by Daniel José Older
Illustrated by Galen Dara | Edited by Brian J. White
They came in boats and airplanes, armed with false documents and holy terror and a cautious wariness of what they would find. They came and breathed sigh after sigh of relief, closed their eyes, and put trembling hands to foreheads. They came and settled into these flashy, suddenly modern digs, cursed at the atrocious weather, renamed streets — forgoing the sharp consonants of English — erected bakeries and memorials and three-star restaurants that reminded them just enough of home to not trigger nightmares.
They came and they left behind family members clutching photographs and promises to send money and frequent letters and peanut butter or vacuum cleaners or whatever was impossible to find that year. They left behind true loves and mistresses and streets pulsing with memories. Each brought along a cord that stretched all the way back to the island, and when they slept each prayed the cord would send along news from home until slowly, each one came to call this place home and the cords wavered beneath the weight of the present tense.
They came and made Miguelitos and Carlitos and Anitas and Selinitas. And they told the little ones stories, tried to remember as best they could but always came up with folktales and lies; no matter how hard they tried, their stories always felt like lies. They cringed at half-learned Spanish and pan-Asian vegetarian takeout and then they tried it and didn’t mind so much, and life rumbled along with new updates now flashing across computer screens instead of pulled from weather-worn envelopes smelling of the past.
They came and made new lives, and me? I got lost in the shuffle. Somewhere in between. There was the glorious upswing of rebellion, the holy terror of ducking from building to building, the nausea of capture — a single, flickering image of a woman, my sister I think, shaking her head — and then nothing. Emptiness. Eons of emptiness, a floating oblivion that resolved to this strange new place, New Jersey, and this shimmering emptiness that is me.
I was a woman once. Perhaps I still am, but without a body now. I had a name, muscle and bone. Now I just shimmer and remain, somehow, as the world swirls and lives and grinds along, I shimmer and remain, shimmer and remain.
There is a man, a boy really, and though he wasn’t born where I was, his heart holds threads that span all the way back. I suspect he is my nephew; that familiar chin and lumbering generosity stirs something inside me. Memories, I think. I am tethered to him, somehow.
You could say I haunt him.
Perhaps I am meant to protect him, but really, I am empty. What can I do?
His name is Ramon and his coffee’s cold and he’s not smoking but his breath comes out in steamy gasps, roll and then stretch up into the gray sky above the hospital. So alive, this boyman. All his cluttered organs and gushy pumping liquids, all that life! No one who has it knows the true meaning of inhabiting form. We, we watch silently as you ridiculous mountains of skin and fat trundle through existence striving for meaning and we chuckle and moan at the irony of it, but you who inhabit those mortal bags; you guys just don’t get it. Ramon puts the mostly empty cup on a trash can lid and wraps his arms around himself for warmth, squints out at the traffic.
I hover just behind his head, a passing glint of nothing, a cold flash. It’s my spot when he comes out here, where I stay.
“All that fat and hair and you’re still cold?” Derringer, another security guard, materializes next to Ramon and lights a Marlboro. “That’s like, such a waste.”
Ramon squints down at him. I know that face: it means he’s swallowing a curseout. Derringer knows it too and he chuckles and then coughs something wet up and swallows it back down.
“All that rotting-ass gunk building up in your lungs and you’re still alive.” Ramon says. “A medical motherfucking miracle.”
“Ah, you’re just salty you quit and the rest of us are still having fun.”
Ramon scowls and tugs on the fur-lined earflaps of his hat.
“What are you so grumpy about?” Derringer asks after another coughing fit.
Ramon shrugs but it’s all over him — Marina: a short Filipina doctor that he’s been spending every other night with. He pulses with thoughts of her; a whole melodramatic speech waits at the tip of his tongue. The sex, judging from their screams and grunts, is fantastic, but beyond that they barely speak. It is, as Ramon once put it, just what it is, but in the past couple days her image has caught fire inside him. He is a quiet behemoth though, attuned more to beats and basslines than words on the tongue, and he’s been trained to appreciate the pretend easiness of just fucking.
“I guess I…” Ramon doesn’t finish his sentence because a short naked man in a cape flashes past them and gets hit by a car.
“The fuck?” Ramon bellows, launching into traffic. He throws his big arms out in either direction, feels more than sees or hears cars pulling to a halt around him. The guy is laughing when Ramon reaches him. His teeth chitter-chatter and he’s sprawled out on the blacktop, writhing and cackling. The cape turns out to be a hospital gown, tied around his neck. It’s one of the telltale bright yellow psych-patient ones, and the guy is all tangled in it.
