Cutting for Stone - Abraham Verghese [262]
Shiva wasn't reading, but reciting word for word from memory. It didn't surprise Hema, but it astonishmed the other physicians at the table. Hema felt proud of Shiva. She was reminded how often she took Shiva's eidetic gift for granted. She knew he could draw the page he was reciting from, reproduce it on a blank piece of paper, beginning and ending each line just as it was on the original, down to the punctuation, the page number, and the staple marks and photocopy smudges.
Shiva, sensing that he had quieted Hema for the moment, addressed Thomas Stone and Deepak, the two surgeons: “May I remind you that the first successful kidney transplant by Joseph Murray involved a dying twin who received a healthy kidney from his identical twin brother?”
Deepak spoke, because it appeared that Thomas Stone was in a state of shock, “Shiva, we also state in the paper,” Deepak said, “that there are ethical and legal implications—”
Shiva interrupted. “Yes, I know. But you also say ‘in all likelihood the first donors will be a parent or sibling, because such a donor has a pure motive and takes on the risk willingly’ “
Deepak and Thomas Stone looked like defendants whose alibi had just been shot down by a surprise witness. The prosecutor was moving in for the kill.
But the attack came from another quarter. Hema said, “Thomas, tell me the truth: in the last four days, given that this is your area of interest”—she tapped the paper, her fingers bunched together—”seeing Shiva lie next to his twin, did the thought of this live donor operation not cross your mind?”
If she expected him to squirm and swallow hard, she was in for a surprise: Stone looked steadily at Hema, and after a beat, he nodded almost imperceptibly. “I thought of the Murray twins, yes. I thought of it. But then thinking of all the hazards … I dismissed it. This is much, much harder than removing a kidney. It's never been done.”
“ I never thought of it!” Vinu Mehta said quietly. “Madam, I should have thought of it. Shiva, I thank you. In anyone else with acute hepatitis B, a liver transplant would simply feed the virus. But with a perfect match … Of course, Shiva, the issue is really the risk to you.”
My brother was ready, and he spoke without glancing at his notes, addressing his comments largely to Thomas Stone even though Vinu had asked the question. “Your estimate, Dr. Stone, based on cutting out one or more lobes from patients with liver trauma, is that the risk of death should be less than five percent for me, the donor. The risk of serious complications, such as bile leaks and hemorrhage, you said should be no more than twenty percent in an otherwise healthy donor.” Shiva pushed a single sheet to Deepak and Thomas Stone. “I had my blood drawn last night. All my liver functions came back normal. As you can see, I am not a carrier of hepatitis B or anything like that. I don't drink or take drugs that might damage the liver. I never have.” Shiva waited for Thomas Stone.
“You know that paper of ours better than I do, son,” Stone said. “Unfortunately, those were estimates, a pure guess.” He put his hands on the table. “We don't know how it might really work in humans.”
“And if we fail,” Deepak added gently, since Thomas Stone was finished, “we lose you who walked in here healthy and we lose Marion. Not to mention that we won't have a leg to stand on or that our careers could be over. Even if we succeed, we will be heavily criticized.”
If they thought Shiva was done, they didn't know my brother. Hema was seeing her son anew. “I understand your reluctance.