The terminal decline: irreversible restenosis, the exit-less coma, the Jaarvik IX as her one chance

pivotal · ~YDAU−1 into YDAU (coma onset; durations clash — see notes)

• When: her dying is a standing condition of the YDAU present; the coma's onset computes to roughly early-to-mid YDAU−1 — "fourteen months" before the 30 April – 1 May YDAU desert night (scene 088) versus "almost one year" before 14 Nov YDAU (scene 156), figures that do not reconcile (Dating notes)
• What: Gertraude is dying at home in Québec — "Marathe's wife was dying slowly of ventricular restenosis", the narration states flatly on the first desert night, and the apparatus glosses the disease itself as a creature of the era: "rare before continental Interdependence; now the third-leading cause of death among adults of Québec and New Brunswick," associated with chronic exposure to the Concavity's dioxin compounds — so that the same regional toxicity story attaches to both her birth defect (event 1) and her heart. She "had never once left southwestern Québec"; Marathe places her "at home in my native province," in "southwestern Québec's Papineau regions, where his wife had need of care" (and scene 153 has him imagining conveying "his restenotic wife and entertainment-hungry children down from St.-Remi d'Amherst's Convexity-ravaged wastes" — the one placename attached to the household, and the one clear attestation that there are also children). The escalation: by the YDAU present she is comatose — "in an irreversible coma for fourteen months" per the narration on the desert shelf; "in a comatose and vegetating state for almost one year", a coma that "has no exit," per Marathe at Ryle's. Her one chance is the advanced Jaarvik IX Exterior Artificial Heart — which, Marathe reports the public-aid cardiologists saying with the story's characteristic bleakness, "With it they say my wife can live for many more years in a comatose and vegetated state." [Attribution note: the dying and the fourteen-month coma are narrated (Marathe-focalized); the coma's texture, the exit-less prognosis, and the Jaarvik IX are Marathe's own account; n.48 is apparatus.]