“Do you mean I could possibly decide that heart transplants aren't a good idea? Is that what you're saying, Peter?”

“You might, although that would be a very foolish view. The fact is that transplant patients are going to die anyway, and quite soon. What we give them is a chance, and sometimes not a very good one at that. The risk is high, most of the time the odds are poor, but there is that chance, and the patient makes up his own mind. Some people just don't want to go through what they'd have to, and they opt not to take the chance. I respect that. But if they let me, I try. It's all anyone can do. I'm not advocating transplant for all patients, that would be mad. But the fact is that for some it's ideal, and right now we will need to open new doors. We can't just operate with human heart donors, we need more than there are, so we're groping for new paths, and it's that process that the public resists. They think we're trying to play God, and we're not, we're trying to save lives, and doing our best, it's as simple as that.” He stood up, as she followed suit, and he looked down at her from his considerable height. “You tell me what you think at the end of today, and tell me if you disagree with the means we pursue. In fact”—he narrowed his eyes as he looked at her—“I'd be particularly interested in what you think. You're an intelligent woman yet relatively uneducated in this field. You come to it with fresh eyes. You tell me if you're shocked, if you're appalled, or if you approve.” And as they left his cubicle, he had another thought. “Tell me something, Mel, have you formed any kind of preconceived opinion at all?” He watched her face intently as they walked and she furrowed her brow.

“Honestly, I'm not entirely sure. Basically, I think that everything you're doing makes sense, of course. But I must admit, the odds you're talking about frighten me. The chances of survival, for any reasonable length of time, are so slim.”

He looked long and hard at her. “What may seem unreasonable to you may be the last straw of hope to a dying woman or man or child. Maybe to them, even two months … two days … two hours longer sounds good. Admittedly, the odds frighten me too. But what choice do we have? Right now, that's the best we've got.” She nodded and followed him into the hall, thinking of Pattie Lou, and she watched him as he began to read through his patients' charts, face intent, brows knit, asking questions, looking at the results of tests. Again and again, Melanie heard the names of the drugs given to heart-transplant patients to allay rejection of the new heart. And she began to make a few notes herself, of questions she wanted to ask him when he had time, about the risks of these drugs, their effects on the patients' personalities and minds.

Suddenly she saw Peter Hallam get up, and begin to walk quickly down the hall. She followed him a few steps, and then stopped, unsure of whether or not he wanted her with him, and as though sensing her indecision, he suddenly turned to her with a wave.

“Come on.” He waved to a stack of white coats on a narrow stainless steel cart and indicated to her to grab one, which she did on the run, and caught up with him as she struggled to put it on. He had his arms full of charts, two residents and a nurse were following respectfully behind. Peter Hallam's day had begun. He smiled once at Mel and pushed open the first door, which revealed an elderly man. He had had a quadruple bypass two weeks before and said that he felt like a boy again. He didn't look much like a boy, he still looked tired and pale and a little wan, but after they left his room, Peter assured her that he was going to be fine, and they moved on to the next room, where suddenly Melanie felt a tug at her heart. She found herself staring down into the face of a little boy. He had a congenital heart and lung disease, and nothing surgical had been done for him yet. He wheezed horribly and was the size of a five- or six-year-old child, but a glance at his chart told Mel that he was ten. They had been contemplating a heart-lung transplant on him, but thus far, there had been so few done that they felt it was too soon to attempt it on such a young child, and intermediary measures were being taken to keep him alive. Melanie watched as Peter sat down in a chair next to his bed and talked at great length to him. More than once, Melanie had to fight back tears, and she turned so the boy wouldn't see her damp eyes. Peter touched her shoulder again as they left the room, this time in comfort.

They moved on to a man who had been given a plastic heart, which Melanie learned was powered by air. The patient was suffering from a massive infection, which apparently was sometimes a problem. Given the odds and the circumstances surrounding these desperately sick people, everything was a risk or a threat or a problem. Danger lurked everywhere, within their own defeated bodies, even in the air. And infection was greatly to be feared, and almost impossible to avoid, in their weakened condition. And then there was another patient, obviously comatose, and after speaking briefly to the nurse, Peter didn't linger long in the room. There were two moon-faced men who had undergone heart transplants within the year, and Melanie already knew from the material she'd read that often the steroids they took had that side effect, but eventually it would be controlled. Suddenly these people came alive to her. And what was even more real to her now was how poor the odds were. Peter answered some of her questions now, as they sat in his cubicle again. And as she looked at her watch, she was amazed to discover that it was almost noon. They had been doing rounds for four hours, had probably been to twenty rooms.

