This is for you, Katie—my daughter, my love.
And this is for you, donor—giver of life. Because of you, my Katie’s alive.
Josh stopped reading. Moisture had filled his eyes, along with a sense of unspeakable joy. He knew beyond a shadow of a doubt where Aaron’s heart lay. It rested within one Katie O’Roark. And he was equally positive that outside of some impersonal medical computer system, he was the only person who realized it.
Eight
“KATIE, ARE YOU sure you want to do this?”
“Yes, Mom. Please help me.” Katie was determined to make it into the bathroom adjoining her private room for a good, long look at herself in the mirror. She knew she’d lost weight. She could feel her ribs and collarbone jutting through the hospital gown she wore. Yet, her hands looked puffy and her face felt fuller.
“Now, you know that the immune-suppressant drugs—the steroids—are making your face look rounded,” her mother warned as she helped Katie shuffle toward the bathroom.
“I know what Dr. Jacoby told me,” Katie insisted. “I still want to see.”
Nervously, Katie positioned herself in front of the mirror. Her mother flipped on the light. Katie stared at the face in the glass and grimaced. “I look awful … like a pumpkinhead. And my arms look like two sticks.”
“The doctors call it ‘moonface,’ ” her mother explained, still holding Katie’s arm for balance. “It will go away when they adjust your cortisone dosage. And once you come home, I’ll fatten you up again.”
Katie tried to not act too disappointed, but wistfully recalled her once trim, athletic body. “I look weird. Totally weird.” She tipped her chin and turned semi-profile, studying her reflection from different angles. “If I had a tan, I’d look like a moon pie.”
Her mother smiled. “You’re silly. The steroids are supposed to help ward off rejection, you know. So, what does it matter how it makes you look?”
“I hope it’s gone before I return to school. No one will know me.”
“I’m sure it will be. Are you ready to get back into bed?”
Katie gently tugged her arm away from her mother and hung onto the sink. “Not yet.” She reached behind her neck with one hand and gave a tug to the strings holding her hospital gown in place.
“Katie, don’t look.” Her mother grabbed at the gown to keep it up.
“I just want to see—” Katie’s voice stopped midsentence as the gown slid off her shoulders and down to the floor. Her eyes grew wide with horror as she stared at herself in the mirror. She saw a ragged-looking wound, vivid red, held together by black sutures that stretched from the lower part of her neck down the middle of her chest, all the way to her abdomen. She recoiled, and cried, “My God! Look at me! What have they done? Why did you let them do this to me?”
Her mother grasped Katie’s shoulders and turned her away from the mirror. “They saved your life, Katie. There was no other way.”
Katie’s mind reeled. For the first time, she understood exactly what the transplant team had done to her. The doctors had opened up her body, spread apart her rib cage, and cut out her heart. In her mind’s eye, she saw a bizarre image of a turkey being prepared for a meal—hollowed out, all its innards removed. She saw the empty cavity refilled with bread stuffing. That’s what they’d done—cut her open, ripped out the old, stuffed in the new. Now, they were pumping her full of medicine so that all her new stuffing wouldn’t be rejected and fall out.
She wondered about her old heart—the one she’d been born with. What had they done with the poor, diseased thing? Did they throw it away, the way her mother tossed out turkey giblets? She felt sick to her stomach.
“I’m a freak! I’m grotesque!” Katie gaped, wide-eyed, at the long scar.
“No, baby, no. The scar will fade. I promise you. In a few months, it’ll be a thin white line.”
“No one will ever want to touch me. I’ll never be able to wear a bathing suit again. I’m hideous, ugly.” Katie was sobbing, unable to control herself.
Her mother hastily retied the hospital gown and managed to get Katie back into bed. “I’m calling the nurse,” she said, pressing the call button. “You’re overwrought. It’s not good.”
“Overwrought! How can you say that? Just look at what they did to me! They sawed me open! They poked around inside me! They’ve put me back together with staples and glue. They should have let me die.”
