The next afternoon, Lauren arrives just as an IV nurse makes an attempt to slide a new needle into my forearm. My eyes are closed tight, but I can identify my friend’s footsteps as she enters the room.
“Lauren!” I open my eyes for just a couple of seconds to take in the happy sight of her.
“Hi, lovey girl,” she says, cheerful but terrifically serene. “I see you’ve got something going on there. Should I step out for a minute?”
I tell her to stay, please; it’s just an IV change. With eyes closed again, I hear her settle into the chair beside my bed. She takes my hand in hers.
“Darn it, darn it, ugh . . .” The nurse sighs with exasperation. “I didn’t get the vein this time either. Sorry.” She places my right arm gently on the bed and takes a deep breath.
It was her third try, and I was verging on tears when Lauren walked in. IVs are harder to insert when the heart is not pumping blood through the veins with requisite strength. The problem is only made worse over time by the daily (or sometimes twice daily) blood draws that inflict innumerable vein punctures, thereby making it even harder to find pristine spots for IV placement. And since IVs have to be removed and relocated every three days to prevent infection, the stretch of available real estate along the arms becomes overpopulated quickly with holes and hematomas. During the two months I spent in the hospital waiting for my first donor heart, I had more than fifty IV changes that became increasingly mangling and agonizing. And now, barely one week into my stay at Cedars, I see my veins moving quickly toward destruction—a portent of many grueling IV changes to come.
“I’m going to give it one more try,” the nurse says through a taut smile, “and if it doesn’t work this time, I’ll get the supervisor, okay?”
“All right.” I feel a tear slip through, even though my eyes are shut tight.
Lauren gives my hand a little squeeze. “Okay, honey.”
“You’re here,” I say, just because it comforts me to confirm this out loud.
“I most certainly am.”
“Good . . . because . . . sniff, sniff . . . it’s been so hard, Lauren, and I need . . . I mean, I . . . I’m just so . . . Thank you, thank you . . .” Tears stream down my nose, my cheeks.
“Love you, girl,” she says.
“Love you too.”
I exhale and settle into the moment.
Everything feels suddenly easier. The unfamiliar hospital room and fraught IV scene that Lauren just walked into do not intimidate her, and I feel at once the power of two in her company. This sense of confident togetherness is something we’ve earned; it’s not a trusted closeness that happened on its own through friendship dating back to childhood, like Jill and I have experienced. Lauren and I didn’t meet until we were young adults—and it didn’t go too well at first. But our relationship has grown steadily and beautifully since our somewhat shaky beginning.
If you ask Lauren about the first time we met, she will say without hesitation that I wasn’t nice to her. “Oh, Amy didn’t like me,” she’ll chide, sort of teasing. Lauren was dating Scott’s best friend and law school roommate, Lenny, back then (he’s now her husband); getting along as a cozy foursome had been my immediate intent. And yet, as Lauren would tell you, when I answered the doorbell and first laid eyes upon her one Sunday afternoon back in 1987 (Scott and Lenny were in the living room watching football), I hardly offered a warm welcome or introduction. “You said, ‘Uh, hi,’ and walked immediately into the kitchen,” is how Lauren remembers it.
“It wasn’t exactly like that.”
“Yah-huh, it was.”
Whenever Lauren and I revisit this early scene, I try to explain that I’m shy by nature, which happens to be true, but she sees no trace of timidity in me at this point in our long friendship and doesn’t buy it. We end up tossing our hands in the air and laughing: We were so young. Who can remember the forces at work when we first met?
I could, actually.
I remember Lauren on that doorstep perfectly. And I have an idea of why I turned away from her at that moment and why still, to this day, I’m taken aback for the first few seconds just about every time I greet her—at the coffee place in town or on the street corner where we start up a neighborhood walk or anywhere, really, even though we’re the closest of friends. There’s something about Lauren that delays an easy hello.
It’s not so much the way she looks, although her attractiveness is striking enough to ignite high-school-level envy and comparisons. Now, at fifty years old, Lauren carries herself effortlessly, with toned muscles and unfailingly perfect posture. But it’s not simply physical loveliness that commands Lauren’s effect; it’s more the way she puts her mind to use and orchestrates success.
I squeeze her hand so tight now, she calls out “Ouch!” right along with me. Even though I’ve turned my head away from the insertion site, I can feel that the needle isn’t in correctly—because it’s painful. When an IV is a well-placed keeper, it doesn’t hurt much at all.
“Your vein, ugh! Just can’t get this in . . .” the nurse laments, removing her gloves and wiping her forehead. “I’m going to get the supervising nurse so I don’t have to keep sticking you, sweetheart.” She gathers the paraphernalia from atop my blanket—a mess of rubbery tourniquets, paper and plastic discards, used needle sleeves and gauze—and tells me not to worry. “Maybe she’ll get lucky and find a good vein—somehow.”
Maybe? Somehow? I careen my torso up and away from the pillow stack. My mouth flies open to make room for a blast of frustration. Lauren’s hand lands on my thigh.
She exhales through her nose and floats at once to standing, as if tied to a helium-filled idea. Taking hold of my left forearm—the one the nurse has not tried yet—Lauren inspects its condition at close range. “Quick question before you go?” she asks amiably, meeting the nurse’s eyes directly. “Why not try this arm? I defer to you, of course, but look . . .” She points to a few green-blue veins visible close the surface of my skin.
The nurse tells her that the previous IV had been placed in that arm, and that it’s preferable to switch with each change.
Lauren pauses for a second, finger to chin. “Oh, okay, I see. And I respect that, of course. But Amy’s had a lot of sticks already—as you so kindly pointed out. Wouldn’t it be great to get a sure thing on the next try? Unless you think that having two left-arm IVs in a row would pose a risk to her . . .”
I shift my eyes to the IV nurse—what’s her reaction to this layperson suggesting how she might do her job differently?
A slow nod. A kind smile.
Three minutes later, I’ve got an IV perfectly in place—on the left. If Lauren’s solution seemed like an obvious one, it was only because she led us all to it with such ease. In hospital settings, where things are done the same way over and over, whether driven by protocol or mere habit, an agile, genteel approach like hers can save the day. There is a lesson for me in what she has accomplished here—I feel it in the calm that pervades the room in the wake of her grace under pressure. It would do me good to channel it in the days to come. But can I really? Her coolheaded decorum isn’t easily emulated, even under the best of circumstances.
