Driving the Heart
Traveling between Danvers and Natick yesterday I saw a man in a flower
truck drive by at eighty m.p.h. with his eyes closed. I turned to Dale,
a guy the hospital hired for me to train, and said, Nothing, not even
someone's liver, is that important. He put his hand on top of the metal
case marked Liver and nodded.
Most of the day jobs involve eyes, livers, morphine, or spleens
traveling to or from the airport. Tonight we are driving way out
to Lebanon Springs, to the town where I was born, with a heart
for a woman about to die from some accident or some disease. Hearts
travel at night.
Dale sits next to me holding the metal box marked Heart.
His eyes droop. His head leans to the right. Next thing he'll
be sleeping, dreaming down the highway. I know what it's like.
When the weather is foul like tonight and the airplane can't make
it, they send us. We're the only choice they have for reaching
a small town in an out-of-the-way place. Cellular phone service
is out and in many places the power is out, but most of the regular
pay phones still work. We stop every hour at designated places
and call the hospital to make sure the patient in Lebanon is still
alive. The hospital is in contact with Lebanon. We are not allowed
to stop for food or drink and, if we can help it, even urination,
on this six-hour journey. We make the call and if she's still
alive we rush on. If not, then we can pause briefly for food and
bathroom before we turn around and drive without stopping for
Worcester where a plane will take the heart to some other person
in a city with a major airport. This heart, however, is getting
old. There probably won't be time to take it anywhere after Lebanon.
Hearts are packed in ice. But even a frozen heart will last for
only twenty-four hours on the outside, unofficially. That's why
if we have to take it to Worcester, there will be time only to
fly the heart to a major airport then rush it from there by helicopter
to a hospital in the same city. There is always a patient. Driving
to Lebanon, we shoot for six or seven hours at the most. Tonight
we have to hurry through the high winds and beating rain, in order
not to waste this heart.
I stop the car and have Dale run out through the rain to the pay
phone with the number I gave him.
"What's her name?" he asks.
"You won't be talking to her," I say, "and it doesn't
matter. Just give the hospital the job number. They'll say drive
on if she's still alive, or turn around."
A few minutes later he comes running back, gets in the car, brushes
the rain off his sleeves and nods his head. After a few more minutes
he says, "I'm hungry," even though I've already explained
Hospital delivery often attracts people like myself, who have
cared very deeply about the wrong things. Who, in less than half
an average life span, have been born, born again, arrested for
armed robbery and born once more. A person can be born only so
many times before even the Christians don't want to take you seriously.
The second time I was born I was twenty years old and lying in
a donated suite on the floor of a jail in Sturgis, Michigan. I
remember one of the officers brought me a bowl of stew and suggested
I eat something before going into court, but I shook my head.
I was being charged with driving under the influence and assaulting
a police officer, although I didn't remember doing those things.
The judge informed me that I had drunk ten ounces of One-Fifty-One
in a few hours. He lowered his head after this announcement, not
because I was a startling case, but because I was the same kind
of case he saw day after day and he was tired. I asked what I
could do to show him that I had finally gotten the picture, that
all I wanted was one more chance. He looked at me and laughed,
which was to say: That's what everybody says. He didn't know that
I was reborn, that over in Grass Lake, where I wanted to go after
I was released, people believed.
We drive all over New England, sometimes to New York, but mostly
we stay around the Boston area. If you know the Wenham-Woburn-Nedham-Braintree
route then you know that the place to live is Belmont, Weston,
Concord or beyond, but not so far out as Lowell. All the names
up and down the coast-Weekapaug, Quonochontaug, Naquit, Teaticket,
Menauhaunt and Falmouth Heights-remind me of the life I could
have had if things had been different. I have a friend living
that life over in Sakonnet right now. I go over and visit him
once in a while-from his second-floor bathroom window a sliver
of ocean can be seen.
