A City Called Z

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Rinne and I were hunkered together in the relative dark of the living room. Our knees were washed up in the television’s bluish glow, almost touching but not quite.

More bad news on CNN. Loads of masked doctors stood under the shadows of ER awnings, gesturing emphatically with their hands. Gruesome, aerial shots of body bags pumping out the back of Bellevue like a colony of ants. And those unending zoom interviews with various commentators: videos recorded on home laptops with cramped, too-tight camera angles, showcasing each academic’s unique set of facial blemishes, their framed degrees adorning the walls of their private studies.

“He could at least have worn a tie,” Rinne said, nodding at tonight’s speaker. Then she looked at me. I didn’t smile. Sometimes I just didn’t have it in me to smile at Rinne, not anymore. Although she did have a point. Despite the realities of lockdown reporting, we should have expected more from them. And from ourselves. We didn’t need to lean into the isolation or take to wearing mustard-stained gym shirts on TV. It made our experts look amateurish, and turned the rest of us into voyeurs, like we were peeping at these people through their garden windows.

Not like I couldn’t relate. The whole world was worn out; Rinne and I especially. But insomnia and decision-fatigue had been haranguing medical trainees for centuries, long before the average American knew anything about wet markets, or Wuhan. We were in different specialties – Rinne was in her first year of a critical care fellowship, I was training to be an orthopedic surgeon - but some things are universal. Stress, like gravity, tethers people to the earth with equal force in China as it does here in Michigan.

And there were other things tethering us, too. Even if we hadn’t caught the virus yet, Rinne and I were certainly infected with something. Call it silence, or distance. Distrust. Whatever it was, it was alive. It had an energy. And because I had nowhere else to put this thing, it just sat there like an insect, molting in my abdomen, preventing me from doing much of anything. My next rotation was supposed to be on the Hand Surgery service, but because our hospital had temporarily cancelled all non-emergent procedures, my workload - and my OR time - had been stripped out from under me. All those carpel tunnel cases had simply evaporated. The hospital was making its position plain. In a pandemic, I was needed less; Rinne was needed more.

It’s hard not to compare yourself to your partner when you’re in the same field. It comes with the territory. Especially if the real root of your problems is something else entirely, something neither of you can talk about. Which, in our case, was that Rinne was fucking somebody else.

But if Rinne refused to bring it up, then I sure as hell wouldn’t.

***

My eyes stayed on the TV. By now, we’d both gotten used to these talking heads every night, along with the death tracker hanging in the corner. Mostly Rinne and I registered the body count subconsciously, like a patient’s blood pressure dipping across a monitor, absorbing the bad news without discussion. Tonight, though, it seemed to me the only thing worth discussing.

“You’re not listening to me, Noah,” Rinne said. “You never listen. And you’re angry about something.”

“I’m not angry.”

“You are.”

“I’m just watching this.” “Exactly!” she said. She sometimes weaponized her good hand during an argument, as she did now. Her hand thinned into a blade and the blade slashed down. “You see? Right now. You’re doing it right now.” Slash.

I turned to her. “Nearly fifty-thousand dead, Rinne.”

For a moment her face turned, distracted, her body glowing in the blue. The ticker changed every few minutes. Two deaths. Pause. Five more. She shook her head, her still-wet curls leaving damp little tracks against her shirt.

“But we know all of this already,” she said. “We’re the ones signing those death certificates.” Rinne looked away and scratched her cheek. The stump of her other arm lay in her lap, buried, as it often was, in the cradle of her knees.

Despite being together for three years, and despite whatever issues we were slogging through now, only once had we talked of her accident. Rinne wasn’t like me. She’d grown up in Wisconsin, on an actual farm, and from what I gathered had been given entirely too much independence around too much farm equipment. I knew nothing about farming, or Wisconsin. To me, her story may as well have been the horror version of a Rockwell painting. Imagine: the rest of her family at the dinner table, surrounding what was probably a large fowl, sunlight gliding solemnly through the windows. And then, from the barn that no adult had bothered to lock, a noise. A scream?

Rinne told me her hand got snatched away in a thresher. It must have been awful. A child’s sharp cries piercing the barn’s canopy; blood misting the bone-dry hay. That sort of thing. I never pitied her – she would have detested me for it. But I have wondered: how does that affect a person, to give up a piece of yourself, an actual limb, before you’d even learnt its value?

In my better moments, I’d often tried to empathize with her, to imagine that frantic ride to the hospital: all six of her siblings piled on top of each other in the van, fretting together, breathing in each other’s faces as they rocketed down those winding, lightless county highways. And then, after she woke up from surgery and found her hand gone, her fingers replaced by air, how it must have felt to have six other sets of hands, twelve concerned eyes, all trained on her, ready to hold her up in the places she couldn’t.