As long as I’ve known Lauren, she’s been a thinker. A measured assessor before action. A careful calculator of this moment and the next, and the one after that. When I first met her, I could tell she was confident and prepared, at twenty-three years old, in ways I hadn’t given even a moment’s consideration. I didn’t have the wherewithal to integrate my sense of her into concrete thought just then, but I could gather this much: This girl has got it together in more ways than I can tell.
Unlike me at twenty-three years old (or fifty), Lauren was and is completely and consistently in control of her presence. The extent to which she’s got her wits about her is instantly apparent and, in my repeated experience, a little daunting. It’s not so much jealousy that hits me; it is more a sense of awe at how she lives the cognitive ideal. Careful thought precedes all action. I can’t imagine Lauren ever running out of a hospital room and hiding from her friend in a darkened hallway. She’d get a hold of herself.
“Listen to this—I water-skied for the first time in I don’t know how many years,” she told me just last summer, “and I dropped a ski and did the rest slalom” (on a single ski, that is). “I fell once and told myself, Lauren, you’ve got to balance more accurately—pull in that stomach and lean thirty degrees to the left and ten degrees back. Then I thought about my arms, rotated my left wrist, and brought my right hand into a more dominant position . . .”
I’d gone water-skiing not too long ago as well and, unlike my more analytically gifted friend, gave it no thought: no self-evaluation of my technique, no purposeful adjustment of my position. I just let the boat pull me willy-nilly for a few feet and then belly flopped into the cold lake.
Every time I say hello to my dear friend Lauren, I feel some of that splash.
Leja is holding her breath. The tip of her nose has turned red and she’s pulled in her chin like a turtle; I’m sure of it, even though I can’t see her. We’re on the phone. Leja is back in New York for a few days of well-earned rest after spending a month here in California. She blows out a gust of air now and takes in another gulp. This is how Leja weeps.
I’m glad I picked up her call. I had ignored all the other rings and pings from my cell phone over the past few days, but when I saw Leja was calling I told Lauren and Jody I wanted to take it.
“We’ll run down for a quick coffee, then,” Lauren whispers, giving Jody the nod to join her as I say hello into the cell. I gesture toward the door—Go ahead . . . I’m fine.
There is loud sniffling on the other end of the phone. “Leja, breathe,” I say gently. “Tell me what’s going on.”
“I do not want to bother to you. You are in hospital.”
“Don’t be silly. I’m always here for—”
“Okay, I will tell to you—it’s that Brenda! I hear that she is telling to the mothers at the bus stop that I go with my friend to California for fun trip and this is why I quit her house. For fun trip!” Leja explains that she’s worried this will ruin her reputation and cause trouble when she tries to find another job after returning from California. Beyond the economics of it, she prides herself on being a hardworking and highly trustworthy nanny and house cleaner, and she can’t fathom her former boss Brenda speaking ill of her. Leja has made a point of being nothing but discreet and private, never sharing with me anything she sees or hears on the job, never criticizing mothers, fathers, kids, or even unruly dogs in the households where she has worked. And while she has cried to me many times over the last couple of years that she’s unhappy working for Brenda (whom I know only as a mere acquaintance), she refrained from saying exactly why; instead, she remained loyal and earnest, wondering aloud to me what she can do to handle the job better and bring a happier attitude to it day after day. She finally decided to return to her affirmations, sitting at the computer for ten-minute concentration sessions once or twice a day, watching her preselected messages trail across the screen: I enjoy my work . . . I do an excellent job and I feel appreciated . . . Work stresses do not bother me . . .
When Scott and I asked Leja to consider coming to California with us for an unspecified number of months, she knew this meant ending her job as a nanny and housekeeper for Brenda. And while the prospect of quitting was not an unhappy one for Leja, she was intent on handling it professionally and giving proper notice. Scott and I talked with her about it, and we decided that two weeks was typically fair, figuring that Brenda likely would have given this same duration of additional employ were she to fire Leja.
“Brenda tells to people that I did a bad thing to her family when I decide go to California for fun trip with you. How can she say such!”
Leja had explained to Brenda that she wanted to help me in this terrible time—that I had been a good friend to her, and that in Croatian culture, good friends do all they can for each other without thinking of themselves. But, according to the chatter, Brenda would not believe that Leja’s motives did not include California fun. “I felt inside me so terrible when I quit her job. I said to her this, ‘Amy is dying’ . . . but she kept telling to me, ‘Two weeks! How can you leave in two weeks!’ I said again to her, ‘Amy is dying’ . . .”
Leja lets out a squeak of anguish and blows her nose. I’ve got to assure her that she has done nothing wrong. “Two weeks’ notice—that’s standard stuff. You shouldn’t feel bad about it.”
“I feel angry . . . I do a good thing and Brenda says this about me. I do not deserve!”
“No, Leja, you do not deserve it one bit. You are a good person and an excellent worker. You are fair and kind. And you are saving my life.” I feel my eyes fill with tears. “Let’s talk about it more tomorrow, okay?”
I sit up against some pillows, pull my laptop toward me, and dare to open it. I don’t have sufficient strength for emails or even texts; I write almost none these days, and most of the ones I receive go unanswered. But I’m rallying myself to try to set things right for Leja.
Dear Brenda,
I thought of you this morning from my hospital room at Cedars-Sinai, where I’m waiting for a second heart transplant. The biggest help to me as I struggle here is Leja, who is and has long been my Croatian sister, friend, and supporting spirit. It was quite hard for me to ask her to leave her job to help me. But it was quite wonderful that Leja responded to my desperate need with such selflessness, thinking of nothing but how she might help. Just know, for what it’s worth, that Leja is doing an angel’s work here as I struggle for each breath, hoping for a miracle.
I do hope that things are going great with your family these days . . .
I lift my fingers from the keyboard and fall back against the pillows, exhausted and nauseated. One email is more than my heart’s energy allows. I open my night table drawer and reach for my Tums and Tylenol stash—contraband that my friends know I’m harboring against the rules, naughty, naughty. No one wants to wait for a nurse to fetch a doctor’s written order when they’ve got nausea or a headache. Secreting away my own Tums and Tylenol is a trick I learned many hospital stays ago, and thank goodness for it: right now I feel close to vomiting. My abdomen has stretched to second-trimester distention, suspiciously firm to the touch and full of the same fluid that has inflated my ankles and feet to near bursting. My liver is now enlarged (due to right-side heart failure, Dr. K tells me), which makes it hard to eat much of anything and inches me toward malnourishment (my blood level of the vital protein albumin is declining, which is a dangerous telltale sign).
