Mend the Living (27 page)

First they have to work on the vessels that carry the blood in and out of the organ. One by one, the veins are cut, closed, manipulated – Harfang and Virgilio work fast, but it seems that the speed is what carries the action, that if their hands slowed they would risk trembling – then, it’s incredible, the heart is lifted from the body and the extracorporeal circulation is put in place: a machine replaces Claire’s heart for two hours, a machine that will reproduce the blood circuit in her body. At that moment, Harfang requests silence – he clinks a blade against a metal tube and, from behind his mask, recites the ritual phrase for this stage of the operation:
Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus
(An Anatomical Exercise on the Motion of the Heart and Blood in Living Beings) – homage to William Harvey, the first physician to describe, in 1628, the human circulatory system in its entirety, already naming the heart as a pump with a hydraulic effect, a muscle ensuring the continuity of the flow by its movements and pulsations. Without missing a beat, each person in the O.R. responds: amen!

The perfusionist is disconcerted by this strange ritual. He doesn’t know Latin and wonders what’s going on. He’s a nurse with turned-up eyelashes, a young guy, twenty-five or twenty-six, the only one here who has never worked with Harfang before. He’s sitting on a high stool in front of his machine, rather like a disc jockey at the turntable, and no one here would know better than him how to find their way around the pandemonium of wires that protrude from big black boxes. Filtered, oxygenated, the blood rushes into a tangle of thin transparent tubes, colour-coded stickers identifying the direction of flow. On the screen, the electrocardiogram is flat, the body temperature is thirty-two degrees Celsius, but Claire is fully alive. The anaesthetists take turns checking the vitals and the IVs. We can go ahead.

Virgilio bends down to pick up the heart from the container. The ligatures of the different pockets that protect it are sprayed with disinfectant, then opened, and finally he takes the organ from the jar, holds it with both hands, and places it deep inside the rib cage. Alice, still poised on tiptoe on the metal stool, keeps her eyes fixed on it, fascinated, and nearly loses her balance when she leans forward to see what’s happening there, inside the body; she’s not the only one to crane her neck like that – the O.R. intern who’s come to stand beside Harfang leans forward too, so dripping with sweat that his glasses slide down his nose and threaten to fall off – he pulls back at the very last moment, pushing them up his nose and bumping into a drip – watch it, please, the anaesthetist says sharply before handing him a compress.

The surgeons now begin the long task of sewing: they work to reconnect the heart, moving from bottom to top, anchoring it at four points – the recipient’s left atrium is sewn to the corresponding part of the left atrium of the donor’s heart; same for the right atrium; the recipient’s pulmonary artery is lined up with the donor’s right ventricular outflow tract, the aorta to the left ventricular outflow tract. Virgilio massages the heart at regular intervals, pressing hard with both hands, his wrists disappearing inside Claire’s body.

A more routine rhythm falls into place now, snippets of conversations swell, sometimes a hubbub of O.R. banter, insider jokes. Harfang asks Virgilio about the game with this mix of condescension and feigned complicity that annoys the Italian: so, Virgilio, what do you think about the Italians’ strategy, do you think it makes for a good game? And the young man replies shortly that Pirlo is an incredible player. The body is operated on in a state of hypothermia, but it’s hot now in this O.R.; they sponge the physicians’ foreheads, temples, and lips and help them to change clothes and gloves regularly – the nurse unseals packages and holds the gowns out flat and inside out. The human energy expended there, the physical tension but also the dynamics of the action – nothing less than a transfer of life – couldn’t help but produce this cloud of moisture that begins to form, to hover in the room.

The work of suturing is finally complete. They flush out the organ, evacuate the air in order to prevent bubbles from rising to Claire’s brain: the heart can now receive the blood.

