Double Sacrifice: A (Possible) Podcast

How would you feel if the organs you'd donated from your dying child wound up killing another child because of a clerical mix-up? An investigation into the aftermath of the Jesica Santillan story

I moved from Portland to New York in August 2019 with very few fixed coordinates. Within days, I received a Facebook message from a woman named Doreen. What she wanted to tell me was so shocking that, 48 hours later, I found myself driving from New York City to Rhode Island to meet with her. I had ambitions to tell her story as a podcast (original pitch deck images below). I never did. Paloma and COVID and Portland riots and Ukraine and events of work and life interceded. I am thinking of going back, at the least what I recorded with Doreen. It’s overwhelming.

My original story, about the death Jesica Santillan after she was given an organ transplant of the wrong blood type at Duke University Medical Center, is called “Grief’s Gravity” (LA Weekly) and can be read the link, or at the bottom of this post.

GRIEF’S GRAVITY

I spent February 19, 2003, the way I’d spent the three previous days: monitoring Jesica Santillan’s condition via the Web. It was the lead story on CompuServe, and I read only, “Bleeding and swelling on the brain,” before I pressed my palms to my eyes.

“Wha-at?” my boyfriend asked. His patience regarding Jesica was wearing thin; even my daughter had given me a jaundiced look the day before in the car when I said, “Maybe Jesica wants me to write about her.” She was 13, and not unsentimental, but would not be complicit in the fantasy her mother was spinning.

I’d started my vigil the day The New York Times ran an article about 17-year-old Jesica that included a photo of the comatose girl: dark-haired, her shoulders bare above the hospital bed sheet, she looked exactly like my daughter. When the story moved to the front page, I went with it. I kept tabs on Jesica via the Web, by the hour, then the minute. Work, books, eating, everything fell away, seemed frivolous compared to the devastation taking place inside this girl.

I knew what everyone else glued to the story knew: That on February 7, Jesica had undergone a heart-lung transplant of a mismatched blood type by surgeons at Duke University Hospital. That her parents, illegal Mexican immigrants who spoke no English, had smuggled her into the country three years earlier in order to seek treatment for her congenital heart abnormality; that a North Carolina homebuilder named Mack Mahoney — the man we saw on TV, begging for a new set of organs for Jesica — had two years earlier established Jesica’s Hope Chest (JHC), a foundation to help pay for the girl’s life-saving operation, which, due to an oversight, was likely going to kill her.

I was unable to accept the fatal error. I bucked every time I thought about the moment when the incompatible organs were placed inside Jesica. This was followed closely by empathy for what I felt sure her family, and in particular her 37-year-old mother, Magdalena, must be going through, after having waited three years for this and then having to watch helplessly as what they waited for destroyed Jesica. And then, after seizures and bleeding and lying in a coma for two weeks, the doctors tried another transplant, and succeeded in killing Jesica’s brain. To me, it seemed, they killed the child twice. The betrayal was impossible for me to keep down.

Why we as readers, as a nation, become involved in one story over another is fueled by primal concerns and fanned by the media. But what keeps us involved? While I am sure many found Jesica’s story wrenching, they turned the page, perhaps on February 20, the day Jesica received her second transplant and also the night of a devastating nightclub fire that would eventually claim 100 lives.

I scanned the photos from West Warwick, Rhode Island, the stunned face of Great White lead singer Jack Russell, the charred foundation of the Station, but the images did not stick. This tragedy was happening to other people; there was nothing I could do. I did not feel this way about Jesica. While the origin of my obsession may have been a thing as random as appearance — the tawny skin and almond eyes and babyish nose were the same as my daughter’s — nurturing the fixation gave birth to something less simple, a launching pad I used to catapult myself into Jesica’s posthumous life.

My flying to North Carolina, to stay with Mack Mahoney, to meet Jesica’s family, to discuss her case with lawyers may have happened because I’m a writer who tends toward immersion journalism. It may have been driven by career ambitions; I boarded the plane with a verbal agreement to write a book about Jesica. It may have been that my obsession simply swept me overboard. My mother said Jesica’s tragedy sucked me in because she had a face, and we know that a news story with a face, whether it’s Willie Horton’s or Laci Peterson’s, incites emotional involvement.

These reasons were true, but ultimately ancillary: I flew to North Carolina because my fixation caused a puncture wound I could not stem alone, there was too much empathy flowing, it needed someplace to go. I no longer felt like a compassionate stranger in Jesica’s tragedy, but a participant. I wanted to know more about her, to meet her mother, to be around others who were grieving for Jesica.

ON FEBRUARY 21, I read, “Irreversible brain damage,” and that Magdalena had said before the second operation that Jesica squeezed her hand and wiggled her toes on command. These, I realized, would be the last sentient communications she’d have with her daughter. Later, when a CNN special report announced Jesica was “brain dead,” I did not see Magdalena in the crowd, but imagined her wanting to claw her way into the past, to reclaim her child, to say, leave her with me, I will take her from here.

