The Fourth Hand

for the hand. Perhaps the true cause of Dr. Zajac’s disappointment was that the hand seemed more like her triumph than his. The principal news was that the donor’s widow was pregnant, and that she still maintained a relationship with her late husband’s hand. And the labels for Wallingford were never “the transplant guy” or “transplant man”—he was still and would remain “the lion guy” and “disaster man.”

And then, in September 1998, there was a successful hand-and-forearm transplant in Lyon, France. Clint Hallam, a New Zealander living in Australia, was the recipient. Zajac seemed miffed about that, too. He had reason to be. Hallam had lied. He’d told his doctors that he lost his hand in an industrial accident on a building site, but it turned out that his hand had been severed by a circular saw in a New Zealand prison, where he’d been serving a two-and-a-half-year sentence for fraud. (Dr. Zajac, of course, thought that giving a new hand to an ex-convict was a decision only a medical ethicist could have made.)

For now, Clint Hallam was taking more than thirty pills a day and showing no signs of rejection. In Wallingford’s case, eight months after his attachment surgery, he was still popping more than thirty pills a day, and if he dropped his pocket change, he couldn’t pick it up with Otto’s hand. More encouraging to the Boston team was the fact that his left hand, despite the absence of sensation at the extremities, was almost as strong as his right; at least Patrick could turn a doorknob enough to open the door. Doris had told him that Otto had been fairly strong. (From lifting all those cases of beer, no doubt.)

Occasionally Mrs. Clausen and Wallingford would sleep together—without sex, even without nakedness. Doris would just sleep beside him—at his left side, naturally. Patrick didn’t sleep well, to a large degree because he was comfortable sleeping only on his back. The hand ached when he lay on his side or his stomach; not even Dr. Zajac could tell him why. Maybe it had something to do with a reduced blood supply to the hand, but the muscles and tendons and nerves were obviously getting a good supply of blood.

“I would never say you were home free,” Zajac told Wallingford, “but that hand is looking more and more like a keeper to me.”

It was hard to understand Zajac’s newfound casualness, let alone his love of Irma’s vernacular. Mrs. Clausen and her fetus had usurped Dr. Zajac’s three minutes in the limelight, but Zajac seemed relatively undepressed. (That a criminal was Wallingford’s only competition in hand-transplant surgery made Zajac more pissed-off than depressed.) And, as a result of Irma’s cooking, he’d actually put on a little weight; healthy food, in decent quantities, still adds up. The hand surgeon had given in to his appetites. He was famished because he was getting laid every day.

That Irma and her former employer were now happily married was no business of Wallingford’s, but it was all the talk at Schatzman, Gingeleskie, Mengerink, Zajac

& Associates. And if the best surgeon among them was looking less and less like a feral dog, his once- undernourished son, Rudy, had also gained a few pounds. Even to the envious souls who stood at the periphery of Dr. Zajac’s life and cravenly mocked him, the little boy whose father loved him now struck nearly everyone as happy and normal.

No less surprising, Dr. Mengerink confessed to Zajac that he’d had an affair with the vengeful Hildred, Dr. Zajac’s now-overweight first wife. Hildred was seething about Irma, although Zajac had increased her alimony—the cost to Hildred was straightforward: she would accept dual, which was to say equal, custody of Rudy. Instead of becoming overwrought at Dr. Mengerink’s startling confession, Dr. Zajac was a portrait of sensitivity and compassion. “With Hildred? You poor man

…” was all Zajac had said, putting his arm around Mengerink’s stooped shoulders.

“It’s a wonder what a little nooky will do for you,” the surviving Gingeleskie brother remarked enviously.

Had the shit-eating dog also turned a corner? In a way, she had. Medea was almost a good dog; she still experienced what Irma called “lapses,” but dogshit and its effects no longer dominated Dr. Zajac’s life. Dog-turd lacrosse had become just a game. And while the doctor had tried a glass of red wine every day for the sake of his heart, his heart was in good hands with Irma and Rudy. (Zajac’s growing fondness for red Bordeaux quite exceeded the parsimonious allotment that was deemed to be good for his ticker.)

