Death and the Intern

by Jeremy Hanson-Finger

  He draws his coinduction agent (lidocaine this time), fentanyl, and propofol into one Syrinx syringe.

  Under their cap-and-mask disguises, he notices the nurses for this operation are different—two women.

  “So you’re a Mixer,” Emanda MacDougall says, her mask puffing out and sucking back into her mouth as she speaks. “I could have guessed.”

  Janwar nods. He’s in operating mode, and he doesn’t want to get drawn into a conversation. Plus, he has a knee-jerk reaction to her badge: the purposeful misspelling of the name Amanda suggests she is one of those extraprivileged girls of the kind he met in university who wear their hair in head-top buns and sport sweatpants and suede moon boots year-round. But she seems less aggressive in her anti-mixing attitude than the two male nurses from his first operation.

  Janwar depresses the plunger, and the solution flows into Mr. Nakamura’s IV.

  When Emanda isn’t looking, the circulating nurse, Rasheeda Mohammed, makes an egg-beater motion and gives Janwar a thumbs-up. The attending surgeon, Dr. Karan Gill, must have noticed, as Rasheeda is in his line of sight, but Janwar can’t read Karan’s expression in the shadow of the Sikh man’s scrub-cap-covered turban. Karan moves in controlled fits and bursts as he readies himself for the operation, like he’s receiving instructions by radio.

  Mr. Nakamura’s face slackens and his eyes fog over, but his breathing remains steady. His blood pressure is acceptable. Janwar draws a new syringe of the paralytic agent, injects it into the now-unconscious Mr. Nakamura’s IV, and then intubates him.

  Dr. Gertie Toledo slices into Mr. Nakamura without incident, Karan cauterizing as Gertie cuts. Sizzles periodically emanate from inside Mr. Nakamura, along with the smell of burnt flesh. Gertie removes the tumour while Janwar monitors the vital signs, which beep and flash and squiggle within the normal range.

  While Emanda is swabbing Ms. Burton’s stomach with antiseptic before the first incision, the skin changes colour, from orange to fish-belly white, and the staff all laugh together—Janwar, Gertie, Karan, Carla, and the nurses, regardless of their induction politics.

  “Why would you,” Gertie gasps, “spray-tan before an operation?” Under her scrub cap, her hair is damp. She made the last operation look easy, but she’s sweating. Karan is sweating, too, under the triple layer of hair, turban, and scrub cap, tributaries running down into his beard. Gertie’s laughter goes on longer than Janwar expects, and when she’s done she still seems giddy.

  Ms. Burton has acute appendicitis, and her operation is even quicker: lidocaine-fentanyl-propofol, rocuronium, a few slices into the right side of the abdomen, and twenty minutes after the start of surgery, the patient is closed up again and her swollen appendix glistens on a tray like a sausage. Karan whips out a cheapo flip phone to check for messages as soon as the operation is over, which strikes Janwar as odd. Who still uses a flip phone?

  On his way to the department to meet with Llew, his Crocs squeaking on the black-and-white-checkered tiles, Janwar thinks about how his situation could just as easily have gone in a different direction. If he’d seen Mr. Nakamura before he saw Mrs. Bradford, maybe he wouldn’t have mixed his drugs, because the situation didn’t require it. And if Llew had been watching that operation, maybe he wouldn’t have decided Janwar was his new protege. Janwar disagrees with Llew; he isn’t a born mixer. He mixed in that particular operation because it seemed like the best choice. But now he’s bound to mixing, unless he wants to piss off the dean of anaesthesiology. And the dean’s not looking upon him kindly could have a majorly deleterious effect on Janwar’s career, which is still in its incubation period. So a-mixin’ he will go.

  Light blue trim surrounds all the doorways in the corridor leading to the anaesthesiology department. It clashes with the bright wood of the doors themselves.

  Emanda has reached the department before Janwar. She leans against a wall, telling a bulky man with a red face and freckles that she doesn’t understand the point of what they’re doing.

  The man rolls his eyes. “The mighty have spoken.”

  “But isn’t there a simpler way?”

  “You’re telling me.”

  Both turn and stare at Janwar as the door swings back, and Emanda pushes past him and out. The man turns the corner.

  They are terrible actors, their movements as exaggerated as a marionette’s. What Janwar has heard is close to meaningless, however, so they don’t have to worry. Something complicated that could have been simpler—that could be pretty much anything in the hospital.

