The Children's Hospital

14

A committee formed. Someone had planned, not for this eventuality, but for something remotely like it: in the event of a catastrophe a special governing body would assemble to oversee the function of the hospital in crisis, its authority superceding that of the regular board. Jemma would have liked for there to have been a button, located in the office of the hospital chief-of-staff, that would have released the pre-selected governors from frozen stasis, but there was no such thing. There was in fact a speed-dial button on the chief-of-staff’s phone, that activated the crisis phone tree, but when someone finally thought to press it, it only caused the angel — Jemma had finally started to call her that, like everybody else did — to sing a lullaby from out of the receiver.

Of those planned governors only one had been in the hospital on the night of the storm: Dr. Snood, who already had a very well developed sense of his own importance. “At least he’s not the grand pooh-bah,” said Vivian, herself a member of the Committee. “Not officially, anyway.”

There was no president, no chairman, no grand pooh-bah, but Dr. Snood was considered by himself and most others to be preeminent. He called the first three members to replace his drowned colleagues. He selected Dr. Sundae, an insomniac pathologist who did all the NICU post-mortems once a week between the hours of midnight and six a.m., a lady familiar to Jemma and the other students as the architect of second-year pathology exams that brought the best young minds of the country to the brink of nervous collapse, and someone who would sooner chew off her own foot than be charitable with a test point. He called Dr. Tiller, an intensivist also known as Dr. Killer, not because she wasn’t an outstanding clinician, but because she was famously cruel to residents and students. And he called Zini, the ill-tempered nurse-manager of the surgical floor, a woman in her fifties whose drooping body was always constrained in shiny, tight skirts and blouses, so she always looked to Jemma like she had been packaged by aliens for preparation as a microwave dinner. She was doing a rare favor the night of the flood, having made herself available as a substitute for the junior manager who should have been called in to help deal with the lack of beds in the full-to-capacity hospital. Dr. Snood was known, like most everyone else in the hospital, to hate her, but even he, in his overweening pride, understood that every hospital government, council, or committee must have at least one nurse-manager to dip her sullen paws into the mix of business.

This tetrarchy of fussbudgets reigned only for a few days before people began to agitate for wider representation. An initial plan for each of the first four to call four others was scrapped when it was met with widespread indignation, especially from the lab techs, housekeepers, and cafeteria workers, who felt sure that their chances of having a say in things would be slim at best with a committee dominated by nurses and physicians. So names were put forward from among the nurses, residents, techs, cooks, cashiers, janitors, parents, students, and others, placed in secure black boxes made by the angel expressly for the purpose of receiving secret ballots. It was not precisely an election, and the committee that eventually took shape was not formed by an entirely democratic process (the fussbudgets chose from among the proposed candidates), but at least it took some of the sting out of oligarchy.

Vivian became the student representative, thrust forward by the surviving third- and fourth-years. Vice-president of their class, she was the most conspicuous choice. Raised along with her were Karen, the surviving chief-resident, Emma the NICU/PICU fellow, Jordan Sasscock, three nurses (two from the floors and one from the ER), two parents, a senior lab tech, and the hospital tamale lady, whose selection was less surprising than it might at first have seemed, given that she had been coming to the hospital for twenty years and knew everyone, and that the cashier/cook/housecleaning faction fell into squabbling and was unable to produce a universally agreed-upon list of candidates. The first action the expanded committee took was to call a seven-teenth member to join them: John Grampus, who came reluctantly, kicking against the pricking insistence of the angel.

The Committee then inaugurated the census that counted and described the survivors: 699 sick children; 37 siblings; 106 parents; 152 nurses; 20 interns; 15 residents; 18 students; 10 attendings; 10 fellows; 10 laboratory technologists; 4 phlebotomists; 5 radiographic technologists; 6 emergency room technicians; 5 paramedics; 18 ward clerks; 1 chef and 14 subordinate food service workers; 1 volunteer; 1 chaplain-in-training; 2 cashiers; 15 housekeepers; 1 maintenance person; 2 security guards; 2 members of the lift team; and the single itinerant tamale vendor.

The census complete, they devoted themselves to dividing and conserving what had suddenly become the only limited resource in the hospital: the staff. Electricity appeared to be inexhaustible; food and medicine were both proving replicable — you had only to ask the angel for what you wanted, be it a pound of tuna or a million units of bicillin; but you could not replicate a new intern when the one you had was all used up. Karen, the chief, who had months of experience creatively inflicting merciless call on her residents, and Dr. Tiller, herself a former chief, were the architects of the various consolidated teams.

