The Children's Hospital

by Chris Adrian

  “Not exactly,” Rob said, ordering a pitcher of lemonade. They took it to the window at the end of the hall and stood together in a patch of sunlight. The sky was marked here and there with starfish-shaped clouds, and the sea matched the color of Ishmael’s eyes, gray green.

  “You don’t remember anything about before?” Jemma asked him again. “Not anything at all?”

  “That’s what he said,” Rob said, with a hint of testiness, because Jemma had been asking and asking this question.

  “Not a thing.”

  “It must be nice,” Jemma said. “Not remembering what you lost.”

  “Maybe it is,” he said, staring at her. “I have nothing to compare it to.” His thin blond hair stuck up from his head in a half-dozen different cowlicks, and made him look even younger than he probably was. She wanted to smooth it down.

  “It must be… nice,” Jemma said again, and looked away from his eyes. Ishmael laughed, a pleasant sound, a deep, Santa-like ho-ho-ho. Rob was smiling as he sipped at his lemonade. Jemma tried to smile, too, but, though she was showing her teeth, what she was doing did not feel like a smile, and she knew it must look ghastly. She looked back at the sea, envying this blank man his blank history, and wondering what it must be like to come new into this place.

  “Seven miles,” Ishmael said, looking out the window with her. “I suppose I’ll just have to wait to believe it.”

  “I’m still waiting,” said Rob, and Jemma thought, Liar, because nobody could cry that hard for something that they didn’t believe in.

  “What sort of patients are up here?” Ishmael asked after they had all been silent and sea-gazing for a moment.

  “It’s a rehab floor,” Rob said. “Kids who are medically stable but have to learn to walk again, or hold a fork—that sort of thing.”

  “And little lunatics,” Jemma said. Pickie Beecher appeared in the hall, as if on cue. They watched him walk down to them. He was dressed in the lavender pajamas that came with his room. She had been spending a lot of time with him, working up his melena under Dr. Snood’s whip, a tough job for Jemma, who could muster no enthusiasm for shit, and did not like even to consider it. She especially did not like to see it, and when she happened upon it, which she often did during her third year of school—it was always leaping out at her from within the pants of the homeless derelicts she encountered in the ER, or shooting out with the baby in a delivery, or surprising her when she turned back the sheets of the deranged or demented—it haunted her, so she’d think the odor was clinging all day on her clothes and her hair. Worse than anything was having to go seeking after it, finger first, the student’s duty.

  But the mystery of Pickie’s poop had to be solved, so Jemma had scheduled the tests and accompanied him down to radiology and to the endoscopy suite. First, she repeated the guaiac test on two more specimens: Pickie dutifully shat in a plastic hat for her, then peered over the rim of the hat as Jemma poked at it with a little stick.

  Two more bright blue hemoccult cards later, she took him down to nuclear medicine to look for a Meckel’s diverticulum, an entity dimly recalled from her first-year anatomy class. “It’s an extra thingie in your belly,” she told Pickie, while the surviving radiology attending, Dr. Pudding, stood behind a dark glass, calling out orders to the tech over an intercom. She was not sure how to describe to a six-year-old a pocket of ectopic gastric tissue in the gut. “It can make you bleed because it makes acid where there shouldn’t be acid.”

  “Sometimes I have a bitterness in my belly,” he said, lifting and dropping the heavy hem of her lead apron. He held very still for his IV, and for the repeated films of his belly. He waited patiently for the technetium to distribute through his body, playing a game with his hands, twisting his fingers up one on top of the other, and then untwisting them. When she told him that the scan was negative he shrugged and said, “I do have a bitterness, though.”

  Colonoscopy necessitates a cleanout. The term brought to Jemma’s mind images of merry little maids sweeping out one’s colon, but it was actually accomplished with large volumes of an osmotic laxative. All night long Pickie Beecher was flushed out with three hundred cc’s an hour of polyethylene glycol. Jemma put the nasogastric tube down herself, while Thelma watched. It was not a procedure that required finesse; you greased the tube and shoved it in, encouraging the patient to swallow when it reached the back of the throat. Nonetheless, she had to do it twice. All seemed to go well the first time, she greased and shoved, and the whole length of the tube disappeared into his nostril, but when she tried to flush it nothing would go in. Then she noticed that Pickie was working his jaws ever so subtly. “Open your mouth,” she told him. When he did, the coiled tube whipped out like a lolling tongue.

