Heart of the Matter (10 page)

“Over the past year or so,” Valerie says. “Jason plays the piano and guitar and has taught him a lot about music.”

Dr. Russo nods, as if digesting this information, and then asks whether Charlie plays any instruments.

“He takes piano lessons,” she says, following the familiar route past the grill and fountain drinks to the coffee station.

Valerie can tell he’s thinking about Charlie’s hand as she continues, “He’s pretty good. He can hear a song and just. . . figure out the notes, by ear.” She tentatively continues, wondering if she is bragging too much. “Runs in the family. Jason apparently has perfect pitch. He once identified our doorbell as an A above middle C.”

“Wow,” Dr. Russo says, looking legitimately impressed. “That’s rare, isn’t it?”

Valerie nods as she takes a cup from the upside-down stack and scans the coffee options. “I guess it’s one in ten thousand or somerhing.”

Dr. Russo whistles and then says, “Can Charlie do that?”

“No—no,” Valerie says. “He’s just a bit precocious. That’s all.”

Dr. Russo nods as he pumps a paper cup full of the regular blend. Meanwhile, Valerie chooses the hazelnut and stirs in a packet of raw sugar.

“You hungry?” he asks, as they pass a row of pastries and other snacks.

She shakes her head, having long since forgotten the feeling of hunger. In two weeks, she has lost at least five pounds, going from thin to very thin, her hip bones two sharp angles.

They make their way to the cash register, but when Valerie pulls out her wallet, Dr. Russo says, “I got this one.”

She does not protest, not wanting to make a big deal of an eighty-cent cup of coffee. Instead she nonchalantly thanks him as he takes his change and leads her to a small booth in the back corner of the cafeteria, a place where she has sat many times before, but always alone.

“So,” he says, sliding into his seat and taking a sip of his coffee. “How are you holding up?”

She positions herself directly across from him as she tells him she’s fine, for the moment believing it.

“I know it’s not easy,” he says. “But I have to tell you . . . I really think Charlie is doing so well. And in large part, I think it’s because of you.”

She feels herself blush as she thanks him and says, “The hospital has been wonderful.
Everyone
here is wonderful.”

It is the closest she has come to thanking him, something she can’t quite bring herself to do directly, for fear that she will break down. He nods, now his turn to look modest. “You’re welcome,” he says emphatically, in a much different tone than the one he used to return Rosemary’s words of thanks.

Valerie smiles at her son’s doctor; he smiles back at her. Then they sip their coffee in unison, all the while maintaining eye contact. Valerie decides that, by any measure, they have just shared a moment, and the joint acknowledgment of this moment renders them both silent for an even longer stretch.

Valerie’s mind races, as she wonders what to say next. She resists peppering him with medical queries, as she feels she asks too many questions already. And yet, she doesn’t feel quite comfortable broaching outside-world topics, as everything seems either too trivial or too personal.

“Well,” he finally says, breaking their silence. “I wanted to talk to you about Monday. Charlie’s graft.”

“Okay,” she says, straightening her posture and wishing she had her spiral notebook and pen with her, so she could take notes, release nervous energy.

“I wanted to make sure you understand the procedure—and answer any questions you may have,” he says.

“I appreciate that,” Valerie says as she conjures the specifics from prior conversations with him, as well as bits and pieces from Charlie’s nurses, and all that she has read on the Internet.

He clears his throat and says, “Okay. First thing Monday morning, an anesthesiologist will come in and put Charlie to sleep.”

She feels herself tense as he continues. “Then I’ll shave his hair and remove the burned skin from his face.”

She swallows and nods.

“Then I’ll take a special surgical instrument called a power dermatome and shave a layer of skin off his scalp to produce a split-thickness graft.”

“Split thickness?” she asks, worried.

He nods reassuringly. “A split-thickness graft contains the epidermis and a portion of the dermis.”

“And that will grow back? On his scalp?”

“Yes. The remaining skin still contains hair follicles and sebaceous glands which gradually proliferate out to form a new layer of epidermis. We’ll dress the area with a moist antibiotic-covered gauze to guard against infection . . .”

“Okay,” Valerie says, swallowing, nodding. “And then? How do you put the skin on?”