“The odds?” He looked at her over his coffee cup. “Heart-transplant patients have a sixty-five percent chance of living for one year after the surgery is performed. That's roughly two chances in three that they'll make it for a year.”

“And longer than that?”

He sighed. He hated these statistics. They were what he fought every day. “Well, the longest we can give anyone is about a fifty-fifty chance for five years.”

“And after that?” She was making notes now, appalled by the statistics, and sympathetic to the defiance in his voice.

“That's about it right now. We just can't do better than that.” He said it with regret, and simultaneously they both thought of Pattie Lou, willing her better odds than that. She had a right to so much more. They all did. One almost wanted to ask what was the point except that if it were one's own life, or one's child, wouldn't one take any chance at all, for a day, or a week, or even a year?

“Why do they die so soon?” Mel looked grim.

“Rejection mostly, in whatever form. Either a straight across-the-board rejection, or they get hardening of the arteries, which will lead to a heart attack. A transplant will kind of step things up. And then the other big problem we face is infection, they're more prone to that.”

“And there's nothing you can do?” As though it all depended on him. She was casting him in the role of God, just as some of his patients did. And they both knew it wasn't fair, but it all seemed to be in his hands, even if it was not. In a way, she wanted it to be. It would have been simpler like that. He was a decent man, he'd make things all right … if he could.

“There's nothing we can do right now. Although some of the new drugs may change that. We've been using some new ones lately, and that may help. The thing you have to remember”—he spoke gently to her, almost as though she were a child—“is that these people would have no chance at all without a new heart. So whatever they get is a gift. They understand that. They'll try anything, if they want to live.”

“What does that mean?”

“Some don't. They just don't want to go through all this.” He waved at the charts and leaned back in his chair, holding his coffee cup. “It takes a lot of guts, you know.” But she realized something else now. It took a lot of guts for him too. He was a matador of sorts, going into the ring with a bull named Death, trying to steal men and women and children from him. She wondered how often he'd been gored by dashed hopes, by patients who had died whom he cared about. Somehow one sensed about him that he was a man who really cared. As though he heard her thoughts, his voice suddenly grew soft. “My wife decided not to take the chance. “He lowered his eyes as Mel watched, feeling suddenly rooted to her chair. What had he said? His wife? And then he looked up, sensing her shock, and his eyes looked straight into Mel's. They weren't damp, but she saw a grief there that explained something to her about him. “She had primary pulmonary hypertension, I don't know if that means anything to you or not. It damages the lungs, and eventually the heart, and it requires a heart-lung transplant, but at the time there had only been two done anywhere in the world, and neither of them here. I wouldn't have done it myself of course”—he sighed and leaned forward again in his chair—“she would have been operated on by one of my colleagues and the rest of the team, or we could have taken her to any of the great men around the world, and she very quietly said no. She wanted to die as she was, and not put herself, or me, or the children through the agonies she knew my patients go through, only to die anyway in six months, or a year, or two years. She faced it all with terrifying calm”—and now Mel saw that his eyes were damp—“I've never known anyone like her. She was perfectly calm about it, right up until the end.” His voice cracked and then he went on, “It was a year and a half ago. She was forty-two.”

He looked deep into Mel's eyes then, unafraid of what he felt, and the silence was deafening in the tiny room. “Maybe we could have changed all that. But not for long.” He sounded more professional now. “I've done two heart-lungs myself in the last year. For obvious reasons, I have particularly strong feelings about that. There's no reason why it can't work, and it will.” It was too late for his wife. But in his heart he would never give up the fight, as though he could still convince her to let him try. Mel watched him with a pain in her soul for what he'd been through, and the helplessness he felt which still showed in his eyes.