  “It’s chewy,” he said.

  Ten hours and four liters later, Jemma took him down to the endoscopy suite. “Sweet dreams,” she said.

  “I will dream of my brother,” he told her when Dr. Wood, the anesthesiologist, pushed the sedative. During the procedure, Jemma tried to hide behind the little curtain the anesthesiologists put up to hide themselves from the surgeons, but Dr. Snood called her out to stand by him as he manipulated the servos that controlled the endoscope. He was almost pleasant as they toured Pickie’s bowels. He pointed out landmarks like a dad on a cross-country car trip. The quality of the cleanout was a source of joy for him. “Pristine!” he kept saying. “Pristine!”

  There was only a little portion of bowel that they could not visualize, scoping from above and below. Everything else was totally normal. No bleeding ulcers, no friable polyps, no sharp foreign bodies, no granulomas. “No bezoars,” Jemma said, trying to hurl the curse back at Dr. Snood. “Not a bezoar in sight.” Dr. Snood sighed.

  “We’ll see what the path shows,” he said, meaning the biopsies. But they were normal, too. Jemma was in the slow process of setting up a tagged red cell scan (the technician who did those was dead, but the surviving ones thought they could wing it) when she solved the mystery quite by accident. Sleepless again, she’d wandered all the way to the ninth floor, taking a survey of sleeping children’s faces, compulsively checking on all her patients. She shadowed their doors, staying just long enough to see the light fall on a plump, pale face, and it was calming to her, and it was making her sleepier and sleepier.

  She found Pickie perched on the edge of his bed, sipping at a juice pack that was actually a unit of fresh whole blood.

  “What do you want?” he asked her around the straw. It gleamed like steel in the light from the hall. When Jemma tried to snatch the blood from him he ran from her, evading her easily, all the while sipping on his blood until the pack was flat as an envelope. He handed that over to her, but would not give up the straw, and Jemma couldn’t find it when she searched him.

  “I thought you were a vegetarian,” she said to him finally, after staring into his guiltless face for a few minutes, trying and failing to formulate a proper scolding.

  “Blood is not meat,” he had said simply, and Dr. Snood had a stern talk with him, and assigned Jemma the job of designing a behavior-modification program that would break him of the habit. She was still working on it, and all she’d come up with so far was slipping him a unit of O negative spiked with ipecac.

  “Hey, Peanut Butter,” said Rob Dickens, when the child walked up to them and stared. Pickie ignored him. He faced Ishmael and bowed deeply to him.

  “I see you,” he said, and then sniffed at Ishmael’s leg. “Will you accuse me like your sister in the walls? Don’t waste your breath. I’m not listening!” Then he plugged up his ears and ran off back down the hall singing la la la at the top of his lungs.

  “Well, hello to you too!” Ishmael said, laughing again.

  “Like I was saying,” Jemma said. “The little lunatics.”

  “But they’re kind of sweet, really,” Rob said.

  Every other child took an instant liking to the stranger. On the eighth floor, the hematology-oncology ward, bald children in facema
sks emerged without permission from their positive pressure rooms to give him a hug, while solemn-faced parents stared appraisingly at him. Rumor of him had spread immediately through the whole hospital. Not just the children wanted to touch him. Nurses and doctors and technicians and more outgoing parents stopped the three of them as they walked to shake his hand, as if to congratulate him for surviving.

  On the ninth floor Jemma had decided he was jolly. On the eighth she decided he was kind, and that he had children, despite his youth, because of the way he touched the heme-onc kids, without any fear, and because of the way he talked to them, which was neither the overly familiar, unctuous babbling or the stiff, formal butler-talk engaged in by people who were unfamiliar with or afraid of children. On the seventh floor she decided he was catty, because he turned to her, after a pear-shaped nurse had scolded him for tickling a liver-transplant kid without washing his hands first, and whispered, “Her ass is as big as Texas!”

