Seven Disconnected Facts about the Human Heart

A Midsummer Tale ~ First Place
Sarah Evans


Photo Credit: Patrick B/Flickr (CC-by)

1. The heart beats 115,000 times a day

The sky darkens and my heart beats uncomfortably fast.

I put the phone down and try to absorb the information, letting it pass from ear to brain. This is it. A possible match. Please get here as soon as possible. Time is of the essence.

For weeks the heat has built; for months I have waited for this call. Now it is here, I’m not ready; I long to return to balmy warmth and postponement. I look down at my list of shakily scribbled instructions. Nil by mouth. Not a problem now nausea has taken hold. Bring all current medication.

My rapid pulse is not good; it is important to remain relaxed and calm, to steer clear of all strong emotion, avoiding undue stress on a damaged organ. The wind has picked up, setting the windows rattling. The rattling of my heart feels like terror; perhaps it is also something else.

I breathe in slowly and slowly out, inhaling the smell of dusty heat through the open window.

I think how this is my once in a lifetime chance to regain my life.

I think how the operation has risks.

I think how someone has died, someone who most likely got up this morning expecting a perfectly ordinary day.

A car accident. An operation gone awry.

A murder.

A suicide.

A bolt out of the blue.

I won’t be told the details, not now. It is morbid to speculate, impossible not to be curious about the stranger whose heart is still beating, the heart which will become mine. Afterwards I will be given the opportunity to write a letter to the grieving family. Thank you for my gift of a heart from someone you loved and lost.

Presupposing that I am still around.

2. The heart is the size of a fist

Lightning flashes across the sky. I don’t want to do this: the thought sparks up hard and fast and I fist my fingers, reason battling against instinct. I stare at the veins on the back of my hand, their bifurcating pattern.

Operative mortality—death within thirty days—is between five and ten percent. Toss a coin four times, all are heads, fail to wake up, or wake up only to succumb to septicaemia. Is the former any worse than the latter? Is dying from the operation worse than dying from this natural but unlucky defect? There are no satisfactory answers.

I have little time left, but am unlikely to die today, not if I stay here safely at home. This is not the way I should be thinking.

The decision is made, my consent given when I agreed to my name being put on the waiting list. No amount of prior discussion—calm and rational—with doctors and my daughter, settles the matter within this instant. But the call has created an obligation. I owe a debt to unknown people—the person who died, the family who have said yes, the one who was next after me on the waiting list—to seize this chance. Even though, right now, every ounce, every minute of here and now life seems so much more precious than my nine in ten chance of a future.

Thunder cracks. I relax my hand. I stand and drive myself forward through the procedures. I retrieve my already packed bag, essentials pared down, keeping things light. I sweep up my cornucopia of pills. I make the single call I need to, leaving a message when Amanda fails to pick up. ‘It’s Mum. They’ve found a match. I’m making my way to the hospital now.’

She knows the score. She has been waiting for this phone call too. I know what she would say if she was here, all the reassuring words she thinks are good for me to hear, reinforcing all that the doctors have already said.

I am doing this for you, I think. So my adult daughter will not be orphaned, so her future children will know their grandmother.

This is my final call for an added decade.

3. The heart beats to an electrically controlled rhythm.

Lightning again, electricity discharging chaotically, then thunder, the gap between them shorter, the storm moving closer, a scattering of rain across the windows. I ring a taxi and try to still the waver in my tone. The woman’s voice—laid back, indifferent—does not provide confidence that this booking is being taken sufficiently seriously, the details properly marked down. ‘It’s urgent,’ I say, and I repeat my address.

‘We’ll be there soon as.’ She sounds annoyed at my pushiness, at my inflection of doubt.

And now there is nothing to do but pull on comfortable shoes and check I have my keys for the umpteenth time. To wander round my flat and double-check all the windows are closed. I confirm the battery level on my mobile phone and go in search of my charger and list the possible ways this will go.

Option 1: I will be in hospital for four weeks. Option 2: I will be sent home immediately, the match not confirmed, or tests revealing an infection, or a deterioration in my health. Option 3: I am not going to think about that.

If sent home, would relief or disappointment gain the upper hand? Best not to ask unanswerable questions. The rain builds; it clatters and runs down the windows in all directions.

