Days soon began turning into weeks, and though Vivi suffered several challenging spells, both mentally and physically, she had periods when she felt almost as normal and strong as she had before her life in London had come to an end. During those times it was hard not to hope that the prognosis for her life expectancy had been wrong, that she was going to defy them all and stage a miraculous recovery. In more difficult and pragmatic moments she understood that her perceived improvement had far more to do with the drugs she was taking to help stabilize her wait for a new heart.
Her wait for someone to die.
She found it so hard to get her head around that, in spite of how often Josh and her mother – everyone she loved – reminded her that no one was giving up their lives willingly so she could live. They were on their own journey, and what happened to them was as random, or preordained, as what was happening to her.
Only to herself did she ever admit how much loving so wholeheartedly unnerved her, making her fear there would be a price to pay for the physical exertion, never mind the hope that came with it. But apart from the unavoidable side effects of the drugs – numbing fatigue, violent headaches and nausea – she hadn’t yet been called to account. Nor had she been able to tell Josh that perhaps they shouldn’t make love so often. She knew if she did he’d stop right away, and that wasn’t what she wanted at all.
She spent most days accompanying him on his rounds and emergency call-outs and soon became so involved with the animals, and with the hectic social project that was Deerwood, that she could hardly remember the life she’d had before. She felt no yearning for it – if she thought about it at all it felt strangely distant, even vague, as though it had happened to somebody else. What mattered much more to her now was being able to lie down in the hay with an elderly ram, smoothing his tired face as Josh quietly sent him on his way. Or she’d dab tears from the eyes of distressed cows whose calves had been taken to market – she’d had no idea until now that cows could cry, much less that they could pine for their young. She’d even lent a hand, up to the elbow, to bring a tiny donkey foal into the world. A sight she’d never forget was Josh’s skilful extraction of a rotten tooth from the mouth of a fully-grown lioness at Kesterly Zoo. As large as his hands were, they’d appeared almost fragile between the vast, powerful jaws of the heavily anaesthetized beast.
There was so much to do, and to learn about his world, not only for her, but for the junior vet, Aaron, whom Josh took on to help with the load.
When they weren’t at Deerwood or visiting the many farms, stables, sanctuaries and kennels that fell into his area, they were usually at home relaxing, or working on Save9Lives. They’d gathered a lot of information by now, and since Vivi had already received assurances from the GaLs that they were happy to fund the website – and would give even more if it was needed – they’d soon be ready to engage a professional designer. It wasn’t that they were cutting out Jim’s student friend, it was simply that he’d decided the project was going to be too big for him now that his final year was underway.
Jim himself, with all the courage and optimism they admired so much, was working hard to gain awareness for his campaign, and listening to him, talking to him over FaceTime, Vivi could almost believe there was nothing wrong with him. Outwardly there was no sign of the pump that kept his heart going, for he wore the cumbersome batteries under his shirt, and the bulk of them was always out of frame.
‘Are you still in pain?’ she asked him one day.
He nodded almost wryly. ‘I’m getting used to it,’ he told her. ‘I won’t let it hold me back.’
Moved by his determination, she said, ‘What sort of drugs are you on?’
He named them all, and the list was so long that they both ended up laughing. What else could they do? ‘Do you ever pray?’ she ventured to ask.
His eyes drifted as he said, ‘I used to, but I’ve kind of lost my faith since the wait …’ He shrugged, as if to say the wait had been so long.
Having discovered from reading other people’s stories that many experienced a move closer to God as the prospect of death became an encroaching reality, the doubt in his beliefs interested her more than it surprised her. Did he want to talk about it, she wondered. Had he believed before?
‘Yes, I did,’ he replied when she asked. ‘Or I thought I did. This kind of changes things, or it has for me. How about you?’
Since she’d never attended church as a child, or even thought much about God before, she shook her head. ‘I’m not sure I know how to pray,’ she admitted. ‘But even if I did would it really make a difference?’
Though he looked unconvinced, he said, ‘It does for some people.’ He shrugged again. ‘I say, whatever works. Does Josh believe?’
Knowing that Josh’s ambivalence was much the same as her own, she said, ‘We both think that when you’re in this position you’re ready to grab at anything, and if turning to God helps then that’s what you should do. Maybe we will if, when, things get worse. It’s hard to say.’ She sighed shakily at the thought of that time. ‘God takes care of his own, is what some people say,’ she added.
