The Children's Hospital

by Chris Adrian

  That morning he was surrounded by his family in his very crowded room. His incipient death had called every available relative to him—his mother and grandmother were with him, his three sisters, his brother and brother-in-law, his twin eight-year-old cousins, and his aunt and his uncle. Only his father was missing, stuck in Bolivia, from whence he had been trying to come since his son had been diagnosed three months previous. So there were bodies everywhere in the room, though since the Thing the hospital had grown enough new rooms that everyone could have moved out. They lay on the floor or in the window seat, in cots and reclining chairs. One of the little cousins was stretched out beside the patient, the other one was curled at his feet.

  Jemma examined him without waking him, something she did not like to do because it felt akin to molestation, pressing on a sleeping body’s belly, and slipping your hand under his shirt to guide your stethoscope over his heart. He looked just like a chemotherapy victim, puffed out with steroids, the same length of hair growing over his head and his chin. One arm was shoved down his pants, the other was thrown over his cousin’s neck. When Jemma whispered his name and shook him he would not respond. She had met teenagers before who feigned sleep no matter how hard you shook them, because they were tired of being woken at six in the morning to talk to a doughnut. She called his name once more, rather loudly, and a stirring passed from body to body all around the room, a shudder, as if the same nightmare creature had gone skipping from dream to dream to disquiet the sleepers. She took his vitals sheet and stepped carefully among the bodies and out of the room.

  Josh Swift was next on her list. She had the chart story: sixteen-year-old boy with trisomy 21 who’d manifested every possible unfortunate association of that syndrome in his short life—duodenal atresia and an endocardial cushion defect and acute myelogenous leukemia—as well as a number of entirely separate afflictions, admitted this month for a big clot in his head. He’d complained of a headache to his primary-care doctor, a lady familiar enough with his disaster-prone protoplasm that she immediately scanned his head, and discovered a venous sinus thrombosis that extended all the way to his jugular. “He’s a freak,” was all Maggie had said about him, “a freak’s freak.”

  But that description dismissed his complexity. He was, in clinical parlance, delayed, a term Jemma found a little curious, because it seemed to imply that the children so described would one day catch up with the normal children, yet they never would. But he had just enough insight into his condition to understand that fortune had treated him very badly—there was a note in his chart from a consulting psychiatrist who’d come by weeks before to evaluate him for depression. Jemma had always thought the extra twenty-first chromosome must code for an abundance of some protein responsible for contentment and sweetness, because all the Down’s syndrome children and adults she had met were smiley and gentle, or that on account of their diminished capacities all the existential sadness of the world passed harmlessly over their heads. Not so with Josh Swift; he knows there is something wrong with him, the psychiatrist had written, and he wants us to do something about it.

  “How’s your head feel today?” Jemma asked him, after she had introduced herself. She found him awake, staring out at the sunrise with his blanket drawn up to his neck.

  “Yuck,” he said, putting out his tongue so it hung over his chin.

  “Worse than yesterday?”

  “Much worse. Much, much worse.” When he frowned at her his big tongue made it look like he had three lips. Jemma hated headaches, especially in patients who had things happening inside their heads, because they made her feel compelled to do a complete neurological exam, the weakest part of her physical next to listening to hearts. She took out her penlight and approached him, ordering the cranial nerves in her head, trying to remember if the glossopharyngeal nerve was number nine, or twelve. She shined her light in his eyes and had him follow the beam as she swung it back and forth across his face. He wrinkled his forehead and smiled for her, stuck out his tongue again and said, “Ack!” She put a hand against his face and had him turn his head into her palm against the strength of her wrist, once on the left, then again on the right. When he did it on the right he touched her palm with his tongue. She thought this was an accident.

  The last one she tested was number eleven, the shruggy nerve—she could never remember the proper name for it. She asked him to turn down his blanket so she could test his shoulder strength. She meant for him just to slip it down below his chest, but he threw it down to his belly, then gave two scissoring kicks to throw it to the floor.

