Behind the door of the operating room, the anesthesiologist checks the placement of the equipment that will monitor the patient’s condition: electrodes to monitor the heart, catheters to provide a continual blood pressure reading, and that device that pinches the patient’s fingertip and tracks oxygen levels in the blood. She sets up the drip, suspending the bag of clear liquid, checking the flow speed — simple gestures, perfectly executed, as you would expect after thirty years of experience — all right, we can get going, is everyone here? But no one is completely ready yet: the team is in the changing rooms, putting on their sky-blue scrubs, short-sleeved shirts, and long-sleeved jackets; everyone wears at least two surgical caps to ensure their entire scalp is covered, and two masks over their mouth. Disposable slippers and overshoes, and multiple pairs of sterile gloves, changed on a regular basis. They wash thoroughly, lathering their hands and forearms up to their elbows with disinfectant soap, cleaning and recleaning their fingernails. Indistinct bodies move into place, check the equipment, but their faces have vanished, leaving only a general notion of appearance, height, shape, gait, mannerisms, and the expressiveness of eyes, which in this room forms the basis of another language. There is a perfusionist, the OR intern, two dressings nurses, and two anesthesiologists: Harfang has worked with these two women — old friends now — for thirty years; he performed his first transplant with them.
And so it begins, like the start of a race. He is wearing a sort of apron gown that covers almost his entire body; it goes on front first and knots in the back; one sleeve is tied to his thumb; with its mid-calf length, it is reminiscent of those straight, narrow aprons that butchers wear. He approaches Claire for one last word: The heart will be here in thirty minutes; it’s a wonderful heart, perfect for you, the two of you will get along splendidly. Claire smiles: But you will wait until it’s in the operating room before you take mine out, won’t you? Harfang stares at her, amazed — are you serious?
Claire is anesthetized. Soon, images appear under her eyelids, a gush of vague shapes and warm tones, an infinite metamorphosis of surfaces, a kaleidoscope of cells and fibers, while the nurses make her head and most of her body disappear under large yellow plastic sheets, which are in turn covered with surgical drapes: only a small area of skin remains visible, lit clearly by the lamps overhead; it is a moving sight, this zone where they will dig. Harfang begins; with a sterile pencil, he traces the lines of the incisions to come, marking out the precise spots where he will make small openings — they slide pipes into these holes, through which they will send a system of tiny cameras. Then the anesthesiologist, ear to the OR phone, announces: Okay, they’re here.
27
Another surgical theater, in a nocturnal estuary, but this one is almost empty now, the teams having left in reverse order to that of organ preparation; the last ones there with Simon Limbres are the urologists, who have removed the kidneys and are now in charge of making the body appear externally whole.
Thomas Rémige is there too, his face gaunt and shining with fatigue, and even though the hour is late, time slowing and slackening as they near the end of the operation, the surgery becoming less urgent, his presence is now accentuated. Every move he makes, even the most imperceptible, expresses the idea that no, they are not finished yet. He exasperates the others, of course, leaning over their shoulders, preempting everything the surgeons and nurses do. It would be so easy now to relax, to cut corners, to rush through the final details and get the thing done — what difference does it make, really? But Thomas silently resists this general exhaustion, maintaining the urgency, refusing to let up: this part of the operation — restoring the donor’s body — cannot be trivialized; it is an act of repair; they must repair the damage they have caused. Put things back the way they were. Without that, it’s barbarism. Around him, they roll their eyes and sigh — stop worrying, what do you take us for, we’re not going to botch the job, everything will be done properly.
* * *
Simon Limbres’s body is hollow; in places, his skin looks as if it’s been sucked inside. And as this atrophied, mutilated appearance does not match the way he looked when he entered the theater, it breaks the promise that was made to his parents. The void must be filled. Quickly, the practitioners create a sort of lining, using fabrics and compresses, a crude stuffing that must be modeled as best it can to resemble the shape, volume, and position of the harvested organs. Their hands move rapidly in what is an act of restoration: Simon Limbres is being given back his original appearance, so that it is him — that image of him — that will be remembered by his family when they see him tomorrow in the mortuary, so they can recognize him as the boy he was.
Now the body is being closed up — on its emptiness, its silence. The oversewing — with a single thread, knotted at either end — will be delicate, painstaking, the surgeon’s needle, thin and precise, tracing a straight perforated line; but what is most striking is that stitching — that ancient craft slowly deposited in human memory since the Paleolithic age — can provide the conclusion to such a high-tech operation. The surgeon works on a wholly intuitive level, absolutely unaware of his own movements, his hand making regular loops above the wound, each loop small and identical, lacing up and closing the skin. Across from him, the young intern continues to watch and learn: for him too, this is the first time he has taken part in a multiorgan removal, and he would probably have liked to perform the suturing himself, to have placed his hand on the donor’s body as part of this collective gesture, but his perceptions have been overwhelmed by the intensity of the operation, and — whether from fatigue or nerves — his vision is clouded by black fluttering butterflies. Tensing up, he tells himself that he didn’t buckle when the blood poured into the bucket, that he’s gotten through the hardest part, and that what matters now is staying on his feet until the end.
* * *
At 1:30 a.m., the urologists put down their instruments, lift their heads, breathe out, lower their masks, and leave the theater, taking the kidneys with them. Thomas Rémige and Cordélia Owl remain, the latter apparently kept going by a residual tension; she has not slept in almost forty hours, and she has the feeling that if she slows down, she will collapse, fall flat on her face. She begins the night’s final tasks — making an inventory of instruments, filling out labels, noting down figures on printed forms, recording the hours — and these administrative formalities, carried out with robotic rigor, leave her mind free to wander, memories flashing into her brain of body parts, fragments of speech, different places — a hospital corridor opens onto a vaulted passage of exquisitely vile smells, a shock of hair trembles over the flame of the lighter, orange streetlamps undulate vertically in her lover’s eyes, green-haired sirens writhe on the side of a van, her cell phone finally vibrates in the night — a porous continuum superimposed by the face of Simon Limbres, whom she treated this afternoon, whom she examined and caressed, and this young woman with her hicky-flecked leopard-print body, thinks suddenly of how long it will take her to decant these hours, to filter the violence, to make sense of the meaning — what have I just lived through? Her vision blurs as she checks her watch, lowers her mask: I have to go back to the department for a while, the intern’s alone in there, I’ll be back soon. Thomas nods without looking: That’s okay, take your time, I can finish up. He hears the woman’s footsteps fade and the theater door close. Now he is alone. He looks slowly around him, and what he sees makes him quaiclass="underline" the room is in chaos, a tangle of equipment and electric wires, screens facing the wrong way, used instruments, soiled cloths piled up on bench tops, the operating table dirty, and the floor splattered with blood. Anyone who looked in would blink in the cold light and then see what looked like a battlefield, an image of war and violence. Thomas shivers, then gets to work.