“So. We’ll take the skin and just drape it right over his cheek, and use a scalpel to punch little holes to allow blood and fluid to drain. We then secure the graft with fine sutures and a little biological glue and cover it with a moist, nonadherent dressing.”

“Does it always . . . take?” she says.

“Typically, yes. It should attach and revascularize . . . and his scalp will be a fine match for his cheek.”

She nods, feeling queasy but reassured, as he goes on to explain that after the surgery Charlie will wear a custom-fitted face mask in order to control facial scarring. “Basically, we want to keep the scars on the face flat, smooth, and pliable.”

“A mask?” she says, trying to picture it, worrying, once again, about the social stigma her son will have to endure.

“Yes,” he says. “An occupational therapist will be coming by later this afternoon to take a scan of Charlie’s face. This data will be transmitted to a company that makes custom-fitted, transparent silicone masks. The mask will cover Charlie’s entire face—except for holes for the eyes, nose, and mouth—and attach with straps.”

“But it will be clear? See-through?”

“Yes,” he says. “Clear so that we can observe blanching of the scar and see where pressure is being applied . . . Over time, the therapist will adjust the fit of the mask by making changes to the mold and reheating the plastic.” He studies her face, as if searching for something. “Sound good?”

She nods, feeling slightly reassured.

“Any other questions?”

“No. Not right now,” she says quietly.

Dr. Russo nods and says, “Well. Just call me if they come up. Anytime. You have my cell.”

“Thank you, Dr. Russo,” she says.

“Nick,” he says. It is at least the fourth time he’s corrected her.

“Nick,” she repeats as their eyes lock again. Another stretch of silence ensues, much like the last one, but this time, Valerie feels more comfortable, nearly enjoying the quiet camaraderie.

Nick seems to feel the same, because he smiles and easily switches to a new topic. “So Charlie mentioned you’re a lawyer?” he says.

Valerie nods, wondering when, and in what context, Charlie discussed her profession.

“What kind of lawyer?” he asks.

“I practice corporate litigation,” she says, thinking of how far away and unimportant her firm and all its politics feel to her. Other than a few phone calls with the head of her department, in which he assured her that her cases and clients were covered and she should not worry about a thing, she had not given work a single thought since Charlie’s accident and couldn’t fathom why she ever let it stress her out.

“Did you go to law school around here?” he asks.

She nods and says, “Yeah. I went to Harvard,” instead of the usual way she avoids that word, not out of a sense of feigned modesty the way so many of her classmates say, “I went to school in Cambridge,” but because she still doesn’t feel quite worthy of the name.

But with Nick, it is different, perhaps because she knows he went there, too—that he is as accomplished as they come. Sure enough, he nods, unfazed, and says, “Did you always know you wanted to practice law?”

She considers this—considers the truth—that she had no real passion for the law, but simply wanted to achieve for the sake of achievement. Especially after Charlie was born, when she desperately wanted to earn a good living and be able to provide for her son. Do something that Charlie could be proud of so that she might somehow compensate for his not having a father.

But, of course, she does not divulge any of this, and instead says, “No, not really. I was a paralegal for a couple of years, and realized that I was as smart as the lawyers at my firm . . .” Then she smiles and goes out on a limb with a joke, her first in ages. “Probably what the nurses around here are saying about you.”

“Probably so,” Dr. Russo says, smiling modestly back at her. “Oh, come on,” she says. “You don’t believe that. You even
told
me how good you are.”

“I did?” he says, surprised. “When?”

“When we first met,” she says, her smile fading as she remembers that night.

He stares at the air above his head, as if he, too, is reliving the night of Charlie’s accident. “Yeah, I guess I did, didn’t I?”

Valerie nods, then says, “And so far ... I’d have to agree.”

She gives him a look as he leans across the table and says, “Just you wait. Give me a few months and a couple more surgeries. . .”

To this, Valerie says nothing, but she can feel her heart racing with gratitude and something else she can’t quite name, as she silently grants him all the time in the world.

9

Tessa

It
is Friday night, and I am sitting in the family room with my mother, brother, and sister-of-law, all in from Manhattan for a weekend visit. We are dressed for our eight o’clock dinner reservations, enjoying a bottle of wine in the family room while the four cousins, freshly bathed and fed, play upstairs under the supervision of a babysitter. The only thing missing from the picture is Nick, who is now twenty minutes late and counting, a fact that is not lost on my mother.

