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Heart of the Matter - Emily Giffin [24]

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bring herself to see Romy, or even call her back. She is not ready to hear her excuses or apologies, and she is certain that she will never forgive. Valerie and her mother have this in common, too, Rosemary holding grudges more firmly than anyone she’s ever known.

“Well, let’s go see him,” Rosemary says, exhaling ominously.

Valerie nods, as they ride the elevator up two floors and then walk in silence to the end of the hall. As they approach Charlie’s room, Valerie hears her mother mumble, “I really wish you had called me straightaway.

“I know, Ma . . . I’m sorry . . . I just wanted to get through those first hours . . . Besides, there was nothing to be done long-distance.”

“Prayer,” Rosemary says, lifting one eyebrow. “I could have prayed for him . . . What if, God forbid . . .” Her voice trails off, a wounded expression on her heavily lined face.

“I’m sorry, Ma,” Valerie says again, keeping silent tally of her apologies.

“Well, you’re here now,” Jason says, flashing Rosemary his most captivating smile. It is no family secret that Jason is her favorite child, his homosexuality notwithstanding.

“And you,” Rosemary says, giving Jason a once-over that he would later joke to Valerie looked like a search for signs of AIDS. “You’re way too thin, honey.”

Jason drapes one arm over Rosemary’s shoulder, further charming her. “Oh, come on, Ma,” he says. “Look at this face. You know I look good.”

Valerie considers his statement and feels herself tense. Not so much because Jason is talking about his handsome, unscarred face, but because of the glance he shoots her afterward. It is a look of worry, of sympathy, of realizing that he, too, just said the wrong thing. Valerie knows this look of pity well and feels an ache in her heart that her son will now come to know it, too.

***

The following morning, while Charlie is still dozing, Dr. Russo comes to examine his hand. Valerie can tell right away that something is wrong despite his impassive expression and slow, deliberate movements.

“What’s wrong?” she says. “Tell me.”

He shakes his head and says, “It’s not looking good. His hand. There’s too much swelling . . .”

“Does he need surgery?” Valerie asks, steeling herself for bad news.

Dr. Russo nods and says, “Yeah. I think we need to go in there and release the pressure.”

Valerie feels her throat constrict at the thought of what “going in there” entails until he says, “Don’t worry. It’ll be fine. We just need to release the pressure and do a graft on his hand.”

“A graft?” she says.

“A skin graft, yes.”

“From where?”

“His leg—the thigh area. Just a little strip of skin is all we’ll need . . . Then we’ll put it in a meshing machine and expand it—and secure it to his hand using a few surgical staples.”

She can feel herself wince as he continues, telling her the whole graft will be nourished by a process called plasmatic imbibition—which means that the graft literally drinks plasma, then grows new blood vessels into the transplanted skin.

“You make it sound easy,” she says.

“It is pretty easy,” he says, nodding. “I’ve done thousands.”

“So there’s no risk?” she asks, wondering if there’s a judgment call involved, whether she should seek a second opinion.

“Not really. The main concern is fluid accumulation under the graft,” he continues. “To prevent this from happening, we’ll mesh the graft with tiny rows of short, interrupted cuts.” He makes a small cutting motion in the air and continues. “Then, each row will be offset by half a cut-length, like bricks in a wall. In addition to allowing for drainage, this allows the graft to both stretch and cover a larger area . . . and more closely approximate the contours of the hand.”

She nods, feeling queasy but reassured by the precise science of it all. “I’ll also be using VAC therapy—Vacuum Assisted Closure—which does pretty much what it sounds like it does. I’ll place a section of foam over the wound, then lay a perforated tube onto the foam, securing it with bandages. A vacuum unit then creates negative pressure, sealing the edges of the wound to the foam, and drawing out

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