The Children's Hospital

by Chris Adrian

  The Committee then inaugurated the census that counted and described the survivors: 699 sick children; 37 siblings; 106 parents; 152 nurses; 20 interns; 15 residents; 18 students; 10 attendings; 10 fellows; 10 laboratory technologists; 4 phlebotomists; 5 radiographic technologists; 6 emergency room technicians; 5 paramedics; 18 ward clerks; 1 chef and 14 subordinate food service workers; 1 volunteer; 1 chaplain-in-training; 2 cashiers; 15 housekeepers; 1 maintenance person; 2 security guards; 2 members of the lift team; and the single itinerant tamale vendor.

  The census complete, they devoted themselves to dividing and conserving what had suddenly become the only limited resource in the hospital: the staff. Electricity appeared to be inexhaustible; food and medicine were both proving replicable—you had only to ask the angel for what you wanted, be it a pound of tuna or a million units of bicillin; but you could not replicate a new intern when the one you had was all used up. Karen, the chief, who had months of experience creatively inflicting merciless call on her residents, and Dr. Tiller, herself a former chief, were the architects of the various consolidated teams.

  Morale was also in their purview—Vivian formulated the slogan that was supposed to bear them all up in the first weeks: Just do the work, and Dr. Snood designed the button and the posters, but philosophies they left to the individual, and while the Committee engaged in a sort of ecumenical boosterism, it forbade any sort of religious debate in session. This policy did not sit well with Dr. Sundae, who was never able to keep her radical liberal Pente-costalism entirely out of the classroom—to sit through her Sunday review sessions was to discover how a leiomyosarcoma might herald the imminence of the Kingdom of God—and so could hardly be expected not to discuss the obvious when they were all, as she pointed out, nestled in God’s palm and afloat on a sea of grace. She pressed for the formulation of a statement of mass contrition, saying that they were sorry for absolutely everything they had done, ever, to be signed by every survivor. Even the micro-preemies would be required to append their footprints. Her measure was defeated before she could even decide to what degree everything must be quantified, or if the word alone would suffice.

  She had a slogan—It wasn’t global warming!—and a few like-minded adherents around the hospital, but the Committee was unanimous against her in deciding to uphold the tradition of strictly secular government. The rich diversity of affiliations embarrassed every catholic notion, anyway. Among the survivors the census numbered what Dr. Sundae called—not maliciously—the sparkling variety of heathen: Muslims and Buddhists and Jains and Hindus and an array of pagans including three Wicca nurses. Jews and atheists abounded, but the pseudo-Christians (her term again) were even more numerous: Mormons and Catholics and Eastern Orthodox and Coptics and Bahai and Unitarians and Jehovah’s Witnesses. Extant Christians ranged along a continuum of propriety, but away with those distinctions, she said in her impassioned speech: Presbyterian and Episcopal and Methodist and Adventist and Baptist and Lutheran and Pentecostal no more; only embrace the Trinity, the absolute sovereignty of God, and absolute repentance, and we can all be united in a new faith.

  She shook her fist and tossed her head—she had fabulous hair, black, shiny, and soft, with a lovely white stripe, of exactly the sort Jemma had always wanted for herself, which she usually kept tucked behind her ear but which waved like a flag when she was excited about something—but she couldn’t even get them to admit, officially, that the world had ended.

  “We’ll just do our work,” Dr. Snood said, summarizing the Committee’s decision on the matter. Whoever wanted to sign a statement of contrition was welcome to do it, provided it did not interfere with the regular business of the hospital—making well the children in their care. Dr. Sundae was silent, but not satisfied, and predicted that by the time the Committee had formulated the terms of its dissolution—they were only placeholders for an elected assembly to come, after all—they would understand how they were practicing foolishness. Meanwhile, she circulated around the hospital with her statement. “No thanks,” Jemma told her, when Dr. Sundae asked her to sign it.

  “She wants to be a Priest-Queen,” Vivian said later to Jemma. Vivian always found her after Committee meetings to complain and decompress. “She’s been waiting all her life for this to happen, she said, just so she could gloat. I wanted to tell her, Everyone knows there has to be something wrong with you to go into pathology. Give it up. Anyway, we put her and her Priest-Queen down. We’ll have a president or a prime minister or a something. Something different, or something better. Something new.”

