Garcia's Heart (22 page)

An hour passed before thoughts of Celia returned, and Patrick excused himself to go outside to look for her, finding her at one of the picnic tables behind the dormitory. She had brought along some watercolour paints and a tablet of paper and to Patrick looked to be engrossed in painting the cornfield in front of her, but as he approached she started speaking without looking up to see who it was.

“He's not a doctor any more, you know. It's wrong, what he's doing.”

“He said they don't have anyone else.”

“So that allows him to break the law?”

Patrick was dumbfounded. Legal or not, Hernan's work was necessary, vital. Would she prefer a father who operated a crane at the port all day? That was legal. Would she prefer he sit and do nothing when there were people who needed him? How could she not see what type of man her father was? Patrick felt a burst of anger at how easily she passed judgment as she dabbed at her watercolour paints and turned her back on the dormitory. “There's more to your father than just that grocery store,” Patrick said fiercely, and turned to go back in. Try to help maybe.

Inside, Hernan was examining the last patient. Instead of having the man come to the back room, Hernan leaned over the cot where he lay. He helped the man sit up and just this act seemed to provoke a breathless grimace. Patrick hadn't had much experience with sick people, but this man's pale,
moon-like face made an impression. He had only ever seen lips that colour on someone who had been enjoying a grape Popsicle. Hernan asked the man to breathe and in response he took a few shallow, unpromising breaths. Hernan then laid him down and studied the side of his neck, where a vein appeared and grew in prominence until it looked like a worm nibbling at the man's ear. Hernan placed the pad of his index finger firmly against one of the man's swollen feet and lifted it to reveal an indentation. He then knelt down beside the man and showed him the stethoscope. The man nodded and mustered a smile through his panting breaths. Both of them glanced at Patrick, who had advanced enough to announce his interest in watching.

Under the man's T-shirt Hernan held the head of the stethoscope and was inching his way toward the man's throat, listening intently, softly naming or describing something with each stop, as though he were a train conductor and this was his line. “Mitral valve,” he said, and closed his eyes. “Aortic valve.” In this way Hernan catalogued the parts of another person's heart, listening to it thumping away in the dark. “S3,” he said, and gave a soft “tsk.” The sick man stared up at the ceiling and Patrick wondered if he was thinking of his family.

And when Patrick looked back at Hernan for a clue to what was happening, he was certain he saw a man caught in reverie, soothed as though he were listening to music or the singing voice of one of his daughters.

Hernan thanked the sick man, packed up his gear in his little black bag, and stood up. Patrick followed him out of the dormitory and into the soul-crushing early afternoon heat. Celia had disappeared.

“What's wrong with him?” Patrick asked, hurrying to keep up with Hernan's long strides.

“Heart failure.”

“Did he have a heart attack?”

“Maybe, once. More likely an infection. Chagas disease.”

“But he's going to be all right, right?”

“He's going to die.”

“He's going to die,” Patrick repeated. He had never heard these words said in real life. He imagined the news of someone dying would be accompanied by shouting and sirens and an effort whose urgency would justify the declaration. But Hernan just kept walking, his pace unwavering. More than any frantic response, Hernan's behaviour heightened the panic swelling in Patrick. The heat pressed down on him and he felt weak. Hernan was searching for something in the car, the trunk open like a disbelieving mouth.

“Are they going to call an ambulance?”

“He'll die on the way if he doesn't die before they get here.”

“But we should call one anyway.”

“He doesn't have insurance, and even if he did I don't know if he'd want to go to hospital here. He's dying. He has a bad heart and it's been that way for years probably.” Hernan shook his head. “They don't have to pass a physical. If they did, he wouldn't have been allowed to come north.” Patrick remembered the competing desires of wanting to run, somewhere, and wanting to go to the toilet. “I'll help him,” Hernan said, noticing Patrick's alarm. “Don't worry, I'll help him. Stay here.”

With that, Hernan walked away from Patrick there in the parking lot, opened the door to the Quonset hut, and
disappeared inside. Patrick hovered outside for another quarter-hour, hyperventilating in the heat. Waiting.

