Authors: Maylis de Kerangal
Tags: #Fiction, #Medicine, #Jessica Moore, #Maylis de Kerangal, #Life and death, #Family, #Transplant, #Grief
The young man who had rushed over, furious to have been duped, reproached her for a lack of restraint in her performance, angina isn’t a heart attack, you’re getting the two mixed up, it’s not the same thing, you should have played it with more delicacy and complexity, you’re messing up the exercise. To make sure he’s been understood, he lists the symptoms of angina one by one – constrictive chest pain, sensation of being crushed across the span of the chest, of being squeezed in a vise, sometimes with other characteristic pains in the lower jaw, one of the two forearms, or more rarely the back, the throat, but you don’t collapse; then he details the symptoms of cardiac arrest – heartbeat shoots up to more than three hundred beats per minute, a ventricular fibrillation that causes the breath to stop, which causes a blackout, all in less than a minute – he keeps going, he could enumerate the treatments now, list the medications, the antiplatelet drugs that facilitate blood circulation and nitroglycerin that relieves pain by dilating the coronary arteries, he’s bewitched, doesn’t know what he’s saying anymore, can’t stop talking, tosses out sentences like lassos in order to keep her close to him, soon his heart races at an abnormally high speed, a tachycardia that approaches two hundred beats per minute, he’s at risk of experiencing the very same ventricular fibrillation that he just described, at risk of fainting, ridiculous, Rose has turned toward him, slow, arrogant as a newborn star, looks him up and down and tells him all smiles that there was a bear sitting on her thorax, if he only knew, and says with a glint in her eye, sure, she’ll start over again, as long as he plays the bear, he has the physique and the finesse, I’ll bet my life on it.
Virgilio Breva does indeed resemble a bear with his suppleness and slowness, his explosive energy. And yet he’s a tall dark blond, stubbly beard and smooth hair tossed back, foaming at his nape, straight nose, fine features of a northern Italian (from Frioul). Otherwise the digitigrade gait of the sardana dancer when he’s nearing a quintal, the corpulence of an ex-obese man calibrating him in thickness, in fullness, but without visible excrescence; in other words, without folds and without fat – his is simply a fleshy body, an even layer enwrapping him and growing fine toward the extremities of his arms, his beautiful hands. An attractive and charismatic colossus, of a considerable stature that matches the eloquence of a warm voice, the enthusiastic though marked-by-excess moods, the bulimic appetite for knowledge and the exceptional capacity for hard work; yet his body has its painful fluctuations, an elasticity that causes him to suffer; it contains its share of shame and haunting – trauma from having been mocked, called chunky, tubby, roly-poly, or simply fat, anger for having been scorned, for having floundered sexually, mistrust of all kinds – and lodges all this self-disgust like a supplication in his stomach. Under constant scrutiny, he spent hours being examined for a speck of dust in his eye, was hydrated extensively for a sunburn, inspected closely for a hoarse voice, torticollis, fatigue: this body is Virgilio’s great torment, his obsession, and his triumph – because now it pleases people, it’s undeniable, you should see Rose’s eyes roving over it – and those who are thick-skinned, jealous of his success, sneer and say that he became a doctor simply in order to learn to master this body, balance its moods, and tame its metabolism.
Top of the class at the residency in Paris, knocking back years of study rapidly, reducing them to twelve, university fellowship and assistantship of surgery included, while most students who chose the same course of study stretched it out over fifteen years – but also, I don’t have the means, he likes to say, charming, I’m not an old boy, and he plays up the role of the unknown wop, son of immigrants, illegitimate, the hardworking scholarship student, over the top – as creative with theory as he is prodigiously gifted in practice, flamboyant and proud, carried forward by an Atlantic ambition and an inexhaustible energy, he gets on a lot of nerves, it’s true, and is often misunderstood. His mother, panicked by his success, valuing social above intellectual hierarchies, finally looks at him sideways, asks herself how did he do it, what was he made of, who did he think he was, this kid, while he flew into fits of rage to see her wringing her hands and then drying them on her apron, to hear her say plaintively on the day of his thesis defence that her presence was useless, that she wouldn’t understand anything anyway, that it wasn’t her place, that she’d rather stay home and cook a feast just for him, these pâtés and these cakes that he loved.
