Bloodletting and Miraculous Cures (9 page)

FITZGERALD:
Fear is natural.

MING:
I'm glad you came, though. It's been so long. You look older. And wiser. I've seen you…looking this way in my dreams.

FITZGERALD:
I've been thinking about the time we had, and about the time we might still have. We have to move forward, either together or apart.

MING:
I've missed you.
(Tears begin to appear.)
I've distracted myself with other things…even other men…I'm so sorry. But I've always missed you. Late at night when I couldn't sleep, I knew you were there.

FITZGERALD:
All is forgiven, my love. We're together again.

 

Lovers embrace. Lips slowly meet. Camera fades to black.

 

Six-oh-five.

The couple in
Starlight over the Rhone
stared at Fitzgerald from above the couch. Their facial features were indistinct, the direction of their gaze unclear. He had assumed that they were a couple, a man and woman bound together in life. But he now wondered that this might not be true. They could be brother and sister, or a man with his mother, or old acquaintances walking together along the river after having encountered each other by chance.

Fitzgerald went to Ming's desk, sat in her chair. A jumbled layer of notes and books stretched from the coffee table across the couch, onto the surface of the desk. A small pile of letters was half-hidden by an open anatomy textbook. He flipped through the telephone bills, the bank statements, and found one of his own
letters. The bills and statements were opened, but his letter was not. At the bottom of this little stack were six of his letters, envelopes intact. He pulled open the drawers, rifled through the highlighters until he found a clump of his correspondence gathered with an elastic band, everything since the phone had been disconnected. None had been read since January.

Six-ten.

The phone rang, and a man's voice said into the machine, “Ming? It's me, Chen. Pick up the phone if you're there. What kind of salad dressing do you want? Guess you're not there. Well, I'm coming down to start dinner.”

A new film scene shot itself in Fitzgerald's mind.

 

Interloper,
CHEN
, enters room where faithful but jilted lover,
FITZGERALD
, sits reading mail at the desk of lost woman,
MING
.

 

CHEN:
Excuse me, who are you?

FITZGERALD:
I should ask the same.

CHEN:
I'm calling the police.

FITZGERALD:
You don't know what you're doing.

 

CHEN
lunges for telephone in kitchen.
FITZGERALD
rushes to stop him. They struggle.

 

FITZGERALD
(while grabbing
CHEN
in a headlock):
Ming promised to marry me.

CHEN:
So you're the loser who keeps hounding her. Get a life!

 

CHEN
, who is secretly a kungfu master as well as a brilliant medical student, suddenly breaks the headlock, flips
FITZGERALD
on his back, and pins him to the ground with his legs while he calls the police using a tiny and very fashionable cellphone. With a quick flip of his knee,
CHEN
knocks
FITZGERALD
unconscious.
FITZGERALD
wakes up in prison, in a cell with three smiling, burly men.

 

She had said that Chen lived in the same building. How long would it take him? Not long. Fitzgerald stuffed his feet into his shoes without tying the laces, grabbed his coat, and slammed shut the apartment door just as he heard the elevator ding down the hallway. He bolted in the other direction, then saw that this was a dead end with only two other apartment doors. The staircase was beyond the elevators. He turned and walked slowly, seriously, along the hallway. He held the bandages on his face and did not look at the man who passed him carrying a head of lettuce, a tomato, and two bottles of salad dressing. The man said something to him, something pleasant that strangers passing in narrow hallways say to each other, but Fitzgerald couldn't tell what it was.

 

One afternoon in September, Fitzgerald and Ming met accidentally on the lawn of King's College Circle in
front of the Faculty of Medicine. They had been walking toward each other, and had noticed one another only once it was too late to discreetly change direction. The grass was singed brown in half-circles at the edges of the lawn where the sprinklers had not reached, and there was no shade of trees where they stood squinting at each other.

“Congratulations,” she said.

“On what?”

“Getting into medical school.”

“Sure,” he said. It didn't seem very important, now that it was done and he was one of hundreds in his class who had accomplished the same thing. The congratulations felt like nothing more than a common courtesy. He said, “How are you doing?” Ming's hair was pulled back in a hasty ponytail that clung to her sweaty neck. Her stance was broad. Seeing her suddenly here, small-framed, her arms crossed, her right hand tapping her left elbow, made him feel as if he had dreamed their whole relationship.

