With every word, Josh felt as if nails were being driven into his heart. Aaron looked alive, but every test, every wonder of modern technology said otherwise. “I can’t believe it,” he said, his voice cracking.
“I’ve lived too long,” Gramps said. “I wish I could trade places with him.”
For a moment, Josh wished the same thing for himself. Aaron should be the one to live. He had such potential, a lifetime of plans and dreams. Josh remembered Aaron’s telling him, “I’m glad I’m playing football in college. It’s my ticket for an education, but I’m no jock. I want the education. I want to do something with my life—be something. I don’t want to waste myself the way Pop has.”
“I think I need to sit down.” Gramps’s voice jarred Josh.
“There’s a room across the hall. We can sit in there,” Dr. Lowenstein suggested. “I’ll have some coffee brought in … and there’s someone who wants to talk to you, a Mrs. Gillespe.”
Josh didn’t want to talk to anyone. He wanted to stay with Aaron, but he also knew his grandfather needed attention.
The small room looked almost homey, with a sofa and easy chairs. A table was centered between the furniture. When the door opened, Josh looked up to see a pretty woman with short, wispy brown hair. She was carrying a tray filled with sodas and coffee. “I’m Bette Gillespe,” she said. “I’m from the Michigan Donor Services.”
She handed Josh a cold drink which Josh drank. He hadn’t realized how thirsty he’d become. The cold soda revived him. “Thank you,” he said.
Dr. Lowenstein sat across from him, next to the woman, and Gramps sagged against the sofa beside Josh. Coach Muller had remained out in the hall to make phone calls. Josh studied Gramps’s hands. They looked gnarled and leathery, and they were trembling. Josh fought back tears, determined not to break down in front of these strangers. He knew they were trying to be kind. Numbness carried him along. As long as he could hold his feelings in check, he knew he could make it.
“Dr. Lowenstein has explained Aaron’s condition to you,” Bette stated. When Josh nodded, she asked, “You understand what’s happened to Aaron?”
“He’s gone,” Josh replied flatly. “He’s never coming back.”
“I’m so sorry,” she said. “There’s no rhyme or reason to any of this. Frankly, you’ll be sorting it out for the rest of your life. Yet, even though you’re hurting right now, I want to offer you an option that may help bring something positive out of this tragedy.”
“An option?”
“Did Aaron ever discuss organ donation with you?”
It dawned on Josh then what this meeting was really all about. He recoiled. “Is that what you want? You want us to give Aaron’s insides to medical science?”
“Not to medical science,” Mrs. Gillespe said quickly. “To suffering, dying people. People who have no other hope to live except through the generosity of grieving families such as yours. The gift of an organ for transplantation—of Aaron’s organs—can turn a sick, hopeless person into a functioning, vital human being again.”
“What’s she saying?” Gramps asked, leaning forward. “She wants us to say it’s all right to cut Aaron up?”
“There will be no disfigurement,” Mrs. Gillespe assured them. “Top surgeons remove only the organs you wish to donate, and they leave your loved one looking perfectly normal.”
Josh was listening to his grandfather’s objections, but he was also recalling the time when he and Aaron had been watching some TV show about a girl hooked to life-support machinery and a family demanding that the machines be turned off. Aaron had said, “Man, I’d never want to be kept alive that way. If I go first, little bro, you make sure I don’t lie around like some vegetable. And before you put me in the ground, pass around my best parts.” He had laughed, made a face, and added, “Like Frankenstein, I’ll rise from the dead.”
Guiltily, Josh glanced down at the floor. He knew what Aaron would have wanted. Still, hearing Gramps’s protestations made Josh pause. Gramps was saying, “We can’t afford no fancy surgeons.”
“You would pay nothing to donate Aaron’s organs for transplantation. You’d pay only for the care he’s had thus far.”
Dr. Lowenstein said, “Because Aaron had heart-chest massage from the moment his aneurysm occurred, his blood was kept flowing. That means his organs are in excellent condition. Plus, he was young and healthy. Many people could benefit from your gift of Aaron.”