He nodded. ‘Except, you’ve only got to look at all the things happening around the world to people – to children – who worship all the time to know that’s not true. It’s hard to trust in a God who repays his followers with war and famine …’
She regarded him carefully, his image as clear and real as if he were with her, not on a screen. ‘Jim, you’re not giving up hope, are you?’ she asked softly.
After a moment he broke into his boyish smile. ‘Not me,’ he assured her, assuming his familiar brave face. ‘I just get a bit down when I think about God, that’s all, but don’t let that stop you and Josh from praying if you want to. Like I said, whatever works.’ Then, changing the subject, ‘Remember Sarah who I told you about? She’s on the transplant list? Well, she’s confirmed that she’s OK with being interviewed for the website, provided you and Josh think she’s right for it. Is there a good time for her to FaceTime you?’
After promising to message him as soon as she’d spoken to Josh, Vivi rang off and sat quietly for a while thinking about Jim and God and faith and miracles – and the fact that maybe she’d used up her quota with having survived her heart attack and cardiac arrests so she could have Josh in her life before she went.
They’d have FaceTimed Sarah sooner if Vivi hadn’t developed a sudden intolerance to one of her drugs. To her relief she wasn’t hospitalized, but she was restricted to bed for over a week with severe migraines and nausea, and the growing fear of what would happen if she continued to reject the medication …
She couldn’t go any further with that thought, it would only lead her into panic or depression and for Josh’s sake, as well as her own, she mustn’t allow that to happen.
So, on the first day that she was able to sit up for a while without feeling queasy or faint, and Sarah was able to make it too, Josh set up the laptop and they met the young mother via FaceTime.
She was impossible not to love right away; with her wild auburn curls, sky-blue eyes and rosebud mouth she looked so playful and sweet-natured that it was hard to believe she was both sick, and in her thirties. The only suggestion that she wasn’t as healthy as she at first appeared was in the purplish hue of her lips and the faintly bruised sockets of her eyes.
‘How long have you been on the transplant list?’ Josh asked, after they’d introduced themselves.
‘This time just a couple of months,’ she replied. ‘I was on it for about a year before I had the VAD fitted, but then I had to come off while I recovered from the surgery.’
Understanding that she’d have been too sick for another major procedure during that time, Vivi said, ‘Have things improved on an everyday basis since you’ve had the VAD?’
Sarah smiled and grimaced. ‘Not especially,’ she replied, ‘it takes some getting used to: not having a pulse is kind of weird. But it’s still early days, so I’ll probably get used to it.’
Wanting to ask exactly how it impacted life with her husband, whether the bulky battery and controller, and the driveline – an external umbilical connecting the pump to her heart – prevented or impeded their intimacy, Vivi tried to form the words, but found she couldn’t. Anyway, it was a question for when Josh wasn’t there, since it would probably embarrass Sarah this early in their acquaintance. It might also have an answer that she’d rather think about alone for a while.
Josh was about to continue when Sarah excused herself, and leaned out of frame. They could hear a child’s voice, urgent and pleading, and when Sarah reappeared on the screen the dearest little boy with a bright red buzz cut and cornflake freckles was on her lap.
‘This is Ben,’ she told them, settling him down. ‘You can only stay if you behave yourself,’ she informed him. ‘Are you going to say hello?’
Though Ben’s blue eyes didn’t leave the screen, he leaned back hard into his mother.
‘Oh, this is all show,’ Sarah chided. ‘You’re not shy really.’
‘How old are you?’ Josh asked him.
Ben said, ‘Ten!’
Everyone laughed, since it was patently not true. ‘I think you’re four, aren’t you?’ Sarah prompted.
‘I had a birthday,’ he informed Josh and Vivi, ‘and all my friends came.’
‘Cool,’ Josh responded. ‘Did you play games?’
He nodded. ‘We played rugby on the grass. I’m good at rugby. Grandpa says I’ll be prof …’ He looked up at his mother. ‘Professional,’ she whispered. ‘Fessional one day,’ he declared. ‘Can you play rugby?’
Josh said, ‘I used to when I was at school, but I don’t think I was as good as you.’
