Rachel M. Mullis
Duck breast with quince compote. It would have gone well with the riesling I had chilling at home. As surgical coordinator I was in charge of ordering food for the entire transplant crew—anything they wanted, from anywhere in the city—but there was, of course, no drinking on the job. On the phone, Clara asked for a porterhouse, medium rare. She thought it said a lot about a person, what you chose to order after eviscerating someone.
Her comment had thrown me. I’d ordered the duck because it sounded refined but potent, which is what I took her to be from the friends we had in common and the sex we’d been having. But since this was the first night we’d actually be working together, and since sex was pretty much all we’d been sharing in what we weren’t calling a relationship, I needed to expect the unexpected. I also needed to remember to think of Clara as Dr. Bouchier.
The San Francisco night felt thin and cold and was singed red from all the streetlights against the fog. I was making my way from the parking lot to the transplant center when Clara materialized from a taxi. She possessed a kind of controlled recklessness when she walked. She moved like a lioness following prey in the bush, just before it breaks into the final sprint. Our paths converged. Her smile put me on edge. She was smirking or annoyed or happy to see me. I told myself it was the latter.
“Cheng,” she said. “On time for once.” She retrieved a napkin from her purse, unfolding it to reveal an apple.
Her comment referred to her practice of taking a cab over to my apartment on thirty minutes’ notice and then giving me grief for not being home yet, and I ignored it. “Hello, Dr. Bouchier,” I said.
“Who is it tonight?” With one pale hand she pulled out her long hair from underneath an expensive and immaculate white pea coat. I had pinned that hand over her head until she cried out in pain, pleasure.
“A girl down in Monterey. Car hit her bicycle.”
“Dori Alvarez.” I had memorized the name, along with other pertinent details. This was my first real night on the job—my first transplant—and even if Clara had gotten me the job, she was still my boss. My boss’s boss.
“So how is the Bach piece?” she asked.
“It’s coming along.”
She nodded, biting into the apple. “In a year you’ll be at Juilliard, maybe. Peabody. Somewhere far away and prestigious.”
“If I’m lucky.”
“And I’ll see you on stage. And I’ll say, ‘I used to know him. He perfused hearts for me.’”
“He does more than that.”
She smiled. “He did.”
I hadn’t wanted Clara at first, at least no more than any other woman I’d casually slept with. Too bony, too neurotic. Too pale. But when she asked for a ride home from the dinner party where we met, I drove, intrigued at the prospect of UCSF’s top heart-transplant surgeon debasing herself with a med school dropout-turned-cellist.
But my image of Clara had been wrong. I knew before I’d even gotten her clothes off. However high her salary, however pristine she might have appeared, her business was the body, and it showed. The confidence she had in herself. The way she moved. Unabashed, or perhaps unflinching was a better word, in her appetite for sex, food, whatever it was she thought she needed. She never responded when I left messages, and never acknowledged this when she called me. She simply wanted to know: was I available. She took shape in my hallway, then in my hands. And then she was gone.
The plane pushed its way through the dark. I checked my watch. It was close to 3 am. We’d touch down in Monterey in half an hour. All the food I’d ordered for the team was sitting in a cooler near the cockpit. The other transplant surgeons and support staff were napping or listening to music. Staring out the window, Clara/Dr. Bouchier sighed, because she knew I was watching her again.
So she would be cold tonight, as she so often was. A few weeks ago she had mentioned that one of the other transplant surgeons at UCSF pulled out the lungs of a dead guy he’d gone to school with. He hadn’t realized until the transplant coordinator happened to mention the guy’s name. It had been the only night she asked to stay over.
Still, Clara was the one to suggest I take the position while I applied for grad schools because her team had been having trouble finding someone willing to work the erratic on-call schedule. The pay was good and the job didn’t require a medical degree, but relevant experience was preferred. While I’d majored in music performance as an undergrad, I’d been pre-med and had gone to med school for a year and a half. There I’d worked on cadavers, of course, and assisted with live patients, and I’d now completed training on each step of the organ harvesting process. Despite all this, I was nervous. I’d never worked on someone about to die. Correction: I’d never assisted with a procedure that would cause them to die.
