Believing Cedric

by Mark Lavorato

  William, leaving Hanif to sort through it himself, walked through to the staging area and opened the bay doors, a burst of autumn air sighing into the building. He stepped outside, checking his watch. In the crisp distance, the approaching siren could already be heard. William scratched at his palm, sauntered out onto the ramp where he saw a car driving by on the township road in front of the hospital, loose leaves chasing close behind it, caught in the eddy of its slipstream like just-married cans tied to the bumper of a honeymoon car. He caught a single flash of the approaching ambulance strobe out of the corner of his eye while looking just beyond the township road, at the marsh on the other side of it, remembering what had happened to him early last week.

  William had been on the way out the door for his daily stroll when his wife asked him to find her a few cattails for a dried-grass arrangement she wanted to put into a tall vase by the fire. So William grabbed the pruners on his way out of the yard and climbed along the old road, now a trail, making his way past the bare spot that looked over the town, the steeples of the churches the tallest points, towering high, almighty, though unused and unthought-of. The trail continued to where it branched off to circle the marsh, which he descended toward, thinking about the logistics of cutting cattails and bringing them back intact. As usual, he was alone on the trail, which he was happy for, appreciative of the space and quiet.

  He found them easy enough, jutting out of the marsh’s edge, though most of them had already gone to seed, their brown velvet splitting along a seam that seemed to bleed out with a type of downy cotton. He decided he would pick them anyway, let his wife be the judge of whether she could use them or not, but as soon as he walked into the reeds he found himself stepping onto a ground that was veiled and unnaturally soft, which had him rethinking the idea. He stopped, looked around. A few remnants of fall colours were standing out against the browns and greys of early winter, a yellow leaf caught in the sepia culms, a brush-dab of maroon, a fist of rust. There were also birds, he realized, twittering and chirring in the rushes in front of him, hidden. On a whim, he clapped, just once, never for a moment imagining that it would have the effect that it did.

  The entire marsh seemed to erupt, and the sky darkened with hundreds, maybe thousands, of small black birds. They formed a bleary cloud that spread and thinned itself one moment, then condensed and folded in on itself the next; but it was always whorled and synchronous, always acting as one. Like history. Like a nation. There was a point when the flock passed low over his head, and he was sure he felt the wind of their countless wings, and flinched beneath its tremolo, ducking low into the sedges. Then the flock collected and spiralled above the marsh that was farthest away from him and, rather abruptly, sunk into the reeds again, leaving the autumn air empty but for their sounds, now remote and muted.

  When he stepped out of the rushes several minutes later, without having procured a single cattail, he looked both ways along the trail, as if about to cross the street, and was somehow disappointed to see that no one else was there, that he was still alone. And as he stood on the edge of the marsh again, he was struck with a strange sensation, a thought. It occurred to him that there might be someone else out there who’d experienced exactly what he just had, who had stood in some rushes mesmerized and half-frightened by a swirling flock of blackbirds. And for some reason—he couldn’t even begin to say why—it was important that that person existed. He continued on, thinking of who they might be, imagining a younger woman, an older man, crouched in another marsh, another time. When he got home, he apologized to his wife for not bringing her back any cattails. He said nothing about the blackbirds.

  And now he found himself looking for them here, in this other marsh, scanning for a brief flapping or flutter above the wetland as the ambulance sped closer, but didn’t manage to spot anything. He began to step backwards, back into the crash room, the sirens switched off as the vehicle turned into the hospital’s driveway, the engine wheezing with a final acceleration before it reached the staging area, where everyone was more than ready for it.

  The rear doors flung open, stretcher wheeled out. The paramedic that had been treating the patient in the back moved along with him, giving chest compressions as he sidestepped into the crash room. There, a collection of hands gripped on to the large man and slid him onto a proper bed, hoisting on the count of three.