“What the hell, jackass?” Derringer demands, panting and irritable from the sudden exertion. The driver hops out of his car, wondering the same thing in a much more colorful way. Then the psych patient is up again and about to make a dash for the park across the street, where a couple of little kids run wild as their babysitters snap pictures on their tiny phones.
“No you don’t.” Ramon snatches the guy up by the back of the neck, and then he and Derringer wrastle him back to the ER bay and through the automatic sliding doors.
Ramon’s coffee waits on the trashcan. I linger over it for a few seconds. I become my breath and let my breath become the breeze, inhabit the empty molecules just within the rim, take in whatever’s left of the flavor. It’s not bad. He got it from the Dominican spot around the corner and they made it right: strong with a swirl of sugar. For a few minutes, as the carnival of bloody body parts and angry curse outs cavorts past, I just stay, and breathe, and stay.
“What the hell did that lunatic do to you?” Marina stands on her tip-toes to get a good gape at the scratch marks crossing Ramon’s shoulder.
“It’s fine,” Ramon says, but you can tell he doesn’t mind the attention.
“It’s not, he probably had all kinds of hideous psych patient bacteria under those nails.” She climbs up on the stretcher behind him and dabs at the scratch with a gloved finger.
“Ow! Fuck. Is that the medical term? Hideous psych patient bacteria?”
“Yes. When was your last tetanus shot?”
“When? If you don’t remember it we should just…”
“Marina.” Ramon executes an impressive swivel, only scowling a little, and pushes his hips forward.
“The door’s closed.”
“Stop,” she laughs. She’s considering it though. You can see the thought dash across her eyes as her mouth opens slightly, as if to accept his looming kiss. Instead, she puts a finger up and shakes her head. “Someone’ll come in.”
“First of all, I locked it. Second of all, so?”
She just looks at him. The look says, you know it, don’t make me say it. It’s never been said, but it’s written all over both of them. Shame and the shame of shame. A double-whammy, ricocheting back and forth between them in some cruel echo-chamber. She’d appeared at the club he was DJing at one night, released an impressive and totally unexpected series of breakdance moves on the dancefloor, and then giddily ran up to him when the set was over, asking when he was playing next. She didn’t recognize him, he’d realized immediately. It only kinda bothered him, and then much less so when they ended up naked back at his place that same night.
But then he’d watched her expression when he told her they worked together. It was inscrutable actually, but he imagined in it a whole web of criss-crossing concerns. He wasn’t too far off the mark, but none of them were enough for either of them to go forgo more sheet-grabbing, so they kept at it and kept quiet, only exchanging brief nods when their paths crossed at the hospital. And Ramon accepted early on that his dreams of some Grey’s Anatomy-style storage-room nookie were probably fleeting at best.
Just say it, he almost says. Say you don’t want anyone to know you’re banging security. The words stay in his mouth and get bitter there. He frowns and turns back around on the stretcher. “Last year at Rutgers.”
“My tetanus shot.”
“Right.” She turns to retrieve her paperwork.
“I want,” Ramon says to the back of Marina’s head.
“I want… I think I want.”
She cocks an eyebrow at him.
She sighs. “Ramon.”
“Not like that. I mean… Yes, like that too but we can do that later. I mean. Can we… be something?”
Her face reveals nothing. Then she shakes her head. “I don’t… I don’t know.”
Ramon closes his eyes, heartbeat thundering in his ears. The door opens and shuts and she’s gone.
The apartment building is dull. White tile hallways and fluorescent lights. Plaster walls. It looks very much like the building next to it, in fact; a semi-suburban pocket of mundane similarity in the midst of a chaotic, teeming city. He slouches along down the hall; the shadows grow across his face as he goes. Key in lock, the familiar squeak of the door, eyebrows raised as he peers inside. The place is dark though; his roommates are out. Ramon can’t decide if he’s relieved or annoyed. He’s inside and naked and in the steaming shower within minutes. Gingerly lathering up the wild man’s scratch marks, Ramon pretends today never happened, over and over again.
Marina is ignoring him.
That’s probably for the best. Technically, they’re ignoring each other. Which is technically not any different than what they do every day. Except now you can see the sadness radiating off Marina. Well, I can anyway. It’s all over her when she steps out of the doctor’s lounge, passes Ramon without smiling and disappears into the ER: she’s devastated. I suppose Ramon’s jumbled declaration caught her off guard. And apparently neither of them had realized they had such strong feelings for each other until it was too late.
Ramon watches the ebb and flow of body aches, asthma attacks, and minor injuries. None of it touches him. It hasn’t for a while, but even less so right now. At noon, ambulances bring in an old man. They’re pumping on his chest, squeezing oxygen into a tube coming out of his mouth but he’s quite dead. Been dead a while and surely isn’t thrilled about such an invasive goodbye party to the world of life. He’ll get over it. Ramon steps of out of the way as they rush the gurney through the bay doors and into the crash room.
