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Those pairs were harder to find. She liked to think, sometimes, that she and Rob made one, and that Vivian and Ishmael might soon represent another, and that Dr. Snood and Dr. Tiller were somehow yin and yang and fuss and budget to each other, and when they came together would make something perfect and prim and utterly unbearable, and that Father Jane and John Grampus could do great things together, despite their mutual disdain for the opposite sex and the fact that Grampus was sort of dating the angel. But the angel seemed to be dating everybody, and lately Jemma had seen John Grampus wearing a new hangdog look.

The hospital was organizing itself, anyway, in ways not formally declared by the Committee or by a principle of pairs. There were the old distinctions and the old hierarchy of ascending power and descending subservience: student, intern, resident, fellow, attending. There was a greater chain, harder to describe, and a little more fluid — Zini could make Dr. Chandra lick her shoe but Dr. Snood could probably make her grovel if he tried hard enough. A lab tech was superior, somehow, to a janitor, and the man from the physical plant was owed deference from the cafeteria workers. Volunteers were for anybody to order around, provided they spoke to them respectfully, mindful of their age and their altruism; nursing assistants were treated like dirty whores — no job was too low for them. Only the tamale lady seemed to soar free of classification, empowered, Jemma thought, by her itinerant status and the fact that she was not an official employee, and by the supreme deliciousness of her tamales — they were a sort of power, and the angel could not reproduce their subtleties of flavor. Even the parents were bound, only the most difficult ones resisting treatments now, with almost every child sicker than they’d ever been before. You could argue these distinctions, or declare them overturned in Committee meetings convened in a spirit of overwhelming generosity, but as long as the children were sick and the hospital was a hospital, they held.

Every attending had their own demesne, determined by geography and specialty. Dr. Walnut, the only surviving surgeon, reigned on the second floor with Dr. Wood, the anesthesia attending. Dr. Snood ruled the sixth floor. Dr. Pudding held court in the dim chambers of radiology on the third floor, splitting his territory with Dr. Sundae, who, as the last pathologist in the world, had assumed control of the clinical lab. Dr. Grouse, the master of the NICU, was famously laid-back, but he had Emma, a lady whose soft bouncy curls belied her no-nonsense attitude, to be his terrible enforcer. The seventh-floor subspecialty units were under the command of Dr. Topper, a touchy nephrologist. Dr. Sashay, the oncology attending, ruled on the eighth. Dr. Mim, the ER attending, deprived of subjects when the last of her patients were transferred upstairs the day after the storm, went up to the ninth floor, where she oversaw management of the increasingly acute issues developing in the rehab patients when she wasn’t splitting call in the PICU with Dr. Tiller, who was queen there. Nine of them altogether, they each had their fellows — except for Dr. Grouse and Dr. Tiller, who had to share Emma — and a team of residents and interns and students to cater to their every professional whim.

Sometimes Jemma daydreamed of traveling to other teams like she used to daydream of traveling to other countries, so she thought her days might pass more pleasantly in the NICU like she used to think she would be prettier in Paris, or that people might have been more tolerant of her generous thighs in Quito or Buenos Aires. But she was stuck fast under Dr. Snood’s thumb, and rounds seemed perpetual. She had had the sense before the Thing, in the middle of her long, early mornings, that she had always been doing this, trudging from room to room gathering bad news, and that she would always be doing it. But she would go home, eventually, and look back and forward into that purgatory with the feeling that she was suspended between eternities. Now, though, in a hospital in the middle of the ocean, a place that every available clue indicated was the extent of the extant world, what before had only seemed, now actually was. Jemma would never go home. The children would never go home. Forever and forever Dr. Snood would roll his eyes at her from under his eternal caterpillar brows.

At least some of her patients were finally getting a little better. Ella Thims was off her hypertensive patch and tolerating three whole milliliters an hour of formula feeding through her little gastric button. Cindy Flemm had not vomited for five days, and had actually been seen out of bed, walking hand in hand around the sixth floor with Wayne, the boy who looked too fat to have CF. Kidney’s constipation had resolved and only the eldest sister, Jesus, seemed to resent Jemma’s early-morning visits anymore. Pickie Beecher was unchanged, however, his affect still flat, his mind still crazed, his shit still black. She knew he must still be sipping from blood packs, though no one had caught him again with one, and Thelma swore there was no way he could be leaving the floor to snack at the blood bank. “Your poop betrays you,” she said to him when he swore that he drank only juices.

“Good morning!” he said from under his bed, when Jemma had rounded on him that morning. “Happy anniversary!”

“Come out from under there immediately,” she said firmly. She’d instituted a policy with him, or thought she had. She was not intimidated anymore by his hiding under the bed, or the strange hissing, deflating noise he sometimes made, or his hanging from the ceiling, or standing on his head in the window. It was Thelma who showed her the way. “You show him who’s boss,” she told her. “Have you ever ridden a horse? It’s just like horses. He can smell your fear, and if you give him an inch he’ll be all over you. All over you!” And she had slapped Jemma gently all over her back and belly, as if Jemma needed help understanding what was meant by all over a body.

“Good morning,” she said to him, once he was sitting on his bed. “What’s the anniversary?”

“You visited me forty days ago exactly.”

“I thought you hardly noticed the passing of days.”

“Mostly not,” he said. “But sometimes.”

“Shirt up,” she said. He exposed his thin pale chest for her to auscultate. His exam was as normal as it always was. “Perfectly clear,” she said. She always made sure to tell him how healthy he was in his body.

“Will you walk with me to the window?” he asked her.

“All that way?” He stood up and raised his hand to her. He walked her slowly around the bed to the window, placing his steps as carefully as a drunk. The sun wasn’t up yet, but a gray light was on the perfectly calm water. Pickie pointed up into the blank gray sky and said, “My brother is absent from there, and from there, and from there.” He pointed at the horizon, and down at the water.

“Mine too,” Jemma said, and tried again to get him to talk more specifically about his brother, in her flailing, junior-junior-psychiatrist way, thinking that it might be a first step toward his recovery, since the antipsychotics and antidepressants and alpha-agonists and anxiolytics seemed not to make any difference at all in how he acted, to get him to talk in real terms about his lost brother. She was always imagining the scene: Pickie witnessing the drive-by, or the lingering toxic death from leukemia, or his crazy mother beating his older brother with a sack full of oranges, or even Pickie himself, carelessly playing with a loaded pistol, staring at his brother’s brains after he’d sprayed them all over the wall, and losing his mind in an instant. It was crude, and probably stupid, to think that she could break him open and let all the poison and craziness in him leak out, but no one else had any other ideas. Dr. Snood kept insisting they try new and different combinations of medications — he had taken it upon himself to try to fill the shoes of the lost psychiatrists, poring over the literature preserved in the hospital computer, ruled by the hour by some new study he transiently admired. Pickie and the anorexics and the three other psych patients took every new intervention calmly, but still ate their blood or found secret places to vomit — all of them, Jemma suspected, assisted by the angel in perpetuating their sickness. It had become obvious that she would help anybody do anything, as long as it didn’t directly harm another person. She was the sort of personality who said you were her favorite, or her best friend, and then went and said that to everybody she knew.