The simple breathlessness I felt one month ago when Leja and I spied the auspicious hummingbird in the bungalow garden is but a quaint memory. In the changing of the friend guard from Leja to Jody to Jill to Lauren, my heart problem has become a systemic one. I have come to realize this not just by noting the daily blood results and EKG printouts from my telemetry monitor that the doctors and nurses show me on request. Even more meaningful to me are the watchful measurements I apply to myself each day—little tests I’ve invented, most of them involving the application of numbers that hark back to my windowpane breath counts. It’s a desperate attempt to find my footing in heart failure quicksand.
So, for the last two weeks, I’ve been counting the duration of my urine flow in seconds. I use this as an indication of my kidney function, which, in turn, gives me insight into whether my heart’s failure is causing other organs to fail as well.
Just last night, for instance, I had the urge to pee and got excited that my body would be expelling more of the fluid that now is not only flooding my feet and ankles, but also settling into my lungs in the form of a vapory gurgle. I sat on the toilet, and . . . one, one thousand . . . two, one thousand . . . three . . .
Back at the bungalow last month, I made it to ten—which I perceived as something of an unsatisfying dribble at the time. But those days, I realize now, were actually the golden ones, so to speak. My flow time has been on a steady downslide since then: nine, seven, and, at last count, an ominous six—not just at night, but every time I answer the rare urge to pee. And to make it worse, the seven steps I walk from the bathroom back to my hospital bed (and yes, of course, I count them) bring on a spate of heartbeat fireworks in my chest that linger long after I’ve lain back down again. I don’t even try to count and assess these beats because I know I can’t. The disappearing pulse that sent me to Cedars’s ER is a permanent fixture now; the pumping of my heart has become so feeble, it is imperceptible at all pulse points.
Leja picked up on this new sign of heart failure just a few days ago. “You feel now it is much more weak, your heart?” she asked, watching my fingers fly from my wrist to the top of my foot and then to a spot directly over my heart—all places where I might land on a beating sensation.
My hands flew again—this time to cover my face as I answered her. “I don’t know, I don’t know . . . I can’t feel my heartbeat anymore. Not anywhere . . .” My voice dropped to a breathy whisper. “And Leja—it makes me think I’m dead!”
“Oh, my friend!” She sprang from her chair, lunging toward me with outstretched arms.
Yeah, sure, Brenda—we’ve been having terrific fun out here in California.
More like one friend disappearing before the other one’s eyes.
Your disease is galloping along . . .
A few words from Dr. K could set Brenda straight . . .
I chew on a couple of Tums while looking over my email. “Too neutral,” I say out loud to no one. Sure, I’m tugging at Brenda’s conscience by detailing Leja’s lifesaving presence here in California; speaking ill of an angel is bad form. There’s some chance that I can lift Brenda’s goodness by exalting Leja’s, after all. But my words, as I reread them, seem too mild in response to the bus-stop gossip that is causing my sweet friend to weep.
I need to add some kick to this email. Seeing my words through Leja’s eyes, I feel the lack in them; laying guilt and hoping for a shift in Brenda’s behavior does not show sufficient fight on behalf of my friend. Leja would be gloves-off and swinging wildly without a second thought if my reputation were attacked—I’m sure of it. Our loyalty toward each other has never been lighthearted. Weakened as I am, I’ve got to make my words strong for Leja’s defense. My first impulse is to ease her angst—always.
I push my fists into the mattress below me and straighten up to a sitting position. With fingers on the keyboard now, I clench my molars with determination—Come on, Amy, add some bite to this thing . . .
A few minutes later, Lauren and Jody walk in holding giant Starbucks cups. “And she wants red . . .” Lauren says. They’re talking prom dresses; it’s mid-March and high school senior girls are already posting their dresses on Facebook and, thereby, claiming them. Lauren brings me into the conversation. “Red isn’t a popular color, so Carly’s probably safe in waiting a few weeks to choose hers.”
“Mmm, red. Bold,” I say.
Jody starts to lower herself into the chair nearest to the door, and Lauren gets ruffled. “Uh, mind if I take that one, Jo? I’ve, uh, got all my stuff next to it . . .” Jody’s eyes pop as she lets out an ah, right! sound that seems to say, Thanks for reminding me!
Hmmm.
It would be no surprise if they conferred about ideal chair positioning outside my earshot (Jody and Lauren are longtime friends, having lived in the same small New York City apartment building when their kids were babies). Whatever they might have worked out, Lauren has sat to the left of my bed and Jody to the right every day so far. But I didn’t realize there might be a purpose behind it until just this minute.
I reflect now on how Lauren has been up and down from that chair and back and forth from the door many times over the last few days. It seems she has been standing guard, managing all admittance to my room since she got here. I hadn’t given it a second thought, but now I have an idea of why Lachalle hasn’t been in for the two a.m. blood pressure check for the last couple of nights. The schedule for nurse’s aides is strict on the cardiac floor: ten p.m., two a.m., six a.m. But after Lauren’s first night sleeping in my room—and the frequent pacemaker firings had her flying from her bed to mine many times—Lachalle’s middle-of-the-night visits dropped off.
“Hey, Lauren, have you noticed—no blood pressure check the last couple of nights?” I ask, interrupting the prom discussion, which has now moved onto danceable shoes. “Lachalle has been leaving me alone.”
“Yup, that’s right. I spoke with Dr. Lunchbox about it. I told him you’re up all night with pacemaker pain and it makes no sense to wake you again for a silly blood pressure check when what you really need is rest. He wrote an order that’s been posted outside your door every night, saying you’re not to be woken ’til six.”
So that’s what she was talking with Dr. Lunchbox about in the hallway the other day. And it dawns on me that I haven’t had to gather myself to chat with the heart transplant volunteers—mostly older men who pull down the necks of their T-shirts to show me their sternum scars (“Can hardly see it, right?”) while waxing enthusiastic about how great my life will be with a donor heart—or the hospital representatives who check in room by room to see if patients are comfortable, or the always-cheerful housekeeping supply replenisher, or the day’s supervising nurse who just wants to introduce herself and say hi. Within twenty-four hours of arriving here, Lauren assessed what might make my days and nights a little less taxing, and she set to it. She’d also had Jill’s emails to go on, and it seems Jill passed the baton to Lauren in a way that would help her to hit the ground running when she arrived.
