A few years back, a car crash took my husband and my child.
After that, I was utterly alone. My life felt destroyed, and I could not see how I would move forward.
Bills still needed paying, and food still had to be bought, so I found work as a housekeeper at a nearby hospital.
I spent a couple of years there, mostly unnoticed. That was fine; I had shut myself off from everyone.
A little over a year ago, a man was admitted to one of the rooms.
His name was Daniel, and he had terminal cancer. A small girl, about six, sat with him often. Her name was Lily.
God, she reminded me so much of my late daughter.
After school each day she would arrive with her backpack, sit beside her father, and stay as long as she could.
Sometimes she even came by before school. Her hair was usually tangled, and she often appeared hungry. Daniel would fumble to braid her hair and share food from his breakfast tray.
It was heart-wrenching.
One day I could no longer watch from a distance. I went over and offered some help. I braided Lily’s hair, took her to the hospital cafeteria, and, with Daniel’s permission, drove her to school.
It became clear they had no one else.
That was how conversations with Daniel and Lily began.
Daniel eventually shared his story. His wife had died in childbirth, and he had been raising Lily alone.
Much time was spent together in his room—tea, small treats, and long talks.
Around them, unfamiliar feelings returned. Smiles came back. Life felt a bit alive again.
Then, while Lily was at school, Daniel took my hand and said:
“Please marry me.”
My legs went numb.
“But Daniel, we barely know each other…”
He smiled and said:
“Sweetheart, I’m begging you. Marry me. I know we haven’t known each other long, but I’ve fallen in love with you. And more than anything, I want to know that when I’m gone, Lily will be with someone who loves her. If you’re my wife, you’ll also be able to stay in this house and use what I leave behind to take care of her.”
My heart ached.
In that short time, both Daniel and Lily had become dear to me. Thinking of Lily, I realized I could not abandon her.
So I said yes.
The wedding took place in Daniel’s hospital room. I wore a white sundress, and Lily wore a sweet little dress.
Lily hugged me that day and said she was glad her dad would have me by his side in his final days.
Two weeks after the ceremony, Daniel died. I mourned him deeply.
Legally, I became Lily’s guardian.
We moved into the house Daniel had left. Life between Lily and me felt right, and I loved her as if she were my own.
A year went by.
No regrets. Lily brought life back into me.
Lately, though, Lily had been unusually quiet.
Repeated questions met with little response, until yesterday while I prepared dinner she approached me.
She extended a small box and said:
“Dad told me to give this to you today. You still have no idea why he chose you.”
My hands trembled as I opened it.
God, I sank into the kitchen chair.
When I saw what Daniel had left for me, I screamed so loudly it echoed through the entire house.
PART 2
Inside the box, wrapped in a square of faded yellow tissue paper, lay a tiny pink hospital bracelet.
I turned it over with a finger that would not stop shaking. It was a soft, narrow, translucent band of plastic, gone cloudy and brittle with age, with a snap closure and a printed label. The name had been typed on a machine that no longer exists. COLLINS, EMMA ROSE. DOB 08/23. Age 5.
I had last seen it on my daughter’s left wrist, in a hospital in Dayton, four years ago, on the worst night of my life.
I had never in all that time known where it went.
I do not remember the scream. I am told it was quite loud. I am told that the neighbor’s dog began to bark, two houses away, and that a woman walking by on the pavement stopped, with a stroller, and stood very still. What I remember is the kitchen. The yellow wallpaper with its faded teapots. The pot of soup on the stove, beginning, slowly, to scorch. The smell of onions. And a small, cold, slippery piece of plastic in my palm, with my daughter’s name on it, in a font like a ticker tape.
“Anna?” said Lily.
She was standing at the end of the table, in her blue school cardigan, with her hands folded in front of her. She was seven. She was a small, pale, thin child, with long dark hair that I had braided that morning, and enormous gray eyes, and a way of standing very straight, with her chin up, as if she were bracing for a wind.
“It’s okay,” she said. “Dad said you’d cry.”
I could not speak.
“There’s a letter.” She pointed. “Underneath.”
