The Book of Lost Saints

by Daniel José Older

  Ramón swallows the tide of nausea sweeping over him and moves alongside the frantic caravan, sliding the worried onlookers out of the way and then rushing ahead of the first stretcher and holding open the trauma room doors. Aliceana looks up from the tiny burnt child and you can see it takes all her strength not to gasp. “What we got? And where’s Dr. Seymour? We need more hands in here now.”

  The medics run down their list of horrors—body percentages and burn degrees, IVs placed and plummeting vital signs and to top it off the grandma’s lungs are filling up with fluid—and then a short Asian lady runs into the room, past Ramón, and starts yelling at Aliceana. “I’m not…” Aliceana puts up her palms, shaking her head. “I’m not Chinese, I mean, I’m Filipina. I don’t … someone tell her I don’t speak Mandarin.” But no one else does either and the lady’s running out of steam. Finally understanding, she sags, and moans, “Baby, my baby…” as Ramón sweeps her out of the room and into the embrace of a confused social worker armed with a pile of forms and legal documents.

  Chaos erupts in the trauma room again, nurses scrambling around the three new patients, applying blood pressure cuffs and EKG stickers, readying syringes and bags of fluid. Aliceana passes ventilating the baby to a nurse and stands in the middle of the room, her eyes scanning from side to side.

  “Does the eight-year-old have a pulse?”

  “Thready and fast, but yes.”

  “The grandma’s lung sounds?”

  “She’s wet all the way to the top.”

  The old woman lets out a series of moaning coughs and you can hear the fluid sloshing around in her airway with each breath.

  “Push one hundred of Lasix and get the intubation kit ready. How’s the four-year-old?”

  “Stable. Airway uncompromised, lungs clear, vitals holding. Burns look mostly superficial.”

  The child’s crying has diminished to a steady whimper and now he glances back and forth at his shattered family.

  “Good.” Aliceana rubs a gloved hand on his little head. “Get him out of here for now but keep him on a monitor and keep someone with him at all times. That tube good?”

  “The tube is good.”

  “Where’s Dr.… oh.”

  Dr. Seymour appears in the doorway and everyone can see he’s drunk. His nose is still red and misshapen from Catalina’s fist and he’s wavering slightly. “What … happened?”

  “Where have you…” Aliceana quickly realizes the futility of the situation. “Just get out. Get out.”

  Dr. Seymour slumps his shoulders and slinks away, and the whole room rolls its eyes at once.

  “Cooling pads on the kid?”

  “Done.”

  “I need paralytics for Grandma—she’s desatting.”

  The nurses keep bustling back and forth, but they’ve slid into a rhythm now. They’re quick but it’s not the desperate rush of the first few minutes: They spin circles and figure eights around Aliceana, barely looking up from their tasks as they call out responses, dosages, pulse numbers. Ramón watches, transfixed, until he realizes Aliceana is saying his name.

  “I … we need your help. I’m sorry. I know this isn’t what you do.”

  He shakes his head, stepping forward. “Anything. What is it?”

  “I need you to do compressions on the kid.”

  Ramón looks down at the crumpled, lifeless body, puts his hands on the tiny chest as the nurse taps out. It’s all the wrong colors: The light parts are bone white and the dark is charcoal-seared black and the flaps of pinkness peel away to reveal bright horrible red. When he pushes down, the sternum gives more than he thought it would and he lets go for a second, horrified.

  Aliceana shakes her head. “Keep going. The ribs are broken. Just keep going.” It’s gentle, a mother’s coo, and then she turns. “How many epis we got in?”

  “Four,” someone yells.

  “Where’s my paralytics?”

  “Coming! We’re looking for the narc key.”

  “Find the key!”

  “We’re looking!”

  “Gloria has it.”

  “No, Ana María took it before she went on…”

  “Wait! It’s in my other jacket. Shit! Be right back!”