  Grey is the primary colour in the anaesthesiology department’s common area. Transit-seat material covers the couches. An old TV inside a metal cabinet hangs from chains attached to the ceiling. The kitchenette features a microwave, a double sink, and a yellowed coffee maker. The room smells like burnt bread crumbs, popcorn, and some sort of nut spread. A peeling sign adorns the coffee machine, written in a hand so poor that Janwar can barely decipher it. He decides in the end that it reads, “There’s no rainbow at the end of the pot of coffee. Just you making more coffee.”

  Sediment has formed at the bottom of the coffee pot. Janwar can imagine why Llew would want his own machine. The TV plays an old detective show on mute: The Rockford Files. A Pontiac Firebird is reversed and spun around. A gun is pointed. Words are exchanged. Handcuffs are clapped. A head is pushed down into a squad car.

  A hallway extends in a U shape from the kitchen area. Llew’s office is at the end of the hall, between the conference room and the frosted-glass door that reads, “Sylvie Dalsgaard, Head of Anaesthesiology,” in gold art deco letters. Janwar hasn’t met Sylvie yet, but the department head is probably too busy to concern herself with medical student interns. The dean, technically part of the university faculty, does make more sense as the person to get Janwar settled.

  Llew’s wingtip shoes rest on his desk when Janwar knocks on the door, which is also made of glass, but not frosted like Sylvie’s. A fan spins in the centre of the ceiling, a holdover from before the hospital was fully temperature-controlled. Llew gestures for Janwar to enter, but someone jostles Janwar as he is about to open the door.

  “So you’re Cadwaladr’s new blue-eyed boy.” The speaker is the bulky man who Janwar saw talking to Emanda. The spray of orange freckles across his cheekbones clashes with his ruddy skin. His name tag bears the label “Dr. Shaughnessy O’Deady.”

  “The new Mixer…” Shaughnessy peers at Janwar’s badge. “Janwar Gupta.” His lips twist and he opens his mouth like he is going to keep speaking, but instead he mutters that Slugger isn’t always going to be around, and maybe one day he, Shaughnessy, will give Janwar a real push. He jostles Janwar again with his left shoulder, harder this time. “You’re not push league, John G.”

  “Push league? You mean bush league? You know what’s bush league? Getting an idiomatic expression wrong,” Janwar says. “Also, John G.? Come on, man.” But Shaughnessy has already stalked off by the time Janwar gets through the second sentence.

  Light burns in through Llew’s venetian blinds, casting angled shadows against the wall. The July sun won’t go down for another couple of hours.

  Llew lowers his feet from his desk. “Don’t mind him. He’s a Pusher.”

  A Pusher? Janwar is struggling to keep up with this department jargon. “Well, yeah, he did push me, and he called me John G. He seems like a bit of a bully, but—”

  “He’s always got his hair off. If he aggravates you again, let me know. You can have a seat.”

  Janwar folds himself into the chair. “But what—”

  “Some of us are going to cop a pint tonight at D’Arcy McGee’s. Right by Parliament. Meeting at seven. You can get to know everyone in a proper tribal state of altered consciousness.” He leans back in his chair. “You a drinker?”

  Janwar nods. “I’ll be there.”

  “Righto. Americano or espresso, is it?” Llew turns on the bean grinder and smiles in apology as it roars to life.

  “Americano would b
e great.”

  Llew slots the basket into position in the gleaming chrome machine. They both watch the black liquid drip from the nozzle. Llew hands Janwar a cup with crema as perfect as Janwar has ever seen and bangs the basket on the edge of a trash can. Janwar glances out the window. A big dark cloud scuds across the horizon.

  In the window’s reflection, Janwar sees Shaughnessy O’Deady standing outside the door, gesturing toward Llew’s office, pointing Janwar out to a moustached man and a short woman with a ponytail shaped like pineapple leaves. Janwar recognizes her as Aspen Tanaka. She’d visited UBC to talk about anaesthesiology at the Civic.

  “Ellis’s condo okay by you?” Llew says.

  Dr. Flecktarn is on holiday somewhere cold during Janwar’s two-week placement, so Janwar has the place to himself. The one-bedroom is minimalist, not unreasonable for a rich person’s home, but it feels more sterile than Nordic.