He chose the heart, and then heart surgery. People were surprised, thinking he could have made a fortune examining naevi, injecting hyaluronic acid into frown lines and botox into the curves of cheekbones, reshaping the flabby stomachs of multiparous women, x-raying bodies, developing vaccines in Swiss laboratories, giving conferences in Israel and in the States about nosocomial infections, or becoming a high-end nutritionist. Or that he could have basked in renown by opting for neurosurgery, or even hepatic surgery, specializations that sparkled in complexity and cutting-edge technology content. But no, he chose the heart. The good old heart. The state-of-the-art heart. The pump that squeaks, that leaks, that gets blocked, that’s on the blink. A plumber’s job, he likes to say: listen, poke and prod, identify the breakdown, change the parts, repair the machine – all that suits me perfectly, hamming it up, hopping from one foot to the other, he minimizes the prestige of the discipline while at the same time allowing all of it to pander to his megalomania.
Virgilio chose the heart in order to exist at the highest level, counting on the organ’s sovereign aura to rain glory down upon him, as it did upon the heart surgeons who whipped along hospital corridors, plumbers but also demigods. Because the heart exceeds the heart, he is well aware. Even dethroned – the muscle’s movement no longer sufficient to separate the living from the dead – the heart, for Virgilio, is the body’s central organ, the site of the most crucial and essential manifestations of life, and its symbolic stratification over centuries remains intact. And even more, as the cutting-edge mechanic and ultrapowerful fantasy operator all rolled into one, Virgilio sees the heart as the linchpin of depictions (paintings and poems) that organize the relation of the human being to the body, to other beings, to Creation, and to the gods; the young surgeon is amazed at the way it’s imprinted in speech, at its recurrent presence precisely at this magic point of language, always situated right at the intersection of the literal and the figurative, the muscle and the affect; he takes great delight in metaphors and figures of speech in which it is the analogy of life itself, and he repeats ad infinitum that although it was the first to appear, the heart will also be the last to disappear. One night at the Pitié, sitting in the staff room with the others in front of the huge fresco (painted by interns) – a spectacular entanglement of sex scenes and surgical acts, a sort of gory orgy, campy and morbid, where a few bigwig faces appear from between enormous asses, breasts, and pricks, among them one or two Harfangs, most often portrayed in the act, doggy style or missionary, scalpel in hand – Virgilio told the story of the death of Joan of Arc with flair, eyes shining like marbles of obsidian, slowly recounting how the captive was brought in a cart from the prison to the Place du Vieux-Marché, the square where crowds had gathered; he described the slim figure in the tunic that had been smothered with sulphur so she would burn faster, the pyre too high, the executioner Thérage who climbs up to tie her to the stake – Virgilio, galvanized by the attention of those listening, acts out the scene, tying solid knots in the air – before setting fire to the fagots like a man of experience, the arm that lowers the torch onto the coal and oily wood, the smoke lifting, the screams, Joan’s cries before suffocation, the scaffolding blazing like a flare, and then this heart they discovered intact after the body was burned, red beneath the embers, whole, so that they had to stoke the fire again to finally be rid of it.
Exceptional student, intern extraordinaire, Virgilio confounds the hospital hierarchy and struggles to nestle into groups with shared destinies, professing with equal militance an orthodox anarchism and a scorn for family dynasties, incestuous castes, and biological collusions – and yet, like so many others, he is fascinated by all the Harfangs in the profession, drawn to these heirs, captivated by their reign, their health, their sheer numbers; he’s curious about their estates, their tastes and their idioms, their humour and their clay tennis courts, so that being welcomed at their homes, sharing their culture, drinking their wine, complimenting their mothers, sleeping with their sisters – a crude devouring – all of this drives him crazy, and he schemes like a madman to get there, concentrating hard as a snake charmer, then hates himself as soon as he awakes, seeing himself in their sheets, suddenly uncouth, viciously offensive, an uncivilized bear rolling the bottle of Chivas under the bed, ransacking the porcelain from Limoges and the chintz curtains, and he always ends up fleeing from there, forlorn, lost.
His entry into the department of heart surgery at the Pitié-Salpêtrière raises his emotionalism a notch: conscious of his worth, he is immediately suspicious of barnyard rivalries, ignores docile dauphins, and works to get close to Harfang, to approach him intimately, to hear him think, doubt, tremble, to catch the very second of his decision and to perceive him in the momentum of his action; he knows that it’s by being near him that he will learn from now on, here and nowhere else.
