A. Yehoshua - Open Heart

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.