The Children's Hospital

22

One could always confide in Vivian. She was a gossip but she operated by sharply defined rules of secrecy: If she knew an item was classified, then she’d not divulge it even under the worst duress, but all secrets must come to her clearly labeled. Information not tagged as sensitive she passed on with glee. So Jemma was sure to say, before she spoke, “This is classified. I mean it’s really, really classified.”

“I’ll die before I’ll tell,” Vivian said seriously. They were back in their abandoned conference room, in the midmorning after rounds two days after Jemma took the pregnancy test. Vivian had stocked the little fridge with synthesized yogurt packaged in bottles shaped like fruit. She was eating one now, scraping with a long, thin spoon at the bottom of a glass peach.

But when Jemma opened her mouth to speak it, she vomited instead. A little blurp that she thought must be just the size of the word “pregnant” fell out upon the table. The rest Jemma directed to a little shin-high garbage can near the door. So Vivian guessed it, and Jemma nodded, hand over mouth. Her body had provided her with only the one clue before she took the test. Afterward, she was mobbed with symptoms. She developed something new at each floor as she made her deliberately long way back to the call room. She woke up nauseated from her nap, and vomited once before she left the garden. On the ninth floor her mouth was flooded with saliva, so she had to stop at every water fountain to spit. On the eighth floor she became terribly tired, and had to lean against the wall every fifty yards or so. Before she had traversed the seventh floor she had to pee three times. On the sixth floor she developed terrible heartburn, and stole milk from the patients’ fridge, sipping it as she walked, then vomiting it up on the fifth floor. She bloated, then, and became flatulent, her ass merrily whistling and driving her forward as she took the last flight of stairs. In their room, she stood with her back against the door, and as she watched Rob sleeping on his side among the twisted blankets, his hands folded and thrust between his thighs, her breasts began to feel full, and tingle, and ache.

She had lived these moments before. After so much obsessing, and fretting rehearsal of this particular crisis, she thought she should know with clear certainty what she should do, but she was utterly confused. In her mind she had run the gauntlet of shrieking, self-satisfied advocates to the clinic door, been pelted with fetal parts, had her doctor shot from the window just as the procedure was about to start. She’d crept in quietly one morning, stepping carefully over a fat housewife snoozing under her placard, inside a clinic staffed by nurses and doctors in muffled shoes, and had it all go fine, or bled to death. And she’d been pregnant in high school, squeezing her belly under the little desk; in college, suffering the ridicule of the cruel, persecuting frat boys, and suffering the shoeless, hairy-footed lesbians to carry her books for her. She had been pregnant in medical school, when second-trimester complications had rescued her out of numerous pathology exams. She’d given her babies away to kind-looking strangers in the supermarket, and to desperate, well-to-do couples in the lobby of the fertility center, as she passed through on a shortcut to the lecture hall. While Vivian sized up a handsome boy, deciding whether they were worth prophesizing about, Jemma imagined a life for him, his butler, and her baby in a giant New York apartment. She thought she’d obsessed sufficiently, that she’d done everything once in her mind, so that no matter what happened, she’d have some idea of what to do. But she had never imagined this situation.

“Mushrooms are not the issue,” Vivian said, clutching and stroking Jemma’s hands. “Mushrooms are irrelevant. I’ve done the reading. The question is, what will you do? All options are open, now you must choose.”

Jemma said she didn’t see very many options. Mushroom-headed monster or not, what could she do here?

“Do you even know who you’re talking to?” Vivian asked. In school she had headed up the keep-abortion-legal faction among the medical students, and had often engaged in public battle against those who wanted a return to the back-alley days. “You say you are for life,” she had thundered once at her nemesis, a fat, mousy girl who snuck around pinning tiny golden feet to people’s backpacks, or to the hanging edges of their coats, “but really you are for death, and misery, and hatred, and death, and death, and death!” The nemesis, despite her mousiness, and her preference to sneak, and a mouth so small it hardly seemed big enough to admit a straw, was just as loud. They shook the auditorium, and spoiled a physiology review, earning the ill-will of every witness for days.

To illustrate the options, Vivian took Jemma to a synthesizer on the seventh floor, in a nurses’ lounge down the hall from Vivian’s room. It was Vivian’s favorite synthesizer, a tall one, the one where she had ordered her mushrooms, and where she conducted all her fashion experiments. She shut and locked the door and sat Jemma down in front of the shallow bay and the frosted glass panel. “Not that anything has been decided,” she said, “but just so you know that there is a choice, like always, wherever you are, before the end of the world, after the end of the world, on the earth, on the moon, wherever. I don’t care. You always have a choice.” She turned to the panel and spoke with great authority: “RU-486!”

There came the familiar humming noise, and the sound like someone shaking ground glass in a bag, and a rush of warm air from out of the machine. The glass window lifted, and the usual mist spilled out, white and thick, falling to the floor and surrounding their feet. Revealed inside was a pair of knitted blue baby booties. Vivian shook them out; they contained no pills.