And then, as I would expect, Lauren added to it her methodical maneuvering. Poor Dr. Lunchbox—he didn’t stand a chance when Lauren cornered him in the hallway with a firm request. No doubt she stood a full head taller than this newbie cardiac resident and held immediate sway over him with her poise. I’m sure her hallway recitation showed careful forethought: she would be respectful of the doctor’s time and would say so right up front, and then she likely dazzled with specifics: Amy is up during the night an average of five times, with pacing pain lasting approximately fourteen minutes each go-round, which means seventy minutes of wakened, painful state and about one hundred ten minutes left for sleep between blood pressure, uh . . . What is it, Dr. Baird? (He’d be looking a little dumbfounded by now.) You’re wondering if I’ve been taking notes for the last three nights? Yes. What do you say the nurse’s aide skips the two a.m.?
Done.
“Wow, thanks so much for that,” I say to Lauren. “I’ve spent a lot of nights in the hospital but never thought to ask for a Do Not Disturb sign on my door.”
“Well, there was no way around it. I had to speak up,” Lauren replies. “You need your sleep.”
And Leja needs to preserve her reputation. Small-town gossip spreads exponentially and sticks. I flip open my computer and press send on my punched-up email to Brenda.
Jody rises to gather her things, telling Lauren how great it was to spend these past few mornings together. “Wish it were under different circumstances, but ya know, when do I get to sit with two New York friends and talk for hours?” she says. They link arms and walk to the elevator. When Lauren returns, she resumes her watchful post in the chair near the door—straight spine, lifted chin.
“You’re sitting there on purpose, aren’t you?” I say.
“Sure am. You don’t need people bothering you all day. I only let in the important ones. I want to do my best for you every minute I’m here.”
“Sounds exhausting.”
“To you, maybe. Not to me. I have only four days in this hospital room, and then I go back to my regular life. Sure, things are going to be pretty chaotic when I return tomorrow night, but I’m going to get into my bed and sleep ’til morning. I’ll be restored in no time.”
“But you didn’t sign on for this. The spreadsheet visits were supposed to be different. We all thought I’d spend my waiting list days at the bungalow, not in a hospital room. We were going to hang out in the little garden, enjoy the sun . . .”
Lauren leans in and looks into my eyes. “Amy, I never thought that,” she says, clear and solemn. “I don’t think any of the girls did.”
“Then how could all of you commit to this in the first place? How could that spreadsheet fill up so fast?”
“I can’t speak for anyone else. But for me, it wasn’t even a question. I would’ve been disappointed in myself if I didn’t come to California—I’d be letting you and myself down.”
“You wouldn’t be letting me down. I would understand.”
There’s a long pause. Lauren is devising a thoughtful response. She pushes her hair behind her ears and stares off for a moment, moving her lips a little as if reciting a grocery list to herself before entering the supermarket. “Okay, now I’m going to sound selfish,” she finally says. “But here’s what you need to know. I love you—well, you know that—and I feel that you and I have a special place in each other’s lives. We’re logical thinkers, we walk each other through the big hard things step by step and figure them out together. You hear me and understand me, and I’ve tried so hard to do the same for you. And you know . . . here comes the selfish part . . . I feel I’ve done a really good job at that. I’m your consigliere, right, and this makes me feel good about myself, like it’s validating that you’ve chosen me. I think I have a lot to offer.”
I make a fist and bring it to my lips. I want to absorb these words, remember them. The honesty of this moment whirs toward me—bright, forceful, nearly blinding. This is once-in-a-lifetime, Amy. Open your eyes.
Lauren continues without pause: “My friendship with you, it’s a source of pride because I’ve come through for you, Amy—my best self every time. So if you ask what I’m doing here, well, I’m doing what I’ve always done and what I’ve really wanted to do—only this time, it’s in a different location.”
My mouth slackens in surprise. I’ve always thought that my being sick is nothing but a drain on my friends. Leave it to Lauren to articulate a completely different perspective.
In this moment, I’m a mirror of Lauren’s emotions. Pride, validation, and love are pulsing through me. Lauren has chosen our friendship to be a measure of herself—how can I not feel energized to bring my best self to it, even during this most trying time?
“Feel better now, silly? Call me selfish, but I’m glad I said all this,” she says.
I do feel better. But I think the words she just shared with me may be the most selfless I’ve ever heard.
Later that day, motion by the door sends Lauren charging toward it, but just after reaching the entryway vestibule she retreats with an apology.
“No worries,” I hear someone say to her, and then Dr. Kobashigawa enters the room. “Afternoon, afternoon!” he pipes.
There it is again, his double greeting: the time of day recited twice in quick succession (Dr. K’s double time, as I’ve come to call it). His cadence is always upbeat, at least at first. “Oh, Scott, hello. I’m glad you’re here,” he says.
Scott comes early every morning to see Dr. K during rounds, but he varies his afternoon hours here with me. Leja, Jill, and now Lauren try consistently to push him out of the room, saying, “Take some time for yourself, please, Scotty. We’re here with Amy so that you don’t have to be.” They urge him to get some air, go for a run, or take a shower for crying out loud. Part of the objective of the spreadsheet is to help him, they say. But Scott rebuffs their orders night and day. He will slide onto my hospital bed at night, preferring to nod off beside me for an hour or so, squished, rather than sleep comfortably in his bed a just few blocks away. Then he’ll slide back in again at daybreak for an hour or so—first handing off a Starbucks Grande to the visiting guest—before rushing back to the bungalow for the first business call of the day.
Lauren was just about to kick him out this afternoon when Dr. K arrived. She offers the doctor her chair.
“All right,” he says, leaning onto his forearms and clasping his hands. “I have something to talk to you about . . .”
Hope flashes across Lauren’s face—Maybe he’s got news about a new heart! But I know this can’t be it; a donor heart match needs no introductory words. I’m also familiar enough at this point with Dr. K’s style to know when he’s couching something unpleasant.
“Now. Have you heard of a total artificial heart?
“Yeah, I know about it. But if you’re thinking I would agree to one of those . . .”
“I’m not saying now. But the approach of our team here at Cedars is to stay one step ahead. We don’t want things to nosedive suddenly and force us—and you—to make decisions under pressure. Let’s line things up so we’re ready to move if we have to.”
“What aren’t you telling me?” My voice is louder than I want it right now, and more intense. I always try to hang on to calm when speaking with Dr. Kobashigawa; I don’t want to lose his respect before I’ve known him long enough to secure it. But this moment is harking straight back to Columbia, where, for twenty-five touch-and-go transplant years, my doctor fed me bad news one encrypted bread crumb at a time until I found myself under a deathly heap, suffocating. Cedars isn’t Columbia—use your mind, choose your words carefully, I remind myself, trying to pattern after Lauren’s displays of self-control. Dr. Kobashigawa has been nothing but straight with you. I try again. “I mean, what’s the chance that I might need an artificial heart?”
