On the seventh day, I was awake long enough for Hema to make the fantastic statement that half of Shiva's liver was in me. Sick patients need to have everything explained at least twice, because you can presume they will not have heard half of what you said. Hema repeated herself at least ten times, and it was only when she showed me the Times, and the picture of me and of Shiva, that I believed.
“Shiva is recovering,” Hema said. “He's fine. But you've developed pneumonia and there is fluid collecting around your right lung. That's why you are still on the ventilator. But it's getting better, so Deepak says you will be off the ventilator tomorrow. Your new liver is functioning well, and your kidneys have bounced back.” This was not the reunion I had imagined with Hema, but the expression on her face, her joy, her relief, were priceless. She rarely left my side.
I saw Deepak and Stone for the first time later that same day. I struggled with my emotions. I know I was supposed to feel gratitude. Sometimes I think we surgeons wear masks to conceal our desires, to hide our willingness to violate the body of another. Only the guarantee of amnesia, the fact that the patient will remember nothing but the anesthetist's saying “Sweet dreams,” allows us to be surgeons. They stood before me, these perpetrators of organized violence on my body. The fact that both men were shy and unassuming seemed almost deceitful given the ambition, the hubris, that had allowed them to risk Shiva's life for mine. It was the only time I was thankful for that evil tube going down my throat and between my vocal cords, because what I would have said to them would have sounded ungratefuclass="underline" It's a good thing Shiva made it, otherwise I'd be after your hides.
When I awoke sometime later, I forgot about the tube and tried to speak, which made me feel I was choking, which made me panic. My struggles triggered the ventilator alarm, and now I was terrified that the nurse would decide I was “fighting the ventilator,” which could bring an order for intravenous curare. That drug, derived from the poison darts of Amazon tribes, paralyzes all the muscles, leaving you still as death, so that the ventilator can do its work unimpeded. But God help you if you aren't given a strong sedative along with it, because then you are awake, alert, but unable to twitch or even blink. The thought of being in that paralyzed, locked-in state had always horrified me, even as I blithely ordered curare (andsedation) for hundreds of patients. Now that I was a patient, my curse was that I knew too much.
With Hema's help, her soothing voice, I did my best to calm down, to let the machine push air into me, and the nurse retreated. When I felt better I wrote, How is Shiva?
She didn't have to reply, because just then my other half came in, led by Thomas Stone.
My brother, whom I had not seen for seven years, looked haggard, not at all like the picture in the Times. I felt vertigo in seeing my reflection moving independently of me. Shiva wore a hospital gown, one palm resting carefully on his belly, the other hand pushing his intravenous pole ahead of him, and using it as a walking stick. My brother wasn't given to laughing and most jokes were wasted on him, but when he saw me, he grinned like the chimp who'd locked up the zookeeper.
You monkey, you, I wanted to say, and I reached hungrily for his hand, our fingers interlocking. You should laugh more, it suits you: see how the furrows around your brow vanish and your ears ease back? I felt fluid running down my temples, and his eyes were full, too. I squeezed his fingers, a Morse code to convey what was in my heart. He nodded—You don't have to tell me anything is what he was saying. He bent forward gingerly, and I wondered what he was up to, surely not a kiss … He clinked his skull against mine. It was such an unexpected, jarring, and surprising act, a throwback to being little boys, the softest of testas, that it made me laugh, which made that horrible tube scratch the inside of my throat, and so I had to stop.
I pointed to Shiva's belly. He pulled aside his gown and I could see some of the incision, though a gauze pad with a drain passing through it hid the remainder. I raised my eyebrows at him, asking if it hurt. And he said, Only when I breathe, and we both laughed and both had to cut that off because of the pain. Stone stood looking on at this silent dialogue, amazed, a strange expression on his face.
Little did I know that Shiva's recovery had been complicated by a bile infection requiring antibiotics. Or that he had developed a blood clot in the vein in his right arm through which he'd been getting fluids. He was on a blood thinner, and the clot was resolving.
I held his hand for a long time, content to look at him, to thank him with my fingers, but he kept shrugging off my thanks. I reached for my pen, and Hema pushed the pad in front of me and I wrote, Greater love hath no man—
He didn't let me finish. He held my pen. He said, You would have done the same. I had my doubts, but he nodded. Yes, you would.
That evening, Deepak drained fluid from around my right lung, and my breath expanded in that direction. Then he took the wretched tube out of my throat. My first words were “Thank you,” and when that ugly blue machine left my room, I fell into a deep sleep.
The next morning was full of small miracles: being able to turn and gaze at the window and see sky, being able to say “Ouch” when the movement pulled on my incision. Hema wasn't around. The ICU was quiet. My nurse, Amelia, was unnaturally cheery. I assumed it was still early morning. “We have an X-ray to do downstairs,” she said, unhooking me from the tethers, and readying my bed to roll.
In Radiology I was lifted into the doughnut for a CAT scan, but oddly, it was of my head and not my belly. Surely it was a mistake. But no, the order was from Deepak, and it read, “CAT scan of the head with and without contrast.”
Back in my room and by noon, still no sign of Hema, or Stone, or Shiva. Amelia said they would be along presently.
The physical therapist helped me stand beside my bed for a few seconds. My legs felt like Jell-O sticks. I took a few steps with assistance, then sat in the chair, exhausted, woozy, as if I had run a marathon. I dozed there, ate what little I could. After lunch, I took a few more steps, and even peed upright. The nurses helped me back to bed. In retrospect, they seemed pleased to get out of my room.
IT WAS 2:00 P.M. when Thomas Stone appeared at my door. There were dark circles around his eyes. He sat self-consciously on the edge of the bed. He touched my hand. His lips parted.
“Wait,” I said. “Don't say anything yet.” I looked out of the window at the clouds, at distant smokestacks. The world was intact now, but I knew once he spoke it wouldn't be so.
“Okay,” I said. “What happened to Shiva?”
“He had a massive bleed in his brain,” he said, his voice hoarse. “It happened last night, about an hour after we left your room. Hema was with him. He suddenly clutched his head in pain … Then, in a matter of seconds, he was … unconscious.”
“Is he gone?”
Thomas Stone shook his head. “He bled from an arteriovenous malformation, a cavernous tangle of blood vessels in the cortex. He has probably had it all along … He was on anticoagulants for the blood clot in his arm … In a week we would have stopped.”
“Where is he?”
“Here. In the ICU. On a ventilator. Two neurosurgeons have seen him.” He shook his head. “It isn't feasible to evacuate the bleed. They think it's too late. And that he's brain-dead.”
I didn't register much of what he said after that. I remember he said that my CAT scan showed a similar but smaller spider knot of vessels, but mine wasn't bleeding, a miracle of sorts, I suppose, since I'd bled from everywhere till I got Shiva's liver.