attachment, Wallingford could tell at what stages Doris had photographed him with Otto’s hand—what she had called the third one.

So he hadn’t dreamed that he was having his picture taken in his sleep. That was why the sound of the shutter had seemed so real. And with his eyes shut, naturally the flash would have struck him as faint and distant, as incomplete as heat lightning—just the way Wallingford remembered it.

“Please throw them away,” Mrs. Clausen asked. “I’ve tried, but I can’t make myself do it. Please just get rid of them.”

“Okay,” Patrick said.

She was crying again, and he reached out to her. He’d never initiated touching her breast with his stump before. Even through her parka, he could feel her breast; when she clasped his forearm tightly there, he could also feel her breathing.

“Just don’t ever think I haven’t lost something, too,” Mrs. Clausen told him angrily.

Doris drove on to the hotel. After she’d handed Patrick the keys and had gone ahead of him into the lobby, he was left to park the car. (He decided to have someone from the hotel do it.)

Then he disposed of the photographs—he dropped them, and the envelope, in a public trash receptacle. They were quickly gone, but he’d not missed their message. Wallingford knew that Mrs. Clausen had just told him all she ever would about her obsession; showing him those photographs of the hand was the absolute end of what she had to say about it.

What had Dr. Zajac said? There was no medical reason why the hand-transplant surgery hadn’t worked; Zajac couldn’t explain the mystery. But it was no mystery to Patrick Wallingford, whose imagination didn’t suffer the constraints of a scientific mind. The hand had finished with its business—that was all. Interestingly, Dr. Zajac had little to say to his students at Harvard Medical School on the subject of “professional disappointment.” Zajac was happy in his semiretirement with Irma and Rudy and the twins; he thought professional disappointment was as anticlimactic as professional success.

“Get your lives together,” Zajac told his Harvard students. “If you’ve already come this far, your professions should take care of themselves.” But what do medicalschool students know about having lives ? They haven’t had time to have lives. Wallingford went up to Doris Clausen, who was waiting for him in the lobby. They took the elevator to his hotel room without exchanging a word. He let her use the bathroom first. For all her plans, Doris had brought nothing with her but a toothbrush, which she carried in her purse. And in her haste to get ready for bed, she forgot to show Patrick the platinum wedding rings, which were also in her purse. (She would show him the rings in the morning.)

While Mrs. Clausen was in the bathroom, Wallingford watched the late-night news—as a matter of principle, not on his old channel. One of the sports hacks had already leaked the story of Patrick’s dismissal to another network; it made a good show-ender, a better-than-average kicker. “Lion Guy Gets Ax from Pretty Mary Shanahan.” (That was who she would be from this time forth: “Pretty Mary.”) Mrs. Clausen had come out of the bathroom, naked, and was standing beside him. Patrick quickly used the bathroom while Doris watched the wrap-up of the Green Bay game. She was surprised that Dorsey Levens had carried the ball twenty-four times for 104 yards, a solid performance for him in a losing cause. When Wallingford, also naked, came out of the bathroom, Mrs. Clausen had already switched off the TV and was waiting for him in the big bed. Patrick turned out the lights and got into bed beside her. They held each other while they listened to the wind—it was blowing hard, in gusts, but they soon ceased to hear it.

“Give me your hand,” Doris said. He knew which one she meant. Wallingford began by holding Mrs. Clausen’s neck in the crook of his right arm; with his right hand, he held fast to one of her breasts. She started by scissoring the stump of his left forearm between her thighs, where he could feel the lost fingers of his fourth hand touching her.

Outside their warm hotel, the cold wind was a harbinger of the coming winter, but they heard only their own harsh breathing. Like other lovers, they were oblivious to the swirling wind, which blew on and on in the wild, uncaring Wisconsin night.

ACKNOWLEDGMENTS

I AM INDEBTED TO Charles Gibson at ABC News and Good Morning America for his sixteen-page, single-spaced fax to me—the most detailed notes I received on the first draft of this (or any other) novel. Thank you, Charlie. I owe a similar debt to Dr. Martin Schwartz in Toronto; this isn’t the first time that Dr. Schwartz has advised me on the medical verisimilitude in a work of fiction. Thank you again, Marty.

I am grateful to David Maraniss, whom I consulted on matters pertaining to Lambeau Field and the Green Bay Packers, and to Jane Mayer for her insightful article “Bad News,” which was published in the August 14, 2000, New Yorker. In The New York Times of November 1 and 2, 1999, the reporting of the crash of EgyptAir 990 was most informative to me—in particular, pieces by Francis X. Clines, John Kifner, Robert D. McFadden, Andrew C. Revkin, Susan Sachs, Matthew L. Wald, and Amy Waldman. Dr. Lawrence K. Altman’s three stories on hand-transplant surgeries were especially enlightening; they appeared in the Times on January 26, 1999, January 15, 2000, and February 27, 2001. As for the glut of commentary and opinion that followed the death of John F. Kennedy, Jr., my sources were largely undistinguished (and often indistinguishable from one another) and too numerous to cite. The same can be said for most of the television I watched on the subject.

Not least, I would like to thank the three assistants who worked for me in the period of time this novel was written: for their careful typing and proofreading of the manuscript, and their thoughtful criticism, my thanks to Chloe Bland, Edward McPherson, and Kelly Harper Berkson. More than ever, my editor, Harvey Ginsberg, has made me look better than I am. And, as always, to my friend David Calicchio and my wife, Janet, who both read this novel more than once—thanks again.

Janet gave me the idea for The Fourth Hand. One night we were watching the news on television before we went to bed. A story about the nation’s first hand transplant got our attention. There were only brief views of the surgical procedure, and hardly a word about how the patient—the recipient, as I thought of him—lost his hand in the first place. There was nothing about the donor. The new hand had to have come from someone who’d died recently; probably he’d had a family. Janet asked the inspiring question: “What if the donor’s widow demands visitation rights with the hand?”

Dr. John C. Baldwin, the Dean of Dartmouth Medical School, has assured me that this probably wouldn’t happen in what we call real life—not without the unlikely concurrence of enough lawyers and medical ethicists to start a small liberal-arts college. But I always listen to the storytelling possibilities. Every novel I’ve written has begun with a “What if…”

—J.I.

ALSO BY JOHN IRVING

BOOKS

My Movie Business

A Widow for One Year

Trying to Save Piggy Sneed

A Son of the Circus

A Prayer for Owen Meany

The Cider House Rules

The Hotel New Hampshire

The World According to Garp

The 158-Pound Marriage

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