“I don’t know. But I will say—and I’m sure this comes as no surprise—your condition is deteriorating more rapidly than expected. You heart failure is now biventricular, which means it’s on both the right and left sides . . .” The right side of my heart is supposed to pump blood to my lungs—that’s where it gets oxygen. Then the left side takes that blood and pumps it through my body to my other organs—kidneys, liver, brain.
“So neither side is doing the job it needs to do,” I reply.
“Yes, exactly right,” Dr. Kobashigawa says, “and this is the cardiogenic shock I talked about last week. Your heart is becoming less and less responsive to the pacemaker. I see it on the telemetry reports. At some point the pacemaker won’t work at all.”
“And that’s when I’ll die.”
Scott shoots me a look—Stop being provocative.
“Ah, heh-heh, Amy, somehow I knew you’d say that. I’m getting to know you better by the day,” Dr. Kobashigawa says, smiling with his eyes for a few seconds before turning serious again. “Now. With the total artificial heart, what would happen is—”
“I don’t need to hear it.”
“Well, I do,” Scott says. He’s annoyed with me now. “Please go on.”
I look out the window while the doctor explains to Scott what I already know about this “bridge to transplant,” as it’s called. A total artificial heart is not a permanent alternative to a transplanted heart, but rather a temporary pumping device placed inside the chest cavity until a matching donor heart becomes available.
“We would remove Amy’s current heart entirely and replace it with . . .”
I look over at Lauren. She’s taking notes. I turn my head back toward the window.
“It’s not without risk—and inconvenience. It’s open-heart surgery, of course, a full opening of the sternum. Amy would have to remain in the hospital here for six months of recovery after this surgery, during which time she would be taken off the transplant waiting list. After that, she would be back on the list and start the wait again.”
Scott shakes his head. “Six months of recovery from open-heart, and then get on the transplant waiting list?” His reaction matches mine, thank goodness. Scott is remembering the horrible months of recovery following my valve surgery just a year or so ago. I have to assume he’s also made a quick calculation of how long our California stay could last in the wake of this surgery and my being relisted for heart transplant: a year, or maybe more.
“Yes. But it could save her life . . . your life, Amy.” I feel the doctor’s gaze upon me and turn to meet it now. “We have great success with artificial hearts here. There’s a young man on the other side of this building who’s got one right now—I’m sure he’d be happy to come talk with you about it.”
“Mmm, thank you, but no. I’m not going to do an artificial heart.” Lauren stops scribbling and stares at me. Scott looks down at the ground, unable to mask his sadness. But I go on. “You’re getting to know me a little, Dr. Kobashigawa, but what you don’t realize is that, for me, death is an option—a real choice that I see as totally legitimate and rational. I’m not twenty-five this time around. I’ve raised my son. I’ve had incredible years with Scott, all of them bonus years, as I see it. And I’ve given this donor heart every last ounce of my energy and devotion—kept it beating for way, way longer than any doctor expected. But now it might just be my time to die. We all die. I’m just going to die sooner than everyone I know.”
He tugs one side of his white coat over the other and chuckles a little. “Ah, Amy, that’s not very optimistic . . .”
“With all due respect—and there’s a lot due here, that I know—you’re the one asking me to look at the worst-case scenario. I’m just saying that I will choose—that I am choosing, and firmly—not to do a total artificial heart. And I think . . . well, I hope . . . that Scott will support my choice. And meanwhile—here’s some optimism for you—let’s get me a donor heart before I croak.” I’m feeling lighter by the minute, content that I’ve spoken my mind, and appreciative that Dr. K gave me the time and space to do so. It’s not a happy choice, sure, but there’s tremendous relief in finally being able to say no to exponential suffering.
Dr. Kobashigawa stands up and shakes Scott’s hand and Lauren’s, and then, more slowly and with steady eye contact, mine. “Think about it, all right?”
I smile, closemouthed. “Mmm.”
Scott follows him into the hall.
Lauren closes her wire-bound notebook and looks up at me. “We’ll talk about this?” she asks.
“Yeah. But you can’t be surprised at my decision.”
“I’m not. It’s a big one, though. It’s got real consequences. You’ve got to be completely sure . . .”
Scott walks in looking dazed.
“Why don’t you go back to the bungalow for a little while and get some rest. I’ve got it covered here,” Lauren says to him.
Before he leaves, though, I want to make sure we’re together on this. “Open-heart surgery, Scotty. Six months in the hospital. Then the waiting list. It could be a year or more in California. What about your work? And for me, what about all the . . . I mean, you know there’s going be trauma and horror with that artificial heart. I don’t have room in my brain for any more of it . . . I just don’t!” My voice cracks and my eyes brim with tears.
Scott climbs on my bed and lies down beside me. We contort immediately into our usual body-braid tangle—legs over legs, feet against feet, arms entwined with arms, head tipped against head. “It’s awful. It’s horrific,” he says, “and . . . I won’t ask you to do it for me.” I feel his teardrops on my neck.
“Good. Because I can’t, I can’t do it, Scotty. It’s beyond me. We’ll just have to wait for a heart and hope I make it.”
“Yeah.” He sits up and wipes the base of his palm across his eyes. Lauren wipes her own eyes with a tissue. We all sit quietly together for a minute. There’s no sense of embarrassment among us. No awkwardness. Lauren has long been a close friend of both of ours, and she’s not simply a witness here; rather, she is, in the truest way, a full part of this excruciating and profound moment in my life, in my marriage, and, more than likely, in my death; everything is intense and open and extraordinarily real. The world stops spinning for a minute—a minute that’s soul-sinking and awful, but also somehow transcendent and valuable.
No one said the unadorned essence of life and death is pretty. It sure is something to behold, though.
Scott gives me a kiss and gets up from the bed. “Okay, I’ll go rest a little,” he says. “I’ll bring some dinner for all of us later.”
Lauren reads from her notebook. “Dr. Kobashigawa says the surgery would be about seven hours. Well, you’ve done longer ones.”
“The valve surgery,” I say. “It was a nightmare.”
“And then six months recovery—in the hospital, he says—”
“No way.”
“And then you get back on the waiting list.”
“But with an even higher number of antibodies. Did you hear him say that?” Dr. Kobashigawa explained that my body would consider the total artificial heart itself to be foreign, and that this would cause increased antibody production—a sort of rejection phenomenon. “Right now I’m able to take a donor heart from only about fourteen percent of the population because of my ridiculously high antibodies. With the artificial heart inside me, I’d have an even worse chance for a donor match.”
