Cutting for Stone (65 page)

I rolled my chair after him. “Dr. Stone,” I said. Every fiber of my being wanted to cry out,
Father!

He came to me. “Dr. Stone,” I said. “Surely an operation … is his only chance. Can't the neurosurgeons go in, tie off the tangled vessels, and evacuate the clot in his brain? So what if it's a long shot? It's his only shot.”

He considered this for a while.

“Son, they say the tissue in there is—sorry to say this—the consistency of wet toilet paper. Blood mixed with brain. The pressure's so high, if they so much as touch him, they tell me it'll only make him bleed further.”

I didn't want to accept that. “Can't
you
do it? You and Deepak? You've done burr holes. I've done burr holes. What's there to lose? Please? Let's give him that chance.”

He waited so long that even I could hear the fallacy of what I was suggesting. My father put his hand on my shoulder. He spoke to me gently, as to a junior colleague, not to his son. “Marion, remember the Eleventh Commandment,” he said. “Thou shall not operate on the day of a patient's death.”

When I was back in my room, Thomas Stone brought up Shiva's CAT scan. I was shocked to see the huge white splotch—which is how blood looks on a CAT scan—involving both hemispheres and spilling into the ventricles. It compressed the brain within the rigid confines of the skull. I knew then that it was hopeless.

BECAUSE OF THE ANEURYSM
or tangled vessel malformation in his brain, Shiva was not a potential donor for heart or kidneys, for fear there might be similar changes in those organs.

Hema didn't want to be there when the ventilator was discontinued. I said I'd be with him. I asked to be alone with Shiva when he passed.

Hema said her good-bye first.

I was outside the room when Vinu escorted her out. It was a heartbreaking sight to see my mother, the tail end of her sari draped over her head, her shoulders slumped, leave her still-breathing child. It must have felt to her as if she were abandoning him. Every eye in the unit was on her, and not one was dry, as her shimmering, sari-clad form floated down the hall on her way to the Quiet Room.

With Deepak's assistance I climbed onto Shiva's bed. It was eight in the evening. I settled myself next to him. Everything but his breathing tube and an intravenous line had been removed. Deepak peeled away the tape that held the tracheal tube to Shiva's cheeks. Then, with a nod from me, he injected morphine through Shiva's intravenous tubing. If any part of Shiva's brain was alive, we didn't want it to sense pain, or fear, or suffocation. Deepak turned off the ventilator, silenced its immediate shrill protest, slid the endotracheal tube from Shiva's mouth, and then he left the room.

I LAY THERE,
my head against Shiva's, a finger resting on his carotid pulse. His body was warm. He never took a breath after the tube came out. His facial expression never changed. His pulse stayed regular for almost a minute, then it paused, as if it had just realized its lifelong partner—the lungs—had quit. His heart sped up, became faint, and then, with a final throb under my fingers, it was gone. I thought of Ghosh. Of all the pulse types, this was both the rarest and the most common, a Janus quality that every pulse possesses: the potential to be absent.

I closed my eyes and clung to Shiva. I cradled him, his skull buttressed against mine and now wet with my tears. I felt physically vulnerable in a way I'd never felt when we were a continent apart, as if with his death my own biology was now altered. The heat was rapidly leaving his body.

I rocked Shiva, wedging my head against his, remembering how for so long I was unable to sleep except like this. I felt despair. I didn't want to leave this bed. Chang and Eng had died within hours of each other, because when the healthy one was offered the opportunity to be freed from the dead one, he declined. I understood so well. Let Deepak give me a lethal dose of morphine and let my life end this way, let my respiration cease, my pulse fade and then disappear. Let my brother and me leave the world in the same embrace with which we began in the womb.

I PICTURED SHIVA
getting the telegram, his coming to me, then putting himself at risk to save me. Would I have done the same for him? Perhaps when he saw me, he'd felt the way I did now: that it didn't matter what might have transpired between us, but life would not be worth living and would end soon if something happened to the other.

His body continued to lose heat in my arms as if I were drawing it away, siphoning it over. I remembered the two of us running up the hill in a relay, carrying a lifeless and cold child to Casualty, the parents trailing behind us. He was now that lifeless child.

The minutes passed.

Ultimately it was the rude coldness of Shiva's skin, the terrible separation it delineated of the living and the dead, the disarticulation of our bound flesh, that forced me to a new understanding, a new way of seeing us in the face of such rapid attrition, and this is what I came to:

Shiva and I were one being—ShivaMarion.