  Had Maggie told her he slept naked? Jemma didn’t think so. She stared at him for a moment, at the thumb-wide sternotomy scar that ran down his chest, and the mass of scars on his belly, and his little bitty penis, lost in a thatch of hair as thick and coarse as a mass of bean sprouts. It was as small and stiff as a pinkie.

  “Put it in your mouth,” Josh told her matter-of-factly. Then he laughed, so his belly scars writhed like sporting worms. “You need to examine it,” he said, reaching toward her head, “with your mouth.” Jemma dodged his hand, and moved to retrieve the blanket. When she tossed it over him he started to cry, and said “You don’t like me. You don’t like me at all!” This was a true statement, but she didn’t tell him so. She just ran. The nurses giggled at her when she sat down at the station to recover. “You guys got a date?” one of them asked her. “When’s the wedding?” asked another. Jemma bent and vomited briefly in the garbage can beneath the desk. “Oh please,” said the first nurse. “He’s not that bad.” But the second nurse patted her back, and wouldn’t hear of it when Jemma offered to change the trash bag.

  Ethel Puffer, a fifteen-year-old girl with rhabdomyosarcoma, a malignant tumor of striated muscle that had popped up in her left thigh and nearly killed her, was more pleasant, if a little weirder than Josh. She went early to the doctor but came late to diagnosis; her pediatrician had thought it was the usual misery of adolescence somatasizing into limb pain. She had been a peppy and inspiring cancer victim, the sort to paint a smiley face on her bald head, bring homemade cookies for the nurses every time she came in for chemotherapy, and spend her time between retching spells boosting morale in the other kids on the floor by means of a rather sophisticated sock puppet show whose degree of obscenity depended on the age of her audience. Before her illness she had been a diver and a gymnast, and up until the Thing she could still be seen walking up and down the halls on her hands.

  Now she was changed. She’d crashed the night of the storm; an occult bacteremia had made her septic, and she’d been nearly as sick as Juan Fraggle for a few days. When she recovered, and woke up again, and understood what had happened, she crashed again, differently. For a few days she would not speak or eat or drink, so Dr. Sashay put her on TPN and searched fruitlessly among the surviving staff for someone who could do a psych consult, coming closer every day to letting Dr. Snood inflict his amateur best on her patient. Then one night Ethel had rung her midnight nurse to ask for a bucket of black paint. He’d obliged her, thinking she was going to craft her way out of despair. When Maggie went in the next day she found that Ethel had blacked out all her windows, and painted a black skullcap on her bald head, and made herself the most incredible pair of raccoon eyes, and rinsed her mouth with paint so her tongue and her teeth were black. “Let me do you up,” she’d said to Maggie. “You’ll feel better.”

  When Jemma went to see her, Ethel’s room was blacker than ever. Dr. Sashay would not restrict her access to black paint, so every day she added another layer to her windows. The sun was well above the water, but when Jemma went in at first she could hardly see her own hand in front of her face. It was fifteen minutes since her last trip to the bathroom, but once again she felt a terrible urge to pee. It occurred to her that she could squat in a corner of the room and wet the carpet and the patient would never know.

  “Hello?” she said into the darkness. “Ethel?”

  “I am here.”

 
“I’m Jemma. I’m your new student. Like Maggie, but not Maggie. How are you feeling this morning?”

  “I am here.”

  “Is your leg hurting at all?”

  “I am here.”

  “Okay,” Jemma said. She moved on to the exam. “She’s just working through it,” Dr. Sashay would say of Ethel. “Think of what she’s gone through, and what she’s lost. Think of what we’ve all gone through, what we’ve all.…” She’d turn to Jemma and put a hand on her shoulder. “Don’t you want to paint your head black?”

  Ethel tolerated the exam. The longer Jemma was in the room, the better she could see her; there were places on the glass where the thick paint had cracked or flaked, so a few motes of light slipped in, and a few more from under the hall door. The way her painted skin blended with the dark, it looked like her face ended just above her eyebrows.

  “Put your hand under my thigh,” Ethel said suddenly, just as Jemma was finished listening to her belly. Jemma hesitated, visions of Josh Swift still belly dancing in her head. “Please,” Ethel said. “Do it.” Jemma put her hand under the covers, and under a firm, muscular leg.