4. The heart pumps 2,000 gallons of blood every day

I operate on autopilot, heading out into the deluge of rain to the taxi, suppressing the instinct to make a quick dash for it. Raindrops bounce off the tarmac; they course down the windscreen and I watch the smear of colourful umbrellas, grey buildings, and greenery outside. The trees with their summer leaves, which I hope to see turn to autumn reds and gold. Roses on the turn. Scorched grass. The people I don’t know, all of them precious, I hope, to someone.

Water drips from the ends of my hair. Shivering, I place my hand over my damp clothing above my poorly functioning heart, which is giving out in the summer of my life. I have no reason to feel attached to this, yet it has been with me from the beginning and I feel reluctant to let it go. I picture how the donor—the person, the body—will be scalpelled and then sawed open, the lungs still inflating, the organ still beating as it is cut free. The same process will be enacted on me, and then the reversal. I will receive a secondhand heart, be sewn back up and brought round. The details provoke a swell of nausea, my brain dwelling on the blood and guts details I’d prefer not to know.

At the hospital I am taken though to a small room whose closed window looks out onto the expanse of low-lying cloud. Someone will be with you soon. I have forgotten to bring anything to read. Unlikely I’d be able to concentrate, but I miss the page turning distraction. Minutes pass slowly and I ought to appreciate every one; instead I feel a fidgety anxiousness, and I try to mute my emotions down while, beyond the glass, light continues to flash and thunder rumbles distantly. I long for the cool freshness of the outside air; I am trapped here amidst the suffocating stuffiness.

The nurse arrives, briskly cheerful and I wish she wouldn’t be. ‘How are we today?’

How would anyone feel before such a major operation?

She takes my pulse and blood pressure, and then a blood sample. I’ve had this done so many times and you’d imagine I’d be used to it by now. Still, I manage to dislike the whole procedure. The application of the tourniquet, the prod and prick as she tries to find a vein. I close my eyes tight and try not to think about the pumping red flow. I have always been squeamish and it’s an unfortunate thing to be, given how much time I spend in hospitals.

5. A disconnected heart continues beating

I stand under the warm downpour of the shower and close my eyes. I wash thoroughly using plenty of soap, mud-brown and smelling of iodine. Dried, I pull on the hospital gown and draw a sterile dressing gown round tight. The doctor turns up, the man who I have seen regularly for months now. He runs through the practical details which I already know. ‘Have you any questions?’

His smile is forced, yet not unkind. I wonder how he feels. Trepidation, knowing what is at stake? The excitement of imminent performance?

I ask if the other heart has arrived yet.

The surgeon looks me in the eye in that disconcerting way he has and I picture this being part of his training. Always make eye contact. Don’t avoid awkward answers. Be honest.

Honesty is not a well-defined thing.

‘Not yet, but it will be by the time we need it.’

‘You won’t remove the old one until the new one arrives though?’

He lets his silence speak.

I have become an expert in this operation. The maelstrom of medical activity involved in cutting me open and severing my heart cannot be done in a hurry. The longer the other heart is on ice, the poorer the chances of success. Timing is everything. The logistical chain is complex. The heart might be in a hospital far away and a team from here will need to travel there for the process of harvesting. Harvest. It’s an uncomfortable term. I don’t know what word I might prefer, but not this one, conjuring picturesque farms abundant with fruits and grains.

What ifs pound in my head. What if the storm means the plane cannot take off or the courier car crashes in the wet? What if the icepack fails? I picture myself lying prone and opened out, my defective organ set aside and still beating, and the finger tapping wait for the new one to arrive. At what point would they put the old one back and what sort of chance would it have?

‘Trust me,’ the doctor says. ‘We’re not going to leave you high and dry without a heart.’

Trust is the hardest of things.

6. Laughter is good for your heart.

Time ticks by and I try to exist outside these moments, to rest suspended, in a state beyond thought. My last moments may thus be unarticulated ones.

The rain against the window starts to ease. My phone rumbles, interrupting my quasi-meditative state. I jolt alert in a wholly unpleasant way, heart beating fast. I pick up.

‘Mum.’

I feel reluctant to take this call, lacking the energy to adopt my usual role of not wanting to worry her. Nurturing, that’s how a mother should be; not needy. Yet now that her voice speaks in my ear, I discover how desperately I need to hear it. Neither of us will refer to the possibility of this being our last ever call, but we are unusually tender with one another. She makes a joke about my heart-age becoming younger than hers and we both laugh and I feel the tension ease. Rays of sun peak out from the leaden sky, the rain reducing to a few heavy drips.

