Chasing Hope

Jacqui spies a baby girl across the waiting room rolling around on the carpet. She blows kisses. "Ay, how pretty," Jacqui says.

On her lap, she cradles a blown-up photograph of her left eye. She's come to see Scheker, the reconstructive surgeon and hand specialist. The next day, Scheker and a reconstructive eye surgeon plan to operate to rebuild her left eyelid. They still haven't decided how.

Jacqui doesn't want to add scars to her face or take tissue from her feet, which are tempting sources of spare parts. Her feet are the only parts of her body that still have full sensation.

"You have to tell me what we're going to do," Scheker tells Jacqui in his gravelly Dominican accent. The doctor has a hands-on bedside manner and exudes relaxed cheer.

Jacqui got Scheker's name from a cousin. One day she cold-called him. He told her to come to Louisville for a look.

Scheker examines Jacqui's face and goes over options. One involves cutting tissue and a blood vessel from her foot to cover her eye.

"What do you want to do?" Scheker asks. They sit inches apart, their knees almost touching.

"I want an eyelid," she says softly.

The doctor leaves Jacqui and Amadeo to think. Minutes pass in heavy silence. Jacqui sighs and taps her foot. Amadeo massages her back.

"Each one has their own idea, and I don't want them to mess with my feet," she says.

When Scheker returns, Jacqui grills him, searching for another choice.

"I have a lot of affection for you," Scheker says, grinning, "but you set the bar very high."

They decide to postpone the operation while Jacqui thinks.

Before she leaves, Scheker examines her left arm. The arm has little sensation and she can't bend her fingers. A nerve must be blocked. They'll have to operate.

"You need so many things," he says.

Surgery, Aug. 24

The Saburidos are due in the hospital in 45 minutes for surgery on Jacqui's left arm and hand. Jacqui lies in bed as Amadeo tugs off the mask and hood.

"I want to sleep another minute," Jacqui mumbles into her pillow.

"It's 7:30 a.m.," Amadeo says impatiently. "Get up. What are you going to wear?"

"Ay, Tito, let go of the stress," she says. Jacqui sits on her bed, daydreaming as Amadeo hastily puts in drops and pulls on her eye goggle. He prods her to move quicker.

"It's always the same with you, your whole life," he says.

"That's how I am, I am like that," Jacqui sings like a nursery rhyme. "And no one is going to change me."

Amadeo pulls her lime green shirt from the closet. "My white hat, please," she says.

Before leaving, Jacqui adjusts her hat and pauses before the wall of saints and teddy bears. She and her father pray in silence.

"Vamos," she says and plunges down the stairs, counting until she reaches 17, then waits for her father to catch up.

THE WAITING ROOM

Amadeo sits alone in the waiting room. When Jacqui went back to prep for surgery, she didn't ask him to come. She wants to do more on her own, he says.

They have faith in this doctor. Maybe she can regain some independence, he thinks. Maybe she'll be able to use her hands.

They've talked about other possibilities, like cutting off toes and attaching them to her hands like fingers. She's not ready for a sacrifice like that. Maybe in a few years.

Amadeo goes into the prep room to kiss her goodbye. She's lying on a gurney under white blankets, wearing a blue surgery cap.

He tells her what he always tells her: "You're going to be better after this. I'll be waiting for you at the door."

As she's wheeled away, he smiles.

THE OPERATION

Jacqui wants more anesthesia.

"You don't want to hear me sing?" Scheker asks as she goes under. Her clamped left arm rests atop deep blue mesh. Lit by two large, saucer-shaped lights, it looks ghostly white, like packaged frozen chicken.

As Jacqui sleeps, seven doctors and nurses take their places around the table. Soft rock music plays quietly over beeping monitors. Scheker perches on a stool, peers through long black eye scopes and draws a blue incision line along her elbow.

With a scalpel, he slices through her skin. With tweezers, scissors and an instrument shaped like a tuning fork, he makes slow, small cuts into the white scar tissue.

Jacqui's muscle looks pale. It should be pink.

Down below, embedded in the scar tissue, Scheker finds her nerve. He traces its path, pulling on it as he looks for the blockage. The line of nerve disappears into a clump of scar.

"Where does it go?" he says.

He works back from the other side, cutting gingerly, then stops.

The nerve isn't blocked. It's not there. Five centimeters are missing, replaced by scar tissue.

"Not good," he says.

Jacqui snores. Scheker takes off his green gown and gloves and walks out.

"When it rains, it pours," he says.

He meets Amadeo in the hallway. The two men lean against the wall, speaking quietly in Spanish as nurses chatter by.

"She has a little piece that's missing," Scheker explains. "Nerves can only be replaced with nerves. If we're going to replace a nerve, quite possibly it has to be from the foot."

"Do you want to make the decision?" he asks Amadeo.

Amadeo frowns, arms folded.

"I don't want to decide for her," he says in his low, calm voice.

Scheker rubs his hands and claps. We'll forget about the nerve for now, he says. Instead, he plans to lengthen her left fingers by widening their web space.

"See you in two hours," he says. Returning to the operating room, Scheker blows through closed lips: Pphhh.

He pulls down his mask and begins cutting the yellowish skin between Jacqui's pinkie and second finger. He cuts as far as he can go.

"She doesn't pity herself," one doctor says as he watches Scheker. "That doesn't happen much."

Scheker moves to the space between the thumb and index finger.

The incisions are only 2 centimeters wide and 2 centimeters deep, but Scheker hopes the cuts will give her fingers more maneuvering room. He sews skin grafts cut from Jacqui's side over the wounds, then pulls up his mask and walks out.