* * *
Close to the stadium, they hit a traffic jam. Shit. Virgilio sits up, instantly tense. What the fuck are they doing? The driver is unfazed. It’s the game — they don’t want to go home. Many of the cars they can see have their windows open, and delirious young men swagger about, waving Italian flags on poles; there are buses chartered by supporters’ groups, and long-distance refrigerated trucks caught up in the euphoric bottleneck. They hear the news: there’s a pile-up on the road ahead. Alice cries out, Virgilio freezes. Inch by inch, the driver manages to widen the gap between the neighboring vehicles, passing through them until he reaches the emergency lane. He drives at a reduced speed for about a mile, passing the accident site, and after that the road is clear, the spaced-out spotlights on the safety barrier now forming one long line of brightness through the dark night. Another slowdown at La Chapelle: Let’s take the beltway. The city exits are strung out to the east, from Aubervilliers to Bercy, in a long bend, after which the car turns right again, entering the city, and now they can see the banks of the Seine, the towers of the National Library, then a curve to the left and they drive up Boulevard Vincent-Auriol, braking at Chevaleret and entering the hospital grounds, here we are. The vehicle stops in front of the building — thirty-two minutes, not bad. Virgilio smiles.
* * *
Inside the operating room, the team barely looks up when they arrive together, carrying the treasure to the foot of the table like an offering left at the feet of a master. Their arrival does not disturb the practitioners’ focus on the operation, which has already begun. Virgilio and Alice are barely welcomed when they enter, already dressed in sterile scrubs, arms washed, hands disinfected, and now Virgilio can see nothing of Alice but her strange eyes, slow and dense-looking, flecked with yellow, chartreuse, and honey, smoky topaz. Harfang, though, does finally ask them: So, everything go okay with the heart? And Virgilio, in the same casual tone, replies: Yeah, just some traffic on the way back.
The heart is placed in a cup, close to the bed. Alice climbs onto a small platform at the end of the table, so she can watch the transplant, her legs weakening as she hoists herself up the step. Meanwhile, Virgilio moves forward to take the place of the department’s intern: it’s all he can do not to start picking up tools, and everything in his body language and facial expression communicates his desire to be there, under the triple surgical lamps, above the thorax, across from Harfang. Now, they will work together.
Suddenly, uncovering Claire’s heart, Harfang whistles and says Christ, it’s really not in great shape, she’ll be glad to get rid of it, and there is a hum of quiet, surprised laughter around him: Harfang has a reputation for the terrifying pressure he puts on all members of his team, seemingly aware of everything, eyes in the back of his head, so this levity is unexpected. But the surgical theater is the only place in the world where he feels truly alive, where he is able to express who he is, his atavistic passion for his work, his fanatical rigor, his faith in humanity, his megalomania, his love of power; it is here that he summons his lineage and recalls, one by one, the men who created the science behind organ transplantation, the progenitors, the pioneers — Christiaan Barnard in Cape Town in 1967, Norman Shumway at Stanford in 1968, and Christian Cabrol, here, at the Pitié—the men who invented transplantation, who first conceived it, who mentally built it up and broke it down hundreds of times before performing it, those men from the 1960s, workaholics, charismatic stars, media rivals who were quick to argue and stole from each other without a qualm, Casanovas at multiple weddings, surrounded by girls in riding boots and Mary Quant miniskirts, made-up like Twiggy, insanely bold autocrats who were covered in honors but never lost their rage.
* * *
First they have to deal with the veins and arteries that carry blood into and out of the organ. One by one, the veins are severed and clamped — Harfang and Virgilio move quickly, but it’s as if this rapidity drives their action, as if by slowing down they would risk trembling — and then, this is impressive, the heart is extracted from the body and an extracorporeal circulation takes over: for two hours, a machine replaces Claire’s heart, a machine that will reproduce the blood flow in her body. At that moment, Harfang asks for silence. He chimes a blade against a metal tube, then through his mask pronounces the phrase that is ritual at this stage of the operation: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus—an homage to William Harvey, who in 1628 became the first doctor to describe the entire blood circulation system of the human body, with the heart named as a sort of hydraulic pump, a muscle that — through its movements and beats — ensured the continuity of blood flow. In the theater, without stopping what they are doing, everyone replies: Amen!
The perfusionist is disconcerted by this strange ritual. He does not understand Latin and wonders what the hell is going on. He is a young nurse, twenty-five, twenty-six, with curled-up eyelashes, the only person in the room who has never worked with Harfang before. He is sitting on a high stool positioned in front of his machine, like a DJ with his turntables, and no one here would be more at home than him in the tangle of wires coming out of the large black boxes. Filtered and oxygenated, the blood runs through a jumble of thin transparent pipes, color-coded stickers specifying their direction. On the screen, the electrocardiogram is flat and the body temperature is 90 degrees, but Claire is perfectly alive. The anesthesiologists take turns checking her vital signs, to confirm she is receiving the necessary substances. They can continue.
So Virgilio leans down and picks up the cup containing the heart. The ties of the various bags that protect the organ are sprayed with disinfectant, then undone; after that, he extracts the heart from the jar, holding it in both hands, and places it at the edge of the thoracic cage. Alice, still perched on the metal step, now stands on tiptoes, staring, fascinated, and almost loses her balance when she moves her chin forward to get a better view of what’s happening, there, inside the body. She is not the only one to crane her neck in this way: the department intern, who is standing next to Harfang, also moves forward, his face so covered in sweat that his glasses slide down his nose and he nearly loses them, drawing back at the last minute to push them up, knocking a drip with his elbow. Please be careful, the anesthesiologist says coldly, before handing him a compress.
* * *
Now the surgeons begin the long process of sewing: they labor to connect the new heart, going from bottom to top so that it is anchored at four points — the recipient’s left auricle is stitched to the complementary part of the left auricle of the donor’s heart, same thing for the right auricle, then the recipient’s pulmonary artery is attached to the end of the donor’s right ventricle, and the aorta to the end of the left ventricle. At regular intervals, Virgilio massages the heart, using two hands to press down hard, so his wrists disappear inside Claire’s body.
An almost routine atmosphere descends now, and there are snatches of conversation, sometimes a hubbub of voices, department in-jokes. Harfang asks Virgilio about the game, with that mixture of condescension and fake complicity that annoys the Italian: So what do you think of the Italians’ tactics, Virgilio? Do you think it makes for an entertaining game? And the young man replies, tersely, that Pirlo is a truly great player. The body is kept in a state of hypothermia, but the air in the room is hot now, and the practitioners’ foreheads, temples, and upper lips are regularly sponged, they are helped to change their clothes and their gloves — the nurse opens the bags then holds up the protective outfits horizontally and inside out. The human energy being spent here, the physical tension and the meaning of each action — nothing less than a transfer of life — seems bound to produce this humidity, which starts to grow, to hover like a cloud in the room.