The boy was still holding his weapon when she turned around, a pretty soda bottle, one of the new ones, rimmed around its fattest part with tiny glass roses. He held it up again and shouted at her, “What are you doing here? Get the fuck out! Get out of my fucking room!”
Some residents and attendings told Jemma they’d spent their whole internship learning to distinguish the sick child from the not-sick child. Everything else you could look up, they said. What was tough was knowing when to act, and they gave Jemma to understand that the sickest children were often the sneakiest, slipping under the sick/not sick detectors of their physicians and acting perfectly normal until suddenly they were dead. But Jemma didn’t need a specially cultivated organ of perception to know this boy was sick. She was seeing him up close and in good light for the first time, and could tell now he must be ten or eleven — before she thought he’d been older. He was almost as tall as she was, and very thin. His eyes were sunk deep in his head, and his lips were cracked at the corners. Jemma was sure his skin, in health, would have been a pretty shade of brown. Now it was gray.
“You look sick,” she observed. “You should come upstairs with me.”
“Fuck the fuck!” he shouted at her, leaping with the bottle in his hand. But his spring was weak, and he passed out in midair, so when he landed he crumpled at her feet. Then her worry almost became panic because she suddenly realized she was all alone, and far from help.
“ABCs,” she muttered. It was the mantra of the panicked and the inexperienced: keep them breathing until someone who knows what they’re doing arrives. She bent to listen at his mouth. When she put her hand on his chest she felt a jolt, and thought she must have kicked up some static by wading through all those candy wrappers. He sat up like a horror-movie murderer and struck her again with the bottle, this time on the cheek. Again the glass failed to break.
“Stop that!” she said sharply, tears springing in her eyes. They blurred her vision as she groped for him. She touched his face and his shoulder, and he fell forward over her. She remembered his weight from when he stepped on her in the gift shop; she had never before met such dense flesh. She took a moment before she rolled him off of her to understand how much her head and her cheek hurt and make sure she was still thinking straight. Still unconscious, he peed on her.
She took him, very slowly — dragging and hauling and resting as infrequently as she could bear, and laying him down every minute to check his breathing — to the ER. The PICU might have been better, but seemed too far away. The ER had been mothballed shortly after the Thing: no one was expecting any more admissions. It even seemed to have shrunk a little, to most observers. A few people slept down there, every so often, and it was rumored to have become a trysting ground for the lonely and not-very-well acquainted, but mostly it was deserted.
It was entirely empty and dark when Jemma struggled in with the boy. She took him into a trauma room because it was closest to the door she’d come through. As soon as she put him on the gurney she reached past his head to the wall and slapped the code button. No red lights flashed. No voice cried out, Code blue! It was just a chime, and it sounded more to Jemma like the call of an ice-cream truck than the announcement of a pending death, but she knew it was ringing in the PICU, too, and that to the people who knew what it meant, it sounded as horrible as any screeching klaxon. After a few seconds of it she heard the angel speak, too. “A child is dying,” she said finally.
“Call somebody,” Jemma said. “Get Emma down here. This kid’s tanking.”
“Name me, I will serve. I have preserved you all these days, but I cannot help you without a name.”
“Just do it,” Jemma said. She had resisted all these weeks, forfeiting fancy pancakes and silk-weave scrubs and fleecy socks — Rob had to do all the making and the shopping and Jemma could only get food by herself at the cafeteria.
“Only name me, and I will serve,” the angel said again.
“Just do it, you stupid fucking bitch!” Jemma said.
“I am named. O, listen creatures, again I am named! Again I serve!” Then she was quiet.
“Did you do it?” Jemma asked. “Are they coming?” There was no answer.
“Stupid fucking bitch,” Jemma said, and looked at the boy where he lay. The bright lights made him look a paler shade of gray. She did her ABCs again. He was breathing fast and deep, his heartbeat was regular. His pulse was weird, bounding and weak at the same time. She pressed on the tip of his finger, waiting and waiting for the blanching to clear. It took five seconds. She straightened up and looked around the room, just in case she had missed the flood of people who were supposed to be coming to help her. She went to the door and looked out at the dark, empty hall. She thought she could put another voice to the cadence of the code chime: Nobody coming, nobody coming, nobody coming. “A child is dying,” the angel said again. “Won’t you help him?” Jemma went back into the trauma bay.
“Fuck you,” Jemma said. She considered the boy, an almost-adolescent who had been drinking and peeing up a storm, who she’d seen snotty with a cold within the past three weeks, who now lay unconscious and obviously dehydrated, breathing deep breaths that were, when she hovered and sniffed above his face, yes, quite fruity. She went looking for a glucometer and found it within seconds: everything in the trauma room was labeled so people made morons by haste could find it with one eye and half a brain. She was about to poke his finger when she considered that he needed fluids. She looked over his arms for a vein; they all seemed to have receded to the level of his bones.
Two pokes in his left antecubital and one in his right, and then she got a flash in her IV catheter. She hooked up the tubing and hung a bag of half-normal saline. He lay quite still, still breathing his deep, rapid breaths. She tried to remember the name for that particular character of breathing, but all that came to mind was the fact she’d neglected to test his blood sugar. It felt to her as if an hour had passed; the code clock, started when she pressed the button, said six minutes. She paged Rob, the only number she knew off the top of her head. She’d never put 911 after her callback number, but she did it now.
She poked his finger and squeezed it till she thought the tip would pop off and fly about the room like a deflating balloon. It yielded a drop of blood the size of a pinhead. Finger, finger, finger: they were all dry. Desperate, she sucked on his thumb to warm it up and finally got a single fat drop, which she almost lost trying to touch it to the glucometer strip with her shaking hand. The little monitor on the glucometer began to count down from sixty seconds. Jemma put it at his feet. She checked the IV, then checked the phone to make sure it had a dial tone. She checked his breathing and his heart, then looked up and realized that the wires and leads of the cardiac and respiratory monitors seemed to be reaching for him. She had no better idea of how to hook them up than she did how to create a beehive hairdo. “I am the preserving angel,” the voice said, and Jemma realized it was speaking in exact one minute intervals, “but only you can save this child.”
She looked at her glucometer again. It was just counting past ten seconds. She watched the countdown, swearing that the machine paused forever at five, as if it had forgotten what came next. At three seconds she finally heard hurrying footsteps in the hall. At one second the room filled up with people, Dr. Tiller first among them. Never in her life had Jemma been so happy to see someone she hated.