Morale was also in their purview — Vivian formulated the slogan that was supposed to bear them all up in the first weeks: Just do the work, and Dr. Snood designed the button and the posters, but philosophies they left to the individual, and while the Committee engaged in a sort of ecumenical boosterism, it forbade any sort of religious debate in session. This policy did not sit well with Dr. Sundae, who was never able to keep her radical liberal Pente-costalism entirely out of the classroom — to sit through her Sunday review sessions was to discover how a leiomyosarcoma might herald the imminence of the Kingdom of God — and so could hardly be expected not to discuss the obvious when they were all, as she pointed out, nestled in God’s palm and afloat on a sea of grace. She pressed for the formulation of a statement of mass contrition, saying that they were sorry for absolutely everything they had done, ever, to be signed by every survivor. Even the micro-preemies would be required to append their footprints. Her measure was defeated before she could even decide to what degree everything must be quantified, or if the word alone would suffice.

She had a slogan—It wasn’t global warming! — and a few like-minded adherents around the hospital, but the Committee was unanimous against her in deciding to uphold the tradition of strictly secular government. The rich diversity of affiliations embarrassed every catholic notion, anyway. Among the survivors the census numbered what Dr. Sundae called — not maliciously — the sparkling variety of heathen: Muslims and Buddhists and Jains and Hindus and an array of pagans including three Wicca nurses. Jews and atheists abounded, but the pseudo-Christians (her term again) were even more numerous: Mormons and Catholics and Eastern Orthodox and Coptics and Bahai and Unitarians and Jehovah’s Witnesses. Extant Christians ranged along a continuum of propriety, but away with those distinctions, she said in her impassioned speech: Presbyterian and Episcopal and Methodist and Adventist and Baptist and Lutheran and Pentecostal no more; only embrace the Trinity, the absolute sovereignty of God, and absolute repentance, and we can all be united in a new faith.

She shook her fist and tossed her head — she had fabulous hair, black, shiny, and soft, with a lovely white stripe, of exactly the sort Jemma had always wanted for herself, which she usually kept tucked behind her ear but which waved like a flag when she was excited about something — but she couldn’t even get them to admit, officially, that the world had ended.

“We’ll just do our work,” Dr. Snood said, summarizing the Committee’s decision on the matter. Whoever wanted to sign a statement of contrition was welcome to do it, provided it did not interfere with the regular business of the hospital — making well the children in their care. Dr. Sundae was silent, but not satisfied, and predicted that by the time the Committee had formulated the terms of its dissolution — they were only placeholders for an elected assembly to come, after all — they would understand how they were practicing foolishness. Meanwhile, she circulated around the hospital with her statement. “No thanks,” Jemma told her, when Dr. Sundae asked her to sign it.

“She wants to be a Priest-Queen,” Vivian said later to Jemma. Vivian always found her after Committee meetings to complain and decompress. “She’s been waiting all her life for this to happen, she said, just so she could gloat. I wanted to tell her, Everyone knows there has to be something wrong with you to go into pathology. Give it up. Anyway, we put her and her Priest-Queen down. We’ll have a president or a prime minister or a something. Something different, or something better. Something new.”

“Are you going to run?” Jemma asked They were at Vivian’s place, one of the new call rooms that had unfolded into the extra space the hospital had acquired after the Thing. As if it had taken a deep expanding breath, it had grown by at least a third. The new rooms were nicest — Vivian had a real bed and a huge television and one of those obstetric whirlpool tubs — but Jemma found them creepy and a little unreal, and worried that they might disappear as suddenly as they had come into existence, their inhabitants vanishing with them. She liked and trusted her little room better.

