Heart of the Matter

“And that will grow back? On his scalp?”


“Yes. The remaining skin still contains hair follicles and sebaceous glands which gradually proliferate out to form a new layer of epidermis. We’ll dress the area with a moist antibiotic-covered gauze to guard against infection . . .”

“Okay,” Valerie says, swallowing, nodding. “And then? How do you put the skin on?”

“So. We’ll take the skin and just drape it right over his cheek, and use a scalpel to punch little holes to allow blood and fluid to drain. We then secure the graft with fine sutures and a little biological glue and cover it with a moist, nonadherent dressing.”

“Does it always . . . take?” she says.

“Typically, yes. It should attach and revascularize . . . and his scalp will be a fine match for his cheek.”

She nods, feeling queasy but reassured, as he goes on to explain that after the surgery Charlie will wear a custom-fitted face mask in order to control facial scarring. “Basically, we want to keep the scars on the face flat, smooth, and pliable.”

“A mask?” she says, trying to picture it, worrying, once again, about the social stigma her son will have to endure.

“Yes,” he says. “An occupational therapist will be coming by later this afternoon to take a scan of Charlie’s face. This data will be transmitted to a company that makes custom-fitted, transparent silicone masks. The mask will cover Charlie’s entire face—except for holes for the eyes, nose, and mouth—and attach with straps.”

“But it will be clear? See-through?”

“Yes,” he says. “Clear so that we can observe blanching of the scar and see where pressure is being applied . . . Over time, the therapist will adjust the fit of the mask by making changes to the mold and reheating the plastic.” He studies her face, as if searching for something. “Sound good?”

She nods, feeling slightly reassured.

“Any other questions?”

“No. Not right now,” she says quietly.

Dr. Russo nods and says, “Well. Just call me if they come up. Anytime. You have my cell.”

“Thank you, Dr. Russo,” she says.

“Nick,” he says. It is at least the fourth time he’s corrected her.

“Nick,” she repeats as their eyes lock again. Another stretch of silence ensues, much like the last one, but this time, Valerie feels more comfortable, nearly enjoying the quiet camaraderie.

Nick seems to feel the same, because he smiles and easily switches to a new topic. “So Charlie mentioned you’re a lawyer?” he says.

Valerie nods, wondering when, and in what context, Charlie discussed her profession.

“What kind of lawyer?” he asks.

“I practice corporate litigation,” she says, thinking of how far away and unimportant her firm and all its politics feel to her. Other than a few phone calls with the head of her department, in which he assured her that her cases and clients were covered and she should not worry about a thing, she had not given work a single thought since Charlie’s accident and couldn’t fathom why she ever let it stress her out.

“Did you go to law school around here?” he asks.

She nods and says, “Yeah. I went to Harvard,” instead of the usual way she avoids that word, not out of a sense of feigned modesty the way so many of her classmates say, “I went to school in Cambridge,” but because she still doesn’t feel quite worthy of the name.

But with Nick, it is different, perhaps because she knows he went there, too—that he is as accomplished as they come. Sure enough, he nods, unfazed, and says, “Did you always know you wanted to practice law?”

She considers this—considers the truth—that she had no real passion for the law, but simply wanted to achieve for the sake of achievement. Especially after Charlie was born, when she desperately wanted to earn a good living and be able to provide for her son. Do something that Charlie could be proud of so that she might somehow compensate for his not having a father.

But, of course, she does not divulge any of this, and instead says, “No, not really. I was a paralegal for a couple of years, and realized that I was as smart as the lawyers at my firm . . .” Then she smiles and goes out on a limb with a joke, her first in ages. “Probably what the nurses around here are saying about you.”

“Probably so,” Dr. Russo says, smiling modestly back at her. “Oh, come on,” she says. “You don’t believe that. You even told me how good you are.”

“I did?” he says, surprised. “When?”

“When we first met,” she says, her smile fading as she remembers that night.

He stares at the air above his head, as if he, too, is reliving the night of Charlie’s accident. “Yeah, I guess I did, didn’t I?”

Valerie nods, then says, “And so far ... I’d have to agree.”

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