  Another collective groan goes up and Ramón keeps pushing up and down, trying to be gentle and still get the job done and not look at the baby’s purple lips and glassy eyes. The baby is dead. I think he knows it now, pushing up and down on his useless endeavor. Aliceana asks how long they’ve been working on him and tells Ramón to stop. He lifts his hands away and finally takes a breath and the air tastes sweet and metallic and everyone looks up at the screen and for a second all you hear is the grandma’s raspy, wet gasps and the beeping monitors nearby, but loudest of all that empty, unrelenting drone of a heart that won’t beat.

  Aliceana shakes her head, looks around at the nurses and they nod their quiet agreement. “Four fifty-six,” Aliceana says, looking at her watch. “You get my paralytics yet?”

  The nurses put a sheet over the baby and pull the stretcher off to the side. The grandma’s flailing again; she rips off her oxygen mask and scratches one of the orderlies trying to comfort her. Pink frothy sputum sputters out from bluing lips. “Push it,” Aliceana says, walking up behind her. “And start bagging.”

  Ramón gets hold of one of her swinging arms and Derringer gets the other, and Rosalie pinches off the IV lines and squeezes in a syringe full of something thick and milky.

  “O2 sat still dropping.”

  “Blood pressure’s two-ten over a hundred.”

  “Succs is in.”

  Aliceana lowers the head of the stretcher down as the old lady slides into dream state, her gurgling howls dissolve into murmurs, and then nothing at all. “How’s the eight-year-old?”

  “Holding steady.”

  “Give me suction.”

  Ramón watches as Aliceana lowers her face shield and goes to work on the lady, prying open her jaw with a blade and suctioning out gobs of pink froth, then leaning in and sliding a tube down her throat and stepping back, panting, as the nurses scramble to get the oxygen bag attached.

  “Sats are coming back up.”

  “I need nitro hung for that pressure. And I need … Respiratory to show up with the vents. Like, now.”

  “We’re on it,” Rosalie says.

  “The OR booked?”

  “OR three is ready for her. And five for the kid.”

  Ten minutes later, both patients are whisked off in an entourage of orderlies and nurses, beeping monitors and sighing ventilators. Aliceana steps back from the carnage, scans the trash-strewn, blood-splotched trauma room, and takes a deep breath. One of the janitors is spraying some noxiousness around and another squeezes out a mop. Ramón stands in the doorway and for a solid three seconds, he and Aliceana just stare at each other across the room.

  She goes to him. He opens his arms to her, but instead of wrapping herself in him, she catches one of his hands, brings it to her face, and whispers: “Come with me.”

  CHAPTER TWENTY-THREE

  This hideous northern winter has shut out the sun and it’s only half past five. The last shards of daytime linger in vague purple splotches on the horizon and New Jersey is a splash of lights breaking up the dark world that stretches out around the hospital. A sign on the rooftop door once warned in all caps that a fire alarm will be triggered, but doctors have long since disabled the alarm and graffitied the sign into oblivion.

  They come here to smoke cigarettes away from the endless hum of ambulance engines or watchful, snickering gazes of other doctors or floor supervisors. Here they step away and catch a moment of peace from the slowly dying and the already dead, the gradual suicides and desperate to hold on, the denial, the doubt, the body parts. Here, a hundred thousand deep breaths have been taken, cigarettes smoked, juicy morsels of gossip passed, chewed on, and then passed again. Here they make love, here they argue, check phone reception, and respond to urgent text messages from lovers who d
on’t get it, won’t ever get it, can’t possibly know what it means to see the inside of a human being, to hold a life in your hands, to watch a heart stop.

  Here come Aliceana and Ramón. I came first, because it was obvious where she would take him and because I wanted a moment to purify the space. I expand myself one last time, push out into every congested corner of this strange little cove, and annihilate the stench of stale smoke and medium-income cologne, the clog of uncertainty and arrogance. And then I watch the elevator light ding and the door slide open and the two walk in, hand in hand, children in a dimly lit, empty cement garden thirty-two stories above the earth and lit by the bright lights of the new night in the old city.