  “As Texas was,” Jemma corrected.

  On the sixth floor she decided he was patient, because he suffered Ella Thims’s game of pick-up-my-toy with utter calm. She sat in her red wagon at the nurses’ station, repeatedly throwing a toy phone on the floor and clapping her hands together. He’d pick up the phone and hold it to his ear, saying, “Hello, hello? I think it’s for you!” before handing it back. Ella wiggled in her flounces and cackled delightedly every time she got the phone back. Jemma could do it only once or twice without wanting to chew off her fingers, but Ishmael played the game twenty or twenty-five times before Rob dragged him on.

  They were delayed again while he entangled himself in other games, playing hopscotch in the hall with a pair of pale, spindly CF twins, and pulling in a surrey a five-year-old boy recovering from myocarditis.

  “You look great, Ethan,” Rob said to him as the boy lashed at the stranger with a terry-cloth rope cut from a restraint.

  “I feel great!” he said. This was the boy that Jemma had helped code on the night of her trip with Vivian. His heart, ravaged by a virus, huge but weak when Jemma had met him before, was now almost back to normal. The day after his bad night his edema was improved and his three different murmurs, each more pathological than the last, were all silenced. Aloysius Pan, the overworked and perpetually sour-faced cardiology fellow, had echoed him for a whole hour, not believing what he was not seeing. “Do you want to hear how loud I can scream?” he asked them, not waiting for an answer before splitting their ears. A nurse and his mother called out for him to shut up. “Before I could only make a peep,” he said defensively. Everyone had recognized his improvement as a miracle though no one had named it such, and he was the only child in the hospital who was definitely getting better.

  On the fifth floor she decided Ishmael was thoughtful, because he brought replicated flowers to Janie, and she suspected he had been a wife-beater, because there was something too practiced about his apology, and about the flourish with which he presented the bouquet. She felt sure, despite his protest to the contrary, that he had done this before.

  Still, on the fourth floor she knew he was gentle, because of the way he held one of the sturdier preemies, recently extubated but still with a feeding tube in her mouth and oxygen prongs in her nose. Little black girls were famous for being the best survivors, and this baby was the star of the unit that week, but she still fit in his hand with room left over. As he stroked her head with two fingers her saturation rose to a new personal best of 97 percent.

  “And who is this little monster?” he asked about Brenda. “Hello, Princess,” he said, putting a hand on her isolette.

  “She really is a princess,” said Rob. “Or she was.”

  “If you touch her, I’ll break your hand,” said Anna, stepping up on the dais with a new bag of feeds in her hand. The feed bag was softer than a pillow, but she handled it in a menacing way.

  “Just admiring,” said Ishmael. When they all looked down at Brenda she pointed again squarely at Jemma.

  “I wish she wouldn’t do that,” Jemma said softly.

  “She’s just stretching,” said Rob.

  “It means she really likes you,” said Anna. Ishmael pointed back at the baby, and laughed.

  On the third floor the tour paused, then ended, in the big playroom. There Jemma decided she could really know nothing about him, and that she was being foolish, thinking she could assemble her cursory perceptions of this man, the strangest of strangers, into anything resembling a real person or a real life. She watched him play in a pool of colored plastic balls with Rob, Ethan, and two others, both Vivian’s patients, unrelated boys with the same rare intestinal lymphoid hyperplasia that required them to be fed periodically through their veins. He and Rob grappled, each holding the other by the shoulders and not moving, though both grinned ferociously and waves of tension seemed to flow from body to body across the bridge their arms made, until Rob was thrown. He spun around once in the air and sent up a splash of colored spheres when he landed. Then all three boys jumped at once on Ishmael, and hung on him like on a tree, one from his neck, one from his arm, and one around his waist. His Santa-laugh filled the whole room, the second biggest one in the hospital, a gym-sized space filled with every sort of amusement

  “Who is that?” Vivian asked her, when she caught up with them after rounds.