  “Wrong thigh,” said Ethel. Ethel moved Jemma’s hand with her own until it rested under a hollow under the other leg. It sat there for a few moments, between the warm flesh and the damp sheets, before Ethel spoke again. “Do you feel it?”

  “Feel what?” Jemma asked.

  “My lump. Do you feel it? It’s what I’ve got. It’s my thing, what’s with me. It’s mine.”

  “Yes,” Jemma said. She wasn’t sure if she did or she didn’t—it might have been a stringy muscle belly rolling between her thumb and her finger under the thin scar, but it was hard to suppress the reflex that made her, when asked Do you hear this murmur, Do you see that cotton wool spot, Do you feel my lump, say Yes, Dr. Snood, Yes Dr. Sashay, Yes Ethel Puffer. Ethel reached a strong claw around to clutch at the back of Jemma’s thigh.

  “I feel yours, too.”

  Laziness used to protect her from extreme anxiety. It was so exhausting to fret; at a particular threshold of worry she simply gave up—before the Thing, she’d always thought nothing worse could happen to her or to the world than the death of her brother and parents—and then whatever happened, happened. But since that anniversary day with Pickie she’d known no ease, and as the seventh week in the hospital had passed she woke every morning with an increasing sense that something was terribly wrong somewhere. Something was wrong everywhere in the hospital, on every floor and in every bed—even the well sibs were falling ill, one of them coming on the one service just as Jemma did, a hopeless new diagnosis of metastatic medulloblastoma—but Jemma had a strange feeling like she was missing something very particular. Yes, I know, she said to herself, and to this feeling, I’m fucking pregnant, and assumed that it was something wrong with the baby, and that the feeling heralded a pending miscarriage. She ran to the toilet a few times when she got a weird burning low in her belly, and looked through her legs at the water, expecting to feel the gruesome drop and see a swirl of blood and parts, surprising herself by whispering, “No, no, no, no.” But the toilet water stayed the same pale blue-green color it had turned ever since the angel took over the hospital physical plant, and the days passed, and every indicator, including Vivian, who as a gunning future obstetrician was the closest thing Jemma had to a gynecologist, said the baby she carried was fine. She went visiting her old patients, checking up on them. They had all taken turns for the worse, just like Maggie had said, but no one was actively trying to die. So she checked instead on acquaintances, making a round of nosy visits, to Vivian, to Ishmael, to Monserrat the Tamale Lady, to Anna and Brenda up in the nursery, asking of them, “Is everything okay? I mean really okay?” Nothing was okay, anywhere, but it was no worse than usual.

  And she looked, of course, for her pal, child number seven hundred. She had not caught even a glimpse of him in more than a week and a half, so she started to look for him in all her spare time, hiding in all the places she’d seen him before, waiting to pop out and accost him, but he never showed. The longer she looked, the more the feeling grew, until she convinced herself that it was just him—not her baby, not the pending death of her patients, not fighting with Rob all the time, not the end of the world. He alone was the source and the target of her worry.

  By the end of her first day on Dr. Sashay’s service, though she was worn out by all the new illnesses and by the attending’s unrealistic expectations and by Rob’s repeated proposals, she was so worried about the foul-mouthed kid that she couldn’t sleep. Rob lay still beside her, but she didn’t think he was asleep, either. “Marry me,” he’d said again that evening, as they settled into bed, she for the whole evening, he for whatever sleep he could grab before the first call came from the one floor.

  “No,” she said.

  “Marry me. Let’s just get married.”

  “No.”

  “Why not?”

  “Because I don’t want to have this conversation.”

  “That’s not even an answer.”

  “Sure it is.”

  “What are you… why won’t you… God damn.”

