It was a very different sort of rounding than she’d become used to, and the novelty of it helped to propel her through the dawn despite her exhaustion. She slowed, as the sun rose, pausing longer and longer at each bedside. She was surprised to miss the conversation with her patients out on the ward, even when she had been just their talking doughnut. It was much harder to socialize with the comatose, even with Maggie, who, deep in her pentobarb coma, had reached a personal apogee of pleasantness. The barbecue boy twitching and crying in his troubled sleep; the spoiled-platelet girl flapping her hands gently in her restraints; the little hypoplast with the recently reopened chest, an opaque window of antiseptic tape fluttering over her heart; Marcus lying still in his bed, staring blindly at the ceiling, dead alive while his blood slid around the room through the crazy-straw architecture of the LVAD: at every bed Jemma looked at the numbers and did a brief exam, and then stood watching over them with increasing solemnity, until, as she stood over Jarvis, it was almost as if she was visiting his grave. She watched him, feeling something catch in herself every time his respirator gave him a breath. She counted them, eighteen a minute. He did not breathe over that rate, nor did he move a muscle in his body, though he wasn’t paralyzed, like other patients on the ventilator. His pupils, when she pried open his lids to look in his eyes, were fixed. When she pinched his fingertip, as hard as a bite, he did not draw away. On the second day after Jemma had carried him out of his nest he’d developed cerebral edema and herniated, though Dr. Tiller raged powerfully against his decline.
By the time Jemma left him the shrunken sun was disappearing into a bank of clouds, and the day had turned sufficiently that her pager quieted and she was no longer on call. Tousled, wrinkly Dr. Chandra found her to get signout on his patients.
“Are they all alive?” he asked her.
“Oh yes,” Jemma said. “Everybody did okay. Let’s see. Bed 1 had a k of 2.0—I bolused. Her pressure was in the eighties after she got some fen-tanyl — so I gave albumin. She spiked, I cultured. She had a film this morning, but I haven’t seen it yet.”
“I hate this place,” he said, stretching and yawning. It was a very different morning than yesterday’s. All that bright sunshine seemed a year ago now to Jemma. The sea was the color of bile and the sky slate-gray. “Don’t you hate it?” he asked her.
“It was only my first night,” she said.
“That’s enough to know. The places are like people, and first impressions count for a lot. I liked the one ward better. They’re nicer up there. I don’t know what it is — the kids are almost as sick upstairs, but down here everyone’s always in a bad mood.”
“They’re not exactly hanging leis up there, either.”
“It’s like they hate me down here. They all think I’m stupid.”
“Nobody thinks you’re stupid,” Jemma said, though she had heard it said of him that he could not diagnose his way out of a wet paper bag.
“They think I’m stupid upstairs, too, but they’re nicer. They’re just nicer people.”
“You know more than me,” Jemma offered.
“You’re a student,” he said simply. “Sort of. I guess there aren’t any students any more. We’re all in the program now, caught in its clutches. The program — I’d been counting down the days left in residency and now it’s going to last forever. It’s not that different than before. You never get to leave and there’s no life outside, and everybody’s horribly depressed because nothing good ever happens here, and it’s the ugly truth about the program that they pretend to care about you eating and sleeping and learning and not wanting to die every minute of your work day, but really they care about you only as far as they can kick you or as deeply as they can fuck you, and nobody pretended more lamely or cared more superficially than our director. How are you? he’d say, and stare at you with his zombie eyes. Call me Dad. We’re all one family — what a horribly unfunny joke. I used to be so jealous, sometimes, watching all the regular people outside — I’d sit in the park and even the homeless people seemed as happy and free as fat little hobbits. But now”—he clapped his hands together, startling Jemma, who always had trouble staying awake around hour twenty-four, and was starting to drift—“just like that, the hospital ate the whole fucking world, and now nobody will ever get out or go home. Do you ever wonder if it would be more pleasant around here if Dr. Tiller were dead? It’s probably a sin to think like that. The angel says it’s okay, but I don’t believe her.”
Jemma wasn’t sure if she should continue with the signout, so she said, “The angel’s a good listener.”
“Yeah,” he said. “What about Bed 3?” She told him the night’s story on that patient, and on the others he was responsible for, 5 and 8 and 13 and 17 and 18, and then his ten babies upstairs. She became lost in her notes, not sure who had thrown up and who hadn’t, or who had spiked, or which baby got the weird purpuric blotch that was shaped just like lost Australia. Chandra was sympathetic. “They’re all kind of the same, anyway,” he said.
When they were finished she went upstairs to start her official morning rounds before Dr. Sasscock could find her — she had carried some of his patients overnight, too. Brenda was lounging in her isolette, looking quite relaxed and even, in her own way, rather healthy. Sound asleep, she nonetheless lifted an arm to point as soon as Jemma stepped up on the dais.
“Hello, little thing,” Jemma said. “I get to visit you every morning now, you know, and be your own special moron. Your very own moron, to do a little dance for you when you’re sad, to lie down at your feet when you need to lord it over somebody, and when you are hungry you can say, Hey, moron, peel me a grape!” The baby dropped her arm, but continued to stare while Jemma felt her head and listened to her chest and belly. She had grown — now she was a thirty-six-weeker, almost big enough to be born, and almost big enough to have gone home, in the old world. Jemma had pictures of her in her new camera, and stored on the computer in the call room, documenting her many visits. Day by day and week by week she looked more human, though never much like a normal baby, with her toaster-shaped head and her train-wreck face and her many-fingered hands, not to mention the tubes that grew as certainly as her more natural appendages. There was still not much body to cover, and not much work involved in a full exam, even as her improving health allowed more detailed probing and firmer poking. But Jemma, when she was done with her exam, felt suddenly tired. It often happened this way. The first twelve hours of call were all right. Fifteen was a logy hour, but sixteen through twenty were fine. Zombie time started at hour twenty-four, and the big crash came in the morning of the next day, at hour twenty-five, when she could hardly remember her name and might fall asleep on her feet if she stopped moving for too long. She felt the crash impending now; to ward it off she closed up the isolette and put her head down on top of the box, meaning to keep it there ever so briefly — sometimes three minutes of sleep could keep you going for another hour. She fell asleep immediately, her hands relaxing where they hung at her sides, and her mouth opening a little, so her breath clouded the plastic.