Dale reaches over and turns up the radio; he leans on his right
elbow against the window. He slumps in his seat. I turn the radio
back down. No amount of training will make a kid like this understand
his job. Even as the passenger you should sit alert. Someone else's
life sits in your hands. His head nods against the passenger window
as I flick off the radio. "No more radio," I say. That
wakes him up. Dale straightens himself and asks what happened
to the woman who needs the heart, but I can tell by the way he
fiddles with the buttons on his coat that he doesn't really care.
I tell him I don't know, that the woman could be thirty, could
be seventy. Could be heart disease, could be anything, that they
never tell me. Usually they take the heart from someone who is
alive but brain-dead and transport it to someone whose thoughts
are clear but whose heart is dead. And in truth, I explain, they
usually give preference to the young. The moment the heart leaves
the body of the donor, it is cross-clamped and the clock starts
ticking. In the Lebanon hospital they are standing there in the
operating room right now, smocked and ready, waiting for us. Dale
nods and we drive on in silence.
I roll down the window for a moment to let in some air and then
roll it back up again. I turn to Dale: "A man in Abilene,
Texas, gets drunk and drives his car through a 7-Eleven. Three
hours later his heart travels on a plane bound for Logan Airport.
Six hours later his heart sits next to you in a large silver case
marked Heart, and we are driving down the highway at the
speed limit toward some prostrate client in a hospital room asleep
or possibly in a coma who will not live another day without this
heart. This," I say to Dale, "is the importance of your
job." He nods, furrowing his brow. No matter how many times
I explain, I don't think he will understand.
"What if something goes wrong?" he asks.
"Nothing will go wrong if you don't get any ideas. Now go
make the call," I say, pointing at the variety store.
I live in a so-so neighborhood. The people there smell and never
take out the trash. I look out my window at a funeral home, and
for four months each year the sun rarely shines in this part of
the country. Some mornings I consider the consequences of quitting
my job and doing nothing for the rest of my life. People will
still get their organs and their drugs, driven here and there
by someone like myself. A replacement. The hospital has them.
The only thing that will happen differently in the world if I
quit my job is that I will not be able to eat.
I ask Dale if he has ever donated an organ. He shakes his head,
looks at me in silence and then we sit there, ahead of schedule,
thinking. I feel like telling him to keep his eyes open.
I've seen some strange things. A woman from Nova Scotia once came
into the hospital and offered to sell two kidneys. She said she
had four. The doctor on duty was interested in such a claim, but
he had to tell her that it was the hospital's policy, the law
in fact, not to accept such offers.
I know what it's like to want things. I've always wanted to travel
the world but probably never will. I've seen pictures. I've always
wanted to date a very beautiful woman. To these things I say:
Only once have I flown in an airplane, crossing the water to London
with a case of hospital files to be signed by a man there.
I remember that somewhere out over Labrador the pregnant woman
across the aisle started to scream. The husband started running
up and down the aisle while his wife was pulling on her seat and
pushing with her knees against the people in front, her stomach
seizing with contractions. The man suddenly whipped around, focused
on me and yelled, "I need a doctor! Is anyone a doctor?"
A woman sitting in back came forward saying she used to be a nurse.
The man stepped aside pointing at his wife in her light-cotton
floral dress, the makeup washing down onto her neck. "She's
only seven months-not even," the husband said. When he stepped
aside a little more to allow the nurse to move in, I could see
liquid from between the pregnant woman's legs pouring off her
seat and onto the floor. The woman who used to be a nurse looked
directly away, holding her head with her hand. She was looking
at me and through me. "How much time before we land?"
the man blurted at the stewardess who had just arrived. "Too
much time," the ex-nurse looking at me said.