‘I’m sure it will all be fine,’ she says, though very obviously she cannot be sure, not beyond the ninety-percent-plus success rate of at least getting through the first thirty days.

‘It had better be,’ I say.

She tells me that she is going to get a train later this evening and should be here for when I wake in the morning. I try to picture opening my eyes, feeling groggy and crap, yet alive, knowing this thing is over. I picture placing my hand on my bandaged chest and feeling a heart beating inside me, one which is not mine, one which has the capability to keep on going. I focus on the image of my daughter being there and the sun shining once more through the window. I am doing this for her.

We are out of things to say and we spend a moment listening to the imagined sound of the other’s breathing, and of their heartbeat. ‘I love you,’ I say and wait for the returning echo.

The door opens. ‘The nurse is here,’ I say. ‘I have to go.’

7. The beating sound is caused by the valves of the heart opening and closing.

The room is windowless, cocooning me from the outside world. I have always hated submitting to anaesthetic, that feeling of drifting away. As a child in the dentist chair, gas mask placed over my mouth, I kicked out, tried to fight the dentist off, before consciousness was switched off and I woke in an eye-blink to a painful, bloody mouth. In bed, sometimes, I catch myself on the very verge of sleep and the thought jerks me awake. The terror of the void. Of not emerging from it. Even though, once I am there, it will not be terrifying at all.

The anaesthetist has a carefully practised manner. She chats about everyday things, things which have no importance within the scheme of facing death. She wouldn’t talk about tomorrow’s weather—the calm after the storm—unless she thought I’d survive, would she?

What would she talk about?

The odds of my coming round are better than nine in ten. The odds will shortly turn binary: life or death.

A person has died; I ought to get my shot at living as cosmic compensation. But there is no ought to this.

The prick of the needle hurts. The woman apologises. Just my luck that she’s less than competent, or having a bad day. I dislike the thought of the cannula, of this opening into my vein. I cannot bear to think of what will happen once I go under. I long to rip the needle out, to shout and scream, to claw and fight my way out of here, to run carefree through the rain-washed world, inhaling the scent of green, to flee my only hope of living.

I don’t. I breathe in the scent of hospital and try to relax. ‘Count down from ten,’ the woman says. And dutifully I do.

Ten…

— I feel the steady beating of my heart —

…nine…

— I fist and relax my free hand —

…eight…

— I imagine the lightning jolt which will kick-start my new heart —

…seven…

— blood courses through my veins, carrying the drip feed of drugs to my brain and adding a mugginess to my thoughts —

…six…

— I picture my heart, disconnected, still beating —

…five…

— I hear the rumble of children’s laughter, my daughter long ago, the grandchildren who might one day come —

…four…

— I feel myself sinking, can hear nothing but the opening and closing of valves, the closing of one chapter, the opening of another —

…three…

…two…

…one…

pencil

Sarah Evans has had many short stories published in anthologies, magazines and online. Prizes have been awarded by, amongst others: Words and Women, Winston Fletcher Prize, Stratford Literary Festival, Glass Woman and Rubery. Other publishing outlets include: the Bridport Prize, Unthank Books, Riptide, Best New Writing, and Shooter. She has also had work performed in London, Hong Kong and New York. Twitter: @sarah_mm_evans

The English Girl

A Midsummer Tale ~ First Place
Sarah Evans


Photo Credit: Anthony Conti/Flickr (CC-by-nc)

Photo Credit: Anthony Conti/Flickr (CC-by-nc)

After the day’s work, they gathered round the fissured table that sat beneath the shading branches of a fir tree. Today it was the turn of the English girl to cook. There had been teasing, inevitably, about English cooking, which felt unfair given Swiss cuisine stretched no further than melted cheese. Her style in any case was not typically English: tonight it was a casserole of Mediterranean vegetables and lentils.

The English girl. It had started as a joke. Already when she arrived, there was a French girl called Marie, and although the two could have been distinguished by the form of pronunciation, nationality provided a simpler distinction. The English girl smiled when she was called that. She didn’t seem to mind and the name stuck.