The next morning I got on a train, and as it left Union Station I saw the sun reflect on the Los Angeles River, making it a blinding silver, and I thought, thank you, Jesica, you have helped me see beauty. I told her she was a very brave girl, and asked her not to be angry with her mother. Not that I thought she would be, but I wondered, as she slipped away, if she questioned whether her mother had protected her enough.

I did what I went to San Diego to do, interview the astronaut Sally Ride. We stood in the Aerospace Museum before a replica of the Apollo spacecraft and talked about the Challenger explosion and how Ride is a hero to young girls. I was so disconnected, she might as well have talked to a leg of lamb. When I got home, my boyfriend had laid the table with wine, bread and cheese, and told me not to check the Web for Jesica, but I had to. I read she’d been taken off life support, and died. I sat at the table, drank the wine, ate the cheese, and after my boyfriend went to sleep, locked myself in the bathroom and knelt on the bathmat and shrieked through my teeth.

I kept a vigil at the Internet. I sent homemade cookies to Jesica’s Hope Chest. I sent a check. Four days after Jesica died, I phoned JHC. Mack Mahoney answered, which I considered an incredible stroke of good fortune. I asked if there was anything I could do besides send money and pray; he said, just keep that up, and hung up. I sat at my desk and stared at my hands. I knew I had to call back.

“Mr. Mahoney, my name is Nancy Rommelmann, and I want to know if you need a writer.” I had no idea what I could do for him, but would have folded laundry if it would have helped. “Ma’am,” he said, “I got 400 writers here and I want to put them all in a hole.”

I told him I might be able to write press releases, anything; he told me to send something to the Hope Chest and he’d get it. I immediately composed a letter, saying, have pen, will travel, and that my father had a home nearby where I could stay. That night, my daughter showed me a poem she’d written for Jesica. I sent it with my letter.

The next day I was at the Los Angeles Zoo, where I worked at the time one day a week writing grant proposals. During my lunch break, I asked Jesica what animals she’d like to see. She said, “Monkeys!” I wondered if this were true, if she did like monkeys. I climbed to the top of the zoo to see the baby chimpanzees. Then I told her I would take her to see my favorite animals. I got lost trying to find the lemur enclosure, walking in the rain, eating an egg salad sandwich, and crying.

I was shelling peas a few nights later when the phone rang. “Nancy, this is Nita Mahoney [Mack’s wife], and I want to let you know your daughter’s poem was read at Jessie’s interment.”

Hearing her voice felt entirely normal, as though I were expecting her call. I mentioned I’d sent Mack some writing.

“We have had so many writers here, and publishers calling, but your name keeps floating to the top,” she said, and asked me to come to Louisburg, “to write about Jessie, while it’s all still fresh in our minds.”

I said I would. Then I went back to making dinner with a sense that I’d been all-consumed by Jesica’s story because I was meant to write about her, and here was the proof.

Bind the wound and grease the weapon. I began to download everything I could on Jesica: how she’d been born with restrictive cardiomyopathy, a condition that meant her heart was enlarged and inefficiently oxygenating her body; how she was originally from Arroyo Hondo, Mexico, a tiny town 100 miles from Guadalajara; how the family, while being smuggled by a coyote over the Texas-Mexico border, had been robbed at gunpoint of everything they had, including the earrings in Jesica’s ears. How Magdalena wanted to bury Jesica in her hometown — a trip the Mexican government offered to pay for — but could not for fear of not being allowed back in the U.S.

I read Duke’s early opaque press postings regarding Jesica, and two days after her death, a message from Ralph Snyderman, M.D., president and CEO of Duke University Health Systems, which began, “I have never been more proud to be a part of the Duke University Medical Center family,” and concluded “. . . the institution has been open, honest and forthright [and has] risen higher than ever before.” I read about a man in Florida who claimed Jesica’s angelic aura had cured his cancer, and was now petitioning the Pope to make her a saint, and this from syndicated columnist Michelle Malkin, author of Invasion: How America Still Welcomes Terrorists, Criminals and Other Foreign Menaces to Our Shores, posted the day before Jesica died: “We cannot ignore the tough public-policy questions in Jesica’s case that the sob-story writers at The New York Times prefer to paper over: When resources are as scarce as the supply of voluntarily donated organs notoriously are, why shouldn’t U.S. citizens get top priority? If Jesica recovers from the second heart-lung transplant, will any federal immigration authority have the guts to enforce the law and send her and her family home?”

A frail girl, a huge institution, a medical disaster, idolatry and bigotry, it smelled so American — and like a big book. Ambition fluttered: Jesica had borne the brunt of others’ mistakes, and had sent the only flares she could: The organs, I read, had quickly turned from a healthy red to a livid purple, as her body went into seizures, trying again and again to reject them. I would not let this horror, and the xenophobia directed at Jesica’s family, and Duke’s obfuscation, be thrown away like yesterday’s news. I would write a book, for fame and glory, but also to keep Jesica alive, in words.

I was at the zoo when the news broke that Elizabeth Smart had been found alive. As the word miracle buzzed from the cubicles, I thought, where was Jesica’s miracle? Within two days, it was reported more than 100 movie and book offers had poured in for Smart’s story. I suspected I was the only one writing about Jesica, and was so glad.

