Chris Adrian - The Children's Hospital

She knew what was happening as soon as she touched her. Sickness was there, a deep, black mark, as plain as Maggie’s absence of chin, or her unpleasantness — but even that had changed. Hadn’t she become a nicer person, or a more joyous one, at least — somebody who was filled with the spirit of clogging in a way that smothered the petty angels of her personality? It was almost like reading her mind, the way that Jemma read the natural history of the disease. A week before Maggie had noticed a dry spot on the skin of her neck, and tried with partial success to moisturize it away. When it faded another one popped up on her thigh. That one grew, no matter how much lotion she slathered on it. Another popped up on her bottom, but she wasn’t aware of it — she wasn’t one of those girls who was always looking at her bottom in the mirror, trying to predict the happiness of a day based on the degree of firmness and lift. She had a sore throat and a headache — these passed, but every now and then she’d have a nasty belch, like she’d just eaten something bubbling with rot. Then came the thing on her heel, another dry spot at first, but then a strange circle of scale that penetrated deeper and deeper into her foot. She scratched at it every night — it didn’t hurt at all — and dug a hole in her heel, night by night. It didn’t affect her dancing, though she thought it was a product of her dancing — she’d never clogged this much in her life, and didn’t quite know what to expect. Waking up happy was a surprise — why not get onion skin on your foot, too? Three nights of scratching dug it only a few centimeters, but she was restraining herself. When she woke that morning it was itchy, but she left it alone until after her morning class. Then she sat on her bed, lifted her foot, lay it across her leg with the heel up, and began to scratch. It was drier than ever — she dug in with her nail. It still didn’t hurt. She began to dig in earnest, feeling nauseated as she scratched into her foot, but unable to stop — suddenly it was very itchy indeed, and she wanted to know how deep she could go. All the way to the bone, that was the answer. That was firm, and hurt to touch. She looked into the hole in her foot, not quite appreciating what she had done, as the scale turned black around the edges, and then inside. She started to cry, feeling sick all of a sudden. She vomited, right in her own lap, and then her whole foot began to hurt, and the pain marched up her leg, all up her right side to the right side of her head. Then she had her first seizure. She was post-ictal for an hour, and when she was awake enough she crawled to her bathroom and pulled that little cord by the toilet.

I see you, Jemma said to the sickness, and burned at it. From her toes to the tips of her hair she filled Maggie with fire, but what was in her was already ash, and didn’t care how much she tried to burn it. Through the fire she could see Maggie getting paler and grayer. Spots appeared on her cheeks. She stopped breathing, so Jemma tried to breath for her, but it was like trying to squeeze an oiled cucumber. She kept slipping away.

“What the fuck?” Jordan Sasscock asked, when Jemma fell back, right on the ground, knowing suddenly that she had a terribly shocked and stupid look on her face.

“I don’t know,” Jemma said, shaking her head. Janie screamed “Oh fuck! Oh fuck! Oh fuck!” but all the others put back on their old roles and fell back on Maggie with needles and monitors and defibrillation glue. They continued the code in earnest, one of them bagging her while Dr. Sasscock got his tube ready and fastened the blade on a laryngoscope.

“Is a Mac 5 big enough for a twenty-five-year-old?” he asked of the air.

“She’s twenty-four,” Jemma said weakly.

“It’s fine,” said Dr. Chandra. “You better do it. Look at how blue she’s getting. Is the oxygen on?”

“It’s on,” said Dr. Sasscock. “You’re bagging like a fucking retard. Get her chin.”

“What chin?” asked Dr. Tiller. “Do we have a line yet?”

“No,” said Emma. “I know I’m in but there’s no flash. Let’s give the ativan IM.”

“Okay,” said Dr. Sasscock. “Let’s go.” Dr. Chandra gave a few more rapid breaths and then took the bag away with an unintentional flourish. Dr. Sasscock swooped in, thrusting the laryngoscope blade between Maggie’s teeth and hauling up on it with his whole arm. Jemma could see the tip bulging in the soft tissue of her neck. “I see it,” he said.

“She’s getting rather gray,” said Dr. Tiller.

“Just hand me the tube before I lose it,” he said. He took the tube from Dr. Chandra and poked it into her mouth, poking and poking with it, trying to get past some obstruction. “I don’t get it,” he said. “I see the cords but it’s not going in.”

“Holy shit,” said Janie. “Look at her!” Maggie got at once more gray and more blue, went briefly into v-fib and then went asystolic.

“What are you doing?” asked Emma, because the skin at Maggie’s neck suddenly burst apart in a spray of black dust, and the silver tip of the laryngoscope poked through.

“I almost have it,” Dr. Sasscock said, but then the pressure of his arm lifted the scope up free through her neck and above it, so her face and neck split like an opening door, releasing a head-sized cloud of dust that expanded to hover over her whole body. Dr. Sasscock was left looking down at his tube. He stepped away, and said something that Jemma, too distracted by the death, didn’t hear.

Strange, Jemma thought, that someone with so much death in her life should never have seen one before. As a student she had always avoided them, managing by virtue of luck and foresight never to be present when the old train wrecks on her medicine clerkship kicked the bucket, or slipping quietly into a side room in the ER to fumble at suturing when a hopeless trauma came in. It was a shock to her new senses, to be aware of Maggie’s feeble soul struggling to raise itself above her ashen body, like it was trying to get a better view of the death, and suddenly be swept away, as if a giant hand had passed through the room to gather it up or knock it away. It was a violent transition; just watching made Jemma feel like she’d been knocked in the head with a cinderblock. She passed out — it seemed like just the thing to do — but not before becoming aware of the vomiting and lamenting and face-pulling of the PICU team, and last of all she saw Jordan Sasscock, holding the dusty, bloody tube before his face, looking at it reproachfully, like it had betrayed him.

Hilary charges it upon the heretics as a great crime, that their misconduct had rendered it necessary to subject to the peril of human utterance, things which ought to have been reverently confined within the mind, not disguising his opinion that those who do so, do what is unlawful, speak what is ineffable, and pry into what is forbidden. Shortly after, he apologizes at great length for presuming to introduce new terms. For, after putting down the natural names of the Father, Son, and Spirit, he adds, that all further inquiry transcends the significancy of words, the discernment of sense, and the apprehension of intellect. And in another place, he congratulates the Bishops of France in not having framed any other confession, but received, without alteration, the ancient and most simple confession received by all Churches from the days of the Apostles. Not unlike this is the apology of Augustine, that the term had been wrung from him by necessity, from the poverty of human language in so high a matter: not that the reality could be thereby expressed, but that he might not pass on in silence without attempting to show how the Father, Son, and Spirit are three. How many hours and days did I waste before I realized that what was really wrong was the same way, enshrined inexpressible by the poverty of my language — unholy instead of holy, created by us instead of Him, rendered ineffable because it is absolutely ubiquitous and absolutely corrupt — and that I could be excused for raging against lies I could not articulate? I am oppressed by a mystery and must overcome it with mysterious tools.