Yes, you're a walking cliché. Come closer, see the warts within. It's the start of fall; summer just a brief fever dream. You have a touch of virus, and you feel weak without falling. Always getting by.
You walk fast, like all urban denizens, down the crowded streets. Singleminded in your reverie. Zooming in between people like switching TV channels.
Flash the ID, walk into the cold lobby, past the guard. Another day registered on the stopwatch of your life.
The elevator arrives on the 8th floor. You turn the corner and smell the dread, hear the incessant beeping.
Hello, hello I'm alive. You dive right into the routine. Never mind that your insides are bleeding.
You look tired, yes I am. Cellular renewal impaired. Give me a vitamin.
You're not sure why your vision is blurry. Yes you stayed up all night. Yes you're hungover. But you've handled that before.
The pages, the pleas all start without hesitation. We need the order for the non-formulary meds, we need to figure out the frequency of the vital sign checks, we need a new bowel regimen. So do I. I'm pulseless and pulsatile. Everything is silver-grey.
No one asks if you're OK, because no one would dare to think you aren't. It's a given that you're infallible, because the alternative would mean disaster. Existentialist madness.
You spout out the plans with surprising efficiency. All that training has turned you into a well-oiled supercomputer. No one can surmise the vessels in your eyes are bursting.
Then you have to see the patients. The best deception of all. Your voice becomes soft and smooth like butter, like an ocean on a windless day. They make you feel a little stronger, because they are indeed sicker than you. They are pale from defective blood, they cannot even stand up. The piss seeps out of them in rubber hoses.
Still, your head is spinning. What you wouldn't give for a dark closet right now, and a toilet as your friend.
Doctor Alcott, Doctor Doctor, everyone is on fire. I know, goddammit, I am the gatekeeper here. I'm the one who grabs your heart with my bare hands and keeps it pumping. I'm the one who whispers that it's OK into your ear before your brainwaves disappear.
It's not OK. You're always lying. We all know the end result. But you can't say it. They think tubefeeding is some kind of hope, that bags of potassium and magnesium imply sustenance. Meanwhile the crater seeps into their backbones, the rot of the decubitus ulcer that comes from just sitting there.
Doctor Alcott, are you alright? You look kind of tired.
Just didn't sleep well last night. A knowing grin in return.
You throw in ABGs and IVs like darts. Lab values punched out like hanging chads. Bam bam bam. Send them and ship them, intubated, extubated. Discharge and admit.
Your stomach is eating itself. Before you faint, you steal a can of nauseous Boost, feel its slippery pseudo-protein sludge down your alimentary canal. Yes, strawberry flavor today. Reminiscent of childhood Quik.
Family member X wants to see you. Then family friend Y. Why can't you order this. Why wasn't this done. Help him, help her. There's got to be something else we can do.
Sometimes you remember to wash your hands in some moldy sink. The irony of hospital bathrooms is that they tend to be the filthiest, because the budget finds housekeeping expendable. Your hands are aging from the industrial grade hyperchlorinated soaps.
Blood and piss and vomit. Sometimes there are more elegant body products for testing—crystalline CSF, the precious clear essence that bathes your brain and spinal cord. Or beer-like belly ascites. Lung edema. Your body is a veritable soda fountain.
You look in the mirror for a second. You managed to press your white coat. Never mind the ring around the collar or the pen ink stains. Fatigue makes you look experienced.
Ace in the hole, you're not going to get the shakes, not yet. They can't smell it when the odor of shit is stronger. They can kiss your ass.
Back into the express lane. Mr. Jones is a 76 yo male s/p MI, complaining of dyspnea, and his lungs are filling with fluid. What's left of his heart isn't playing games anymore. Lasix, lasix again.
Ms. Smith is a 69 yo female dying of end-stage ovarian cancer, and she is a pale wisp of a woman. She speaks like half of her is in the other realm, in a fairy-like voice. Thank you Doctor, for everything.
Ms. Anderson has no family or friends and wants you to change her bedpan. She spits out her meds with venom and needs restraints.
Down the caseload you go. Halfway through, you take a break, and go to the back lounge. You look outside the grimy metal frame of the never-cleaned window and look at the hard, polluted city. What would this have looked like 500 years ago, you wonder. Swampland. What if this was the last thing you ever saw, like at the end of Last Tango in Paris?