The most exciting thing that can be said about me is that I delivered
pizzas in dangerous neighborhoods when I lived in New York. How
I can be both obsessed and relaxed at the same time is a mystery
to me, but I consider it one of my greatest accomplishments. I'm
not very old, but I would say that so far nothing has gone according
to plan, that people have been unpredictable, and that's about
the extent of it. I would also say that certain ideas seem basically
true to me: you cannot serve two masters well. Our thoughts are
of little consequence. Live cautiously. You have to in my family.
Back when I was twelve, for instance, I was traveling down Capisic
Street in Lebanon when a woman traveling thirty, forty miles an
hour hit the rear tire of my bike. I rolled over the hood and
the roof, bounced off the trunk and landed standing on my feet.
She screeched to a stop and broke out weeping on the steering
wheel afraid to look. I walked up and tapped on her window. Her
fingers danced on the dashboard. She looked at me. "Are you
all right?" I asked. "I don't believe it," the
woman said, resting her head back down on the wheel. "I don't
The road we're traveling down tonight feels familiar, the rhythm
of the bumps and ruts against the tires, but in the dark nothing
looks familiar. Dale fumbles with the map, turning it toward the
window so he can read with the help of an occasional street light.
"Where is this place we're going to?" he asks.
"Lebanon Springs." I don't tell him I was born there.
One of the first rules with new employees is not to share
"It's not on the map," Dale says.
"What?" I ask.
"Turn it over, it's on the other side." Dale turns over
the map and brings it up close to his face. "Find the green
line I made. It starts in Boston; follow to where it ends."
"I found it," he says. "It's tiny. There can't
be much to this town."
"There's a woman who needs a heart," I say. "That's
all you need to know."
Some people say I was thinking too much and some people say I
wasn't thinking enough, but I probably just wasn't thinking about
the right things. Don't take advice from yourself, don't leave
your apartment without a good reason, don't have a telephone,
don't own too many things, don't own too few. Live on the first
floor. Watch out for people.
Dale lets out a long sigh. He runs his hands through his slicked-back
hair, then rubs the back of his neck. Dale is wrong for the job.
There's no use even getting to know him because I'll just be training
someone new next week and asking all the same questions, explaining
all the same rules.
Dale asks if he can look at the heart, to see how it's kept alive.
He thinks it might be helpful for the job, but I think otherwise.
Does he think I haven't sat alone in this seat next to a case
marked Heart and not looked inside? There's nothing to
look at. It either works or it doesn't.
I turn to Dale: "You've read the manual?"
He nods, but I'm not sure he even knows what manual I'm talking
"You get to one of the designated stops only to find that
the phone is out. What do you do? Stop at the next phone along
the road or drive on? No time to think. Page fifty-two of the
"Stop at the next phone," he says. "The next phone
along the road, I mean."
"I know what you mean and you're wrong. You drive on."
I let him fiddle with the glove compartment handle and crack his
knuckles. "When in doubt," I tell him, "always
drive on. Just remember that one thing, all right? All right?"
"All right," he says.
He looks out the window. I look briefly where he's looking, but
the shape of the hills on the horizon depends on the phase of
the moon. I don't recognize a thing. On a night like tonight,
when the moon is hidden by the storm, we can only recognize the
windshield wipers, the sheets of rain and the vague shape of the
white road-sign letters. We could be headed anywhere. The last
time I traveled down this road I was hitchhiking home and ended
up in a car accident. I told a guy and a girl who picked me up
on Route 302 somewhere that I would go as far as they were going.
He told me that they were headed for her parents' house in a little
town out where 302 turns into 89 called Lebanon Springs. I nodded,
and he drove faster than the speed limit. I had been outside in
the snow for too long, and my feet were numb. I took off my shoes
in the back seat and rubbed each toe, worried that they might
not come back. Suddenly there was a thud, breaking glass, and
we slid into the guardrail. The head of a large buck had smashed
against the windshield, spraying glass shards onto the driver
whose head rested against the steering wheel. I crawled out the
back door. The tiny glass fragments melted into the bottoms of
my bare feet. The guy's girlfriend had to crawl out her window
and over the hood. She walked toward me, swaying her hips like
a model, rubbing her head. The deer stood in front of the car
watching us. Then he closed his eyes. I didn't make it back to
Lebanon that time.
