The next morning, along with letters, checks, music boxes, telegrams, baby clothing, stuffed animals, and—yes—a bright-green baby-sized Harley-Davidson from the company itself, I got a call from Renee Mayerling.
Her first words were, “Vincent Cappadora?”
As though we’d never said goodbye, I let the laughter bubble up.
“The grapevine is that good?”
“It’s a short vine,” Renee said.
I told her, “He was the only one there.”
We talked for two hours. Renee was now the lieutenant at the legendary Engine Company 78 in Wrigleyville, the Waveland Avenue Miracle. She had received three commendations for bravery. What she said next stopped my breath: Renee had been burned. She was knocked down by the explosion of a water heater in a manufactured home and pinned for critical seconds before one of her rookies hauled her free, knocking aside the superheated oversize tin can on her back with a single adrenaline kick of his work boot. She’d been burned so badly on the back of her neck and lower scalp that she was furloughed for three months with full pay and had undergone skin grafts. They were thirteen years better than my first grafts and thankfully didn’t show under her curly brown hair, which Renee now wore long. “I never dreamed what you went through, Sissy,” she said. “I guess I didn’t really want to know. Maybe that’s why it happened.”
“That’s magical thinking, Renee. I’ve been told that a hundred times in the past year. You’re not supposed to know how a victim feels. You’re a victor. You gave me a hell of a hand once upon a winter’s day.”
“Sicily, you’re the sweetest kid. My gosh, you’re not a kid anymore, are you? I can come and see you, right? Even though you’re the bubble girl?”
“Sure,” I said. “Sometimes much is asked of those to whom not much is given,” I said.
“Awwww, Sissy,” Renee said.
I told her, “It’s okay.”
“So, you and Vincent. It’s great. Who would have thought that it would be you and the scourge of the neighborhood? He was the legendary delinquent when I was in high school. Then the movie and the Oscar and all that? Does he have an Italian car like all those people? And what is the commuter thing like?”
Imagine how that was. Imagine. You know how badly I wanted to tell my old babysitter, my tutor—my savior—that it was all Cristal and yellow-diamond engagement rings and daily devotional telephone calls, videos on MyShare with Hollywood stars all wishing me Godspeed and fair winds? More than you know. More than I know.
“We don’t talk,” I said.
“What do you mean? You mean because you’re in the isolation tank?”
“No. That’s not why. We’re not together, Renee. You know, this happened as a result of a brief thing in California. He didn’t want any part of the pregnancy. Then he did, but I didn’t want him to have any part of the pregnancy anymore. Then I wanted him to. Then he did. Then he didn’t.”
“Are you in love with him?” Renee asked.
“Yep,” I said.
“Oh, Sicily. Come on. Really?”
“In some sick, self-loathing, denial-of-my-own-rights way.”
“That’s true for everybody.”
“Not you.”
“I outrank my husband. I have to spend my whole life being apologetic and faking how sexed up I feel and making pies and chili from scratch at home when I don’t have to cook at the station.”
Renee was good. On Valentine’s Day, she came to the hospital, bringing me what she promised were sterile 82 percent cocoa chocolate bars, a set of new DVDs of horrific on-scene training videos, a fire-science textbook she used, and all twelve volumes of Anthony Powell’s A Dance to the Music of Time, said to be the longest single narrative ever written.
“That should keep you busy,” she said.
“Until Monday,” I said.
“And all this will keep your mind off Vincent Cappadora. He was cute, I’ll say that. Good genes.”
“Like Henry the Eighth. He was a looker too.”
“But Good Queen Bess, right?”
“We can hope.”
“Sissy,” Renee said. “Let’s crack open one of those fire-scene DVDs. They’ll make you feel lucky. In fact, you’re going to be lucky, I can tell. You’ve got a long streak of good luck owed to you.”