“Don’t ever say that. It’s only a scar.”
A nurse came hurrying into the room. Katie buried her face—her ugly moonface—in her hands and wept. She heard her mom and the nurse whispering, heard the nurse say things like, “typical reaction” and “postoperative depression.” Katie didn’t care what they called it. She’d seen with her own eyes what a freak she’d become. She felt violated, abused, and ruined.
The nurse left, then returned and gave her a shot. Minutes later, her tears subsided as a drugged sleep stole over her.
“May I help you?”
Josh gazed down at the hospital receptionist, momentarily stumped by her question. Around him, people bustled past toward banks of elevators for hospital visiting hours. “I … uh … was wondering what room Katie O’Roark is in.”
The woman typed the name on the computer terminal. Josh shoved his hands into the back pocket of his jeans and shifted nervously, telling himself, You’re stupid, man. This whole idea is stupid. The receptionist glanced up at him. “She’s in room 906, but she can’t have visitors.”
“Oh.” Josh felt keenly disappointed.
“Is there something else I can help you with?”
Josh shook his head. “Does it say when she might be able to have visitors?”
“No. Sorry.”
“No problem.”
“I can take a message from you and see that it’s delivered to her room.”
Josh stepped backward, suddenly losing his nerve. “That’s all right. I’ll … I’ll just check back in a few days.” He turned before the receptionist could say anything else and hurried to the front door. He stopped long enough to catch his breath, calm his pounding heart, and rethink his strategy.
“This was dumb,” he muttered under his breath. He should have known he wouldn’t get in to see her. Even if he had gotten in, what would he have said? “Hi. You don’t know me, but you’re using my brother’s heart.” Josh shook his head, trying to clear his thoughts.
True, it hadn’t been smart for him to come, but ever since he’d read Mr. O’Roark’s column about his daughter’s transplant, he couldn’t get it out of his mind. He thought about it every waking hour, and had even dreamed about it the night before. He’d dreamed of coming to the hospital, going into a room, and seeing Aaron sitting up in a hospital bed.
Aaron had grinned at him, waved, and said, “Hey, bro. What took you so long to come and see me?”
Josh had said, “I thought you were dead. I thought they took out your organs and gave them to dying people.”
“They did. But what the people who received my organs don’t know is that over time, they turn into me.”
In the dream, Josh had felt so joyful that he’d rushed across the room and thrown his arms around his brother. He’d awakened, his face damp with tears, alone in his bedroom, in the dark. The feeling of elation slipped away, and melancholia washed over him. The dream had been so real, he could recall the feel of Aaron’s body weight against him.
So, right after school, he’d driven the old car that he’d inherited from Aaron to the hospital, only to be told that Katie O’Roark couldn’t have visitors. Josh walked out to the car, got in, and slumped against the seat. He felt so lonely. “I miss you, Aaron,” he said aloud.
He stared up at the hospital building, rising into the somber October sky. Somewhere on the ninth floor there was a part of Aaron. He wanted … needed to see Katie, who sheltered Aaron’s heart within her body. If only he could see her, touch her, it might bring Aaron back to him in some small way. With a sigh, Josh rubbed his eyes
, started the car, and drove slowly out of the parking lot.
* * *
“Your mother tells me you had a bad day,” Dr. Jacoby said as he stood beside Katie’s bed that evening.
She said nothing, only turned her back and huddled down under the covers.
“This kind of reaction isn’t unusual, you know. Your body’s gone through a big transition, and so have your emotions. I’m going to send in the psychiatrist you met when you and your parents talked about your suitability for the donor program.”
“You think I’m crazy?” Katie asked.
“No. Actually, I think you’re adjusting very well, but you need to talk about your feelings. You need to get them out in the open.” He lifted her chin with his forefinger. “Katie, you’ve got a long road ahead of you, and a lot to learn about managing your own health. No one can do it for you—you’ll be completely in charge.”
