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November 1, 2011 | Fiction

Darwin and the Heart Lobotomy

Carmela Starace

Darwin and the Heart Lobotomy photo

This is the story about how I lost my husband.

 

 

Jamie had been in the hospital getting blood work and pre-op type treatment since finally,finally, he’d made it to the top of the transplant list and there was a donor match. While he was getting treated like a pincushion, I tried my best to make his room more comfortable with stuff from home. I brought his favorite lamp, framed photos, a vase with some flowers. The nurses didn’t like it one bit.

“You’re getting me in trouble,” Jamie said as I pulled a stack of vintage books out of my bag and lined them on the windowsill.

“You can take it,” I said. “Just flash them your James Franco smile and remind them you are having a heart transplant. They’ll be putty in your hands.”

“It’s not right to abuse my powers like that. I can’t help it if I’m irresistible.”

The word irresistible shocked me into stillness. He’d said the exact same thing three weeks earlier when I’d caught him making out with one of his grad students during an end of semester get-together at our apartment. But before I could get angry about it all over again, Dr. Parker arrived. Normally a benign guy, Dr. Parker walked in with fisted hands and teeth grinding.

“What’s wrong?” I asked the doctor without saying hello.

“Ask Jamie,” Dr. Parker said poking his index finger in three short jerking motions in the direction of my husband.

We both stared at Jamie.

“What?” he asked laughing. “Don’t look at me. I’ve been a good boy.”

“It seems,” Dr. Parker said, “that in fact you have not been a good boy.”

Jamie immediately became serious. “What are you talking about?”

“I am talking about the drug test we gave you yesterday. It came back positive.” Dr. Parker’s voice rose with each word so that by the time he got to the word “positive” he was just short of yelling.

I watched Jamie’s face drain of color as I collapsed into the chair behind me. Jesus Christ. We were our own Greek tragedy.

“Well? Come on. Tell me. Why exactly are you snorting cocaine a week before you have a heart transplant? Why are you snorting cocaine at all? You have a single damaged heart. A poor broken solo organ working over time to keep you alive and you thought cocaine would be the right thing to do to it? Are you suicidal?”

Jamie and I looked at each other. I covered my eyes with the heels of my hands hating myself. Hating him. Hating the world.

“We didn’t know,” Jamie said for both of us. “How were we to know you would finally call now? I’ve been on that list for five years. Five years of no salt, no exertion, taking eight pills a day, meditating, no red meat, no smoking, hooking up to machines, having pace makers put in, having pace makers taken out. Last weekend I turned thirty-five. We just wanted to have one normal night. We wanted to go out and dance and feel like we did ten years ago. We drank. We did a little coke. How were we to know? How the hell were we supposed to know that now finally you would call?” He was crying as he spoke. Not balling, but red and wet in the eyes.

“Well I hope it was worth it,” Dr. Parker said sounding more tired then angry. “You’ve been removed from the wait list. Drug use is automatic expulsion. It’s over. They’ve already reassigned the heart to a boy in Dallas.”

“What?” I said rising from the chair. “They can’t do that. That’s Jamie’s heart.”

“It was Jamie’s heart. But it’s gone. And he’s off the list. It’s over. I’ll have the staff physician discharge you.” He turned and walked towards the door.

“Wait a minute,” I screamed. “Just wait a minute. What about...” I looked at Jamie. The bones in my spine and shoulders turned to gel as I worked up to what I had to say. “What about Plan B? We can still go forward with me as the donor.”

This stopped Dr. Parker in his tracks. He’d made it no secret that he was dying to do the procedure one way or the other and his greedy little face betrayed the hint of a smile.

“Yes,” he said. “We can still do that.”

“No we goddamn can’t,” yelled Jamie. “It’s not an option. You need both of yours,” Jamie said to me.

Technically, that wasn’t true. Medicine had long ago proven that none of us actually needed both of our hearts to live. Similar to kidneys, one heart was enough to fulfill the physiological job of the organ. But unlike kidneys, there were other, more severe side effects associated with heart donation—side effects that both Jamie and I had decided long ago made me being a donor out of the question despite having discovered I was a match.

“I’d rather have one heart and know you are alive,” I said, meaning it at the time.

“No. I won’t take it. I’ll check out right now. We’ll find another donor. We’ll figure something else out.”

“You’re off the list Jamie,” Dr. Parker reminded him. “Drug use, even once, means you will never get a heart through the transplant network. You’ve been looking for a private donor for over three years now. You haven’t found a single one. And I know you’re about three hundred thousand dollars short of being able to buy one.”

“We can keep looking,” Jamie said to me. “We can keep trying.”

“Baby,” I said grabbing his hand. “I can’t. I can’t keep trying. I just want to know that it’s over. That you are okay. Even if it means we aren’t together. I just can’t stand this... waiting anymore.” I looked at Dr. Parker. “Can I be in this room?” I indicated the empty bed on the other side of the curtain.

“We can have you in here for all the pre-op work up to the surgery. After that, we’ll have to put you on a different floor. That’s normal protocol with donors.”

“I want to do it tomorrow. Can we go that soon?”

“Wait,” Jamie said, his voice a shadow.

“We have everything ready. We’ll have to do work on you today.”

“Fine,” I said looking for my purse, my cell phone. I needed to call work.

“No damn it. It is not fine.” Jamie said.