  “That’s him,” Jemma said.

  “You’ve got to be fucking kidding me,” Vivian said again and again, placing different emphasis on different words each time, now on the got, now on the fucking, now on the kidding, as Jemma told the short story of Ishmael’s exit from the sea. Her face changed while Jemma spoke. Jemma thought he was having the same effect on her that he had had on everyone else; that his survival outside the hospital was inspiring hope for other miraculous survivals.

  “Look at those arms,” she said. “Look at those hands. He looks nice. I bet he’s nice. Is he nice?”

  “Nice enough,” Jemma said. “So far. We all just met him.”

  “Well God damn,” Vivian said, staring and shaking her head and idly rubbing her belly in the same way she always did on one of their nights out, staring in a bar at some new galoot.

  Jemma might have given her proprietary lecture, the same one she’d shouted in nightclubs at her unlistening friend, with the added caveat that this was a man who had just washed out of a killing sea, a miracle and a mystery and a danger, but just as she opened her mouth to give it she noticed Rob, still sitting up to his chest in round plastic balls. He had been staring at her, for how long she did not know, one finger resting precisely on the top of his head.

  “I’ve been praying,” Rob said to her in the call bed. She lay against him, her back to his chest. His big hands were folded neatly across her belly.

  “I think I noticed,” she said, thinking of the times when she knew he was not sleeping, but he would not answer when she called his name in the dark. Sometimes she would hear a stray whisper from him, words that sounded like the names of his sister or his mother.

  “Not something I’ve ever done before.”

  “I know.” He came from a family of supremely rational atheists. Jemma had found them difficult to get used to, the way they said just what they meant, proposed every action before executing it, and kept their promises.

  “I wonder if I’m doing it right.”

  “Is there a wrong way?”

  “There must be. Doesn’t there have to be? Something’s been going wrong, hasn’t it?”

  “You’ve been listening to Dr. Sundae.”

  “Would you like to pray… together?”

  “No,” she said simply. “Maybe you could ask Father Jane.”

  “We could just say a little one.”

  “Or we couldn’t.” She hadn’t said a prayer since Calvin died, and even before then it was only the ones he taught her that she said regularly. She thought of his book, and wanted suddenly—the desire came as swiftly as a cramp, and was as much of a surprise—to read it. She’d thrown it away as soon as sh
e read it, and now remembered nothing except for a few scattered phrases like blasphemy is the straightest route to God and Grace is perfectly violent, raving testimonials to his most secret insanity. When she’d thrown it in the river it had felt like the first right thing she’d ever done, but now she wished she had it with her, and pictured him sometimes, kicking Father Jane in the face and taking her place before the podium to read from it until everyone in the audience bled from their ears.

  “Maybe later,” he said.

  “Maybe.” She tried to imply maybe never.

  For a while they were quiet, Jemma watching the window. Every so often a wave would splash against it, but mostly it just showed the darkening blue sky.

  “This was nice,” he said, squeezing her.

  “Very,” she said, though it had not been one of the great ones.

  “It seemed like we should wait forever, before. And then after today I didn’t know what we were waiting for.”

  “I’m not sure either.”

  “It seemed wrong, to do anything like celebrating.”

  “Oh,” she said, thinking but not saying how there was such a thing as miserable desperate fucking, and a sort of fucking you did when you felt bad that was not necessarily meant to make you feel better about anything.

  “Do you think anybody else… do you think this was the first time?”

  “Who knows?”

  “Well I hope it gets things going all over the hospital. I want everybody else to feel better like this.” He squeezed her again.

  “What was the water like?” she asked after a moment, thinking of how warm it was on her foot.

  “Like soup. I should have washed it off. It’s disgusting, when you think about it.”

  “Don’t think about it.”

  “Do you think that anybody else could come up?”

  “I guess. Maybe.” She thought of his mother and sister, rising entwined through the blood-warm water, passing through the shadow of the hospital. She closed her eyes and saw a hand and a face at the window.