“Hell no,” Vivian said, but smiling in a way that Jemma knew meant Almost certainly. There was not much time to prepare a candidacy, though, or execute a campaign, in those first few weeks, and people forgave the Committee for being all talk and little action when it came to engineering their own destruction, because they were all so busy with the ordinary business of the hospital. The babies in the NICU had been representative of a hospital-wide trend — every child in the place had taken a turn for the worse on the night of the storm, and few of them retreated from the precipice as quickly as those babies did. On the IBD ward the Crohn’s patients were fistulizing like mad and the UC boys and girls were pouring blood out of their bottoms almost as fast as the angel could replicate it. In the one wards tumors recurred or stopped responding to chemo, and sepsis became as commonplace as a bald head, though no two kids grew the same bacteria out of their blood. The anorexics on the ninth floor confessed that they felt huger than ever, and each rehab kid lost at least one hard-won-back skill every two days. It was Jane Dressel, a lesbian Unitarian chaplain-in-training who gave voice to the popular sentiment, noting in a sermon during one of her six-days-a-week services that their affliction seemed to grow day by day. It was a lot for a Unitarian to process, Jemma thought, calling on all the knowledge of such people that came down to her from Calvin — his own obsessive opinions and what was in his book: Unitarians, he had said, worshipped a great powerless unpresence. Wearing leather pants, like Jane did, probably made you better qualified to be the last cleric at the end of the world, but there was an obvious sweetness about her that, in the context of all the affliction, made her seem overwhelmed. In the first few weeks she was really the only person in the hospital doing anything like preaching, or anything like trying publicly to put a sense to what had happened to them, though private conversation and private enterprises, like Jemma’s and Vivian’s, naturally abounded, and there were already conclaves of affection, in which like-minded people came together. But a circle of hand-holding reformed Jews was not Father Jane, as people started to call her, standing in front of the podium before a standing-room crowd in the auditorium, the space that used to host Grand Rounds and the occasional medical school lecture. In her sermons she always tried to convince herself to look on the bright side, but she wasn’t stupid, and could never make a good case for hope out of such poor evidence. “We need a sign,” she told the crowd, not exactly a congregation — the avowed Unitarians in the hospital could be counted on two hands—“but signs are for us to find as well as for Him to give. Let’s look around,” she said, and she looked for signs high and low in the hospital but all that was there was sickness and grief and confusion and a curious loneliness — they were stuffed all together in this round floating box and yet weren’t they all, except the very few families that had survived intact, still strangers and still alone from each other? “The dying child is not the sign, the weeping nurse, the exhausted intern asleep in the middle of the hall — she looks very peaceful, doesn’t she, but look briefly on her dreams and your eyes will drop out of your head. The sign is our own hard work, and our hope, and our dedication to make these children better — they and we are the seeds of a new world.” It was as obvious, and as hard to believe, as the water everywhere outside.

But Jemma, listening in the back, in the same seat where she’d last month fallen asleep during a lecture on the heartbreak of teenage chlamydia infection, found the sermon no more inspiring than Dr. Snood’s posters, written and drawn by the angel under his direction: people at tasks, lab techs and radiology techs and interns and residents and nurses looking very strong and committed as they shot a film or drew blood or peered into a child’s ear, all of them having inherited his strong jaw and superior posture. To Jemma they looked too strong and clean and happy to exist in this time and this place. They were a fake, and could only inspire fake, strained hope.

A better sign than those came on the twenty-third day after the storm. Jemma was in the NICU, visiting Brenda, though the child was on Rob’s service, not hers. Rob accused her gently of being obsessed with the little girl, because she confessed that she crawled into her thoughts on the hour, and that she felt a bond of curiosity and unwarranted affection with her. “She’s got nobody at all,” Jemma said, and wondered why it should seem so horrible for this child when it could be said of all the children whose parents had been caught outside on the night of the storm.

Her incubator still sat on its dais, so Anna always had to walk up the four steps to turn her or suck out her endotracheal tube or cater to a desaturation. “Isn’t she pretty?” Anna asked, when Jemma, AWOL from the ward team before evening rounds, climbed up to look in on her. She was larger, but no prettier than she’d been three weeks before, and was not just back on the ventilator, but had already failed conventional ventilation. Now she was on an oscillator, a machine that breathed for her hundreds of times a minute, and made her chest vibrate fast as an insect’s wing. An indwelling orogastric tube snaked along her endotracheal tube to disappear into her bunny mouth. She had more access than almost anybody else in the unit: two peripheral lines, one in her foot, and one in her scalp; a peripherally inserted central line that went in her left arm and traveled in her vein to the antechamber of her heart; and an arterial line in her left wrist. Jemma successfully followed the line of her foley where it twisted over the bed, through a bundle of wires and catheters, into a tiny urine bag.

“She gained a hundred grams yesterday,” said Anna.

“That’s great,” Jemma said.

“It’s too much, honey. Normal weight gain’s about twenty or thirty, all the rest is fluid. They’ve got her overloaded.”

“Don’t call me honey,” Jemma said.

Anna smiled and pushed back her hair. “It wasn’t a ’fuck you’ honey, or a ’suck my ass’ honey. It was just a ’honey’ honey. It was sweet. But sorry. Sorry anyhow.”

“Sorry,” Jemma said, too, regretting her experiment with sauciness. But she had vowed not to suffer any more abuse from the nurses, no more condescending sighs, no more stabbing diminutives, no more of the thousand ways they disguised a hearty “fuck you.”

“It’s all right,” said Anna, still smiling, her face entirely open. Jemma, her malice sensors at maximum gain, detected none. An alarm sounded, and Anna bent over the isolette. “She’s never done that before,” she said. Jemma looked and saw that the child had turned toward her and was reaching out her arm and her hand to point squarely at Jemma’s face. Her tiny index finger, no bigger than the tip of a crayon, was perfectly straightened, and the other fingers curled in, so there could be no mistaking the gesture. “I’ve never seen any of them do that before.”