On Valentine’s Day, both Beth and Aunt Marie came to see “the big ultrasound.” I lay on my bed and the tech slicked my undeniably topographic belly. She used the teeny handheld ultrasound machine, simply because it had fewer places on it that could freight infection into my room. The smaller machines were touchy, she said, and it might take a moment to find the little one, but instantly …
Wow, I thought. Hey, that’s my baby. Big eyes. A big nose. Fairy fingers. The tech displayed our window on Baby Coyne’s world to each of us. For the first time, I had the equally weird and epically sweet sensation of sharing my body with another actual person. What had popped up on the screen, as though playing a game, no longer looked like a vaguely humanoid bean, bent over by the stresses of growing milk teeth and a liver. It looked like a baby, a very active baby, with pudgy cheeks and a definite pout, rolling around. My throat tightened when the baby reached up and, seemingly intentionally, rubbed its eye with that quintessential gesture of unself-conscious innocence. As I reached out toward the image on the screen—as though the baby lived in there, instead of inside me, the way the world now seemed to live in the television—Dr. Setnes came bustling into the room. “I’m sorry,” she said. “Emergency. Had to get all cleaned up before I came in here.”
“No problem,” my aunt said. “The more we get to peek.”
“Let me have a look at those measurements,” Dr. Setnes said. One of the risks of SM965,900 was that a fetus might not grow as well, or at least not grow in size, before term. While having all its essential parts, the baby could just be smaller. At the time, this meant approximately nothing to me—small baby, easier to push out. If it’s essential, you can put aside everything you know better than to believe.
A moment later, in her own gear, Dr. Ahrens joined Dr. Setnes.
We resembled those old films of people inside spacecraft, trying to eat ice cream through a straw. After a moment, someone delivered a strip of images sent wirelessly to a printer down the hall, which somehow—like my food—didn’t have to be put through an autoclave before it was passed through the door. The doctors stepped away from the doting grandmas standing around me and the sonographer.
Dr. Ahrens said, “Hmmm.”
Hmmm.
I could have paid for the college education of every kid in the hospital if I had a dollar for every time someone in a medical setting took a look in my direction and said, Hmmm.
“Nothing’s wrong,” said Dr. Setnes before I could ask. “But this is a small person for its gestational age.”
Dr. Ahrens said, “Maybe this has nothing to do with the medicines. Sicily, the usual reason for this is that you aren’t completely sure of the date of conception. Are you positive that conception took place—”
“Not to the minute,” I said. “But within a four-hour span.”
Dr. Ahrens said, “Hmmm.”
But Dr. Setnes was her matronly and assuring self. She said, “If this is a small baby, he or she might require some extra attention, Sicily, that’s all. From what I can eyeball, the developmental markers seem on target. I can’t eyeball everything. The drugs you need to take can have this result in animals, but most babies that are small at birth for no reason other than a mother’s size or medical condition do as well as bigger babies and much better than babies that grow overly large as a result of factors such as gestational diabetes. Let’s not go looking for zebras.” Oddly, although the medical expression—when you hear hoofbeats, it’s usually horses, not zebras, so don’t seek exotic solutions until you run out of ordinary ones—was so old it had moss on it, at that moment, from Dr. Setnes’s mouth, it was supremely comforting to me.
“Now let’s talk about something imp
ortant,” she said. “Do you want to know the gender?”
“You bet,” I said. Turning to my aunt and Beth, I said, “I have to know whether it should be named Taggert or Ambrosia.” My aunt, who was valiantly trying to carve a compact but serviceable nursery from a hedonistic single-girl digs in the approximately eight hours a week she got to spend at home, was enthusiastic. Beth, on the other hand, said she loved surprises, the good kind, and might put her hands over her ears.
