Second Nature: A Love Story

  “Sicily,” he said. “Is Sicily going to be okay?”

  Dr. Setnes shrugged. “I wish I knew, let’s hope.” To me, she said, “What we have to decide now, Sicily, are two huge things. And deciding right now is critical. One, there is still plenty of time to reconsider your decision to terminate the pregnancy in light of this event. The other issue is the alternative protocol. Do you want to continue? The human-subject group for this protocol, with a face transplant, is one.”

  Dr. Ahrens said, “Human hands aren’t human faces, although there are striking similarities. And the face-transplant animal studies are extraordinarily promising, but they are animal studies. Essentially, if we go ahead, you know that this would be a drug trial with a single subject, for which the hospital ethics committee has given its approval, considering the nature of the circumstances. But you didn’t start this drug protocol right away. We don’t know what the earlier protocol did to this fetus, and we don’t know what this one will do.”

  “You don’t know if it will work.”

  “I think it will work. But, no, I can’t be sure,” said Dr. Ahrens.

  “And if I have the pregnancy terminated?” I looked up at Dr. Ahrens instead of at the shape of the tiny hand.

  “Well, we’ll put you back on standard levels of the commonplace immunosuppressive drugs we’ve always used for the first year after transplant, and you’ll be out of here in a couple of days.”

  “That would straighten you out immediately,” Dr. Setnes said.

  I breathed in and held it. Could I let this baby soul go, this inconvenient child, and lasso it again someday later, in a child I adopted, in a child another woman gave birth to using some likely donor’s sperm mixed with my egg? This baby now seemed to slip away from me. This had all seemed possible for me to do—sustaining the pregnancy, being a single mother—but now I saw the full gruesomeness of a face that would not even be patched on carefully, as my previous topographical mash had been over months and years, but slapped on to keep life in and infection out. There would be hanks of cultivated skin and strips torn in haste off my back and my buttocks, which would leave not the tiny snail-trail scars that lurked under this discreet fold and that but raw, red, raised, welted ridges. My beautiful body. My one vanity, transformed by urgency into a hell of stinging striped scrawls, a bombed field seen from the air—and for all of this nothing saved but my life, a changed and solitary life, my apartment a place to crawl back into. I wouldn’t come out again. I wouldn’t. Swathed and long-sleeved, I would receive my newspapers and work correspondence from Angel, my takeout from a series of acne-stippled boys. Or perhaps I would no longer work. There would be no more brave interviews with new clients. No one would want to hire the grotesquerie I would be—the girl who lost her face, twice. I might subsist on disability. My apartment was paid for and was my own.

  And my child would live with me, in that dimly lit world. If he turned out to be a mutant like me, we might be boon companions. If he was a normal child, I wouldn’t be able to go to baseball games, kindergarten graduation, parent–teacher conferences, to the zoo, and … to ride on the teacups at Disneyland. He would love me, as the grandchild of the woman I’d drawn in my art class loved her. And as soon as he could, he would flee, to college, to the world, where torment meant losing a job or a girl. There would be no pictures of me in his dorm room, no pictures of me holding him triumphantly in the birthing room, at the baptismal font, helping him put together his wooden train under the Cappadoras’ lavish Christmas tree.

  I might live for thirty years, for fifty years, for sixty years, long after Aunt Marie was dead and my grandparents were dead.

  Long after Vincent was married and a father.

  That was if I lived at all.

  The baby and I might die together—him with quick and blessed unawareness. I would go slowly and in pain, as the hospital staff pulled out all the stops to save me.… To save me for what?

  Or maybe, if everyone on this crack team I’d so abused acted quickly, my face would be just fine and, after counseling—lots of it—I would no longer feel as though my heart was a gourd filled with sand.

  Beth would not photograph this, my loss of face. The project was over. What combination of ego and altruism, stubbornness and arrogance, had moved me? Why the exhibit? Why, oh, my God, why the pregnancy? What a fool I was—a hateful, irresponsible, self-centered, grasping, greedy, impractical, dreamy-eyed fool.

  Why had I ever met Beth? Or, worse, Vincent?