“In charge, how?” Katie asked.
“You’ll be taking immune-suppressant medications for the rest of your life. They must be taken at exact prescribed times, and you can’t ever miss a dose. Not one.”
Katie glared at him. It sounded as if the schedule controlled her, not vice versa. The serious expression on his face caused angry words about the stifling prospects of her life to die in her throat. He continued, “You’ll learn how to monitor your own vital signs—take your temperature and pulse, listen to your heartbeat. You’ll come in every three months for a heart biopsy. You’ll adhere to a strict diet and an exercise regime.”
Exercise. At last, he’d said something she wanted to hear. “What kind of exercise?”
“You’ll start slowly, but build up to as much as you can handle.”
“Before all this happened, I was a runner,” she said cautiously.
“After you’re all healed, you may be a runner again.”
Katie felt a surge of hope. “That’s what I want.”
“Tomorrow, I’m having a stationary bicycle put in your room. A physical therapist will work with you and design a program of exercise just for your needs.” Dr. Jacoby smiled. “I can tell that pleases you.”
Katie nodded. “I’d like that a lot. I need to test this heart you’ve given me. And I’ve got some money to spend,” she added, thinking of the Wish funds sitting in the bank.
“You can do it all, Katie,” the doctor told her with a grin. “You just can’t do it all at once.”
She shot him a sideways glance. “We’ll see,” she muttered stubbornly under her breath.
Nine
“I WISH ALL my patients were as cooperative as you, Katie,” Barry, the physical therapist, said with a grin. “Mostly, I get fifty-year-old men who’ve never done anything more physical than use the remote control on their TV set. They aren’t the least bit interested in exercise.”
“I am,” Katie declared with determination. Actually, every muscle in her legs was protesting the workout on the stationary bicycle, but she knew from her athletic experience that the kind of pain she was feeling was good pain. “I haven’t exercised like this since last spring, before I got sick,” she told Barry. “It feels pretty good to sweat.”
He laughed. “Don’t overdo it, or the doc will have my hide. Now, stop and take your pulse. Tell me what you feel.”
She quit pedaling and put her fingertips against her wrist and counted. The coursing of the blood through her veins sent out a steady rhythm, making her smile. She felt the heart—her heart—pounding in her chest, young and vibrant with health. It was a good heart, with a lifetime of work left in it.
At the end of sixty seconds, she told Barry her pulse rate. He flashed a wide smile. “That’s good, Katie. Real good. You’ve been doing better every day this week.”
“Tell that to my mom. If she had her way, I’d be an invalid for the rest of my life.”
“She’s scared,” Barry said. “I see that kind of reaction in patients and their families all the time.”
“Well, I’m not scared.”
“You need a balance,” Barry cautioned. “You can’t abuse your new heart, either.”
“All I want is for it to help me run again.”
“Doc Jacoby told me you were once a track star.”
“I plan to be one again,” Katie replied with a lift of her chin. “Are you going to try and talk me out of it?”
“Not me. Transplant patients can do anything they want, so long as they take good care of themselves.”
“We can?” This was the first positive word Katie had heard since her operation. “Tell me more.”
“I’ve read about recipients becoming marathon runners. It takes a great deal of work and medical supervision, but it’s possible.”
Katie felt as if a door she’d been banging on for months had suddenly swung open. “That’s what I want to do—run. I used to be good at it, you know.”
“You can test yourself in the Olympics,” Barry said.
“The Olympics? I don’t know if I’m that good.”
Barry laughed. “The Transplant Olympics, I mean.”
Katie eyed him skeptically. “Are you making fun of me?”
“No way. Years ago, when transplanting first started, most people died early on. In the mid-seventies, medicine almost gave up the operations altogether. The doctors knew how to do the surgeries, but the rejection problem couldn’t be licked.”
Katie squirmed. She’d come to fear the word rejection more than any other. “I thought the problem was under control.”