In the dawn haze I start to recognize sections of forest from
the last time I was here, eight years ago. We will probably drive
over the spot where I was born, and I must remember not to say
anything to Dale. He does not need to know. But now that I think
about it, we'll enter from the east side of town, so we won't
have to use the Thurman bridge where I was born crossing over
from Stockton in a Chevy, my father behind the wheel and my mother
sprawled out in back. The story goes that my mother said she wasn't
going to make it, and my father said she had to wait. She said
she couldn't and there was screaming. She wanted something to
kill the pain. He told her just to think about something else
and hold it in and then before she knew it they would be there.
But all she knew was that she couldn't wait another second, and
I was born at 11:42 p.m. before we even crossed the river.
Staring through the rain-splattered windshield into the dark gray
forest I am reminded of the same forest, twenty miles from here,
where I lived with my parents at the end of a long dirt road.
We lived there for five or six years, but one morning it
was so cold that the storm pane cracked down the middle and fell
into the backyard. I woke up and wandered into my parents' bathroom,
waiting for them to wake, stepped up on a stool, opened the medicine
cabinet and pulled down a box of razor blades hidden from me behind
the shaving cream. Taking out two, I placed one in the palm of
my right hand then squeezed my fingers shut. With my left hand
I ran the other blade lightly, painlessly, up and down my arm
from the shoulder to the palm. The little slits remained dry for
a second, as if caught off-guard, before red lines appeared and
eventually washed together like flooding rivers. I walked into
their bedroom, groping my hand along the wall for the light switch.
Her head bolted up. Then I found the light switch.
Several years later-I can't remember how many-we must have lived
there for more than seven years, I was ten years old standing
at the same window, my father having been gone from the house
for quite some time, and I heard my mother's faltering footsteps
climbing the stairs. I locked my bedroom door, pushed one of the
chairs up against the knob and then returned to the window. I
heard the floorboards creak as she crept up to the door and carefully,
trying not to wake me, turned the doorknob and pushed forward.
When the door would not open, she pushed more frantically and
cursed under her breath. The rain splashed against the window.
It has stopped raining now and the sky has started to lighten.
Dale runs off into Ken's Variety, twenty miles east of our destination,
to make our last call. Twenty minutes to go. I decide that when
Dale returns I'll ask him some questions about his life, about
the letter "D" sewn onto his high school jacket, about
what he wants to do with his life after this. I should try to
Maybe he wants to live over in Wayland or Lexington and summer
down at Marion or Pocasset, slightly off the beaten path, where
it's warm and the grass comes right down to the ocean and the
beaches keep going. It sounds like a good life to me.
I hear a car engine gearing down behind me and then the grumble
of the braking wheels against the gravel of the shoulder. Two
guys pull up beside my window in a pickup. The truck weaves a
little as it comes to a stop. The driver rolls down his window,
spits out some of his chew, and moves his hand in a circle, signaling
me to roll down my window. When I do, he raises his upper lip
and asks me what time it is. I look down at the blank face of
my digital watch, tap it a couple of times and tell him my watch
is dead. There is a clock on the case, but I would have to get
out of the car and walk over to the passenger's side to check
it. I'm not about to waste time doing that. The guy says he thinks
I'm lying about not knowing the time, so I show him the watch.
"The watch is dead," I say. Then he asks how much money
I have and I tell him. "Nothing." He says he knows I'm
lying and I say, "Is that so?"
"We're hungry," he says. "We're driving all the
way down from Elmira with no food. We want to buy some food at
His partner raises a shotgun and hands it to the driver who points
it at me. "How much for your life?" he says. He turns
back to his buddy then back to me. "My friend here says ten
dollars. Fair price, huh? Ten dollars and your life is yours."