Years later, it was still unclear to Patrick why he'd returned to the dormitory, if it was curiosity or the need to prove to himself that he wasn't afraid, but he went in through the back, so that Hernan would not see him. He crept through the kitchen, and from there he saw Hernan sitting on a stool pulled up to the sick man's cot. Hernan was bent over slightly, supporting the man's head. There was a movement of hands: Hernan's reaching for something, the patient's fluttering from his head to his chest in a way that Patrick recognized was the sign of the cross. Hernan appeared to be saying something to the sick man, but Patrick couldn't hear any of it. He witnessed the agony dissolve from the man's face. When Hernan let his head rest on the small vinyl pillow, Patrick understood that he was dead.

By the time Hernan had gathered his things and left through the front door, Patrick was already outside with Celia. Hernan said nothing except to call for them to get into the car. They were going home.

They stopped at a
bar laitier
just outside St. Remi where Hernan offered to buy ice cream. There was no space on the terrace so they sat inside the little canteen and ate their ice creams in silence. Celia got up to use the washroom, and in an effort not to speak to Hernan, Patrick peered around the room: a little theme park of wood panelling and Arborite furniture. In the corner, a large sunburned man enthusiastically humped and slapped a misbehaving pinball machine.

Celia came back from the washroom and the sunburned guy gave up on the pinball machine. By dinner they were back in
Montreal. Patrick felt stunned by the day's sun exposure and everything else he had seen and stumbled home without a word to Celia or Hernan.

This was memory. But what
was
memory? Over a hundred years ago Ebbinghaus showed that details degrade within seconds. Studies showed that eyewitness testimony–including that of a sixteen-year-old boy (or even that of the Hondurans who were listened to with reverent awe at the tribunal)–was disturbingly unreliable.

He knew too well that the larger items, moments with emotional heft or novelty, were retained, burned into more permanent memories that then served as points around which a more dubious narrative was constructed. That was the moment when memory began to fail, where bias, suggestibility, and misattribution clouded the truth.

An example: he remembered Hernan listening to the sick man's heart, looking up and saying “S3,” a term used to describe a heart sound present in patients with heart failure. Looking back, Patrick was fairly certain there was no way he could have remembered Hernan saying that. People just don't recall arbitrary terms that they have never heard of. Patrick would have had no idea what an S3 was until medical school–five years after that moment in the dormitory. More plausibly, he reasoned, the memory had been recreated and rehearsed with the knowledge he acquired later to make sense of the situation, creating something compelling: a man lay dying, Hernan attended to his failing heart, diagnosed him properly, and served him humanely. Yes, Patrick had decided, watching all of this, he would be a doctor too.

Patrick was certain he remembered some other things that were real. The big guy and the pinball machine. The heat and
the odd claustrophobia of being outside but surrounded by fields. He remembered Celia.

All the other details had been arranged and recounted in his mind so many times that they seemed part of a story he'd always known, its truth implied. But in the last seven years, from the moment Patrick met Elyse, he'd been forced to revise that history, focusing on one moment, a moment that he now worried Anders Lindbergh suspected and needed to know more about. What had Hernan carried from the trunk of the car to the bedside of the dying man? Patrick remembered something being cupped in Hernan's hand as he walked by. For the longest time, this object was unimportant. Patrick assumed it could have been any of a hundred objects a doctor could be expected to carry during a day of work. A bundled tourniquet. Some gauze. A bottle of Tylenol or aspirin, anything. But Patrick hadn't seen the object clearly, not seen enough that he could say for certain what it was. Or wasn't. And so the memory was revised and the object altered. Had it been a vial of potassium chloride, a single shot to stun and stop the heart? Could he have seen an ampoule of morphine in Hernan's hand? Or was it something else, similarly effective? He once wished he had the answer, but now he knew better than that.

