Mend the Living (20 page)

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Authors: Maylis de Kerangal

Tags: #Fiction, #Medicine, #Jessica Moore, #Maylis de Kerangal, #Life and death, #Family, #Transplant, #Grief

BOOK: Mend the Living
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She breathes in the winter for a long moment, eyes closed: the bluish planet drifts in a fold of the cosmos, suspended silently in a gaseous material, the forest is starred with rectilinear rays, red ants stir at the foot of the trees in a sticky jelly, the garden dilates – mosses and stones, grass after rain, heavy branches, scratch of the palm tree – the cambered city keeps a cover on the multitude, children in bunk beds open their eyes in the darkness; she imagines her heart, morsel of dark-red flesh, seeping, fibrous, all its various pipes, this organ beset by necrosis, this organ that’s failing. She closes the window again. She has to get ready.

Nearly a year that Claire Méjan has been living in this two-room apartment rented sight unseen, the words “Pitié-Salpêtrière” and “second floor” having been enough to make her sign a cheque immediately for an exorbitant amount to the guy at the agency – it’s dirty, small, and dark, the cornice of the balcony on the third floor shading her window like a hat brim. But she doesn’t have a choice. That’s what it means to be sick, she tells herself, to not have a choice – her heart doesn’t give her the choice anymore.

It’s myocarditis. She found out three years ago during an appointment in the cardiology department at Pitié-Salpêtrière. Eight days before, another flu, and she poked at the crackling fireplace with a blanket over her shoulders while in the garden snapdragons and foxgloves (Digitalis) bent under the wind. She had been to see a doctor at the Fontainebleu, complaining of fever, of aches and fatigue, but had neglected to tell him about these occasional palpitations, this pain in her chest, this shortness of breath that came with every effort, getting these signs confused with lassitude, winter, a lack of light, and a kind of general exhaustion. She left the appointment armed with anti-flu meds; she would stay in her room and work from her bed. A few days later, after dragging herself to Paris to see her mother, she goes into a state of shock: her blood pressure drops, her skin goes pale, cold, and sweaty. She’s taken to emergency sirens wailing – cliché of an American TV series – they revive her, and then the first tests begin. Straightaway a blood test confirms inflammation, and then they examine her heart. A flurry of tests follows: the electrocardiogram detects a rhythm anomaly, the x-ray shows a slightly dilated heart, the echocardiography finally confirms heart failure. Claire stays in hospital, she’s transferred to cardiology, where the tests become more and more specialized. The coronary angiography is normal, which rules out the possibility of a heart attack, so they proceed to biopsy her heart: Claire is pricked inside the cardiac muscle via the jugular. A few hours later, the results of the biopsy let drop a hostile hendecasyllable: inflammation of the myocardium.

The treatment covers two fronts: heart failure – the heart is exhausted, it’s not beating efficiently anymore – and irregularities in the rhythm. Mandatory rest is prescribed for Claire, zero physical effort, plus antiarrhythmic agents and beta blockers, and a defibrillator is implanted in order to prevent sudden death. They treat the viral infection at the same time, prescribing powerful immunosuppressants and anti-inflammatories. But the illness persists, grows more serious – it invades the muscle tissue, the heart grows more and more distended, and each second carries a lethal risk. The organ’s deterioration is judged to be irreversible: they have to operate. A transplant. Another human heart implanted in place of her own – the hand gestures of the doctor, there again, mime the surgical act. In the end, it’s the only option.

She goes home that same night – her youngest son has come to pick her up at the hospital, he drives on the way back. You’re going to say yes, right? he murmurs softly. She nods mechanically – she’s crushed. When they reach her house at the edge of the forest, this fairy-tale house where she lives alone now, her children grown and gone, she goes upstairs to her room and lies down on her back, stares at the ceiling: fear pins her to the bed, irradiating future days and leaving no room for possible loopholes – fear of death and fear of pain, fear of the operation, of the post-operation treatments, fear her body will reject it and that everything will begin all over again, fear of the intrusion of a stranger’s body inside her own, and fear of becoming a Chimera – of not being herself anymore.

She’ll have to move – she’s taking a risk, living in this village sixty-five kilometres from Paris, far from the major highways.

Claire hates the new apartment right from the start. Overheated in summer as in winter, lights on in the middle of the day, the noise. Last airlock before the operating room, she envisions it more as the antechamber of death, believing she’ll die there without having been able to leave because even though she’s not bedridden, she is trapped, every exfiltration requiring a superhuman effort, each step on the staircase increasing her pain, each movement causing the sensation that her heart is separating from the rest of her body, unhooking from inside her rib cage, tumbling down in pieces, a dislocation that turns her into this shaky, claudicant creature, on the edge of breaking. Day after day space contracts around her, places a quota on her gestures, restricts her movements, a shrinking of everything as though her head were stuck inside a plastic bag, a nylon, something fibrous that suffocates her and coats her life in a sticky murk. A shadow comes over her. One night when her youngest son comes to see her she tells him that waiting to contain the heart of a dead person disturbs her, it’s a strange state of affairs, you know, and it’s wearing me out.

