His Brother's Keeper: A Story from the Edge of Medicine

Chapter One
Portents
When they were boys, Jamie and Stephen Heywood loved to arm wrestle. They made it a ritual: first the right arm, then the left, then, if there was time, a wrestling match on the rug. Their rules of engagement were so complicated and so long unspoken that no one else ever learned the game. Even Jamie's best friend Duncan Moss did not know how to play. Duncan would take one step across the line on the rug. Then he would see the look on Jamie's face.

What? What did I do?

He did not know the rules.

The Heywoods lived in an old house on Mill Street in Newtonville, Massachusetts, a suburb of Boston. All three of the Heywood boys, Jamie, then Stephen, and then the youngest, Ben, were athletic dreamers, inventors of many rituals and adventures. The house on Mill Street is a block from a patch of woods and a pond. The brothers played football there in a corner field that belonged to a neighbor they called Aunt Betsy. Late at night when it rained hard, Jamie and Stephen snuck out with boogie boards. They hopped a fence to the creek, which got roaring in a good storm. Through the dark and the rain they rode the rapids into Bolough's Pond.

Their parents, Peggy and John Heywood, are well known in Newtonville. They love traditions, too. Each of them has served terms as Senior Warden of Grace Church, in Newton Corners. When their boys were young, they went back every summer to the dairy farm in South Dakota where Peggy had grown up. She had won a full scholarship to Radcliffe, in Cambridge, which is where she met John. Peggy worked as a therapist; she kept her practice small and devoted herself to the family.

Every seven years, they spent a year in England, where John was born and raised. John Heywood is a professor of mechanical engineering at the Massachusetts Institute of Technology, and an international authority on internal combustion engines. He is the son of a British coal engineer who turned to solar power early on, back when only the cranks were interested in what he had to say -- back when a maverick who worried about coal smoke, soot, and acid, and praised the power of the sun, was like a bolt from the future. John Heywood consults about energy efficiency for Ford in Detroit, Ferrari in Italy, Toyota in Japan. When he is at home, he runs MIT's Sloan Automotive Laboratory, to which he commutes from Mill Street on a bicycle.

Each summer in July or August, Peggy's side of the family gathered from across the country for a reunion at the beach town of Duck, near Kitty Hawk, in the Outer Banks of North Carolina. A few of the children on the beach were always honorary Heywoods, as Aunt Betsy was an honorary aunt. John and Peggy, Jamie, Stephen, and Ben each brought friends. The boys swam, sailed, surfed, and raced on the cold shining track the waves made for them. Every summer on one of their last days at Duck they played a game of basketball with their cousins and with strangers they roped in from up and down the beach, wickedly violent games that routinely sent a few Heywoods to the hospital.

As Jamie and Stephen got older, they kept arm wrestling, ritually. In their late teens and early twenties, when the two and a half years between them no longer mattered, they were perfectly matched. But Jamie became a mechanical engineer, like their father and his father in England. Jamie was intelligent and driven, and spent his days and nights working at a desk. Stephen became a carpenter, a hands-on man like their mother's father and brother in South Dakota. Stephen was intelligent, too, but he mistrusted desks and ambitions. He spent a few years swinging a hammer on a framing crew, and his right arm became unbeatable.