Ben seemed to take that as a given. ‘Grandpa and me go to watch our team sometimes, but Mummy doesn’t come because she’s a girl.’
As though reading the question in Vivi’s mind, Sarah said, ‘I’m a single parent, but my dad is great with him.’
Leaning towards the camera, Ben said to Josh, ‘I had a PlayStation for my birthday.’
‘Wow,’ Josh responded, suitably impressed.
‘We got it on eBay and it came with a game of Yooka-Laylee.’
‘Is that your favourite?’ Josh asked.
Ben put a finger to his lips as he tried to remember. ‘I think so,’ he said. ‘Do you know how to play it?’
‘I’m afraid I don’t,’ Josh admitted.
Ben seemed to consider whether or not this was a problem. ‘Do you have any children?’ he asked.
As Vivi’s longing flared into a knot of discomfort, for this was something she and Josh had never discussed – they couldn’t – Sarah said, ‘You’re not supposed to ask questions like that.’
‘No, I don’t have any children,’ Josh told him kindly. ‘But I have nieces and nephews.’
Apparently deciding that made him OK, Ben said, ‘I can beat Mummy at most of our games. She’s not very good, are you, Mummy?’
With a laugh, Sarah pressed a kiss to his head. ‘Not as good as you,’ she assured him. ‘Now, would you like to get down?’
He shook his head, and looked up at her as he whispered, ‘Are they going to find you a new heart?’
Sarah’s smile was sad as she said, ‘Not today, sweetheart.’
Seeming just as sad, he leaned into her as he turned back to the screen. ‘Do you know where my mummy can find a heart?’ he asked hopefully.
‘I wish we did,’ Vivi replied, wanting to hug him, ‘but we’re doing our best.’
He gave that some thought, then said, ‘Have you got any children?’
Feeling Josh’s arm go around her, Vivi said, ‘No, but if I did I’d like to have a little boy just like you.’
Ben nodded, clearly understanding that.
Pulling him tighter into her arms, Sarah said, ‘Obviously, finding a new heart would make all the difference in the world to us.’ She didn’t have to add that it would mean she could watch her precious son grow up, and no longer have to live with the constant fear of what would happen to him if a donor wasn’t found, it was there in her eyes.
‘Doesn’t having a small child put you on the super-urgent list?’ Vivi asked.
Sarah shook her head as she smoothed Ben’s hair. ‘It doesn’t work like that,’ she replied. ‘At the moment I’m able to function with the VAD. It’s only if a problem develops with it that things might change. Then you’ve got to hope that the problems don’t put you into the category of being too sick for a transplant. Anyway, we try to look on the bright side, don’t we, Ben? It’s not like no one on the non-urgent list ever gets a heart, because they do. I even got called in for one a while back, before the VAD, but by the time I got there they’d discovered there was a problem with the donor heart so it couldn’t go ahead.’
Understanding how crushing that blow must have been, Vivi had to shut her mind down to the horror and frustration of it before it crushed her too.
Josh said, ‘If you’re willing to repeat all this on camera, it would make you one of our most powerful contributors to the website.’
‘I’m happy to do it,’ she assured him. ‘Anything to get the message home about organ donation. You don’t know what it’s like, waiting, until it’s happening to you.’
After they’d rung off Vivi leaned back against Josh and closed her eyes. Small children, healthy hearts, carefree hopes and dreams, none of it a part of life for them. But at least she and Sarah were amongst the lucky ones who could wait at home; so many were hospital-bound, some miles from their families. Vivi knew she couldn’t bear that: the praying and hoping every minute of every day that the right heart could be found to set her free.
Seeming to know what she was thinking, Josh wrapped her in close and pressed his lips to her head.
‘If we do go to church and pray,’ she said, bringing up a discussion from the night before, ‘we have to include Sarah and Ben. And Jim, of course.’
‘I agree,’ he murmured.
‘And I think,’ she added, putting her hands over his, ‘just in case a chat with God might work, we should go sooner rather than later.’