Not that the issue had dropped off the radar: The March 16 New York Times Magazine was devoted to medicine, and titled “Half of What Doctors Know Is Wrong.” Though there was nothing in it specifically about Jesica, the thrust of the issue was that medicine is an evolving and ever-reactive odyssey. That same night, Duke University Hospital’s CEO, Dr. William Fulkerson, told Ed Bradley, on a segment of 60 Minutes about Jesica titled “Anatomy of a Mistake,” “Unfortunately, I think historically the way a lot of issues have been identified and analyzed and improved has been in a reactive fashion, after something has occurred. And unfortunately, we’re reacting in [Jesica’s] case.”

Yes, I told the friends watching the program with me, except that Jesica’s death was not the result of some cutting-edge technology doctors are still getting the bugs out of, or an unforeseen problem encountered during surgery. This was a simple screwup: Dr. James Jaggers got a call about an available heart, type A blood, and when the patient for whom the organ had been offered — a patient whose name appeared on the list of possible recipients — was deemed an unsuitable match, Jaggers asked if there were lungs with the heart? And there were, and so began the process of the organs being flown from Boston, and Jesica being driven to Duke, and in order to save time (because the highly perishable organs were held up on the runway in Boston for an hour due to bad weather), she was prepped for surgery, possibly (probably) to the point where her own organs were removed and she was placed on life support. But there was a problem: Jaggers had neglected to check whether the organs’ blood type matched Jesica’s, whose name, while on a national registry, had not appeared on this list as a possible recipient for these organs because she was type O.

During his 60 Minutes interview, Jaggers struck me as a man divided: shattered during the opening, as though he was moving robotically through his life. And then, fatalistic, explaining that what he and others do is miraculous, it’s extraordinary, and sometimes things go wrong, and patients do not live. He said something about it being 3 in the morning when he got the call about the organs, and maybe his judgment was off. I had no idea what to make of Jaggers.

I BOARDED A PLANE for North Carolina in late March. From Raleigh-Durham, the Mahoneys’ home was a 45-mile drive, in Louisburg, in a half-built subdivision at the end of a circular court. As a runty, bat-eared dog barked at our feet, Nita threw her arms around me in welcome, then sat me at her kitchen counter and poured me a big glass of Diet Coke.

“Me and Mack are just common folk,” she said. She did look the part in a large smock-like top, short mussed hair, and a light sweat going at all times from diabetes and high blood pressure.

“Move your car or my postman will have a fit,” was the first thing Mack said to me, as he came in from a job and tossed his keys on the counter crowded with junk food and paperwork. He’s of average height, and wore the Panama hat he always wore on TV, perhaps, I could now see, because he is bald. He has a scruffy auburn beard and had a portion of his jaw and throat scooped out to remove tumors brought on by Agent Orange. He waved off his wife’s offer of a cold drink and told me to follow him up to his attic office, which is also JHC headquarters.

The walls were covered with photos of six JHC kids — three of whom have died, one at Duke while Jesica was there — but mostly of Jesica, including a large studio portrait of her dressed as an angel, with Mack’s arm around her.

“She said she wanted to take a picture with me,” he said, smiling. “I said, ‘Jesica, I’m not even dressed up.’ She said, ‘Oh, it’s okay. You look like my Mack.’” He began to rock his office chair back and forth. “She was a beautiful girl. It was a shame what happened to that baby. You see how happy she was? When she was with us, she just glowed out loud.”

Mack first learned about Jesica from a June 2000 editorial in The Franklin Times accompanied by a picture of then-14-year-old Jesica. The editorial explained that money was needed not for a transplant, but a series of cardiac catheterizations, each of which cost $7,000. The following day, as reported in JHC press materials, Mack guaranteed payment of the procedures, and, after being “impressed by this brave little girl’s optimism,” committed himself to raising the $350,000 needed for the transplant surgery.

By August 2000, Mack and Nita, well known Franklin County homebuilders, established Jesica’s Hope Chest as a nonprofit, and they had a plan: build a house with donated labor and materials, sell it, and use the proceeds to fund the operation. It took two years and was finally sold, on Christmas Day, 2002, an event that prompted headlines on the JHC Web site such as, “There really is a Santa Claus!”

It was not as if Mack and Nita didn’t have anything else to do. He’d run Elizabeth Dole’s senatorial campaign in Franklin County, and in 2001, the Franklin County Chamber of Commerce awarded the Chamber Business Leader Award to the M.E. Mahoney Building Company. The couple had plenty of work as far away as Virginia, not to mention two grown children and several grandchildren, and dozens of employees.

Why Mack reached out to Jesica and, later, other critically ill children was, he said, as simple as seeing a child in need. It is not that simple. Jesica — whose condition Duke’s Pediatric Cardiovascular Program, as early as November 2000, described as “uniformly fatal . . . she is likely to die in the next one to two years. Her death will be sudden” — was something to fight for, and Mack likes to fight. Long before he became an international figure for taking Duke to the mat, he was butting heads with people who didn’t give him what he wanted for Jesica. In 2001, he publicly criticized Duke after, he says, it reneged on an agreement to treat some of Jesica’s needs on a pro bono basis. He trashed a local builders’ association for not being more onboard with Mack’s plan to build more Jesica’s houses. But he begrudged none of the time Jesica took; he wanted me to know he loved the girl, and she him.