At the beginning, she’s reluctant to really settle in – whether she lives or dies she won’t stay here, it’s just temporary – but still she puts on a brave face. The first weeks in this apartment change her relationship to time. It’s not that time has changed speed, slowed down by paralysis, the anguish of suspension, or all that she’s prevented from doing, nor is it that it stagnates like blood stagnates in Claire’s lungs – no, it just crumbles away in a dismal continuity. The alternation of day and night soon has no caesura – the constant dimness of rooms contributes to this – and all she does is sleep, on the pretext of canalizing the shock of this forced move. Little by little, her two older sons instate Sunday as visiting day, which makes her sad without knowing exactly why. They sometimes reproach her for her lack of enthusiasm – right across from the Pitié, after all, it doesn’t get better than that, they say, without a trace of irony. The youngest one, though, still turns up at any time, and takes her in his arms for long moments. He’s a head taller than her.

Dreary winter, cruel spring – she doesn’t see the greening of the forest, the colours that explode again, strong, and she misses the undergrowth, the golden stumps and the ferns, the light that plumbs space in vertical rays, the multitude of sounds, the foxglove scattered in the partial shade on secret paths behind the mountains. Desperate summer. She grows weak – you need a routine, say those who stop in to see her, meals at fixed times, a daily framework, they hammer out the refrain; they find her depressed, elsewhere, uncertain and a little alarming, her dark-eyed blond beauty altering, corroded by anxiety and the lack of the outdoors – her hair is dull, her eyes are glassy, she has bad breath and lives in loose clothes. Her two eldest try to find someone to take care of her, a homecare worker who could do housework, shopping, and monitor treatments. When she catches wind of this scheme, she bristles, enraged, are they trying to spear the little bit of freedom she has left? House arrest, she stammers, white and bitter, can’t stand it anymore, the view the healthy have of sickness.

A first call comes to her on the night of the fifteenth of August, the window’s open, it’s eight in the evening, they’re suffocating in the room – it’s the Pitié, we have a heart, it’s tonight, it’s now, always the same antiphony; she’s not ready, puts her fork down on her untouched plate, looks at her family pressed in around her, together for her birthday, her fiftieth, they’ve folded their elbows along their sides like birds’ wings, her mother, her three sons, the young woman who lives with the oldest and their little boy, all of them sitting frozen except for the child with garnet eyes, I’m going, I have to go, chairs topple, champagne flutes vibrate, things splash and spill, a suitcase with toothpaste and facial spray is buckled closed, they go down the stairs with that hurried slowness that causes them to stumble and snap at each other – the sorbets in the kitchen are forgotten, the health card is forgotten, the telephone is forgotten – then it’s sticky pavement, smoky sky, people hanging from windows, a bare-chested guy walking his dog, a little boy running on the sidewalk, caught by his mother, tourists that consult their map at the exit from the metro, and finally the hospital fringed with little lights, the front desk, the scrubbed room where she waits again, sitting on the edge of this bed that she won’t ever get into, because in the end there’s a scuffling in the corridor, footsteps hammer the ground, and Harfang suddenly appears, pale and blunt, red-rimmed eyes: we’ve had to refuse the heart.

She listens to him explaining his decision, lets nothing show – the heart is no good, small and poorly perfused, it’s a useless risk, we’ll have to wait longer. Harfang believes she’s in shock, disappointed, crushed by false hope, but really she’s just stunned, dazed, with only one thought in mind – to get out of here; her feet hang in the void, her buttocks slide imperceptibly toward the edge of the bed, she lands gently on the ground, then pulls herself up straight, I’m going home. Outside, her sons kick in the bushes that release their burning dust, her mother bursts into tears in the arms of the youngest son, the eldest’s partner continues to chase the little boy who doesn’t want to go to sleep, and everything breaks down. The group heads home, back the way they came, no appetite now, impossible to sit down again to the meal they’d left; but they could drink, a rosé champagne in bubbly flutes and Claire who holds her full glass out over the table smiling, beautiful now, don’t take it to heart! You’re not funny, you know, her youngest son murmurs.