Elevator music is faintly playing in the linoleum corridor. You're trapped in some early 70s nightmare. Your scrubs feel drafty.
You dive back and finish everything, and no one realizes you are running on empty. Even without the throbbing headache you'd be miserable by now post-call. It's even worse.
The fat nurses shriek like banshees against the incessant false alarms beeping. Jackie, Susan, Mary, either anal-retentive or super-lazy, Gilda, Maude.
Finally the shift is over. The loose ends dangle for another day.
Home alone, in your dusty overpriced cubicle, you order delivery yet again. Pizza today, Chinese tomorrow, dank, greasy, filling. The shot of whiskey. The second shot. The third.
It's always been about maintaining exteriors. Even Jennifer left the apartment clean before she left for good.
You can't do this to me, you don't know what it will do.
I can't see you like this anymore, you don't get it, you never will.
You remember when you first saw her soft, iconic face. Simple straight hair, eyes as docile as a cow's. Fingers delicate like Buddha. You thought she would always forgive you, even when you weren't sinning.
And she did. You would miss dinner. You would oversleep. You would forget altogether. But she didn't leave right away. She would brush the hair out of your eyes as the sun rose and put the blankets over you again.
But she wouldn't forgive this one thing that you couldn't see, like a blind spot. How petty, how unbelievable. Everyone does it.
Everyone dies from it, she would say back. And I won't be around to see it happen.
Of course it got worse after she left. You wonder how it was in the beginning. You knew how it would end, and yet you thought you could alter fate. It's not fate, she would say, it's your fucking habit. You couldn't control it though, you were sinking into the depths. There was no fighting gravity. Screw your helpless drama, you aren't a 3 year old.
I was a 3 year old. I watched my teddy bears burn and my action figures melt. I walked on broken glass. I played doctor from a very young age. You could fix things, you thought. They might break, but you could put them back together.
Did it matter how you met Jennifer. You admit you were just thinking of another screw at first, but then it hit you. Wholly unexpected. She made you happy for a little while. You would drown in the deep lull of love. So you drank more. Lie damp in the dark water. Curled up in this warm cold spot. Never wanting to leave.
Even if you don't care about yourself, and I know you don't give a shit about yourself, what about your job, you might kill someone else.
No, that won't happen. I'm too good at it.
The sunlight stabbed my eyes. I had missed the alarm. Now you've done it. Two and a half years of this and you'd never been late. Your game was slipping.
The apartment had never looked so bright before. I had always left before the sun came up. I was going to heaven on a boatride. My mattress would float into the sky.
The phone rang. Terrified, I let the machine pick it up. My pager burped out a reminder beep.
"Hello, Dr. Alcott, it's Rebecca, you haven't shown up for rounds yet, and we were wondering if you were OK. Please call us."
My pager went off again. I looked at the clock.
3 hours late. Unbelievable.
When you oversleep, you have time to sober up. I hadn't felt like this in quite some time. Bare, quiet, terrified.
I could see the liquor bottles waiting in a row on the table, like a set of ritual elixirs from a witch doctor. They gleamed shades of amber, emerald, and crystal.
What would you tell them? My car broke down. My mom died. My dog ate the homework.
Damn it, why did you oversleep? You were so good at keeping it together, and now you felt everything about to split into glass shards. But you weren't going to get the crap beat out of you again.
What would happen if you just never showed up again? You just disappeared. You joined a nomad tribe in Inner Mongolia. I guess he wanted a change. Would Mr. Jones and Ms. Smith and Ms. Anderson finally peacefully slip into death? Would everyone die? Would that be a bad thing?
You arrive at work 45 minutes later, same as it ever was. You had to attend to an emergency. No one questions you. It has never happened before. The other senior has covered you. You catch up with Rebecca the intern on what has happened. Mr. Jones had shortness of breath relieved by nebulizers, Ms. Smith spiked a fever, Ms. Anderson hasn't been eating. The routine continues and nobody dies.
You were sober today, for the first time in a long time. You did not feel bad or good. You were just there.
When you get home, you pour another one like an automaton. You let the tumbler sit on the table and stare at it as you call Jennifer.
"I'm going to hang up."
"Should I quit? I stopped today."
"Do whatever you want. Goodbye."
A dial tone.
Do whatever you want.
The glass sits in front of you, perfectly still.