Cold Hearts

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“Where is he?” Doris said in a shout that echoed through the waiting area. People bot sick and waiting turned and what they saw were two people, parents presumably, followed by a third, a girl of no more than seventeen, hair dyed black, and anger in her eyes. It was the same anger that her mother Doris had. Mad at the world but scared too. The father, Richard, was in a daze. He looked at the surprised receptionist with no emotion, no anything, like a dust mote just floating by.

The receptionist came from behind her desk and approached them quickly. Her hair was pinned back, all business. Her right hand had a metallic gleam. It was robotic, but with her deep blue turtle neck sweater, there was no telling how far up the robotics went. “I’m sorry mam, who are you looking for?” The receptionist asked without judgment. She had been there before, on the other side of this conversation.

“My son, where is my son?” Doris’s demanded. She couldn’t help but eye the robotic hand.

“Jacob, her son is Jacob Larsen,” Francine, the daughter, said quickly. “We were told that he was brought here. Is he okay?”

The receptionist asked for their names. The question flustered Doris, but Francine gave their names.

“Okay, let me see here,” the receptionist said as her robotic fingers flicked across a screen. “He is in surgery now, but that is all I can really tell you. I need to have you go on over to C-Wing. That’s straight through there,” she pointed her robotic hand beyond the people. “You will turn left at the reception desk, and then you will look for a sign that says, ‘ICU Waiting.’ I will let the nurses know you’re on your way.”

“But is he okay?” Doris said as Francine tried to corral both her parents along, “I just need to know that he’s okay.”

The receptionist put her robotic hand on Doris’s shoulder, and Doris recoiled. If the receptionist noticed, she didn’t seem to mind. “They are doing their best mam, and if you go to the ICU waiting area they will have more information for you.” If Francine hadn’t pushed her mother along this would’ve turned into an argument.

They were together when the call came to the house. Jacob had been in a car wreck. Even with self-driving cars, things still did happen.

Richard sat in the corner of the empty waiting room. His hands rubbed against his knees impatiently as his eyes darted around the room. Occasionally they would pick out a word on a magazine from the nearby table. His mind would latch onto the word, if only briefly. It lessened the sting of waiting, but eventually, the pain returned. They had been waiting for just over three hours now and had come no closer to knowing what Jacob’s condition was.

Francine and her mother were pacing at opposite sides of the room. If not for this shared trait, it would have been hard to tell that they were related at all. Maybe the fair complexion could have given it away, but not much else. Francine was tall and slender of face and body. Her nose was her dominant facial feature. It wasn’t big so much as it was long, making the gap from her eyes to her mouth larger in proportion to the rest of her face.

Her mother was a rounder woman. Her short hair was the color of worn sandalwood and anyone could tell that she took care of it. Even now, when her hair caught the light just right, it would almost glow.

The mother was crying, sobbing, and speaking to herself. All that her family could hear from her were phrases like, “I don’t understand,” and, “I just don’t understand.”

Francine was pacing sharply, turning almost like a soldier mid-march. Words never left her mouth. Instead, her lips just drew back exposing her teeth slightly. There was a small zit, or possibly a mole on the side of her neck that she kept picking at. The dark curtain of her hair concealed it from view, and she had been unaware of its presence before tonight. The picking of it had quickly become a nervous habit, and whenever her mind wandered too close to Jacob her hand went back to the site on her neck.

Doris stopped her own pacing to watch her daughter. Doris saw her daughter’s worried face, her distant eyes, and her idle neck picking. “Francine? Are you going to be okay? Do you need… anything?”

Francine rolled her eyes, “Not now Ma.”

“But honey.”

Richard got up. “Leave her be dear.”

“But this has to be hard on her.”

“It’s hard on all of us Ma.” Francine moved away and into her own little corner of the waiting area, Doris tried to follow, but Richard stopped her.

More hours ticked off the clock, and the room was still empty except for them. It had been designed that way. Designed to give the friends and family who were going through the hard times, some space to themselves.

Francine had had enough space. Francine wanted answers. In a small huff, she set herself to going outside the waiting room and looking for somebody. Doris and Richard’s eyes just followed her, wishing that it had been their idea, and wordlessly wishing her good luck.

Before Francine even made it to the door, a doctor came in.

“Is this the Larsen family?” he held a tablet and only looked up from it briefly to address the group.

Richard shot up from his chair and the three of them quickly formed a huddle in front of the man in the white lab coat. They were together when they got the call, and they would be together now.

“My son?” Doris said in her tear-soaked voice, “How is my son?”

“We think your son will be fine. He endured a great deal of chest trauma. We were able to bring back the collapsed lungs. His ruptured gallbladder had to be removed, but that can be replaced with an implant down the road should he choose. The heart however, was the worst. It had a small tear and was pumping blood into the chest cavity. By the time we got to it, the heart had too much damaged tissue for Jacob to ever lead a normal life again. Trying to repair the heart at that point would have likely resulted in death. The consulting doctors and I decided that a replacement heart would be the best course of action.”

“So he’s going to be okay?” Doris asked letting hope slip into her voice.

“He’s not out of the woods yet. The heart has been switched on, and his body appears to be holding blood and oxygenating correctly, but his breathing is still unstable.”

“Wait,” Francine said seriously. “You put a robotic heart in him?”

“Yes, but I can assure you they’re perfectly safe.”

“He’s an anti-ferrite,” Francine said as she narrowed her eyes. “He doesn’t believe in having mechanical augmentations.”

The doctor gave the slightest sign of an exhale. “I’m sorry. Unfortunately, this was the best and only option that we had. Live heart transplants are rarely available in emergency situations like these. On the bright side, Kold Hearts are nine times less likely to be rejected by the body, and the recovery process can usually occur at an accelerated pace.”

“I am sorry,” Richard said. “Cold hearts?”

“Yeah, it’s just a brand name. It’s spelled with a ‘K.’ The heart isn’t actually cold. I believe it’s the last name of the lead medical engineer on the project. Dimla, the manufacturer, names a lot of their organs like that.”

“Oh,” Richard said.

“Well when do we get to see him?” Francine asked.

“If everything goes well, I would say you should get to see him in a few hours. He will probably be out for the rest of the day though. He is on a ventilator, a breathing tube, and they can be quite uncomfortable. Until he is strong enough to breathe on his own, we will keep him sedated.”

“I don’t suppose you’re going to replace his lungs too?” Francine said flippantly. She spun away returning to the safety of the waiting room.

After the doctor left, Doris found Francine holed up in her own little corner again. “At least he will be okay,” her mother said.

“What about his beliefs? Don’t they mean anything?”

“Why are you taking this so hard? They are my beliefs to you know, but I am just happy that he’s alive.”

“And what if he doesn’t make it?”

Rage boiled up in Doris, and she almost hit Francine. She had never hit her before. The rage, without any other place to go, went into her voice. “Don’t you talk like that! We have come too far, and he is too strong!”

“So, you’re just trading away your beliefs?”

“No, I will keep my beliefs, and I will keep my son. Both are suffering today, and both will live until tomorrow. If the choice were left up to me I would have made the same decision as the doctors.”

“Then what is the point of your beliefs? What is the point of being an anti-ferrite?”

“It’s about the preservation of life, human life, the way the world made it. In a way that was still upheld today. At least as far as I’m concerned. Besides, what do you care? You don’t believe like we do?”

“I care because he cared.”

“Alright that’s enough,” Richard said in a voice that slowly built into a shout. “We’ll just wait here. Wait. Not argue.”


The air in Jacob’s room was stale. Francine hated watching his chest rise in-tune with the machine next to him. It wasn’t the machine that bothered her, not really. It was the image of his broken ribs expanding against the force of his inflating lungs. She kept looking for signs of pain in Jacob’s placid face. There was no heart rate monitor in the room. Instead, a computer screen plugged into a small port on his arm. The screen streamed out bits of data, oxygenation levels, pressures, and blood cell counts among many other things. She watched the numbers fluctuate, trying to associate meaning with each one.

Doris held her son’s hand and kept talking to him in low tones. “We are here now. You are safe,” she uttered on more than one occasion. Her face twisted into a sad smile. The doctors had high hopes for his recovery. The new heart, which claimed to have higher efficiency than any mere human heart, would make the job even easier on the lungs. None of this settled Doris’s mind. Now that she was with her son, all she could do was worry.

Richard held himself in the back of the room for a long time. He stared at his son’s body as it mechanically inflated and deflated. It felt like his son was there and then it didn’t. When he did approach, it was because of curiosity and not compassion. He stared at Jacob’s heart numbers for a long while, looking for the small changes that would indicate something. He noticed a new piece of jewelry around Jacob’s neck. A small metal tag shaped almost like a tombstone. There looked to be some circuitry inside it. An identification tag maybe. Imprinted in the metal was the word “Pulse-less.” He carefully leaned in over his son’s chest. Carefully he pressed his ear against where the beating of Jacob’s heart should be. Carefully he listened and heard a gentle whir. No beat, no pulse, just whir, whir, whir.


Slap, slap, slap, went Jacob’s feet as they pounded against the orange-red tarmac. His breath was hot in his lungs, but it did not burn. He looked at his watch, and, out of instinct, he almost tried to take his pulse. The others would be waking up now, he thought, time to be getting home.

He took one more lap, just a quick one, and then ran out of the chain-link fence enclosure. It was his old high school, but during the summer kids rarely came to run the track. He had been running every day since the kids stopped coming.

When he came in through the door, he saw the empty dining room table. He checked his watch again, before shrugging and heading into the kitchen to make his own breakfast.

He grabbed a box of pancake mix and found a package of bacon. A voice from behind him said, “What are you making me?”

Without turning, Jacob replied, “How is it that you always have perfect timing Francine?”

“I don’t know. Just lucky I guess.” She slid out a chair and took a seat. “Could you hurry up? I’m starving.”

“Where’s Mom and Dad?”

“There’s some farmer’s market thing that they wanted to go to.”

“And why didn’t you go?”

“Are you serious?”

Jacob laughed, “In all honesty, I am surprised you still live here.” He poured out the first of the pancakes on the griddle and laid in a few strips of bacon.

“I only just turned eighteen. Is it that hard to believe?”

Jacob turned to smile at Francine. “Yeah a little,” he said.

Francine laughed with a raspy little laugh that only Jacob could seem to draw from her.

They occupied the kitchen in relative silence as Jacob finished making breakfast. He plopped a plate down in front of her and set his tablet down by his own plate before taking a seat.

Francine could make out apartments on the screen. “Are you looking for something for me?” Francine asked.

“No, myself, but I will let you know if there are any places that you can stay rent-free.”

“Don’t you think it’s a little soon? Aren’t you still in recovery?”

Without looking up Jacob replied, “Technically, but it was almost six months ago now. I just ran five miles. That’s like, something I’ve only been able to do in high school.”

“You are just exercise obsessed now. You’d think you had a heart attack or something.”

“And I think I’m beyond needing Mom and Dad’s care. I mean living here is great and all, but you of all people should know how annoying they can be,” he looked up with a wry smile.

“You better stay in town this time. I might need a couch to crash on. When you aren’t around Mom and Dad expect me to be perfect like you were.”

“And we all know how impossible that is. I’ll have a couch for you. Don’t worry.”

“What about a job? You’re going to need one of those.”

“I’ll manage. I have a few interviews this week already.”

“Where at?” Francine asked out of politeness.

“Dimla Pharmaceuticals for one.”

“What? The organ manufacturer? Do Mom and Dad know?”

“No, they don’t know. What’s the big deal?”

“Are you a ferrite now? Did that heart change you?”

“No, it didn’t change me. I’m allowed to change my beliefs, aren’t I? This thing in my chest saved my life. I have to recognize the value in that.”

Francine exhaled and went back to her pancakes. She shot a glance at Jacob from under her brow, “Are you going to change your mind too?”

“What do you mean?”

“I mean literally. Get rid of that old gray mush pile and go with something robotic. If you can’t have beauty, you might as well pay for brains.”

“Why stop there? I can pay for beauty too.”

“For you, that could cost a fortune. Maybe Dimla will give you a discount.”


Francine saw a shadow move from behind the peephole. “Who the hell is it?” Jacob’s voice came from behind the door in mock harshness.

“It’s your damn sister!” she shouted. “I come for the couch you promised me.”

The door swung open wide. “What’s the matter? Mom and Dad kick you out?”

“Please, they wouldn’t have the heart to throw poor little defenseless me out on the streets,” Francine’s grin was rueful, but her tone indicated that something was wrong.

“You know they worry about you.”

“Yeah, because I’m the youngest. They don’t want me to leave, and they don’t think I have it in me to survive, or something. So, I’m showing them that I can.”

“By crashing on my couch?” Jacob motioned her inside. She was about to push herself in anyway.

“Yeah, about that, could you not tell them I came here?”

