Read an Excerpt
You ran the stop sign. You had your imitation wolf-skin jacket on, your headset was plugged into your ears, and you never even slowed down. The rain had just stopped, and soon it would start again. The sky was the color of ashes, and above the branches of the plane trees, above the TV antennas, it was filled with great, twittering, feathery flocks of starlings. They looked like giant blotches, black against the gray of the sky, veering and swerving in tight formations, packed so close that they were touching one another, but harmlessly; and then they would open up and spread apart and almost disappear from sight before coming together again, as densely as before. Down on the ground, the pedestrians were covering their heads with newspapers, even with their bare hands, to protect themselves from the hail of droppings raining down from the sky, sliming the pavement, mingling with wet fallen leaves in viscous clusters, and giving off a heavy sweetish smell everyone was in a hurry to get away from.
You came flying along the avenue, heading for the intersection. You almost made it—the guy in the car almost managed to miss you. But the street was slick with starling guano. The car wheels skidded a little on that slippery surface, not much, but enough to graze your motor scooter. You flew up toward the birds and then down into their shit, and your backpack with all the stickers on it came down with you. Two of your notebooks landed in the gutter, in a puddle of black water. Your helmet, which you'd neglected to fasten, bounced off the street like an empty head. Someone ran over to you right away. Your eyes were open, your face was filthy, you'd lost all your front teeth. Your skin was peppered with asphalt cinders that darkened your cheeks like a man's beard. The music had stopped; your earphones were tangled up in your hair. The man in the car sprang out, leaving the door wide open, and ran to where you were lying. He looked at the big gash in your forehead and reached into his pocket for his cell phone, but it slipped out of his hand. A boy picked it up—he's the one who called in the accident. Meanwhile, the traffic was at a standstill. The guy's car was where he'd left it, straddling the streetcar tracks, and the streetcar couldn't pass. The driver got out, along with a lot of his passengers, and they all walked over to where you were. Total strangers stood in a circle around you and stared. A little groan came out of your mouth, followed by a bubble of pink froth; you were sliding into unconsciousness. All the blocked traffic delayed the ambulance, but you weren't in a hurry anymore. You were closed up in your fake-fur jacket like a bird with folded wings.
At last, the EMTs got to you, put you in the ambulance, and sped away through the traffic with their sirens wailing. Some cars pulled over to the side of the road to let you pass, but the ambulance driver had to jump the sidewalks along the river, and all the while the IV bottle was swinging above your head and a hand was squeezing a big blue bag, again and again, pumping breath into your lungs. In the emergency room, the doctor who took charge of you slipped her finger into your mouth and down between your mandible and your hyoid bone. That's an extremely sensitive pressure point, and your reaction was abnormally weak. She took some gauze and wiped away the blood that was running out of your forehead. She examined your pupils; they were fixed and asymmetrical. And you were bradypneic, you were breathing too slowly. They put an artificial airway into your mouth to reposition your tongue, which had slid to the back of your throat, and then they inserted the suction catheter through your nose to clear your airway passages. They pulled up blood, tar, mucus, and tooth fragments. They put a pulse oximeter clip on one of your fingers to measure the oxygen saturation of your blood. Your oxyhemoglobin percentage was eighty-five, dangerously low, and so they intubated you. The doctor slid the blade of the laryngoscope, with its cold light, into your mouth. A nurse came into the room, pushing the cart with the cardiac monitor, but when she plugged the machine in, it didn't start. She struck the monitor a gentle blow on the side, and the screen lit up. They pushed up your T-shirt and pasted the electrodes onto your chest. The CAT-scan room was in use, so you had to wait a little before they put you into the scanning tunnel. The scan showed that you had a head trauma affecting your temporal lobe. On the other side of the glass window, the emergency physician asked the radiologist to make new, more detailed cross sections. They revealed the depth and extension of a hematoma outside the cerebral parenchyma. On the opposite side of your skull, the contrecoup hematoma, if there was one, wasn't visible yet. But they didn't inject you with the contrast medium, because they were afraid of renal complications. They quickly called the third floor and had them get the operating room ready. The emergency room physician asked, "Who's the neurosurgeon on duty?"
