Brenda’s hands are gentle as she eases me up and off the bed and into the chair in the corner—a flea-market find, upholstered in a pale yellow print, the chair where I sat when I nursed my girls, when I read my books, when I wrote my reports. As I watch, she deftly strips the sheets off the bed, shakes the pillows free of their creased cases, and gives each one a brisk whack over her knee before settling it back on the bed. Dust fills the room, motes dancing in the beams of light that push through the dirt-filmed windows I’d been planning to have cleaned.

I huddle in my nightgown, shoulders hunched, knees pulled up to my chest. “Why are you doing this?” I ask.

Brenda looks at me kindly. “I am being of service,” she says. She carries her armful of soiled linen out of the bedroom and comes back with a fresh set. When she struggles to get the fitted sheet to stay put, I get up off the chair and help her. Then she goes to the bathroom and turns on the shower. “Come on,” she says, and I pull my nightgown off over my head and stand under the showerhead, with my arms hanging by my sides. I tilt my head to feel the warmth beating down on my cheeks, my chin, my eyelids. Tears mix with the water and wash down the drain. When I was a little girl and I’d come home from the hospital with Steri-Strips covering my stitches, my mom would give me a sponge bath, then sit me on the edge of the tub to wash my hair, pouring warm water over my head, rubbing in the shampoo, then rinsing, then conditioning, and rinsing again. She would touch the thick, braided line of pink scar tissue that ran down the center of my chest, then gently pat it dry. My beautiful girl, she would say. My beautiful, beautiful girl.

My sheets are silky and cool as pond water, but I don’t lie down. I prop myself up against the headboard and rasp out the question that I’ve heard hundreds of times from dozens of clients. “What do I do now?”

Brenda gives a rueful smile. “You start again,” she tells me. “Just like the rest of us.”

PART I

Half a Heart

Rachel

1985

I was born with a broken heart. This was a line that got me a lot of sympathy from preschool through sixth grade, when I decided that a congenital heart condition was not what I wanted to be known for, and stopped talking about it at school. My condition was called tricuspid atresia, which meant that on the right side, the valve between the upper and lower chambers of my heart wasn’t formed correctly. Blood that should have flowed smoothly from my heart to my lungs moved instead in a sluggish trickle—a lazy schoolkid who’d overslept and couldn’t be bothered to run for the bus. Not a good thing if you want to, as the doctors say, survive.

I’d been diagnosed thirty-six hours after my birth, when I’d done the docs the favor of turning a lovely shade of plum. At the local hospital, they didn’t know exactly what was wrong, only that they couldn’t fix it, so they airlifted me to Miami Children’s Hospital, where I received something called a Blalock-Taussig shunt to give the blood an unobstructed path.

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Once I’d recovered, my terrified parents took me home, along with an oxygen tank and instructions about what to do if I turned blue or started gasping. For the first year of my life, I slept in a portable crib pushed up next to my mother’s side of the bed, with her hand on my chest. Photographs show a tiny, wrinkled raisin of an infant floating in her onesies, with none of the succulent, squeezable plumpness of normal babies. “Failure to thrive” was what they wrote on my charts, and my mother took it like a straight-A student receiving her first failing grade, like she’d been the one who’d been unable to successfully nurture me, instead of me being the one who hadn’t grown. Before I was born, she’d been a librarian—just part-time after my brother had come, but it was work she loved. After I was diagnosed, she quit and devoted herself to my care.

“We used to put olive oil in your baby food,” she told me—this was when I was a teenager and had embarked on the first of many lose-five-pounds-in-a-weekend schemes, that one involving grapefruits and cucumbers. She would melt butter in my rice cereal, slather it on bread and crackers, feed me milk shakes where other kids just got milk. Still, it was years before I crept into the very lowest height/weight percentiles for children my age, years before I graduated to my own bedroom, where, all through my childhood and into my teens, I would wake up at least once a week with my mother’s hand on my chest and her face twisted in fear that would melt into relief when she was sure that I was still breathing, that my heart was still beating, that I was still alive.

“We thought we would lose you,” she told me, over and over. I couldn’t blame her. Besides all the surgeries and the risks they involved, when I was six I’d had pleurisy, a lung infection that made my oxygen saturation levels drop dangerously low. My parents brought me to my cardiologist, who sent me straight to the hospital, where the surgeons performed an emergency procedure that night to close off veins that had gotten too big, in a misguided effort to help my body deal with the faulty valve. I’d gone home the next day, even though my mom said she’d begged the doctors to keep me longer, that she didn’t think she’d be able to stand it if she found me turning purple again. By my seventh birthday, I’d been hospitalized six times—once after the pleurisy, once with pneumonia, four more times for cardiac catheterizations so the doctors could check the shunt.




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