by Chris Adrian
“So? You think that means you can’t get hooked on it? These GI kids get hooked on anything, you moron. And if you give another med on my floor I’ll have you thrown the fuck overboard. Got it, Mr. Goodbar?” Jemma blushed and opened her mouth. A few things her brother might have said ran through her head—Double fuck you, bitch; Step a little closer so I can kick in your fucking face; You are as small and puckered and ugly as an asshole—but she couldn’t bring herself to say them. She only stood there and blushed, and said, “Mr. who?”
“Just watch it,” Carla said, and huffed out of the room, the syringe clutched in her hand.
“Fuck you,” Jemma murmured, and imagined the phrase floating down the hall to settle in her ear, so she’d hear it echoing there all day. She turned back to Cindy—sound asleep now, and looking much more comfortable. “Cindy?” she said, but the girl didn’t even snore. Jemma listened to her heart and poked her once in the belly—she couldn’t bring herself to do much of an exam on a sleeping teenager—then went to see her next patient.
Five doors down, there was a four-year-old with hideous constipation. Not pooped in seven days, is what the consult-request note said. The child was in the hospital for endocrine issues—she and her eight siblings had all been admitted for rickets after Child Protective Services had discovered them living in a commune with their father and three mothers, fed on a strict diet of guava juice and spelt. They had names like States’-Rights and Valium and Shout and Shoe-Fly; Jemma’s patient, named Kidney, walked half the time on all fours because she was weak and her bones were hideously deformed. Jemma hated vitamin D; the structure was confusing and calcium metabolism had never made any sense to her. She’d reviewed it with Rob for an hour the night before, sure that the attending, an enthusiastic pimper, would test her knowledge.
The room was dark, and full of beds, two under the window and two stacked in bunks against each wall—it wasn’t legal but the children had flocked into the same room the night of the storm and refused to be separated again. It was full morning outside, but the blinds were drawn, and someone had thrown a blanket over the window. “Kidney?” Jemma said, and every shape in the bed stirred. They were sleeping double and triple, leaving one bed under the window empty. Pale faces came out from under the blankets. They were all blond. “Hi everybody,” Jemma said.
“What is it?” asked one of them.
“A lady,” said another.
“Good lady or bad lady?” said a third.
“Her aura is black,” said a fourth—Jemma wasn’t even sure where the voice was coming from.
“It’s a doctor,” said the first one, directly above Jemma on the top bunk.
“Student,” said the third one, by the window. “The coat is short.”
“Who’s Kidney?” Jemma asked.
“We are all Kidney,” said the one in the top bunk, “and none of us are Kidney.”
“A doughnut,” said the one by the window. “Don’t talk to it.”
“Don’t talk to it.”
“Don’t talk to it.”
“I’m kind of in a hurry,” Jemma said, “and I’m here to help. I’m Jemma. I’m a student doctor.”
“You are a doughnut,” said the one by the window, a girl.
“You’re Couch,” Jemma said. “You’re the oldest, right?”
“I am Kidney,” she said.
“Jesus,” Jemma said, passing her hand across her face.
“Over here!” said a new voice, but Jemma looked up too late to see where it came from.
“Okay,” Jemma said, turning on the light. “Everybody up.” She sat them up and counted all nine of them, and examined the two girls who appeared to be around five. Both of them were too ticklish for a good belly exam. Her watch alarm went off as she was wrestling with the second one.
“Time to go,” said the one by the window.
“I’ll say when it’s time to go,” Jemma said, but she left just a few minutes later. She walked slowly back down to the charting room, thinking too late of tricks she might have tried—prize for Kidney; candy-gram for Kidney; time for Kidney to go dogsledding. Vivian would have wet a towel and cracked it above their heads.
In the charting room Anika was talking to Dr. Chandra, one of the few interns who remained an intern. Anika had a harried, motherly energy to her—she was always trying to calm you down but only succeeded in infecting you with her own high-frequency anxiety. She had her hand on Chandra’s knee, and was scolding him and comforting him.
“You just can’t let it get to you, Siri,” she said. “We’ve all got a job to do.”
