The little dark-haired girl is vomiting when I open the door, and her father looks up at me with pleading eyes. He doesn’t say anything, but I read his thoughts clear enough: Make my daughter well. I pass behind him and place a damp towel on the back of the child’s neck, up beneath the thick mane of her hair. She is sweating, her bony arms encased in a sheen. The heaves subside, and the mother wipes a different towel across the child’s mouth.
“Darling? How is your head?” I ask the sweating girl, and her lower lip trembles as she opens her eyes to look at me. She immediately drops them closed again, and that tells me plenty. “Okay.” I explain to the parents about the medicines I have for her: an anti-nausea and one for pain. We’ve already been through known allergies and a brief history. She fell from the top of the slide, and they think she hit the base of her skull on an exposed root, which explains the double vision she is experiencing. “Dr. Kuhn wants to do an MRI, just to make sure what we are dealing with.”
“They said it’s a concussion,” the father says, not remembering that it was me who said that to him.
“Yes, sir,” I say with a nod. “We need to understand the severity. We want to make sure there isn’t a bleed.”
The mother gasps, her hand coming to cover her mouth, and she melts around her daughter as if she can shield her baby with her own body. The father pats the child’s thin arm.
When I was seven, I tripped off the landing at the top of a slide, pushed backward by the boy in front of me who was swinging in preparation for his plunge forward. I should have seen it coming. We all did that, but I was unprepared, daydreaming, and when his rear pushed against me, I jerked back and careened to the ground. I landed with my arm outstretched, trying to break the fall. I got up from the dirt and brushed myself off and walked stoically away as if nothing had happened. I made it through the day, my forearm throbbing and aching, without giving myself away.
When I got home, I told Eddie, my mother’s then-boyfriend, I had fallen and hurt my arm. He grabbed my wrist. “Shake it off,” he said. I fainted, overwhelmed by the sudden, excruciating pain from his pull.
When I woke from the shock, Eddie was on one side of me, my mother on the other, patting my arm like it was a pet. “Alice, get me one of your wooden spoons.” My mother did as she was told. “And something to wrap it,” he added. She came back with a spoon and a pillowcase, and he set to work aligning the bone of my forearm, calling out again for duct tape, which my mother supplied. He wrapped it in a thick layer around the pillowcase covering my arm. He then fashioned me a sling while my mother sat and watched. I’m pretty sure it was broken, but we had no money to spend on a doctor. I stayed home from school for two days, and Mom gave me adult doses of ibuprofen. When I finally went to school again, I wore a jacket with my arm tucked inside, not wanting anybody to see my homemade cast.
I was embarrassed by her even then. Yes, my arm healed, but I was so humiliated that we couldn’t afford to go to a doctor for a proper sling. Cori Radcliffe had a broken leg at the same time, and everybody in class signed her purple cast. I just wanted a regular cast, like everybody else. But even then, I was different; I was standing outside the room looking in through the window. By the time Eddie cut the grimy tape and pillowcase from my arm, the muscle was withered and atrophied, but the bone had set and healed. It wasn’t maybe the best thing to have done, but he’d fixed it.
Beth and Cheryl, techs from the MRI lab, are at the door, and I turn my young patient over to them.
“I want to go with her,” the mother says to the new team, and I step through the door and out into the hallway, leaving Cheryl and Beth to work it out.
Chaos has erupted at the end of the hall, and I race to meet the incoming paramedics. They are wheeling the stretcher through the door, one of them counting compressions and the other squeezing the AMBU bag. Dr. Jerry Kuhn is already at the entrance, ready with the crash cart. He had received the call from the medics en route.
Cardiac arrests that happen outside the hospital are nearly always fatal. Very few survive. Of those saved, there is often some level of neurological dysfunction after the fact; the brain has gone too long without oxygen. The screen of the mobile monitor shows an irregular rhythm, a fluttering of the heart muscles. Without an organized beat, no blood flows.
I join the team at the stretcher, relieving the medic of the AMBU bag, taking up his count to keep the same rhythm. Lisa takes over compressions. I place two fingers on the flesh of the patient’s thin neck, feeling for movement in the black ink of a tattoo, although the screen tells the story. He is mid-forties, thin, gaunt—maybe older. Lisa’s eyes connect with mine, pausing her compressions. Her fingers lace together, and her forearms are ridged, waiting for the next count.
The crash cart hums.
“I’ve got no rhythm,” I say, answering her unspoken question.
Jerry steps closer, wielding the paddles, and Lisa steps back, giving him room for this last-ditch effort to reignite the electric impulses in the man’s heart to establish a pulse.
The man’s shirt is already tattered, exposing pale skin with a bright red area where Lisa, and before her, the medic, have pressed, forcing blood from the man’s heart through his body again and again.
His arms are thin; recent tracks of needles step over enlarged veins.