  “Are you going to run?” Jemma asked They were at Vivian’s place, one of the new call rooms that had unfolded into the extra space the hospital had acquired after the Thing. As if it had taken a deep expanding breath, it had grown by at least a third. The new rooms were nicest—Vivian had a real bed and a huge television and one of those obstetric whirlpool tubs—but Jemma found them creepy and a little unreal, and worried that they might disappear as suddenly as they had come into existence, their inhabitants vanishing with them. She liked and trusted her little room better.

  “Hell no,” Vivian said, but smiling in a way that Jemma knew meant Almost certainly. There was not much time to prepare a candidacy, though, or execute a campaign, in those first few weeks, and people forgave the Committee for being all talk and little action when it came to engineering their own destruction, because they were all so busy with the ordinary business of the hospital. The babies in the NICU had been representative of a hospital-wide trend—every child in the place had taken a turn for the worse on the night of the storm, and few of them retreated from the precipice as quickly as those babies did. On the IBD ward the Crohn’s patients were fistulizing like mad and the UC boys and girls were pouring blood out of their bottoms almost as fast as the angel could replicate it. In the one wards tumors recurred or stopped responding to chemo, and sepsis became as commonplace as a bald head, though no two kids grew the same bacteria out of their blood. The anorexics on the ninth floor confessed that they felt huger than ever, and each rehab kid lost at least one hard-won-back skill every two days. It was Jane Dressel, a lesbian Unitarian chaplain-in-training who gave voice to the popular sentiment, noting in a sermon during one of her six-days-a-week services that their affliction seemed to grow day by day. It was a lot for a Unitarian to process, Jemma thought, calling on all the knowledge of such people that came down to her from Calvin—his own obsessive opinions and what was in his book: Unitarians, he had said, worshipped a great powerless unpresence. Wearing leather pants, like Jane did, probably made you better qualified to be the last cleric at the end of the world, but there was an obvious sweetness about her that, in the context of all the affliction, made her seem overwhelmed. In the first few weeks she was really the only person in the hospital doing anything like preaching, or anything like trying publicly to put a sense to what had happened to them, though private conversation and private enterprises, like Jemma’s and Vivian’s, naturally abounded, and there were already conclaves of affection, in which like-minded people came together. But a circle of hand-holding reformed Jews was not Father Jane, as people started to call her, standing in front of the podium before a standing-room crowd in the auditorium, the space that used to host Grand Rounds and the occasional medical school lecture. In her sermons she always tried to convince herself to look on the bright side, but she wasn’t stupid, and could never make a good case for hope out of such poor evidence. “We need a sign,” she told the crowd, not exactly a congregation—the avowed Unitarians in the hospital could be counted on two hands—“but signs are for us to find as well as for Him to give. Let’s look around,” she said, and she looked for signs high and low in the hospital but all that was there was sickness and grief and confusion and a curious loneliness—they were stuffed all together in this round floating box and yet weren’t they all, except the very few families that had survived intact, still strangers and still alone from each other? “The dying child is not the sign, the weeping nu
rse, the exhausted intern asleep in the middle of the hall—she looks very peaceful, doesn’t she, but look briefly on her dreams and your eyes will drop out of your head. The sign is our own hard work, and our hope, and our dedication to make these children better—they and we are the seeds of a new world.” It was as obvious, and as hard to believe, as the water everywhere outside.

  But Jemma, listening in the back, in the same seat where she’d last month fallen asleep during a lecture on the heartbreak of teenage chlamydia infection, found the sermon no more inspiring than Dr. Snood’s posters, written and drawn by the angel under his direction: people at tasks, lab techs and radiology techs and interns and residents and nurses looking very strong and committed as they shot a film or drew blood or peered into a child’s ear, all of them having inherited his strong jaw and superior posture. To Jemma they looked too strong and clean and happy to exist in this time and this place. They were a fake, and could only inspire fake, strained hope.

