“I almost lost you. If I ever needed a lesson that saying goodbye isn’t something you do casually, I sure as hell got one.” Finn brings my hand to his cheek, laying my palm along it, leaning into my touch. “I will never ask you to go anywhere without me again,” he says softly. “If you swear to me you’ll never leave.”
I close my eyes and see two blue-footed boobies, bobbing and weaving in an ancient dance, then snapping at each other’s beaks.
They’re going to kill each other.
Actually, they’re going to mate.
My eyes fly open, my gaze fixes on Finn. “I promise,” I say.
The intensivist comes to see me. His name is Dr. Sturgis, and Finn doesn’t know him very well; he only started in the ICU at New York–Presbyterian at Christmas. He runs down my list of medications; he says my oxygen levels are improving. He asks me if I have any questions.
I am careful not to talk to Betty or Syreta about my memories of the Galápagos, because the response always involves Xanax or Ativan, and I don’t want any more pharmacological interference in my mind. But contrary to what they’ve said in passing about how the hallucinations patients have on ventilators fade away, mine have not. If anything, they’ve been honed sharper and more brilliant, because I revisit them when I am alone in my room for hours on end.
“The … ?dreams,” I say to the intensivist. “The ones I had while I was on the ventilator. They aren’t like any other dreams I’ve ever had.” I force myself to continue; this is a physician, he can’t dismiss my concerns as foolish. “I’m having a hard time believing they’re not real.”
He nods, as if he’s heard this before. “You’re worried about your mental state.”
“Yes,” I admit.
“Well. I can tell you there’s a physical explanation for anything that doesn’t make sense. When you’re not oxygenating right, your mental status changes. You have trouble interpreting what’s actually happening to you. Add to that pain meds and very deep sedation—it’s a recipe for all kinds of delirium. There are even some scientists who think that the pineal gland, under stress, produces DMT—”
“I don’t know what that is.”
“It’s the main ingredient in ayahuasca,” Dr. Sturgis says, “which is a psychedelic drug. But that’s still just a theory. The truth is, we don’t really know what happens when we medically sedate someone, and how your mind syncs your reality with your unconscious. For example, at some point, you were likely restrained—most of the Covid patients on vents try to rip out their IVs otherwise. Your brain, in its drugged state, tried to make sense of the insensible, and maybe you hallucinated a scenario in which you were tied down.”
What I hallucinated wasn’t confinement, but freedom. Now that I’m constrained again it chafes. I want to wander to Sierra Negra. I can still smell the sulfur. I can feel Gabriel’s hand on my bare skin.
“Neurons fire and rewire during a near-death experience,” the doctor says. “But I can promise you, it was just a dream. A particularly three-dimensional one, but still a dream.” He looks down at my chart. “Now, your nurse says you’re having trouble sleeping?”
I wonder why everyone’s answer involves more medication. This will be Tylenol PM or zolpidem or something that will knock me out. But that’s not what I want. It’s not that I can’t sleep; it’s that I don’t want to.
“Is it because you’re worried about having more hallucinations?” Dr. Sturgis asks.
After a moment, I nod. I can’t admit the truth: I’m not afraid of revisiting that other world.
I’m afraid that if I return there, I won’t want to come back.
I am moved to a step-down unit that isn’t the ICU, which means I no longer have Syreta or Betty or the Hot CNA taking care of me. Instead, I am now in the ward I was in when I was first brought to the hospital, the one I don’t remember. The nurses here are flat out, with more patients to attend to. It is impossible for Finn to sneak in to visit me here, because he’s stationed in the Covid ICU and he’s not allowed elsewhere due to safety protocols.
If anything, I feel even more isolated.
There are a lot of codes on this floor.
I realize that the vast majority of patients who move from this space to the ICU do not return. That I am the anomaly.
When a speech therapist comes in to see me, I am so grateful to interact with someone that I don’t want to tell her I can already talk—even if it’s raspy. Sara reads my mind, though, and says, “Speech therapy isn’t just about talking. You’re getting a swallow test. We’ll try different consistencies of food to make sure you don’t aspirate. If you pass, you get to have your NG tube removed.”
“You had me at food,” I answer.
By now, I can sit up for nearly a half hour without getting dizzy, which is what makes me eligible for this swallow test. I dutifully sit with my legs swung over the side of the bed. Sara scoops some ice chips onto a spoon and places them on my tongue. “All you have to do,” she says, “is swallow.”