At the hospital I donned scrubs and followed the teams into the OR, where Dori Alvarez waited. The room was much brighter than I’d remembered from other experiences. Still, shadows collected in the folds of the blue sheet over Dori’s body. Her thin wrist was bent back, broken, and her hand hung from the side of the table. She wore too much makeup, and was younger than I’d expected. She couldn’t have been out of high school yet. Her skin was a healthy, lovely rose-tinted brown. Her pulse beat slow and steady from the heart monitor. I circled the room. The right side of her head was a mess.
The preservation solution I was prepping sluiced through my gloved fingers, icy to the touch. Dr. Bouchier walked in, hidden behind her surgical mask, body obstructed by loose-fitting scrubs, no longer Clara. But the look in her eyes haunted me: I had seen the same expression on her face during sex.
It happened fast. Bouchier guided the scalpel down the girl’s still-warm skin. The skin fell back, yielding bones and a beating heart beneath. She sawed through Dori’s breastbone. Dori’s heart was beating faster now. How was that possible? I watched the scene as if hypnotized, half expecting the girl to open her eyes. The surgical team helped Bouchier butterfly Dori’s ribs, then continued to fold back the flesh of her abdomen. Dori’s exposed viscera gleamed like a secret never meant to be revealed. I tried to quell images of her on her bike. Maybe pedaling to the store. Maybe coming home drunk from a party. No helmet. Just a stupid kid who believed life only ended for everyone else. Some of Dori’s mourners had to be waiting for us to finish. Or perhaps they weren’t allowed to see her again until her body had been repaired and dressed for the funeral. I didn’t know. Wanted to know. Surely a few wished they could take the girl’s place, but they wouldn’t see this part. This was why I hadn’t become a doctor. You had to be able to let go.
Bouchier clamped the blood vessels leading into Dori’s heart with brutal precision. I helped pump in the flush.
The heart wound down like a dying watch. The seconds seemed to falter with it.
The beating stopped. I thought of a quote I’d heard somewhere: every person is a civilization lost forever in death. I wondered if every time I watched this procedure it would feel like the end of the world.
Bouchier cut the vessels. The heart went in the bag. The other teams began working on Dori’s kidneys and liver, picking her not-quite-carcass clean with efficient brutality; an organ free-for-all. Dori profoundly revealed, then discarded.
The bag went in the cooler. The cooler went with Bouchier.
She never even looked back.
All that was left of Dori’s life went with her.
On the way back to San Francisco I didn’t eat my duck, though the choice had seemed so important. For the first time, I was having doubts about the ethics of eating meat. Clara sawed through her steak with a dizzying resolve. If it were necessary to survival, she would have eaten metal in the same manner. I felt betrayed, but also satisfied that now I knew who she was behind the aloof veneer. Self-serving. Empathically defective. One life for another, and to hell with what was left behind. Even ancient humans performed funeral rites to honor the bodies of their dead. I would never have been able to do what she did.
I had helped, though, hadn’t I?
After her meal, Dr. Bouchier slept. Dawn was breaking through the low clouds and cast a blue light over her face that made it seem she was underwater. I remembered that the hard part for her was still to come: several hours in surgery where every gesture mattered. Several hundred thousand dollars spent on one life hanging in the balance. If I could meet one of her famed recipients, maybe I would understand. She had the power to give life. Perhaps she couldn’t afford to be sentimental about the life that had been taken.
I turned back to the window and thought about what awaited me at home. An empty fridge, a hamper full of dirty clothes, and the conservatory applications I was slogging through. I played well, at least, with “a languid sensuality.” I worried that performing was all I had the stomach for.
That night Clara showed up drunk at my apartment in Oakland, dropping her purse on the coffee table and sinking into the couch.
“Don’t stop,” she mumbled when she noticed the cello was out.
“That’s alright. I was ready for a break.”
She smiled, a real smile, eyes closed. “The cello is the closest instrument to the human voice.”
“That’s what they say.”