In the taxi, Virgilio checks the composition of the Italian team on the screen of his
telefonino
, checks that Balotelli is playing, Motta too, yes, that’s good, and Pirlo, and we have Buffon, then exchanges predictions and insults with two other clinic directors who’ll go out tonight and drink to his health before a giant plasma screen, French men who detest the Italians’ defensive game and cheer for a team that’s physically underprepared. The vehicle speeds along the length of the Seine that lies flat and smooth as a laneway, and as they near the entrance to the hospital, Chevaleret side, he makes an effort to quell his excitement and his torment. Soon he’s simply smiling, not responding to the messages from the other two, forgetting about the bets and the one-upmanship. Rose’s face reappears, he starts to type her a gallant text – something like: the curve of your eyes encircles my heart – and then changes his mind, the girl is nuts, she’s crazy and dangerous, and he can let nothing, tonight, come to disturb his concentration, his self-control, he can let nothing affect the accomplishment of his work.
T
he retrieval teams arrive one after the other starting at 22:00. The ones from Rouen show up in a car, since only an hour’s drive separates the CHU from the hospital in Le Havre, while those from Lyon, Strasbourg (the Alsatians), and Paris will have taken a plane.
Coordinating teams have organized their transportation, called a charter airline that accepted this Sunday mission, and made sure that the little airport in Octeville-sur-Mer is open at night, formalizing all the logistical details. At the Pitié, Virgilio paws at the ground with impatience beside the nurse on duty who is phoning everyone – he doesn’t immediately notice the young woman in a white coat, also standing there, silent, who pushes herself up from the wall when their gazes meet and comes toward him, hello, I’m Alice Harfang, I’m the new intern in the department, I’ll be doing the retrieval with you. Virgilio looks hard at her: no white lock grows in a cowlick in the middle of her forehead but there is no doubt she’s one of them, and ugly, ageless, with yellow eyes and a nose like an eagle’s beak, grandfathered in. A shadow comes over him. The handsome white coat with the fur collar bothers him especially. Not exactly the perfect outfit for slogging in hospitals. She’s the kind of girl who rolls up like a tourist and believes money grows on trees, he thinks, irritated. Okay, well I hope at least you’re not scared of flying? he asks curtly and then turns away as she’s replying no, not at all; the nurse on duty holds out a freshly printed map, you can go ahead, the plane is on the tarmac, takeoff’s in forty minutes. Virgilio picks up his bag and strides toward the department doors without a look at Alice, who follows close on his heels, then the elevator, the taxi, the highways, and the Bourget airport where they pass jetlagged businessmen in long cashmere overcoats clutching luxury handbags, and soon they can both be seen climbing into a Beechcraft 200 and buckling their seat belts without having exchanged another word.
The weather is fair: only a little wind and no snow, not yet. The pilot, a handsome woman in her thirties with perfectly straight teeth, announces good flying conditions and an estimated journey of forty-five minutes, then disappears into the cockpit. As soon as he is seated, Virgilio plunges into a financial magazine left behind on his seat; Alice turns toward the window and watches Paris become a tapestry of sparkling threads as the little plane gains altitude – the almond shape, the river and the islands, the squares and the main arteries, the bright zones of the boutique neighbourhoods, the dark zones of the projects, the parks, all of it darkening if you let your gaze wander from the heart toward the fringes of the capital, above the bright circle of the ring road; she follows the path of tiny red and yellow dots that flow along invisible streets, silent animation of the earth’s crust. And then the Beechcraft rises above a hydrophilic substance and here it is – the celestial night; and probably now, disconnected from Earth like this, projected outside any social cadastre, Virgilio begins to think of her differently, the woman who accompanies him – maybe he begins to find her less repellent – is this your first harvesting? he asks. She starts, turns from the window and looks at him: yes, first harvesting, and first transplant. Virgilio closes his magazine and warns her: the first part of the night can be overwhelming, it’s a multiple-organ retrieval, the kid is nineteen, we’ll probably take everything, the organs, the vessels, the tissues, shoop, we’ll scrape out everything – his hand opens and closes in an ultrarapid contraction of the fist. Alice looks at him – her expression, enigmatic, could just as easily signify “I’m scared” as “I’m a Harfang – did you forget already?” – then she brings her chairback up and fastens her seat belt again, as Virgilio, jostled, does the same: they’re beginning the descent into Octeville.