with a guy in Virginia, a fifty-five-year-old grandfather who’d also had a face transplant.

“One guy?” I asked. “Isn’t there someone closer? Like in Indiana? Someone I can actually meet face-to-face, so to speak?”

“There are a number of people closer. But he was the one who agreed to talk to you,” Kelli said. “And only on the telephone.”

“What’s wrong with the others?”

“Sicily, most people are very private about this kind of stuff. You’re obviously the exception.” Kelli still wasn’t entirely okay with the fact that Beth had been taking pictures since I’d come to the hospital and was even now receiving her gown and instructions about where she could and could not move or sit during the actual procedure.

“Why are they so … guarded?” I was genuinely puzzled.

“They gradually reintroduce themselves to the community.”

“You mean, they try to pretend they just had lipo?”

“No, Sicily. Some face transplant recipients have lived their lives in a very protected way, some with only their immediate family seeing them. It’s a process, going out into the world, and it’s as much about their reactions as other people’s reactions to them.”

I knew that I would have some bruising and swelling. The team had impressed this upon me, oh, about seven hundred times. I was not to expect that when the bandages were removed after five days I would look in the mirror and see a movie star. Some residual scarring, probably below my neckline, could be permanent, although not cosmetically severe. Someone even gave me a kit of all this therapeutic makeup and demonstrated how to use it to cover the temporary bruises and the permanent scars. I’d already tried stuff like that, which is sort of like corpse makeup and is used to cover birthmarks as well as scars. But it’s so gross and heavy, for me anyhow, that I gave it up. For work or going out, I had recently begun to use stage makeup. It worked almost as well and it seemed like it was harder to sweat it off.

It wasn’t like I was fooling anyone, after all. My makeup was just meant to take the edge off.

That morning at about 5:00 a.m., a nurse had given me some woozy juice, probably IV Versed, to take the edge off while I was still in my room. When you’ve had as many surgeries as I have, you have approximately the same drug tolerance as a Clydesdale, no matter what you weigh. I could have recited the periodic table, if they hadn’t added all those new, crazy mixed-up elements. I tried reciting the names of the bones of the foot, but I got only to the calcaneus before I fell back to my sad pondering about what Mrs. Cassidy was doing right now. Somewhere on the same floor as I was, she was saying goodbye forever to Emma—or already had.

Because doing the right thing was “the whole tortilla” for Emma, it was better for her to be in the hospital rather than at a facility like Sundial. Once they “harvested” her—my—face, the surgeons would step back and let other transplant physicians take her heart, her healthy lungs, and her beautiful hazy brown eyes. Weather and other delays can really be hell on organs, so it’s better that they come from the neighborhood, and I know how that sounds. Mrs. Cassidy would not be there for the horrible bits, but I thought of her agony as something like Mother Mary’s. Yes, Emma was gone, but it was also true that Mrs. Cassidy (whom I never called “Julia”) had sacrificed Emma, the only thing she loved, so that others might live. And so that I could have the full woman’s life Emma never would. And then I realized that this is why you didn’t get to know your donor or her family. I cried until I threw up (nothing) in the green plastic basin. The emotions were absolutely torrential. I’d outfoxed myself.

Of course, the way I found out about Emma was by calling Mrs. Viola, the mother of my old school friend Victoria, who had died in the fire. Despite all those months after the fire when she’d become my ghastly, needy stalker, Mrs. Viola had finally remade her life. She found meaning in caring for people who were going to “cross over” soon, to where Victoria was. She’d done this not in an insane way, or so my grandma Caruso, who knew Gail Viola pretty well, told me. I’d called Mrs. Viola one day last winter, after the preliminary testing, because the very few hints of the way Kelli described the place where the young woman was gave me a hunch. Not many places like that were as nice as Sundial and also took welfare, which is what Emma was on. Sundial was not a real hospice, run by the national organization, where some terminally ill people received their last care. It was something between that and a nursing home. In order for Emma to go there when she left the hospital, after there was no more that anyone could do, after it was clear that Emma could never get better, Mrs. Cassidy had reduced her hours, given up her little house, and gone on assistance.

When I called Mrs. Viola, we made some small talk about my grandparents and my aunt. Then I asked her, “Is there a girl at Sundial who’s going to be a donor for a face transplant?”

Mrs. Viola didn’t even hesitate—no worries about patient privacy there! She said, “Yes, Sicily. There’s this beautiful little Irish girl and her sweet mother.” And then Mrs. Viola stopped and said, “Sicily? Get out of here! Are you kidding me?”

