Page 582 - A Little Life: A Novel

Andy stops, placing his hands on his knees, and looks at them. For a long
while, none of them speaks, and then Willem begins to ask questions, smart
questions, questions he should be asking: How long is the outpatient

recovery period? What kind of physical therapy would he be doing? What
are the risks associated with the surgery? He half listens to the responses,
which he already knows, more or less, having researched these very
questions, this very scenario, every year since Andy had first suggested it to
him, seventeen years ago.
Finally, he interrupts them. “What happens if I say no?” he asks, and he
can see the dismay move across both of their faces.

“If you say no, we’ll keep pushing forward with everything we’ve been
doing and hope it works eventually,” Andy says. “But Jude, it’s always
better to have an amputation when you get to decide to have it, not when
you’re forced to have it.” He pauses. “If you get a blood infection, if you
develop sepsis, then we will have to amputate, and I won’t be able to
guarantee that you’ll keep the knees. I won’t be able to guarantee that you

won’t lose some other extremity—a finger; a hand—that the infection won’t
spread far beyond your lower legs.”
“But you can’t guarantee me that I’ll even keep the knees this time,” he
says, petulant. “You can’t guarantee I won’t develop sepsis in the future.”
“No,” Andy admits. “But as I said, I think there’s a very good chance you
will keep them. And I think if we remove this part of your body that’s so
gravely infected that it’ll help prevent further disease.”

They are all quiet again. “This sounds like a choice that isn’t a choice,”
he mutters.
Andy sighs. “As I said, Jude,” he says, “it is a choice. It’s your choice.
You don’t have to make it tomorrow, or even this week. But I want you to
think about it, carefully.”
He leaves, and he and Willem are left alone. “Do we have to talk about it

now?” he asks, when he can finally look at Willem, and Willem shakes his
head. Outside the sky is turning rose-colored; the sunset will be long and
beautiful. But he doesn’t want beauty. He wishes, suddenly, that he could
swim, but he hasn’t swum since the first bone infection. He hasn’t done
anything. He hasn’t gone anywhere. He has had to turn his London clients
over to a colleague, because his IV has tethered him to New York. His
muscles have disappeared: he is soft flesh on bone; he moves like an old

man. “I’m going to bed,” he tells Willem, and when Willem says, quietly,