  As this was happening, the paramedic that had been driving held the patient’s chart out in front of him and brought everyone up to speed. “Okay: fifty-eight-year-old male; single motor-vehicle accident off Highway 118; found unresponsive behind the wheel; no trauma noted per se, except for minor laceration to right arm; gentleman extracted from vehicle without difficulty; no pulse on arrival, chest compressions were begun; hooked up to AED and found patient to have ventricular fibrillation; shocked once, got a brief pulse, which fell into pulseless v-fib again; shocked a second time, got some electrical activity, but no pulse. We’ve been bagging and masking with chest compressions for thirteen minutes now.”

  “Thanks, John,” William, his back already turned to the paramedics, prepared to intubate while Janet hooked Cedric up to the cardiac monitor.

  “Doctor Kirby,” Hanif said, busy watching the screen, waiting to see what would come up on it, “Can you intubate please? Oh yes. I see. Good.”

  William had worked the laryngoscope into Cedric’s mouth, found the slot between the vocal chords, and fed the plastic tubing inside, fixing it onto his cheeks with stretchy material and tape. The lower part of Cedric’s face was now obscured.

  The paramedic continued with chest compressions, numbering them off under his breath, “. . . five-and-six-and-seven-and-eight-and-nine-and-thirty. Breathe.”

  The other paramedic, who had just taken position at Cedric’s head and connected the bag and mask to the tube, gave two squeezes of air.

  Everyone paused to look at the monitor. But there wasn’t much to see. No sound, no movement, no squiggling lines.

  “Asystole. Okay,” Hanif said. “Okay. I think we should try for a shockable rhythem. Let’s cut his clothes off and get a Foley in please.” A forty-five-second flurry of hands, medical scissors, yanking fists of fabric, and Cedric was naked with a catheter in his bladder, his bloodless urine a good sign.

  “Okay. Continue compressions please. Janette, let’s get an IV in heach arm.” Hanif sidled around to one of the arms and Janet handed him a needle for insertion. “Thank you.” He bent low, his face close to Cedric’s skin, fingers massaging into the flesh, looking for a vein. He found it, pierced the epidermis, taped.

  The doctor liked what he was seeing with Hanif. In William’s book, it was the little things that counted, the cordial transitions, the methodical, though still human, interactions that had to take place quickly and efficiently. He hadn’t gotten to know the resident on any kind of personal level, hadn’t invited him for a drink or quick lunch, Hanif having only been there since the beginning of the month.

  He’d apparently chosen to do a four-week elective in Ontario for a few reasons: specializing in family medicine, he’d been looking for a place where the problems he would have to deal with were sure to run the gamut, but he also wanted to be around, and interact in, colloquial English, a combination that was hard to come by in his native province of Quebec. Ontario, of course, dove at the chance to help him out. Quebecers, thought William, they’ve always gotten the red-carpet treatment. Then, checking himself, he wondered if that was really the case or just the way we liked to conjure it.

  At least Quebec is where William assumed Hanif’s roots were, even if, judging from his looks and name, along with the throaty pronunciation he’d given to an Arabic word that came up in conversation the week before, he might have been from North Africa or the Middle East. William supposed he was Muslim, though couldn’t really say why. It probably had to do with how thoroughly polite he was, as if he were trying to take up as little social space as possible, knowing how cramped the scaremongering world felt with even the
presence of his religion.

  Hanif took a vial of epinephrine from the crash cart and drew a little more than a milligram into a syringe, hastily injecting it into one of the IVs.

  William switched with the paramedic who was giving the compressions, as he was heaving audibly from the exercise, getting tired. “Thanks,” the man said breathlessly.

  Both the doctor and the intern stopped at the end of the cycle, pausing to glare up at the monitor, hoping the drug would have an effect. But there was nothing.

  Hanif, jumping the gun on the three-minute mark before he could inject more medication, followed the epinephrine up with forty units of vasopressin, into the other arm. Another cycle. Another pause, all eyes on the monitor. Waiting for a sound, a beep, a leaping spike. No activity.