“He did say that, yes. But he also said that donor matches have been found for patients who could only accept hearts from one percent of the population, and that means—”
“Can we stop this?”
She drops her chin and peers at me over her reading glasses. “Of course.” The notebook closes in her lap. “We can talk later. You don’t have to make a decision on this right away.”
“Lauren, I’ve already made my decision.”
“Ah . . . but . . .”
“I need you to be on my side.” I begin to tremble.
“It’s not about sides. We’re talking this through, taking it apart like we always do . . .”
My brain goes fuzzy with anger. “You want me to get this ridiculous contraption in my chest—cut my heart out and put a friggin’ motor in there and then rot in the hospital for six months?”
“No. I didn’t say that.”
“You’re pushing me to do what’s good for you, not for me!” My hands ball into fists at my side. The situation strikes an explosive chord in me. There’s something about the casual tone of Lauren’s voice—insistence cloaked in a let’s wait and see timbre—that suggests I’m being irrational and need careful stringing along until I come to my senses. I’ve heard this affected nonchalance before, but this time I can’t keep myself from challenging it directly. Frustration grabs me by the throat now. Words come flying from my mouth. “This is just like what happened that day with the police. I still haven’t forgiven you for that.”
Lauren looks away. She’s biting her lower lip. I’ve brought up a terribly sore spot between us—something we’ve never talked about, but rather let fall away from us, unexplained. It is an awful memory, still raw, of an upheaval that rocked our relationship.
The ordeal occurred just three months before the bad-news angiogram (and four months before I headed out to California): a breast sonogram picked up a strange-looking spot in my right breast. I didn’t worry at first because soon after my first transplant, the regimen of immunosuppressive medicines caused benign fibroadenoma masses to grow in my breasts. They were easily spotted on sonograms and sometimes grew so large I had to get them surgically removed. But this particular spot looked different. When I asked the biopsy radiologist if she thought she’d just put a needle into something scary, she threw up her hands. “Gosh, this is a weird-looking one,” she said. “I don’t know what it is.”
It was cancer.
Of all the emotions and questions that followed, Why me? was not among them. Transplant medicines are strongly linked to cancers, especially after imposing decades of immunosuppressive wrath on the body. Added to this menace were the seventy-nine heart biopsies and twenty-eight angiograms I’d had—all of them done under powerful X-rays to the chest with no localized protection since the heart area was being imaged. I was a breast cancer lump waiting to happen. And so it did.
When I got the post-biopsy call from my breast doctor, Scott happened to be on his way to Las Vegas with Lenny and another friend to meet Jack for a weekend of golf. They’d planned this trip for a long time, and I insisted that he go, even though I was waiting on a test result. The moment he landed, my doctor called him with the news—even before she spoke with me (a break from usual protocol, but this doctor had been my transplant physician since the beginning). Scott and his friends never left the airport; they retrieved their bags and got on the next flight back to New York.
When she reached me with the news, I froze.
“Oh, come on! With all you’ve been through, this is easy stuff!” my breast doctor implored. She couldn’t have chosen more enraging words. I’d known this doctor since I started growing those golf ball fibroadenomas just after my first transplant, and I liked her a lot. But she was barking up a dangerous tree at a tragic moment by trying to turn my years of illness into a rallying call, when I was seeing it as a signal to raise the white flag.
“I’m not doing it,” I said. “I had a horrid open-heart valve surgery just a few months ago. And, frankly, my heart isn’t feeling so great lately. I’m not taking on breast cancer. I’m . . . I’m out.”
Ooh. Nice.
I liked the feel of these words as they rolled off my lips for the first time—I’m out.
“You can’t quit now! You have to fight this. You’re just the kind of person who’s going to do great—”
“I’m out! I’m out! I’m out!” Wow, I loved the sound—and the sentiment. I’m free! I don’t have to do this anymore! For me, taking on an additional life-threatening illness was completely unfathomable. It was so beyond okay or understandable or doable or fair. “I gotta go now . . .”
“Go where?”
And this is where I made a really big mistake. “I’m leaving,” I said. “I’m getting in the car now. I’m not doing this anymore.”
“You can’t. You have to do this. Amy! Let’s talk! Would you come to the city and meet with me? I’ll cancel my afternoon . . .”
“Bye.”
I left.
And then I was driving, blindly. My cell phone rang and it was Scott, telling me that my breast doctor called the local police because she’s worried about me. The police were at the house now, he said, and Lauren was on the way to meet them. He told me to go back home. “I’m out!” I cried, and kept driving.
I didn’t know where I was headed, but the distance from my house took on urgency now; this was an escape. The speedometer shot from fifty-five to seventy. I switched on the radio, found a hard rock station, and turned the volume way up. I opened the windows and let the ice-cold air inflate my anger. No way I was turning around. There was a party going on at my house, for fuck’s sake, with law enforcement and everything.
Lauren moves now from her watch post by the door to the chair nearest my bed. She’s got tears in her eyes, but her mouth is set with determination. “You say you haven’t forgiven me for that day. Well, you don’t know what really happened with the police. I haven’t told you because things moved so quickly from the breast stuff to your needing a second transplant—I didn’t feel it was important to explain myself. Until now.”
The hospital room seems to shrink around us. The moment narrows and we teeter on its edge. Our eyes lock as Lauren begins to tell the story I do not know.
“I get a call from Lenny and he says to go to your house because the police are coming. I don’t know if you’re there or not, but I race over,” she explains. “I pull up to your house and there are three cop cars and they are on your lawn—why they didn’t park on the driveway, I don’t know. I go to your door, and the police have busted through the window. I walk in and hear them in your bedroom, so I head upstairs and they’re rifling through your closet and drawers—clothes are everywhere. One of them has got your journal and he’s standing there reading it. I think to myself, I have a job to do. I have to protect Amy. And I dive into conversation with those cops, rambling on and on, pretending to be helpful. They ask me what color your car is, and I waste ten minutes saying, Hmmm, I don’t know. They ask if you were likely to head north or south, I tell them north—because I know you’re much more likely to go south . . .”
I get a call from Lauren, and I don’t pick up. Another call, and I don’t pick up.
“I keep trying your cell, but you won’t answer. The cops are asking me, ‘Would she hurt herself?’ and I tell them no. She got some really bad news and she wants to be alone. I know her well. She’s fine. But they tell me I have to call you again because they want you back here. They put an alert out on your car.”
Meanwhile, I call my breast doctor and the receptionist puts me right through. “Why did you call the police!” I shout. “It’s my choice to fight breast cancer or not. You’ve known me so many years, you’ve seen all I’ve been through—how can you force a decision on me? I can’t believe you did this!”