Even when an ocean separated us, even when we thought we were two, we were ShivaMarion.

He was the rake and I the erstwhile virgin, he the genius who acquired knowledge effortlessly while I toiled into the night for the same mastery; he the famous fistula surgeon and I just another trauma surgeon. Had we switched roles, it wouldn't have mattered one bit to the universe.

Fate and Genet had conspired to kill my liver, but Shiva had a role in Genet's fate, and hence my fate. Every action of ours turned out to be dependent on the other. But now by a brilliant and daring rearrangement of organs, ShivaMarion had readjusted. Four legs, four arms, four kidneys, and so on, but instead of two livers, we had downsized to one. Then karma and bad luck took us even further, forced further concessions: we lost ground on his side, a few organs died. Okay—just about everything on his side died, but we retained half his liver, and it was thriving. What we had to do now was economize further, go halves again, tough measures for tough times: two legs sufficed, so also with eyes, kidneys. We'd go with half a liver, one heart, one pancreas, two arms … but we were still ShivaMarion.

Shiva lives in me.

Call it a far-fetched scheme that I conjured up to allow me to go on … Well then, it allowed me to go on. It gave me comfort. It dried my tears, helped me untwine my arms and legs from the body that we were discarding. In the eerie quiet of that room, so primed for machines but with the machines all silent, the blinds closed, and with an icy corpse next to me, I felt Shiva was instructing me. He had rowed over from the sinking ship and he was telling me to think this way, and it was just Shiva's kind of logic.
One being at birth, rudely separated, we are one again.

THEY WERE ASSEMBLED
outside, a ghoulish receiving line was what I thought at first. But they couldn't know what had just transpired, and so I didn't blame them. Their hearts were in the right place. Thomas Stone, Deepak, Vinu, and so many of my nurses and nursing assistants— my friends, my Our Lady family before they became my caregivers. I shook each hand, and thanked them for the two of us. I believe they will tell you my manner was composed, far different from what they expected. I left Thomas Stone for last. After I shook his hand, I followed an irrational instinct—Shiva's, I believe, certainly not mine—which told me to hug him, not to get but to give. To let him know that as a father it turns out hed done what he was meant to do; he lived on in us and we lived because of his skills. The way he clung to me, held me as if he were drowning, told me Id made the right choice, or Shiva had, awkward as it was.

I walked slowly down the hall to our Quiet Room, a euphemism for the place we chose to give bad news, a place with chairs, a table, a sofa, a big picture window, a cross on the wall, but no TV, no magazines, only a solid and soundproof door. How many times had I made this walk as a trauma surgeon? So often I had lingered outside the door, conscious of the devastation my news would be bringing. Had I honored the feelings and the dignity of those who waited in that room, the parents, siblings, spouses, and children, even if what I had to say dashed all their prayers? I could remember every such encounter; I could recall each face as it turned in hope and apprehension when the door opened.

I FOUND HEMA,
hands crossed in front of her, gazing out of the window at the lights of the Battleship housing project that abutted our house-staff quarters, and the distant outline of the bridge beyond. Her back was to me. She saw my reflection in the glass before she saw me, but unlike every single person I had ever come to see in this room, she did not spin around. Instead, she stood like a statue, staring at my reflection in the window. I stopped where I was, holding the door open. I saw in that glass her eyes widen, the eyebrows rise. She held my gaze for the longest time. Her face showed surprise … as if who she saw wasn't the person she had expected to see.

“Here we are, Ma,” I said.

She cocked her head at my voice. She brought one hand up to her chin, her fingers aligned and locked together and resting contemplatively along her cheek, her movements exaggerated. She studied my face, my reflection, just like a village girl who is surprised in the act of drawing water at the well, and who must now read the intentions of the tall, smiling avatar whom she sees standing behind her.

Then, in slow motion, as if this were a dance, and both of us dancers, she turned and faced me.

I moved to her. “Here we are,” I said again, my arms extending toward her. “We can go home now, Ma.”

It must have seemed to her a very strange thing, even the wrong thing, to say. To live purely in the here and now, to look forward but never to the past—that was vintage Shiva. “Here we are,” I said.

She came into my arms.

We held her tight.

