The Children's Hospital

80

She always knew when somebody died. Never mind the angel’s flute, playing a universally hated tune that sounded to most ears like a mournful cell-phone ringer, or how she announced every death no matter how many people pleaded with her to shut up: “A great soul has passed! A great soul is flown from the earth! Celebrate this life!” During adult codes she was silent now, except that sometimes she would start to play her flute along with the alarm chimes, a slur on the code teams. But Jemma could feel them, too, every death a prick against her awareness, a complaint and a sadness in her head, and then a tearing sensation, like someone was peeling a band-aid off her face.

She tried not to go to them, but as they passed day two hundred and fifty at sea and they became more frequent, you could hardly avoid being present at one unless you stayed locked in your room, always an option for Jemma, who was usually pursued by the still-hale Arthur and Jude and still under an injunction of house arrest by the Council, even if they no longer tried to enforce it. She could stand less than ever to be in her room, lonely for Rob and for Pickie and for Vivian. Jemma was the only unemployed person in the hospital — every child too small to work was busy sleeping — so now she made wandering her full time occupation.

If only they knew, the ignorant morons who call you the angel of death, how very different you are from my littlest brother — if only they could see him, everywhere around them, or appreciate how deeply he is settled in them, ashes in the marrow of their bones. He is not a glowing pregnant lady in a yellow gown, green scrubs, and sparkly blue sneakers, who takes two steps toward the dying for every one step she takes away from them, a struggle plain on her face, grimacing or clenching her teeth but never smiling, like some people say she does. You have refined your art at every death, the fire growing thinner and more subtle until it is just an unease in the air, easily lost in the greater unease surrounding the death, the shouting and the hurried flurry of meds and compressions and the deployment of the wonderful and futile new machines, the liquid-respirator helmets and the implant-able LVADs and the nanobot solutions that every fourth or fifth death extend a life by another hour or day.

There she is again, they say when they see you leaning again against a wall, just beyond the code fray, staring at the patient. Like a ghoul, some say, but I know that blank look is on your face because you are looking beyond the physical, and that time you drooled at Dr. Walnut’s code was because you were trying so hard to patch up his ruptured abdominal aneurysm, and not because, like Dr. Sundae suggested, you were hungry for his soul. “You’re not supposed to be in here,” Arthur says to you sometimes, but it’s been weeks since they tried to pull you away by your arm. They think you still need to touch a person to wreak your havoc on them so as long as you stand at least ten feet away from the bed they leave you alone, and do not realize that the little swing in your hips is all you show of how tremendously you are pummeling at the botch. It’s extraordinary how hard you can work, and how little you can show it, and how a part of you can appreciate how pointless your effort is even as you enthusiastically exhaust yourself, and you think of all the other impossible things it is like, this impossible thing you are doing: folding a marshmallow in half, studying for a pharmacology exam, retracting to the satisfaction of a surgeon.

Jordan Sasscock was the first to die that day. For a long time he’d been on the way out, stuck in one of the ultra-critical care units on the fifth floor, sustained by one of the new floating respirators and still cognizant enough to continue to participate by remote proxy in Council meetings, and even as he was actively dying he was still enough present in his body and his mind to look fondly at his eight wives, to reach weakly for their hands and turn his cheek into their palms when they surged forward to touch him.

“He’s too young to die,” said Carla, the stupidest thing Jemma had heard in weeks, twenty-nine being ancient, everybody knew, in the new order where the botch spared no one over the age of twenty-one. The Council had made an official, preliminary declaration extending childhood until the twenty-fifth year — weren’t there young men and women of that age who acted as foolish and carefree as teenagers, and who were as innocent of the grosser accumulations of sin? Probably not, Jemma had said, though by that time she was already impeached, deposed, and locked up. The law saved no one.

Sasscock was still handsome, even with the tube in his nose and the respirator claws attached to his neck, the artificial kidneys hanging like two plastic eggplants from his waist, and his palms, as dry, black, and rubbery-looking as a gorilla’s. He still had his chin and his jaw, and he still had his appealing olivey smell, but he could hardly keep his eyes open and Jemma could feel an agonizing pain in his spine where the botch had eaten through the bone to rot on the cord. She stood by the door, tapping slowly with her foot, imagining a gauge for his pain, one of those huge fundraising thermometers, and brought the level down just a touch with every tap. It had to be slow enough for him not to notice it but fast enough to make a difference.

“It’s not fair,” said Carla, falling back out of the crowd and bending her neck to place her face in the crook of her arm. It was another obvious statement. Jemma did not know how to reply to it.

“Come on, Carla,” said Jordan. “Come on now, we talked about this. Everybody tell her.” Two of the women took her arm and drew her back to the ring around the bed, but no one spoke, except Musette, who merely reported that she was pushing some fentanyl-555. Five of the eight were nurses, and the other three had become experienced caretakers in the dormitory and the adult wards, though before the rain one had been a cafeteria cashier, one a lab tech, and the last the mother of three hemophiliacs, the youngest admitted for a head bleed after playing a forbidden game of football, and now sound asleep. Jordan coughed and smiled: Jemma gasped at the pain in his back. Carla glared at her.

“Come on now,” said Jordan. “Everybody cheer up. Let’s turn up the dopanephrine a little.” Dr. Tiller and the rest of the unit team were standing a few feet off, watching Jordan, but essentially letting him be. It was almost like he was running his own code, except that he was in a very particular sort of extremis, actively dying, Jemma was sure, but so jacked up on meds and potions and machines that he presented an appearance too calm and civil for a man in the process of divorcing his own body. Jemma felt a lurch. With a twist of her hand she deflected a high crest of pain — it made her laugh, not cry out, because it was a skillful blow and her best success in days.

“Just fucking shut up!” said Carla, turning to Jemma and throwing a bit of wadded gauze at her. Weighted with pus, it fell just at her feet.

“Sorry,” Jemma said, staring down at the ground. There was another lurch, and the dense botch in Sasscok’s abdomen suddenly detached from its moorings and rolled onto his aorta, drastically compromising the blood supply to his legs. “Oh,” he said quietly, and that motion seemed to set off a series of collapses elsewhere in his body. A little spot of botch in his lung grew and then collapsed, pulling his lung in on itself and away from his chest wall until it had shrunk to a nubbin. Another spot on his heart did the same thing, and blood began to trickle into his pericardium.

“Carla,” he said. “Don’t be gloomy. Musette, remember that I love you. Hannah, I love you too! I love everybody — don’t forget!”

Another little botch bomb exploded along his aorta, and he started to exsanguinate into his chest. Carla saw his pressure dropping and opened up his fluids while Musette hung hypernephrine on top of the dopa. Jemma ground her head into the wall, astounded by the extraordinary pain he was supposed to be suffering. Surely it was enough for your lung to collapse and your heart to leak and your great vessels to explode — it all hurt enough, by itself. Why pluck at his thalamus to make phantom agonies real? There was something too cruel about a plague like this — someone had to be in charge of it. She knocked her head softly on the wall three times, every knock a blow against an organizing principle she imagined but did not perceive.

They pushed more meds and more fluids, and hung the synthetic blood that Sasscock himself had perfected, but it ran out as quickly as they pushed it in, pouring from his bottom and his mouth, and they all kept going, bagging him and doing compressions and changing out his chest tubes when they clotted, until his brittling bones broke under their hands, his handsome face collapsed under the mask, and then under their resuscitating kisses, and he was like any of the others, a mess of blood and ash in the ruined shape of a person.