  “I need to see my aunt and Vincent alone for a moment,” I said to Dr. Ahrens. “I’ll have the pregnancy terminated as soon as it’s possible. You do believe you can save me? Right?”

  “I really do believe we caught this very early, Sicily, and that you will be fine.”

  “How soon can I have the termination? Do I need to be conscious for it?”

  “Not tomorrow,” she said. “That would just be too sad. The next day. And, no, you can be thoroughly sedated.”

  “Will it hurt the … fetus?”

  “Sicily, there’s a huge amount of controversy about things like that. Nothing will hurt for very long.”

  “If it can be tomorrow, then I want tomorrow,” I told her.

  My aunt rushed to the side of the bed, reaching down and holding me to her with a fragile strength. “Tell Beth not to open our gifts,” I said to Aunt Marie. “It’s important.”

  “I gave her a first edition of an Alfred Stieglitz book from both of us,” Marie said. “Why?”

  “Mine is like this,” I said, thrusting the ultrasound picture at my aunt. “From last week. I put it in a little silver frame.”

  “There’s nothing wrong with that,” Marie said.

  Over my aunt’s head, I studied Vincent, his pelt of thick light hair disarranged, his perfect California-guy shawl of cotton sweater hanging askew. Our baby would have gray eyes, like Vincent’s and mine, eyes as gray as the clouds reflected in a pond.

  Or in a ditch.

  “Did you want this?” I asked him. “Is any part of you in pain over ending it?”

  “Sicily, I promised in the emails I sent to you. I would have wanted to help you support a child of mine and even know it.”

  “You want to know it.”

  “I mean that I want to be a father in any way I can.”

  “In any way you can without being a father, really,” I said, and inhaled deeply.

  “Sicily, wait. Tonight when I saw you …” He looked at Marie. “This really is private.” My aunt whirled and left the room. “I wrote to you that I wanted to try to help and support you in having this child, my child. Our child. But tonight I saw you. And when I touched you, it was different.”

  “What happened? You got aroused? I did too.”

  “I thought what I thought the last time. What I never got to say. Maybe we can get to know each other. Over these few months. I have a bunch of work to do with the movie coming out. But I can make time. I’ll visit. We’ll talk about what we do and what’s important.”

  “What’s important this minute?”

  “This emergency.”

  “And you? And the baby? And me?”

  “I want to be a part of this.”

  “Vincent, this is a terrible question to ask anyone but one you have to consider right now. If I were to have this baby and lose the face I have, if I had to have a face that was mainly scar tissue, like my face before, would you still want to get to know me? Would you still want to know the baby?”

  “I can’t think of that. I can’t. No one could.”

  “If I died, would you want to raise our child?”

  He stood still for a long while, head down, gripping his elbows with his arms folded across his chest.

  “No,” he said. “I would want Ben and Eliza to raise the baby.” Vincent took a deep breath and shook his head. “It’s not worth the risk to you. I know you. I don’t know some unknown, unformed child.”

  “It’s too great a risk to me, Vincent. I have to ha
ve an abortion.”

  His eyes widened. “I’m so sorry. It’s so horrible. We’ve seen him, and he’s alive and real. You’re doing this and we just saw our child, alive and real, with hands and a little face.”

  “But I’m alive and real,” I said. “And I have a face. And I need this face to face the world. I do want children someday, some way, and someone to love me, Vincent. And if I kept this baby but I lost my face, you wouldn’t be able to stomach me. I don’t blame you for that.”

  Vincent pulled his beat-up leather jacket off the hook and stuck his arms into it. “You don’t know that for sure. I don’t know that for sure.” For a moment, Vincent pulled up a metal chair and sat down beside me. He took my hand, careful not to dislodge my IV. Then he said, “I do know it would scare the hell out of me, and I couldn’t be sure if what I was feeling was love or pity. And you know what, Sicily? It would scare you too. I know you had a face before that was hard to look at. But you were used to it. Now you’re not used to it. You’re used to being pretty. You don’t even know who you’d be after something like that. Or how you’d act. If I could be sure you’d be that girl I met that day at the airport … but you can’t be sure. And I can’t make that decision with a gun to my head. If I was wrong, that would be the worst thing of all.” He called to my aunt. “Do you need a ride, Marie?”

