Open Heart (57 page)

I promised that I would drive to Jerusalem first thing in the morning, as soon as my night shift was over. As I entered the
changing room, I saw Dr. Vardi, my short and sturdy
rival-friend
, standing in a blood-soaked green uniform, with the mask still tied around his neck emphasizing the burning seriousness of his eyes as he looked at us. Hishin asked him about the operation that had just been concluded, and Vardi began to answer with his usual compulsive thoroughness, until Hishin seemed sorry that he had asked. He appeared distracted and troubled, as if his mind were somewhere else. “Do you want me to assist you?” asked Vardi, who seemed upset by my sudden presence at the side of his patron. “No, there’s no need. You’ve done enough today, you can go home,” said Hishin, and laid his hand on my shoulder. “I’ve got Benjy here, as both a former surgeon and a present anesthetist, and as a friend, and that’s quite enough.” We went into the operating room, washed our hands, put on gloves and masks, and suddenly he asked me if I could manage the anesthesia alone. I answered confidently in the affirmative,
although
formally speaking I was not yet supposed to be the only anesthetist present at an operation. He told the anesthetist that he could go, after getting some necessary information from him, and turned to the white stomach of the woman, which as always gave rise to tender feelings of compassion in me. With a swift and precise movement he cut a thin, firm line from her navel to her pubic hair, which for a moment seemed on fire in the ray of light filtering through the round porthole in the door. Although the bypass operation I had witnessed a week before by far surpassed the abdominal surgery now being performed by Professor Hishin, who suddenly seemed a little like a butcher, in its
medical
-technological complexity and even its aestheticism it was
impossible
not to admire his precision and skill, and also the human warmth and intimacy of his long fingers as they felt their way among the tissues opening up in front of him, not only to see but also to sense what needed to be done.

There were three of us in the operating room, Hishin and I and a new nurse whom neither of us had seen before, with a face as fresh and pure as an angel’s. After half an hour, when the critical stage of the operation was approaching, the internal telephone fixed to the wall rang. I went to pick it up and immediately recognized Levine’s voice, asking urgently to speak to Hishin. At first, in the wake of the reconciliation between us, I wanted to identify myself, but Levine sounded so agitated that I decided
against it and confined myself to saying that I didn’t think Hishin would be able to come to the telephone now and would call back as soon as he could. But Levine insisted, and Hishin, who was listening with half an ear to the conversation, asked me to find out what was the matter. Still without saying who I was, I said that Hishin couldn’t come to the phone now and wanted to know what the trouble was. A note of hesitation came into
Levine
’s voice, and he asked who was speaking. After I identified myself, his agitation increased, and he said in a deep voice, “I think that you were right, Dr. Rubin, about Lazar’s arrhythmia. His condition has deteriorated—at the moment he’s being mechanically ventilated. There’s a cardiologist from coronary
intensive
care with him now. He’s diagnosed ventricular
tachycardia
and is considering an electric shock, but it’s very important to me for Hishin to come up here at once to see him, because he knows his general condition better than anyone else.” And he put the phone down. From the tone of his voice I realized that Hishin’s presence was important to him not for the reason he gave but because he wanted him by his side in this emergency in order to share the responsibility for any catastrophe. I
immediately
filled Hishin in on the picture. He froze in his place and raised his two bloody hands in the air as if he wanted to hold his stunned head between them. He knew that Lazar was now
fighting
for his life upstairs, and he knew that there was no way he could leave the operating room. He couldn’t even send me to find out what was going on. Suddenly I saw that his hands were
trembling
, and I sensed that he was losing his intense inner
concentration
. He tried to go on working, but immediately stopped and asked me to go out and see if Vardi was still around to take over from him, and when he saw that I was hesitating, unwilling to abandon the anesthesia machine, he added angrily, “Don’t worry, I’ll look after it while you’re gone.”

It was breaking every rule in the book to leave the operating room now, but I knew that if I could find Dr. Vardi, Hishin would be able to go upstairs, and with his courage, his
resourcefulness
, perhaps he would be able to save Lazar’s life. But the wing was empty except for a couple of nurses in the intensive
care unit. Suddenly the twilight turning red around me intensified my feeling of dread, and in the absolute silence I could sense my heart beating. Hishin was absorbed in the woman’s stomach, and nobody was watching the anesthesia machine. But I pressed the button of the main door of the wing nevertheless and hurried out into the bustling corridor to see if I could find some other
surgeon
to take Hishin’s place. In the distance I saw Nakash’s brown suit. He was on his way home, but the minute I told him what was up he hurried back into the surgical wing with me, although he wouldn’t enter the operating room itself in his
ordinary
clothes. In my absence there had been another phone call from Levine. “But what does he want?” cried Hishin, his face gray. “How can I leave the operating room now?” In the
meantime
the rumor of the administrative director’s deteriorating
condition
had apparently spread through the hospital like wildfire, and two doctors from cardiothoracic surgery had already hurried upstairs, as Dr. Levine called desperately for help in all
directions
. With a pang I saw that Hishin’s hands were trembling again. He stood still for a moment, closed his eyes in
concentration
, and then returned to work at the proper tempo, refusing to give way to the temptation to hurry things up.