“I’m sorry, I’m sorry. I’ll call them back. It just sounded like you might do something . . .”
“I’m fine. I’m upset because . . . how many times and in how many ways can I be dying? I’m not going to drive off a bridge, for God’s sake! And even if I did, that would be my business.” I’m shuddering with anger.
“But I’m under legal obligation, Amy. I could get in trouble if I know you are going to hurt yourself and then you do.”
“Well, I’m not going to hurt myself. But I am not going to take on breast cancer either. I just had valve surgery. It’s my choice.”
“I’ll call the police and tell them everything is okay, but you have to come and meet me to talk. I’ll meet you at my house or at Starbucks near my office if you want. I just want to lay out what the treatment would be so you can make an informed choice.”
“Okay, I’ll meet you. Four thirty. Starbucks. Now call the police and tell them I’m fine!”
A few seconds later, Lauren calls again, and this time I pick up. She asks me if I’m all right.
“I need time alone. I don’t need another person telling me I have to fight breast cancer, blah blah blah!” I tear at the zipper on my winter coat, tugging it down as I shake my shoulders out from underneath, frenzied. I am boiling with fury.
She tells me the police are there. My doctor hasn’t reached them yet.
“I heard. And I know everyone wants me to come home and be a good little breast cancer–valve surgery–heart transplant patient, just racking up the life-threatening illnesses and their shitty, half-assed treatments—”
“Yes . . .” is her reply, and it’s like a quick slap in the face. It’s as if what I want has no value. It’s as if I have no agency.
I burst out at her, “I have to say, Lauren, after all we’ve talked about all these years, and with all that you know about me and the unbelievable shit I’ve had to endure to stay alive since I was twenty-five fucking years old, I would expect you’d be more understanding. But no. You’re not on my side!”
I am battled out. How can she not see this?
“Mmm-hmm . . .” she says. There’s noise in the background. I can hear a police officer saying something about a call from my doctor. “Oh, so you’re meeting your doctor at Starbucks in half an hour. That’s good. The police chief says you should have your doctor call him when you’re with her, and then they’ll get out of here.”
Lauren takes a tissue box from the windowsill now, pulls one out and then offers me the box. “So while I’m waiting to reach you on the phone, I call the window-repair place in town and I ask them to come right away, but it was late in the day on a Friday. The guy says he’ll come after the weekend, but I beg him, please, my friend is ill. I didn’t want you to come home and see the huge mess of glass all over the place. I swept that up,” she tells me softly. “Vacuumed too . . .”
She also folded and put away all the clothes that the police had dumped onto the floor from my drawers. And the minute the police chief was done inspecting my journals, she placed them back in my night table drawer. “Then, finally, you pick up my call, thank God. And here’s what you need to understand—I was trying to think and plan ahead the whole time, to figure out what was best for you. When I called you, I knew I needed to position myself across the room from where all the cops were standing. But they don’t want me way over there because they want to hear everything you’re saying to me. So I tell them, ‘If you want her to open up, you’d better keep the walkie-talkies away from me,’ and I plant myself on the couch. Then you get on the phone and start asking me if I’m on your side, and what am I supposed to do? The cops are watching me, they’re listening to my responses. I can’t say, I support any choice you make, because I’m trying like hell to protect you.”
She pauses and takes a breath. “It was one of the hardest moments in my life—I had to act calm and neutral when I was completely overwhelmed and under pressure. And then you’re yelling at me, saying I’m the worst friend.”
“I had no idea . . .”
“I know, and that’s okay, I understand why you thought I was being awful to you. But I hope you realize now—I was trying to be the best friend I could to you in that moment. And all these months, you didn’t know.”
We hadn’t spoken about it since then. Lauren was in my kitchen when I got home—and so were Jill and another friend, Jane. I went up to my room, and they stayed put until Scott arrived a couple of hours later. Less than a week after that, I underwent a double mastectomy. But I never for a minute saw the undertaking as a courageous, lifesaving fight on my part. It was more a giving in—a ceding to what seemed like the normal, rational thing for a woman of my age to do. I was not afraid of major surgery (I’d had my sternum severed by a chain saw more than once, after all). I was not one to grieve the loss of my breasts (parting with my natural-born heart at twenty-five felt far more devastating).
And, if only to escape friends and family urging me to “just think about it . . . just think about it,” I did the opposite and dove right into a commitment to mastectomy the day after the police left my house. It felt to me so much easier to just walk the walk of saving my life than talk the talk of what I really felt—which was that my heart wasn’t going to last too much longer anyway, so why bother? I had been feeling burning cardiac pain down my arms by then—felt it spread into my neck and chin too when I walked the hundred yards from the breast biopsy suite to my car. But I didn’t tell anyone.
Turns out there were a lot of things about that time that we all kept to ourselves.
“I’m incredibly”—breath—“sorry, Lauren,” I tell her, feeling my lungs weighed down by the details she has just given me.
“I’m sorry that I made you think I wasn’t on your side,” she says, furrowing her brow. “And you’ve got to know now—with this total artificial heart . . . I support your choices. Maybe I wouldn’t have felt the same way ten years ago, but I’ve seen you suffer terribly over the last few years, and in my mind, the breast cancer was the last straw. The last valiant effort required of you. But then there was more in store for you—who would have thought that a couple months later, you’d be in California on a waiting list for retransplant. Amy, I believe you can do any physical feat, but it’s gotten to the point where enough is enough.”
She gets it. I feel a rush of gratitude—and remorse.
“I am so sorry I said those things to you on the phone . . .”
“Yeah, well, it was hard to take. I went home and cried about it—a lot. Because there I was, doing all I could for you, and I was proud and grateful to be the one who could do it. The whole time it was happening, I kept thinking, I’m so glad I’m the one who’s here first. I can give Amy what she needs—some space to process this really bad news.” Jill and Jane were on their way to the house as well, she tells me, but by the time they got there, I’d already made it to Starbucks to talk to my doctor.
“Honestly, I wasn’t really processing the bad news,” I admit to her now. “I was acting on it. But not in the way everyone thought. I didn’t get into my car that day to kill myself—because I didn’t have to. My body has been plenty good at dying without any help from me, and then, voilà, look at that, there’s breast cancer to speed things along. I was just so ready to say I’m out at that point—death by omission, if you know what I mean.”
Lauren nods. “I do.”
“And so, now, saying no to the artificial heart is—”
“I understand,” she says, and I believe her.