Vivi wasn’t so much surprised, when she received a call from the cardiac clinic asking her to go in, as she was struck with dread, for she’d sensed it was coming, how could she not? Her increasing exhaustion, combined with continued nausea and dizziness, clearly meant that she was rejecting her medication again. This time they weren’t simply going to change her prescription, they were probably going to carry out a right-heart catheterization, the procedure that helped them decide if she was eligible for a VAD. If she was, the implantation would require extremely delicate open-heart surgery and up to a three-week stay in hospital. After that she’d have to live with the cumbersome apparatus strung about her neck, packed around her body, knowing that if it failed she very probably wouldn’t survive.
She knew crying wouldn’t change anything, that it was no more effective than praying, but what else could she do? There was no clearer sign than this that time was running out, and that the quality of the life she had left was going into a steep decline.
‘But you’re always talking about Jim Lynskey and how well he’s coping with a VAD,’ Michelle pointed out when she brought in lunch later.
Vivi looked at the food so kindly prepared by Michelle and had to fight down another wave of nausea. ‘We’re all different,’ she explained, ‘but you’re right, it’s supposed to improve everything from my breathing to my blood flow, which is great, but it doesn’t get us away from the fact that it’s a final bridge to a transplant that might never happen.’
Though Michelle’s face was pale with worry, she was trying to stay positive. ‘Did the cardiologist’s secretary actually say that’s why you’re being called in?’ she asked.
‘No, of course not, it wouldn’t be her place to. I just know that it’s the next step, and with the way I’ve been feeling lately …’ She looked at the food and once again felt her stomach rise.
Apparently realizing the problem, Michelle quickly cleared the salads away. ‘So when’s the appointment?’ she asked, coming back from the kitchen.
‘Next Monday. So they’re not hanging around.’ That alone was alarming, but she had to remind herself that it was better than being left until it was too late.
‘Have you told Josh about it yet?’
Vivi shook her head. ‘He’s got several surgeries on the agenda today, so I don’t want to call him. I just need to try and get my head round what it’s going to be like to have two brick-size devices in the bed with us, attached to a driveline planted under my diaphragm.’
Frowning, Michelle said, ‘I can’t see it making a difference to him …’
‘But it would to me,’ Vivi cried in frustration. ‘I don’t want it there, even if it is supposed to make me feel better, keep me alive even. It’ll be a constant reminder of everything I’d rather forget, and the fact that my condition is worsening is my own fault. The adrenalin rush of making love has put added pressure on my heart and brought the end closer …’ She clasped her hands to her face, hating herself for the tears that wouldn’t stop, and the self-pity that was no more effective than crying or praying, but still unstoppable.
‘Making love when you have an ICD isn’t forbidden,’ Michelle said. ‘You told me that yourself …’
‘But I didn’t allow enough time for my heart to build up the strength it needed to cope. They warned me about it right after the ICD was implanted. OK, they didn’t put a time on it, but they were clear that intimate relations weren’t a good idea until I was stronger. And yes, there have been times when I’ve felt stronger, but I’ve lost count of how often my medication’s had to be changed since, and I’ve never admitted to the physiologists that I’m making love. They haven’t known what they’re dealing with, and now here I am, reaping the results of my deception … Oh God, I’m sorry, I’m sorry, I need to pull myself together. I don’t want Josh seeing me like this.’
Going to her, Michelle said, ‘Don’t apologize to me. I understand how horrible this is for you; I just wish there was something I could do.’
Vivi sobbed, ‘The only person who can do that is the one who has to die to make a heart available, and how can I wish for that when whoever it is will have a family and friends who love them just as much as mine love me?’
Holding her closer, Michelle said, ‘You can’t allow yourself to think that way. You have no more control over fate than the rest of us, so there’s nothing wrong with putting all our hopes into finding a new heart for you.’
‘We can do that,’ Vivi agreed, ‘but then we have to remember that there are a hundred or more people also waiting who are more likely to get it than me.’
The following Monday it was bright but cold as Josh drove them to the clinic. He’d insisted on taking her, and she was glad, because having him close was strengthening her determination to cope with whatever was in store. Her mother and Gil came too, but when she was called through for the ECG, echogram, X-rays, angiogram, blood and respiratory tests and numerous further scans and assessments, she went alone.
They were there for virtually the entire day, with Josh, Gina and Gil haunting the corridors and coffee shops as they waited, and Vivi sending occasional texts to update them on what was happening. No mention of a catheterization yet, she told them, and she hadn’t asked for fear of seeming to make the suggestion.