“It’s such a nice thought.”
I softened a little. “It is.”
“Play something for me.”
“How’d you get here?” I said as I sat back down in the chair.
“These are expensive trips you’ve been making, all the way from the city.” I wanted her to admit something, anything to me, about what she felt.
“I make three hundred thousand dollars a year and haven’t taken a vacation in years. What else am I going to spend it on?”
I pulled the instrument close, bow poised.
“Play me the Bach suite,” she said.
I had been waiting for this day for so long. For her to ask. For her to care. For her to see me as I truly was—as she would never let me be when I assisted her in the hospitals, or even when I had sex with her. I’d fantasized that when she heard me play, I would provoke the same reaction she stirred in me. She would slip off her brutalized skin like a vestige. Something better would evolve in its place.
I would play the first movement, the Prélude. I placed the sheets on the stand before me. Though I no longer needed them, the familiar rise and fall of notes on the page calmed me, the words of a story read over and over again. Sometimes when I closed my eyes to fall asleep, all I saw were those notes. I willed myself to forget her entirely.
I translated the succession of wounded, disconsolate phrases. She sat in exactly the same position, her eyes locked on the cello, studying the low throb of the bow against the strings, the tremor of restrained longing and grief. The throat as it sang, never the voice. I let the last chord hang in the air for some time. When the sound died, she finally looked up, eyes wide, mouth ajar, arrested by this new perception of me. Yet in her gaze I confirmed what I had suspected as I played: that she could not even begin to understand what the piece, what I, was communicating. Or maybe it was just that I no longer cared.
“Beautiful.” She thought she was being sincere.
“I didn’t write it.” I got up to find her some saltines.
“My patient died,” she said when I come back from the kitchen. “Died on the table.” One of the corners on the box of crackers had been crushed and she traced its crushed seam.
She shrugged and dragged a hand under eyes ringed in a fatigue of purple shadow. “Nine years old, you know? Jesus. Why have kids at all?”
She took a cracker and leaned back into the sofa. “I used to think I wanted to help people.”
So we would talk about her again. “You do help people.”
“It’s just a job. Like any other job someone might have. You know why I asked you to drive me home all those months ago? Because you’re choosing a life of passion. You’re trying to treat your life like it means something.”
“At that same dinner party you talked about how inspiring your patients are. How they go off and do all the things they were too afraid to do before they had to face death.”
“That’s what I tell everyone. It used to be true.”
“They don’t do those things?”
“They do.” She sighed. “It just doesn’t inspire me anymore.”
I never knew when to believe her. I knew that she loved her job, even if she also hated it. I knew she wasn’t dealing with all the death around her. The first time I went home with her she didn’t want to talk at all. I should have known then where this would end.
We sat there for a while, the room deathly still and growing cold. Clara fell asleep. I pulled her up and carried her to the bedroom. It was the second night she stayed, and the last. When I put her on the bed she contracted into a ball, like a pill bug prodded by the hands of a child. I pulled the covers up to her neck but still heard her muffled voice.
“When you leave all this behind, you’ll never look back.”
In the morning I watched her face, responsible for the fate of hundreds of worlds colliding all around us. A face so troubled, even in sleep. She was stronger than I. But weaker too. I wanted more than anything to sit down at my cello, but I let her sleep well into the afternoon. She’d been on call for at least sixteen hours. Her face was turned away from the western light pouring in through the window, light that transformed the room into a Klimt painting. Time dissolved like words on tongues when there is nothing left to say.
When she woke I made her coffee and added hot water and an egg to a package of ramen. As she ate she began to cry. Maybe because of her patient, maybe because of the death that must occur to save lives, or maybe only because I could not help her. I sat on the edge of my bed, staring through the gauze of the curtain at the line of blue that is the bay beyond. When she left we both looked at each other like there was something the other could have done. I knew that was what we would tell ourselves.
Hailing originally from Northern California, Rachel M. Mullis completed her MFA in Writing from Vermont College of Fine Arts and now lives in Burlington, Vermont. She is also a reader for the New England Review.