John Irving - The Fourth Hand

Before the historic procedure, Dr. Zajac had been running in the predawn darkness in the gray slush along the banks of the Charles. To his dismay, a young woman had passed him in the ghostly mist as if he’d been standing still. Her taut buttocks in spandex tights, moving resolutely away from Zajac, tightened and released like the fingers of a hand making a fist and then relaxing, and then making a fist again. What a fist it was!

It was Irma. Dr. Zajac, only hours before he would attach Otto Clausen’s left hand and wrist to the waiting stump of Patrick Wallingford’s left forearm, felt his heart constrict; his lungs seemed to cease expanding and he experienced a stomach cramp that was as crippling to his forward progress as being hit by, let’s say, a beer truck. Zajac was doubled over in the slush when Irma came sprinting back to him.

He was speechless with pain, gratitude, shame, adoration, lust—you name it. Irma led him back to Brattle Street as if he were a runaway child. “You’re dehydrated—you need to replenish your fluids,” she scolded. She’d read volumes on the subject of dehydration and the various “walls” that serious runners supposedly “hit,” which they must train themselves to “run through.”

Irma was what they call “maxed out” on the vocabulary of extreme sports; the adjectives of maniacal stamina in the face of grueling tests of endurance had become her primary modifiers. (“Gnarly,” for example.) Irma was no less steeped in eat-to-run theory—from conventional carbo-loading to ginseng enemas, from green tea and bananas before the run to cranberry-juice shakes after.

“I’m gonna make you an egg-white omelet as soon as we get home,” she told Dr. Zajac, whose shin splints were killing him; he hobbled beside her like a crippled racehorse. This lent nothing newly attractive to his appearance, which had already been likened (by one of his colleagues) to that of a feral dog. On the biggest day of his professional career, Dr. Zajac had breathlessly fallen in love with his housekeeper/assistant-turned-personal trainer. But he couldn’t tell her—he couldn’t talk. As Zajac gasped for breath in hopes of quieting the radiating pain in his solar plexus, he noticed that Irma was holding his hand. Her grip was strong; her fingernails were cut shorter than most men’s, but she was not a nail-biter. A woman’s hands mattered a lot to Dr. Zajac. To put in ascending order of importance how he’d fallen for Irma seems crass, but here it is: her abs, her buttocks, her hands.

“You got Rudy to eat more raw vegetables,” was all the hand surgeon managed to say, between gasps.

“It was just the peanut butter,” Irma said. She easily supported half his weight. She felt she could have carried him home—she was that exhilarated. He’d complimented her; she knew he’d noticed her, at last. As if for the first time, he was really seeing who she was.

“The next weekend Rudy is with me,” Zajac choked, “perhaps you’ll stay here? I’d like you to meet him.”

This invitation seemed as conclusive to Irma as his hand on her breast, which she’d only imagined. Suddenly she staggered, yet she was still bearing only half his weight; the unpredictable timing of her triumph had made her weak.

“I like shaved carrots and a little tofu in my egg-white omelets, don’t you?” she asked, as they neared the house on Brattle Street.

There was Medea, taking a dump in the yard. Seeing them, the craven dog furtively eyed her own shit; then she sprinted away from it, as if to say, “Who can stand to be near that stuff? Not me!”

“That dog is very dumb,” Irma observed matter-of-factly. “But I love her, somewhat,” she added.

“I do, too!” Zajac croaked, his heart aching. It was the “somewhat” that sent him over the edge for Irma; he had the exact same feelings for the dog. The doctor was too excited to eat his egg-white omelet with shaved carrots and tofu, although he tried. Nor could he finish the tall shake Irma made him—cranberry juice, mashed banana, frozen yogurt, protein powder, and something grainy (possibly a pear). He poured half of it down the toilet, together with the uneaten omelet, before he took a shower.

It was in the shower that Zajac noticed his hard-on. His erection had Irma’s name written all over it, although there’d been nothing physical between them—discounting Irma’s assistance in getting him home. Fifteen hours of surgery beckoned. This was no time for sex.

At the postoperative press conference, even the most envious of his colleagues—the ones who secretly wanted him to fail—were disappointed on Dr. Zajac’s behalf. His remarks were too trenchant; they suggested that handtransplant surgery would one day soon be in the no-big-deal category of a tonsillectomy. The journalists were bored; they couldn’t wait to hear from the medical ethicist, whom all the surgeons at Schatzman, Gingeleskie, Mengerink & Associates despised. And before the medical ethicist could finish, the media’s attention shifted restlessly to Mrs. Clausen. Who could blame them? She was the epitome of human interest.

Someone had got her clean, more feminine clothes, free of Green Bay logos. She’d washed her hair and put on a little lipstick. She looked especially small and demure in the TV lights, and she’d not let the makeup girl touch the circles under her eyes; it was as if she knew that what was fleeting about her beauty was also the only permanent thing about it. She was pretty in a kind of damaged way.

“If Otto’s hand survives,” Mrs. Clausen began, in her soft but strangely arresting voice—as if her late husband’s hand, not Patrick Wallingford, were the principal patient—“I guess I will feel a little better, one day. You know, just being assured that a part of him is where I can see him… touch him…” Her voice trailed away. She’d already stolen the press conference from Dr. Zajac and the medical ethicist, and she was not done—she was just getting started. The journalists crowded around her. Doris Clausen’s sadness was spilling into homes and hotel rooms and airport bars around the world. She seemed not to hear all the questions the reporters were asking her. Later Dr. Zajac and Patrick Wallingford would realize that Mrs. Clausen had been following her own script—with no TelePrompTer, either.

“If I only knew…” She trailed away again; undoubtedly the pause was deliberate.

“If you only knew what ?” one of the journalists cried.

“If I’m pregnant,” Mrs. Clausen answered. Even Dr. Zajac held his breath, waiting for her next words. “Otto and I were trying to have a baby. So maybe I’m pregnant, or maybe I’m not. I just don’t know.”

Every man at the press conference must have had a hard-on, even the medical ethicist. (Only Zajac was confused as to his erection’s source—he thought it was Irma’s lingering influence.) Every man in the aforementioned homes and hotel rooms and airport bars around the world was feeling the effects of Doris Clausen’s arousing tone of voice. As surely as water loves to lap a dock, as surely as pine trees sprout new needles at the tips of their branches, Mrs. Clausen’s voice was at that moment giving a hard-on to every heterosexual male transfixed by the news. The next day, as Patrick Wallingford lay in his hospital bed beside the enormous, foreign-looking bandage, which was almost all he could see of his new left hand, he watched Mrs. Clausen on the all-news network (his own channel of employment) while the actual Mrs. Clausen sat possessively at his bedside. Doris was riveted by what she could see of Otto’s index, middle, and ring fingers—only their tips—and the tip of her late husband’s thumb. The pinky of Patrick’s new left hand was lost in all the gauze. Under the bandage was a brace that immobilized Wallingford’s new wrist. The bandage was so extensive that you couldn’t tell where Otto’s hand and wrist, and part of his forearm, had been attached.