Maggie Helwig - Girls Fall Down

‘If we can’t determine his health coverage, we will have to ask you for payment. You may be able to get it refunded if he’s eligible.’

‘Oh, for God’s sake,’ said Alex loudly. ‘I work here. Take it out of my damn paycheque.’ The nurse turned around and glared at him, snapped a file closed as loudly as she could. He stood by the wall, eating his granola bar, avoiding Susie’s eyes.

Outside the movie theatre at College and Yonge a woman knelt on the sidewalk, her arms wrapped around herself, cradling her body like an infant.

‘You shouldn’t touch her,’ shouted someone. ‘We don’t know what it is.’

‘She’s just sick to her stomach, it’s nothing,’ said someone else, as they stood in a circle around her, not quite near her, and she swayed back and forth and vomited onto the sidewalk.

It’s nothing.

Don’t touch her.

A man leaned against the glass window of a coffee shop with one hand in the air, holding a fluttering magazine, trying to summon a taxi before he fell, and an ambulance rounded the corner, the sound of its siren slowly flowing through the night.

They stood in emergency for a couple of hours, or it might have been longer, he hadn’t checked the time. One of the nurses had set up a preliminary triage station at the door, collecting the breathing problems in one area, the children with intestinal viruses in another. Alex could see the ambulances lined up in the parking lot, paramedics and orderlies waving their hands at each other in the pools of light on the asphalt. An intern dragged two more portable oxygen canisters into the waiting room, fastened the plastic masks on two more patients slumped in the chairs.

A man with a press card and a camera came in the door, and an orderly grabbed his shoulder and pushed him outside again. Someone turned up with his hand wrapped in a blood-soaked strip of canvas and was sent to the corner of the room, one of the lowest priorities, a trail of blood running slowly down his arm, a smear drying on his face; then the paramedics ran in with another stretcher, a body strapped down in restraints, foam curdling at the edges of the mouth. Solvents probably. Glue, or plastic bags of gas. The nurse at the door was handing around a bottle of antibacterial alcohol gel now, demanding that everyone wipe their hands as they entered. The man with the camera got inside again and was again expelled.

Alex wondered what was happening in the city outside the doors, as chaos arrived at the lobby in tiny pieces. He was very tired, and drained of almost every possible emotion, and his mind was wandering in half-connected ways, probably about as valuable as the insights you had when you were stoned. Wondering if it was possible to distinguish, really, between illness and fear, immune systems equally mobilized now against germs and dreams. Susie blew on her coffee, the fluorescent lights reflecting on its surface. Her eyes were redrimmed and damp.

‘Are you okay?’ whispered Alex.

‘Don’t talk to me,’ she said.

He stared at the TV hanging from a corner of the ceiling and tried to take an interest in a replay of a hockey game. Conscious in a crystalline way of how much knowledge they shared, and how far it estranged them. A hundred dead things stood between them, and not one of them a clear death that could be mourned.

‘Alex?’

His eyes snapped open and he jerked in a quick startle reflex when a hand touched his arm; he thought at first it must be Susie, then saw an intern he recognized standing beside him.

‘Are you on call tonight?’

Susie was sitting on the floor, her head lowered, her hair veiling her face.

‘No, I’m… Look, I’m in my winter coat, do I look on call? I’m here with a friend. Is there… ’

‘Oh geez.’ The intern, Sam, that was his name, frowned nervously. ‘Could you do us a favour, man? We’ve got an assault over there, and… ’

Assault. He rubbed his eyes. Sam was still talking.

‘… some kind of glass bottle, and they said he was talking about an anthrax letter, but the thing is he’s all cut up… ’

‘No. No.’ Alex pulled his coat around himself, though he was sweating from the heat, his shirt wet under the arms and along his back. Thinking of flesh and broken glass, the metal tang of blood, shards in the muscle. ‘No, I can’t do it. You’ll have to page Laura.’

‘Please, man? The police want this on record as quickly as – and we’ve got this reporter hanging around who… ’

‘Go,’ said Susie from the floor. ‘Just go, Alex.’

His chest was half collapsing on itself, his eyes filmy. ‘Sam, call somebody else,’ he said, as if he hadn’t heard her. ‘I can’t do it. I’m sorry, but I can’t.’

‘I told you to go,’ said Susie. But then a nurse was kneeling down beside her, touching her shoulder and telling her she could come up to intensive care now. Susie rose, and began to walk, and then the nurse turned around again.

‘Wait. Are you the person who arrived with her?’

Alex nodded, Sam still gesturing to him.

‘You’ll need to come with us as well. The doctor needs to talk to you about infection.’

They rose up in the elevator to a different world, insulated from the crowds below them, and walked down a long low corridor, the sound of their boots hollow in the sudden quiet, into the waiting room. Armchairs and couches upholstered in dark blue fabric, pink and white prints of flowers on the walls. Someone was lying on a couch wrapped in a grey blanket, other people eating takeout sandwiches from plastic plates. The nurse left them standing in the centre of the room, assuring them the doctor would be there soon.

Alex went to a vending machine in the hallway and bought two more cups of coffee, and when he came back he saw that a resident, a tired young woman with unwashed hair, was sitting in one of the soft chairs beside Susie. He started to walk to another corner of the room, but the doctor beckoned him over, and spoke to them about vectors of transmission, how the bacteria rode on the fluids of the mouth and the nose. How, where, people touched each other.

Alex told her about the damp handshake, about wiping Derek’s mouth when he found him in the tent, and the doctor nodded.

‘I don’t think you’re high risk at all, but I’m going to prescribe you a course of Rifampin as a precaution. And…’ she glanced at her file ‘… and Ms Rae? Would you have had any very close type of contact?’

Alex looked at Susie, who was biting down again on her index finger.

‘You shared a bottle of water,’ he said.

‘Yes,’ said Susie. ‘Yes, that’s right.’

‘Last week.’

‘Yes.’

‘Okay, that’ll be Rifampin for you as well. We won’t have a definite diagnosis until we get the bacterial cultures, but it’s presenting pretty clearly, and we’re aware of other recent cases, so it’s best to start the prophylaxis right away. Can you tell me – I understand his lifestyle was a bit unusual – but do you know if there’s anyone else who could be at risk?’

Susie shrugged. ‘The street nurses visited him. I doubt he would have let them get very close, but I can give you the number for the group.’

‘I’d appreciate that. Public Health will need this kind of information.’ She looked at her file again. ‘Now, again, this is really something that Public Health will take up, but the particular outbreak we’re experiencing right now seems to have started with a young sex worker. Would your brother,’ she glanced down again, ‘would Derek, to your knowledge, have any reason to be in contact with… that type of activity?’

Susie put her head down on her knees. ‘Low end of the street trade?’ she said, her voice muffled. ‘Probably an addict?’