Jodi Picoult - Harvesting the Heart

They left at the top of the seventh, and Nicholas sat in the seat behind his father on the T. When they pulled into the driveway of the big brick house, Nicholas jumped out of the car and ran into the forest that bordered the backyard, climbing the nearest oak tree faster than he ever had in his life. He heard his mother say, “Where’s Nicholas?” her voice carrying like bells on the wind. He heard her say, “You bastard.”

His father did not come in to dinner that night, and in spite of his mother’s warm hands and bright china smiles, Nicholas did not want to eat. “Nicholas,” his mother said, “you wouldn’t want to leave here, would you? You’d want to be here with me.” She said it as a statement, not a question, and that made Nicholas angry until he looked at her face. His mother-the one who taught him that Prescotts don’t cry-held her chin up, keeping back the tears that glazed her eyes like a porcelain doll’s.

“I don’t know,” Nicholas said, and he larÁaid, and went to bed still hungry. He huddled under the cool sheets of his bed, shaking. Hours later, in the background, came the muffled splits and growls that he knew were the makings of an argument. This time it was about him. He knew more than anything that he did not want to grow up to be like his father, but he was afraid of growing up without him. He swore that never again would he let anyone make him feel the way he felt right now-as if he was being forced to choose, as if his heart was being pulled in two. He stared out the window to see the white moon, but its face was the same as that of the baseball lady, her cheek smooth and white, her ear marked by the brush of his own father’s lips.

“Wake up, Sleeping Beauty,” one of the residents whispered into Nicholas’s ear. “You’ve got a heart to connect.”

Nicholas jumped, hitting his head on the low roof of the helicopter, and reached for the Playmate cooler. He shook the image of his father from his mind and waited for a surgeon’s reserve of energy to come from his gut, pulse into his arms and his legs, and spring to the balls of his feet.

Fogerty was waiting in the operating suite. As Nicholas came through the double doors, scrubbed and gowned, Fogerty began to open Alamonto’s chest. Nicholas listened to the whir of the saw slicing through bone as he prepared the heart for its new placement. He turned to face the patient, and that was when he stopped.

Nicholas had done more than enough surgeries in his seven years as a resident to know the procedure cold. Incisions, opening the chest, dissecting and suturing arteries-all these had become second nature. But Nicholas was used to seeing a patient with wrinkled skin, with age spots. Under the orange antiseptic, Paul Alamonto’s chest was smooth, firm, and resilient. “Unnatural,” Nicholas whispered.

Fogerty’s eyes slid to him above the blue mask. “Did you say something, Dr. Prescott?”

Nicholas swallowed and shook his head. “No,” he said. “Nothing.” He clamped an artery and followed Fogerty’s instructions.

When the heart had been dissected, Fogerty lifted it out and nodded to Nicholas, who placed the heart of the thirty-two-year-old woman in Paul Alamonto’s chest. It was a good fit, a near match, according to the tissue analyses done by computer. It remained to be seen what Paul Alamonto’s body would do with it. Nicholas felt the muscle, still cold, slipping from his fingers. He mopped as Fogerty attached the new heart just where the old one had been.

Nicholas held his breath when Fogerty took the new heart in his hand, kneading it warm and willing it to beat. And when it did, a four-chamber rhythm, Nicholas found himself blinking in time with the blood. In, up, over, out. In, up, over, out. He looked across the patient at Fogerty, who he knew was smiling beneath his mask. “Close, please, Doctor,” Fogerty said, and he left the operating room.

Nicholas threaded the ribs with wire, sutured the skin with tiny stitches. He had a fleeting thought of Paige, who made him sew loose buttons on his own shirts, saying he was better at it by trade. He exhaled slowly and thanked the rghtÁhanked thesidents and the operating room nurses.

When he moved into the scrub room and peeled off his gloves, Fogerty was standing with his back to him at the far side of the room. He did not turn as Nicholas jerked off his paper cap and turned on the faucet. “You’re right about cases like that, Nicholas,” Fogerty said quietly. “We are playing God.” He tossed a paper towel into a receptacle, still facing away from Nicholas. “At any rate, when they’re that young, we’re fixing what God did wrong.”

Nicholas wanted to ask Alistair Fogerty many things: how he’d known what Nicholas was thinking, how come he’d sutured a certain artery when it would have been easier to cauterize it, why after so many years he still believed in God. But Fogerty turned around to face him, his eyes sharp and blue, as splintered as crystal. “Seven o’clock, then, at your place?”

Nicholas stared for a moment, dumbfounded, and then remembered that he was giving his first dinner party for his “associates”-Alistair Fogerty, as well as the heads of pediatrics, cardiology, and urology. “Seven,” he said. He wondered what time it was now; how long it would take him to change gears. “Of course.”

Nicholas had been having nightmares again. They weren’t the same ones he’d had when he was in medical school, but they were every bit as disturbing, and Nicholas believed they stemmed from the same source, that old fear of failure.

He was being chased through a heavy, wet rain forest whose ivy vines dripped blood. He could feel his lungs near bursting; he pulled his legs high from the spongy ground. He did not have time to look back, could only brush the branches from his face as they lacerated his forehead and his cheeks. In the background was the banshee howl of a jackal.

The dream always started with Nicholas running; he never knew what it was he was running from. But sometime during the sheer physical concentration of sprinting, of balancing and dodging thick trees, he’d realize that he was no longer being chased. All of a sudden he was running toward something, just as faceless and forbidding as his pursuer had been. He gasped; he grabbed at a stitch in his side, but he couldn’t move quickly enough. Hot butterflies slapped against his neck and leaves striped his shoulders as he tried to move faster. Finally, he hurled himself against a sandstone altar, carved with the leers of naked pagan gods. Panting, Nicholas slid to his knees in front of the altar, and beneath his fingers it turned into a man, a person made of warm skin and twisted bone. He looked up and saw his own face, older and broken and blind.

He always woke up screaming; he always woke up in Paige’s arms. Last night when he had become fully conscious of his surroundings, she had been hovering over him with a damp washcloth, wiping his sweaty neck and chest. “Sssh,” she said. “It’s me.”

Nicholas let a choked sound escape from his throat and pulled Paige to him. “Was it the same?” she asked, her words muffled against his shoulder.

Nicholas nodded. “I couldn’t see,” he said. “I don’t know what I was running from.”

Paige ran her cool fingers up and down his arm. It was in these moments, when his defenses were down, that he would cling to her and think of her as the one constant in his life and let himself give in completely. Sometimes when he reached for her after the nightmares, he would grasp her arms so tightly he left bruises. But he never told her the end of the dream. He couldn’t. Whenever he had tried, he’d started shaking so badly he couldn’t finish.