  A better sign than those came on the twenty-third day after the storm. Jemma was in the NICU, visiting Brenda, though the child was on Rob’s service, not hers. Rob accused her gently of being obsessed with the little girl, because she confessed that she crawled into her thoughts on the hour, and that she felt a bond of curiosity and unwarranted affection with her. “She’s got nobody at all,” Jemma said, and wondered why it should seem so horrible for this child when it could be said of all the children whose parents had been caught outside on the night of the storm.

  Her incubator still sat on its dais, so Anna always had to walk up the four steps to turn her or suck out her endotracheal tube or cater to a desaturation. “Isn’t she pretty?” Anna asked, when Jemma, AWOL from the ward team before evening rounds, climbed up to look in on her. She was larger, but no prettier than she’d been three weeks before, and was not just back on the ventilator, but had already failed conventional ventilation. Now she was on an oscillator, a machine that breathed for her hundreds of times a minute, and made her chest vibrate fast as an insect’s wing. An indwelling orogastric tube snaked along her endotracheal tube to disappear into her bunny mouth. She had more access than almost anybody else in the unit: two peripheral lines, one in her foot, and one in her scalp; a peripherally inserted central line that went in her left arm and traveled in her vein to the antechamber of her heart; and an arterial line in her left wrist. Jemma successfully followed the line of her foley where it twisted over the bed, through a bundle of wires and catheters, into a tiny urine bag.

  “She gained a hundred grams yesterday,” said Anna.

  “That’s great,” Jemma said.

  “It’s too much, honey. Normal weight gain’s about twenty or thirty, all the rest is fluid. They’ve got her overloaded.”

  “Don’t call me honey,” Jemma said.

  Anna smiled and pushed back her hair. “It wasn’t a ’fuck you’ honey, or a ’suck my ass’ honey. It was just a ’honey’ honey. It was sweet. But sorry. Sorry anyhow.”

  “Sorry,” Jemma said, too, regretting her experiment with sauciness. But she had vowed not to suffer any more abuse from the nurses, no more condescending sighs, no more stabbing diminutives, no more of the thousand ways they disguised a hearty “fuck you.”

  “It’s all right,” said Anna, still smiling, her face entirely open. Jemma, her malice sensors at maximum gain, detected none. An alarm sounded, and Anna bent over the isolette. “She’s never done that before,” she said. Jemma looked and saw that the child had turned toward her and was reaching out her arm and her hand to point squarely at Jemma’s face. Her tiny index finger, no bigger than the tip of a crayon, was perfectly straightened, and the other fingers curled in, so there could be no mistaking the gesture. “I’ve never seen any of them do that before.”

  Jemma was going to ask the question, Can infants point? But when she looked away from the little finger, she saw the man floating at the window, and screamed. It was not like her to do that, and such a girly little shriek had not escaped her lips for years and years. It was a high, teakettley little noise, short and piercing, that drew everyone’s attention, not to the window and the man, but to Jemma, who had raised her hand to her mouth. She pointed at the window, and then all the heads turned that way. No one else shrieked, but Anna said, very calmly, “No fucking way.”

  The windows used to open. When the hospital changed, the slim metal sashes disappeared, but the NICU staff, clustered at the windows, still ran their fingers over the glass, seeking an invisible knob to turn. A floor above, in the PICU, the windows were intact at forty-foot intervals along the wall. So the recovery was launched from the fifth floor, and it happened to be Rob, strong, able bodied, and, as a medical student, traditionally disposable, who was lowered down by sheet ropes to grapple at the corpse and retrieve it. Jemma, running back and forth between the floors with a growing crowd of oglers, marveled at how well preserved it was. Weeks in the water ought to have made it bloated and patched with rot, but the skin looked pink and firm, and the thin blond hair shined beautifully. Jemma understood what a big body it was when Rob was laid out along it, grabbing and seeking to get his arms around the thick chest. When they hauled him up he had an arm around the waist and one through the legs, reaching around to clutch half the square ass. Jemma could not help feeling a proprietary glee, watching Rob’s arms and back flex with the effort he was making. The corpse slipped, and Rob wound his legs around the legs, so the living and dead bodies entwined even more intimately as they came out of the water. They twisted on the rope and Rob’s face was suddenly right in front of her. He smiled.