  Hanif cleared his throat. He took his stethoscope from his neck and listened on the side of Cedric’s chest. “Okay. We avv bilateral breath sound with the bagging.” He lifted one of Cedric’s eyelids to check for pupil constriction with a penlight, ran his cold finger along the bottom of Cedric’s eye. There was no reaction to either. “Okay.”

  At the two-minute-and-fifty-second mark, he injected one milligram of atropine and drew blood to be sent to the lab, William’s whispering the only sound in the room: “three-and-four-and-five-and-six-and-seven-and-eight-and-nine-and-twenty-and-one-and-two-and . . .”

  Seven cycles of CPR. The quiet was becoming an uncomfortable one. Both the paramedics, with little to do, stood, shifted, watched, wordless.

  Janet picked up the chart to write out the steps that they’d taken so far, the type and quantity of what they’d administered, eyeing the blank monitor every few minutes. She wasn’t noting the information hurriedly.

  Hanif injected more epinephrine, more atropine. Janet noted it down. She stopped looking at the screen.

  William began to exchange glances with Hanif more frequently, until he eventually broke the silence, huffing, tired, “And what’s our time?”

  Hanif checked his watch, knowing that they had far exceeded the fifteen minutes that, even if they had been chasing a vague rhythm, and had done everything perfectly, would be enough to cause brain death. “Let’s just do two more cycles. Then we’ll . . . then we’ll see.” He injected the last milligram of atropine, having reached the maximum dosage, and stepped away from Cedric, toward the monitor, reading through the empty digits, watching the bottom of the graphs, his eyes busy, the screen calm.

  In the room, on the bases of the instruments and bed, the wheels teetered stationary, idle. The clinical apparatuses shed indistinct shadows onto the mottled flooring. Empty hooks on the IV stands curled, their ellipses glimmering, rigid. On the soap dispenser above the sink, a lobe of foam sagged from its tip, gradually clotting in the dry air. The cloth of the bed gripped tightly on to its folds and wrinkles.

  When the two cycles of CPR were finished, Hanif put his hands in his pockets, looked at the toes of his shoes.

  William, having stopped, took a step away from the bed. “So,” he said, waiting long enough for his own breathing to return to normal before speaking, “I guess we should call it.”

  “Right,” Hanif agreed, then leaned over Cedric to do one last test for pupil restriction. Without seeing an inkling of a reaction, he straightened up, comparing his watch with the clock on the wall. Janet, pen poised above the corresponding box on the chart, scribbled the numbers down as he said them. “4:43 PM.”

  “Okay.”

  “Okay.”

  A crackle on the radio from the ambulance just outside sent one of the paramedics to check on it, the other paramedic trailing awkwardly behind him. “We should probably be getting back. So . . .”

  William waved. “Go ahead. Thanks again, John.”

  Janet was turning Cedric’s driver’s licence over in her hand, writing things down. “I’ll uh . . . I’ll call his information into the station so they can notify the family.”

  “Thanks, Janette,” Hanif mumbled after her.

  The two men, alone in the room, stood around the body for a moment or two, William making his way to the monitor and turning it off. He found himself watching Hanif as he did so, considering the possibility that this might be the very first death Hanif had ever witnessed, the first body (besides the inert cadavers that he’d had to dissect in his gross anatomy labs) that he’d ever seen. And there was something about the way he was looking at the man’s face, as if studying it—looking over the soft dents of Cedric’s temples, the slackened muscles of his brow and cheeks—which made William aware that, for some unseen reason, this was more than just a poignant experience for the resident.

  William offered what he could. “As I’m sure you know, sometimes, with massive heart attacks, there’s really nothing medical science can do. We did our best.”

  “I know, yes. But still, it gets you . . .” Hanif broke off with a heavy sigh. “I mean, I’m wondering . . . right now . . . Do you . . . ? What do you think happens when our body dies?”

  William stiffened, became noticeably nervous, worried that the conversation was about to spiral in the direction of fluffy clouds and paradise, of Allah and seventy virgins; or was it seventy-two? William wasn’t sure. He felt suddenly ignorant, realizing that his knowledge of Islam didn’t go far beyond the discriminatory media and its regurgitated stereotypes. If he was about to have a sensitive religious dialogue, he was entirely unarmed for it. He half-cringed to clarify, “You don’t . . . mean, as in: Is there a heaven, do you?”