“Who would get his organs? Would we know?” Josh asked.
“Probably not,” Mrs. Gillespe said, “although the trend to keep donors and recipients apart is changing. Research is finding that often such knowledge is beneficial to both parties. If the family of a donor ever gets to meet someone who’s received a loved one’s organ, they feel blessed.
“For the most part, however, donors and their families don’t know the recipients. The organs are matched by computer with people on a waiting list. Every effort is made to place an organ in the immediate area, at least within the state. But donor and recipient must be matched by medical urgency, blood type, time on the waiting list—” She paused. “All those factors have to be considered.”
“You didn’t just let Aaron die so you could get his organs, did you?” Gramps blurted out.
Josh could see how confused and upset he’d gotten. Josh reached over and took his arm. “Take it easy, Gramps.”
Five
“I’M NOT INVOLVED with the organ transplant program,” Dr. Lowenstein explained calmly. “I called Mrs. Gillespe because I’m a physician who strongly believes in organ transplantation, and the trauma around Aaron’s death makes him an ideal candidate.”
“The decision belongs to the family,” Mrs. Gillespe said. “Please consider letting something positive come out of this terrible tragedy. For Aaron’s sake, for yours, for all the people he can help with a gift of life.”
“We should call your mother,” Gramps said slowly to Josh. Then, turning to the others, he explained, “My daughter … Aaron’s her son.”
“No.” Josh shook his head firmly. “You’re our legal guardian, Gramps. She probably wouldn’t be sober enough to decide what to do, anyway.” He looked over at Mrs. Gillespe. “How much time do we have to decide?”
“Unfortunately, time is our enemy. Once brain death occurs, deterioration of a body and its vital organs is rapid. The machines are keeping Aaron going for now, but we should act quickly.”
Josh felt torn, as if he were two people—a sixteen-year-old boy who was losing his brother, and a grown man who was being asked to make a decision no one should have to make. He looked to his grandfather. “It’s up to us, Gramps. You and me. We have to decide.”
The old man nodded. “I suppose it is. I didn’t ever expect it to come to something like this when I said I’d be responsible for you and Aaron. I wish Gran was here.” His voice sounded raspy. “She’d know what to do. You’ve known Aaron all your life, Josh. I’ve just really come to know him recently. Do you know what he would have wanted us to do?”
Josh covered his eyes. The light in the room seemed too bright, and it was giving him a headache. Aaron, what should I do? he pleaded silently. Help me. Aaron had always been there for him, shielding him, standing up for him when their father had come home drunk and mean. It had been Aaron who was always in the stands cheering for him when he ran track. Aaron, who’d been his true family. But now, Aaron was leaving him alone with this heavy decision.
Josh lowered his hand and looked directly at Gramps. “He would have wanted us to donate his organs, because that’s the kind of person he was. He put others first.”
Gramps hunched his shoulders, and Josh saw a tear trickle down the old man’s face. Afraid he’d come unglued himself, Josh stood abruptly. “Can I see Aaron again?”
“Certainly. Take your time. I know how difficult it is to say good-bye.”
At the door, Josh paused. “When will you start … you know … taking out his organs?”
“We??
?ll put the call out immediately with all Aaron’s vital statistics. When a donor match is found, a transplant team will be dispatched here. We’ll take him upstairs and begin prepping him for organ harvesting this evening.”
Organ harvesting. To Josh, the phrase sounded like some kind of primitive farming ritual. “I’m not sure I want everyone to know what we’ve decided.”
“You can decide whether to tell others or not.”
“We’ll want to have a funeral,” Gramps said. “So we can say a proper good-bye.”
“Don’t worry—the hospital and the university will work with you to make arrangements,” Mrs. Gillespe said. “Thank you so very much. What you’ve decided to do today will help many people.”
Josh walked out of the room and back to Neuro ICU. Once inside the cubicle, he bent over his brother’s body. Mesmerized, he watched Aaron’s chest rise and fall in perfect cadence with the respirator. On the screen of the monitor, he studied the ragged green line as it moved in perfect harmony with the machine. Tentatively, he placed the palm of his hand on Aaron’s chest. Through the thin material of the hospital gown, Josh could feel the thumping of his brother’s heart.