Jemma was going to ask the question, Can infants point? But when she looked away from the little finger, she saw the man floating at the window, and screamed. It was not like her to do that, and such a girly little shriek had not escaped her lips for years and years. It was a high, teakettley little noise, short and piercing, that drew everyone’s attention, not to the window and the man, but to Jemma, who had raised her hand to her mouth. She pointed at the window, and then all the heads turned that way. No one else shrieked, but Anna said, very calmly, “No fucking way.”

The windows used to open. When the hospital changed, the slim metal sashes disappeared, but the NICU staff, clustered at the windows, still ran their fingers over the glass, seeking an invisible knob to turn. A floor above, in the PICU, the windows were intact at forty-foot intervals along the wall. So the recovery was launched from the fifth floor, and it happened to be Rob, strong, able bodied, and, as a medical student, traditionally disposable, who was lowered down by sheet ropes to grapple at the corpse and retrieve it. Jemma, running back and forth between the floors with a growing crowd of oglers, marveled at how well preserved it was. Weeks in the water ought to have made it bloated and patched with rot, but the skin looked pink and firm, and the thin blond hair shined beautifully. Jemma understood what a big body it was when Rob was laid out along it, grabbing and seeking to get his arms around the thick chest. When they hauled him up he had an arm around the waist and one through the legs, reaching around to clutch half the square ass. Jemma could not help feeling a proprietary glee, watching Rob’s arms and back flex with the effort he was making. The corpse slipped, and Rob wound his legs around the legs, so the living and dead bodies entwined even more intimately as they came out of the water. They twisted on the rope and Rob’s face was suddenly right in front of her. He smiled.

By the time she and the crowd arrived upstairs again the body was laid out in the PICU. Half-a-dozen people were clustered around it, bustling more than was appropriate for any corpse, no matter how miraculously preserved.

“He’s warm!” Rob called to her. “He has a pulse!” He and a nurse were drying the man with a towel, rubbing him as vigorously as one rubbed a newly delivered baby. Jemma stepped on a sopping towel as she approached the bed, and the water, warm as sweat, splattered on her ankle. Rob, drying the face, removed his towel with an unintended flourish, revealing the straight nose, the high cheeks, the scar under the chin. Now that the eyebrows were dry they sprang up in shapes like wings. Another nurse finished attaching the man to a monitor, and Jemma saw his heartbeat illustrated on the screen.

“Normal sinus,” Dr. Tiller murmured approvingly. She was standing apart from the action, with her arms folded, giving orders. It was a standard pose, Jemma had noticed, and the one you were supposed to assume in a code, if you were running it. This man looked too healthy to code. He looked better than Jemma felt — perpetually post-call, she was perpetually exhausted — and healthier and more rested than anyone else in the room. Still, he got the standard battery of tests, an EKG, a chest film, blood, and urine. Jemma put an IV in the left hand and took blood from it while Rob stuck the right radial artery for a blood gas. It was a big hand, with big veins laid out in perfect stark relief; an easy stick. She got it with just one try, and the man did not stir. Rob was still probing for the artery as the blood filled up her tubes, and found it just as she finished. She had never seen such bright red blood as came out of the wrist, and never felt blood as hot as what warmed the four tubes in her palm. She passed them off to a lab tech, then looked for something else to do. Janie, the nurse who had hooked up the monitor, was now putting in a foley, but struggled with the foreskin. “Shall I retract?” Jemma asked. Janie grunted. Jemma fetched a sterile glove. Vivian maintained that penises had personalities, or that they signified the personalities of their attachees. She would expound, if allowed, over gay pornographic weeklies: “Timid, don’t be fooled by the size. Sneaky. Peripatetic. Grief-stricken, something horrible happened to that one. Loyal. Loving, probably too loving.” About this one Jemma thought she would say, “Noble.”

“Wakey wakey,” Janie said lightly as she drilled in the foley catheter with an expert, twisting motion. Then she was halfway to the door of the bay, sprawled just beyond one of Rob’s wet footprints, because the man had woken, and sat up, and struck her with the hand that Jemma had just tapped for blood, and all with such speed that Jemma only realized it was happening after it was over.

He was sorry. He was terribly, terribly, terribly sorry, and could not apologize enough to Janie. He said he’d never hit a woman before, or hit anyone before, though of course he couldn’t be entirely sure about that, because he had no memory of anything before he’d woken in the PICU. He did not know his name, so they gave him one. They had a contest right there in the unit: Motherfucker (Janie’s suggestion); John; Gift-of-the-Sea; Mannanan Mac Lir; Poseidon; Aquaman; Nimor; Joe. Rob called him Ishmael, and won.