“S’amatta?” Derringer asks.
“Man… I’m bored. At least let me live vicariously through your obviously chaotic and at least vaguely interesting life.”
Ramon looks down at Derringer, who seems to always be squinting for no apparent reason, and shakes his head. “Nah man, I ain’t in the mood.”
“I’m saying though…”
It’s just starting to rain when they hear the sirens. It’s not the usual long wail or occasional yelp that the ambulances use when they pull in; this one’s a frantic splattering of sound, machine gun shrieks speckled with occasional resonating blasts from an airhorn. A minute later, Ramon sees why: it’s a police cruiser, not an ambulance, and it’s blasting the wrong way down a one-way street towards where he stands in the ER bay. It screeches around the small round-about in front of the hospital, nearly clips an absent-minded gynecologist who was listening to music on his cigarette break, and barely pulls to a halt before the door opens and two cops jump out.
“ER!” one of them yells at Ramon. “Where’s the fucking… ER?” He’s crying, Ramon realizes as he slides his security card over the laser monitor. The air smells strange, crisp somehow. Another cop comes out of the back and he’s carrying something tiny in a blanket. I catch a glimpse of pale, charred skin, see a little plume of smoke creep out from the folds and it’s all I need to know.
“Let me through!” the cop carrying the kid bellows as he rushes past. Then he’s gone and only the awful smell of burnt flesh is there, insinuating itself into Ramon’s nostrils as he realizes what’s going on.
Nurses flood into the ER, grabbing supplies, ushering confused family members out of their way. Ramon passes the cop walking away from the trauma room, his eyes watery and blood shot. Derringer’s voice blurts out over the loud-speakers: “All guests please leave the Emergency Room immediately, we have a notification.”
Ramon clears a small crowd of drunks and enters the trauma room just as Nurse Dolores screams: “Where’s Doctor Nessinger? Did you call a code?”
I leave Ramon’s side, let myself drift towards the viciously bright overheads glaring down on the whole scene. They hum serenely beneath the chaos.
“He’s off today,” someone yells from the other side of the room. “And Doctor Raj is on holiday.”
“Get the clothes off.”
“I need an IV, people.”
“Someone call for cooling fluids.”
“What about Dr. Seymour?”
“He’s upstairs but…”
“Page him! You page him?”
“What’s going on?” Marina appears in the doorway. She sizes up the situation and makes a dash for the bed. The kid is tiny, just what’s left of his skin and bones. I already know there’s nothing to be done. There’s no spirit there, no life. Nothing to save. I think Marina knows too, the way she looks down at him, but there are things you know and there are protocols and paperwork and lawsuits and anyway, they have to try: it’s already in motion.
“Everybody listen to me,” Marina says. She says it quietly but it works, people slow their frenzy and turn around. “I’m the only resident here right now and we’re going to do this right. Page who you have to page, get respiratory ready, fine, but first we need this patient on the monitor and we need to start CPR.”
Rosalie, a middle-aged Filipina nurse who is notorious for kicking drunks to the curb, puts her hand on the kid’s chest and gingerly pumps up and down. Dolores throws some EKG stickers on those charred little limbs and Marina puts an oxygen mask against the child’s face and starts squeezing air into him.
“Don’t those damn cops know we’re not a burn center?” Dolores grumbles. “Don’t they…”
“It doesn’t matter right now,” Marina says.
“But we’re not even equipped to…” The anxious braying of the red notification phone cuts her off and for a second everything stops.
“Someone gonna get that?” Marina asks. “My hands are full.”
An orderly named John with a wispy little mustache and horrendous acne picks it up, nods solemnly and then turns to the room. “There’s three more coming in.” Groans and gasps. “Two other kids and the grandma.”
Ramon looks at Marina as the rumblings of shock and dissent rise up from the nursing staff. There’s a flash of something in her eyes — fear maybe? But it quickly subsides back to neutral. She looks back at him. Perhaps they share a moment, it’s hard to tell with her. Then she says, “Get out front, I need you to keep the path between here and there clear so there’s no trip up. They’ll be coming in fast.”
Outside, the cop is smoking a cigarette and trying not to cry.
Ramon stands beside him for a few seconds, letting the swirl of excitement rise away from him like steam. Behind Ramon, I linger once more, a vague disturbance in the air. “What happened?” he asks.
The cop sniffles, wipes his nose. “Fucking electrical fire in a tenement.” He’s still burning with all the adrenaline, doesn’t even know what to do with his body. “Ol’ lady was home watching the kids I guess and it was naptime so they were all caught unawares. Fire pulled that one out and there’s more on the way with EMS. When we got there there was no buses though, and this kid… he’s bad, man. So we just, we ran with him. You can’t stay, you know? You can’t stay. There were so many people. But EMS was coming when we pulled off so… you know. There’s more on the way.”
