Jodi Picoult - Harvesting the Heart

Finally, Jack steps out into the pediatric waiting room. It is now morning, and the staff nurses are starting to arrive, pulling out a box of Big Bird Band-Aids and sunny smiley-face stickers for the day’s patients. Nicholas knew Jack when they were at Harvard Med together, but he hasn’t really kept in touch, and suddenly he is furious at himself. He should have been having lunch with him at least once a week; he should have talked to him about Max’s health before anything like this ever happened; he should have caught it on his own.

He should have caught it. That is what bothers Nicholas more than anything else-how can he call himself a physician and not notice something as obvious as an abdominal mass? How can he have missed the symptoms?

“Nicholas,” Jack says, watching his colleague pick up Max and sit him upright. “I have a good idea of what it might be.”

Paige leanwas

Jack ignores her questions, which infuriates Nicholas. Paige is the baby’s mother, for Christ’s sake, and she’s worried as hell, and that isn’t the way to treat her. He is about to open up his mouth, when John Dorset carries Max past them. Max, seeing Paige, reaches out his arms and starts to cry.

A sound comes out of Paige’s throat, a cross between a keen and a wail, but she doesn’t take the baby. “We’re going to do a sono gram,” Jack says to Nicholas, Nicholas only. “And if I can verify the mass-I think it’s sausage-shaped, right at the small bowel-we’ll do a barium enema. That might reduce the intussusception, but it depends on the severity of the lesion.”

Paige tears her gaze away from the doorway where Max and the doctor have disappeared. She grabs Jack Rourke’s lapels. “Tell me,” she shouts. “Tell me in normal words.”

Nicholas puts his arm around Paige’s shoulders and lets her bury her face against his chest. He whispers to her and tells her what she wants to know. “It’s his small intestine, they think,” Nicholas says. “It kind of telescopes into itself. If they don’t take care of it, it ruptures.”

“And Max dies,” Paige whispers.

“Only if they can’t fix it,” Nicholas says, “but they can. They always can.”

Paige looks up to him, trusting him. “Always?” she repeats.

Nicholas knows better than to give false hope, but he puts on his strongest smile. “Always,” he says.

He sits across from her in the pediatric waiting room, watching healthy doddering toddlers fight each other for toys and crawl all over a big blue plastic ladder and slide. Paige goes up to ask about Max, but none of the nurses have been given any information; two don’t even know his name. When Jack Rourke comes in hours later, Nich olas jumps to his feet and has to restrain himself from throwing his colleague against the wall. “Where is my son?” he says, biting off each word.

Jack looks from Nicholas to Paige and back to Nicholas. “We’re prepping him,” he says. “Emergency surgery.”

Nicholas has never sat in Mass General’s surgical waiting room. It is dingy and gray, with red cubes of seats that are stained with coffee and tears. Nicholas would rather be anywhere else.

Paige is chewing the Styrofoam edge of a coffee cup. Nicholas has not seen her take a sip yet, and she’s been holding it for a half hour. She stares straight ahead at the doors that lead to the operating suites, as if she expects an answer, a magical ticker-tape billboard.

Nicholas had wanted to be in the operating room, but it was"›‹¡€† against medical ethics. He was too close to the situation, and honestly he didn’t know how he would react. He would renounce his salary and his title, just to get back the detachment about surgery that he had only yesterday. What had Paige said after the bypass? He was incredible. Good at fixing. And yet he couldn’t do a damn thing to help Max.

When Nicholas was standing over a bypass patient whom he hardly knew, it was very easy to put life and death into black-and-white terms. When a patient died on the table, he was upset but he did not take it personally. He couldn’t. Doctors learn early that death is only a part of life. But parents shouldn’t have to.

What are the chances of a six-month-old making it through intestinal surgery? Nicholas racks his brain, but he can’t come up with the statistics. He does not even know the doctor operating in there. He’s never heard of the damn guy. It strikes Nicholas that he and every other surgeon live a lie: The surgeon is not God, he is not omnipotent. He cannot create life at all; he can only keep it going. And even that is touch and go.

Nicholas stares at Paige. She has done what I can never do, Nicholas thinks. She has given birth.

Paige has put down the Styrofoam cup and suddenly stands. “I’m going to get some more coffee,” she announces. “Do you need anything?”

Nicholas stares at her. “You haven’t touched the coffee you just bought.”

Paige crosses her arms and rakes her fingernails into her skin, leaving raw red lines that she doesn’t notice at all. “It’s cold,” she says, “way too cold.”

A collection of nurses walks by. They are dressed in simple white uniforms but wear felt ears in their hair, and their faces are made up with whiskers and fur. They stop to talk to the devil. He is some kind of physician, a red cape whirling over his blue scrubs. He has a forked tail and a shiny goatee and a hot chili pepper clipped to his stethoscope. Paige looks at Nicholas, and for a second Nicholas’s mind goes blank. Then he remembers that it is Halloween. “Some of the people dress up,” he explains. “It cheers up the kids in pediatrics.” Like Max, he thinks, but he does not say it.

Paige tries to smile, but only half her mouth turns up. “Well,” she says. “Coffee.” But she doesn’t move. Then, like the demolition of a building, she begins to crumble from the top down. Her head sinks and then her shoulders droop and her face sags into her hands. By the time her knees give way beneath her, Nicholas is standing, ready to catch her before she falls. He settles her into one of the stiff canvas seats. “This is all my fault,” she says.

“This isn’t your fault,” Nicholas says. “This could have happened to any kid.”

Paige doesn’t seem to have heard him. “It was the best way to get even,” she whispers, “but He should have hurt me instead.”

“Who?” Nicholas says, irritated. Maybe there is someone responsible. Maybe there is someone he can blame. “Who are you talking about?”

Paige looks at him as if he is crazy. “God,” she says.

When he had changed Max’s diaper and seen the blood, he didn’t even stop to think. He bundled Max in a blanket and ran out the door without a diaper bag, without his wallet. But he hadn’t driven straight to the hospital; he’d gone to his parents. Instinctively, he had come for Paige. When it came right down to it, it didn’t matter why Paige had left him, it didn’t matter why she had returned. It didn’t matter that for eight years she’d kept a secret from him he felt he had every right to know. What mattered was that she was Max’s mother. That was their truth, and that was their starting point to reconnect. At the very least, they had that connection. They would always have that connection.

If Max was all right.

Nicholas looks at Paige, crying softly into her hands, and knows that there are many things that depend on the success of this operation. “Hey,” he says. “Hey, Paige. Honey. Let me get you that coffee.”

He walks down the hall, passing goblins and hoboes and Raggedy Anns, and he whistles to keep out the roaring sound of the silence.