Annie coughed, and her eyes crowded in toward her nose, almost wrinkling the pale skin above her eyes. "It's a girl?" she asked. "How old is she?"
I made it a practice never to tell recipients information about their donors until after they had recovered, but something in Annie's eyes told me she wasn't asking for her benefit. She was asking for the donor's. "Mid-twenties."
Annie's eyes whirled around the inside of the helicopter, studying the lights, gauges, and odd mixture of medical supplies with aeronautical function and design. "Do you think she's already in heaven?"
I shrugged. "I don't know, Annie. I guess she's the only one who really knows that right now."
Annie thought for a minute, rubbed her sandal, and said, "God knows."
I nodded. "I guess He knows too."
Annie continued studying the instruments around her. Her pulse was elevated, but her color was good and her breathing, while forced, was deep and controlled. Her eyes steadied on mine. "Reese?"
"Yes. "
Just then, Steve crackled from the pilot's seat, "Donny?"
I looked up front and saw the lights of Atlanta growing closer through the glass.
"Royer's calling from Texas. I'm patching him through."
I nodded, understanding that Steve could selectively do so and would patch him through to only my set of headphones.
Joniiy?„
"Go ahead."
"We've landed and I've had a look at her. The donor's BP has not dropped, which is good, seeing as how they've weaned her from dopamine. The electrocardiogram looks good, heart rate normal, and from what I can tell, the heart muscle itself suffered no damage. 'Course I won't know for sure until I open her up. The chest X-ray is clear, neither lung is collapsed, and no pneumonia. We're at 90 percent go."
I made several mental notes and said, "Call me when you know."
"Will do."
Royer hung up and no doubt returned to the OR, where other doctors were performing their tests to determine if other tissues were also viable. The sequence of removal follows the best physiological progression, not the order of arrival. First the heart, then liver, kidneys, corneas, bone, and then other tissue, like skin. That meant nobody would touch the donor until after Royer was finished.
Annie squeezed my hand again and brought my thoughts eastward from Texas, up through the kitchen floor at the lake, and down into the helicopter. "Reese?"
"Yes?"
"Don't worry. Okay?"
I nodded and watched Atlanta growing closer over Steve's shoulder.
Annie tugged on my arm and pulled me closer. "Reese?"
My face hung just a few inches from hers. I didn't say a word.
"You don't need to worry," she said again.
I tried to smile and shrug her off and act as though my attention were needed up front.
She tapped my hand and feigned a smile. "What would Shakespeare say about all this?"
I thought for a moment and attempted the same smile. My ability to remember the words that had brought me such comfort had disappeared. I had almost completely forgotten every passage I'd ever read. It was as if they knew they were no longer needed, so they had taken flight and found another soul in need. I pawed at the air, trying to remember. When nothing came, I felt lonely and cold. "No, not tonight."
She pulled my ear to her lips, tapped her chest, and whispered, "Whether or not I wake up ... I'll have a new heart."
Cindy covered her mouth and looked out the window toward the east and the lights of Stone Mountain. The darkness hid her eyes, but the blue glow from the instrument panel lit tip the shiny streaks cascading down her face. Before us spread the urban sprawl of Atlanta, which now covered Sherman's once-scorched earth.
Highway 400 stretched out below us, marked by the occasional junction lights or northbound headlights. We circled once, then landed amid a sea of lights and scurrying medical personnel, many of whom seemed as anxious to see me as Annie. Word had spread fast, and I knew my life of anonymity was over.
At first they were afraid to say hello, but when we placed Annie in the chair, and the two electric doors closed behind us, I turned to Mike Ramirez and said, "How's your family?"
He smiled a wide grin and said, "Fine." His chest swelled a bit, and his grin grew wider. "The boys are in school, and we have two little girls at home."
One by one, nurses and doctors came to wish Annie well and shake my hand or offer a quiet hug. We loaded onto the elevator, and while the doors closed, I reminded myself that while I needed those hugs and handshakes, this wasn't about me. And we weren't simply taking out a girl's tonsils. We were taking out her heart.
Chapter 52
e descended two floors in the elevator, and I thought about Royer. When he first inspected the heart, he had to be absolutely certain. I knew he would look for signs of damage. He would feel for flutters-like water running rapidly through a pipe-that meant the heart was not functioning properly. Next he would run his finger down each of the three major coronary arteries, the vessels that lie on the surface of the heart, that feed it with oxygen and nutrients. He'd look for plaque, any sign of hardening, the first signs of disease. Like Charlie, Royer would "read" the heart with his hands.
We rolled Annie into her room at the end of a long and quiet hall in the heart wing of the hospital. Immediately, the nurses began invisibly flurrying about, performing a battery of tests. After a few minutes, a nurse I did not know whispered, "Doctor?" When I didn't move, she whispered again, this time louder, "Doctor."
Finally, Cindy got my attention and pointed discreetly at the nurse.
I turned and read fenny on the shoulder of her scrubs. She held two things: a white jacket with Jonny stitched above the topright pocket and two syringes, out of Annie's view.
I had been expecting the syringes, but not the jacket.
She held it forth and whispered, "Royer's had this hanging on the back of his door for I don't know how long. Said to give it to you when you arrived."
I nodded, and she helped me slip into it, like a tailor at a men's shop. In the pocket I found a stethoscope. I unfolded it, and she whispered again, "He's been keeping that for you too. Said he's been waiting till it fit you again." She hung it around my neck and smiled.
Then she held the syringes, eyed Annie, and said, "You or me?"
"Me," I whispered. It was a kind gesture, and I appreciated her offering. Those shots were the first step, and a very painful one, in what would become a lifetime routine of taking immunosuppressants. The shots had to be given in the thigh, and Annie was not going to like it.
Jenny stood behind me, ready to help but not in my way, and I turned to Cindy. "You might ought to leave us alone a minute."
Cindy shook her head, grasped Annie's hand, and gritted her teeth. I looked at Annie, and she eyed the needles in my hand.
"Dr. Royer told me about those." She lifted her gown, I swabbed the skin, and she grabbed my hand. She looked up with a forced smile and whispered, "I keep a close watch on this heart of mine. I keep my eyes wide open all the time. Because you're mine, I walk the line."
The rhyme puzzled me, and I knew I'd heard it someplace before.
Annie tilted her head. "My mom was a big fan ofJohnny Cash."
She closed her eyes, gritted her teeth, and I quickly injected the drugs. She winced, and her eyelids squeezed the tears out from underneath. I straightened her gown, kissed her on the forehead, and she looked up at me, offering another whisper through still-gritted teeth. "I guess sometimes it's got to hurt before it can get better."
I nodded. "Hearts are like that."
Jenny returned with a small cup of water and a pill, which would put Annie on a more sedated field. It wouldn't quite put her to sleep, but it'd take away any anxiety.
Annie swallowed obediently, and someone paged me over the intercom. "Dr. Mitchell? Dr. Morgan's on line two."
I checked my watch. He was three seconds early.
I stepped out into the hall and picked up the phone. "Talk to m
e."
"I'm here. Other doctors are checking her out now; I'll have a look in ten minutes or so. I'd say, get Annie to sleep and get her prepped. This woman looks healthy. I'll call you in twenty when I know for sure."
I hung up, and Jenny ran the IV into Annie's arm. The drugs worked slowly, giving us about five minutes. I sat down next to the bed, and Annie slid her hand beneath mine. For the next three minutes I watched her fight a losing battle against her eyelids. During that time, her mouth said nothing, but her heart spoke volumes.
A minute later, she was asleep.
Cindy waited in the room while I walked down the hall to the OR and met, or got reacquainted with, the team. When I entered OR4, the phone lit up and the perfusionist, who stood closest, picked it up. She turned to me. "It's Royer." His calling meant bad news. I took the phone.
"Reese, the heart is showing signs of disease. Getting crunchy. Not a problem now. We can put it in her, but then we've got to tell her that she's got to go through this again in five years or so. How do you think she'll handle that?"