Jemma found herself the silent partner on a hospital tour, her association with Rob getting her on the bus, though evening rounds were coming and she had not seen any of her patients since the morning. Vivian had promised to cover for her, but she considered anyway how Dr. Snood would release some new affliction from his ass to punish her. It would be worth it, she thought. Rob was almost chipper as he took them from the top of the hospital to the bottom. She followed along behind their two broad backs, hurrying to catch up and then running into the both of them when they stopped to examine some aspect or attribute of the hospital. Always Ishmael would turn and smile at her when she collided with him. When he had gotten out of his bed in the PICU, all observing heads had craned back on their necks as he rose to his full height. He had not looked so tall floating in the water.

“Replicators!” he said on the ninth floor. “Just like in that television show. I remember it… with the red-haired boy, and the little girl with the talking robot doll that smote all her enemies.”

“Not exactly,” Rob said, ordering a pitcher of lemonade. They took it to the window at the end of the hall and stood together in a patch of sunlight. The sky was marked here and there with starfish-shaped clouds, and the sea matched the color of Ishmael’s eyes, gray green.

“You don’t remember anything about before?” Jemma asked him again. “Not anything at all?”

“That’s what he said,” Rob said, with a hint of testiness, because Jemma had been asking and asking this question.

“Not a thing.”

“It must be nice,” Jemma said. “Not remembering what you lost.”

“Maybe it is,” he said, staring at her. “I have nothing to compare it to.” His thin blond hair stuck up from his head in a half-dozen different cowlicks, and made him look even younger than he probably was. She wanted to smooth it down.

“It must be… nice,” Jemma said again, and looked away from his eyes. Ishmael laughed, a pleasant sound, a deep, Santa-like ho-ho-ho. Rob was smiling as he sipped at his lemonade. Jemma tried to smile, too, but, though she was showing her teeth, what she was doing did not feel like a smile, and she knew it must look ghastly. She looked back at the sea, envying this blank man his blank history, and wondering what it must be like to come new into this place.

“Seven miles,” Ishmael said, looking out the window with her. “I suppose I’ll just have to wait to believe it.”

“I’m still waiting,” said Rob, and Jemma thought, Liar, because nobody could cry that hard for something that they didn’t believe in.

“What sort of patients are up here?” Ishmael asked after they had all been silent and sea-gazing for a moment.

“It’s a rehab floor,” Rob said. “Kids who are medically stable but have to learn to walk again, or hold a fork — that sort of thing.”

“And little lunatics,” Jemma said. Pickie Beecher appeared in the hall, as if on cue. They watched him walk down to them. He was dressed in the lavender pajamas that came with his room. She had been spending a lot of time with him, working up his melena under Dr. Snood’s whip, a tough job for Jemma, who could muster no enthusiasm for shit, and did not like even to consider it. She especially did not like to see it, and when she happened upon it, which she often did during her third year of school — it was always leaping out at her from within the pants of the homeless derelicts she encountered in the ER, or shooting out with the baby in a delivery, or surprising her when she turned back the sheets of the deranged or demented — it haunted her, so she’d think the odor was clinging all day on her clothes and her hair. Worse than anything was having to go seeking after it, finger first, the student’s duty.

But the mystery of Pickie’s poop had to be solved, so Jemma had scheduled the tests and accompanied him down to radiology and to the endoscopy suite. First, she repeated the guaiac test on two more specimens: Pickie dutifully shat in a plastic hat for her, then peered over the rim of the hat as Jemma poked at it with a little stick.

Two more bright blue hemoccult cards later, she took him down to nuclear medicine to look for a Meckel’s diverticulum, an entity dimly recalled from her first-year anatomy class. “It’s an extra thingie in your belly,” she told Pickie, while the surviving radiology attending, Dr. Pudding, stood behind a dark glass, calling out orders to the tech over an intercom. She was not sure how to describe to a six-year-old a pocket of ectopic gastric tissue in the gut. “It can make you bleed because it makes acid where there shouldn’t be acid.”

“Sometimes I have a bitterness in my belly,” he said, lifting and dropping the heavy hem of her lead apron. He held very still for his IV, and for the repeated films of his belly. He waited patiently for the technetium to distribute through his body, playing a game with his hands, twisting his fingers up one on top of the other, and then untwisting them. When she told him that the scan was negative he shrugged and said, “I do have a bitterness, though.”

