John Irving - The Fourth Hand

Wallingford was still napping—dreaming of the cottage on the lake—when Mrs. Clausen came to his hotel room. She hadn’t called first. Her mother was watching the baby. She’d brought the car and would drive Patrick to her house to see Otto junior a little later.

Wallingford didn’t know what this meant. Was she seeking a moment to be alone with him? Did she want some contact, if only with the hand, that she didn’t want her mother to see? But when Patrick touched her face with the palm of his hand—being careful to touch her with his left hand, of course—Mrs. Clausen abruptly turned her face away. And when he thought about touching her breasts, he could see that she’d read his mind and was repulsed.

Doris didn’t even take off her coat. She’d had no ulterior motive for coming to his hotel. She must have felt like taking a drive—that was all. This time, when Wallingford saw the baby, little Otto appeared to recognize him. This was highly unlikely; nevertheless, it further broke Patrick’s heart. He got back on the plane to Boston with a disturbing premonition. Not only had Doris permitted no contact with the hand—she’d barely looked at it! Had Otto junior stolen all her affection and attention?

Wallingford had a bad week or more in Boston, pondering the signals Mrs. Clausen might be sending him. She’d said something about how, when little Otto was older, he might like seeing and holding his father’s hand from time to time. What did she mean by “older”—how much older? What had she meant, “from time to time”? Was Doris trying to tell Patrick that she intended to see him less ? Her recent coldness to the hand caused Wallingford his worst insomnia since the pain immediately following his surgery. Something was wrong. Now when Wallingford dreamed of the lake, he felt cold—a wet-bathing-suit-afterthe-sun-has-gone-down kind of cold. While this had been one of several sensations he’d experienced in the Indian painkiller dream, in this new version his wet bathing suit never led to sex. It led nowhere. All Patrick felt was cold, a kind of upnorth cold. Then, not long after his Green Bay visit, he woke up unusually early one morning with a fever—he thought it was the flu. He had a good look at his left hand in the bathroom mirror. (He’d been training the hand to brush his teeth; it was an excellent exercise, his physical therapist had told him.) The hand was green. The new color began about two inches above his wrist and darkened at his fingertips and the tip of his thumb. It was the mossy-green color of a well-shaded lake under a cloudy sky. It was the color of firs from a distance, or in the mist; it was the blackening dark green of pine trees reflected in water. Wallingford’s temperature was 104.

He thought of calling Mrs. Clausen before he called Dr. Zajac, but there was an hour’s time difference between Boston and Green Bay and he didn’t want to wake up the new mother or her baby. When he phoned Zajac, the doctor said he’d meet him at the hospital—adding, “I told you skin was a bugger.”

“But it’s been a year !” Wallingford cried. “I can tie my shoes! I can drive! I can almost pick up a quarter. I’ve come close to picking up a dime !”

“You’re in uncharted water,” Zajac replied. The doctor and Irma had seen a video with that lamentable title, Uncharted Water, the night before. “All we know is, you’re still in the fifty-percent-probability range.”

“Fifty percent probability of what ?” Patrick asked.

“Of rejection or acceptance, pal,” Zajac said. “Pal” was Irma’s new name for Medea.

They had to remove the hand before Mrs. Clausen could get to Boston, bringing her baby and her mother with her. There would be no last looks, Dr. Zajac had to tell Mrs. Clausen—the hand was too ugly.

Wallingford was resting fairly comfortably when Doris came to his bedside in the hospital. He was in some pain, but there was nothing comparable to what he’d felt after the attachment. Nor was Wallingford mourning the loss of his hand, again—it was losing Mrs. Clausen that he feared.

“But you can still come see me, and little Otto,” Doris assured him. “We’d enjoy a visit, from time to time. You tried to give Otto’s hand a life!” she cried. “You did your best. I’m proud of you, Patrick.”

This time, she paid no attention to the whopping bandage, which was so big that it looked as if there might still be a hand under it. While it pleased Wallingford that Mrs. Clausen took his right hand and held it to her heart, albeit briefly, he was suffering from the near-certain foreknowledge that she might not clutch this remaining hand to her bosom ever again.

“I’m proud of you … of what you’ve done,” Wallingford told her; he began to cry.

“With your help,” she whispered, blushing. She let his hand go.

“I love you, Doris,” Patrick said.

“But you can’t,” she replied, not unkindly. “You just can’t.”

Dr. Zajac had no explanation for the suddenness of the rejection—that is, he had nothing to say beyond the strictly pathological.

Wallingford could only guess what had happened. Had the hand felt Mrs. Clausen’s love shift from it to the child? Otto might have known that his hand would give his wife the baby they’d tried and tried to have together, but how much had his hand known? Probably nothing.

As it turned out, Wallingford needed only a little time to accept the end result of the fifty-percent-probability range. After all, he knew divorce—he’d been rejected before. Physically and psychologically speaking, losing the first hand had been harder than losing Otto’s. No doubt Mrs. Clausen had helped Wallingford feel that Otto’s hand was never quite his. (We can only guess what a medical ethicist might have thought of that.)

Now when Wallingford tried to dream of the cottage on the lake, nothing was there. Not the smell of the pine needles, which he’d first struggled to imagine but had since grown used to; not the lap of the water, not the cries of the loons. It is true, as they say, that you can feel pain in an amputated limb long after the limb is gone, but this came as no surprise to Patrick Wallingford. The fingertips of Otto’s left hand, which had touched Mrs. Clausen so lightly, had been without feeling; yet Patrick had truly felt Doris when the hand touched her. When, in his sleep, he would raise his bandaged stump to his face, Wallingford believed he could still smell Mrs. Clausen’s sex on his missing fingers.

“Ache all gone?” she’d asked him.

Now the ache wouldn’t leave him; it seemed as permanently a part of him as his not having a left hand.

Patrick Wallingford was still in the hospital on January 24, 1999, when the first successful hand transplant in the United States was performed in Louisville, Kentucky. The recipient, Matthew David Scott, was a New Jersey man who’d lost his left hand in a fireworks accident thirteen years before the attachment surgery. According to The New York Times, “a donor hand suddenly became available.”

A medical ethicist called the Louisville hand transplant “a justifiable experiment”; unremarkably, not every medical ethicist agreed. (“The hand is not essential for life,” as the Times put it.)

The head of the surgical team for the Louisville operation made the now-familiar point about the transplanted hand: that there was only “a fifty-percent probability that it will survive a year, and after that we just really don’t know.” He was a hand surgeon, after all; like Dr. Zajac, of course he would talk about “it” surviving, meaning the hand.

Wallingford’s all-news network, aware that Patrick was still recovering in a Boston hospital, interviewed a spokesperson for Schatzman, Gingeleskie, Mengerink, Zajac & Associates. Zajac thought the so-called spokesperson must have been Mengerink, because the statement, while correct, demonstrated a characteristic insensitivity to Wallingford’s recent loss. The statement read: