The Law of Bound Hearts by Anne Leclaire

name for such a large insect. Part of the macrocosm of the prairie. Which was one of the things Richard appreciated about this place. The order of it. Everything playing a part. Even things like fire, he’d told her, things that seemed like devastation, were a necessary part of the overarching plan, which was why each year, in early spring, a part of the prairie was set aflame, whole swatches of grass and plants reduced to nothing more than charred stubble. The fire prevented trees from encroaching on the grassland, he had told her. It returned nutrients to the soil.
    What was the role that made sense of this devastation in her body? What if one’s physical order went awry?
    Dr. Carlotta Hayes was a surprise. Libby had not expected the “best nephrologist in the Midwest” to be a short, dark-haired woman with the fingers of a pianist, a woman who urged them to call her by her first name and held both of Libby’s hands in hers the first time they met. Libby, not charmed, had withdrawn her hands. She wanted a male doctor, someone tall and strong and with a trace of arrogance, someone to whom foreign potentates would send their ill sons, not this woman who acted like someone’s grandmother.
    Richard
was
charmed, especially when Carlotta mentioned that she had heard him play two years before. A violin and cello concerto with the Chicago Symphony. She was on the CSO board of directors, she told him. Then she looked at Libby.
    â€œThere’s no easy way to say this,” she said. “Your kidneys are failing.”
    â€œOkay. That’s what we
do
know.” Libby tried to soften her rudeness, only an attempt to gain control, with a vestigial smile. But she
hadn’t
known that. Not really. She had been hoping that the new test results would prove otherwise. She had hoped that the changes she’d made recently were all that was needed. (She’d eliminated salt, every speck; she’d
meditated,
for God’s sake.)
    â€œWe’ll need more tests,” Carlotta said. “And a biopsy. We’ll talk about treatment when we get the results.” She left the room and was gone for several minutes.
    â€œWhat a coincidence,” Richard said as soon as she disappeared.
    â€œWhat?”
    â€œHer being on the CSO board, hearing me play.”
    â€œYes,” Libby said, her jaw so tight it ached. “How lovely for you.”
    â€œI’m only saying she seems nice.”
    Libby didn’t want nice. She wanted professional. She wanted someone to cure her.
    Carlotta returned with a folder, which she handed to Libby. “I’ve put everything in here,” she said. “You’ve got an appointment tomorrow for the biopsy and I’ve set up a time to see you next week. By then we’ll have a clearer idea of our protocol.”
    The days passed slowly. Libby slept late, moved cautiously, stopped having wine with dinner. When she returned for the next appointment, she had lost three pounds.
    It wasn’t lupus or HIV or hepatitis.
    â€œYou have a disease called focal sclerosing glomerulonephritis,” Carlotta told her. “FSGS for short.”
    Richard asked her to repeat it, to spell it for him. He wrote it down carefully, parroted back the spelling to ensure he had it right.
    â€œWe usually find it in African American patients,” Carlotta continued, “but certainly not limited to them. Caucasians can contract it, as well.”
    â€œHow long have I had it?”
    â€œThat’s impossible to say. People can have the symptoms for years and years and not know. The first symptoms you would notice were exactly what you experienced: swelling in the legs, puffiness in the face and hands, foamy urine.”
    â€œHow did I get it?” Libby thought of the traveling she and Richard had done. The trip to Guatemala to see the ruins at Tikal. Snorkeling in Belize. The Yucatán. She was meticulous about what they ate and drank on these