  “God damn is right,” she said, and turned away from him, thinking of the boy, and not her boyfriend, so it was him laying beside her, frustrated and confused, thinking he didn’t know her at all, and he didn’t, if he thought she could just up and marry any old body when she was already married. It had been enough of a ceremony to last a lifetime, when Calvin gathered up leftover blood from one of their parents’ fights and ashes from their cigarettes, and mixed them together in a paste that she only just barely let him put on her tongue. It was Calvin at his ritual-making best—he had a ceremony for everything, after all—who made her swear, clothed in her mother’s old prom dress at the age of nine, to take him as a husband. “It’s not incest,” he said, though she did not know enough to raise that objection. “It’s protection.” He meant to protect her from the misery of matrimony by taking her as a bride himself, and then making her swear, on pain of utter doomsday punishment, never to forsake him. It was easy enough to swear, back then. He was still the most important boy in her life, and she could never have imagined that anyone would supplant him. She got up to look for the boy. Rob didn’t say a word.

  Exhausted with worry, sick of worrying, angry at herself for enslaving herself to anxiety, and angry at the elusive boy for making her worry, she walked the whole length of the hospital. She’d grown a superstition—if she behaved all day and tried hard at work and didn’t have ice cream for dinner and thought one charitable thing about every third person she met out on the ramp or in the lobby or on the roof, then she’d be rewarded at the end of the day with a glimpse of him. Never again to speak to him, never to touch him and never, ever to hear him answer what was wrong and ease her worry, but if she was good she could see him, and that was its own small relief. That night she searched and searched for hours and got nothing. She covered all the usual places—she loitered in the research wing and threw open the door to a dirty utility room in the endocrine ward and slipped quietly into a meditation room on the psych ward—and a dozen unusual ones, even under Pickie Beecher’s bed. There was not even a discarded blood pack there.

  On the roof she finally resigned herself to failure, to lying awake all night, trying to tolerate this intolerable feeling, and was drifting back down toward her room when she noticed that the worry was increasing as she went lower and lower into the hospital. On the ninth floor it was a bother, on the seventh a weight, on the fifth a burden. As she passed the fourth floor she noticed that she was breathing fast. On the second she began to sweat profusely. Outside the gift shop she took her pulse: one hundred and twenty beats per second. She walked around the lobby, following her worry, and it led her to the door to the basement. It opened to her hand, and she went down.

  Two, then four flights passed before she even reached a landing, let alone a doorway. The walls opened up after the first flight of stairs,
or rather, they were replaced with walls of pipes and wires through which Jemma could make out the shadows of more pipes and wires. A breathing noise was rising up from the stairwell. Jemma stopped, because her worried feeling grew suddenly a little bit duller. The light stopped another flight down; she saw more stairs descending into the dark. She turned around and went up another flight. The feeling came back, and worsened as she stepped out onto a ledge among the pipes. It ran in either direction for fifty yards under a straight row of yellow lights. Jemma went left.

  The lights were not as bright as they were on the stairwell. When something crunched beneath her feet she thought she’d stepped on a bug, but when she stooped down she saw it was a candy-bar wrapper. She encountered them more frequently as she walked, scattered on the floor, or stuck to a pipe by a piece of dried residual chocolate. Her worry mounted, but she didn’t need it anymore to guide her. She had the wrappers, and also a scent she remembered from the days when she’d shared a bathroom with her brother: old pee. It became overpowering as she walked on. The platform stopped at a row of thick pipes seven abreast, but opened on her right. Garbage lay thick before her. She stepped on a plastic bottle and it curled around her foot, an accessory shoe that she had to sit down to remove. The space grew closer as she moved forward. She had to duck under and twist around the pipes, and she thought she would not be able to go any farther, though her worry was all but pushing her ahead, and an odor of much fresher pee was wafting toward her. Then the pipes and wires opened into a little clearing.

  It was a rectangle, about ten by fifteen feet. At one end the trash was heaped up in a nest; a dirty hospital blanket covered part of it. Beside the nest was a smaller pile of comic books and gift-shop books of the sort to enthrall bored parents. At the other end of the clearing was a pile of clothes, scrubs and gowns and institutional pajamas. Jemma bent to examine them, and pressed on the topmost layer with her finger. A bit of urine seeped out. She wiped her finger on her thigh, and then someone struck her on the head. For a second or two she saw nothing but the bright white flash of pain, but she didn’t lose consciousness.