“Jesica used to call me 20 times a day. I couldn’t get anything done,” he said, with a grin. “When me and Nita went to see our kids in Texas, she called the phone machine over and over again. When I got back, I said, ‘Jesica, now why did you do that?’ And she said, ‘I just wanted to hear your voice.’ She always said, ‘You’re my Mack.’”

Before Mack and I spent the next four hours talking about Duke, and sifting through the thousands of PayPal donations JHC received while Jesica lingered between operations; before I saw a copy of the anonymous $50,000 check as well as the shit-smeared dollar bill with attached note reading, “JESICA SHOULD NEVER HAVE BEEN ALLOWED TO GET THE TRANSPLANTS. USE THE ENCLOSED $1 TO GET THE FAMILY OUT OF MY COUNTRY”; before I read the condolence letter from the governor and a cramped, six-page missive from a goth kid in Illinois who said he was in love with Jesica and was “thinking about killing myself right here to see if my organs would work [for her],” Mack wanted to get one thing straight with me:

“The lawyers already contacted a writer at Random House they feel would be better.” My heart beat in my throat. “[The writer] did some checking up on you,” he continued, “and said some pretty bad things, such as, you’re a single mom.”

I wanted Mack to approve of me — he’d already told me he had the rights to Jesica’s story, which I wanted to write almost as much as I wanted to breathe — but I could see, by the smile playing at one corner of his mouth, that he was baiting me. I told him that was right, and that I also lived with my boyfriend, who was not the father of my child.

Mack seemed to have already dropped the subject. “You know what [Dr. James] Jaggers said when he come out of surgery? He said it all went well, but there was an error; that the blood types didn’t match, but that blood protein was the least important factor in a transplant, that he’d already put her back on the transplant list, and that they could keep her alive for up to a year with chemotherapy drugs.”

At the height of Jesica’s ordeal, typing her name into Google’s News search yielded more than 20,000 documents, but nothing I’d read touched on this.

“And you know what [Duke spokesman Richard] Puff told the Louisburg papers?” asked Mack, his voice a hard rasp. “‘Rejection is always a factor early on.’ They wanted to keep the whole thing quiet, but they didn’t count on this cowboy. I was Duke’s worst nightmare!”

He leaned into my tape recorder. “Do you know what that CNN cameraman said to me the last time I left my hotel [near the hospital]? He said, ‘Mr. Mahoney, do you realize that you have stood for the past two weeks where few men have ever stood? You’ve stood at the center of the world stage. CNN broadcasts to 70-something countries, and your words have been translated into 47 different languages. You’ve stood where presidents and monarchs have stood.’”

He then told a derogatory story, involving too much drinking and possible spousal abuse, about Melecio Huerta, who the world knew as Jesica’s dad, but who Mack told me was not her dad, nor was he married to Magdalena, but another woman, in Mexico. The story included how he, Mack, had called the local sheriff and gotten him to agree not to disclose to the newspapers that Melecio had been arrested, as well as how he’d parried with a social-services woman who wanted Magdalena to press charges.

“She said, ‘Mr. Mahoney, I don’t know what kind of control you have over this family, but this is none of your business,’” said Mack, his voice high as he parroted the woman. “I told her, we’re going to get these charges dropped. Then, I called the D.A.’s Office . . . I said, if this thing comes up in court, it’s gonna be a big problem for me, and it’s gonna be a problem for Franklin County, because everyone’s gonna start digging into your affairs, and I said, I am going to tell you right now, you can’t afford that. And he took that offensively!” Charges were eventually dropped.

Mack wanted me to laugh along; I did. Then he said he was going to make Melecio get a divorce and marry Magdalena, to sluice the immigration process. “And if she doesn’t want to marry him, I can marry her to someone else,” he said.

When I asked if Magdalena wanted to get married, Mack gave me a look that said I was naive.

“It don’t matter what she wants,” he said. “These people essentially have a sixth-grade education; where they come from there aren’t even roads. They’ll do what I tell them to do.”

MACK TOOK ME to what he called “Jessie’s favorite place in the world,” a comfy downstairs den that had a singing bass on the wall and smelled of cinnamon carpet deodorizer. He had a Corona as we watched war coverage on the big screen; he told me he was a Vietnam vet and wanted this war “over quickly.”

Nita set down a plate of Hot Pockets. “Magdalena and them’s coming over.”

My heart was in my throat again. I was about to meet the woman I’d empathized with every hour for the past month, a mother who’d actually lost her child, as opposed to me, who’d appropriated grief. What right did I have? I desperately did not want to impose on Magdalena, I wanted to be invisible, and then she was walking past me, a small woman in shorts who gave me a weary glance before sitting in a loveseat opposite me. Mack told her in Spanish that I’d be writing a book about Jesica. She did not seem particularly interested, or maybe was just too polite or exhausted to ask, who the hell are you? “Let’s all go out to dinner,” said Nita. Magdalena would meet us there. I drove with Mack in his Expedition.

“You’re sitting in the seat she used to sit in,” he said, and slid in what he said was Jesica’s favorite CD, Mexican pop music as sweet and bubbly as pink soda. Nita clapped, and I hung my head out the window, and felt amazed: I had wanted so much to be here, and here I was.

We climbed the porch of a small Mexican restaurant that appeared so low-key as to be closed. Magdalena, Melecio — a heavyset man with a teardrop-shaped face — and their 6-year-old daughter Dulce and 8-year-old son Ulises were already at a table. I sat across from Magdalena. She has a spray of dark discolorations on her cheeks, thick eyebrows, and small, girlish hands. She looked not on the edge of grief, but sleepwalking, and when spoken to softly said, “Mmm hmm.” When the food came, she picked a gordita off her plate and held it to me, and watched me eat it. I gave her some shrimp cocktail, which she said was Jesica’s favorite dish.

While Nita made the kids wash up, Melecio, Magdalena, Mack and I stood on the porch. Magdalena felt strongly the book should also be published in Spanish; I agreed. Melecio then said something in Spanish that made Magdalena laugh, and when she did, I felt as though I fully exhaled for the first time in a month.

“Mack likes you,” Nita confided the next day. “He wants you to write the book.”

“You can stay here this week,” said Mack, and then drove me to see Jesica, whose mausoleum is on a hill in a new graveyard.

“She was a pretty famous girl in Louisburg. I made her famous,” said Mack, as he righted a large heart-shaped ‰ wreath that had blown over.

I’d wanted to come here since the day she was interred, had imagined many times being able to tell Jesica how sorry I was, to mourn in her presence. Mack had other ideas, and as I pressed my hand to the cool marble crypt, he recited the presidents-and-monarchs story again.

“We bought all her clothes for her, you know,” said Mack, when we were back at the house, standing before the mantel, with its many portraits of Jesica dressed as an angel. “But I would not buy her some of the stuff she wanted, hip-huggers and midriff tops. I told her, that stuff makes you look like a little slut.”

I felt as though I’d been slapped across the face. I turned away from him and knelt in front of a big trunk, which Jesica had spray-painted gold and stuffed with Mardi Gras beads, toy dollar bills, oversized coins, and photos of herself and her siblings. This was Jesica’s hope chest, and before it was a big photo album.

“That’s Jesica’s diary,” said Nita. “She left it here the day of the operation.”

I opened the book. There was no writing in it, only drawings, of a rose being pierced by a knife, Latin girls with boobs bursting out of skimpy tops and boys in muscle cars, temporary tattoos that read “Naughty As I Want To Be” and “Sweet Thing,” and pictures of Shakira and Enrique Iglesias torn from magazines. I knew Jesica had barely gone to school; she was a very sick girl on sudden-death watch who spent her days in bed watching novelas. She’d never kissed a boy; never got her period; never developed breasts. But she yearned like any other teenage girl, and I was holding the record of those yearnings, a secret scrapbook virtually identical to the ones my daughter makes. I knew it would not make the cut in the hagiography Mack was bent on shaping; he’d asked me several times how he could copyright her name and image. And though he was fond of saying, “Jesica was a mess, but she was my mess,” he wanted her known as immaculate, and nodded when Nita asked if I’d consider calling the book Jesica: God’s Angel.

It was becoming clear Mack meant to control Jesica’s legacy as he’d controlled her life. With the exception of her never telling him that Melecio was not her real father (an omission that nagged Mack), he insisted he was her alpha and omega, and not without reason: He’d named his organization for her, and told her he would save her life. He fought for her. He also fought with her: He’d given me a photo of a glowering Jesica at a JHC fund-raiser.

“She’d seen me talking to Sarah,” says Mack, of another JHC child who’d undergone a successful heart-lung transplant. “Jesica could not stand me to pay attention to anyone but her.”

But if Jesica was greedy for Mack’s attention, it is no wonder: Stuck at home all day with Nita (Mack insisted Jesica never wanted to go to her own home); deemed too weak to attend school, first by the Mahoneys, then by the doctors (though she very much wanted to go), and with Mack the only person she saw daily with whom she could converse (Nita speaks no Spanish), why would she not call him 20 times a day? Who else was she going to talk to? And if Mack minded, it was not evident in his stories, including one he told several times.

“We was riding in the car one day, Nita was there, and I said to Jesica, ‘Someday you’re gonna get yourself a hairy-legged boyfriend and fall in love.’ And she was real quiet for a minute, and then she said that she didn’t think that was gonna happen; she said, ‘I could never give my heart to anyone else, Mack, because you bought it for me.’”

Mack literally had; he’d paid for everything for Jesica and her siblings, found Magdalena a job, employed Melecio, rented the family homes; he’d arranged and financed Jesica’s medical care, and yet none of it was enough. “I tried to save a young girl’s life, and I failed,” were among the first words Mack ever said to me. I did not think Mack was used to failure, to having anyone tell him no, to having things taken away, and certainly not with the random brutality with which he lost Jesica. Maybe this was why to me he was becoming not merely overbearing but worrisome.

Nita fixed dinner: dry pork chops, biscuits with margarine, cold red wine. Mack told hours of stories disparaging Melecio, Jesica’s relatives, Duke University. In every tale, he was the hero, fighting for damsel Jesica, who was portrayed as jealous of her best friend Heather, of other JHC kids, of the Mahoneys’ two grown daughters. He and Nita did not seem to find this at all odd. They also did not tire. They told me about taking Jesica to doctors’ appointments, to school when she was able, to the zoo in Charleston . . . the zoo?

“What animals did Jesica like?” I asked.

Mack looked puzzled. “Liked? I don’t know. I think she liked the polar bears.”

“I was constantly telling Duke [after the first transplant], ‘You have a chance here to be a hero; join me . . . get this baby the organs she needs, but don’t waste no more time.’”

It was 5:45 in the morning, and Mack, still in his bedclothes, had given me a cup of coffee and told me to turn on the tape recorder.

“Instead of doing that, they fought me,” he said, “they kicked me, they tried every way in the world to get me out of their building . . . They told the parents that they needed to get rid of me, they needed to pull away from me, that I was talking to the press, it was interfering with their daughter’s medical care, which was a lie.”

He said Magdalena pleaded with him not to say anything to the press. “She said we needed to trust the doctors; that they had her daughter’s life in their hands and she did not want anything I said to upset them and affect how they were caring for Jesica.”

I had a flash of Magdalena in the hospital hallway, begging Mack, please; he was riling the people who quite literally could decide whether her daughter lived or died. I bit my lips.

“But it didn’t matter,” said Mack. “I would’ve still been doing what I was doing, even if Magdalena said no, because I’d already decided this needed to be done.”

Melecio came in, ready for work.

“You need to marry Magdalena,” Mack told him.

Melecio shrugged. “She don’t want to marry me.”

“Where is she?” asked Mack. “Is she home?”

Mack, Nita and I drove down a shady street lined with weathered wooden houses, one of which Mack rents for the Santillan family. Magdalena’s car was not there.

“Where could she be?” asked Mack. We took a short drive through Louisburg, past the college where Magdalena had worked as a cleaner, past a statue that honored the Confederacy, and back to the house.

“Look, Mack,” said Nita, pointing. “Her car’s pulling in.”

Magdalena saw Mack’s truck and froze, her hand on her car door. She was wearing a silky white blouse with a pattern of black flowers, and looked as though she’d been crying.

“She’s probably snuck out to the cemetery,” Nita whispered to me, as Magdalena and Mack went in the house. I stayed on the porch.

“You can go in,” said Nita.

I opened the screen door. The house, which the family had moved into in December 2002, had little furniture and felt unlived in. I walked down the hall, and stood on the threshold of Jesica’s room: a small bed, a desk, an unplugged computer . . .

“Nancy, come in here,” said Mack. He was at the kitchen table with Magdalena, speaking to her in Spanish about me, about marrying Melecio, about needing to sign the insurance papers Nita was waving before her. Magdalena sat facing a big window, not looking at Mack as he told her she needed to speak to me, tears forming but not falling as she murmured, “Mmm hmm.”

I watched Magdalena pick an envelope off the table and rub its edge, over and over. This is exactly what I do when I am trying not to cry. As she rubbed, and rubbed, I began to feel increasingly horrible. I wanted to tell she did not need to speak with me, and told Mack to translate this, but instead he said, “She loves your daughter.” He was trying to make me look worthy, but this was the last thing I felt; I felt like one more person ripping the scab off her anguish. I looked at her hand, three inches from mine, and wanted to hold it but did not have the courage. There were three photos of Jesica on the wall, looking down on us. Mack kept talking, Magdalena kept rubbing and saying, “Mmm hmm,” and finally, not knowing what to do, I took two photos of my daughter from my wallet.

“Mi hija,” I said.

Magdalena looked at them. “Muy bonita, sí?”

“Sí, como Jesica.”

She rubbed my daughter’s school photo between her fingers. “Only one?” she asked. I nodded. “Maybe, uno más?” she asked, her dark eyes impish.

“Sí,” I said, “maybe uno más.”

“Me, uno más, para Yesica,” she said, and then she told Mack her cousin in Mexico was pregnant, and if it was a girl, she would name her after Jesica. This moment was like a sparkler, and then it went out. Again, Mack hammered her with demands, to speak with me, to sign the papers, to get married, and again she was saying, “Mmm hmm,” and rubbing the envelope, and crying. And I started to cry; I shielded my eyes, and then wiped them with a shred of paper towel. It became wet and stained with mascara, and I stuck it in with the photos in my wallet, where it is to this day.

Magdalena signed the papers, and as we left, I touched the arm of her blouse, and told her it was pretty. She smiled.

In the morning, I took flowers to the cemetery on the hill. I stood alone before Jesica’s yet-to-be-engraved crypt and told her how sorry I was. I did not cry. It struck me that, distilled to its simplest form, I’d done what I came to do, which was place roses on a young girl’s grave and tell her mother how sorry I was.

Mack wanted me to meet with the lawyers, to discuss the book, and had made them send a stretch limo to drive us to Greenville. It was fully stocked, with booze and fresh fruit, and a TV that showed an ad for 1-800-HURTLINE, as Mack told me that the lawyers had found an attorney who was “a specialist in brain death.” He gave me the man’s card; his office was on Long Island. I looked at Mack, who was crowing about “going for 100 million,” and realized he was an unsophisticated man. He started in for the hundredth time about how Jesica was jealous of everyone, including his grown daughters.

“But my older daughter was jealous of her, too,” he said, and added how his daughters didn’t trust him around other women, owing to a past indiscretion on his part. “Like right now, they wouldn’t be happy that I was alone with you in this limo.”

“Then your daughters are imbeciles,” I said.

Mack’s smile froze. I didn’t know or care whether he was trying to bait or come on to me; I did not feel like playing.

The lawyers’ offices are in a three-story home with gleaming wood banisters and fake floral arrangements. Mack and I were shown into a formal conference room, and joined by a compact man in a good suit. Frank Cassiano, the lead lawyer, sat at the head of the table.

“We spoke to the Santillans last night to ask whether they knew their name was not on this contract,” he said, referring to the book agreement my agent had sent through.

Mack sprung out of his seat as though he’d been shocked.

“You have no right to go behind my back and speak with those people,” he shouted, standing over Frank with his fist tensed.

“Whoa, whoa,” said Frank, shielding himself. “Are you saying I am not allowed to speak with my own clients?” Then he turned on me. “Show me in this contract how the Santillans are taken care of financially.”

He cited a point where Mack warranted he had the rights to sell Jesica’s story.

“Oh, I didn’t even really read that part,” scoffed Mack, and sat back down, which is when I realized that, just as he’d assumed everything else having to do with the Santillan family, he’d assumed the rights to Jesica’s life, and I’d been too eager to write about her to consider who owned what. I felt myself retract into in my chair.

“These people aren’t going to understand contracts,” said Mack. “They barely have a sixth-grade education!”

“I don’t think that’s an assumption you can make, Mack,” said Frank.

“Oh, for Christ’s sake,” said Mack, screwing up his face. “We’re just gonna sign the damn papers.”

“No, we’re not, Mack,” said Frank.

Mack stood again, went to the window, ‰ and smacked the sill so hard I flinched. “Come on, Nancy,” he said, “let’s go.”

I didn’t move. The curtain that had been parting regarding Mack — that he would subsume whatever was around him; that his relationship with Jesica’s family had gone from protector to dictator—came fully open.

“I said, come on!” he barked. I sat still. He gave me an odd, sad look, and left. I calmly told Frank I now found the agreement, more a letter of intent that stated Mack and I agreed to work together, unacceptable and wouldn’t sign.

“You’ve betrayed me!” yelled Mack as he marched back in. He and Frank went head-to-head. Frank said Mack was trying to control the Santillans, Mack countered that he’d been the one supporting the family, and what did we think, “that there’s some sort of pay fairy?”

Kurt Dixon, the lawyer I’d seen on TV representing the Santillan family, arrived and tried to placate Mack as Frank surreptitiously wrote me notes on a legal pad: I sometimes trust [Mack’s] judgment 100% and other times, not at all, and, Is this a book you would want to do with Magdalena? to which I softly said, “Yes, sir.”

“I’ll get them to sign over the rights to me,” said Mack, marginally cooler. When I told him this was unacceptable to me, that it was the Santillans’ story, he waved me off.

“You don’t worry about it,” he said.

When I told him I had to worry about it, his arm shot across the table.

“Nobody cares what you think!” he said, his finger practically up my nose. “You’ll just write the damn book!”

“Whoa, whoa!” said Frank. “Do you hear what you just said to her, Mack? How you are trying to control her?”

Three hours after we’d entered the conference room, we left it. Before I got in the limo for the drive back to Louisburg, Frank told me to keep in touch and handed me his card. He was a truck-injury attorney.

On the drive back to Louisburg, Mack tried to get me to agree the lawyers had been deceitful; I would not.

“Well, then you won’t write the book,” he said. When I didn’t say anything, he changed tacks, grew buttery and assured me, “It will all work out.” I gave a few noncommittal hmms, but mostly, sat in the small dark space in silence.

Back at the Mahoneys’, I went immediately to the cinnamon-scented den and booked a 6 a.m. flight home. Mack was yelling, “She can’t get out of here fast enough!” as I dragged my bags upstairs.

He and Nita were at the kitchen table. They hadn’t turned on the lights.