“It’s not that,” he said. “I just didn’t get up on time. I asked the angel to wake me up, but I didn’t hear her.” He was rumored to be slow and lazy, and was not very popular among the students because he made them all call him Dr. Chandra, even though he was just an intern, and was always trying to foist his work onto them. But he hadn’t tried to foist anything on Jemma yet, and she found that she sort of liked his haplessness and his messy hair and the way his pants fell down past his hips, like Calvin’s had.
“You don’t have to make up a story,” said Anika. “I know how it is. It would be so much easier for us all to roll over and give up, but we just can’t. The kids are still sick, you know. Everything else may have changed, but that’s still the same.”
“I’m very tired,” he admitted, “but if she had just told me what time it was. You know, I think I asked her and she lied. I think she just tells you what time you want it to be, instead of what time it actually is.”
“It’s not going to get any better,” Anika said, squeezing on his knee and staring deep into his lazy, heavy-lidded eyes with hers, which were always wide open and seemed never likely to close, not even in sleep. “Get a better alarm clock.”
“She said she would wake me up.”
“But now you know that’s not a job for her. Let her make you breakfast, but don’t let her wake you up. Would you like me to page you tomorrow at five?”
“I’ll set my alarm.”
“All right, then. Well, we’re done with that. Let’s have some tea.” She turned and spoke to one of the now ubiquitous replicators—there were two of them in the crowded charting room. “Anika’s blend,” she said, “two cups with honey and milk.” Jemma was still not used to the machines, and did not think she ever could get used to them. She preferred to go down to the cafeteria and take food from a heap, though that stuff came out of the replicator mist, too, always made to order by the angel. “There you are, sweetie,” she said to Jemma, pretending like she had just noticed her, though Jemma had been standing there for the past minute and a half. “How’s it going?”
“Okay, I think,” Jemma said.
“Any dire crises?”
“None that I recognize, but there are a couple things that I’m confused about. And I’m not sure I even managed to find one of the patients.”
“Well, have a cup of tea and tell me all about it.” She ordered another cup of Anika’s blend but Jemma didn’t touch it. Pre-rounding should have been more of a comfort. Certainly Anika meant it to be one, a stress-free opportunity to fill her in on the events of the night and ask her questions about symptoms or treatments beyond Jemma’s third-year ken. But her staring eyes and the violent, bird-like way she nodded her head made Jemma nervous, and she tended to focus all her attention on aspects of the exam that Jemma hadn’t realized were important—were the contents of the ostomy bag burnt sienna or burnt umber?—and her answers just made Jemma more confused.
“So that’s an okay pressure?” Jemma asked, because Anika had seemed entirely unfazed by Ella’s vitals.
“Of course not, honey,” Anika said, but before Jemma could get her to elucidate, the rest of the team crowded into the room and it was time to go off to rounds. That morning they were a worse misery than ever before. She supposed it was to be expected. She’d had only the most cursory contact with most of the eleven patients she’d seen, a quarter of whom were new t
o her that morning. She had so many excuses for doing a bad job: she was only a third-year medical student; she didn’t know the patients; the world had ended. She voiced none of them, but suffered the withering glare of Dr. Snood, who stood on his personal Olympus and hurled down thunderbolts meant either to destroy or educate her, she could not tell which.
Vivian, a chronic succeeder, tried to help her. She knew all her own patients as intimately as her own fancy underwear, and even knew many of Jemma’s better than she did. Outside Ella Thims’s room, after Jemma had summarized the little girl’s progress overnight, stuttered out her incomplete assessment, and murmured a vague plan for the day, Dr. Snood tested her knowledge. “What is most likely to kill this child?” he asked Jemma when she was done talking. For a moment Jemma could only consider his horrid bangs, the combed-forward emissaries of a hairline that had probably receded to his neck. Your dreadfully ill-advised hairdo! she wanted to shout, but she said nothing yet. Instead she put on her thoughtful face, a look like she was just about to speak, which always bought her a few moments in situations like these. She looked past Dr. Snood, and Anika, and Dr. Chandra, and Timmy. Vivian caught Jemma’s eye with her own and fed her the answer. She turned around and placing her hands on her lower back, rubbed her flanks sensuously. She was able to do most anything sensuously. Jemma had scrubbed in for surgeries with her and seen men stare helplessly as she washed her long fingers, each separately, one after another, and when she put on her long sterile gloves she looked like she was getting ready to go to the opera.