  “Great, thanks. I was expecting to have to live in a hotel, so, much appreciated. Student loans.”

  “We take care of our own by here, boyo.”

  Janwar points at the hickory baseball bat and worn-in glove leaned up against one wall. “Do you play softball?”

  “Hardball. Ain’t nothing soft about me, boy,” Llew drawls. “Call ourselves the Stitch Hitters.” He reaches for the bat and glove, then stops, switching back to his regular melodic tones. “Can you do me a favour? Aim these in the Rubbermaid tub in the closet on your way out? If I put them down any old place, the cleaners play baseball in here.” He gestures to a glass trophy with a chip missing and a crack down the centre.

  “Sure will,” Janwar says.

  Exhibit A

  TRANSCRIPT OF AUDIO RECORDING FOUND ON SUSAN JONESTOWN’S CELLPHONE

  SPEAKING: SUSAN JONESTOWN, ALAN TURNER, DENIS ALLEMAND, MARTINA GONZALEZ

  Friday, July 4

  Hey Siri, take a note. Oh, you’re already going. Cool. Cool. Testing. 1-2. Check. Check.

  The number Professor Palomino assigned me was six, which matched a pushpin stuck in Applewood Park. Nothing significant, interesting, or new, has ever happened in Alta Vista, let alone in Applewood Park. I’ve got to head there anyway. Hey Siri, stop—

  Alan’s a contractor so he’s one of the few people I know who drives. I’m walking over to his place because he said it’d be cool if I borrowed his truck.

  ALAN TURNER: Hey, Susan. How’s grad school going?

  SUSAN JONESTOWN: Okay so far. My reporting prof has got this

  drawing his kids did of him in his office. They might think he’s Satan.

  Ned seems all right to me, though.

  AT: That’s Satan’s thing. Seeming all right.

  SJ: Guess so.

  AT: Did you just come from class?

  SJ: Yeah. Libel and slander.

  AT: Learn anything juicy?

  SJ: There’s such a thing as “the small penis rule” in libel law. The guy who wrote Jurassic Park used it as a defence in 2006.

  AT: A defence against what?

  SJ: Couldn’t tell you. Anyway, I’ll have Black Magic back tonight and I’ll fill her up for you. Thanks for lending her to me. Oh and say hi to Jess.

  AT: I will. How’re your parents?

  SJ: Dad sunk the boat again trying to get it into his boathouse.

  AT: Classic cottage dad move. And your mom?

  SJ: All about real estate. She wants me to get into this condo market while it’s hot, but unless she’s willing to front forty grand…

  AT: It’s not worth it. I should know—I’m the guy building them.

  The park is even less exciting than it looked on Google Maps. Bunch of trees and a safe-looking playground. Plastic play structures. None of the splintery wood I remember.

  Could write about the death of risk in playgrounds. But that’s nothing new. Play structures have been plastic for years. What quotes am I going to get? Kids saying they miss the danger of wood toys?

  Wish I’d bought some coffee before I left the university.

  Shit, loose German shepherd charging toward dogwalker and pack. Snarling. Tail straight out.

  All dogs wearing backpacks. On trend.

  Burly man with grey ponytail and goatee chases shepherd.

  DENIS ALLEMAND: King, you fucker, no.

  Dogwalker’s pack panicks. Dogs attached to woman’s belt can’t escape.

  Shepherd tears through grey dog’s pack. Canister falls in grass. Shepherd spits out nylon and lunges. Grey dog falls onto back. Other dogs yowl.

  Dogwalker punches shepherd in ribs.

  Dog pauses. Owner tackles, flattens dog.

  DA: I’m going to kill you. You fucker.

  Am hiding behind fort wall in playground. Don’t think they spotted me. If I whisper and keep my mouth close to the mic…check, check, yeah.

  Pack made up of wide range of dogs. Two tall black ones, two bulldogs. Some medium-sized ones, unknown breed. Purebred though. Too glossy to be mutts.

  Dogwalker inspects grey dog’s sides. Seems okay.

  DENIS ALLEMAND: Shit, I’m sorry, Martina. Is he all right?

  MARTINA GONZALEZ: Who’s a good assault victim?

  DA: He jerked the leash right out of my hand.

  MG: Maybe time to think about a muzzle.

  DA: He never does this.