I put my hand over the wallet in my pocket and thumb through the
bills inside, thinking about the heart. "I don't have a dime,"
"Not a dime," he says.
"Not a cent."
The driver squints and releases the safety on the shotgun. "I
know this isn't true," he says, closing one eye and lowering
his head down next to the stock. "My friend says shoot you
before someone comes along, but I'd rather have the ten dollars,
so I'm waiting another couple seconds to see what happens."
I look down the double barrel, stop breathing, and wait to see
what happens. For a long time I listen to the unsteady rumble
of their truck's engine like it's my own breath.
Suddenly he opens his eyes wide. "Bang," he says, pulling
the gun back in but leaving his eyes pointed at me. His lips move
up around his teeth. "Guess you're hungrier than we are,"
he says, and they drive away. I fall against the steering wheel,
my chest heaving, my right hand on the silver case.
Dale comes out of Ken's, trips on the steps, picks himself up
and keeps running. He climbs in the car, sucking in a mouthful
of air and says, "I couldn't get through." I throw it
into drive and pull forward, knowing perfectly well what the situation
is and what we have to do. "I don't know," Dale says.
"The phone lines around here are fine, but Ken said the storm
is worse back in Boston. Maybe the lines are down there."
"No matter," I say.
"Hey," Dale says, sitting up in his seat as if remembering
an important message. "When I was on the phone, Ken looked
out the window and mumbled something about your being in trouble.
"It was nothing," I say. "Now in this situation,
what do we do?"
"What situation?" Dale says, rubbing his forehead.
"You made the phone call and were not able to get through."
"Oh. We drive on, right?"
"You tell me."
"We drive on," Dale says, and we sit there in silence.
After a few minutes a police car approaches from behind and flashes
its blue lights. I pull over to the side of the road and roll
down my window. The officer parks his car, pulls some papers off
the dashboard, opens his door, closes it carefully and starts
walking toward us. He stops halfway, removes his cap, smooths
back his gray hairs, and puts the cap back on before continuing
forward. Dale looks at the floor.
"How are you this morning?" the old officer says.
"Fine, sir," I answer.
"Glad to hear it," he says. "The reason . . . I've
seen you before, haven't I? I know you."
"It couldn't be," I say. "I'm afraid you must be
making a mistake."
"Well," he says. "I stopped you because old Ken
gave the dispatch a ring saying you were having some trouble out
in front of his store."
"It was nothing," I say.
"Ken said that some guys in a pickup . . ."
"Officer," I say. "I hate to interrupt, but we
are on an urgent job, delivering a heart to the hospital just
across town. We're coming all the way from Boston through the
storm and every second counts. We have to drive on. After we deliver
the package I will be happy to answer any of your questions."
"A heart, you say?" The officer rubs his head. "I've
never heard of such a thing. Is that what your partner has there
in that case?"
"Yes it is."
"And you're taking it over to Community?"
"Yes we are."
"Then I won't hold you up."
"Thank you, officer."
"Well. I won't hold you up," he says again, staring
down at me. "But, please, stop down at the station when you're
done. We'd like a description."
"Thank you," he says and backs away from the car.
I drive on, spinning the wheels a bit in the gravel and holding
the pedal all the way down as the speedometer slowly climbs back
up to fifty-five. After ten minutes of silence, passing swiftly
over Washington Avenue, down Winthrop Street and across Thorton
Avenue, we stop outside the electric doors and the lighted sign,
Emergency. "Here," I say, grabbing the case.
"Follow me." Holding the case in front of me I walk
swiftly without running for the doors of the emergency room. Dale
takes several leaps to keep up with me. I walk right up to the
glass booth where a woman behind a desk is filling out forms.
Someone else, an enormous woman, sits in one of the waiting chairs
with no obvious injuries. The man next to her holds a rag clamped
over his bloody hand. They both stare at the opposite wall.