The sensation was supposed to mean life. In Aaron’s case, it meant only an imitation of life. Aaron’s body may have been stretched out on the bed, but his spirit, his consciousness, was far removed from this time and place. “Hey, bro,” Josh whispered, using the term Aaron had often used for Josh. “I guess this is it. I tried to do the right thing by you with this donation business, because I was pretty sure it’s what you would have wanted.”
Josh kept his hand on Aaron’s chest, afraid to break off this final connection. “I don’t know when I’ll see you again, but I will,” he added. His voice broke, and despite all his efforts to remain in control, sobs came quickly, silently. All at once, the walls of the room seemed to be moving in on him, and Josh knew he had to get outside into the cold autumn air. He had to leave this room of death, leave this body, which looked like his brother in form and substance, but really was no more than an elaborate mannequin.
Josh bent, kissed Aaron’s forehead, and fled the room.
“Katie! Katie, wake up! The beeper’s gone off.” Her father’s urgent voice sounded as if it were coming from a long way off. Katie struggled toward it, like a swimmer exhaustedly treading water.
Her eyes blinked open as she took long gulps of pure oxygen. “My beeper?” she mumbled.
“They’ve found you a heart, honey, and the doctors want us at the hospital immediately.”
Her parents bundled her up and switched her to a portable oxygen tank. She carried it in her lap, even after they arrived at the hospital and placed her in a wheelchair. Time blurred as she passed from procedure to procedure, area to area. In order to keep her mind off the ordeal awaiting her, she focused on small things—the feel of her mother’s hand on hers, the changing of her clothes to hospital issue, the smiles of staff, nurses, doctors, technicians, and orderlies. She half heard their explanations of preparation for her surgery. She felt the pricks of needles and the excruciating pain of the first injection of immune-suppressant drugs in her thigh muscle. She knew that she’d be taking immune-suppressant medications for the rest of her life once her new heart was in place. Fortunately, most came in pill form.
At one point, she heard her father ask Dr. Jacoby, the transplant surgeon, “Who’s the donor?”
The doctor answered, “I don’t know. Only that he was a young man who died suddenly and unexpectedly. His organs were in outstanding condition. Katie’s getting his heart, a boy in Detroit is getting his liver, and his kidneys are on the way to Chicago and Indiana.”
Katie tuned out the conversation. She didn’t want to know … couldn’t bear the idea that someone’s body parts were being flown all over the country, even if it was to save lives like hers. Yet, she was grateful, too. Unspeakably grateful.
Orderlies rolled her on a stretcher down the hall toward the operating rooms. Her parents walked on either side. Her mother’s face looked pasty, and although Katie was groggy from her preop medications, she was concerned for her mom. Her dad looked less pale, but she could tell by the iciness of his fingers as they gripped hers that he wasn’t handling what was happening with ease.
At the door of one of the ORs, the stretcher stopped. “This is as far as your family can go, Katie,” Dr. Jacoby said. “There’s a waiting room down the hall for them.”
“How long?” her mother asked.
“The surgery takes around four hours.”
Katie saw her dad slip his arm around his wife’s shoulders. “We’ll be waiting.”
They bent over Katie. “I’ll be praying for you, baby,” her mother whispered. Katie heard a quiver in her voice.
“I love you both so much,” Katie told them. Her tongue felt thick, difficult to move.
“You’re a winner, Katie,” her father said. “You’ve been a winner all your life, and this time you’re running the ultimate race. You’ll win it, too.”
Katie was certain she saw tears in his eyes. “Thanks, Daddy.” She held up her fingers in a V-for-victory sign. “One more thing,” Katie whispered. “If something goes wrong in there, please do something special with my Wish money.”
“You’ll be spending that money yourself,” her dad insisted. “Every penny of it.”