“Better, now,” she said.

“How's second year?”

“Tough. Lots of work.”

Young men wearing T-shirts translucent with sweat ran at each other on the field, kicking at a soccer ball and panting.

“I wrote to you, for a while,” he said. He stood, sweating, squinting against the sun. Ming's shoulders slouched more than Fitzgerald remembered. He was
surprised that this was the person to whom he had told himself he was irrevocably attached, that conviction amplified by his resentment and anger at her absence. What surprised him was that he would have expected to feel more emotional, to experience some mix of elation and anguish at seeing his beloved. Instead, it felt as if he were meeting a celebrity at a grocery store. To see Ming now was to discover that the enticing onscreen femme fatale had a very ordinary and chaotic selection of groceries, chapped lips, and slightly dirty fingernails.

“I decided to not read your letters,” she said. She regarded him with a hard clamp of her jaw. “I guess you know that.”

The length of her silence, without her leaving or walking away, made Fitzgerald think that she was expecting something of him. Even though her hard presence now made his memories seem like a mirage, Fitzgerald knew the set of her mouth well enough to know that she was waiting for something from him. There was something she wanted him to say.

Fitzgerald thought of the long winter when he had wanted to see her, the months during which he had imagined the way their words would again link and hold them. After his interview, that had faded. His acceptance into medical school had been a vaguely important event. Once it was done, he couldn't quite articulate how he had gotten to that point. He stopped writing to Ming, and the desperate winter was now embarrassing to think of.

She said, “You didn't lock the door. Things were moved around. It was obvious.”

“Right,” he said. All of that now seemed incredible; that he had propelled himself to her apartment, broken in, sat there anticipating nothing that he could even clearly remember as being real. Now he was amazed that he had never considered the obvious—that she would know he had been in her apartment. He said, “I'm sorry.”

“You should be.” She continued to look at him. “Anyhow.” Her mouth relaxed.

So that's all she wanted. An apology for breaking into her apartment. A very reasonable expectation, he thought. He said, “I'm sure you have things to do.”

“Yes, actually.”

“I won't keep you,” he said.

“Same.” She raised her hand, and waved slightly.

“Bye.” She walked past him.

Suddenly, he felt the tightness of wanting to love Ming, and that roaring feeling of wanting revenge for her abandonment. All of this filled his centre in the instant that he could no longer see her. Should he turn to look at her? Would the reality of her shrinking figure dispel these emotions, or would turning around to watch her depart make him want to run after her, to chase his screen idol? Perhaps it was best simply to stand here in the sun for a while, to sweat in the heat, heart pounding. Droplets of sweat traced his torso like fingers. For an instant, he imagined that Ming had not
walked away at all, that she was standing right behind him, watching him. His back cold with sweat. No, no, that was not her. She would be halfway across the field by now.

Fitzgerald dared not turn.

He closed his eyes, and the sun was still bright through his eyelids. He heard the stutter of the sprinklers coming on one after the other on the field, the shouts of soccer players running through them. Slowly, he sat down on the grass. He was feeling almost normal again. He felt a lingering temptation to turn around and gaze at Ming, close or distant, just to prove that he could do it and it would be okay, but he decided not to.

His eyes were still closed and Fitzgerald could hear the sprinklers come to life closer and closer to him. He lay on his back and waited for them to swing around and spatter him with cool water.

 

CODE CLOCK

“
WALK BRISKLY. DON'T RUN. I NEVER RUN,” NIGEL
says.

They are in the hallway already, having abandoned the patients and consults in the emergency department.

The overhead voice repeats, “Code blue, 4A West, room 467.”

Past the fracture room, through the back door in radiology, they turn the corner to the elevators.

The
up
button.

Where is the elevator?
Fitz thinks but does not say. He
looks toward the stairs, then at the doors that should be sliding open.
It would have been faster if we'd walked, but now that we've stood here for maybe fifteen seconds, even twenty? Now it's probably faster to take the elevator. But it's still not here.

“Code blue, 4A West, room 467.”

The elevator is coming. Stay cool, stay calm, and get into a good headspace.

Ding!