Suddenly it sounds like air raid sirens are going off as urgent wailings sing out from the city around us. They get louder and louder and the cop shifts back and forth on his feet and the rain keeps drizzling onto the sleek streets and steam rises from a manhole and it looks like the steam rising off that tiny charred body and the sirens get louder and then two ambulances and then a third and a fourth zoom around the corner and into the bay. They pull to shaky, uneven halts and doors are flung open, stretchers are pulled out, and then the grim parade marches past: first the grandma, arms flailing while the medics try to keep her oxygen mask on and not get scratched, then the two kids, both older, one unconscious, maybe dead, with a tube coming out of her mouth and black char marks on her cheeks and the other wailing, skin bright pink and peeling, voice lifting up above the hospital in peals of fear and sorrow.
Ramon 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. Marina 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 in the room, past Ramon and starts yelling at Marina. “I’m not…” Marina puts up her palms to the lady, 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 Ramon sweeps her out of the room and into the arms 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. Marina passes ventilating the baby to a nurse and stands in the middle of the room, her eyes scanning from one side to the next.
“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 grandma lets out a series of moaning coughs and you can hear the fluid sloshing around in her airway with each breath.
“Push 100 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 diminished to a steady whimper and now he glances back and forth at his shattered family.
“Good,” Marina 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 Doctor… oh.”
Doctor Seymour appears in the doorway and everyone can see he’s drunk. His nose is still red and misshapen from a fistfight with a psych patient yesterday and he’s wavering slightly. “What… happened?”
“Where have you…” Marina quickly realizes the futility of the situation. “Just get out. Get out.”
Dr. Seymour slumps his shoulders and slinks back out and the whole room rolls its eyes at once.
“Cooling pads on the kid?”
“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 lost cause rush of the first few minutes: they spin circles and figure-eights around Marina, barely looking up from their tasks as they call out responses, dosages, pulse numbers. Ramon watches, transfixed, until he realizes Marina 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.”
Ramon 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.
Marina 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!”
“Gloria has it.”
“No, Ana Maria took it before she went on…”
“Wait! It’s in my other jacket. Shit! Be right back!”
Another collective groan goes up and Ramon 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. Marina asks how long they’ve been working on her and tells Ramon stop. He lifts his hands away and finally takes the breath he hadn’t realized he’d been holding 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.
Marina shakes her head, looks around at the nurses and they nod their quiet agreement. “Four-fifty-six,” Marina 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,” Marina says, walking up behind her. “And start bagging.”
Ramon gets hold of one of the grandma’s 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.”
Marina lowers the head of the stretcher down as the old lady slides into dreamstate, her gurgling howls dissolve into murmurs and then nothing at all. “How’s the eight-year-old?”
“Give me suction.”
Ramon watches as Marina 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, out of breath, 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. Marina steps back from the carnage, scans the trash-strewn, blood-splotched trauma room and takes in a deep breath. One of the janitors is spraying some noxiousness around and another squeezes out a mop. Ramon stands in the doorway and for a solid three seconds, he and Marina just stare at each other across the room.
She crosses 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.”
Stupid northern winter has shut out the sun and it’s only half-past five. The last shards of daytime linger in purple splotches on the horizon and New Jersey is a splattering 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 grafittied the sign into oblivion. They come here to smoke cigarettes away from the endless hum of ambulance engines or watchful, snickering gaze of other doctors or floor supervisors. Here they step outside 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, all splayed, opened, diagnosed, diagramed, and dissected in their minds while patients prattle along their angst-ridden diatribes, absolutely certain of their uncertainty. Here, a hundred thousand deep breaths have been taken, cigarettes smoked, juicy morsels of gossip passed, chewed on and then passed again, now juicier, saturated with some new doctor’s saliva and speculation. Here they make love, here they argue, check phone reception, and respond to urgent text messages from lovers that don’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 Marina and Ramon. I beat them here, 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 fluorescent-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. This is not high school, although the caliber of drama does veer towards adolescence more often than not. But doctors are, if not mature, at least aseptic in their mating habits.
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 become smudges of color against the darkness.
“I think,” Ramon 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.
Marina 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. Ramon, 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 Ramon, 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 tip-toes 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. She was ready for it to open back up into something beautiful, she had even imagined the opening salvos of reconciliation while cleaning up and catching hot bated breaths. 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, however laden with past and future.
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 so he kisses her a little deeper. 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 the past disappears around them and then, grudgingly, so do I.