Colonoscopy necessitates a cleanout. The term brought to Jemma’s mind images of merry little maids sweeping out one’s colon, but it was actually accomplished with large volumes of an osmotic laxative. All night long Pickie Beecher was flushed out with three hundred cc’s an hour of polyethylene glycol. Jemma put the nasogastric tube down herself, while Thelma watched. It was not a procedure that required finesse; you greased the tube and shoved it in, encouraging the patient to swallow when it reached the back of the throat. Nonetheless, she had to do it twice. All seemed to go well the first time, she greased and shoved, and the whole length of the tube disappeared into his nostril, but when she tried to flush it nothing would go in. Then she noticed that Pickie was working his jaws ever so subtly. “Open your mouth,” she told him. When he did, the coiled tube whipped out like a lolling tongue.

“It’s chewy,” he said.

Ten hours and four liters later, Jemma took him down to the endoscopy suite. “Sweet dreams,” she said.

“I will dream of my brother,” he told her when Dr. Wood, the anesthesiologist, pushed the sedative. During the procedure, Jemma tried to hide behind the little curtain the anesthesiologists put up to hide themselves from the surgeons, but Dr. Snood called her out to stand by him as he manipulated the servos that controlled the endoscope. He was almost pleasant as they toured Pickie’s bowels. He pointed out landmarks like a dad on a cross-country car trip. The quality of the cleanout was a source of joy for him. “Pristine!” he kept saying. “Pristine!”

There was only a little portion of bowel that they could not visualize, scoping from above and below. Everything else was totally normal. No bleeding ulcers, no friable polyps, no sharp foreign bodies, no granulomas. “No bezoars,” Jemma said, trying to hurl the curse back at Dr. Snood. “Not a bezoar in sight.” Dr. Snood sighed.

“We’ll see what the path shows,” he said, meaning the biopsies. But they were normal, too. Jemma was in the slow process of setting up a tagged red cell scan (the technician who did those was dead, but the surviving ones thought they could wing it) when she solved the mystery quite by accident. Sleepless again, she’d wandered all the way to the ninth floor, taking a survey of sleeping children’s faces, compulsively checking on all her patients. She shadowed their doors, staying just long enough to see the light fall on a plump, pale face, and it was calming to her, and it was making her sleepier and sleepier.

She found Pickie perched on the edge of his bed, sipping at a juice pack that was actually a unit of fresh whole blood.

“What do you want?” he asked her around the straw. It gleamed like steel in the light from the hall. When Jemma tried to snatch the blood from him he ran from her, evading her easily, all the while sipping on his blood until the pack was flat as an envelope. He handed that over to her, but would not give up the straw, and Jemma couldn’t find it when she searched him.

“I thought you were a vegetarian,” she said to him finally, after staring into his guiltless face for a few minutes, trying and failing to formulate a proper scolding.

“Blood is not meat,” he had said simply, and Dr. Snood had a stern talk with him, and assigned Jemma the job of designing a behavior-modification program that would break him of the habit. She was still working on it, and all she’d come up with so far was slipping him a unit of O negative spiked with ipecac.

“Hey, Peanut Butter,” said Rob Dickens, when the child walked up to them and stared. Pickie ignored him. He faced Ishmael and bowed deeply to him.

“I see you,” he said, and then sniffed at Ishmael’s leg. “Will you accuse me like your sister in the walls? Don’t waste your breath. I’m not listening!” Then he plugged up his ears and ran off back down the hall singing la la la at the top of his lungs.

“Well, hello to you too!” Ishmael said, laughing again.

“Like I was saying,” Jemma said. “The little lunatics.”

“But they’re kind of sweet, really,” Rob said.

Every other child took an instant liking to the stranger. On the eighth floor, the hematology-oncology ward, bald children in facemasks emerged without permission from their positive pressure rooms to give him a hug, while solemn-faced parents stared appraisingly at him. Rumor of him had spread immediately through the whole hospital. Not just the children wanted to touch him. Nurses and doctors and technicians and more outgoing parents stopped the three of them as they walked to shake his hand, as if to congratulate him for surviving.

On the ninth floor Jemma had decided he was jolly. On the eighth she decided he was kind, and that he had children, despite his youth, because of the way he touched the heme-onc kids, without any fear, and because of the way he talked to them, which was neither the overly familiar, unctuous babbling or the stiff, formal butler-talk engaged in by people who were unfamiliar with or afraid of children. On the seventh floor she decided he was catty, because he turned to her, after a pear-shaped nurse had scolded him for tickling a liver-transplant kid without washing his hands first, and whispered, “Her ass is as big as Texas!”

“As Texas was,” Jemma corrected.