In the meantime, they had started preparing you for surgery. A nurse carefully undressed you, cutting off your clothes with a pair of scissors. No one knew how to notify your family. They were hoping to find some kind of identification on you, but you didn't have any. Then they looked in your backpack and found your diary. The emergency room doctor read your first name, then your surname. She stared at it for a few seconds before returning to your first name. All at once she felt hot, her face was burning, she needed to breathe and couldn't; it was as if a stubborn mouthful of food were obstructing her windpipe. She forgot about her sanguinary profession and looked you in the face like an ordinary laywoman. She studied your swollen features, hoping to prove herself wrong, to drive away her awful thought; but you look like me, and Ada couldn't help seeing the resemblance. The nurse was shaving your head; your hair was falling to the floor. Ada gestured at your dark brown locks. "Careful, Be Careful," she whispered. She went over to the intensive-care unit and spoke to the neurosurgeon on duty. "That girl, the one they just brought in . . ."
"You don't have a mask on. Let's step out."
They left that aseptic environment, where relatives aren't allowed, where the patients lie naked and breathe artificially. They went back to the room where the nurse was prepping you. The neurosurgeon looked at the monitor, checking your heart rhythm and your vital signs. "She's hypotensive," he said. "Have you excluded thoracic or abdominal injuries?" Then he gave you a sidelong, furtive look. With a quick movement of his fingers, he opened your eyelids.
"Well?" Ada asked.
"Are they ready in the operating room?" the neurosurgeon asked the nurse.
"Not yet. They'll be ready soon."
Ada was insistent. "Don't you think she looks like him?"
The neurosurgeon turned around and held your CAT-scan results up to the light that was coming in the window. "She's got a subdural hematoma."
Ada wrung her hands and raised her voice: "She looks like him, doesn't she?"
"It could be intracranial, as well. . . ."
It was raining outside, but Ada took the exterior walkway that led from the emergency wing to the main hospital building. Wearing her short-sleeved tunic, her arms tightly folded, she stepped silently in her green rubber medical clogs. Instead of taking the elevator up to the surgery floor, she climbed the stairs. She needed to do something, to keep moving. I've known her for twenty-five years. For a brief time, when I was still single, I used to flirt with her, half seriously, half in jest.
Ada opened the door to the physicians' lounge, where a nurse was clearing away some coffee cups. Ada took a plastic cap and a surgical mask from their containers, hurriedly put them on, and entered the operating room.
I must have noticed her after a little while, when I shifted my eyes to the nurse to pass her the clamp. I thought it was strange to see Ada there. She works exclusively in intensive care, and our rare encounters generally take place in the snack bar on the basement floor. But I didn't pay any particular attention to her; I didn't even nod a greeting. I removed another clamp and passed it to the nurse. Ada waited until my hands were away from the operating field. Then she whispered, "Doctor, you must come." The nurse was taking the suturing needle out of its sterile wrapping; I heard her tearing the plasticized paper as I looked up at Ada. She was standing very close to me—I hadn't noticed how close. She wasn't wearing any makeup, and I found myself staring into a pair of naked, tremulous, glittering female eyes. Before she was transferred to the emergency room, she'd been one of the best anesthesiologists on the hospital staff, and she'd pumped nitrous oxide into many a patient of mine. I'd seen her remain calm and unemotional even in the most crucial moments, and I'd always admired her for that, because I knew how much effort it cost her to bury her feelings inside her green hospital tunic
"Later," I said.
"No, Doctor, it's urgent. Please come."
Her voice sounded different, filled with a strangely intense authority. I believe my mind remained blank—I suspected nothing—but my hands suddenly felt heavy. The nurse presented the needle holder. I'd never left an operation unfinished. I closed my hand, realizing as I did so that I was reacting too slowly. I started sewing the abdominal wall back together, but then I took a step backward, trying to put some distance between myself and the patient, and I collided with someone standing behind me. "You finish up," I told the assistant surgeon. The nurse passed him the needle holder. The metal instrument struck his gloved hand with a dull slap that sounded amplified in my ears. Everyone in the room looked at Ada.