Stepping in.

Whoossh.

Stepping out.

“Code blue, 4A West, room 467.”

Both Nigel and Fitz consciously hold in their steps to keep from breaking into a jog. Their feet tick-tock in the empty nighttime ward hallways.

“You want to run the code?” says Nigel.

“Sure.”

“You ever run one?”

“I've been at lots.”

“You sure?”

“I'll do it,” says Fitz. “Left. West wing.”

“Huh. You run the next one.”

“Whatever.”

Fitz walks faster.

“Walk briskly, don't rush,” says Nigel. “My rule is when you come into a code, your heart can't be faster than the clock.”

In the room, it's the second bed.

They see the stillness in him.

“Okay, what's happening? Who called it?” says Nigel.

“It's Mr. Dizon,” starts the nurse in blue. Fitz at the bed already, his hand in the groin feeling for a pulse and his stethoscope on the quiet chest. “I was here for Mr. Singh's meds, and he said Mr. Dizon seemed quiet.”

Fitz feels a stillness beyond the lack of motion.

“VSA,” says Fitz, “I'm going to start bagging. Who's going to compress?”

“How long has it been?” asks Nigel. “And where's the crash cart?”

“Can you compress?” shouts Fitz at the nurse in blue.

The blue nurse says, “The cart is coming. I called you two minutes ago.” She folds her hands together over the quiet chest and begins to pump it down, down, down.

Fitz has the mask on Mr. Dizon, and his fingers draw tight to pull the jaw into the plastic cushion on the Laerdal bag.

“But how long has it been?” says Fitz.

“Well, I was on break, and then I finished and actually I was going around to see Mr. Singh, and Mr. Dizon isn't even my—”

“How long?” says Nigel.

“Well, I was here just a minute before, but then Mr. Singh didn't mention anything, so—”

“I'm not saying anything's wrong,” says Nigel. “I just need to know how long. Where's the crash cart?
Does anyone know how long since Mr. Dizon has been seen with vital signs?”

A nurse in green appears, pushing the crash cart ahead of her. The green nurse is out of breath, and she flutters through the pages of the chart to make an entry.

Nigel grabs the paddles from the cart, scrunches the man's gown up around his neck, and slaps the paddles onto the chest where black stitches stencil a vertical scar.

“Ten minutes,” says the green nurse, speaking into the chart. “Mr. Dizon is mine, and I saw him ten minutes before Maria called the code. Here, do you want the chart?” She writes the time, ten minutes ago, into her notes. She shows the chart to Nigel. “I'm Sharon, this is Maria, and you are?”

“PEA in two leads,” says Fitz, his gaze on the monitor, addressing everyone and no one.

“I'm Dr. Nigel, and this is Fitzgerald, my medical student. Why is this guy here?”

Sharon notes the names on the chart.

“Post-bypass. Came to the floor this morning.”

“Sharon. You got the clock? Twelve minutes.” There is a flashing red timer on the cart, which Sharon sets at twelve. Fitz is at the head of the bed. His left hand squeezes the mask onto the face. His fingers achingly pull the jaw up, so that the mouth is tight into the plastic of the mask. His right hand pumps the bag. His thumb can feel the lung's resistance succumb to his hand's blowing motion. The little yellow valve flips open as he squeezes, and falls shut
when he allows the bag to refill. Maria is over the chest, her left fist in her right palm, pushing, pushing, pushing motion into the stillness.

“One of epi,” says Nigel, “two bicarb.”

Sharon draws epi from an ampoule, injects it into the IV port in the bend of the arm. Now looking for the bicarb.

Fitz feels his hand cramp. He stretches his fingers between bagging. “You want me to tube him?”

“Sure,” says Nigel. “You comfortable?” meaning,
do you know what you're doing?

Fitz says, “Can I get some help? Move that chair, we have to push the bed forward. Sorry, what's your name? Come on, come on, everyone, let's make some room.”

“I'm Sharon.”

“Sharon, get me a Mac-3, check the light, 8–0 tube with a stylet.”