“Her kidneys,” Jemma said.
“And what else besides?” Vivian wrote it in the air behind them, a giant P, then a U, and finally an S.
“Infection,” Jemma said boldly.
“Those are the two most likely,” said Dr. Snood. Vivian couldn’t help her anymore when Dr. Snood asked about the particulars of Ella’s kidney disease, mesangial sclerosis not lending itself to mime. Inside the room Dr. Snood triumphantly revealed the cause of Ella’s elevated blood pressure, rummaging in her twisted blankets to bring out her antihypertensive patch. “See that she gets another,” Dr. Snood said, sticking it to Jemma’s forehead and sweeping out of the room.
“Bye bye!” Ella said, waving both her swollen hands. Outside Cindy Flemm’s room, after Jemma finished what she thought was a very thorough presentation, considering how little she knew the patient, and that she’d hardly touched her, Dr. Snood asked her impatiently, “But what about her stool?”
“I don’t know,” Jemma said. That was the wrong answer to give a man who had devoted his life to the bowels, and it literally turned the remainder of rounds to shit. Thereafter Dr. Snood uncovered her failures with a curious combination of fury and glee, and made a great show of interrogating all her patients on the quality of their feces. Kidney, a lowly consult, got deferred to afternoon rounds, but not even Pickie Beecher, whose mood Jemma pretended (fruitlessly) to know intimately, escaped questioning, though he had no GI complaints. Dr. Snood pointed out to Jemma the risk of intestinal obstruction in a boy who habitually consumed all the hair off his head. “He could have a bezoar,” he said, “a bezoar” and the strange word sounded like a curse on her incompetence.
“And how are your poops?” Dr. Snood asked Pickie Beecher, after the briefest conversation about his mood, conducted while the rest of the team stared out the window or pointedly away from it—it was another distinction, noticed not just by Jemma; some people did the windows and some people didn’t. Timmy and Anika kept their eyes on the floor, but Vivian and Dr. Chandra kept their eyes fixed on the horizon.
“Lonely,” said Pickie. “And my bottom is hurting. I have got a sore on it.” Dr. Snood, raising an eyebrow at Jemma, asked if he could see it. Pickie Beecher obediently turned over in his bed, lifted his rear, and raised his gown.
“Look closely,” he said, and Dr. Snood did, whipping a penlight from his pocket and peering almost eye to eye into Pickie Beecher’s bottom.
“Where is the hurting?” Dr. Snood moved his light and his head at various angles.
“Here!” Pickie Beecher said, and cast a net of liquid brown and black stool over Dr. Snood’s head and shoulders. Then he collapsed in a paroxysm of giggling, rolling off the bed to the floor, laughing and laughing while the uniquely hideous smell filled the room and everyone but Timmy and Dr. Snood held their sleeve to their nose. Dr. Snood stood up calmly, touching his finger to the stool then holding it at arm’s length for inspection. “Fetch me a guaiac card, Dr. Claflin,” he said to Jemma. “I do believe this is melena.”
Here and there, in blocks of two or three hours, she and Rob would sleep. He’d finish crying, his sobs quieting to little hiccups, and then he was snoring and already starting to drool. Jemma always fell asleep soon after him, but woke within an hour or two. She might watch him for a little while, note his eyes moving under his lids and wonder if he was dreaming of his mother and his sisters, but then she would rise and wander. Every night, passing by the patient rooms, she’d see nurses or parents or bleary-eyed residents, standing beneath the televisions and looking uselessly from channel to channel. She would have avoided the television in any disaster, anyhow. All the late junior disasters had made her stomach hurt to consider, and she’d actively run away from the screens everywhere that played them over and over again. She stopped once beside a nurse she didn’t know and looked up at the screen, imagining in the static an endless repetition of flood, a supremely high and distant vantage that showed the earth in space turning a deeper and deeper blue. If you flipped for long enough the angel-lady would offer you a cheery movie, whether you wanted one or not.
They wanted a voice and an image, she supposed. Someone to tell them what was happening, even after the windows cleared and it became so obvious what had happened. Never mind that the angel broadcast blessings in her buzzing, broken mechanical nose voice. They were as repetitious and horrible, in their way, as a television scene would have been. “Creatures,” she’d call out. “I will preserve you.” It sounded less comforting every time she said it.