I lifted the tissue.
There was an envelope. It was long and cream-colored, with a thin brown crease down the middle, as though it had been folded and unfolded and folded again. On the front, in Daniel’s tall, crabbed, shaky hand, was a single word.
Anna.
And, beneath it, another envelope. A small, square, lavender one. Soft at the edges. Stamped with a postmark I knew.
The handwriting on the front was mine.
To the family who received her heart.
I put my hand over my mouth.
I have to tell you what that meant.
I have to tell you that on the eleventh of March, four years ago, at ten past nine at night, on a wet road outside Dayton, a truck with a bad tire crossed the center line, and my husband and my five-year-old daughter died in the back of a blue minivan. I was not in the car. I was at work, on a double. I have thought about that every day since.
I have to tell you that at two the next morning, a woman in a navy cardigan sat down beside me in a hospital waiting room, on a molded plastic chair, and put a hand on my arm, and said, in the gentlest voice I have ever heard, that there was a very sick child in the pediatric unit, three floors up. A little girl. Three years old. With a heart that was failing. And that Emma’s heart was, if I wished it, a match.
I said yes.
I said it in about four seconds. I do not know why. I think I said it because it was the only thing in the world I could still do. I signed, with a pen I could not feel. I was not told the child’s name. That was the rule. I was told that the family would be informed, that I might, if I chose, write a letter, and that it might, in a year or two, be answered.
I wrote it. I wrote it that very week.
It was never answered.
I had stopped, I think, expecting it.
I tore open the lavender envelope. I do not know why. I knew every word. I had written them at my kitchen table, with a cup of cold tea, in a black dress, on the fourth day.
To the family who received her heart,
Her name was Emma. She was five. She loved lemon drops, and braids, and a purple stuffed octopus named Ollie. She was afraid of the dark, and brave about everything else. She sang in the car.
I do not know who you are. I hope you are well. I hope she is a good heart.
Please take care of it.
— Anna & Tom Collins
Pinned beneath it, in a small clear sleeve, was a three-by-five index card. It was typed. At the top, in capitals, in the stiff, flat font of a hospital form:
RECIPIENT: Marlowe, Lily Grace. DOB 07/19. Age at transplant: 3 yrs, 2 mos. Congenital hypoplastic left heart. DONOR: Collins, Emma Rose. Age 5.
I looked up.
Lily was looking at me.
She had come around the table. She stood very close, now, at my elbow, with her gray eyes fixed on my face, and her small, cool, dry hand lay, very lightly, on my sleeve. She did not smile. She was looking at me the way a person looks at a closed door, behind which something she has long wished for is waiting.
“Dad said you wouldn’t know,” said Lily.
“I didn’t.”
“He said it was a secret. For a year.” She swallowed. “He made me promise.”
I could not breathe.
“Lily,” I whispered. “Honey. Is this — are you—”
“I’ve got her heart,” said Lily.
She said it quite simply.
And then, very gently, as one lays a hand on a sleeping animal, she took my palm, and pressed it against the front of her blue cardigan, over the place where her ribs met. I felt the soft wool. I felt the small, warm, fragile, narrow chest beneath.
I felt it beat.
PART 3
I will tell you what it is like to feel your daughter’s heart.
I cannot. I have tried, many times, in the long dark hours since, to find the words, and there are none. There is only a quick, steady, faintly irregular little thud, against the heel of my hand, like a bird at a window. There is the way my own breath stopped, and my own pulse, so that for a long, strange, suspended moment, in the yellow kitchen with the scorching soup, there seemed to be only one rhythm in the room.
“It talks to me sometimes,” said Lily.
I looked at her.
“At night. When I’m — when I can’t sleep.” She did not take her eyes from mine. “It goes faster. It sounds like—” She hesitated. “It sounds like it’s looking for something.”
I put my other hand over my mouth.
“I used to think it was scared,” said Lily. “But then you came. And at the hospital, when you braided my hair, it went—” She made a small, fluttering motion with her fingers. “It went like that.“
I knelt.