The day had faded into evening and the earlier warmth of the sun was released back from the hard-baked earth; it lingered as a glow on skin. The English girl’s nose was peeling in small, white flakes—raw pink beneath—and it would burn again if she weren’t more careful. The backs of her hands were stained nut-brown, the deepness of pigmentation continuing up her arms, until close to her shoulders the colour lightened by degrees, reflecting the varying sleeve lengths of the four cotton shirts which she rotated, rinsing one out each evening.

That night there was someone new at the table. She saw him first in profile, from a distance, knowing instantly from the rapid ease with which he chatted to Anneliese that he was one of the permanent staff.

The English girl had volunteered to work for Fourth World for three months, the whole of her university summer holiday. She had arrived with a rucksack, whose weight she had struggled beneath on the long walk from the station. She had been there a month now and people had come and gone. Permanent staff moved between locations. Most volunteers worked only for two weeks or so.

As she approached the table, the large earthenware dish weighing heavily under her hands, she was aware of how her arm muscles had strengthened over the weeks of light manual work. She concentrated step by step, fearful that a tree root might set her tripping. Her stomach growled with the aroma of herbs and garlic and she observed how, even sitting, the newcomer appeared short and squat. His skin was gypsy dark, the type of brown that comes from living outdoors; his hair was black dots against his scalp, continuing into the stubble on his chin. Thuggish looking was her first thought, registering simultaneously that a certain type of ugliness—Jack Nicholson ugliness—can be attractive in a man. She noticed those things even before the moment when—food delivered safely to the table—she turned her eyes more openly on him and felt his gaze on her, unsettling in its masculine conceit.

‘This is Johannes,’ Anneliese said, in her German-accented English. ‘And this is Marie. The English girl.’

 

The end of that week marked some local festival, providing the excuse for a party with folk music playing on a battered CD, and a roughly-built brick barbecue filling the air with smoke and the smell of burning fat. Sitting in the cool of a falling evening, eating burgers dripping grease between torn hunks of rustic bread, the English girl found herself perched on the end of a bench with Johannes at her side. All week she had been conscious of his presence, while he had shown no sign of noticing her.

Johannes pushed his plate away, declaring himself—‘How you say? Stuffed?’—slouching forward over one elbow, the skin of his forearm dark, the hairs darker still, one hand reaching for his chunky glass, the other under the table and settling on the English girl’s knee. The heavy feel of it frissoned through her. She abandoned a burnt nub of meat and sipped her lukewarm beer, its hue almost black, its taste heavily hopped and bitter. She focussed on her expression remaining smooth.

English was the common language for the group, the only language which all of them—the French, German, Italian, Spanish, Polish—knew at least a little of. Johannes was talking, his bad English lapsing sometimes into rapid German, which Anneliese translated in summarised form. He shifted further forward over the table, the bulk of his body lending weight to strong opinion, his legs spreading so his denim covered thigh now pressed the length of the English girl’s. She was wearing wide shorts which reached halfway to her knee. His hand followed the ridge of her leg, then curled inwards so his thumb hooked over the top of her leg and his fingers rested on her inner thigh.

And all the time he talked.

The English girl sat unmoving and silent. She had no particular desire to talk to Johannes or to thrust herself into the conversation. She liked the fact that he was the natural focus and everyone was listening and that what he expressed chimed so fully with her own beliefs.

The Fourth World. She had tried to explain it to friends at college. Poverty exists in all societies, she said, feeling self-conscious and anxious that she would sound pious. Even in the most affluent countries there exists a substrata, outside the common flow, who remain trapped. The Fourth World, like a fourth dimension, coexisting with and yet invisible to those who prefer not to look. The centre where she was spending the summer would provide an alpine holiday for poor families; she and the volunteers were carrying out essential maintenance—building wooden fences, turning an old horse carriage into a children’s playhouse and preparing flower and vegetable gardens—before the centre could open. She remembered the scepticism on her friends’ faces. Poverty? In Switzerland? ‘You should see my bank balance,’ Thomas had said. ‘I think I must qualify.’ She had smiled politely and felt a flash of dislike.

Sitting here now, she could feel Johannes’ passion transmitting through his faulty English, through the heat of his body and his gesticulating hand; his passion mirrored her own notions of equality and fairness, views that her friends—firm believers in the magic of markets and capitalism—declared naïve. She liked that others here would see how the line of their bodies was pressed together without seeing what was happening beneath the table.