How absurd she was.
Eventually she came to join them in the waiting room and sat with her head on Josh’s shoulder and a hand in her mother’s until she was called back in. Rather than dread the results of her tests, she made herself think only of how she and Josh had spent the evening before. It was so much more calming to project her mind back instead of forward, especially when she had something so wonderful to look back on.
In a way, knowing everything would probably change from tomorrow, it had felt as though they were going to a last supper at Michelle and Sam’s. However, before they’d left the flat Josh had done something that had made her happier – although in a way sadder – than she’d ever felt in her life.
‘When this next stage is over,’ he’d said, holding her hands in his and gazing far into her eyes, ‘and you’re feeling strong again, do you think you might like to marry me?’
As yet more tears flooded her eyes and she started to sob, he folded her into his arms.
‘Can I take that as a yes?’ he murmured.
‘Yes,’ she choked, ‘it’s a yes. Oh God, I love you so much. I didn’t know it was even possible to love someone so much.’
‘Me neither,’ he responded huskily, ‘and I could question why it’s making you cry, but then you might feel you have to answer and right now I’d rather kiss you.’
So that was how he’d managed to turn dinner last night into a celebration instead of some kind of depressing meal that had to be got through, and when they’d returned home later and made love, he’d shown her exactly how it could be done with two bricks in the bed.
Now, smiling at the idiocy of it, she snuggled more closely in to him and checked her phone as a text arrived. It was from Jim Lynskey.
Just to say thinking of you. Hope it’s going all right. Don’t forget to let me know what they say. Jx
A few minutes later her phone buzzed again; this time it was a message from Sarah Barker whom she hadn’t told about today, but apparently Jim had. Have you received the results yet? VAD not as bad as you might think, promise. Sx
Vivi hadn’t been tested for one, but maybe that was still to come.
What if they carried it out and decided she wasn’t eligible? What then?
More long, dreadful minutes ticked by as they continued to wait. Gina received a text from Mark asking for an update, and a while after that Josh took a call from his mother.
‘No news yet,’ Vivi heard him say, and then her insides tightened with unease as his face paled. ‘Don’t worry, I’m at the hospital,’ he said, sitting forward. ‘I’ll find him when he comes in. Are you on your way? OK, I’ll see you when you get here.’ As he rang off he turned to Vivi. ‘They think my grandfather has had a stroke. The paramedics are bringing him into A & E …’
‘You have to go and find him,’ she insisted. ‘I’ll be fine, honestly. Mum will come in with me and if I’m admitted for some reason she or Gil will let you know where I am.’
Seeing he was as reluctant to leave her as she was to let him go, she whispered in his ear, ‘Tell David that I’m counting on him being at our wedding.’
He touched a hand to her face and as he kissed her he said, ‘I love you, Vivienne Shager, and whatever they say in there, just remember, nothing’s ever going to change that.’
At last Vivi and her mother were seated opposite the cardiologist, Saanvi Sharvelle, the softly-spoken Canadian whom they’d last seen several months ago during Vivi’s first visit to the clinic. Since then Dr Sharvelle had presumably overseen the monitoring of Vivi’s progress, and from the way her sharp grey eyes were fixed on the computer screen in front of her now she was still assimilating and assessing the results of today.
‘OK,’ she said finally, turning to them. She didn’t smile, or change the tone of her voice as she apologized for making them wait so long, she simply linked her long fingers together and rested them on the desk in front of her.
‘I’ve been in regular contact with your team at the transplant centre,’ she told Vivi, ‘and we are all of the same opinion, which is why you’ve been called in today to undergo more tests.’
Vivi’s mouth was dry; her nerves were so tight that she had no idea how hard she was squeezing her mother’s hand until Gina was forced to ease herself free.
‘First of all,’ Dr Sharvelle said evenly, ‘there is a …complication that we weren’t expecting …’
Vivi reeled and missed the next few words.
‘… but before we get into the detail,’ Sharvelle was saying, ‘you need to understand that your decision will affect whether or not you remain on the transplant list.’
Vivi swallowed drily and glanced at her mother. She knew she’d have to come off the list if she had a VAD, at least for a while; she also knew that some people refused them.
