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“Is it in?” he had asked Emma, when he had tried to intubate the monstrous child.

“I don’t fucking know,” she said. “We’re tubing a baby, not having sex.” Then she bumped him out of the way and looked in the child’s mouth. “In his brain, maybe,” she said, yanking out the tube, then putting in another, all in about twenty seconds. “There you go,” she said, patting Dr. Chandra on the shoulder. She walked off, and he noticed for the hundredth time how she had curls that really bounced. Natalie was shaking her head. The medical student was staring at the ceiling. When the respiratory therapist asked him for vent settings, Chandra just walked away.

I could just leave, he thought to himself in the cafeteria. It was a thought that had occurred to him before, to walk out of residency, out of the hospital, and out of the horrible half-life. He’d walked out of rotations before, but only as far as the Residency Director’s office, to complain and to cry to the man who insisted they all call him Dad. Nothing ever came of it, and he always went back to work. Tonight it was raining too hard to walk out, though maybe that would be a better option than remaining — to leave the hospital and be swept away, out into the bay and through the Golden Gate, out to the Farrallons where he could live on puffins and baby seals, a better diet than humiliation and misery and vanilla pudding.

A noise took him away from the Farallons — a surge in the wind. Suddenly it blew so heavily he felt the hospital rock. The few other late-night diners looked up from their pizza or ice cream or pudding. Chandra rose and pressed his face against the window. Now the rain was falling so hard it totally obscured the garden. When the window went dark he thought it was because of the sheer volume of rain, until he saw his pale face reflected in the depths of the darkening glass, and saw that all the others were going to the windows to examine them, too. When he pressed his face against the glass, and cupped his hands at his temples to block out the light, he still couldn’t see through. Staring and squinting, he saw a dim flash of light, as if at a great distance, and thought it must be lightning struggling to shine through the rain.

“What’s going on?” he asked no one in particular. Nobody answered. The others in the cafeteria only tried like he had to see out the darkened windows. He turned back and was about to try again when he felt the first big lurch. They’re all going to laugh at me, he thought as he fell, just after he knocked his head on the table. But before he felt himself pressed back flat against the floor, he had time to see that everyone else was falling, too.

Three floors up Emma was relaxing — as much as she ever did on call — in her luxurious call room. It was really an attending-level call room, but then she was nearly an attending, and had anyway been outthinking and outclassing most of the attendings since her first year of fellowship. But who needed a vanity in their call room, and to take a bath in the whirlpool tub was only asking to be called out wet and naked into the middle of a crisis. She lay in bed a little while, visiting in spirit every baby in the unit, holding them a minute in her expansive mind, considering their afflictions and trying to anticipate the dips and turns their hospital courses might take that night. There was nothing she could think of that she had not already warned Natalie to watch for, or that Natalie would not anticipate herself. You couldn’t spell out everything for them, and she left more than usual unspoken with Natalie, who was smarter than the average third-year, or less dumb, at least. She did an imaginary survey of the PICU as well, since she was covering both units tonight. The regular PICU fellow was still trying to swim in.

Sirius Chandra passed briefly through her mind, tangled up and confused and goofy and already slightly smelly, she’d noticed standing close to him, though the night was hardly half-over. She thought of tracking him down in whatever hidey-hole he’d retired to, for the sort of talk a good and empathetic Fellow was supposed to deliver to a really dispirited Intern, but it seemed too late for tears and complaints and excuses. She turned on the television but it played only a moment — a glimpse of a girl and her horse who she managed to recognize as Pippi Longstocking before the station cut out, and then every station she tried was off the air. She turned it off, and sat down on the bed, and got a page, not from the unit just outside her door, but from her home.

“She’s fine,” her husband said as soon as he picked up the phone. Their daughter was five months old that week.

“Pretty late for a social call,” she said.

“Such a storm,” he said. “I couldn’t sleep.”

“Well, I might have been.”

“Better to be woken by someone you love.”

“Who says I don’t love these people?”

“She’s sleeping right through the thunder. Did you know she twitches when she sleeps?”

“Are you sitting there watching her again? No wonder you can’t sleep. Were you checking her breathing? It’s fine. It’s always going to be fine, and even if it wasn’t, you’re not going to catch it by staring at her. You’ve just got to relax. Don’t you think I’ll tell you if there’s something wrong with her? Paul? Paul?” She listened for him — sometimes he fell very silent and she could barely hear him breathing — and she thought the line was dead until a lady’s voice spoke out of the phone.

“He is gone, my love. Gone forever, not to be seen again in this world. He is already drowned, but not you. You I will protect and preserve and love for all your allotted time.”

“Who is this?” Emma demanded, so nervous all of a sudden that she was holding the phone in front of her face and shouting into it. “Is this the fucking operator?” She only got silence for an answer, and then she got the terrible heaviness that comes of being thrust up so impossibly high, so impossibly fast. Not even an angel wielding the sheltering grace of God could cushion her fully. She fell back, like all the rest.

Down the hall, in another call room, Rob was speaking.

“Something awful has happened,” he said to Jemma, and she was reminded of her mother, who had spoken those very same words, in the same sort of frightened, croaking whisper, when Jemma came home on the night of her brother’s death. She was reminded, too, of the feeling she’d had as soon as she came in the house — she had known that something was horribly wrong before she saw anyone, before anyone delivered the news. She and Rob dressed hurriedly, pulling on each other’s scrubs by mistake, so Jemma’s shirt hung on her and Rob’s clung tight across his shoulders. Neither of them remembered to put their socks on. Jemma opened the door, after they’d both hesitated a while, listening. The hall outside was empty. The red preemie footprints wandered along the carpet, same as they had when the two of them had gone into the call room. It all seemed quite normal, until a great wail, not a child’s, came washing along the walls. The telephone lady’s voice spoke as if in response. “Be comforted, my darlings.”

They followed the little footprints back toward the NICU. The call room was placed so that a person should be able to run from bed to the unit or the delivery rooms in less than two minutes, but they creeped along so carefully that it took a whole five minutes just to come to the door to the glass bridge, or rather the place where that door had been. What previously had been a glass door was now a great circle of darkened glass, opaque and slate gray like the window in the call room, reflective only of flesh-colored shadows. Jemma put her hand against it and drew it back immediately. The glass was so cold her fingers stuck a little as she pulled her hand away. “What’s happening?” she asked.