I did not decide to. My knees simply went. I was on the cracked yellow linoleum of my own kitchen floor, with my arms around a seven-year-old girl, and my face in her thin shoulder, and the whole world was a roaring, soundless white.
“Oh, Lily,” I said.
“I’m sorry I didn’t tell you.”
“No.”
“I wanted to. For a year. But Dad said — it was in the letter. He said I had to wait until the anniversary. And then I got scared.” Her voice broke. “I thought you’d be sad. I thought you’d look at me, and you’d see her. And you wouldn’t want me.”
I pulled back.
I took her face in both my hands. It was small, cold, damp, pinched with an old, patient, practiced fear. It was the face of a child who has spent a whole year bracing herself for a loss.
“Lily Grace Marlowe,” I said.
She stared at me.
“I want you to listen. I want you to hear every word.” My voice was shaking, and I let it. “I do not look at you and see her. I look at you and see you. I see a girl who hates peas, and sings in the bathtub, and cheats at Go Fish. I see somebody who is brave, and funny, and a little bit bossy.” I drew a breath. “I’d have loved you anyway.”
“Even if I didn’t have—”
“Even if you’d had no heart at all.”
She began, very slowly, to cry.
I held her.
I do not know how long. We sat on the floor of the kitchen, with my back against the stove and the soup long since burnt black in its pot, and the light slid from yellow to orange to gray across the teapot wallpaper. At some point the smoke alarm went off. Neither of us moved. At some point, Lily’s head came down on my shoulder, heavy and warm, and her breathing slowed, and I understood that she had fallen asleep.
I read Daniel’s letter by the light of the oven.
It was two pages long. It was written in the tall, crabbed, trembling hand of a man who has less strength in his fingers than he would like.
Dear Anna,
By the time you read this, I will have been gone a year, and you will have had a year with her. I hope it has been a good one. I hope she’s been a pain.
I am going to tell you why I chose you. I owe you the truth, and I haven’t the time to be tactful.
I knew who you were the first week.
I didn’t recognize your face. You wouldn’t have expected me to. But you were braiding my daughter’s hair, in the corridor, and you said, to nobody, in a voice you probably didn’t know you’d used: “Emma never could sit still for a French plait.”
I had your letter. I’d kept it, in my wallet, for three years. I read it so many times it went soft. I never answered it, because I did not know how. What do you say? “Thank you” is such a very small phrase.
I wanted to tell you. In the first week, I wanted to say it. But I had six months, and a little girl, and no one. And I was afraid. I thought, if I tell her, she’ll think it’s the only reason. She’ll think I’m using her.
So I did a thing I’m not proud of. I waited.
And then you stayed. Day after day. You brought her socks. You brought me tea. And somewhere in there, God help me, I stopped being grateful, and started being in love.
I did not marry you because of the heart, Anna. I need you to understand that. I married you because you are the kindest person I have ever met. I married you because I wanted my daughter to have a mother who would sit on a cold floor for her.
But I won’t deny that when I looked at you, I saw something else, too. I saw a woman whose daughter had stopped. And a child whose heart had not.
They belonged together. I only had to wait for them to find it.
Be good to each other.
— D.
I folded the pages.
I held them against my chest.
I looked down at the small, sleeping, dark-haired girl in my lap, with her hand curled in the front of my dress, and a damp patch on my shoulder where her cheek had been.
And, through the wall of the old house, in the gray, ordinary, humming dusk, I heard, or thought I heard, the quick, faint, steady drum.
PART 4
It was three in the morning, the following Thursday, when Lily woke me.
I felt it before I heard it. A small, cold hand, on my arm. A voice, so low that I thought for a moment it was a dream.
“Anna.”
I sat up.
She was standing beside my bed, in her yellow nightgown, with her hair in a tangle, and her face, in the moonlight from the window, the color of old candle wax. She had one hand pressed flat against her breastbone.
“What is it, sweetheart?”
“It feels funny.”
“What does?”
“My heart.” She swallowed. “It feels like — it’s going so fast. And it’s flipping. Like a fish.”
I was out of the bed before she finished.