CHAPTER 53
She Is Coming

O
N A BEAUTIFUL MORNING,
just three weeks after Shiva's transference, Hema and I took leave of Our Lady of Perpetual Succour. Thomas Stone insisted on being our escort. We stepped outside into air so crisp I felt a cough or a sneeze would shatter it like glass. The brick façade of Our Lady of Perpetual Succour glistened with dew as we said our good-byes. The hospital's recent turn in the limelight had brought in special city funds and sparked emergency repairs; as a result, the monsignor in the fountain was no longer tilting, his swizzle stick was gone, as was his crusting of bird droppings. Polished and sanguine, he looked emasculated and alien to the place where I had spent the last seven years of my life.

Our yellow cab sped across the Whitestone Bridge to Kennedy Airport. The sun had barely come up, and yet the freeway was thick with cars, the solitary drivers insulated from one another in wafer-thin metal, which at these speeds offered only the illusion of protection. We merged like wingmen rejoining the formation. Hema looked out meditatively just as I had when I arrived seven years before. I wondered if she could hear the hum of the überconsciousness, the superorganism who kept this from descending into chaos.

The year
1986
was a disaster for our family. Hema believed that it had something to do with the number, because it had birth in the
1
and destiny in the
8
. Nineteen eighty-six had started off terribly with the
Challenger
spacecraft exploding on January
28
(which was month
1
, and there was the number
8
again). Then the Chernobyl tragedy was exactly eighty-eight days after the
Challenger
disaster. On that scale, the death of one twin—on the eighteenth of the month—hardly registered.

There was yet another death eight days later that had bearing on us: my neighbor Holmes came with Appleby of the detective agency to let me know that Genet had passed away in a prison hospital in Galveston just as I was regaining my strength. Genet's son had been adopted by a family in Texas, and she had gone in search of him. Shed been living hand-to-mouth in a cardboard lean-to a few blocks from the seawall when she was picked up. She was a mere skeleton and survived just two days in the prison infirmary. She had supposedly died of adrenal failure caused by tuberculosis. I knew better. She had died chasing greatness and never saw it each time it was in her hand, so she kept seeking it elsewhere, but never understood the work required to get it or to keep it. I'm ashamed to say I felt relief when the word came; only her death could ensure that we didn't keep tearing each other apart for what remained of our lives.

IN THE INTERNATIONAL DEPARTURE HALL,
I heard snatches of Bengali, Arabic, and Tagalog. A man bound for Lagos protested in screeching pidgin about the unfairness of British Airways, because there was no way he was four pounds over. In this setting, Thomas Stone, without his white coat or scrubs, looked like the newly arrived foreigner.

“Will you be back, Marion?” he asked when it was time for saying good-bye.

All I knew was that I wanted to be with Hema when she interred Shiva's ashes between Ghosh and Sister Mary Joseph Praise. The grotto by Missing's back wall and in earshot of the little creek was rapidly becoming the family burial plot. I was going back also to see Matron, Almaz, and Gebrew. I knew that my presence would help console them. Beyond that, I hadn't given great thought to my future.

“Of course I'll be back,” I said. “I still have my house, the car, my job …”

“Be careful what you eat, drink …,” he said. It was his way of telling me to protect his handiwork.

I felt better than well. Other transplant patients had to fight to keep their bodies from rejecting the lifesaving organ. The cortisone they took led to cataracts, diabetes, hip fractures, and other side effects. I was blessed not to have to swallow a single pill. I felt no pain if you didn't count the twinges under my ribs, which I considered promising and not painful; they were the sign of Shiva's half liver growing to fully occupy its new home.

“How about you?” I had yet to find a comfortable way to address my father; it was “Dr. Stone” in the hospital and nothing at times like this. “Will you have a job to go back to?” I teased. He hadn't seen Boston since I fell ill.

His slow smile only exaggerated the sadness in his face. He took Shiva's death personally, as if fate had never forgotten that he'd once attempted to destroy Shiva, and so when he had operated to save Shiva, his original intent had betrayed him.

My father made no attempt to shake my hand. Our one hug after Shiva's passing was good for a lifetime. We parted with a nod.

Hema, however, took Thomas Stone's hand in both of hers. I had missed their reunion at my bedside. Now, I watched like a nosy child.

“Thomas, stop this at once!” Hema said, chiding him for his melancholic expression. “You did everything you could, do you hear me? You did your best for your sons. No one else in the world could have done what you did. Thomas, if Ghosh were here, he'd say the same thing. He'd have been so proud of you and he'd say, ‘Go on with your work because it is so important.’ “ She released his hand, after patting it one last time, then she turned and walked away.