‘You’ll continue with the ICD,’ Dr Sharvelle informed her, ‘and the medication, of course …’
Vivi was finding it impossible to focus. She kept missing words, misunderstanding their meaning, then her mother suddenly gulped on a sob, clasping her hands to her face.
Vivi stared at the doctor. What had she said? What did all this mean? Oh God, oh God, it was obviously really bad.
Apparently realizing Vivi hadn’t connected with what she’d been told the doctor began again, this time spelling it out more clearly.
Vivi was already at the flat by the time Josh came in from the hospital looking tired, but relieved, for David’s suspected stroke had turned out to be a much less serious TIA.
‘They’ve decided to keep him in overnight,’ he said, pulling her into his arms, ‘and Nate will collect him in the morning. Now I want to hear about you.’
She gazed up at him, and wondered if he really was even more handsome than she’d realized, or perhaps it was just that her news was making her see him in a clearer light.
‘What?’ he prompted, when she continued to look at him.
She found herself turning away. Right up until the time he’d come through the door she’d been rehearsing how to tell him what the doctor had said, but she still wasn’t sure that she’d found the right words.
Taking her arm, he turned her back. ‘What is it?’ he asked darkly, and tilting her chin up so he could see her expression, his own tightened with more unease. ‘Tell me what it is,’ he said urgently.
She swallowed hard, bracing herself. ‘We’re … we’re going to have a baby,’ she whispered raggedly.
He stared at her in shock, appearing to have no idea how it could have happened, which might have been funny if the situation weren’t so serious. A beat later she could almost see, even hear, the questions blazing around in his head.
Answering them before he could ask, she said, ‘They can’t tell me for certain yet if my medication has already caused any damage to the foetus. I have to see an obstetrician tomorrow. We might know more then, but it’ll probably be a few more weeks before they can tell us anything for certain.’
Taking that in, he swallowed drily as he said, ‘So they’re not saying that you shouldn’t have it?’
She shook her head. ‘In fact, they’ve already taken me off the warfarin and put me on unfractionated heparin instead – anticoagulants can be a big problem during pregnancy, apparently. A lot will depend on the results of the ultrasound tomorrow. If the obstetrician is happy for things to continue, then they’ll keep a close eye on me throughout. It’ll probably mean having to spend a lot of the time with my feet up, and maybe I’ll even have to stay in hospital until it’s born. It’ll also mean coming off the transplant list, but I want this baby so much, Josh. Tell me you do too.’
Wrapping her tightly in his arms, he said, ‘Don’t ever doubt it. Not for a single minute. I want it as much as you do, but if it’s going to put you at risk …’
‘I’ll be fine,’ she assured him, willing it to be true. It had to be, it just did.
He drew back to look at her again, and began shaking his head in a way she couldn’t quite understand. ‘This is so not what we expected when we left here this morning,’ he said hoarsely. ‘I thought … I was afraid …’
‘I know,’ she whispered, and seeing the tears in his eyes she pulled his mouth to hers. ‘I only wish I could tell you that my heart is healing, but this news … Maybe it’s even better.’
He seemed unable to answer that, so he simply kissed her again. ‘Does your mother know?’ he asked.
‘She was there when Dr Sharvelle told me. Gil knows too, and I’ll have to tell Michelle and Sam, your mother too, but outside our immediate circle I think it’s best not to say anything until we’re more sure of what’s going to happen. If we really can continue with it.’
He nodded agreement. ‘Do you know how far along you are?’
‘About six weeks.’ Her eyes twinkled. ‘It’s what all the increased nausea and tiredness has been about lately. I should have realized. I would have, if it weren’t for everything else.’
Pulling her to him again, he said, ‘Tell me what you want to do about a wedding. If you’d rather wait until everything’s more certain …’
With tearful laughter in her voice, she said, ‘I’m not sure. I can hardly think about anything at the moment.’
Understanding, he lowered his mouth to hers and kissed her deeply. ‘Let’s make a decision after tomorrow,’ he said gruffly. ‘I love you so much. I hope you know that.’
‘I love you too, more than I can put into words.’
They stood together for a long time, feeling the currents of hope and belonging and dread enveloping them. They couldn’t lose this baby, they just couldn’t, but if her drugs had already damaged it, or if it turned into a choice between its life and hers, she knew there probably wouldn’t be a choice at all.