I didn’t have to confirm or deny. I am sure that by the end of her shift, everyone on the West Side who had a phone or could lip-read knew. So I had to hurry up and connect with Beth, which I did. Two weeks later, on a Friday afternoon—Mrs. Viola’s day off, but she managed to switch with someone else to be there—we went to see Emma and Mrs. Cassidy at Sundial.

When we walked in, Emma’s room looked like the kind of gift shop where grandmothers buy presents. There were things you would never use in real life: elaborate acrylic flower arrangements that looked real, and wooden birdhouses that were actually jewelry boxes with drawers that you knew would never close. Everything was pink or quilted or both. Mrs. Cassidy showed me one of the quilts, made by a close friend of hers, a longtime customer, and each square was a photo of Emma at a different age. All around the walls were framed drawings, some of them very accomplished, from Emma’s sketchbook. There was a chair for Beth and one for me, and we sat there as though we were at a wake, just, I suppose, out of respect.

Mrs. Cassidy offered us coffee, which I refused politely and Beth said would be wonderful. Mrs. Viola was there with a mug of coffee in a flash, so we knew she’d been standing outside the door. I didn’t mind, because by then Mrs. Viola seemed to have some sort of trunk line to the universe. She acted as though she believed she was living what might have become of Victoria, if she had survived, through me. And wasn’t that the least Mrs. Viola deserved? She’d given her whole life to people, most of whom would never get better.

“How often do you come to see Emma?” I asked, because it was obvious that Beth wasn’t going to say anything. It looked to me as though Beth was taking her camera entirely apart and putting it back together again.

“Every day after work, and all day Friday and Sunday,” Mrs. Cassidy said. “I’m friends with some of the people who work here, like Gail. Sometimes we play cards or do a crossword. I’m pretty good at crosswords. English was my best subject in school, that and science.”

At first, Mrs. Cassidy said, all of Emma’s friends who had been with her that night at the party came, two or three times a week. (“It wasn’t drugs,” said Mrs. Cassidy. “She had one beer. No one knows what caused it, and Emma’s heart is apparently still very healthy, although she can breathe only with the respirator.”) Emma’s hospital room was sort of a gathering place. Back then—nearly eighteen months ago—all the friends expected her to wake up, and they competed to be the one who would get her to react. They sang to her and talked about boys Emma had a crush on and called Emma’s cell phone. But then Emma’s
best
friend came. She fainted right there in the room, because Emma looked exactly like Emma. Her hair was in this little bob, and the roots hadn’t started to grow out. After the faint, which gave the best friend a lump on her head, the hospital wouldn’t let minors come to see Emma without their parents.

“Do her friends still come? Here? Do they know that Emma isn’t going to be kept alive?” I asked Mrs. Cassidy. Beth looked at me like she wanted to crush my esophagus.

“No,” Mrs. Cassidy said. “They want to remember her as she was, and they definitely don’t want to think about her being a transplant donor. Which is something I understand. It’s a highly emotional situation and not an issue that every person understands so well.”

For a year, Mrs. Cassidy still acted as though Emma were alive and could see and feel and hear everything around her, which Mrs. Cassidy believed. She’d read all the articles about people who seemed to be in persistent vegetative states but who suddenly woke up and asked for cornflakes; slowly, though, the reality set in. With the kind of equipment that existed, that just didn’t happen anymore. But there was a million-in-one chance it could.

Mrs. Cassidy said, “The person who came most often is Eric, who’s my business partner. I would ask him, ‘Do you think she sees me?’ And at first Eric would say, ‘Maybe, I think so, Julia.’ ”

But in her hours alone, at night, Mrs. Cassidy had to admit that even if Emma had some level of awareness, like that of an exceptionally mentally challenged person, her daughter could not bear to live on, to signal her needs with a blink, for all the years left on earth to her, maybe after Mrs. Cassidy died.

Because we were coming, Mrs. Cassidy had washed and trimmed and styled Emma’s hair. As she always did, she tried to uncurl the crablike clench of Emma’s little fingers. They could be pried into a semblance of the attitude of a normal hand. But as soon as her mother let them go, they stubbornly curled again. Emma’s brain wanted her fingers—and her small pale feet as well—to point in and down. Cortical contractions would be agony if the person felt them. Mrs. Cassidy had to believe Emma couldn’t. But what if she did? For months now, Mrs. Cassidy’s only relative, Ryan, a brother who lived in Florida, had said, “Julia, let her go.” But her brother had no child, just a stepson he referred to as “The Couch,” because the guy was twenty-three and had never had a job. When The Couch was a child, Mrs. Cassidy’s brother didn’t even know him.