  By the time she and the crowd arrived upstairs again the body was laid out in the PICU. Half-a-dozen people were clustered around it, bustling more than was appropriate for any corpse, no matter how miraculously preserved.

  “He’s warm!” Rob called to her. “He has a pulse!” He and a nurse were drying the man with a towel, rubbing him as vigorously as one rubbed a newly delivered baby. Jemma stepped on a sopping towel as she approached the bed, and the water, warm as sweat, splattered on her ankle. Rob, drying the face, removed his towel with an unintended flourish, revealing the straight nose, the high cheeks, the scar under the chin. Now that the eyebrows were dry they sprang up in shapes like wings. Another nurse finished attaching the man to a monitor, and Jemma saw his heartbeat illustrated on the screen.

  “Normal sinus,” Dr. Tiller murmured approvingly. She was standing apart from the action, with her arms folded, giving orders. It was a standard pose, Jemma had noticed, and the one you were supposed to assume in a code, if you were running it. This man looked too healthy to code. He looked better than Jemma felt—perpetually post-call, she was perpetually exhausted—and healthier and more rested than anyone else in the room. Still, he got the standard battery of tests, an EKG, a chest film, blood, and urine. Jemma put an IV in the left hand and took blood from it while Rob stuck the right radial artery for a blood gas. It was a big hand, with big veins laid out in perfect stark relief; an easy stick. She got it with just one try, and the man did not stir. Rob was still probing for the artery as the blood filled up her tubes, and found it just as she finished. She had never seen such bright red blood as came out of the wrist, and never felt blood as hot as what warmed the four tubes in her palm. She passed them off to a lab tech, then looked for something else to do. Janie, the nurse who had hooked up the monitor, was now putting in a foley, but struggled with the foreskin. “Shall I retract?” Jemma asked. Janie grunted. Jemma fetched a sterile glove. Vivian maintained that penises had personalities, or that they signified the personalities of their attachees. She would expound, if allowed, over gay pornographic weeklies: “Timid, don’t be fooled by the size. Sneaky. Peripatetic. Grief-stricken, something horrible happened to that one. Loyal. Loving, probably too loving.” About this one Jemma thought she would say, “Noble.”

  “Wakey wakey,” Janie said lightly as she drilled in the foley catheter with an expert, twisting motion. Then she was halfway to the door of the
bay, sprawled just beyond one of Rob’s wet footprints, because the man had woken, and sat up, and struck her with the hand that Jemma had just tapped for blood, and all with such speed that Jemma only realized it was happening after it was over.

  He was sorry. He was terribly, terribly, terribly sorry, and could not apologize enough to Janie. He said he’d never hit a woman before, or hit anyone before, though of course he couldn’t be entirely sure about that, because he had no memory of anything before he’d woken in the PICU. He did not know his name, so they gave him one. They had a contest right there in the unit: Motherfucker (Janie’s suggestion); John; Gift-of-the-Sea; Mannanan Mac Lir; Poseidon; Aquaman; Nimor; Joe. Rob called him Ishmael, and won.

  Jemma found herself the silent partner on a hospital tour, her association with Rob getting her on the bus, though evening rounds were coming and she had not seen any of her patients since the morning. Vivian had promised to cover for her, but she considered anyway how Dr. Snood would release some new affliction from his ass to punish her. It would be worth it, she thought. Rob was almost chipper as he took them from the top of the hospital to the bottom. She followed along behind their two broad backs, hurrying to catch up and then running into the both of them when they stopped to examine some aspect or attribute of the hospital. Always Ishmael would turn and smile at her when she collided with him. When he had gotten out of his bed in the PICU, all observing heads had craned back on their necks as he rose to his full height. He had not looked so tall floating in the water.

  “Replicators!” he said on the ninth floor. “Just like in that television show. I remember it… with the red-haired boy, and the little girl with the talking robot doll that smote all her enemies.”