I will tell you what I did, because I have been proud of it ever since. I did not panic. I took her hand. I put two fingers on her wrist. It was racing, a thin, thready, irregular flutter, like a moth caught in a jar. Her skin was clammy. Her lips, in the dim light, were a faint, bluish gray.
“Okay,” I said. “Okay, baby. We’re going to the hospital.”
“Am I dying?”
“No.”
“Is it rejecting?”
I did not answer.
She had been taught the word at four. She had grown up with it, as other children grow up with the word bedtime. She knew the names of her medications. She knew the dose. She knew, I realized, with a cold lurch, exactly what was happening.
“Anna,” said Lily. “I didn’t take them. On Tuesday.”
“What?”
“The pills. I — I was so scared. After the box. I thought, if I don’t take them, maybe it’ll — I don’t know.” Tears began to run down her face. “I thought, maybe if it goes away, you won’t be sad.”
I picked her up.
I carried her down the stairs, in my nightgown, with her face against my neck, and out into the cold black yard, and into the car. I drove to St. Anne’s at fifty-five in a thirty-five zone. I do not remember the road. I remember only the small, rapid, shuddering breath at my shoulder, and my own voice, saying, over and over, in a low steady murmur, you did nothing wrong. You did nothing wrong. You did nothing wrong.
They took her in at 3:41.
The pediatric cardiologist was a tall, spare, gray-haired woman named Dr. Lindqvist, who had been Lily’s doctor since she was three. She met us at the doors in a white coat and a pair of clogs, with her hair standing on end. She took one look at Lily, and one look at me, and said, quite quietly, “Acute rejection. Early. Mild to moderate, I’d say. We’ll know after the biopsy.” She laid a hand on my arm. “Mrs. Marlowe. I need you to stay calm.”
“It’s Collins,” I said. My voice was a thread. “I’m not — it’s Anna Collins. I’m — her guardian.”
Dr. Lindqvist looked at me.
Something moved, very slightly, in her face.
“I see,” she said. “Yes. I think I remember.”
I did not ask what she remembered.
They took Lily into a bright white room, with a bed and a monitor and a great many wires. I stood in the corridor, with my hands pressed against a pane of glass. I watched a nurse in blue scrubs lift her gown. I watched a tube go in. I watched the monitor above her head flicker, and steady, and begin to tick.
It was a small green line.
It rose, and fell, and rose.
I put my hand against the glass.
Please, I said.
I did not know whom I was speaking to.
Please. Not her. Not again. I can’t. I can’t do it twice.
Dr. Lindqvist came out at five.
She was wiping her hands on a towel. She looked tired, and old, and steady. She stood beside me, at the window, for a long time, without saying anything, watching the small green line.
“We’ve started steroids,” she said. “She’s responding. It’s a good sign.” She paused. “The next twelve hours will tell us a great deal.”
“Is she going to—”
“I don’t know.” She said it very gently. “I’d like to be honest with you. I don’t know.”
I closed my eyes.
“Mrs. Collins.”
I looked at her.
“May I tell you something?” said Dr. Lindqvist. “I’m not supposed to. It’s — it’s against the rules. But I’ve been a transplant doctor for thirty years, and I have never in all that time seen what I saw, this past year, in that child.”
“What?”
“She’s happy.” Her eyes were bright. “She came in for her checkup in October. I put the stethoscope on her chest. And I thought: this heart is singing.” She smiled, faintly. “I’ve never said that to a parent. It isn’t a clinical term.”
I put my face in my hands.
“Go in,” said Dr. Lindqvist. “She’s awake. She’s been asking.”
PART 5
I went in.
She lay in the high white bed, small and thin and very pale, in a gown too big for her, with a plastic bracelet on her wrist and a clear tube taped to the back of her hand. Her hair had been braided, by a nurse, in two crooked plaits. Her eyes were closed. On the monitor above her, the green line rose and fell, rose and fell, in a slow, steady, unhurried rhythm.
I sat down on the edge of the bed.
I did not touch her. I did not trust my hands. I sat very still, in my crumpled nightgown, with my coat over my shoulders, and watched her chest go up and down.