Jemma wasn’t sure what she was looking for, the first time, when she went out from her room, not sleepy and not protected by work. She felt naked to the fact of the changed world in a way she did not when she was rushing from patient to patient, trying to make sense of their diseases and their progress, or wilting under the withering abuse of Dr. Snood or Anika’s remote, lizardlike gaze. She went out into the hospital, wrapped in the stony feeling that returned as soon as distractions failed. She knew that what she felt, or rather what she didn’t feel, was wrong. She knew that it was a sin, perhaps the first and worst sin of this new world, to look out on the water and miss nothing that was under it. It was uncharitable to feel so sharply lucky, that the only two people she cared about were in the hospital with her. So she would shadow a doorway when she heard weeping coming from it, and see a parent crying in a chair next to their child’s bed, or she might follow after a nurse when she slipped into the bathroom to break down. Everyone was weeping separately. There was not, like she thought there should be, a mass weeping, no mass gathering for catharsis on the ramp, though certainly at any moment there were any number of people crying at the same time. Sometimes they’d murmur names or words as they knocked their heads gently against the nearest hard surface, calling out Oh God, Oh God, and sometimes eliciting a reply of comfort from the angel. Jemma tried to open herself up to it, and make herself susceptible to the sadness—just hearing someone vomit could make her throw up, after all, and just looking at Cindy Flemm, eternally pale and clammy, made her feel nauseated.
It never worked, it was only wearying to listen to. Eventually it drove her back to sleep, but it never put anything so distinct as sadness in her. She’d lie down again next to Rob, her back turned against his back, looking out the window at the dark sea and beating her hand softly against her chest, as if that might make her heart hurt.
“We really shouldn’t be doing this,” Jemma said. They had both fin
ished their evening rounds, Vivian helping Jemma with her patients, seeing three of them for her and writing orders on two more.
“Who’s to say?” Vivian replied. “Maybe this is the one thing we should be doing, above all others. The lady didn’t object. She helped. She made them to order.”
“Still,” Jemma said. They sat at a little table in a playroom on the fourth floor, emptied of children by the late hour. Jemma’s chair was far too small for her, but she found it comfortable, to sit with her hips flexed and her chin on her knees. She watched Vivian as she arranged and rearranged crumpets on the tiny plates, and lifted the lid off a teapot only as big as her fist to check the progress of the steeping.
“Doesn’t it smell wonderful?” Vivian asked, holding the teapot toward Jemma and moving it under her nose. Jemma coughed at the acid, bitter odor.
Every month or so, before the Thing, Vivian would have Jemma over for mushrooms. She would make mushrooms over pasta, or a mushroom ragout served in pastry shells, mushroom salad served up in a wooden bowl big enough to wash a baby in, mushroom pizza, mushroom brownies, and once, ill-advised, nauseating brown mushroom smoothies. Then they would talk all night in Vivian’s apartment, a place she decorated with artificial monkeys from her extensive collection, plastic and plush, metal and wood, sitting on shelves, perched over door frames and posed on the furniture in tableaux that were gruesome or whimsical depending on the mood of their mistress. Their eyes of button or glass always seemed to watch Jemma as she lay back on Vivian’s lime-green sectional. “Your monkey,” Jemma would whisper, “he’s staring at me!” No matter how many times she said it, it always seemed hysterically funny. Once or twice the monkeys might hiss or spit, or speak a line of poetry, or caress each other lewdly. At the height of each trip she and Vivian would go outside and walk hand in hand through a world that seemed to Jemma to thrum with a secret significance that she knew but could never express. Once they stood on the bridge outside Jemma’s apartment and watched the moon rise. No ordinary moon, it was too big, and too white, and seemed to stretch and pull itself like taffy until it stood up out of the water, a magnificent, god-like schmoo. Jemma looked at her own hands bathed in the pure white light, and felt like she finally understood what they were for. She reached over to touch her friend, who was trembling and glowing. When she put her hands over Vivian’s heart she was filled with inexpressible, deep understanding, which passed as quickly as it flashed over her, but left her with a serene sort of hangover.