  She came back into the room. “I’ll stay here with Sicily.”

  Without another word, he left. I heard the ping as the elevator arrived: There was almost no wait for an elevator at a hospital on Christmas Eve—when everyone well enough to be pushed, pulled, or dragged goes home, at least for the night, even if it’s to die. I heard the whoosh of the doors. And Vincent was gone.

  My aunt held me and tried to pretend that she wasn’t crying, but her tears soaked the front of my dainty gown. The nurses had candles now and were walking slowly from door to door, stopping at each one—where someone had received a kidney, or was in isolation waiting for marrow, a heart, a liver. A face to face the world. I had to remember the girl I was once, who would have closed her eyes to shut out the sight of the candles.

  Dr. Ahrens brought me a cup loaded with my discs and cylinders of drugs and I gulped them down. In a soft voice, she told my aunt that she had arranged for sedation for me at six in the morning before the procedure. I asked Dr. Ahrens for something that would make me sleep, sleep deeply, so I would not think of that little hand, swimming unawares within me through the dark water, toward the shore, toward me. Dr. Ahrens brought another paper cup, tasting of dry wood, and a glass of water that did nothing to quench my immense thirst. But she’d given good drug, she had.

  As I began to sink, I confused the voices of the nurses with angels. I saw their scrubs with polka dots and polo necks and smiley-faces as gowns of white, and they sang of hope and joy and of the baby in the barn. And I rushed into the dark until it closed over my head.

  CHAPTER EIGHTEEN

  I woke with my nose chilled, the familiar cocoon of warm blankets and the clang of bright lights the telltale signals of the operating room. I had awakened before, and someone had generously put me to sleep again, treating me like an animal that might become anxious if it sensed its fate. Slowly, the darkness of morning returned to me: the nip of the IV—which I noticed of late, because needles and IVs were no longer customary for me—the balm of the Valium, a good dose, a Sicily dose, straight to starlight.

  “It would be unkind to wish you a Merry Christmas, so I won’t,” said Hollis.

  “Why are you in this dream?”

  “You’re not dreaming, Sicily, though I can’t say that it wouldn’t be easier for it to be a dream,” she said. “I came back last night as soon as I heard about this.”

  “I’m sorry.”

  “It’s not yours to be sorry. I should be sorry. I am sorry. I should have been more of a doctor. I needed to be here,” she said. Hollis had taken my hand, the one without the IV. I was drowsy. The anesthesiologist murmured through his mask about IV Versed.

  “I’m doing the right thing,” I said.

  “Well, probably best, honey,” said Hollis. “But I sympathize. This is a loss now, and I hate that you have to bear it. But you’ll wake up just as you did when the bandages came off. And, as for the rest, time will come again.” Rustlings and adjustments were going on around and under me: Can-you-lift-your-hips-just-a-little-Miss-Coyne, that’s-great-thank-you, now-let’s-put-one-foot-here, warm-enough-now-good. Through a gauze, I saw Hollis recede, and in her place came a burly man, whose face and ginger fringe of hair I didn’t recognize. He leaned close to study my eyes.

  “Can you hear me, Miss Coyne?”

  “Of course.”

  “Maybe she can have a little more?”

  “Nope,” said the anesthesiologist. “Already got the Mike Tyson amount.”

  “Where is Dr. Setnes?” I asked.

  “She’s not here,” said the red-haired doctor. “She’s not needed for this morning.”

  His voice was mellow, if terse. I had taken this man’s Christmas morning for a grim purpose, so that my psychological suffering would be eased. But it would never be eased. I would always have scars on my soul. The doctor was gowned and masked and gloved. I wondered if doctors scrubbed in so rigorously for routine abortions. I was a special case, though. An infection could thrust me farther into the shadows. But wasn’t abortion a bit of an ordinary process, performed each day on dozens of sobbing teenagers and tight-lipped forty-year-olds, in office settings? A suck and a scoop?

  “Dr. Setnes is an obstetrician, Miss Coyne,” the doctor said, and I felt the cold tongue of the speculum. “I’m a gynecological surgeon. And I’m going to take the best care of you. My name is Doug Sherry. This isn’t going to take very long, and you won’t feel a thing. Please relax.”