He’s a junkie. The whole of the Midwest is full of junkies. As the factories have closed and moved production overseas, the Midwestern middle class has devolved into the upper lower class. People who work at the university or the hospital make a decent wage, but beyond that, it’s minimum wage in retail shops and fast food. I would never have dreamed that Charleston could become more depressed than it was. We used to have family farms that ringed the edges of all the small towns outside of Charleston, but the farm crisis in the eighties destroyed them. Farmers sold out because the big guys could do it cheaper, and land that had been in the same family for generations was sold off for a winter’s worth of comfort. Kids growing up here used to have hope that they could stay in town and make a living wage, but now they don’t. If they have ambition, they pack up and leave. Those who lack purpose or direction stick around and stew in the soup of poverty and addiction.
Meth is an epidemic. It is cheap and made with everyday chemicals: battery acid, drain cleaner, acetone combined with a variety of different cold medicines. It’s a horrible drug. Once a month or so, some makeshift lab explodes, and another of the daughters or sons of the town goes to hell. You can see them, walking down the street with holes dug into their flesh, their teeth rotting from their skulls. Meth is so addicting, worse than any other street drug out there. Even if they get clean from it, they’re never the same. The detox alone is sixty to ninety days, and most people relapse. Meth gets into your body at a cellular level and destroys the dopamine receptors in your brain. Meth-heads are the walking dead, their jaws ratcheting, the skin melting from their faces.
This man is probably one of those, I think, taking a look at the tracks on his arms, where his veins had given out and he’d searched for another place to insert the needle. I’m sure his legs look the same. I don’t lift his lips to see his teeth, which would tell the whole story. I hope heroin was his mistress, which is almost as addicting but less toxic inside the body. I shake my head. It’s too late to matter for him, anyway. It’s all dangerous, heroin or meth or copious amounts of alcohol; it’s all suicide by different names.
“Clear!” Jerry yells. The paddles touch the man’s narrow rib cage, and his body arcs. I place my finger again on the inky neck, pressing, feeling the artery, like a snake beneath the skin. I press the bulb with my other hand, keeping the rhythm, keeping air moving in and out of his chest. “I’ve got no pulse,” I repeat.
The crash cart hums, regenerating, and Jerry readies the paddles.
Two more times the body arcs, two more times it settles, silent and pulseless. I look at Lisa, my fingers on the non-throbbing carotid, shaking my head. “No pulse.”
Jerry locks eyes with mine, then he looks at Lisa. “We’re gonna call it.” Lisa and I glance at the clock. “10:43,” we say, almost in unison, although he died before the ambulance ever reached him. He was a DOA. I peel the bulb away, exposing the bottom half of his face. His eyes are closed, long lashes pressing a crescent above the bony ridge of his eye socket. Now that I’m no longer holding his head upright with the AMBU bag, his face falls to the side, exposed. My heart stutters in my chest, pausing rebounding.
He is older than he should be, his face ravaged by the years since I’d last seen it.
“Do we have a name for this man?” I call out to no one in particular, hearing the sharp edge of hysteria riding along the rim of my voice.
“No ID. A John Doe.”
I look up, seeing the medic who responded. They had stuck around the few minutes after they brought him in to know the results, although they undoubtedly knew. Miracles sometimes happen, but not tonight. Tonight is no night for miracles.
I shift from the top of the stretcher to stand at his side, to see his face in a more natural position, and in the shifting, I fully recognize him. The hairs on my body stand, and sweat beads at my hairline. This face is one that I still sometimes dream of, lying to the side on a pillow beside me, looking at me, talking, telling me about whatever happened at the bar that night, laughing at some grand joke.
“Al, you okay?” Lisa asks.
I nod. “He’s no John Doe.”
“Did you know him?”
“Yep, once.” I pull the sheet up over his face, resting my hand on the bones of his chest, and I say a prayer for his soul.
She is beside me, her hand lightly on my shoulder.
“He was a hell of a drummer.” I smile at her. “I’ll walk him down.”
The service elevator is down the hall and on the right. The morgue is in the basement. I angle the gurney through the doors and wait while they close. We travel to the basement, my hand resting on his chest. This ride is the last ride Warren and I will ever take together. I close my eyes and breathe. Trying to control the rising panic.
Maybe it’s not Warren Robinson. Perhaps this is one of his many brothers or cousins. All the Robinson men looked so much alike. This shell of a man could be his cousin Don, who I bought my first and second car from, except for the tattoos. It could be him, except I know Don is no junkie. It could be Elliot or any number of brothers or cousins I lost track of or never met. They all have that same dark-haired look. They all look like they should dress in 1950s greaser gear.
It’s not death that causes the panic to rise. I have seen much of that; it’s the death of this man. It has been twelve years since I last saw him on a stage in Los Angeles at a New Year’s Eve party. Thirteen years since he walked out of our apartment above Lola’s Dry Cleaners in Greenville, Illinois. A few months more than that when we created a baby together. We never managed our ninth step. I always thought there would be time. We came close when he came to Life House, but there was still so much water under that bridge.
How will I tell our baby that he is gone?
Of course, I won’t ever tell her. She doesn’t know me. She is somebody else’s daughter, people who could raise her and give her a better life than I had. I wonder if she even knows about me? Does she know she was adopted? Does she sense tonight that someone who meant something to her is gone? Did I do the right thing? If I had been stronger, could I have saved him . . . could we have kept her, together, and been a family?