Two more weeks passed before Jemma told Rob, all the hated embryology coming back to her in the meantime. She wanted not to remember it, but couldn’t help it. Where was it when she needed it, she wondered, when she needed to know when the blastocyst differentiates into the bilaminar germ disc? It was on the eighth day. Now she remembered, three years and seven miles of water later, when those lost two exam points were no more recoverable than the lost life of Dr. Goode, her anatomy professor, who was always touching his handsome fifty-year-old body to show them this or that bony process, or stroking the long muscles of his thigh in a way that made Jemma’s throat hurt. He had sleepy-looking eyes and never wore socks, and was a theology student before he was an anatomist.

A blastocyst floated in her head. Lying next to Rob, with her eyes closed, she could see it busily dividing and growing. She looked away for a moment, and when she looked back it was bigger. Cytotrophoblast, syncytiotrophoblast, hypoblast, epiblast: she counted the days again on her fingers.

Best not to get too attached, she thought, though of course they were already attached. It had burrowed into her like a mite, and sealed up the wound with a fibrin plug. Anything could happen, though, and no matter what Vivian said she still thought it could come out tripping in each of its three heads. She had a particular feeling, considering it, like she was stuck at the top of a shudder.

It was probably a reflex, Jemma was sure, to think of your own mother, when this happens to you, and to want to call her, if she weren’t dead and dead again. Jemma had been thinking about her, and when she first knew about Calvin. She was older than Jemma was now. They had been trying, and must have been so happy when they found out. She imagined her mother’s pregnancy as a single long day spent sitting in a comfortable chair, brushing her lustrous, lengthening hair and drinking non-hallucinogenic tea — it was all so very different from what lay ahead of Jemma. The hugely pregnant medicine attendings she had known had seemed heroic to her, as had the surgery attending who had excused herself from morning rounds to go deliver and been back for walk rounds in the evening, strolling with her IV pump down the halls at the head of the team. Now they seemed as gruesome as beasts who dropped a litter on the run.

She tried not to put her hand on her belly, but it strayed there as soon as she stopped paying attention to it. Rob kept asking if she was feeling sick, though he only saw her vomit once — the night before she finally told him she’d dashed out of bed just after they’d lain down. Her morning sickness never came in the morning.

“There are a lot of barfy babies in the PICU,” he said, when she came to bed again. “Maybe I brought something back and gave it to you.”

“Maybe,” said Jemma. She was waiting for the right time to tell him, or the right place, but every time and every place seemed wrong.

“I’m just a big fomite,” he said. “Sorry.”

“We’re all fomites here,” she said, sitting up and staring thoughtfully down at her toes. He started to rub her back. She almost thought it was time to tell him.

She was poised to strike just as he was falling asleep, and almost asked, Are you awake? just as his breathing was shifting. Somehow she thought the news would be easier for him if he was drugged with sleep. But she couldn’t speak the words. Nor could she speak them in the morning. She woke first, and woke him by sliding a finger down his chest. She meant for them to be the first words of the day, but all she said was, “Hello, sleepyhead.”

She couldn’t tell him, not when she fled from rounds to have lunch with him in the NICU, not during the random pager-mediated conversations, not when she found him lurking in the hall after she changed out Ella Thims’s gastrostomy tube with Timmy. “You just sort of twist and pull,” Timmy told her, popping the tube in and out of Ella’s stomach while the child watched one of the fancy new cartoons that a subcommittee of parents had ordered up from the angel. They meant well, trying to combine or strengthen virtues by mixing up stories, but the results were almost as strange as the new pornography circulating among the adults. Batman was just and good, but too dark and broody, his whole world in need of a lesson of bright, carefree love, so they moved Pooh Corner to Gotham, and Christopher Robin became Batman’s smooth-limbed sidekick while Piglet wore a rubber suit and lashed a whip alongside Catwoman. Jemma didn’t know what made her more nauseated: the cartoon or the wet, sucking noise the tube made as Timmy popped it in and out of the hole. “You try it!” he told her, but she had to barf, so she excused herself. Years and years ago she used to vomit, not for fun, but to improve herself, but try as she might she could not remember how it could have been anything but an occasion of misery. Now as then she carried a toothbrush everywhere she went and her gums were getting sore.

She found Rob when she came out of the bathroom. In front of Timmy, he said there was a chest tube for her to help with in the PICU — chest tube trumps G-tube, Timmy admitted — but what he really wanted was to take her into the meditation room. It was meant to contain parents made contemplative or just miserable by their children’s illness, but they used it for a daily afternoon smooch. Nor could she tell him when he came to her after dinner, and found her on the sixth floor, hiding in a cubby, finally finishing her daily progress notes.

He brought her coffee, which she pretended to sip once, then put aside. “Why do we still do all these damned notes?” she asked him. “Who’s ever going to read them?”

He looked over her shoulder at her cramped writing, and her page and a half note on Ella Thims. “That’s probably a little long,” he said. Third-year medical students were ridiculed for their long, overly detailed progress notes, and scolded if they ever dared write a note that was too short by even a sentence.