On the sixth floor she decided he was patient, because he suffered Ella Thims’s game of pick-up-my-toy with utter calm. She sat in her red wagon at the nurses’ station, repeatedly throwing a toy phone on the floor and clapping her hands together. He’d pick up the phone and hold it to his ear, saying, “Hello, hello? I think it’s for you!” before handing it back. Ella wiggled in her flounces and cackled delightedly every time she got the phone back. Jemma could do it only once or twice without wanting to chew off her fingers, but Ishmael played the game twenty or twenty-five times before Rob dragged him on.

They were delayed again while he entangled himself in other games, playing hopscotch in the hall with a pair of pale, spindly CF twins, and pulling in a surrey a five-year-old boy recovering from myocarditis.

“You look great, Ethan,” Rob said to him as the boy lashed at the stranger with a terry-cloth rope cut from a restraint.

“I feel great!” he said. This was the boy that Jemma had helped code on the night of her trip with Vivian. His heart, ravaged by a virus, huge but weak when Jemma had met him before, was now almost back to normal. The day after his bad night his edema was improved and his three different murmurs, each more pathological than the last, were all silenced. Aloysius Pan, the overworked and perpetually sour-faced cardiology fellow, had echoed him for a whole hour, not believing what he was not seeing. “Do you want to hear how loud I can scream?” he asked them, not waiting for an answer before splitting their ears. A nurse and his mother called out for him to shut up. “Before I could only make a peep,” he said defensively. Everyone had recognized his improvement as a miracle though no one had named it such, and he was the only child in the hospital who was definitely getting better.

On the fifth floor she decided Ishmael was thoughtful, because he brought replicated flowers to Janie, and she suspected he had been a wife-beater, because there was something too practiced about his apology, and about the flourish with which he presented the bouquet. She felt sure, despite his protest to the contrary, that he had done this before.

Still, on the fourth floor she knew he was gentle, because of the way he held one of the sturdier preemies, recently extubated but still with a feeding tube in her mouth and oxygen prongs in her nose. Little black girls were famous for being the best survivors, and this baby was the star of the unit that week, but she still fit in his hand with room left over. As he stroked her head with two fingers her saturation rose to a new personal best of 97 percent.

“And who is this little monster?” he asked about Brenda. “Hello, Princess,” he said, putting a hand on her isolette.

“She really is a princess,” said Rob. “Or she was.”

“If you touch her, I’ll break your hand,” said Anna, stepping up on the dais with a new bag of feeds in her hand. The feed bag was softer than a pillow, but she handled it in a menacing way.

“Just admiring,” said Ishmael. When they all looked down at Brenda she pointed again squarely at Jemma.

“I wish she wouldn’t do that,” Jemma said softly.

“She’s just stretching,” said Rob.

“It means she really likes you,” said Anna. Ishmael pointed back at the baby, and laughed.

On the third floor the tour paused, then ended, in the big playroom. There Jemma decided she could really know nothing about him, and that she was being foolish, thinking she could assemble her cursory perceptions of this man, the strangest of strangers, into anything resembling a real person or a real life. She watched him play in a pool of colored plastic balls with Rob, Ethan, and two others, both Vivian’s patients, unrelated boys with the same rare intestinal lymphoid hyperplasia that required them to be fed periodically through their veins. He and Rob grappled, each holding the other by the shoulders and not moving, though both grinned ferociously and waves of tension seemed to flow from body to body across the bridge their arms made, until Rob was thrown. He spun around once in the air and sent up a splash of colored spheres when he landed. Then all three boys jumped at once on Ishmael, and hung on him like on a tree, one from his neck, one from his arm, and one around his waist. His Santa-laugh filled the whole room, the second biggest one in the hospital, a gym-sized space filled with every sort of amusement

“Who is that?” Vivian asked her, when she caught up with them after rounds.

“That’s him,” Jemma said.

“You’ve got to be fucking kidding me,” Vivian said again and again, placing different emphasis on different words each time, now on the got, now on the fucking, now on the kidding, as Jemma told the short story of Ishmael’s exit from the sea. Her face changed while Jemma spoke. Jemma thought he was having the same effect on her that he had had on everyone else; that his survival outside the hospital was inspiring hope for other miraculous survivals.

“Look at those arms,” she said. “Look at those hands. He looks nice. I bet he’s nice. Is he nice?”

“Nice enough,” Jemma said. “So far. We all just met him.”

“Well God damn,” Vivian said, staring and shaking her head and idly rubbing her belly in the same way she always did on one of their nights out, staring in a bar at some new galoot.

Jemma might have given her proprietary lecture, the same one she’d shouted in nightclubs at her unlistening friend, with the added caveat that this was a man who had just washed out of a killing sea, a miracle and a mystery and a danger, but just as she opened her mouth to give it she noticed Rob, still sitting up to his chest in round plastic balls. He had been staring at her, for how long she did not know, one finger resting precisely on the top of his head.