His fingers reached higher. She remained perfectly still, aware, vaguely—because everything that evening felt vague, perhaps due to the beer, perhaps more fundamentally—that to surrender so easily with no indication of her own will, went against all her feminist principles. She thought, but only fleetingly, of Thomas, who she had started dating towards the end of term, and whom she had so far fended off as far as full sex was concerned. What was she waiting for, he’d asked, exasperated.

Johannes said something—‘but there it is, no?’—bringing his diatribe to an end and removing his hand from her leg equally abruptly. Dismay crashed and crushed, and stupid thoughts chuntered through her brain, that he would not like her precisely because she seemed so readily acquiescent. He shifted away, turning his back on her, swinging a leg to straddle over the wooden bench, all the while laughing and talking unintelligibly fast to Anneliese. The English girl smiled with muscle-ache inanity.

She stared down at her brown hands and cupped them around her empty glass, certain suddenly that Anneliese, that everyone, would see how she had been discarded. Then she felt the touch of his hand on her shoulder. ‘Kommst du,’ he said, his head jerking towards the clearing and the others. ‘Come.’ She scrambled to standing, banging her hip hard on the wooden table, fearful that if she hesitated she would lose the moment and its momentum.

The cassette player had been replaced by an accordion, played by the Spanish guy whose name was Jesus, the awkwardness of which made her shy to talk to him.

People were dancing to a fast French jive and Johannes had taken her hand and was pulling her towards the centre of the group.

‘No,’ she said, pulling back and laughing, conscious of just how much she hated dancing, aware that allowing yes to groping then saying no to dancing was perverse.

Johannes stood his ground, gripping her hand firmly, and he stood there—squat and insistent—ignoring her no, and gesturing to the group of dancers with his stance. Her resistance slackened and she was drawn into a dance that she had no knowledge of.

The music rollicked and rolled. Johannes’s rhythm, his sequences of steps, became hers. He pulled her in close—chest to chest—then cast her outwards to arm’s length. They circled round, then rapidly changed direction. Partners were swapped, without her having any say in it, and suddenly she was in someone else’s arms and her fleeting gracefulness deserted her; she felt clumsy, acutely aware of why it was she’d never liked dancing. Johannes reclaimed her, or perhaps it was just the chancy outcome. She felt herself lifted off her feet; her thighs tightened round his hips as he swung her around and then she was tilting downwards so it seemed her head might bounce along the ground. But it didn’t, because he knew precisely the moment to swing her back upright.

She found herself passed along again, this time landing with the Polish guy who’d been trailing her all week and whose bumbling movements served to exaggerate her own ineptitude. Out of breath, she mumbled excuses and extracted herself from his clinging hold to draw back to the edges of the group, standing under the shadow of trees, watching. Waiting.

A figure appeared out of the darkness beside her and the two of them stood there. She listened to his breathing and the shuffle of pine leaves beneath his feet. Then he took her hand, pulling her back amongst the firs. Vegetation crunched and the world smelt of dried-out green and sunsoaked earth. It was dark, getting darker amidst the thickening branches, but at the same time her eyes were adjusting and shapes in denser shades of black emerged and there was a path of sorts, forming a silver ribbon through the trees.

Johannes stopped when they came to a narrow clearing, lit by a sliver of a moon. Something swooped in near—a bat perhaps—and she jerked away from it, turning into him, feeling his hands touching her shoulders and the damp heat of his breath against her neck.

He pressed her against a tree and whispered low, guttural words. Her hands reached behind to the textured bark, which was rough like the stubble on Johannes’s chin as his mouth met hers.

 

She woke next morning in the ancient bed with its sagging mattress, under a bedspread that was poked through with the sharp ends of feathers. Light filtered through the flaking, green-painted shutters in sharp lines. The air smelt of wood resin, of stale sweat and sex, and she thought of what had happened in the woods and of how Johannes had returned with her to this bed, then slipped away at first light. She stretched her body out long and thin and contemplated the effort of walking down the external wooden staircase to the outside toilet. Her hand touched the smooth rawness of her face and she remembered Johannes’s skin sandpapering hers. Sex as exfoliant. Glancing at the pale glow of her alarm clock, she realised how much she’d overslept.