“I’ll leave you two to talk. Someone will come by in about an hour to get you admitted.” Dr. Parker walked out without acknowledging Jamie.

“What the fuck are you doing?” Jamie said.

“Please,” I said lying down next to him. “We need to accept it. I don’t want to spend the last day fighting.”

“It’s not worth it. I’d rather be dead. I’d rather be dead then not be able to go near you. And I’d damn well rather be dead then know you are out there somewhere, half the person you used to be.”

It was an exaggeration, the part about being half a person. I wouldn’t be half of myself. But I would be different. Doctors discovered it after the first rush of heart donors years ago, when the living heart transplant was first introduced and loving wives and husbands and family members tripped over themselves to donate their second hearts. After two weeks it became apparent things were wrong. The donors reported no interest in activities that prior to surgery had been life long passions. Readers no longer read. Painters no longer painted. Activists no longer cared. Some people didn’t recognize their own dogs. Others lost their appetites, developed eating disorders and eventually had to have feeding tubes inserted. The manifestation of the effects was different in everyone. Try as they might, doctors could not find a pattern although there was suspicion that the type of side effects were linked to whether you donated your left heart or your right.

I took Jamie’s hand and placed it under my shirt and on my right breast. “Which one?” I asked him. “Which one should I give you?”

“Don’t do this,” he said. “You’re making it so that we will never see each other again. We’ll have to divorce. I won’t do it.”

But he would do it. I could already tell. We all have the same survival instinct. Think about it. If a mugger came up to you and held a gun to your head and said I can either shoot you dead right now or let you live if you promise never to see your wife again, what would you do? In the moment, you’d agree. No matter how much you loved her. No matter how much she was your soul mate. Given the choice between a soul mate or a soul, Darwinism demands we chose life.

Jamie wasn’t exaggerating about us not seeing each other. It was the other clusterfuck—the second big discovery made after the first string of transplants. The transplanted heart wouldn’t work right if it was within a certain distance to its mate still housed in the donor. Researchers were running experiments with chimpanzees to try to find a solution. Until then, it was a simple fact. And it made familial donations of hearts for transplant an almost unheard of thing. Oh, there were the rare sensational saintly stories, a father donating a heart to a daughter and then moving to Alaska, a brother donating to his sibling and then moving into a foster home, keeping in touch with his family every day through Skype. Television had had a bunch of shows on them a few years back, but it was out of vogue now. No one would want to see a talk show about Jamie and I, estranged forever because I gave him my heart.

We spent the rest of day in bed together, once I was checked in and had given samples of every bodily fluid conceivable. I put a chair in front of the door and a sign in the hallway asking for privacy. In between making love, we talked about practical things, where I would live, what I would take from our apartment while Jamie stayed in the hospital recuperating. We decided to split the money we’d been saving towards buying a black market heart. After years of saving, we barely had twenty percent of what we needed. He would use his half to pay for a nurse. I would use mine to start over somewhere in a different borough. We didn’t talk about how we could make it work. We didn’t talk about what would change about me once I lost my heart.

But when Jamie finally fell asleep, I couldn’t stop thinking about it. What aspect of myself would I lose? And would I even know that I had lost something? In a way, it was like a little death, some part of me gone forever and what was left having no consciousness about it. It wouldn’t bother me once it happened. So why was it giving me a massive panic attack in the hospital the night before?

I’d read interviews with former donors. They truly didn’t seem to know what they had lost of themselves. There was a flatness to them that I both admired and feared. I’d always been impulsive, frenetic, moody, energized. Maybe this heart lobotomy would be a relief. A way to not feel everything so much. I’d heard of people signing up to be donors for strangers for that very reason. Some psychiatrists recommended it for people with bipolar disorder and borderline personality. I guess the theory was that some people were too much. Taking a way a tiny bit would even them out.

If I were a better person, I would have been thinking about losing Jamie that night, not some small piece of myself. Once the surgery was over, I’d never be able to be within a hundred feet of him without giving him palpitations or a tachycardia relapse. I’d never be able to touch him or be touched by him. I’d never feel him inside me again. Strange considering a small piece of me would be inside him forever.

But that wasn’t what kept me lying awake that night. It sounds callous, but I could live without Jamie. The percentages of people waiting on the organ list far outweighed the percentage of people who had transplants and a part of me had been preparing to lose Jamie for five years, since his first hearts attack. The doctors had removed the left heart, which hadn’t worked in years and replaced the damaged valve on his “good heart” with a pig valve. Right from the start they’d told us it wasn’t going to last, that he needed a transplant. Since that day a little bit of me had known. Someday I would lose Jamie.

But I’d never thought about the fact that someday I might lose me too. I hadn’t prepared for that. Either way, Jamie was lost to me. But despite the bravado with which I’d spoken to Dr. Parker, I didn’t want to lose any part of myself. That’s the Darwinism, I guess. Anyway, that’s when I got up and got dressed.

I hope that Jamie woke up the next morning and a small part of him—perhaps even his sole damaged heart - was relieved. I like to imagine he opened his eyes and looked at the empty bed and at least for a single second was happy that I’d escaped into the night with both of my hearts. I’d like to think he had that moment of joy for me before the realization that he wasn’t going to get the transplant crashed down on him. This is the way I hope it happened. I imagine it that way.



 

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image: Ryan Molloy


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