  There’s even a stretcher, complete with implicit understanding that sheets will be changed, spill precautions will be taken, used safety devices properly disposed of.

  He flicks off the light. The domed glass roof, remnants of the failed greenhouse plot of a much-ridiculed pediatrician, lets in the city night. It congeals with their breath before they even begin, makes the lights into smudges of color against the darkness.

  “I think,” Ramón says when they find themselves in the center of the room, which might as well be the center of the sky, arms around each other and spinning in a slow circle to some faraway melody neither of them could describe.

  Aliceana shushes him, wisely. And they just rock back and forth for a while like an old drunk couple teeter-tottering along to their marriage waltz hours after their friends have all gone home after a long night of celebrating their lifetime of love. Ramón, eyes closed, beautiful doctor nestled securely in his grasp, does everything to memorize the moment. I can feel his mind turning circles around itself, clutching and clawing to preserve some snippet of the present for the future.

  She can sense it too. I’d liked her before, but when she feels his uncertainty, his hesitation, she squeezes him a little tighter, snaps him out of it, and then, I love her. Because she has studied Ramón, in just this flicker of time they’ve been together, and she has learned. And then he gives in to the moment, to the night and the woman, and he lifts her slightly and she gets on her tiptoes and they kiss.

  They’d kissed before but always carefully—not grudging or cold, but certainly not like this. Nothing like this. It’s all over her that she wasn’t prepared for this at all. She was, in fact, just planning on a slightly confusing but utterly satisfying fuck after such a swirl of chaos. It would be divine, and simple in that impossible way. It wasn’t much thought through beyond that—the moment had been severe and they both deserved some loving.

  But this: This was not what she had bargained for and for a minute she’s dizzy in it, having calmed him. Because when he kisses her he means it, and then she’s lost in it. And in order to not blemish the blessing by the sin of overthinking, they lay each other down on the stretcher. And she slides easily out of her scrubs and he lifts her and finds her ready and the city is alive around them and slowly, slowly, the past disappears and then so do I.

  * * *

  Isabel. One last time.

  I didn’t see her jump, but I can imagine it. Have imagined it, hundreds and hundreds of times. She didn’t smile, didn’t even pause before plunging. She was never dramatic like that. Never outward or the type to dance around anything. She did. She moved. She was. She fought. So hard, and when the fight emptied her out, she died.

  But the last time, she was cruel enough as to offer me a little bit of hope. Cruel because I’m sure she already knew then that there was none to be had. Not for her and not for Cuba, not for us. But she insisted, demanded that our last meeting be some kind of sweet.

  She made me coffee and we cracked open cans of things and scooped them onto crackers and I complained about Nilda—I’d tried to get her to come with me, maybe out of some misplaced urge to make us all a family again, maybe because somehow I knew, I knew it was over for Isabel. But Nilda had been Nilda through and through: She’ll get us all killed!

  That obstinate rightness that Nilda radiates. There comes a moment in every argument with her where you can actually see the blinds close over her eyes and it’s just over; there’s no point in going on after that, you’re wasting your time.

  Isabel laughs when I tell her the story, but I can tell she’s just doing it for my benefit. You know Nilda, she says, leaning forward. I don’t know why you even tried.

  For old times’ sake, I guess. It feels tiny and corny when I say it, but it’s all I got.

  Isabel shakes her head. Old times are gone now, Mari. They’re gone. We all make our choices, and we live and die with them.

  I know she’s right, but right now I don’t care about all these high-minded philosophies, I just want us to be us again. All three of us. I did it for us, I try. For the family.

  She blinks a few times, then looks out the window, and I feel bad, like I’ve just accused her of shattering us even though that’s not what I meant to do, but also, she kind of did shatter us. I just know she did it for a good reason, and the world feels gigantically unfair.

  I wonder if she’ll kick me out for surfacing the impossible specter of our family, when she taps me on the knee and when I look up her grin is back and it’s real. You want some rum? It’s the good stuff!

