validation. And what about loving Noni, loving the kids, loving Joe—even more now that he was gone? It all required so very much of her. What would happen if she put the sack down? Maybe carrying all these people around wasn’t strictly required of her. The twins were nearly teenagers, Louis now in high school. Noni had bought hiking boots for her trip and foldout maps of each city they’d be visiting.
Caroline stopped in the shadow of the house, the neighbor children’s voices reaching her, glad shouts and then some crying, and she realized that it had never occurred to her to try another way. To try not loving Nathan. To try loving herself. What would happen? It had never before occurred to her, but now—yes, now it did.
Chapter 16
Renee first met Melanie Jacobs at a Monday-morning intake appointment, one of the first in her new office at New York-Presbyterian Hospital. Renee and Jonathan had recently returned from their travels, Renee to accept a permanent position as a transplant surgeon, Jonathan to focus on private commissions for the retablo pieces he’d first developed in Chiapas. This was nearly four years after Joe’s death, during the time Renee, Caroline, and I weren’t speaking. Did Renee miss us? Later she told me no, she didn’t think about us; she was too busy to miss anyone, and that was precisely her objective.
Melanie was one of Renee’s first new patients, a twenty-seven-year-old woman with cystic fibrosis, already on the lung-transplant list. A sprite of a thing, barely five feet tall, married to a longshoreman named Carl who towered over his wife. Shoulders nearly as wide as Melanie was tall. Dark hair receding in a sharp widow’s peak. A kind, gentle smile.
As they entered Renee’s office, Carl held the door for Melanie and pulled the portable oxygen tank behind them. Clear tubes ran from the tank over Melanie’s ears and into her nostrils. Melanie held out a hand to Renee, the long fingernails painted a brilliant aqua blue. “Matches the hospital gowns,” she said. “I’ve got mascara the same color, too.”
Renee laughed.
Since Melanie’s diagnosis, her doctors had managed the disease, but her condition had worsened in the past year, and she came to Renee for a new evaluation to move her position up the transplant waitlist. Because of Melanie’s small size—105 pounds at the height of good health—her potential donors were limited: a man’s lungs, for example, would not fit inside her chest.
“My heart is so full!” Melanie told Renee. “My rib cage just doesn’t know it.”
Renee advised her to keep exercising, to be ready to come to the hospital at any moment, to travel no more than an hour from the city, to stay healthy, to eat well. They’d shaken hands again at the door, and Renee felt vitality in the warmth and press of Melanie’s palm.
Over the course of the next six months, Melanie Jacobs grew sicker and sicker. After she was admitted full-time to the hospital, Renee would find herself lingering in Melanie’s room, talking and laughing with her. On paper the two could not have been more different. While Renee was graduating magna cum laude from college and pursuing her medical degree, Melanie worked as a receptionist at a Toyota dealership, as a packer at a vegetable-canning facility, and as a waitress. She met Carl when she served him a piece of chocolate cream pie and he offered her a bite. But like Renee, Melanie had been raised by a single mother. Like Renee, she’d worked her way through college, though Melanie had stopped one semester shy of graduation after another hospital stay.
Month by month Melanie’s name rose higher and higher on the national transplant list until finally Melanie Jacobs was the sickest lung-transplant patient in the country.
“A dubious honor,” she croaked to Renee, who had seen her diminish from the bright, blond smart aleck to this, a frail shell beneath a sheet. Carl would arrive every day straight from work with Thai food and DVDs or a People magazine or a thriller that he would read aloud to her. After Melanie fell asleep, he would leave and then return the next day to do the same thing all over again. His union provided excellent benefits, Carl told Renee. The work was punishing, the shifts long, but he couldn’t quit now. Not until Melanie was better.
“We’re having a kid when this is all over,” Carl told Renee one afternoon as she conducted a routine exam. By now Melanie had been waiting