The first hint of sun grazes the windowsill, and I wake to the clickity-squeak of metal wheels approaching my door. Lauren jumps from her cot and bolts to the entryway like a mother to a crying newborn, all instinct and protective drive. “No, no . . . not today,” she whispers, and I hear the wheels retreat into the hallway. Lauren has just spared me this morning’s weigh-in. She shuffles back to bed, gets under the covers, and settles in for a little more sleep. In two hours, she will head to the airport.
“I don’t want to leave you,” she said last night, a few minutes after coaching me through a particularly rough pacemaker firing.
“Yeah,” was all I could get out before emotion grabbed my throat.
“We did good, though,” she added, sitting herself down beside me on the bed and taking my hands in hers. “We work well together.”
She’s right. During Lauren’s four-day visit, she finagled a few helpful changes—from the nighttime Go Away sign on my door to the easing up on daily weigh-ins and hourly urine measures. We’d also come up with a sleep plan, as she called it (a euphemism, because the increasing number of pacemaker episodes kept us both up most of the night). According to the plan, at ten o’clock we are each to be in our separate beds. I am to watch some mindless show downloaded to my laptop (Scandal, in honor of Joy) and then go to sleep. No talking allowed, just quiet calm. I am supposed to wake Lauren the minute I feel pain; she’ll sit on my hospital bed and try to soothe me with light fingernail strokes up and down my back. And then it’s bonus time: a test we’ve come up with to help move me through the duration of pacing. Without looking at the heart monitor screen, we see if I can pinpoint the precise moment when the pacemaker stops firing—this way, we can look forward to relief in just a minute or so.
“And . . . now!” is how I call it out, marking the instant at which I feel my heartbeat climb above eighty. Lauren watches the monitor: she’s learned not only how to identify the pulse number in blue, but also how to read the particular line of the EKG that spikes exaggeratedly when my heart is pacing—and she tells me if I am correct.
“You got it! Exactly to the second. It’s amazing how well you know your body!”
“It’s easy to feel, actually. My heart’s inside my chest, you know. Just underneath some skin and bone.”
“Give yourself some credit, would you? The way you breathe through that awful pain is incredibly brave. It’s like labor, only you have it every night and you’re not cursing at your husband,” she says with a laugh. “And then you manage somehow to feel exactly when your pulse starts to go up. I’m in awe.”
“Stop it.”
“I will not. What you do is incredible.”
I pause, savoring her words. “I have to say, no one ever tells me that. Thank you, Lauren, really, thank you.” Her compliment is a rare but welcome affirmation.
“Well then, I’m just going to have to hang around you more so you can hear it more often.”
But Lauren is leaving shortly for New York.
Shaking off all signs of sleep deprivation, she’ll slip on her black suede booties that haven’t come out from under the cot since she got here and wheel her little carry-on through that airport. She will be sure to email the girls while waiting to board the plane, following a protocol of group communication forged by Jill—a protocol that is as much for my benefit as it is for the next friend whose name appears on the spreadsheet. Lauren’s ability to implement helpful adjustments within hours of arriving in my hospital room may be thanks, in part, to Jill’s detailed reports and suggestions. But the goal Lauren set for herself was her own: “I want to do my very best for you every minute I’m here,” she said.
And she’s done this in the form and style I would expect—so smooth around the sharp turns of these days and nights at my side, steering through the specter of a total artificial heart, gearing up for cyclical agony, and heading straight into the truth about the day I called her a terrible friend. Lauren has glided along the landscape seamlessly.
Yes, it sometimes is hard to say hello to my friend Lauren. But once you ride with her for a little while, it’s much, much harder to say good-bye.
* * *
I thought God would protect me. Maybe it would be Jesus doing the work, I don’t know. I was born to Jewish parents and raised completely without religion, but we had a housekeeper for a while when I was very young, and she taught me that God is everywhere, which only made me feel bad at first because it meant that every time I sat down, I was crushing him with my butt cheeks. “No, he can’t be under there,” Ena instructed. “Always above you! That’s where God is.” I think I was helping her sort socks at the time—a task that made me proud at six years old—and I laid my little body out on the cold basement floor and looked up at the lattice of wooden rafters and steel beams.
“Ena,” I whispered, pointing at a single crisscross, “there!”
She fanned herself with a creased, dusty brown hand while her eyes fluttered toward the ceiling. “Jesus! Lord Jesus, amen!” He was hovering, I guess.
Still, it took a while until I felt right about sitting down.
I had a sense of something grand and protective up there or out there—perhaps bearded, perhaps in cloud form, or light or fire—and I carried this sense with me long after Ena returned home to her daughters in Costa Rica. She scratched out letters to me every so often, one of the last coming on the thinnest airmail paper imaginable. “I’m ninety-seven now,” she wrote. “God is calling me.” I wrote back and told her that he seemed to be calling me too, even though I was only twenty-five. She answered one final time before leaving this world and me. “He holds you in his hand, child.”
Then a donor match came through and I was blessed with a healthy heart again. Scott and I got married. Casey arrived and I became a mother. Feeling safe and saved, I had to explain God to myself anew, and it seemed only right to do it this way: God—whoever and whatever that may be—couldn’t stop my heart from failing, not for lack of powerfulness, but because, well, it’s not possible to watch every little thing all the time; some bad stuff falls through the cracks. But he sure stepped in and made certain that I lived. My being alive was not mere coincidence; heart transplants had just become successful right around 1988. If my heart had failed a few years earlier, say, when I was eighteen instead of twenty-four, I would have died. It’s reasonable to say that God held me up until science caught up to my heart’s disease. And he sent Scott to me—just in time. And then Casey too, right at the point when I could receive him.
God—or fate or karma or the pull of the universe—may not always have omnipresent vision, but with focus, he-she-it can be very good indeed. How could I not feel the proof of this? Of something making things right after they went so wrong for me? Of a force that recognized that I’d climbed the tall, terrible mountain towering in front of me and was carrying a heavy burden still, which ensured protection from further onslaughts of enormous ill fate?
Breast cancer?
Nah. Not possible. Not me. That’s for other women—the ones who haven’t had to lose their natural-born hearts.
Lightning can’t strike twice. God–fate–karma–the universe wouldn’t allow it.
It’s the same reasoning I’ve given to family members and friends who’ve admitted to being afraid as we’ve boarded airplanes together. I’ve got a great way to calm them. “Relax,” I say. “I am not a likely person to die on a plane. It would be against the order of all things in the cosmos. Just too darn incongruous. So long as you’re flying with me, you should figure you’re safe.”
But then: breast cancer.
Uh, God?