But they couldn’t get that rascally baby to turn around enough to assure what they were seeing at the cleft of its bowed legs. The tech kept trying. Finally, I told her that I should probably just wait. I was starting to feel sort of lousy and drowsy and sick of the prodding. After each grandma got a picture, Beth went home and my aunt left to do an on-site interview. I pasted the eye-rubbing image in the journal Hollis had given me. So here you are, I wrote. You’re literally the size of a little turtle without a shell, all scrawny and vulnerable. I have to think you’ll be brave. You were brave to break through in the first place. As for what you’ll have to handle in your life, it will probably all seem ordinary to you, because you’ll never know anything else. I’ll help you. We’ll help each other. I have no idea how, but I’m going to be the fixed point in the universe for you …
I heard a ping and pulled my table toward me. There was a Valentine from Upstart Productions. It was an e-card that read, Love is like trick or treat/At its best, fine whiskey neat/At its worst, prickly heat/For me, a ringside seat … Vincent Cappadora.
I guess he signed it that way so I didn’t confuse him with Vincent van Gogh.
Slightly encouraged that he’d written at all, I started to finish my now-nightly note to my fetus, but I got tired and laid down my pen. It was odd to feel too worn out even to write, when I’d spent the whole day doing nothing. I was sapped, tired in body, and thought that if I didn’t sleep I’d melt.
In the night I woke and asked for a glass of ice, which a nurse slipped through the Velcro’ed window in my door. I glanced in the mirror. In the half dark, my face was pallid as bone. I depressed the call button as though I was throttling a joystick. Dr. Ahrens must have come through a pneumatic tube, she got there so quickly.
She confirmed that I was in rejection.
CHAPTER TWENTY
“This is not as bad as it seems,” Dr. Ahrens told my aunt.
“This is as bad as it seems,” my aunt insisted. “This is her second episode.”
“Most people have three and some have five. The first year is dicey,” said Dr. Ahrens. Dr. Park had turned up by then, as had Hollis, who was soon to scrub in for a surgery, along with Wayne Neville, a critical-care perinatologist.
He was cut from the Dr. Glass mold, as warm and fuzzy as cut glass. “As far as the fetus, whatever has been done to it with that stuff has already been done, frankly.”
Frankly.
And here we all thought he’d been wearing kid gloves. Dr. Neville had a case and promised to return later to do an ultrasound. I thought, The baby will emerge looking like something from an old Warner Bros. cartoon, like Sylvester the Cat sticking his finger in an electrical socket, hair standing out straight as stickpins.
“Should she go back on the old protocol if what he said is true?” my aunt asked.
“I’m not thinking so,” said Dr. Ahrens. “Let me go tinker.”
She went to tinker with SM965,900.
The new dosage began that morning.
By the following night, the normal skin color of a human being crept slowly back onto the disturbing pearly surface of my face. The heavy lassitude began to subside. Although I still didn’t feel entirely up to par and my blood pressure wasn’t its usual steady low fraction, I was up, if not exactly around, within a week.
One thing was very worrisome.
A bit of skin just under my jaw had become discolored, obviously dead tissue. Hollis was reluctant to cover it and so treated it with antibiotic gel and cautioned me (not that I needed the caution) not to put my hands anywhere near it. Daily, she measured that spot and photographed it, sometimes as Beth photographed her. I began to have terrible trouble sleeping. Studying the spot, which was half an inch square, I imagined my whole face simply crisping up to a brown frill of burned egg and sloughing off. When I dreamed of that, I woke up screaming in my cell. One night, after I dreamed twice of washing my face and seeing my nose and eyebrows come off when I splashed on water, Aunt Marie sat next to me and held my hand for hours. In the morning, my face was noticeably better, my blood pressure down. With a local anesthetic, Hollis excised the bit of skin from under my chin. “You won’t notice that scar,” she said.
“Especially if there are even bigger ones, like one hundred and twenty square inches of them,” I said.
“Don’t, Sicily. A couple of episodes of rejection are not uncommon at all. You’ve done beautifully. This is a special circumstance, isn’t it?” Hollis said, patting my tummy. People cannot resist doing that, even if your face is coming off.
“If she’s in rejection, why are you still using the new experimental thing?” Aunt Marie asked. “What if it’s not going to work?”
“I still think it’s going to work,” Dr. Ahrens said.