  Hanif flashed him a dreary glance. “No. Of course not.”

  They both snickered, releasing some of the tension.

  “What I meant was,” Hanif continued, “medically, scientifically, what do you think happens inside the cerebral cortex, to consciousness, while the brain is in the hact of shutting down? What do you make of these things like tunnels of light and your life blinking before your eyes?”

  William was focusing on the part of Hanif’s tone that almost sounded hopeful, as if it were important that this peaceable summation occurred. He also realized that this wasn’t a question he’d given a great deal of thought to. Though he did know that when you witnessed someone die, or even saw a body just after it had passed, there was a definite finality in their posture and presence, something that was unquestionable, complete. It was as if, in their deepest physiology, they had flicked a switch, an unequivocal, polarized switch. And William doubted very much that there was any kind of lingering between the On and Off position of that switch.

  But he also felt, and perhaps more importantly, that Hanif’s question, with its strange pang of hope mixed into it, was a dangerous one, one that fell on the other side of that line that William liked to draw, between hard science and everything else.

  “So you’re asking what I think happens to consciousness . . . as the brain shuts down?” William repeated, plainly stalling.

  “Yes. That is what I’m asking. What do you think?”

  Finally, reluctantly, William squared his shoulders to Hanif and answered him in a calm, deadpan voice, “Nothing.” He honestly hoped he wasn’t offending the man. That was just the way it was. He was sure of it. “Nothing happens.”

  A pause. “Right,” said Hanif, turning to look at Cedric again, though in a way that insinuated how, while that was close, it was somehow not quite—not exactly—what he, himself, believed.

  Epilogue

  The autumn that Cedric passed away brought with it unexpected gifts. One of them was the funeral itself. Melissa had sat in her appointed seat, among the featured mourners, looking calmly at the rouged and powdered face of her late father, his hands folded in a serene way that, Melissa considered, was quite unlike him. She teared, consoling her mother beside her, and wasn’t at all prepared for what she saw when she turned around at the end of the service and looked through the faces of the other people in attendance. It struck her that she knew almost none of them. Ex-business partners, ex-lovers, ex-friends. It was disconcerting to think how some of them might
know her father’s story much better than she did. It was disconcerting that she had never thought of her father’s life as a story.

  Then came the day that Julie handed her a brown envelope. Julie had been asked to go through his personal effects, and had found it, in the top drawer of his desk. It was a series of poems that Melissa had written and stapled together when she was younger, about the life of Primo Levi, the paper now supple and yellowed.

  “Wait . . . He stole this from me.”

  “Yes.” Julie grinned. “I think he did.”

  This time around, Melissa didn’t destroy the poems. She kept them in the same envelope, and left them sitting on her own desk, where they lay perfectly still.

  That winter Eamon also passed away. It happened abruptly, and due to complications after he’d caught pneumonia. Melissa was the only one at his burial. She had written him a warm elegy, one that she had imagined herself reading during the service but couldn’t quite bring herself to do it. Instead, she folded the paper into a tight rectangle and dropped it into the winter ground to be buried along with him. She lay fresh flowers at his grave. They froze.

  At her home, cuticles of snow grew along the windows. The winter air was seldom windy, and mostly grey. Nights were long, the harbour of her bed inviting. She took a bit of time off work, spent much of it in silence, the refrigerator humming to itself in the kitchen nearby.

  The envelope of poems that Cedric had stolen from her still lay on her desk. Sometimes she caught herself watching its brown lines and divots.

  Until, one afternoon, she took out a spiral notebook, sat down, and set out to write an elegy for him, Cedric. Her father.

  ( i )

  Reaching up to the frosted copper handle

  and opening the door to air

  so warm it stings the cheeks

  Supper steaming at the window

  with the sweet breath of fried onions

  Mittens drying on the furnace duct