  The heaviness remains but I nod enthusiastically and she plonks the bottle on the table and pours some out into two plastic cups and then we tap them against each other and say clink! because it doesn’t really make any sound and laugh and drink.

  That warmth rushes through my chest and it feels like what love must feel like, a sudden gravity, like the wind getting knocked out of you but in the best way, and I gasp and we both laugh some more, and I don’t care why, all I know is that it feels so good to laugh with my sister, to see her face open wide with a smile, a real one, the smile I know Isabel to have, which is at once mischievous and loving, a snicker and a glow.

  She smiles and outside La Habana churns and when we settle back down from laughing, I ask her, Do you regret it? And her eyes dart away from me, out the window. Given what’s happened, I say. But there’s no need. The code is already established by now, anything that isn’t clarified is presumed to be about It. The It that’s eaten into our lives and eroded all of our most sacred secrets, that It. Because there’s no other, so there’s no need. It’s defined by our silence about it, a tragedy explained through negative space, and so Isabel just frowns, nods slightly, and sips her rum.

  Sometimes, she whispers, a few seconds after I’ve given up any hope that she’ll answer. Sometimes I do, yes. Then she shrugs, the most Cubanest of Cuban shrugs, adds a slight grimace to her frown, and lights a Popular.

  Tell me, I say, and without meaning to, I’m begging her. It’s one word in Spanish, dime, just one letter off from dame, give me, because what I want is the gift of her thoughts, her story. Tell me. Give it to me. Don’t be a hundred miles away on this, our last cup of coffee shared between sisters in the living world. Tell me before everything falls apart even more, while you’re still here to tell. Give it to me.

  In this city where everyone is listening always, and our very thoughts are contraband, to tell the truth is an act of rebellion. She told me: about the long nights sleeping under the stars in the Sierra Maestra or tucked away in hideaways and storehouses along side roads and back alleys. About the lice and the diarrhea and the time she was caught and had to let a soldier touch her and then suck him off to get free. She told me about understanding the gun, the heaviness in your arms and the shock of the release, the way it feels like everything’s breaking inside the first time you shoot and the way your body gets used to it and the way it feels like everything’s breaking inside the first time you kill a man and then the way your soul gets used to it and how that makes it worse. She told me about her friends who helped her along the way, Gómez, of course, and others too, and the men who laughed at her, tried to kick her out or rape her, sneered and spat at her. She laughed and shook her head and told me about the bittersweet victory
and the gradual disenchantment.

  And that’s when I knew, even if I couldn’t admit it, it was over for Isabel, because no one in their right mind tells the whole truth in such a place, such a time. No one. That was perhaps the first act of her suicide. So many who’d fought in the revolution were already gone by then, like the movement was eating itself from the inside: Huber Matos, who led the assault against Santiago, had been taken into custody, and Cienfuegos, vanished in a plane crash. So many more. And, of course, Gómez, his last cutoff curse still echoing through all of us, and maybe that’s when she decided. When she gave up.

  Says she already knew things would spin out of control, even before they did. She’d been watching from the inside, holding whispered consults with Gómez whenever their paths crossed. As the whole multifaced rebellion collapsed into one, singular force and then that one spread out in shock waves across the country, Isabel and Gómez watched, nodding sadly. Then the killings began. One by one the old warriors crumbled, scattered their broken armies, and disappeared into prisons or were lined up against the wall and cut down, their last breaths cursing a single man and his huge maniacal vision.

  And some simply fled.

  But clearly, there was no stopping the machine. Even when rumors spread of an uprising in the Escambray, Isabel didn’t have much hope. She did what she could. Used some of the resources and skills she’d gathered during the revolution to smuggle arms and food along toward the whispers of a new front. But they were just whispers, and Cuba was a giant echo chamber with one booming voice cascading down on all our heads, keeping us up at night, poisoning our dreams, hopes, and fears.