“Anna?” said Lily.
“I’m here.”
“Is it mad at me?”
“Is what mad at you, sweetheart?”
“The heart.” She opened her eyes. They were enormous. “I didn’t take my pills. It might be mad.”
I laughed.
I could not help it. It came out of me in a cracked, wet, hiccuping gasp. “No, baby,” I said. “It isn’t mad.”
“How do you know?”
I thought about it.
I thought of a small girl, in a car seat, in a blue minivan, singing, off-key, the second verse of a song about a purple octopus. I thought of a child who had been afraid of the dark, and brave about everything else.
“Because I know the person it came from,” I said. “She was never mad at anybody for more than about four minutes.”
Lily’s mouth twitched.
“She sounds nice.”
“She was very nice. And very stubborn. And she’d have loved you.”
“Would she have liked me?”
“Lily Grace,” I said. “She’d have followed you around like a duckling.”
A small, wavering, tentative smile appeared on her face. It was like watching the sun come up on a very gray morning.
“Anna?”
“Mm?”
“Can I listen?”
I looked at her.
“To your heart,” she said. “Not mine. I think — I think hers might like to hear it.”
I did not answer.
I bent. I lowered my head, very slowly, as one lowers it to a shrine, and laid it against her narrow chest, on the thin cotton gown, over the place where her ribs met. And she put her hand, very lightly, on the back of my hair.
I listened.
I heard it.
It was a quick, soft, steady thud. Faintly irregular, like a drum played by a child. Steady. Insistent. There. There. There.
I do not know how long we stayed that way.
I know that the sun came up. I know that a nurse came in, a young woman in blue scrubs, and stood in the door, and went quietly out again. I know that the green line on the monitor, which had been wavering, went, by degrees, smooth. I know that, at some point, the drum began to slow.
I know that I was crying.
I know that I was, at last, entirely, helplessly, thankfully, home.
Lily came home on the following Tuesday.
She is well. I want to say that, as plainly as I can, because I know it is what you will want to know. Her biopsy was clean in a week. The steroids did their work. She takes every pill, now, at eight and eight, with a glass of orange juice and a small, formal, enormously serious air. She has an alarm on her wrist, shaped like a ladybug. She wears it to bed.
I adopted her in March.
It was a quiet, sunny, ordinary morning in a small paneled room at the county courthouse. There was a judge, a heavyset, kindly man in a black robe, who said, Mrs. Collins, do you understand that this is permanent? and I said, yes, Your Honor, I do. There was a long pause. There was a stamp.
There was a little girl, in a blue dress, who stood on the chair and shouted, in a clear, carrying, triumphant voice, so that the whole courtroom turned: “She’s MINE!”
Her name, now, is Lily Grace Marlowe-Collins.
It is a long name. She insists on all of it. She writes it, with a flourish, at the top of every school paper, in purple crayon.
On the eleventh of March, we drive to Dayton.
We go to a small, green, grassy cemetery on a hill, with a view of the river, and a single tall oak tree. We carry a bag of lemon drops, and a purple stuffed octopus, which Lily has chosen herself, at the toy shop on Fulton Street, after long and solemn consideration. We stand in front of a plain gray stone with two names on it.
THOMAS JAMES COLLINS. EMMA ROSE COLLINS.
She does not say anything.
She kneels, in her good blue dress, in the damp grass. She sets the octopus on the stone. She tucks a lemon drop, carefully, under its arm. And then she lays her small, thin, dark-haired head against the cold granite, and presses her hand, very lightly, to the front of her coat.
I stand behind her.
I do not need to ask.
I know, because I have heard it. In the evenings, on the sofa, with the lamp on and her head in my lap, a quick, soft, steady drum. A heartbeat, that I would know in a thousand. A little girl’s, and not a little girl’s. Mine, and not mine.
Daniel wrote, in his letter, that he did not know how to say thank you.
I have thought about that a great deal.
I think he did.
He said it in the only way a man in his position could. He gave my daughter’s heart a home. And he gave me, in return, the only thing I had ever wanted.
He gave me somewhere to put my love.