“They need to know you’re safe.”

“And they will. I’ll tell them I rented a room at a friend’s house for a week or two. I just don’t want them to know I came crawling over to big brother’s house.”

“I could never imagine you crawling anywhere.”

“Do you promise?”

“Yeah, yeah, I won’t tell them. Just make sure that they know you’re safe. I don’t need them to bring their worry over here.”

“I’ll will.” Francine gave a paper thin smile. “Don’t worry.”

“Okay, good. If you want to crash, go ahead and crash, but I have to head off to work in a few minutes.”

Francine took in Jacob’s odd state of dress for the first time since her arrival, “Is that what you wear for a day at Dimla?” He was wearing jogging shorts with tennis shoes on the bottom, and a button up with a tie on the top.

“No, I,” he hesitated. “I just got back from a jog.”

“Still running? Still obsessed?” she called after him as he slipped into his bedroom.

“We’ll talk later.” He had pants on as he reappeared in the hall. “I have to go now. Give me a hug Sis.” After a quick embrace, he was out the door, and she was left to herself in his apartment.

It wasn’t anything large. One bedroom, one bathroom, one couch, one television, one of everything needed for modern survival. Francine sat down on the couch and already considered it hers. She gathered the two throw pillows together on one side and laid down. Her hand reached blindly toward the end table for the remote. She snatched it and accidentally pulled something else with it.

The something was a cheap glossy brochure for Dimla’s line of mechanical organs. It had everything. Lungs, livers, spleens, both bladders, kidneys, intestines, and more. Some organs even had made-up names like adreno-pump and metabo-booster. These were listed in the add-on section with the words “More to come…” printed at the bottom.

Several of the replacement orangs had circled around them in what appeared to be red pen. She tossed the brochure back on the end table and rolled over. Forgetting about the television, she closed her eyes and made an attempt at sleep.


When Jacob came through the door some hours later, she was still on the couch. Instead of sleeping, she was staring at the blank television screen.

“What’s the matter? Can’t find the remote?”

“Mom called like six times. I didn’t answer it.”

“Did you ever call her and tell her where you were?”

“I messaged her.”

“Well, I better call her back. I don’t know why she always insists on using the home line.”

Jacob produced his phone and selected his mother out of the contacts, purposefully picking her cell phone instead of her home phone.

“Hello,” she answered.

“Yeah Ma, what’s up?”

“Have you seen Francine?”

“No, I haven’t,” he darted a glance and a smile in Francine’s direction. “Are you sure she’s not staying at a friend’s?”

“She said she was, but I know she isn’t. Look, this is important. She is off her medication.”

Jacob furrowed his brow and shot another glance at Francine who appeared to be ignoring his conversation. He went into another room and spoke in hushed tones. “Medication for what?”

“For her depression. She hasn’t told you? I would have thought of all people she would have told you.”

“How long has this been going on?”

“Almost two years. Right around the time that you left home the first time, before your accident. We didn’t want to tell anybody. Figured we would leave that to her, but I always assumed.”

“No mother, she never told me. Is she okay?”

“I thought so. She was doing better. Getting out more. Smiling more. But now she’s stopped taking her medication. She left it all here. I checked the dates and counted the pills. She hasn’t had any in over a week.”

“Maybe she’s better now. Maybe she doesn’t need it anymore.”

“You never really get better honey. At least that’s what the doctors say. Sometimes in old age, it goes away, but until then it must be treated as a lifelong condition. Oh, I thought she would have told you. You, of all people…” her voice trailed off into a sob.

“I got to go Mom.”

“Is she there? Just tell me she’s there.”

“Don’t worry Mom. I will take care of this. Bye, I love you.” He did not wait for her to reply before hanging up the phone.

He went back out into the living room where Francine was still lying. Still staring. “I suppose you know all my secrets now?” She said as she sat up on the couch without averting her gaze from the blank screen.

“Why didn’t you tell me? I thought we told each other everything?”

“We both know that’s not true. We still keep our secrets.”

“What secret have I ever kept from you?”

“Where you hid Larry’s lunch money in the seventh grade when you started bullying him for bullying me. I always thought I deserved a cut of that.”

Jacob smiled, “You did. We split it fifty-fifty. Except, your fifty went back to me for pain, suffering, and emotional trauma.”