“I don’t even know why it works,” Marie said. “The other stuff was pretty straightforward. You suppress the part of the immune system that has to do with the T cells—which is why she’s at a greater risk for cancer, at least possibly—and she can still fight off infection with her natural immune system.”
“Exactly, Marie. But things that were pretty crude when the first face transplant took place have come a long way.”
“So with that, she might not have experienced any rejection?”
“She might well have. And if she had, in the early months, that would be no indicator of how well she would do after the transplant really took. It depends on so many factors. We immunologists started out just studying infectious diseases, so that’s what we knew how to prevent.”
“I thought you were an internist,” my aunt said.
“Both,” said Dr. Ahrens.
“So what you suppressed at first …”
“Was the kind of immunity that depends on T cells—in the very simplest terms, the cells that basically yell, Hey, look, kill this! But when we suppressed them, there was no real backup, no real surveillance system, so it makes sense that certain kinds of viruses, like Epstein-Barr—which is linked to an increased risk of lymphoma and maybe leukemia—have an easier time sneaking into the house.”
“But this is different.”
“Auntie,” I said, “it’s like homeopathy. You give a bit of the bad stuff so that the body learns to protect itself from the bad stuff, except it’s not really bad stuff. It’s just, for my body, unfamiliar stuff.”
“Homeopathy is quackery,” Marie said.
Dr. Ahrens said, “Sicily is putting it a little too simply. What we’re giving her now is what we would have given her before the transplant if she had been on this new protocol. Which isn’t approved for us to do. We’re giving her donor-specific class-two MHC peptides—”
“No—please, I work in television news,” Marie said.
“We’re giving her medicines that contain protective protein materials like the ones that were in Emma’s body, so Sicily’s body doesn’t scream, Kill that! And since it’s more like Emma’s body, there’s just less … mismatch strangeness and …”
“Fewer burglars sneaking into the house.”
“Exactly.”
“Why didn’t someone think of this before now?” Marie asked.
“People have been thinking about it for nearly fifty years,” said Dr. Ahrens. “But the big research bucks for transplant technologies weren’t really there, because this isn’t what kills sixty-year-old bankers. It’s only in the last ten years, when people like Dr. Grigsby proved that a hand transplant or a face transplant could be a life-enabling issue and not just a quality of life issue for some people, that the work started to
look really, really good.” She paused and instructed the space-suited phlebotomist to draw two more purple tubes of blood, then said, “This is going to be okay. Sicily is the first cathedral built with this therapy, but we already had three-D blueprints for the design. We’re just tinkering with success here. I know it. I know.”
“Okay. Should I know?” I asked.
“Yes, It will help if you know. Your father was a fireman, right? Every day he had to exercise a little denial, right? It’ll be good.”
And so it seemed. The numbness and itching disappeared quickly, as did the overall flulike aches, but part of that might have been inactivity. Exercise is making love to your heart—and your joints—after all. Before any of this ever started, if I didn’t get my workout, I got a pain in my neck and became a pain in the neck to everyone else. I’d done my best, but this situation was in every sense the true meaning of “confinement.”
Dr. Neville decided it was time—“It was high time,” he said (frankly)—for an amnio. And so, using an ultrasound machine, with my bladder engorged with water, Dr. Neville searched for a place to withdraw a syringe of amniotic fluid. Every time he thought he had a bull’s-eye, the baby moved. When that happened, Dr. Neville turned and stared at me.
“I’m not making the baby move around,” I said.
“I realize that,” he answered. He set forth again. Just as he was going in with his needle, the baby did a full roll, and I heard Dr. Neville’s muffled curse.
After forty minutes of near sticks, Dr. Setnes said, “We have the nuchal fold—”
“That’s not really as significant as what we could have here, Doctor.”
“But you don’t want to take the risk of doing harm to the fetus,” I said. Dr. Neville must have been mute in his childhood. His transparent blue eyes were eloquent with sour scorn. “From my point of view, we’ve had enough tries. This is not going to happen.”