"Probably not too well."
"You've spent time with her. Day-in, day-out time. What's your call?"
I leaned against the wall, closed my eyes, and thought of Annie, trusting me with her life. I wondered whether she had the strength to wake up and hear that she didn't have a new heart. I also wondered whether we had time to find another one.
`Donny," Royer said, "at best, this is a Band-Aid. Can she hold off?"
One of the most difficult aspects of transplantation was making decisions with people's lives that could kill them if you were wrong. It made it that much worse when you loved them.
"Yes."
"Let her sleep, and we'll break the news tomorrow. The rest will do her some good."
"See you in a few hours."
"And, Jonny?" I heard my friend talking, not my partner. "We'll find one."
"See you shortly."
On the surface, Cindy took the news pretty well. When I suggested we go to the Varsity and grab a chocolate shake, she nodded, and not until we got in the car and away from the hospital did she crack. The tears came all at once. Niagara Falls and she cried loudly.
I pulled off the interstate and wound through the buildings at Georgia Tech. When I found an open parking spot, I parked, and Cindy fell against my shoulder. She shook, clenched her fists, buried her face in my chest, and screamed at the top of her lungs. The years of worry and holding it all together had finally crumbled.
"I can't live like this! I can't! Please! What kind of a sick life is this?" Cindy pulled at her shirt. `Just cut me open. Take mine. I don't want it anymore, and if she can't live, I don't want to." She cried and shook her head as though bees were stinging her face.
I held her tight and said nothing. I felt the release, the warmth of tears on my chest, the rise and fall of anguish and despair.
How many times had I wanted to scream the same way? To purge myself and release the pain in my soul. But somehow, I never had. Maybe those who felt free to do so were only those who didn't possess the guilt of having put the pain there in the first place.
Minutes passed. Finally she wiped her eyes, sat back in the seat, and propped her feet on the dashboard. I put the stick in drive, and we wound slowly through the campus and into the drivethrough at The Varsity. I ordered a shake and a PC: short for "pure chocolate." Nothing but some chocolate milk poured over crushed ice. When the drinks arrived, we sipped in silence.
A WEEK PASSED. A LONG ONE. ANNIE HAD GROWN QUIET SINCE she woke, but she took the news as well as could be expected. While I tinkered with the surface coating on the Hacker and the surface coating on my heart, Cindy and Annie read some of the books in my house and ran their toes through the sand along the shore of the lake.
Without their knowledge, Royer and I had delivered a perfusion machine to Rabun County, along with half the sixteen pints of blood donated by her many friends. It was a just-in-case precaution. If Annie ran into trouble and we were lucky enough to get her to Rabun, that machine would give us options that we might not have otherwise. We also, with Annie's knowledge, gave her stepped-up doses of what might be considered ultrahigh amounts of antibiotics. Since we had given her the painful shots in her legs, we had kept Annie's blood swimming in the best and most aggressive antibiotics we could administer without killing her.
One morning, after I had made her swallow her horse pills, she gulped, wrinkled her lips, and then tugged on the leg of my jeans. I knelt on the kitchen floor and brought my face level to hers. Reaching behind her neck, she unclasped her sandal, gave it a long look, and motioned me closer. As I leaned in, she hung it around my neck. "It's yours now."
Cindy held up the doorframe and watched, her eyes on Annie.
I shook my head. "Annie, I can't. . ."
Annie shook her head, held out her hand like a stop sign, and took a deep breath. "Nope, we've talked about it." She looked at Cindy, Cindy looked at me, and Annie looked back. "Besides, I already told you ... I won't need it."
I looked down and read the thumb-worn letters on the back.
Annie continued, "But! There's one condition."
I looked up. "What's that?"
She stood up on her chair and pulled me up with her-her eyes level with mine. "You must always remember ..." She patted my heart gently with her hand.
My heart knew what was coming, and it took every ounce of strength within me to let her finish. The tears collected in the corners of my eyes, but she caught them before they fell.
"Whether I wake up or not ...... she whispered, "I'll have a new heart."