The scene that followed made perfect sense. Hernan, seeing a man gasping for breath, a man for whom he could do nothing, chose to relieve his suffering. The morphine, if it was morphine, depressed the respiratory centres in the brain stem that controlled breathing, easing the air hunger. It was used in the care of the dying, and in the medical profession's nervousness about euthanasia, the dose was carefully calculated to ease pain without obviously hastening death.
But in the dormitory in the middle of a field, with his patient panting through dusky lips, what calculations had Hernan made? Had he made the decision, not to let the thought of death limit the relief he would provide? Minutes after Hernan went to the bedside, the man had died. Patrick remembered Hernan holding the man's head, the way he had since seen a father hold his son's head, whispering encouragement during a swimming lesson as the child floated on his back, kicking at the water. What did Hernan say? Did Hernan tell him he was about to die?

 

Anders Lindbergh lacked the air of solemn vindication Patrick imagined for a chief counsel for the prosecution who was winning his case. Lindbergh looked tired. Or bored. Maybe the drama of the case, if there was ever any, was done. Without drama, Patrick imagined the job became one that involved a series of formalities. Get the witnesses to Den Haag, record the data, and have the justices pronounce. Any interesting job could be reduced to a series of bureaucratic functions, and Lindbergh appeared to be a man content with being a well-referenced concierge of justice.

This was a bias, and it was likely wrong, but it was based in part on the fact that in the two minutes Patrick had known him, Lindbergh succeeded in giving off an aura of a man perpetually trying to stifle a yawn. His lips were drawn, barely meeting to keep his teeth hidden. At first Patrick had to consider whether Lindbergh was grimacing, if the chief counsel was in terrible pain.

Lindbergh's office was larger than Marcello's, or so it seemed, although Lindbergh moved with an economy that could create a false impression. Patrick searched the office for
something of scale, a bookcase or a window, and these elements seemed similar to those in Marcello's office. He was becoming too familiar with these offices.

Patrick knew Elyse had probably interviewed Lindbergh in the course of researching her latest article. The climax, really, of her story. And although he didn't seem like the sort of person who could carry the story, maybe Elyse had found something fascinating about Lindbergh, a childhood trauma or personal tragedy, a thin wedge of personality she'd use to split open the story. More likely, she had gathered a hundred factoids about the man, which she would scatter throughout the feature to flesh out the barrister as she went along.

“Firstly, welcome to Den Haag, Dr. Lazerenko,” Lindbergh said, his hands folded on a tidy desk. “Mr. McKenzie, my associate, should be here any moment. He has asked to sit in on the meeting. I hope you don't mind.” Patrick was shaking his head just as the door opened behind him. Lindbergh stood and Patrick pushed himself out of his chair. “James, this is Dr. Patrick Lazerenko,” Lindbergh said and swept a hand toward Patrick. By the time Patrick had got to his feet, McKenzie was already in his face, a snapping-turtle handshake making the violation of personal space complete. McKenzie was tall and athletic-looking, probably the type who enjoyed regularly beating people at games of squash.

“It's a pleasure to meet you, Patrick. Elyse Brenman has told me a lot about you,” McKenzie said and sat down in the chair next to Patrick, across the desk from Lindbergh.
Ah-layze.
He spoke with an accent that Patrick guessed came from South Africa or New Zealand. Just the mention of Elyse and McKenzie's wide, almost lurid grin led Patrick to consider that he was the person who'd taken that picture of Elyse on
the sailboat. This epiphany discouraged Patrick and started a parade of other mysterious and equally unpalatable mental states, jealousy for whatever sort of relationship this man had with Elyse, embarrassment for being jealous, outrage at himself and amazement for concocting all of this out of nothing, all in the moment it took to shake hands.

“What happened to your face?”

“I was assaulted.”

“Here, at the tribunal?” McKenzie asked, flatly enough to make it sound not without precedent.

“No. Outside. I was mugged.” McKenzie winced in commiseration.

“I like your work,” McKenzie said, and Patrick dreaded having to smirk his way through another tired recounting of the “porno studies” before McKenzie and Lindbergh got down to whatever good lawyer/bad lawyer shtick they had planned. But then he fired an aside at Lindbergh. “Dr. Lazerenko once delivered a paper called ‘The Neural Basis of Utilitarianism.' Very interesting. But that was the last of his publications,” McKenzie continued, talking to Lindbergh in a way Patrick understood to be staged. “After that, our friend left academia and went to work for the dark side.”