Katie wanted to tell her parents a hundred other things, but her brain felt fuzzy, and it was growing harder to think straight, much less put her thoughts into words. She was afraid that once she was rolled inside the OR, she’d never see them again. The door to the OR swung open, and a nurse dressed in green scrubs and a mask said, “We’re ready.”
Katie clutched her mother’s hand. She wanted to scream, “I’m not.” She heard her mother say, “See you in a few hours. We love you so much.”
Katie was shuttled into the OR, helplessly watching her parents’ beloved faces until the door swung shut, closing them out. The operating room was so bright, it hurt her eyes. She caught glimpses of machines and stainless steel tables. She was lifted onto a cold table. Dr. Jacoby leaned over her. “We’re going to give you a brand new heart, Katie,” he said through his mask. “I know this is scary for you, but my team and I’ve done this operation many times before, and we’re really pretty darn good at it.
“As I’ve explained, we’ll put you to sleep, cool your body temperature, and put you on the heart-lung machine.” He gestured toward a large piece of gray-and-blue machinery. “Then I’ll take out the old and put in the new.”
“When you wake up, you’ll be in the recovery room. You’ll have tubes coming out of your chest and out of your mouth. You won’t be able to talk until we remove the breathing tube, which should be on day two of your recovery. Don’t be alarmed. The tubes will be pulled as soon as you’re stabilized.”
His eyes crinkled above his mask. “You’ll be in isolation for the first few days—there are lots of nasty germs floating around, and we don’t want you to catch any of them. You’ll be able to see your parents and, of course, me.” He smiled again. “You’re going to do just fine, Katie.”
Heart-lung machines, tubes, isolation—the terms swirled around in her head. “How will I know if I’m alive?” Katie asked, in a fit of dark humor.
He laughed. “You’ll feel alive. At first, you’ll feel as if a freight train ran over you but you’ll have an immediate awareness that you’re better. Your fingernails will turn pink again, and you won’t need oxygen in order to breathe. It’s like falling in love, Katie—you’ll just know.”
She gazed up at him. “Then let’s get moving.”
“Hi. I’m Max, your anesthesiologist. I’m slipping some ‘happy juice’ into your IV, then I’ll put this little rubber mask over your face. Breathe deep and try to count to ten. I bet you won’t make it to four.”
Katie could feel a numbness stealing over her body from the IV dripping into her hand. She suddenly felt light, weightless, as if she were floating right off the
table. “See you in recovery, Katie,” Max said. “Sweet dreams.”
In recovery, Katie thought silently, as she felt the rubber mask being placed over her mouth and nose. Or in heaven.
Six
KATIE DRIFTED ON a luxurious sea of warmth like a piece of wood coasting on ocean waves. Voices came and went; she could hear them, but she couldn’t make out what they were saying. She didn’t care. The water felt so blissful, so peaceful, she never wanted to leave it.
A bright light came toward her, hovering above her face as she lay stretched out in the water. The light began to take on a form. It shimmered and dissolved into a being of incredible beauty. “Who are you?” Katie asked.
“I’m JWC,” the being said.
“You are?” Katie felt a surge of delight. “You gave me the money!”
“It was nothing. It was for your heart.”
“I haven’t got a heart.”
“I know. You’re like the Tin Man from The Wizard of Oz—no heart.”
“The Wizard gave him a heart.”
The beautiful creature laughed. “Not at all. I gave him a heart.”
“You did? But in the movie—”
“Whoops! Got to go.”
Katie tried to touch the beautiful being, but her arms felt pinned. “No. Don’t leave me!” Katie cried.
“Can’t stay. I have money to give away. Hearts to buy.”
Katie watched the phantom JWC recede and felt an overwhelming sense of panic. “Don’t go! Please!”
The light moved away from her and started growing brighter. Katie tried to close her eyes, because suddenly the light was so bright, it burned her eyeballs. There was a terrible crushing sensation in her chest. She gasped, struggled to breathe, reached out her hand toward the light, the way a drowning person grabs for a lifeline.
“… wake up, Katie. It’s all over, little girl. Come on, wake up and give Max a smile.”