The unexplained ache in Patrick Wallingford’s new left hand continued to be of little concern to Dr. Zajac. But one night when Patrick was lying chastely in bed with Doris Clausen, she asked him, “What do you mean by an ‘ache,’ exactly? What kind of ache is it?”

“It’s a kind of straining, only my fingers are barely moving, and it hurts in the tips of the fingers, where I still have no feeling. It’s weird.”

“It hurts where you have no feeling?” Doris asked.

“So it seems,” Patrick explained.

“I know what’s wrong,” Mrs. Clausen said. Just because she wanted to lie next to his left hand, she should not have imposed the wrong side of the bed on Otto.

“On Otto?” Wallingford asked.

Otto had always slept at her left side, Doris explained. How this wrong-side-of-thebed business had affected Patrick’s new hand, he would soon see. With Mrs. Clausen asleep beside him, at his right side, something that seemed utterly natural happened. He turned to her, and—as if ingrained in her, even in her sleep—she turned to him, her head nestling in the crook of his right arm, her breath against his throat. He didn’t dare swallow, lest he wake her. His left hand twitched, but there was no ache now. Wallingford lay still, waiting to see what his new hand would do next. He would remember later that the hand, entirely of its own accord, went under the hem of Doris Clausen’s nightie—the unfeeling fingers moving up her thighs. At their touch, Mrs. Clausen’s legs drew apart; her hips opened; her pubic hair brushed against the palm of Patrick’s new left hand, as if lifted by an unfelt breeze.

Wallingford knew where his fingers went, although he couldn’t feel them. The change in Doris’s breathing was apparent. He couldn’t help himself—he kissed her forehead, nuzzled her hair. Then she seized his probing hand and brought his fingers to her lips. He held his breath in anticipation of the pain, but there was none. With her other hand, she took hold of his penis; then she abruptly let it go. Wrong penis! The spell was broken. Mrs. Clausen was wide awake. They could both smell the fingers of Otto’s remarkable left hand—it rested on the pillow, touching their faces.

“Is the ache gone?” Doris asked him.

“Yes,” Patrick answered. He meant only that it was gone from the hand. “But there’s another ache, a new one…” he started to say.

“I can’t help you with that one,” Mrs. Clausen declared. But when she turned her back to him, she gently held his left hand against her big belly. “If you want to touch yourself—you know, while you hold me—maybe I can help you a little. ”

Tears of love and gratitude sprang to Patrick’s eyes.

What decorum was called for here? It seemed to Wallingford that it would be most proper if he could finish masturbating before he felt the baby kick, but Mrs. Clausen held his left hand tightly to her stomach— not to her breast—and before Patrick could come, which he managed with uncommon quickness, the unborn child kicked twice. The second time elicited that exact same twinge of pain he’d felt before, a pain sharp enough to make him flinch. This time Doris didn’t notice, or else she confused it with the sudden shudder with which he came. Best of all, Wallingford would think later, Mrs. Clausen had then rewarded him with that special voice of hers, which he hadn’t heard in a long time.

“Ache all gone?” she’d asked. The hand, again of its own accord, slipped from her giant belly to her swollen breast, where she let it stay.

“Yes, thank you,” Patrick whispered, and fell into a dream. There was a smell he at first failed to recognize because it was so unfamiliar to him; it’s not a smell one experiences in New York or Boston. Pine needles! he suddenly realized.

There was the sound of water, but not the ocean and not from a tap. It was water lapping against the bow of a boat—or maybe slapping against a dock—but whatever water it was, it was music to the hand, which moved as softly as water itself over the enlarged contour of Mrs. Clausen’s breast. The twinge (even his memory of the twinge) was gone, and in its aftermath floated the best night’s sleep Wallingford would ever have, but for the disquieting thought, when he woke up, that the dream had seemed not quite his. It was also not as close to his cobalt-blue-capsule experience as he would have liked. To begin with, there’d been no sex in the dream, nor had Wallingford felt the heat of the sun in the planks of the dock, or the dock itself through what seemed to be a towel;