The tension spikes again around the table and Harfang says: okay, we’re ready, we can start the flow. This is it. The filling happens by the millilitre, requiring a highly calibrated flow – too sudden and the heart could deform and never go back to its original shape – the nurses hold their breath, the anaesthetists are on the alert, the perfusionist is sweating too; only Alice remains imperturbable. No one moves in the O.R. A compact silence covers the operating table as the heart is slowly irrigated. Then comes the electric moment: Virgilio picks up the defibrillator paddles – and holds them out to Harfang – they remain aloft long enough for their eyes to meet and then Harfang nudges his chin in Virgilio’s direction, go ahead, you do it. And maybe in that moment Virgilio gathers up all he knows of prayer and superstition, maybe he pleads with Heaven, or, on the contrary, maybe he takes hold of everything that has just been accomplished, the sum of actions and the sum of words, the sum of spaces and emotions – and carefully places the electric paddles on either side of the heart, casting a glance at the electrocardiogram screen. Everyone clear? Shock! The heart receives the shot, the whole world stands still above what is now Claire’s heart. The organ stirs faintly, two, three spasms, then goes still. Virgilio swallows, Harfang has placed his hands on the edge of the bed and Alice is so white that the anaesthetist, scared she might collapse, pulls on her arm so she’ll come down from her standing stool. Second try. Clear?

– Shock!

The heart contracts, a shudder, then moves with nearly imperceptible tremors, but if you come closer, you can see a faint beating; bit by bit the organ begins to pump blood through the body, it takes its place again, and then the pulsations become regular, strangely rapid, soon forming a rhythm, and their beating is like that of an embryo heart, this twitching that’s perceivable from the first ultrasound; and yes, it is the first heartbeat that can be heard, the very first heartbeat, the one that signifies a new beginning.

Did Claire hear Thomas Remige’s song during her anaesthetized dreams, this song of a good death? Did she hear his voice in the dark, at four in the morning, when she was receiving Simon Limbeau’s heart? She’s placed on extracorporeal life support for another half-hour, and then she too is sewn up again, retractors releasing the tissue for a delicate damsel’s suture, and she remains under surveillance in the O.R., surrounded by black screens that show the luminescent waves of her heart, long enough for her body to recuperate, long enough for the crazy state of the room to be tidied, long enough for them to count the instruments and compresses, for them to wipe up the blood, long enough for the team to break up, and for each one to take off their O.R. clothes and get dressed again, to splash water on their faces and wash their hands, then leave the hospital to go catch the first metro, long enough for Alice to regain her colour and venture a smile while Harfang whispers in her ear, so, little Harfanguette, what do you think of all this? long enough for Virgilio to push back his sterile cap and pull down his mask, to decide to ask Alice to go have a beer near Montparnasse, a plate of fries, a rare steak, that old story of prolonging the moment, long enough for her to pull on her white coat again and for him to caress the animal collar, and long enough, finally, for the underbrush to grow light, for the mosses to go blue, for the goldfinch to sing and for the great wave to come to an end in the digital night. It’s five forty-nine.

TRANSLATOR’S NOTE

I ended up in the south of France again this past winter, in Arles, at the residency dedicated to literary translators where I first worked on Maylis de Kerangal’s novel
Naissance d’un pont
(
Birth of a Bridge
). The residency is housed in the old hospital where Van Gogh was admitted at various times in his difficult life. Between stays, he painted scenes of the garden: a square plot enclosed in a stone courtyard, divided neatly into geometric sections, dominated by the colour yellow and converging at a central fountain where there once were fish. Each day that I grappled with Maylis’s labyrinthine phrases, I walked through this garden, and each day I experienced a kind of doubling of consciousness. I breathed in the present-day scents of earth and irises in bloom, simultaneously feeling like I was walking in Van Gogh’s painting
The Courtyard of the Hospital at Arles
from 1889. This seemed to echo the doubling of mind I was experiencing as I translated this book – thinking, sensing, in two languages – the English sentences like a transparency lain over the original.

As in
Birth of a Bridge
, this book pulls us into the streaming realm of long sentences and what Maylis has called a “language hold-up” (
braquage du langage
) – an inventive use of rare words and concrete vocabularies. Her way is to mix the very tactile, grounded aspects of life with metaphysical observations, in prose that astounds or makes things strange, shimmering, beautiful.