  MG: Really? You’re going to be one of those people? Want a do-over on that line, Denis?

  How do they know each other’s names?

  Snuck a photo. Five-foot-five woman with pack of suburban purebreds lecturing biker and junkyard dog.

  DENIS ALLEMAND: Okay, okay.

  MARTINA GONZALEZ: It’s not like you can’t take it off, if you do want him to bite.

  DA: Sure, yeah. Are you going to be cool, King?

  King’s not going to be cool. Denis cuffs him in the head. King slumps down. Martina looks around.

  MG: Here’s your wax.

  Martina reaches into hole in grey dog’s backpack. Tosses canisters in front of Denis and King. Like the one that fell on the grass.

  Martina’s neon green windbreaker and yoga pants put her anywhere between twenty-five and forty-five.

  MARTINA GONZALEZ: We’re going now. Come on, guys. And Denis, don’t ever let this happen again, or Jacques is going to hear about it.

  Going to stand up and approach them now.

  MARTINA GONZALEZ: What are you looking at, blondie?

  SUSAN JONESTOWN: I’m a journalist. Can I ask you a couple of questions?

  That didn’t go well. Martina shoved me aside with her dogs. Is now moving diagonally across the park, a fluorescent bishop.

  Denis didn’t respond. He picked up the containers and stuffed them in his shoulder bag. Now walking off in the other direction from Martina, King slinking behind him. Says “Support Crew 81” on the back of his T-shirt.

  Hells Angels are very public about their allegiance. Eight and one, H and A. Not too complicated a code. The “Support Crew” means Denis isn’t a true Hells Angel. Just a hanger-on who aspires to angelic status.

  That’s in Ned Palomino’s book Whole Hog.

  Can’t see any high-viz neon green. Waited too long to start following Martina.

  Heading east, hoping I see Martina in the distance.

  No luck, but the container that fell earlier should still be in the grass. Crossing back over where the altercation took place. There it is. Red Lantern-brand paw wax.

  Can feel something loose moving inside it. Might be nothing, but my first thought is “false bottom.” And “false bottom,” plus “handoff,” plus “Hells Angel,” could equal “crime.”

  Opening the tin. The liner has come free from the exterior.

  Under the liner there’s a plastic bag. And inside the bag—orange pills with “30” stamped into one side and “OC” into the other. 30 mg of OxyContin.

  CHAPTER 2

  Trans Am – Weird Foam – D’Arcy McGee’s – The Damned – Love Games - Fang Spears a Rat – Entry-Level Rape Culture Behaviour

&
nbsp; Monday, July 7

  Inside the air-conditioned hospital, Janwar could forget that he was in mythical Eastern Canada, where on good days smog shrouds the tops of tall buildings and on bad days it settles in the valley at ear-nose-and-throat level. Ottawa is the land of real seasons, not just the “wet” and “slightly less wet” climate of Vancouver, and the “slightly less wet than Vancouver” climate of Victoria. But out here, even walking north along Bank Street, Janwar has trouble breathing because the air is so hot and thick. Plus the smog.

  This is the kind of heat that makes murder rates go up in Port-au-Prince and Miami, and probably also Ottawa.

  Trying not to think about the temperature and the way his clothes stick to his skin, Janwar focuses on the street’s details. Nestled among the federal-government office towers are corporate coffee shops, muscle-building-supply stores, takeout shawarma joints. Dotting the sidewalks: red fire hydrants with flags sticking out of the top so they don’t get buried in snow, bus shelters, grey plastic garbage bins, eight-foot-tall advertising frames.

  The advertisements in the frames are all part of the same series, designed in a faux-1950s style and featuring the face of a pudgy and deeply tanned white man. In one ad he wears a Hawaiian shirt and stands on a condo balcony above the slogan “Live the high life. Call Lowell.” In another he sports a gingham shirt and overalls, relaxing in a rooftop vegetable garden above the words “Lowell impact living.”

  Given that the man’s skin is even darker than Janwar’s, the almost-certainty of skin cancer befalling this Lowell Chilton Corp. poster boy reminds Janwar of the threat of cancer in general. He takes the opportunity to surreptitiously palpate his testes through his pocket and ensure they are lump-free, which they are. His family doctor told him when he was a teenager that it’d be a shame for a young man like him to let testicular cancer get too advanced because he didn’t palpate his testes enough.