“Does Nick always work this late on the weekends?” she asks, crossing her legs as she glances purposefully at the Timex watch she now wears in lieu of the Cartier my father gave her for their last anniversary.

“Not usually,” I say, feeling defensive. I know her question likely has more to do with her frenetic personality, and her inability to sit still for any length of time, but I can’t help taking it as a covert affront, a question along the lines of,
Are you still beating your wife?
Or, in this
case, Are you still letting your husband beat you?

“He just needed to check on a patient—a little boy,” I say, feeling the need to remind her of just how noble Nick’s profession is. “He’s having his first skin graft on Monday morning.”

“Damn,” my brother says, cringing and shaking his head. “I don’t know how he does it.”

“I know,” my sister-in-law agrees with an admiring look.

My mother is not as impressed. She makes a skeptical face, then folds her cocktail napkin in quarters. “What time is our reservation?” she asks. “Maybe we should just meet him at the restaurant?”

“Not until eight. We still have thirty minutes. And the restaurant’s very nearby,” I say tersely. “We’re fine, Mom. Just relax.”

“Yeah. Chill out, Mom,” my brother says teasingly.

My mother puts her hands up, palms out. “Sorry, sorry,” she says, humming under her breath.

I take a long drink of wine, feeling as tense as my mother looks. Normally, I don’t care when Nick is late, just as I’m a good sport when he gets paged. I’ve accepted these things as part of his job and our life together. But it is a different story when my family is in town. In fact, the last thing I said to Nick this afternoon when he told me he had “to run into the hospital for a few minutes” was,
“Please
don’t be late.”

He nodded, seemingly understanding all the nuances of the instruction—that for one, we don’t want to give my mother ammunition to prove her point about his life taking precedence over mine. And for another, although I adore my older brother, Dex, and am very close to my sister-in-law, Rachel, I am sometimes a little jealous of, if not sickened by, what I perceive to be their perfect marriage and can’t help using them as a yardstick of our relationship.

On paper, the four of us have much in common. Like Nick, Dex has a stressful job, working demanding hours as an investment banker at Goldman Sachs, while Rachel, too, gave up her legal career once she had children, first working part-time, then quitting altogether. They also have two children—Julia and Sarah (ages seven and four)—and like the dynamic in our house, Dex defers to Rachel when it comes to parenting and discipline (which, interestingly, does
not
rile my mother as it does when Nick takes a background role; to the contrary, she has occasionally accused Rachel of expecting
too
much of Dex).

But the most striking thing my brother and I share is our relationship history, as he, too, broke
his
engagement mere
days
before his wedding. It’s crazy, really: two siblings born two years apart, both canceling weddings, also two years apart—a fact that any psychiatrist would have a field day analyzing and likely attributing to our parents’ own split. Dex believes this is the reason for their incredible support both times around; they lost thousands of dollars in wedding deposits and must have been embarrassed in front of their more traditional friends, but they seemed to believe it was a small price to pay for making sure their children got it right on their first try. Still, the joint scandals scored us some rather ruthless ribbing from my mother, who felt the need to give us both the woolliest, thickest socks for Christmas—for our cold feet, naturally. In addition, we had to endure her endless advice that we
not
marry on the rebound. To which Dex, in his analytical way, argued that he could more readily identify “the one” on the heels of “the
wrong
one”—and that he was absolutely sure about Rachel. And which I simply rebutted with a straightforward: “Butt out, Mom.”

As an aside, though, Dex’s situation was far more scandalous as Rachel was actually
friends
with my brother’s former fiancée—
childhood
friends, in fact. Moreover, I am fairly certain there was some cheating involved. This suspicion has never been confirmed, but occasionally Dex and Rachel will let a detail of their early days slip, and Nick and I will exchange a knowing glance. Not that these circumstances really matter at this point, years into their marriage, other than the fact that I think a shady genesis puts a greater burden on a relationship. In other words, if two people have an affair, they’d
better
stay together. If they do, they have this romantic “we were meant to be” story and a certain degree of exculpation for their sin; if they don’t, they are just a couple of cheaters.