I tap nervously on the glass. "Can I help you?" the
woman says without looking up.
"I'm here with the heart from Boston General. Here are the
forms," I say, shoving them in front of her face. She takes
the forms but does not look at them.
"A heart?" she says, looking at me and my metal case.
"Yes," I say.
She takes a deep breath and shifts her behind on the swivel chair.
"What do you mean you're here with a heart?"
"Look," I say. "It's an emergency. We've been delayed.
There is a woman here who needs this heart. This heart will not
last much longer." The woman stares at me, looks at the forms.
"Didn't anyone tell you?" I ask.
"I just came on," she says. "I haven't heard anything
I set the case down and grab onto the edge of the partition separating
this woman from myself. I stare down, fixed on her lower lip.
"Look," I say. "The heart is here."
"I'll have to go back and check with one of the doctors,"
she says, smiling faintly and disappearing down a corridor. I
lean against the glass and close my eyes. I can hear the large
woman in the chair shift from one hip to another. The man with
the injured hand coughs briefly and then starts tapping his foot.
He taps it out of boredom, not pain. Once every couple of seconds
he lets the toe hit the floor. Then he stops and I feel his eyes
on me and the silver case. The fluorescent lights lining the ceiling
buzz like insects, becoming louder with every moment until in
the distance I hear the clicking heels of the receptionist and
the squeaks of a doctor's rubber heels coming down the corridor.
I turn around suddenly, wondering what has happened to Dale. And
just as the doctor comes up behind me, I see Dale appear from
around a corner and pause next to a black sign with an arrow that
says Cafeteria. The doctor puts his hand on my shoulder
and rests it there, waiting for me to turn toward him.
"I'm sorry," he says when I don't turn. "Boston
General should have told you on the last call."
He removes his hand and waits patiently for me to respond. The
receptionist returns to her desk and picks up the next form off
the enormous stack. Dale has stopped to unwrap the rest of a sandwich
he just bought down the hall. He leans over, allowing the lettuce
strands to fall on the floor instead of his jacket and then continues
toward me. A sliced tomato hangs over his bottom lip. He swallows
and keeps walking. After a few steps he stops to take another
bite, this time scooping up the strands of lettuce with his free
hand and pushing them in the corner of his mouth. The doctor picks
up the case and, placing it against the wall, says a few words
to the receptionist, who opens a drawer and shuffles through a
bunch of papers. It is too late for Worcester, I think. When Dale
sees that I am staring he stops walking and tries to swallow what's
left in his mouth. The doctor steps up beside me again carrying
a clipboard. "We need to have you sign these," he says.
I take the clipboard and the pen without looking at him.
"I was hungry," Dale says, shrugging his shoulders.
"I figured we were here. I couldn't wait any longer."
"That's no excuse," I say and lower my head to the forms
resting in my hands. I sign my name. Time of arrival, it
says. I turn my wrist and look down at my blank watch. I look
at the doctor. "Time?" I say.
He raises his naked wrist. "Forgot to wear it today."
He smiles, dark circles under his eyes.
Dale shoves the rest of the sandwich into his pocket. "It's
seven o'clock," he says, pursing his lips in an effort to
take our job more seriously. He walks over to the silver case
and picks it up. "What do we do now? I thought we were here."
I walk over to him, take the case out of his hand and lay it down
next to the wall. "It's too late," I say, but he furrows
his brow and stares at the case. It is a good sign when a trainee
doesn't understand how a job can fail. I remind him as we head
for the door that a heart, once removed from the body, will last
only twenty-four hours. There is nowhere left for us to drive.
At the door he turns away from me looking for the silver case,
which a nurse is carrying down a long yellow hallway. I give just
a light tug on his arm, but he won't turn around until the nurse
has disappeared down another corridor. I understand this is the
hardest part of the job; there is no way for me to explain how
we could have driven all this way with a heart for which, in the
end, there is no life.