“It’s become less of a problem with cyclosporine.”
“That’s one of my medicines.”
“You know what it is?”
Katie didn’t have a clue. “A test-tube drug?”
Barry launched into a story. “Some microbiologist discovered it in a soil sample he’d dug up on a plateau in Norway when he was on vacation. He was searching for a new antibiotic, you know, like penicillin—and just happened on this new organic compound no one had ever seen before.”
“You’re making this up,” Katie chided.
“It’s the truth, Katie. The stuff wasn’t worth a thing as an antibiotic, but another scientist noticed that in his laboratory, this compound had a powerful effect on the immune system. After a lot of testing, cyclosporine proved far better than steroids for handling rejection. Once that breakthrough came”—Barry shrugged—“transplants got popular again. And now more people are living than dying from them. So … the survivors get together once a year and have this big Olympics called the Transplant Games. They compete in athletic events, meet others like themselves, and put out the good word about organ donation.”
“Where are these games held?”
“This year, they’re in Los Angeles, on the UCLA campus. I’ve read that officials are expecting maybe six hundred participants.”
“Six hundred and one,” Katie said. Her pulse was tripping, but not from physical exertion.
Barry laughed and patted her shoulder. “They’re held in July, Katie. You have a long way to go before you’re competitive again.”
“I’m willing to work hard.”
Barry’s brow puckered. “You’ll just have to see how you’re doing with your new heart. Remember, people hold the Games in order to bring national attention to the need for organ donation.”
“Then, I’ll be a walking billboard,” Katie insisted. “Can you get more information about the Games for me?”
“Sure.”
“Good.” Katie put her feet back on the pedals of the stationary bike. “Let’s get back to work.”
“Now, Katie—”
“Oh, don’t be a drag, Barry. I have enough problems with my parents—although Mom’s worse than Dad.”
That night, when she told her parents, each reacted just as Katie had predicted. Her dad perked up with interest. Her mother recoiled in fear. “I just don’t think this therapist has any right to give you any false hopes,” her mother said.
“Barbara, don’t be so negative,” Katie’s dad said.<
br />
She shot him a scathing look. “I only want what’s best for Katie.”
“I have money enough to take us all,” Katie declared. “You said I could spend my Wish money on something I really wanted. Well, I want this in the worst way.”
“I think you should think about something else. You could buy a car for yourself,” her mother suggested.
“You mean you’ll let her drive?” her dad asked sarcastically. “Or does she need to get a personal chauffeur?”
“Really, Dan! I’m only thinking about Katie’s overall safety.”
Katie didn’t feel like listening to them argue. In fact, she wasn’t feeling well at all. Her head hurt, her hands and feet felt icy cold, and her body was weak and trembling. Perhaps she’d exercised too hard that afternoon, she told herself. “Could you not talk so loud?” Katie asked. “I have a headache.”
Both her parents looked at her. Her mother’s eyes narrowed. “Are you all right?” She placed her hand on Katie’s forehead. “Dan, she’s got a fever. Get a nurse.”
“I’m fine, Mom,” Katie mumbled, knowing that she wasn’t.
In minutes, her room filled with nurses and technicians. Katie heard one nurse tell another, “Call Dr. Jacoby. Stat.”
Katie tried to insist she was all right, but she couldn’t make her mouth shape the words. Her parents huddled to one side, looking frightened. She struggled to tell them not to worry, that she would be fine.
When Dr. Jacoby came, he smoothed her brow and checked the results of her blood work on her medical chart. “We’re moving you back into isolation, Katie.”
“No …” she mumbled weakly. “I want to stay here.”
“You can’t. You’re having an episode of rejection. You know that we’ve expected this.”
“Please … make it go away.” Tears slid from the corners of her eyes.
“We’re working on it,” Dr. Jacoby said. His expression was grim.
Katie cried as they began to roll her bed down the hall toward the ICU.