Here again, as in
Birth of a Bridge
, character names contain a plethora of references and significance. In my recent conversation with Maylis for
Bomb
magazine, I learned that she cannot begin writing a book until she knows the character names. She describes names as little stones within a sentence – they remain unchanged, but illuminate the words around them. Birds, flight, tragedy, and fixity are themes in the cast of names for
Mend the Living
. “Revol” contains
vol
(flight), revolt, and revolution – the Revolution of 1959, the character’s birth year; “Remige” is a flight feather; “Harfang” is a male snowy owl; and the last name of Cordelia “Owl” needs no explanation. “Cordelia” is also reminiscent of Lear’s daughter, linking her to tragedy and the heart. Marthe “Carrare” reminds us of the marble of antiquity, the time of classical Greek tragedies. “Marianne” evokes the Mariana Trench (
La fosse des Mariannes
), that bottomless chasm. “Juliette” is another clear link to tragedy and to love. And then there’s Simon. Simon’s last name in the French book is
Limbres
, which is one letter away from the French word for limbo – les
limbes
 – and is also very near to the word for darkness and shadows –
l’ombre
. These echoes would almost certainly have been lost for an Anglophone audience, so I chose to translate this central name. My deep thanks to David Gressot for first suggesting and helping me arrive at “Limbeau.”

Anyone who spoke to me during the translation of this book knew that I grew obsessed with the digital night of the penultimate sentence:
le temps … que s’achève le grand surf dans la nuit digitale
. What did she have in mind, what image did she intend to project with this enigmatic descriptor,
digitale
? And how to approach the fact that French has two distinct words where English has only one – “digital” means both “of or relating to fingers or toes” (
digitale
) and “using or characterized by computer technology” (
numérique
). Because I’m in touch with her, I know that there were archaeological layers of meaning Maylis wished to express with these few words. She was thinking of the trace writing leaves behind, the trace of this book and the heart transplant described within; night as a kind of screen (but not a computer screen) on which you might press the tips of your digits, leaving behind tactual prints. A gesture toward memory and the act of writing. As I searched for a way to convey all these intentions, I combed through words that express the “digits” aspect of “digital” (words like “metacarpal,” “phalangeal,” “manual,” “manipulate”). I spoke to Francophone friends about how much the sense of “digital” (as related to computers) was in their hearing of
digitale
 – a fair bit, they said (it seemed it might not be so distinct from
numérique
after all). When I found the word “dactylic” I thought I had struck gold – a word that relates to fingers and also to literature! – but I quickly discarded it, not least because it was causing people to think of flying dinosaurs. More than one person suggested that what was important was translating what the reader would get, as opposed to the mostly invisible strata of meaning in the author’s mind. (Should one “be true” to the author or to the text?) After a long circuitous journey, I arrived back at “digital,” in the original sense of the word, because it’s softer, and because it echoes the digitalis of the foxgloves, the homeopathic cure for a weak heart.

At some point while I was in France, during the year I spent working on this translation, a friend sent me a mid-fever revelation he’d had:
art is home
. And I realized that
Réparer les vivants
was the closest thing I’d had to a home in months. All my stuff was in storage. This book was where I spent my time. This book was my constant. On quays and couches in Arles, on mountain paths in Banff, on buses and trains I lived inside these sentences. And in all the places this book took me, there were people who helped me find an expression or solve a linguistic dilemma. Huge thanks to David once again, whose love for this author’s work remains steadfast and inspiring; thank you to Dominique for many consultations, to Julie, Valérie, Hélène, and all the other translators and staff at the
Centre international des traducteurs et traductrices littéraires
; to Anglophone friends, my mum and Erin in particular, for puzzling out all things digital and phalangeal with me, and to my sister Breanna for consults on what the kids these days are saying; to Alayna for the lake house; and to the Banff group, especially to Katie for encouraging me to take measured risks and to Maryse for helping decode. Thank you to Nadia and the editors and
Brick
magazine, and to Mónica and editors at
Bomb
magazine in New York. My gratitude to the team at Talonbooks, to Charles for a second pair of eyes on the French text, to my editors Ann-Marie and Shazia, and to Kevin. This book, my home for a time, becomes a new work as it, like Simon Limbeau’s heart, “migrates over the orbs, along the rails, along the roads,” reaching this other language. May it bring great richness.