I picked her off the chair, wrapped my arms around her neck, and knew then that she was right.
IT WAS NOW LATE SEPTEMBER, WHAT CHARLIE AND I REFERRED to as the wet and ugly month. When the late summer hurricanes made their annual migration across Florida, they would demolish whatever cities happened to be in their paths, spin out their madness across the rest of the state, and then turn northeast and drive the residue of their systems up through Georgia and beyond. There they would continue their terror, mostly through rainfall, before flinging themselves back out into the northern Atlantic and disappearing.
Most systems spun out their anger and dwindled by the time they reached Atlanta, but occasionally, one system would reach the residue of another system moving south out of Canada. When those two systems collided, cold air from Canada hitting the warm air from the Gulf, problems arose. The Palm Sunday Killer caught everyone by surprise because of the time of year and the fact that, according to the weatherman, no system was soon to collide with any other system. I guess that's why it was remembered as a "killer."
At least with hurricanes, we knew to be on the lookout. Problem was, on Saturday evening, we were quietly listening for the ringing or pulsating of cell phones and pagers. Not the sound of a freight train pummeling straight up the lake.
There's not a train track within several miles of Lake Burton. Sometimes, at night, when the air is clear, you can hear a faraway whistle, but never during daylight hours. That's why the sound of a coming train brought me running out of the woodshop.
I saw the waterspout rising above the trees and felt the air charged with electricity. By the time I got to Annie, she had seen the spout and frozen in fear. I picked her up, and she and Cindy and I ran back toward the workshop. We reached the doors just as the trees started snapping around us. I turned, and the spout rose about a mile high out of the lake and toppled from side to side like a flag waving in the breeze.
I leaned against a rolling toolbox, inching it out of the way, and the roof started to shake. When the tin started peeling back and the glass windows shattered, I flipped their heart-of-pine kitchen table on end, covering half the door, rolled the toolbox in front of it to wedge it into place, and we slipped farther back into the L-shaped bunk room and turned the corner.
Inside the rock, it was quiet, damp, and very dark. We sat on my bunk, huddled together, unable to see our hands in front
of our faces. Cindy cradled Annie in her lap while I blanketed the both of them. The noise and flashing light around the corner told me that the workshop was coming apart at the seams.
Behind it all, Annie was whispering. I could only hear bits and pieces.
"... bind up the brokenhearted ... beauty for ashes ... oil of joy for mourning ..."
For maybe thirty seconds, we braced for the blow that would bring the rock down around us, and then, just as quickly as it had appeared, it was gone. Blue light and silence crept around the corner. We sat in the dark rock hole, listening to the sound of our breathing. And that's when it hit me.
Annie had quit whispering.
I felt her wrist for a distal pulse and didn't find one. I touched her neck and felt the fibrillation.
In the dark, Cindy couldn't see what was going on, but she didn't need to. "Reese?" she said with the panic building.
I grabbed Annie and pushed against the table and toolbox that now lay on its side. I walked out into where the workshop had once been and looked around, but it was gone. Tools, power cords, and wood splinters covered the ground as though someone had taken a weed whacker to every tool I'd ever owned. The only thing still in its place was the concrete floor. The walls, roof, everything, had disappeared.
Before me lay the lake, scattered in debris that had once made up homes for miles down the lake. I looked for the boathouse, but the only thing that remained were the twenty-four pilings it had once stood on. No walls, no deck, no hammock. If I had to guess, I'd say the Hacker never even hit the water before the tornado gave it wings and sent it heavenward.
I looked at Annie. Her color was ashen, her lips blue, her eyes were falling back behind her lids, and her body was a twitching combination of limpness and lockjaw rigidity. She had maybe three minutes. If I could make it to the house, I might have time. I turned, but except for the chimney, the house too was gone. And along with it, everything I needed.
I laid Annie on the floor and flung open the drawer of the toolbox, slinging tools and parts of tools across the floor. Inside, I found Charlie's bag of barbecue basting utensils. Inside was the injecting needle. I pulled the needle, lit the lighter in my pocket, and fanned the needle through the flame.