* * *
—
EACH ICU HAD PERSONALITY. The cardiac ICU had its cardiologists, lots of men coming in to talk about electrophysiology and tiny gadgets to put in the heart.
The surgical ICU had its surgeons and anesthesiologists, doctors who wrote the shortest and most indecipherable notes. The notes reminded me of haikus, and because I wasn’t a literary person, I called my time in this unit difficult poetry.
The medical ICU was my favorite. With no specialties and subspecialties, it was just me and my team, meaning that I had full autonomy; I had the floor. The medical ICU saw any number of cases, and the lack of knowing what was ahead, to be in control but completely in the dark, was my jam.
This unit was also home to ECMO, or extracorporeal membrane oxygenation, or my all-time favorite machine. Four feet tall, eighty-three pounds, with tubing that could extend out farther from its body and into a person, ECMO lived only at hospitals and was worth the same amount as a luxury sedan. To keep someone alive, the machine bypassed the person’s lungs and heart. Blood was pulled out of the person via a tube and funneled into ECMO to be cleaned, oxygenated, and returned. A person on ECMO could be sedated or awake. A person could walk with her ECMO as if it were a friend to lean on but also drag along. Two weeks on ECMO was average; anything longer, a month or months, was very bad news.
How could human engineers have created ECMO? I wondered. This boxy machine on a cart rarely needed maintenance, while in every public bathroom everywhere, half the automatic faucets didn’t run and the only paper towel dispenser didn’t dispense.
When I saw Madeline later, she was giving me notes for my rotation into medical, and I was telling her that no coincidence to me ECMO sounded similar to Elmo, that lovable red Muppet with the giant flapping mouth. I saw myself as its friend, as friend of ECMO, Tickle Me ECMO.
You need to stop anthropomorphizing, said Madeline.
It’s true that I have thought of putting googly eyes on ECMO or drawing on a face.
As I was telling Madeline about googly eyes, how a set of them can make anything funny, even a blood-pumping machine, I was also eating a bagel with strawberry cream cheese. Suddenly, she leaned over into me, and I thought she had fallen or fainted, but she was trying to give me a hug. Because I wasn’t near a table, it was either drop the bagel or not return the hug. I dropped the bagel, napkin, and the entire paper plate, as Madeline had never been this welcoming before.
If you ever want to talk, she said, mid-hug.
At work, Madeline was a true badass, using only her fingers to teach, no handouts, and she could run a code with impeccable form.
To run a code was to run the death algorithm, a series of chest compressions and adrenaline shots that had a one in four chance of bringing a person back.
To call a code was to stop the death algorithm and to announce three out of four times that the person had died.
Once the hug was over, I picked up the bagel and cleaned the pink smear off the floor.
* * *
—
LIKE MACHINES, ATTENDINGS WENT on service or off, two-week intervals at a time. When they were off, you couldn’t get ahold of them, you didn’t know where they were. But when they were on, they were on, reachable at every second of the day, and manning their unit, unless they were asleep.
I hated being off but had two weeks of nothing at the start of October. I’d been texting with Madeline about my dilemma, that after cleaning my apartment and buying groceries, a total of two days were spent, with twelve more empty ones to go.
She asked how I felt then about having kids—that was a great way to fill time, since it was around-the-clock unpaid care.
I said my brother keeps asking me the same thing. My sister-in-law. Reese once or twice. And sometimes people I didn’t really know.
A joke, Madeline clarified, from one childless woman in her thirties to another.
Two years younger than me, Madeline had just turned thirty-four. Pivotal year for women, the reproductive window coming to a close, and since she didn’t know yet if kids were in her future, she had frozen ten eggs. Did you? she asked me. I hadn’t. Not too late, she said. But only if I wanted to, and should she eventually decide against kids, I could have her eggs.
But then my kids might be blond, I said.
Right, she said. Kids are a risk.
I thought of how open Madeline had become after just one hug. What would happen after two?
In trying to help me fill my days, she asked about my interests, any hobbies like listening to music or reading, making art. I could visit a museum or fly to a tropical island or adopt a whole windowsill of plants.
All great ideas, but none that sparked initiative. I wasn’t a creative or tropical person. Plants were hard to read and museums required too much reading.
So, what do you like?
I considered that question and finally said being on my feet for many hours at time.
Then go for a walk, she suggested. Get some exercise.
That sparked. I dressed and went out. I started circling the block in a clockwise fashion.
* * *
—
MY NEIGHBORHOOD WAS STRANGE in that it was at the intersection of three others: Harlem, Columbia University, and the Upper West Side. There was a mix of Montessori day cares and bodegas, gleaming multimillion-dollar condos two blocks away from huge brown buildings for lower-income tenants. During summer, the area was loud. People played music from their car subwoofers and set off fireworks at night. Sometimes the fireworks could sound like cherry bombs, because they were cherry bombs. And every day, a gang of motorbikes zipped by, neon yellow with purple stripes, a patriotic three-wheeler ATV in red, white, and blue. If I was home during the day, I would hear at least an hour of car horns from any of the one-way side streets clogged by a double-parked van. Occasionally there was crime, stolen packages, removed car batteries, a domestic fight dragged out into the street, drawing a crowd. Every few years, a drive-by shooting happened, targeted and aimed at one person. The death would make that evening’s news and the street would be silent, only to recover the morning after.
So, the area had some danger to it, though I’d never felt unsafe. The area was also changing, with old, full residences being torn down to make room for more luxury condos and retail spots that stayed empty for months.
I walked up to the cathedral that was by the hospital and an avenue away from Morningside Park. Unfinished and one of the largest in the world, the Cathedral of Saint John the Divine had Gothic towers and arched buttresses, enormous slabs of granite and limestone, that shot up into the sky and were streaked with brown. By its main gate hung a large sign about peacocks. The church was home to three peacocks that freely explored the grounds. do not feed, said the sign in all caps. do not pet.
When it started to drizzle, then pour, I turned back around.
My own residential building was distinguished-looking. A classic prewar ten-story, thirty-six-unit, and built the same year the Titanic sank. The entrance had an enormous black awning with ornate black crests all around. The awning was the width of the sidewalk and, from a distance, reminded me of a comically long brim on a comically tall cap. Building amenities included a twenty-four-hour doorman, and the weekday one, the head doorman, who called tenants Ms., Mrs., Mr., called me Ms. Joanna. I liked that name; I didn’t mind being her. But since the day that I left for China, I felt new friction between us. In the lobby that day, he saw me with my small suitcase and said I looked particularly well. Where’s the vacation? he asked. Where’s the beach?
I told him about my father, which prompted him to take off his captain’s hat and hold it solemnly against his chest. I’d never seen the doorman hatless and learned in that moment that he was bald.
Ms. Joanna, what a terrible thing to lose a father so young.