No more of that, he told himself every time he did it. And yet he kept doing it again and again, knowing that it was inferior to what he was pursuing with Vivian, and knowing that it would hurt her, and knowing he must keep it secret from her. And what made him saddest about the whole business was that his skill at it, and his familiarity with bodies, and the sense as he raged upon the man or woman in his grip that this was all so familiar, made him think that this was what he had done in the old world. But what kind of job was that, and what sort of person did it? “Do you know,” he said to Thelma, pushing her great hammock-sized bra up off of her breasts, “it is my first time.”
“Mine too, baby,” she said. “Ha ha ha!”
27
The Committee proclaimed the end of another rotation, and Jemma got to visit Jarvis in an official capacity when she switched onto the NICU/PICU team. Rob joined the surgeons, Vivian took Jemma’s place on the heme-onc service, and Maggie, the pale, chinless goat of their class, came onto the intensive-care service with Jemma. “At last,” she said, “some really sick kids,” actually rubbing her hands together, while she and Jemma were waiting for their orientation lecture from Emma. Maggie had not planned, before the Thing, to work with children much more than was necessary to graduate. Kids creeped her out and big-headed googly-eyed kids creeped her out especially. Her brother and sister, senior residents at one of the most prestigious and toxic internal medicine programs of the Northeast, had a place reserved for her to come suffer and thrive and fulfill her bright, evil promise. She’d only been in the children’s hospital that night because she was doing a rotation in pediatric anesthesia, seeking to learn procedures made more challenging by tiny airways and veins, and she still lusted shamelessly after every sort of insertional intervention. She had a little six-word song she kept singing, and kept trying to get Jemma to sing with her. “I just can’t wait,” it went, “to intubate!”
Jemma could wait. Though there had been, before, a certain amount of junior professional pride that came with successfully completing a procedure, she was already sick of them. She never wanted to see another epiglottis again, but she and Maggie had not been in the unit an hour when she was presented with one. Emma stood in a PICU conference room and gave them their orientation lecture, a plain exhortation to do good work and not be overwhelmed by how complex the patients were, modified for the new days with a coda in which she told them the unit was the best place to be at a time like this, because when you’re doing chest compressions and such you really don’t have time to worry about all the really horrible shit. Already exhausted not an hour into her day, Jemma still had thirty-five hours of call before her. It didn’t matter that what Emma was saying was vitally interesting — past a certain threshold of exhaustion all lectures were soporific. Jemma stared out the window at the sea, and another beautiful morning — the sun was behind them, so the PICU looked out into the ice-cream-cone-shaped shadow of the hospital.
“It was always important,” Emma was saying when they were interrupted, “to keep them, to save them, though there was a point where you always said, after this it’s more suffering than living. Maybe that shouldn’t have changed, but it has. Now there’s a new rule: never let them go, never ever, because we can’t lose one more. Not even one. This was never an easy place to be, and now it’s even harder — they’re all sicker, they really are — so listen: I’m always here, if you see something that makes you want to chew off your fingers and you need someone to stop you. Just ask the angel to call me, or page me yourself the old-fashioned way: 719-0058.” She made them recite her pager number, and did not smile, but her face softened a little under its cap of curls. Maggie raised her hand, but before Emma could acknowledge her they were interrupted by the soft tinkling of the code bell, and the angel’s calm alarum: “A child is dying.” Emma was off in an instant, Maggie and Jemma followed close behind.
They didn’t have far to go. A child had collapsed just a few yards from the conference room, the brother to a boy in the unit, an eight-year-old who’d arrested during soccer practice. He’d spent four days on bypass, and emerged ruined from the interventions of the intensivists, alive but unable to move or speak or probably even think. The cardiologists had fallen swiftly upon the whole family, but come up with no answers. The boy whose code inaugurated Jemma’s unit experience, the youngest child, had been put on an antiarrythmic despite a normal EKG, but had, it turned out, been cheeking and spitting the little yellow pills since the great storm.
“Marcus, my friend,” Emma said to him as she felt in his neck and groin for a pulse. “What do you think you’re doing?” When she couldn’t find the pulse she told Maggie to start chest compressions.
Not again! Jemma thought, because she was still having nightmares about Jarvis, who lay intubated a few beds down. He followed her around on her sleepless peregrinations or they were living out a married life in his basement nest or she was crack whore to his stylish pimp and he called her “motherfucker” or “stupid bitch” and kicked the shit out of her all night long. But she didn’t say it out loud. And she didn’t run away, like she wanted to do.
She hated to bag, but Emma made her do it. She’d never managed to force the mask tight enough against the face for a good seal, and always worried, even with big people, that she’d squeeze so much air into them that she’d pop their lungs.
“Shouldn’t I intubate?” Maggie asked. Emma ignored her. Dr. Tiller arrived at the head of a mob of nurses.
“What’s this?” she asked Emma.
“Pretty much what it looks like,” she said. She pressed a pair of defibrillator paddles against the boy’s chest and looked briefly at the rhythm. “V-fib.”
Emma announced the all clear. Jemma, too intent on the bagging, didn’t hear. “That means you, especially,” Emma said, nudging her with her knee. “There now,” she said, as she delivered a shock and the child went back into a normal rhythm. By the time they’d moved him to a bed, though, he’d become pulseless again.
There was something dreamlike about the time that followed, maybe because the deep, sighing breaths Jemma was putting into the boy were breaths in the cadence of sleep, and they cast a dreamy pall over her, and even over the activity in the room, which was as graceful as it was frenetic. Jemma considered, as she breathed, how every actor in the room, except the patient, was a female, and wondered if that had anything to do with the exquisite coordination that was taking place. Dr. Tiller stood at the head of the bed, ataraxic and remote, arms folded across her chest. Emma got access, and the nurses pushed the code drugs barely a half minute after Dr. Tiller called for them. Emma called for some atropine and handed the laryngoscope to Jemma, though Maggie, still laboring at compressions, made a swipe at it as it was passed off. Jemma had the irrational feeling, as she beheld the thing, that the boy’s epiglottis was somehow indicting her as a procedure thief. She missed it twice but Emma would not take it from her. “There’s no hurry,” she said. “We’ve got him right where we want him, he’s not going anywhere. I’ll just bag a little while you think of something peaceful.”