Behind our backs, the door of the operating room closed silently and firmly. We stood facing each other in the preanesthesia area. I said, "Well?"
Ada's chest was heaving under her tunic, and her bare arms were blotchy from cold. "Doctor, we've got a girl with a cranial trauma down in intensive care. . . ."
Automatically, almost without noticing it, I stripped off my gloves. "Go on."
"I found her diary. Doctor, her last name is the same as yours."
I raised a hand and removed the surgical mask from her face. Her voice wasn't agitated anymore; her courage was at an end, and what remained was a calm, breathless plea for help. "What's your daughter's name?" she asked.
I think I leaned toward her so that I could see her better, so that I could search her eyes for a name that wasn't yours. "Angela," I murmured into those eyes, and I saw them flood with tears.
I ran down the stairs, I ran through the rain outside, I ran past an arriving ambulance that jerked to a dead stop a few feet away from my legs, I ran inside the glass doors of the emergency room, I ran across the nurses' station, I ran into a room where someone with a broken limb was screaming, and I ran into the next room, which was empty and in disorder. That's where I stopped. Your brown hair was on the floor. Your wavy brown hair and some bloodstained gauze, all swept up into a little mound.
In an instant, I'm turned into dust, walking dust. I drag myself to the intensive-care unit and go down the hall to the glass wall. There you are, shaved and intubated, with bright white bandages around your bruised, swollen face. It's you. I enter the room and stand beside you. I'm a father, a poor father like any other, sweaty, dry-mouthed, shattered by grief. My scalp is cold. I can't get my mind around what's happening; it's looming over me, ready to crush me, and I remain in a kind of blurry stupor. My sorrow dazes me, cripples me like an embolus. I close my eyes and reject my sorrow. It's not really you lying there; you're in school. When I open my eyes again, I won't see you. I'll see another girl, any other girl, some ordinary girl in the world. But not you, Angela. I open my eyes and it's really you, some ordinary girl in the world.
There's a box on the floor with dangerous waste written on it. I discard a part of myself: the man, not the physician. I must do this. It's my duty; it's the only thing left for me to do. I must look at you as though you're a stranger to me. I move the electrode that's rudely touching your nipple to a more seemly position. I look at the monitor: fifty-four heartbeats per minute. But going down: Now it's fifty-two. I raise your eyelid. Your pupils are anisocoric. The right one is completely dilated; the intracranial trauma is in that hemisphere. You need immediate surgery so your brain can breathe. The mass of tissue displaced by the hematoma is pressing against the hard, unyielding inner wall of your skull, smothering the centers that control all the nerves in your body, depriving you with every passing instant of a bit more of yourself. I turn to Ada. "You've given her cortisone?"
"Yes, Doctor. And medication to protect the lining of her GI tract."
"Does she have other injuries?"
"Possibly a ruptured spleen."
"Hemoglobin?"
"Twelve."
"Who's in neurosurgery?"
"Me, I am. Hello, Timoteo."
Alfredo puts a hand on my shoulder. His white coat is unbuttoned; his hair and face are wet. "Ada telephoned me. I had just left the hospital."
Alfredo is the best surgeon in his department, and yet nobody gives him any special consideration. His manner is tentative, his behavior is frequently off-putting, he has no visible merits; he works in the shadow of the chairman of surgery, who stands around watching while Alfredo wears himself out. Many years ago, I gave him a few words of advice, but he never listened to me; his character's not as highly developed as his surgical skills. He's separated from his wife, and I know he has a teenage son more or less your age. He wasn't on duty, he could have opted out, no surgeon likes operating on a colleague's relative. Nevertheless, he jumped into a taxi and had the driver drop him off in the middle of the traffic outside. He ran through it as fast as he could, darting past the cars in the rain. I'm not sure I would have done the same.
