Grief’s Gravity

A frail girl, a huge institution, a medical disaster, idolatry and bigotry, it smelled so American — and like a big book. Ambition fluttered: Jesica had borne the brunt of others’ mistakes, and had sent the only flares she could: The organs, I read, had quickly turned from a healthy red to a livid purple, as her body went into seizures, trying again and again to reject them. I would not let this horror, and the xenophobia directed at Jesica’s family, and Duke’s obfuscation, be thrown away like yesterday’s news. I would write a book, for fame and glory, but also to keep Jesica alive, in words.

I was at the zoo when the news broke that Elizabeth Smart had been found alive. As the word miracle buzzed from the cubicles, I thought, where was Jesica’s miracle? Within two days, it was reported more than 100 movie and book offers had poured in for Smart’s story. I suspected I was the only one writing about Jesica, and was so glad.

Not that the issue had dropped off the radar: The March 16 New York Times Magazine was devoted to medicine, and titled “Half of What Doctors Know Is Wrong.” Though there was nothing in it specifically about Jesica, the thrust of the issue was that medicine is an evolving and ever-reactive odyssey. That same night, Duke University Hospital’s CEO, Dr. William Fulkerson, told Ed Bradley, on a segment of 60 Minutes about Jesica titled “Anatomy of a Mistake,” “Unfortunately, I think historically the way a lot of issues have been identified and analyzed and improved has been in a reactive fashion, after something has occurred. And unfortunately, we’re reacting in [Jesica’s] case.”

Yes, I told the friends watching the program with me, except that Jesica’s death was not the result of some cutting-edge technology doctors are still getting the bugs out of, or an unforeseen problem encountered during surgery. This was a simple screwup: Dr. James Jaggers got a call about an available heart, type A blood, and when the patient for whom the organ had been offered — a patient whose name appeared on the list of possible recipients — was deemed an unsuitable match, Jaggers asked if there were lungs with the heart? And there were, and so began the process of the organs being flown from Boston, and Jesica being driven to Duke, and in order to save time (because the highly perishable organs were held up on the runway in Boston for an hour due to bad weather), she was prepped for surgery, possibly (probably) to the point where her own organs were removed and she was placed on life support. But there was a problem: Jaggers had neglected to check whether the organs’ blood type matched Jesica’s, whose name, while on a national registry, had not appeared on this list as a possible recipient for these organs because she was type O.

During his 60 Minutes interview, Jaggers struck me as a man divided: shattered during the opening, as though he was moving robotically through his life. And then, fatalistic, explaining that what he and others do is miraculous, it’s extraordinary, and sometimes things go wrong, and patients do not live. He said something about it being 3 in the morning when he got the call about the organs, and maybe his judgment was off. I had no idea what to make of Jaggers.

***

I boarded a plane for North Carolina in late March. From Raleigh-Durham, the Mahoneys’ home was a 45-mile drive, in Louisburg, in a half-built subdivision at the end of a circular court. As a runty, bat-eared dog barked at our feet, Nita threw her arms around me in welcome, then sat me at her kitchen counter and poured me a big glass of Diet Coke.

“Me and Mack are just common folk,” she said. She did look the part in a large smock-like top, short mussed hair, and a light sweat going at all times from diabetes and high blood pressure.

“Move your car or my postman will have a fit,” was the first thing Mack said to me, as he came in from a job and tossed his keys on the counter crowded with junk food and paperwork. He’s of average height, and wore the Panama hat he always wore on TV, perhaps, I could now see, because he is bald. He has a scruffy auburn beard and had a portion of his jaw and throat scooped out to remove tumors brought on by Agent Orange. He waved off his wife’s offer of a cold drink and told me to follow him up to his attic office, which is also JHC headquarters.

The walls were covered with photos of six JHC kids — three of whom have died, one at Duke while Jesica was there — but mostly of Jesica, including a large studio portrait of her dressed as an angel, with Mack’s arm around her.

“She said she wanted to take a picture with me,” he said, smiling. “I said, ‘Jesica, I’m not even dressed up.’ She said, ‘Oh, it’s okay. You look like my Mack.’” He began to rock his office chair back and forth. “She was a beautiful girl. It was a shame what happened to that baby. You see how happy she was? When she was with us, she just glowed out loud.”