By Marcy Phipps, BSN, RN, CCRN, chief flight nurse at Global Jetcare
The Heart, a new novel by Maylis de Kerangal, caught my attention with a cover art image suggestive of the vascular and as beautiful as an angiogram. Taking place over a 24-hour period, the novel describes a 19-year-old accident victim who suffers brain death and the people who are connected to the heart transplant that follows: his parents, the doctors and nurses, the recipient of the heart. As a nurse who’s seen the organ transplant process from a number of angles, I wasn’t sure how De Kerangal could possibly navigate such material.
But the novel, which has been ably translated from French, is both subtle and powerful, casting light on the complexity of every character, from the pre-accident vitality of Simon, the donor, to the conflicted gratitude of the heart recipient; from the inexperienced ICU nurse to the surgeons.
Two important characters are nurses, though they are only a part of the larger picture:
Cordelia Owl, Simon’s ICU nurse, is an inexperienced practitioner. She carries out her nursing tasks in a distracted, perfunctory manner, speaking aloud to the unresponsive Simon as she cares for him. In doing so, she inadvertently intensifies the anguish of his parents, who are standing nearby and struggling with the concept of brain death.
Though her behavior shocks the attending physician, she’s not dealt with harshly. The physician tells her: “that young man is dead . . . the appearance of his body seems to contradict the facts . . . such words, spoken in the context of treatment, blur the message we are trying to communicate.”
Here and again later, the young Cordelia is guided toward insight, leaving me finally with the impression that there is hope for her to grow and rise above her distractions. I’ve precepted new nurses and students like her who are not yet aware of how nursing care touches people and how its reach far surpasses the “chartable” tasks.
Thomas Remige, the organ donation coordinator, is an experienced nurse who describes his ICU background as “an underworld, a parallel universe, a subterranean space on the edge of the ordinary world . . . .” He sings to clear his head, fills his life with birds and music, and ponders “the singular uncertainty on the threshold of living” and “the human body and its uses.” He’s not only adept at taking care of patients but also a master of reading the subtle cues of their loved ones, knowing what needs to be said, when to stay quiet, when to hold a hand, and when to step out. I appreciated his character and connected with him, as I have known many excellent nurses like him in the ICU.
I’ve been the ICU nurse, emotionally weighted with the care of patients as gravely injured as Simon. I’ve worked with the procurement coordinators and have felt conflicted in the maintenance of organs while bereft of hope for the body that contains them. I’ve stood in the operating room and watched the procurement, bearing witness to a procedure that’s somehow beautiful and barbaric at the same time. And now, as a flight nurse, I’ve been privileged to rush a heart recipient to a hospital in a Lear jet, his exuberance and joy infectious but bittersweet, shadowed by the knowledge that his gift was the result of another’s tragedy.
Amazingly, De Kerangal manages to accurately present every one of these perspectives, and in beautiful prose, making this fiction feel true and important. It’s a read I highly recommend.