Maylis de Kerangal - The Heart

Révol’s voice recites precisely the wording that he expected. Rémige nods without a word, instantly going through the finely calibrated operation that he will soon set in motion within a legal framework that is both dense and strict, a high-precision movement that must be unfolded in accordance with a very specific time line, which is why he now looks at his watch — something he will do many times in the hours that follow, something they will all do, repeatedly, endlessly, until it is all over.

They begin a rapid dialogue, alternating questions and statements about Simon Limbres’s body. Rémige sounds out Révol on three main points: the context of the diagnosis of brain death (where are we with that?), the medical evaluation of the patient (cause of death, background check, feasibility of transplantation), and, lastly, the situation regarding next of kin: Has he been able to talk to the boy’s family about the brutality of the event? Are his next of kin present? To this last question, Révol replies in the negative, then clarifies: I’ve just talked to the mother. Okay, I’ll get ready now. Rémige shivers with cold. He is naked, remember.

* * *

A few moments later, wearing a helmet, gloves, and boots, his jacket zipped up to the collar and his indigo scarf wrapped around his neck, Thomas Rémige mounts his motorcycle and sets off in the direction of the hospital. Before putting on his helmet, he listened to the echo of his footsteps in the silent street, attentive to that sensation of being inside a canyon, a bottleneck of sound. A flick of the wrist and the engine roars; after that, he too heads east, following the straight road that splits the poor part of town — a road parallel to the one taken earlier by Marianne — swallowing up the miles on Rue René-Coty, Rue du Maréchal-Joffre, Rue Aristide-Briand — bearded names, mustachioed names, names with paunches, names wearing pocket watches and fedoras — Rue de Verdun and so on, as far as the expressway interchanges, as far as the city limits. His full-face helmet makes it impossible for him to sing, and yet some days, overcome by some mixed emotion midway between fear and euphoria, he lifts his visor in these urban corridors and lets the space vibrate in his vocal cords.

* * *

Later, in the hospital. Thomas knows every inch of this vast, oceanic lobby, this void that he crosses diagonally from the end of the path to the stairs that lead up to his office, the Coordinating Committee for Organ and Tissue Removal, on the second floor. But this morning, he goes in as a stranger, as vigilant as if he did not belong to this organization; he goes there as he goes to other hospitals in the area — institutions unauthorized to remove organs. Speeding up as he passes the reception where two men wait, red-eyed and silent, wearing big black down jackets, he waves to the monobrow woman, who, seeing him hurtling into view when she knows he is on call, guesses that a patient in the ICU has just become a potential donor, and responds to his wave with just a look. The arrival in the hospital of the coordinating nurse is always a delicate matter: the patient’s next of kin, unaware of what is about to happen, might hear him talking to someone else about the reason for his presence and make the connection to the condition of their child, their brother, their lover, the news coming as a terrible shock — a situation that would not augur well for the interviews that follow.

* * *

In his lair, Révol, sitting behind his desk, hands Simon Limbres’s medical file to Thomas. He raises his eyebrows as he does this — eyes widening, forehead wrinkling — and continues their earlier telephone conversation as if no time has passed: a nineteen-year-old boy, nonreactive to neurological testing, no reaction to pain, no cranial nerve reflexes, fixed pupils, hemodynamically stable, I’ve seen the mother, the father will be here in two hours. The nurse glances at his watch — two hours? The last of the coffee in the pot is poured into a plastic cup, which makes a little crumpling noise. Révol goes on: I’ve requested the first EEG, they’re doing it now — words that are like the pistol shot at the start of a race, because, by ordering this exam, Révol has triggered the legal procedure for recording the death of this young man. There are two kinds of protocol for this: either a CT angiography (or, in the event of brain death, a scan confirming the absence of intracranial blood flow) or two thirty-minute EEGs, carried out at four-hour intervals, showing the flat line that signifies the disappearance of all cerebral activity. Thomas receives this signal and declares: We’ll be able to carry out a complete evaluation of the organs. Révol nods: I know .

* * *

Out in the corridor, they go their separate ways. Révol goes up to the recovery room to check on the patients admitted that morning, while Rémige returns to his office, where he immediately opens the green folder. He immerses himself in it, reading each page attentively — the information provided by Marianne, the emergency team’s report, today’s scans and analyses — memorizing the figures and synthesizing the data. He gradually forms a precise idea of the condition of Simon’s body. He is not without apprehension, though, for while he knows all the different stages, the signs that line the route he must take, he is also well aware that this is no well-oiled machine, no simple chain of events, no mere checklist of items to be crossed off one by one. This is terra incognita.

When he’s gone through the dossier, he clears his throat and calls the Biomedical Agency in Saint-Denis.

The street is silent too, as silent and colorless as the rest of the world. The catastrophe has spread through everything — places, objects — like a plague, as if the world were adapting itself to what happened this morning, the brightly painted van crashing at full speed into the post, the young guy propelled headfirst through the windshield, as if the surrounding landscape had absorbed the impact of the accident, had swallowed the aftershock, muffled the last vibrations, as if the shock wave had grown smaller, spread itself thin, weakening until it was a flat line, a simple line rushing into space and merging with all the other billions and billions of lines that formed the violence of the world, this pin cushion of sadness and ruin, and as far as the eye can see, nothing: no glimmer of light, no burst of bright color, no gold or crimson, no music drifting from an open window — no pounding rock tune, no melody to which you might sing along, laughing, happy, and vaguely ashamed at knowing the lyrics to such a sentimental song — no smell of coffee or flowers or spice, nothing, not a red-cheeked child running after a ball or crouching, chin on knees, eyes magnetized by the progress of a marble rolling along the sidewalk, not a sound, not a single human voice calling out or whispering words of love, no newborn baby’s cry, not a single living being caught in the continuity of time, occupied in some simple, insignificant act on a winter’s morning. There is nothing to disturb Marianne’s suffering as she moves forward like a robot, her movements mechanical, her expression vague. On this fateful day. She repeats these words to herself, under her breath, unsure where they came from, saying them as she stares down at her boots, as if the words were lyrics accompanying her muffled footsteps, a regular sound that spares her from thinking that, for the moment, there is only one thing to do: take one step and then another step and then another and then sit down, and drink. She heads slowly toward a café that she knows is open on Sundays, a shelter she reaches on the verge of collapse. On this fateful day, I pray to you, my Lord. She whispers the words over and over again, enunciating their syllables like the beads of a rosary. How long is it since she said a prayer out loud? She wishes she could never stop walking.