Later, as our plane banked over Queens and headed for open water, I thought about Hema's parting words to Stone. Buried in there had been her apology for having fashioned him into a monster in her mind for all these years. In patting his hand and walking away, she was releasing herself.

Alitalia took us to Rome. Mechanical problems on the connecting flight had the agent projecting a fourteen-hour layover. It gave me an idea. In no time Hema and I were once again in a taxi on a freeway, but this time we were heading to downtown Rome. We were like children playing hooky from school.

Hema had needed little convincing. We went to a first-class hotel, the Hassler, Rome's best, I was once told. It was a grand building that overlooked the Spanish Steps. From the rooftop at dusk the sky's red hue outlined the dome of St. Peter's in the distance.

Each morning we set out for the briefest sightseeing. We returned to our hotel for lunch and a long afternoon nap. The evenings we wandered down the streets and alleyways beneath the Spanish Steps. Eventually we'd pick an outdoor café for dinner. “It's so familiar, isn't it?” Hema said. “These menus, typed out and mimeographed, minestrone and
pasta fagl-oli,
the waiters with white shirts, black pants, white aprons …” I knew what she meant. The Italians had brought it all to Ethiopia, right down to the umbrellas that hung over the little Formica-topped round tables. Hema's face at dinner was as tranquil as Id seen it since I became conscious of her at my bedside at Our Lady. “I wish Ghosh could have been with us. How he would have enjoyed this,” she said, smiling.

ON THE FOURTH MORNING,
we let the concierge talk us into a private tour with a guide from our hotel. What did we want to see? Surprise us, we said. Take us off the cow path. Places where there isn't too much walking or waiting in line.

He began with the Santa Maria della Vittoria, a ten-minute ride from our hotel. It was a homely church, sitting right on the street, cars passing by, the elaborate façade looking as if it had been slapped on to the front of an unadorned stone box. Our guide said it was built about
1624
, first dedicated to St. Paul, and later to the Virgin Mary. The interior was small—tiny when compared with St. Peter's—with a short nave under a low vault. Off to the side, Corinthian pillars flattened into the wall demarcated three “chapels” which were nothing more than recesses, each with a rail for private prayer and a place to light candles. As we came to the end of the nave, our guide turned to the left and pointed. “This is the Cornaro Chapel. It is what I wanted you to see,” he said.

It took a few seconds for my eyes to relay the sight to my brain, and longer still for my brain to believe. The blue marble sculpture floating before me was Bernini's
Ecstasy of St. Teresa.
I wanted to silence our guide and say,
Stop, I know this sculpture.
But in truth what I knew was only a print that found its way onto a calendar which my mother had then thumbtacked to the wall of the autoclave room. It had been up for perhaps thirty years before Ghosh had taken that aging piece of paper and framed it for me, to protect it from further deterioration. The print meant the world to me, yet it had never seemed at ease on my walls in America, where it looked like the cheapest kind of tourist gewgaw. I'd packed it with me on this journey, planning to restore it to the one place where I knew it was at home, the autoclave room.

I looked over to Hema. Her face was aglow. She understood. What providence had brought us to this spot? Surely this was Ghosh announcing his presence, because Ghosh was the sort of man who could be counted on to know that Bernini's
Ecstasy of St. Teresa
was minutes from our hotel, even if he'd never been to Rome before. Ghosh had brought us here, led us to this spot, not to see St. Teresa in marble, but to see Sister Mary Joseph Praise in the flesh, for that is what the figure was to me.
I have come, Mother.

WE LIT CANDLES.
Hema fell to her knees, the flame throwing a flickering light on her face. Her lips moved. She believed in every kind of deity and in reincarnation and resurrection—she knew no contradictions in these areas. How I admired her faith, her lack of self-consciousness—a Hindu lighting candles to a Carmelite nun in a Catholic church.

I knelt, too. I addressed God and Sister Mary Joseph Praise and Shiva and Ghosh—all the beings I carried with me in the flesh and in spirit.
Thank you for letting me be alive, letting me see this marble dream.
I felt a great peace, a sense that coming to this spot had completed the circuit, and now a blocked current would flow and I could rest. If “ecstasy” meant the sudden intrusion of the sacred into the ordinary, then it had just happened to me.

My mother had spoken.

What I didn't know then was that she had more to say.