 

Soon, Maria feels herself falling onto the body instead of pushing into it. She is tiring. She can see the monitor and can see the compressions showing on the screen, but no other rhythm. Fitz asks her to stop compressions while he gazes at the tracing. Maria climbs onto the bed, kneels. Fitz says to resume compressions, and she does so on her knees. The compressions shake the whole bed, and Mr. Dizon shakes with it. He is limp, though stiffening against those around him.

“Time? Where are we?” asks Nigel.

“Fifteen minutes,” says Sharon. She fits a rigid stylet into an 8–0 endotracheal tube.

Fitz takes the tube and bends the end like a hockey stick. How is it that this tube finds its way beyond the teeth, into the back of the throat, and then through the trachea? Fitz can't quite resolve it in his mind, the anatomy, when he thinks of it. He says, “Have we got suction?” He thinks,
I'm comfortable. I am.

“Another epi,” says Nigel.

Fitz unlocks the bed's wheels and pushes it out from the wall. Maria crouches on it, elbows locked, pushing into the stiff chest.

“Hold compression. I'm going to tube him,” says Fitz.

The motion stops. Maria slides off the bed, flexes and stretches her arms.

Fitz tilts the head back, thrusts the chin up into the air, draws Mr. Dizon's face into a pose of prayer. Fitz crouches behind the top of the bed, his right hand cups the head and his left hand grips the angular, L-shaped laryngoscope. The blade of the laryngoscope slides in easily, and with it Fitz pushes aside the tongue and slips it deep, into the small fold where the blade tip rests. Now he's at the entrance to the trachea.
Where are the vocal cords? The cords are the door to enter.
Fitz pushes the blade up. Straight forward and up, toward the ceiling. The tongue is pushed up to the left.
I always forget how heavy a head is,
he thinks,
until I'm trying to straighten an airway.

“You want some pressure?” asks Sharon.

“I'm okay.” Fitz can see the arytenoids.

Fitz tilts the forehead back further, extends the neck, lifts up. The pillowcase slackens as the head floats upward.

“Let me look,” says Nigel, and nudges him.

“I'm okay.”

“Jeez, just let me look.”

“I can see the false cords. Give me some cricoid pressure.”

Nigel presses his right thumb and forefinger on the thyroid cartilage of the neck. It looks as if he is about to strangle the man. “Fine. You position me, I'll hold it.” Nigel steadies the head with his left hand and pushes on the neck with his right.

“I'm almost there.” Fitz has his right hand on Nigel's, pushing and angling, flexing slightly and trying to line up the cords with the teeth and throat.

Nigel says, “Let me do it.”

“Hold on.” Seconds pass, a thin sweat running to Fitz's cheek. “One sec.” Fitz hears Sharon's pen scratching on the chart. “I've got it. Tube.” He can see the white, almost ribbon-like vocal cords. When they take the tube out afterwards, people often have a hoarse voice, these little ribbons traumatized.
If
they take the tube out.

Sharon holds out the tube to him, and he glances up briefly to take it.

“Damn.” As he looked up his position had changed slightly. He repositions, his forearm tight and trembling with the laryngoscope. Fitz tells himself,
I am absolutely comfortable.

“Have you got it?” says Nigel.

“Yeah, I've got it.” He slips the tube down the back of the mouth and thinks he sees the tip at the door of the vocal cords.

“Are you sure?” says Nigel.

“Absolutely,” says Fitz.

He isn't sure.
Relax.
He breathes.
Doesn't matter, probably.
Fitz looks steadily down the blade of the scope, the fibre optic light bright now on the cords. The tube passes through.
In.
As it goes in, the deflated cuff pushes gently past the cords; he can feel that slight hesitance upon penetration, and then in. The feel of it, once in, reassures him.
Trachea, not esophagus.

“I'm in. Cuff up.”

Sharon plunges the syringe to inflate the cuff.

“You got a good look? Saw the cords?” says Nigel.

Fitz switches the bag from the mask to the mouth of the endotracheal tube, and listens to the chest with his stethoscope as he pumps the bag.

“It's in,” says Fitz.

“Okay. Time?” asks Nigel.

Sharon says, “Eighteen minutes since we called you.”

Nigel says, “Pick it up next time, Fitz.”

“He's a big guy,” says Fitz.

“Tape it in,” says Nigel.

“'Course,” says Fitz, having forgotten the tape until reminded. Then to Sharon, “Another epi.”