A little later, she emerged from the weight of feathers and pulled clean clothes over her unwashed body. Descending the steps, she waved at the farmer who had donated the use of his room and called out, ‘Grusse!

Walking down the hill took ten minutes and her heartbeat rose as she opened the door into the large wooden chalet, finding everyone already finishing breakfast. Everyone except Johannes.

‘Hi!’ She offered a vague salute from the doorway as she made straight for the bathrooms, where she could get a shower and emerge fresh and clean.

Anneliese rose from the table and headed purposefully her way. She could feel the heat of her face and the stink of her body radiating outwards. ‘I’m sorry,’ she said. ‘For being late.’

Anneliese’s smile was wide and tight as she delivered an instruction that the showers needed cleaning, which could easily have waited. The English girl’s simple pleasure on waking transmuted now to embarrassment and she wondered if Anneliese and Johannes were lovers, or might once have been.

Johannes appeared at lunchtime, and there was nothing to indicate that she was any more to him than anyone else, less in fact, because the English girl didn’t speak any German and his English was bad. He sat beside her as they ate, not touching, but nonetheless sitting a little closer than he needed to. And by evening, he had gone.

 

Time moved forwards; people arrived and left; gradually the days shortened and the humid heat gave way to thunderstorms, breaking on the distant jagged peaks. Until it was her last day.

Anneliese proposed a farewell party.

‘There’s no need,’ the English girl said.

‘But we must do something,’ Anneliese insisted in her somewhat correct and distant tone. Of course, Anneliese always had such a lot to do with new volunteers turning up and needing to be instructed; she had little time for friendship.

Johannes hadn’t visited for ten days. The English girl had never understood the schedule by which he appeared and then went away. She began to think that she would leave and not have seen him to say goodbye.

The weather had turned cooler and they ate indoors. An iron fondue pot—containing four types of laboriously grated cheese—was placed in the centre of the table and served with roughly-cut cubes of bread alongside large carafes of local, yeasty wine.

Please would Johannes come. It felt an awkward type of prayer.

Then just as she was willing him to be there, just as it seemed hopeless that he would come, he materialised in that way he had, appearing with a magician’s flourish as if from a hat. He greeted Anneliese in German, explaining something at length, before offering a vaguer greeting round the table and then nudging in beside the English girl whose skin was flushing hot beneath her tan as she passed him the basket filled with bread.

‘So,’ he said to her, scraping the bread across the layer of cheese that by now was congealing at the bottom of the pot, ‘English girl.’ She was sure he must know her name, though she couldn’t remember him ever using it. ‘You go home tomorrow.’

‘Yes,’ she said, her voice far too bright. ‘I’m afraid so.’ And she thought it was a strange phrase, and that she was in fact deeply afraid. ‘My summer’s up.’

‘A pity,’ he said. ‘Wir werden dich vermissen.’ He’d miss her, or, more accurately, they would miss her.

‘Me too,’ she said, ‘Mich auch,’ thinking how much she would miss the shifting community she been absorbed into, the broken communication which operated at a deeper dimension than the competitive chit-chat of her college friends with their constant striving to entertain.

The evening continued with more wine, talk and laughter. Finally, she separated herself to walk up the hill. She walked slowly into the darkness and waited for Johannes with his unhurried footsteps to slip in beside her, the way he had done, on and off, all summer. They walked, hand in hand, beneath the wide scattering of stars.

 

The next morning, he rose early from the ancient bed in the wooden house, and he parted with a simple, ‘Bis bald!’—he’d see her soon—despite the fact he wouldn’t.

He was gone by the time she descended to the centre for breakfast. She set off shortly afterwards, carrying her large rucksack back along the road to the small station where she would take a local train, and then more trains and then a ferry, which would deliver her back to England. England, where her tan would fade and her muscles slacken, and the summer turn to anecdote. England, where, she would cease to be the English girl. Where she would rebecome Marie.

pencilSarah Evans has had over a hundred stories published in anthologies, magazines and online. Prizes have been awarded by, amongst others: Words and Women, Winston Fletcher, Stratford Literary Festival, Glass Woman and Rubery. And publishing outlets include: the Bridport Prize, Unthank Books, Bloomsbury and Best New Writing. She has also had work performed in London, Hong Kong and New York.