  I began to breathe slowly, deeply, in and out, willing my shoulders down into the table. Soon it would be over. Soon I would have the chance to begin again, to take up where I had stopped so abruptly. I saw those vulnerable drooping cheeks on the grainy TV screen of the sonogram. The furled tiny hand. I saw myself naked in the night, Vincent’s body golden and red in the firelight, our arms so supple in light and shadow, so tightly against each other that we were like estuaries of a single river that met in a hollow of sand. Wide-spaced eyes. Babies not meant to be. Vincent’s eyes, his shock and awe. Annunciation. Swimming little foot. All unawares. I heard myself speak to the doctor and he murmured in return, adjusting the drape over my knees—so kind, even the drape had been warmed. I tried again. Could they hear me? I tried to sit but my legs were cumbersome and thick. The anesthesiologist spoke up.

  “Dr. Sherry, she said no.”

  “I don’t think so. She’s not aware.”

  “I did,” I told the room wearily. “I said no. Stop it. Stop everything.”

  “Sicily, do you need more time?” the red-haired man asked.

  “I don’t need more time,” I said. “I need to go back to my room, and I am not going to schedule another procedure. Ever. I am half sick of shadows.” I had memorized only one poem ever, Tennyson’s “The Lady of Shalott,” and then only under duress. But I had gone to Catholic school, and I remembered it well. God, in his mercy, lend her grace. As the Versed ebbed like something uncovering my lucid mind, I saw the rest of my body ringed by a dozen faces, all peering at me with various degrees of astonishment, annoyance, amusement, anger. The red-haired gynecological surgeon pulled off his mask.

  “Did I have an abortion?” I asked.

  “No,” said the surgeon. “No. You refused it.”

  “I refused it. I was not saying, no, this can’t be happening to me. I was saying no, this will not happen.”

  “I’m glad Dr. Haryana heard you. You don’t need me now. If I leave right away, my kids won’t be up yet.” He turned to leave and then looked back. “Don’t worry. Good luck, Miss Coyne. Good luck, and I mean that.”

  “I will need it,” I said.

  “Happy Christmas. I got a good
feeling,” said Dr. Sherry.

  I did too. This guy had grown up on the West Side. I heard it in his voice and saw it in his big-veined nose, which had seen more than a few cups of kindness in its time.

  “Good luck from me too, Sicily,” said the anesthesiologist, whose liquid East Indian eyes and lilt I now recognized.

  “I won’t be seeing you again, I promise,” I told him.

  “You never know. Maybe six months from now, you could have a stubborn baby who doesn’t want to come out. Apparently he is a stubborn baby already. Determined to stay put. I think he has got a right to his chance in this bad world. Maybe not always bad.”

  Of course, Hollis was waiting outside the doors of the OR. Although there was nothing for me to be ashamed of, I wanted to look away. As the nurses at the head and foot of the rolling bed wheeled me toward the elevators, she walked beside me, whistling softly, “O Come, O Come, Emmanuel,” which she could not on earth have known was the song we were singing when the Christmas trees exploded on the altar. Even I had forgotten. She said, “What’s your favorite Christmas carol?”

  “ ‘Silent Night,’ ” I said. “I’m very big on sentimental nonsense. As you have just seen demonstrated.”

  “Like some kinds of religion.”

  “Hollis, this had nothing to do with religion.”

  “I didn’t mean the Catholic religion,” she said. “I meant the religion of love.” Hollis thumbed the button while the nurses slipped the cot into the elevator: It barely fit. They always had to jockey it around and slam it against the walls. Why was that? Why didn’t somebody suggest changing either the size of the bed or the size of the elevator? Didn’t they have different sizes of elevators, some for an urban hospital, some for a French restaurant, some for the W Hotel or Lincoln Center? Hollis waved and told me she’d be back later, after getting on her computer to chat with her family in Louisiana.

  Dr. Ahrens was waiting in my room on the ninth floor. She was not tapping her foot, but I could tell that her restraint was forced.

  “Hi,” I said. “What are you doing?”