“Please, you liked doing it,” she gave a small laugh before reaching to the end table and picking up the Dimla brochure. “What about these organs?”

“What about them? I work there you know?”

“Yeah, but why did you circle them?”

“I don’t know. Maybe I’m interested in one or two of their products.”

“But why? You are perfectly healthy now that you got your new heart. What more could you want?”

 “This morning I ran farther than I ever ran in my life, and I still felt great. I still felt like I had miles left in me. Look at where I was only a year ago. I needed your help just to walk to the bathroom, and I couldn’t stand for more than a few minutes without feeling faint. Imagine what replacing some of my other organs could do for me. They estimate that replacing your organs ahead of time, in a young body, could add years to your life. Why would I not try that? Why would I not be interested? Wouldn’t you try if you could?”

“If I could?” she said looking at him for the first time since he got home. “If I could?” she repeated with anger. “Ma told you how fucked I am, up here,” she pointed to her head, “don’t you think I’d want to fix that?”

“But what about the medications? Isn’t that what they do? Mom said they were helping.”

“Helping and not helping. You don’t know how it feels to not trust your brain. You don’t know how this shit feels,” she said jabbing her finger at her temple. “I used to think it was normal. I used to think that everyone woke up every day with a small piece of hatred for themselves that they had to put away. I wondered what this hatred was that I had to cover up with a smile.” Tears flooded her eyes. Jacob wasn’t used to seeing her sister cry. “I started wondering if I wasn’t normal. But who the hell could I talk to? I couldn’t talk to Mom or Dad or even you.”

“Why not?”

“Because you would just give me that sorry look like you’re doing now. You would just pity me. You wouldn’t treat me as normal. I don’t blame you for that. It’s not your fault. It’s just the reasonable response. I asked Mom if I could see a quack, you know, a psychiatrist. I told her I was just having anxiety issues. Even with that, she looked at me like I was a sick puppy. When I came back with my diagnosis, it only got worse. Mom and Dad both treated me different. They worried more and pushed me less. All of a sudden, it didn’t matter if I got a C in physics. It only mattered if I smiled at breakfast.”

“I’m sorry, but you know you could have told me. You didn’t have to go through all of this alone.”

“Yes, I did. That’s the thing about the brain, it’s yours, and it’s you. Whatever crap it spews at you, you have to deal with yourself. It’s not like a homework assignment or a childhood bully. I have to listen to it every day. The drugs just numb it. No, they don’t even numb it, they fog it over. It’s like being drunk, except I’m always questioning the motive behind every action. Am I doing this because I want to or because the chemicals in the drugs are telling me to?”

“This might not be what you want to hear right now,” Jacob implored. “But I think Dimla-“

She cut him off, “I know about the organs. I read about them when you got your new heart. They are just glorified drug dispensers. It’s the same thing as taking a pill except without the choice.”

“At least the drugs helped you survive, didn’t they?”

“Yeah, but how could I ever know if my thoughts were my own? We live in an age where people can just scoop out their insides and change who they are. Fix every flaw that nature handed them, but we still can’t fix the brain. We drug the brain. That’s what we do.” She held her face in her hands for a long moment, while Jacob just stood there frozen in uncertainty.

“I’m sorry to dump all this on you,” Francine said. Her voice muffled by her hands. “I know it’s not your fault.”

Jacob sat down next to her on the couch and put his arm around her. His other hand wiggled its way into hers as her head fell to his shoulder.

“I’m sorry,” she said with an emotionally strained voice.

“You don’t have to be. If you need someone to push some anger or frustration on, it can be me.”

“I don’t want to take those drugs anymore. I just don’t want to. Can you understand that?” she was imploring him, begging him to see things her way.

“A lot of people have been right where you are now, and I am sure that a lot of them eventually found that the drugs did help.”

“I know. I know. I just want to try it this way again. I just want to try being me again.”

“We can do that. We can do that. Just promise me that if things get bad, you will let me know. That when the world is crushing you, you’ll tell me.”

“I can try,” she nestled her head against his chest, where just a year ago a heart would have thudded. “You still have a good heart you know?”

“Yeah, I just wish it could do my taxes.”

“Maybe in the next upgrade?”

They both laughed.


“Yeah Francine?”

“Can you promise me one thing?”

“What’s that?”

“No matter what they scoop out of you, and no matter how much robotic wizardry they replace it with. Can you promise me that you’ll still be you?”

“I promise.”

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