“You see what our lives are like,” said Nita, fretful and sweaty. She went on to talk about how “We really don’t need the Santillans to tell the story, as they are only a small part of it.” I disagreed. She said she’d assumed the book would be “by Mack Mahoney, as told to Nancy Rommelmann.” I told her this was an incorrect assumption. It was clear they felt any book about Jesica was actually about them, because, as they’d told me countless times, they’d been the ones who found her, who loved her, who devoted inordinate amounts of time and resources to her. And I thought, for a moment, that perhaps they were fighting so hard to control what was left of Jesica because they simply could not bear to let her go, a concept I understood in my heart.

“We’re from Texas, and we’ve worked with Mexicans all our lives,” said Nita. “And they are human beings, but they’re not like us. They don’t think like us. To them, money is the thing.”

I envisioned jet packs on the backs of my shoes. The Mahoneys each carried a piece of my luggage to the car. Nita hugged me. Mack did, too.

“Be good, girl,” he said, and thrust five JHC T-shirts into my hands.

I’d been home two days before Mack called, with what he said was good news.

“I got the family to sign over the rights to Jesica’s story, which means we’re free to write the book.” When I told him I would not write a book with him, he was silent for about five seconds.

“Then send me all my stuff back,” he said, and hung up.

I spent the next six weeks underwater. In my mind’s eye, Jesica was there and we sat quietly. I wrote some assignments I don’t recall. I got a raise and fired from the zoo in the same day. I spent my evenings in front of the NBA playoffs typing page after page about Jesica. I raged against Mack to anyone who would listen; that his consummate need to control everything about Magdalena’s life would only prolong her misery. I did, for a while, want very much to save Magdalena; I sent her a letter via Frank — whom I called each week for an update — to apologize for disappearing, and to tell her I’d do whatever she wanted regarding a book, but the letter was not delivered. Postings about Jesica on the Web shrank, and then disappeared. And then one day, I forgot to check. The terror and melancholy that had kept me clinging to her began to slip off me like effervescence, and though it felt like one more person failing her, I let go of Jesica, and rose to the surface.

The phone rang a month later at midnight. Part of my sleep-addled mind knew it was Frank Cassiano.

“He’s drunk on fame,” he said. His breath on the phone sounded labored and wet. “Some incredible stuff has happened,” he said. “Are you ready to hear it?”

I stood in the yard in my pajamas, and listened to a two-hour monologue about how Mack had arranged for Magdalena to speak on-air with the family of the original organ donor; that he’d excitedly told Frank, “We can’t buy this kind of publicity!” and how Frank had yanked Magdalena from Mack’s home with the cameras there before the spectacle could air.

“I get a screaming call later from Mack saying, ‘If you ever embarrass me again it will be the last thing you do!’ I said, ‘Are you threatening me, Mack?’ and he said, ‘It’s a promise. And don’t think I can’t get them people to fire you by tomorrow.’”

Which is exactly what Mack did; he also had Magdalena’s phone disconnected, which meant Frank could not reach her by phone. More, Kurt Dixon had quit the firm to stick with Mack and represent Magdalena, and had sent out a press release stating as much in which he misspelled the word attorney.

“The betrayal is so intense.”

The betrayal, I knew, was why he was alone in his office at four in the morning. Jesica’s case was clearly the biggest thing Frank had ever done and one he told me would make his name, but also make something right for Jesica and her family. He’d had that taken away; he would not be given the chance to help Jesica or Magdalena, and he was heartsick, and was calling me because he knew I’d know exactly how he felt.

IT TOOK MONTHS for me to realize this was not about betrayal, but being left out. But why should I have been included? As much as I may have thought of myself as a participant in Jesica’s tragedy, my pain was fabricated and self-inflicted, and I think now, had I really been her mother, I would have looked at someone like me and said, What are you doing here? Why can’t you leave us alone? Why I imagined I could provide deus ex machina is perhaps presumptuous, even shameful, but I don’t think it is unique; believing one can swoop in and deliver salvation is powerful stuff; Frank thought he could be Jesica’s hero, too, albeit he tried harder than I did, for longer.

The truth is, we don’t often get to pick our heroes. Mack, for better and for worse, has been Jesica’s champion for four years. He still runs Jesica’s Hope Chest, and is still fighting for Magdalena. He is the last man standing. While his firing of Frank was unceremonious, it was perhaps prudent: Since June, Jesica’s case has been handled by Howard Nations, a highly regarded personal-injury lawyer from Houston, Texas, who said last week by phone, “We’ve gathered all the facts about what happened to Jesica, and we are in negotiations and making every effort to come to a settlement with Duke.” He sounded confident.

Had Mack not blown the whistle on Duke, the world never would have known of Jesica Santillan, of this I am certain. As a direct result of her death, Duke last year instituted procedural changes that bars doctors from requesting organs for patients not on the recipient list, and that also requires more than one person checks that blood types match. JHC recently produced a series of public service announcements, in English and Spanish, featuring Magdalena speaking about the importance of organ donation, a crusade that, according to Nations, has lifted her out of her grief and provided some purpose to her daughter’s death. Last August, Melecio left and went back to Mexico. Magdalena remains in Louisburg. While her status in the United States is in limbo, she and her two surviving children continue to be supported by Mack, who recently installed a marble bench near Jesica’s mausoleum, where Magdalena goes and sits five days a week.