The quiet, fresh-faced young nurse, who had not yet opened her mouth, could no longer restrain herself and asked, “Who’s Lazar?” Hishin didn’t answer, but I began to tell her much more about Lazar than her innocent question warranted, as if I wanted by my words to strengthen his soul as it hovered between life and death. The telephone rang again. It was Nakash, who announced that he had succeeded in persuading Levine to bring the still
unconscious
Lazar down to the cardiothoracic surgery intensive care unit, which was close to us in the surgical wing. Hishin nodded his head. The hour of his most terrible test was upon him, under the watchful eyes of the entire medical staff of the hospital. Would he really be able to save his friend? But he went on cauterizing the blood vessels to prevent bleeding. From time to time he would offer his forehead to the nurse for her to wipe away the perspiration. The sound of loud, excited voices reached us as Lazar was brought into the wing, but Hishin didn’t budge from his place and he signaled me too not to move. Nakash came into the room, wrapped in the green operating room uniform, a plastic cover on his head and his face hidden behind a mask. In
his quiet, noble way he offered to help so that Hishin could leave as soon as possible. All he could tell us about Lazar was that his heart was still fibrillating in spite of the electric shock he had received. Suddenly Levine burst into the room in his ordinary clothes, with a strange, rather mysterious expression on his face, looking as if his psychiatric leave had already begun. But Hishin stopped him immediately. “For God’s sake, David,” he said in a stern tone, “let’s try to keep our heads here. I have to finish the operation. And this young woman too deserves to get everything we can give her.” He bent over the gaping stomach, steadily continuing his work, and when it was all over and she was ready to be sewn up again, I could no longer hold back and offered to complete the suture for him. Hishin gave me a hard look, his little eyes burning in his pale face; he thought for a minute, and then he said, “Right. Why not? Nakash can take over the
anesthesia
.” He put the scissors down on the tray, held out his hands to the nurse for her to remove his gloves, and hurried from the room.

I began stitching the big incision, straining my ears to hear what was going on in the intensive care unit, even though I knew that the heavy doors would prevent any sound, encouraging or otherwise, from reaching us. I suggested to Nakash that he pop out to see what was happening, but he waved a dark hand in firm refusal and said, “No, Benjy, let’s wait. We don’t want to disturb them now,” as if he too were afraid to see what was happening next door. And so I continued neatly and carefully suturing the surgical wound, doing my best to ensure that the scar on the young woman’s stomach would be as unnoticeable as possible.

At last I was able to give Nakash the signal to bring our
patient
around and to ascertain from the state of her pupils, before he got dressed and hurried home, whether she had indeed
returned
to the land of the living. Outside in the corridor I felt the full weight of the weariness and the anxiety that had
accumulated
inside me. I decided to sit down for a moment on one of the little chairs, to fill in the anesthesia form and to ask the nurse with the face as pure as an angel’s to find out what was
happening
in the intensive care unit at the end of the corridor. She came back immediately and said, “I’m sorry, Dr. Rubin.” I jumped up and hurried there myself. My eyes were immediately drawn to the bed crammed between the various instruments, between the
respirator and the big old defibrillator. His body was covered with a white sheet, but over his face there was a green sterile cloth, which for some reason brought back in a flash the picture of the two of them in the textile bazaar in New Delhi, standing next to a stall selling silk scarves, where she’d tried on one scarf after another and he’d watched her with an expression of
weariness
and boredom and had tried to move on; and then she’d held out a green silk scarf, and before he could resist, she’d put it on his head and adroitly tied the ends under his chin, like a granny’s handkerchief, and stepped back to contemplate his embarrassed and amused expression before bursting into peals of jubilant laughter, in which she was momentarily joined by the passersby. And now he was dead. The pain clutched my heart. And his good friends Hishin and Levine would not be able to escape the duty of going, stunned and eaten up with guilt, to give the terrible news to the woman who couldn’t stay a single day by herself. Nakash was now standing beside me in his suit and tie. For a moment he hesitated, and then his curiosity got the better of him and he went up to the dead body lying between the medical instruments and lifted the green cloth off, to look at Lazar’s face and perhaps to say good-bye to him too. In spite of everything Nakash had come to us from the East, and despite his great expertise in anesthesiology and his thorough knowledge of
medicine
, in the depths of his soul he remained a fatalist, and when death descended on someone close to him, he accepted it
completely
, without question, without complaint, and above all
without
trying to blame anyone.

He also did not want to hear my diagnosis, but calmly took his leave of Lazar and of me and went home, switching off the light behind him with his usual economy and casting the entire wing into gloom. I decided not to change my clothes but to hurry as I was to the emergency room, not only because my shift had
already
begun but also because I was sure that somebody there would be able to tell me what had happened. But the two young surgeons I found there, who had been with Hishin and Levine and the others when they tried to resuscitate Lazar, were still so stunned and upset that despite their eagerness to explain and interpret everything, as eager young doctors will, it was difficult to get a clear picture from them. All I learned was that after Lazar had been declared dead, Levine and Hishin had rushed off
to treat Einat, who went into shock when she heard of her
father
’s death. At first they had wanted to co-opt me to join the delegation bearing the bad news to his wife, but since I was still busy in the operating room, they had called on Lazar’s secretary instead, who went into hysterics and began to scream and cry. Again, unlike the usual practice, the young doctors did not try to blame anyone. Not even Levine, who had been with Lazar when the fibrillation began. Nobody could have expected it—only two hours before an EKG had yielded completely normal results.
Arrhythmia
was characteristically elusive—it came and went as it pleased. I decided to keep my peace, since nobody could possibly know just how deep my ties with the Lazars went, and I busied myself with the work of the emergency room, which was
particularly
intensive, with the knowledge of the death of the hospital director breaking over us in wave after stunning wave as we worked into the night. At two
A.M
., I was called to the surgical wing to assist with a local anesthesia. As soon as it was over I went into the little instrument-packed room again, as if to be certain that the body had indeed been transferred to the hospital morgue, where I had for some reason never been before.