“I’ve been praying,” Rob said to her in the call bed. She lay against him, her back to his chest. His big hands were folded neatly across her belly.

“I think I noticed,” she said, thinking of the times when she knew he was not sleeping, but he would not answer when she called his name in the dark. Sometimes she would hear a stray whisper from him, words that sounded like the names of his sister or his mother.

“Not something I’ve ever done before.”

“I know.” He came from a family of supremely rational atheists. Jemma had found them difficult to get used to, the way they said just what they meant, proposed every action before executing it, and kept their promises.

“I wonder if I’m doing it right.”

“Is there a wrong way?”

“There must be. Doesn’t there have to be? Something’s been going wrong, hasn’t it?”

“You’ve been listening to Dr. Sundae.”

“Would you like to pray… together?”

“No,” she said simply. “Maybe you could ask Father Jane.”

“We could just say a little one.”

“Or we couldn’t.” She hadn’t said a prayer since Calvin died, and even before then it was only the ones he taught her that she said regularly. She thought of his book, and wanted suddenly — the desire came as swiftly as a cramp, and was as much of a surprise — to read it. She’d thrown it away as soon as she read it, and now remembered nothing except for a few scattered phrases like blasphemy is the straightest route to God and Grace is perfectly violent, raving testimonials to his most secret insanity. When she’d thrown it in the river it had felt like the first right thing she’d ever done, but now she wished she had it with her, and pictured him sometimes, kicking Father Jane in the face and taking her place before the podium to read from it until everyone in the audience bled from their ears.

“Maybe later,” he said.

“Maybe.” She tried to imply maybe never.

For a while they were quiet, Jemma watching the window. Every so often a wave would splash against it, but mostly it just showed the darkening blue sky.

“This was nice,” he said, squeezing her.

“Very,” she said, though it had not been one of the great ones.

“It seemed like we should wait forever, before. And then after today I didn’t know what we were waiting for.”

“I’m not sure either.”

“It seemed wrong, to do anything like celebrating.”

“Oh,” she said, thinking but not saying how there was such a thing as miserable desperate fucking, and a sort of fucking you did when you felt bad that was not necessarily meant to make you feel better about anything.

“Do you think anybody else… do you think this was the first time?”

“Who knows?”

“Well I hope it gets things going all over the hospital. I want everybody else to feel better like this.” He squeezed her again.

“What was the water like?” she asked after a moment, thinking of how warm it was on her foot.

“Like soup. I should have washed it off. It’s disgusting, when you think about it.”

“Don’t think about it.”

“Do you think that anybody else could come up?”

“I guess. Maybe.” She thought of his mother and sister, rising entwined through the blood-warm water, passing through the shadow of the hospital. She closed her eyes and saw a hand and a face at the window.

“Maybe they’ll all come back. Maybe they’re just waiting.”

“For what?” she asked, but he didn’t have an answer, or didn’t care to answer. He put his face in her neck.

“Once when I was little,” he said finally, “I think I must have been three or four, my sisters and my parents went to dinner and left me behind. They didn’t notice that they’d forgotten me. I was pretty quiet then, especially in cars. I hated to talk while the car was moving. I was next door with a friend, making mud pies. When I came home and the door was locked, I thought they were inside and had locked me out because they hated me. My sister had said she hated me, the week before, because I cut her hair while she was sleeping — I never knew why I did that. It was just a little snip, and she forgave me, but no one had ever said they hated me before, not that I remember. So I thought she’d been pretending, and that she still hated me, and everyone hated me, so they had shut up the house against me, and would never let me in again. But then it got dark, and the house stayed dark, and I realized that the car was gone, and that they had gone somewhere without me. I was sure that they had moved away, and that they were never coming back. So I sat on the front steps and put my head in my arms and cried for an hour straight, until they came home. My mother said she had to scream my name at me to make me stop crying, and shake me to make me understand that she was there, and that they were back. I remember that. When they came back it was like they had been there all along, but I had gone someplace where they weren’t. I cried and cried. The house disappeared, and the steps disappeared. The noise of the crickets and even the noise of my crying disappeared, all I could think of was how they were gone and never coming back. I didn’t even know what death was, back then.”

She could tell he was waiting for her to answer him somehow, so she told him something she’d already mentioned in another bed-bounded conversation. “Sometimes,” Jemma said, “if I put my head down in a dark room I get a feeling like Calvin is right behind me, reaching out his hand to touch my shoulder. If I would just wait long enough he could touch me. But I always turn around, and he’s always not there.”

Rob’s breathing became so deep and even that Jemma thought he must be sleeping. Then he spoke again.

“Are you sure you wouldn’t like to pray a little?”