And then time changes character again, it regains its shape. Or rather it takes the exact shape of waiting: it hollows and stretches out. From now on the hours have only one use – to be available, for the event of the transplant to be able to take place, a heart could appear at any moment, I have to be alive, I have to be ready. Minutes become malleable, seconds ductile and then autumn arrives, and Claire resolves to have her books and her lamps brought to these thirty square metres. Her youngest son sets up Wi-Fi for her, she buys a pullout couch, a wooden table, gathers a few objects: she wants to start translating again.

In London, her editor greets this return gladly, sends her Charlotte Brontë’s first collection, poems published with her sisters under masculine pen-names: Currer, Ellis, and Acton Bell. Autumn passes in a freezing cottage battered by winds where three sisters and a brother write and read together by the light of a few candles, united by books, restless, exalted, tortured geniuses who invent worlds, beat through the heath, drink litres of tea, and smoke opium. Their intensity is infectious and Claire perks up. Each day of translating delivers its lot of attempts, sets down a few pages; the weeks pass and a working rhythm is established, as though it were a matter of synchronizing the wait – which becomes clearer as the state of her heart degrades – with another timeline, that of poems to translate. She sometimes has the feeling she’s substituting a fluid back-and-forth movement for the painful contractions of her ailing organ, the come and go that happens between her native French and her second language, English, and that this rotary movement carves a crevice in her in the form of a cradle, a new cavity – she had to learn another language to truly come to know her own, and now she asks herself whether this other heart will allow her to know herself even more deeply: I’ll make room for you, my heart, I’ll clear a space for you.

On Christmas Eve a man resurfaces with an armful of purple foxgloves that he places on her bed. She’s known him since she was a child, they grew up together – lovers, friends, brother and sister, accomplices, they are nearly everything a man and a woman can be to one another.

Claire smiles, surprises are risky, I have a heart condition, you know. Indeed, she has to sit down and recover while he takes off his coat. The flowers are from her home, she can smell it. They’re toxic, did you know that? she says, pointing at them. The kind you forbid children to touch, breathe in, gather, taste – she remembers contemplating her fingers powdered with fuchsia, fascinated, alone on the path, and the word “poison” that swelled above her little-girl head when she brought them toward her mouth. The man slowly plucks a petal and places it in the hollow of her hand: here, look. The colour of the petal is so vivid that you would think it was fake, made of plastic; it trembles in her palm and grows covered with microscopic creases as he tells her: the digitalis contained in the flowers slows and regularizes the movements of the heart, it supports cardiac contraction, it’s a good molecule for you.

That night, she falls asleep with the flowers. The man undresses her with care, unfolds the petals one by one and places them on her naked skin like the scales of a fish, a vegetal puzzle forming a ceremonial cloak: he takes care to perfect it, murmuring from time to time, hold still, can you do that for me? and meanwhile she sinks into a cataleptic state of delight, ornamented and tended to like a queen. When she wakes, it’s still dark, but the children are already tumbling around in the apartment upstairs, letting out shouts, their heels hammering the floor, they’re running to tear open the paper of presents that had appeared in the night near the ectoplasmic Christmas tree. Her friend is gone. She shakes the petals off her body and uses them to make a salad that she dresses with truffle oil and balsamic.

A T-shirt, a few pairs of underwear, two nightshirts, a pair of slippers, toiletries, her laptop, her phone, the various chargers. Her medical file – the administrative forms, the last tests, and these big stiff envelopes containing x-rays, scans, and MRIs. She’s glad to be alone while she packs her bag, to go down the stairs with a careful step, to take her time outside. She crosses the boulevard on a diagonal, trying to catch the eyes of the drivers who brake before her, listens to the burning rails vibrating above her head, she wishes she might meet an animal – ideally a tiger, or a barn owl, its facial disk in the shape of a heart, but a stray dog would do just fine, or some simply marvellous bees. She is more terrified than she’s ever been, she’s anaesthetized by terror. I should probably call, she says to herself as she enters the hospital grounds, and scrolls to her sons’ numbers, sends them a text – it’s happening, tonight – calls her mother who’s probably already asleep, and last, her friend of the foxgloves on the other side of the world, signals that are emanations of this present moment and that stretch out long in the fabric of time. She turns around once more, looks hard at the window of her apartment, and suddenly all the hours she’s spent waiting behind that wall of glass condense into a sliver and converge in the back of her skull at the very instant she passes through the hospital gates, quick snap of the fingers that sends her into the inner walls, along the paved ribbon that runs past the buildings, then it’s a left turn, the entrance to the cardiology institute, a lobby, two elevators – she holds herself back from thinking she must choose the one that will bring her luck – fourth floor and this corridor lit like a space station, the nurses’ desks walled in glass, and Harfang standing there, white coat clean and buttoned, white lock smoothed back from his forehead: I’ve been waiting for you.

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