“This is short for Ella. She’s got something wrong in every system.”

“I have three words for you: continue current management.”

“I’m not senior enough to write that,” she said, thinking, I have three words for you, too.

“Sure you are. You’re an intern now, remember?”

“Maybe you are,” she said. But for Ella’s second-to-last system she wrote, Continue current management, and for the last she wrote: OB-GYN: No ovaries, not pregnant! Rob didn’t notice. She shut the chart and filed it away with the others.

She went to pee and vomit, and then went to the roof. He’d told her to meet him by the sycamore tree, because he had something to show her. The moon was up, so the shivering leaves cast a shadow on the ground, and she could see pretty clearly beyond the shrubs and flowers that there was no one around anywhere. She was just about to pee again when she heard his voice.

“Up here,” he said. She went to him, climbing higher than she was used to going — he’d gone up to the highest branches that could support his weight. He struck a match as she climbed up next to him, and lit a circle of candles glued by their own wax in the ring of branches above their heads.

“You’ll set the tree on fire.”

“I’m watching them,” he said. But they soon distracted each other, smooching precariously, one hand on the branch and one on each other. They repositioned, and proceeded, Jemma wasting another opportunity to tell when he fiddled unnecessarily with a condom. As she lowered herself it occurred to her that she should not be up in a tree — she imagined the fall, and imagined a thousand girls falling down miles of stairs through the centuries — but that didn’t stop her. Her symptoms fled away while she moved. She imagined the collection of cells afloat inside of her, its peace disturbed by pleasure. “Hush,” she said to it.

“Hush yourself,” said Rob.

They sat for a while after they had finished. Two branches grew out close together about ten feet up the tree. He sat on them, with his back against the trunk, and she lay against him. The candles had burned down half their lengths before he spoke again. “It’s not strange. Strange is the wrong word. But it’s… something else. Part of me keeps saying that everything’s gone, and then part of me keeps asking, What’s left, and then noticing that there’s actually a lot. The hospital, the kids, the work, the water, the hope that we’ll get out of this, eventually, maybe to something else or even something better. And there’s you, but you’re the best of everything. The longer we go, the more I know that. I love you even more than before.”

She wasn’t a weeper. She never cried but did this other thing instead, a dry sob, and her face twisted up like someone who was crying but she never dropped a tear. She did it now. She’d met pregnant women who cried when they tried to decide on what shoes to wear in the morning. She hoped she wouldn’t become one of those. No matter why, though, she knew she must get away from Rob. She fell away from him, and swung down from branch to branch. He chased her, but she outdistanced him easily. In all her wandering she’d learned very well the new geography of the hospital, and he had to find his pants before he could follow her. Down the stairs, across the eighth floor, three spiraling circuits down the ramp, and down a more obscure staircase that only led from the fifth to the fourth floors, she ran hiding her twisted face from Dr. Snood, John Grampus, Dr. Sasscock — roadside witnesses whose stares she could feel, whose thoughts she could hear: There goes the crazy fat girl. Man, she can really move when she wants to.

She went to their room, no secret place. When he caught up with her she’d been doing her dry sobs, harder and harder, into a pillow for five minutes.

“What’s wrong with you?” he asked, angry and tender.

“What’s wrong with you? Why do you have to say shit like that?”

“Are you kidding? What do you want, then? I should say I hate you? I should say, I’d be all right, if it weren’t for you. You ruin everything. I can’t stand you. I can stand anything but you. All that”—he pointed at the window without looking at it—“is fucking fine, but you, you’re unbearable.”

“You know what I mean!”

“I have no clue,” he said, quiet but furious. “I have no clue what you mean, or what you want — why all the good stuff has to be bad. What would you prefer? You want a kick in the head instead of a kiss? I don’t get it, Jemma. I don’t get it at all…”

He had a fist raised, shaking it at her. She closed her eyes and put out her face, still sobbing, ready for a punch — she suddenly knew it was time for that. Go on! she thought, but didn’t say a word. The noise, when she heard it, was perfect, and perfectly remembered, a crack and a thud — her brother would have hit the wall harder, but Rob’s sigh was forceful and deep. She opened her eyes and saw him shaking his hand.

“Fuck,” he said, rubbing his knuckles and looking at the floor.

“It’s not that simple,” she said, trading her sobs for hiccups, and then coming to a loss for words. He didn’t know the half of it, she wanted to say. She herself didn’t know the half of it. She sat there hiccupping; he sat next to her rubbing his knuckles. When her hiccups had stopped, she reached under the bed and found the little kitty case. She took out a pencil, and the wrote the news on the wall behind the bed.

He had to lean close and squint to read her writing, which was even more cramped and scratchy than usual. It was like watching him get hit with an invisible pillow or pie. He looked back and forth from the wall to her face, then took the pencil and wrote his own message under hers. Jemma watched every letter as he laid it down: You must marry me.