Mending the Living

“There’s been a car accident. The ambulance is taking your son to Barnes Hospital,” said an unfamiliar male voice.

On the way to the hospital, I tried to block out the “What if’s,” but scenarios clicked through my brain like a photo slideshow. Fractures, casts, crutches. Scars. Or the more ominous “internal injuries.” Or worse yet, brain damage. Being a doctor doesn’t help in cases like this. It just makes your worries more specific.

My voice cracking, I said, “Don’t you think it’s a good sign he was able to ask someone to call us?” My husband Bill only nodded. I blinked back tears. Could all my efforts at raising this kid end like this? I tore my mind away and just looked at the winter scape along the highway.

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In the novel The Heart, by French writer Maylis de Kerangal, translated by Sam Taylor, the worst does happen to 19-year-old Simon Limbres. He and two surfing friends drive off in the early morning to catch an exceptional wave off the Normandy coast. On the way home, the driver falls asleep, runs off the road and hits a post. Simon, sitting in the middle seat of the van and not belted in, is thrown into the windshield.

The Heart takes us through the next 24 hours and all the lives affected by Simon’s accident. Marianne and Sean are the parents. She is French. His background is Maori. They are separated. The hospital finds Marianne first. She goes to the hospital and is met by the ICU doctor. He tells her that Simon has had cranial trauma. He is in a coma. It is irreversible. She cannot see him just yet.

Marianne leaves several messages for Sean. When he finally calls back, she realizes that he is still in a world where Simon is okay. As she breaks the news to him, she hears that “his voice has defected now, leaving the land of the innocent and joining Marianne, piercing the fragile membrane that separates the lucky and the damned.”

They go together to the ICU to see Simon. Other than the bandage on his head, he looks intact. Marianne can hear his heart beating and thinks back to hearing his heart in her womb on an ultrasound. Sean takes his son’s hand and says, “Simon. We’re here. We’re with you, you can hear me, Simon, my boy, we’re here.”

The parents’ grief takes many turns. Marianne thinks of all the times she’s heard of people coming out of comas. Maybe it’s some computer glitch, his brain scan. Sean blames himself for making the surfboard for Simon. In his grief, he bangs his head again and again against the car steering wheel. Marianne blames Sean for giving Simon a love for the sea. Even as they are sharing the sorrow with their young daughter Lou and Simon’s girlfriend Juliette, a part of them thinks about what the day might have been like had the accident not happened.

As the sorrow of Simon’s family grows wider and deeper, another set of people goes into action: the transplant teams. Their job is life-and-death important and urgent. Simon’s organs can save many lives. But, the organs need to be harvested as soon as possible.

The parents must be treated with utmost kindness but also utmost truth. The ICU doctor tells them that the latest of several serial EEGs shows that Simon’s brain continues to show no activity. With sensitivity but also brutal frankness, the transplant coordinator, Thomas, who had been in the room with the ICU doctor, brings up the subject of organ donation.

He asks for their consent “to the removal of his organs for transplant operations.” The parents are stunned. Sean declares, “Simon’s body is not just a box of organs that you can help yourself to.” The parents leave the hospital, walk near the sea, and after some time, decide for the donation. Marianne realizes, “They won’t hurt him. They won’t hurt him at all.”

This decision triggers a cascade of activity. Thomas calls the Biomedical Agency, a central data bank for organ transplants. Marthe, who takes the call with all of Simon’s medical information, searches for recipients who are compatible with Simon’s blood type and immune system. They even need to be compatible with the shape and size of Simon’s heart. She feels the weight of the responsibility, knowing the tornado of activity she will generate, and the hope.

She decides on a 51-year-old woman in Paris for the heart. “Strasbourg takes the liver (a six –year-old girl), Lyon the lungs (a seventeen-year-old girl), Rouen the kidneys (a nine year old boy).”

Claire Mejan, the heart patient in Paris, has three grown sons and a mother. She is a translator. She has myocarditis, an inflammation of the heart muscle, which causes heart failure. She struggles to breathe and tires easily. She has had this for three years. She moved into a teeny, dark apartment in Paris because it is across the street from the hospital. A heart transplant is her only option. She is aware that for her to live, someone has to die.

Thomas, the transplant coordinator at Simon’s hospital, had promised the parents two things. Just before they clamp the blood vessels to remove Simon’s heart, Thomas whispers into Simon’s ear that “Sean and Marianne are with him, and Lou and Grandma, he whispers that Juliette is there by his side.” Then he places ear buds into Simon’s ears and plays a track of sea sounds that the parents had given Thomas. Then, the removal proceeds.

Thomas’ second promise to Sean and Marianne was, “Your son’s body will be restored.”

Thomas exhorts the surgeons to close up with as much care as they used in their retrieval of the precious organs. They fill out the hollowed out spaces with fabrics and compresses. When the surgeons leave, Thomas and Cordelia, the young nurse who has taken care of him since his arrival into the hospital and who assisted in the surgery, clean Simon and wrap him in an immaculate white sheet, knotted at the head and foot.

“Tomorrow morning, Simon Limbres will be returned to his family, to Sean and Marianne, to Juliette and Lou, to his loved ones, and he will be returned to them ad integrum,” (restored to his previous appearance). In less than twenty-four hours from the time Simon got up from bed to catch the big wave, his heart beats in Claire Mejan’s chest.


The Barnes ER was spacious, brightly lit and impersonal. We were told to wait. We waited. When we saw Alex return on a gurney, presumably from X-ray, we followed him to his room. He gave me a smile that conveyed mixed feelings—glad to see me but not sure if I’d be mad. I looked him up and down. A scraped knee, torn jeans and stitches across his left eyebrow. “That scar over your eye will look dashing someday,” I said. Alex gave a deprecating shrug.

The doctor told us that Alex had no broken bones. He gave us instructions on wound infections and told us to check Alex every two hours for signs of head injury, such as lethargy, vomiting, or seizures. To my great relief, the doctor mentioned that a blood test for alcohol and urine drug screens were negative.

Reading The Heart reminded me of the word “catharsis,” that I learned in high school.

The purpose of the Greek tragedies, according to Aristotle, was to cleanse the heart through pity and terror. He called that release of emotion “cartharsis.” Reading Simon’s story, I felt like I had dodged a bullet that time with Alex. I had landed on the side of the lucky, and I was grateful beyond words. Not that I didn’t have nightmares and anxiety for a long time afterwards. Even now, whenever Alex, who has two sons of his own, leaves my house, I tell him “Drive safely.”

Tell me: What play, movie or book has been a cathartic experience for you?

By Cathy Luh

I am a doctor, a writer and Grammy to Edin and Caleb. I live in St. Louis with husband Bill.

2 replies on “Mending the Living”

I shared a similar emotional experience with you when my son broke his leg during a bike accident. Years later, after reading Dr. Oliver Sacks’ book, The Man Who Mistook his Wlfe for a Hat, I have learned to appreciate ways to find something positive, uplifting even in depressing, tragic situations. Thank you for recommending this book. It is now on my annual To-Read List.

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My cathartic movie experience was with Children of Men. (Stars Clive Owen, Julianne Moore, Michael Caine; novel by P.D. James.) The story explores how the structure of our lives could so easily be reduced to chaos, but then — in the final 3 seconds of film — provides a glimpse of salvation. As the credits rolled, I was emotionally exhausted & filled with gratitude . 🙏🏻

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