For a kid like me, who’d grown up in Connecticut as an only child, with a chronically depressed mother and perpetually traveling father, I would have withered under that type of scrutiny. And though I loved the OR – the elegance of the surgical field, cordoned off by blue little drapes – I still abhorred being touched. Handshakes were okay. But a sudden, unprovoked hand on the shoulder? No. My body seemed wired for the fast twitch escape.

“It’s called haphephobia,” a therapist once told me. I remember how her pencil clicked against her notepad. “Fear of human touch.”

“I know,” I said. I’d come across the term a few times, mostly during those desperate, late-night google searches. My searching usually got triggered by something. Like that time when the grocer reached for my twenty and grabbed my hand instead, and then I spent the next few hours in the bathroom scrubbing my fingers into nubs.

The therapist smiled. And then she asked me the usual. What did touch really mean to me? When did it first become a threat? When, in my life, did I first feel unsafe?

“But I do feel safe.”

​

She’d arched an eyebrow over the rim of her glasses. “Do you?”

After the hour was up, I left the office and knew I wouldn’t be going back. Not that I didn’t want to; it’s just that the question felt impossible. Because I wasn’t abused or anything. Nothing so traumatic, nothing so big that you could point a finger at and say “there, the root of all evil”. But when you’re a kid, and you’re mostly left alone in a large, empty house, habits build at a slant. Say your father’s been gone during those long summer months on some corporate real-estate venture – Dallas or Oklahoma or Dubai – and your mother’s in her bed, shades drawn against the noonday sun, eyes closed with a leak of spittle draining down her neck. What do you do?

You sit in front of the TV, that’s what. You watch movies long into the night. Your ear tunes itself like an overbent antenna, scanning the airwaves for contact. But this only works until it doesn’t. I remembered the lonely terror of all those zombie flicks, for instance, where some beautiful actress gets herself trapped in a woodshed, and before you know it a bunch of corpses come crashing through the slats, their rotting limbs reaching, reaching, reaching.

But the movie always ends, doesn’t it? The horror goes away. But then you’re just alone again. And sometimes, being alone is worse.

***

The next morning, I got up early.

We kept the treadmill in the small den. The rent posting had claimed the space as a second bedroom, though, at best, it was little more than a very sunny closet. We’d always kept the runner tucked up against the far wall to keep the window unobstructed. Which was pretty in the mornings, when pre-dawn light flooded across the carpet and splashed against the stacks of textbooks lying in the corner.

I did six miles. Not bad.

By the time I emerged from the bathroom, the endorphin rush had settled into a mellow high. Steam rose around the silence. I wrapped myself in a towel and went to the kitchen, thinking I might make us an egg bake. Which was not something I previously would have had any inclination to do. Not when things had been easy between us, anyway, back when Rinne and I were riding on momentum alone. But today the birds were chirping outside the window, we had a fully stocked fridge, and the air was pleasantly cool on my face as I poked around the bell peppers.

But by the time I closed the fridge and went back to the bedroom, dripping water across the floorboards, Rinne was already gone. The sheets lay ruffled in a messy, sunlit pile at the foot of the bed.

A note on a sticky pad by the door: Had to pre-round on my patients. I’m on call until nine. Don’t wait up.

***

When I’d first told Rinne about my phobia on our third or fourth date, she’d laughed it off. And I remember sitting there at the Olive Garden, feeling a slippery type of nervousness. Maybe a little incredulous. Because it wasn’t a small thing to recoil from affection. Relationships had been nuked over less.

“Really?” she said. “Touching? Is that why you haven’t made a move yet?” Then she reached for my hand and saw how I pulled back, how the blood rushed my cheeks after.

“Sorry,” she said, drawing back her hand, then waving it away. I slunk back in my seat. A waiter passed by balancing an unnecessary quantity of breadsticks on his saucer.

In the corner of the restaurant, by the fake, old-timey oven, a kid was looking at me. It wasn’t hard to tell. She was with her parents and must have seen me blushing. I avoided eye contact. But Rinne must have seen me looking because she followed my gaze. And when she spotted the little girl – her hair in pigtails, hands folded quietly in her lap – Rinne stuck out her tongue. And then the little girl stuck out her tongue, and Rinne just laughed. The girl smiled back.

Rinne turned back to me, buoyed somehow. And I remember how her laugh steamrolled any doubt. She leaned towards me and held up the stump of her arm, the zippered surgical scar puckering against the candlelight. “Well, I think we’ll be fine. I’m only half the toucher I used to be.” And then she laughed again in that carefree way she had, with her mouth wide open, and a soggy piece of bread curled near the back pocket of her throat. She’d nearly spilled her wine.

That was another difference. Whenever Rinne was crass, she was crass on purpose.

***

That day I saw five patients before noon, all of us wearing masks.

Henry Ford Hospital had been one of the last places to switch their outpatient visits from in-person to Telehealth. Consequently, there I was in the parking lot of the outpatient building, staring at my reflection in my rearview, praying to God that, on my last day, nobody coughed in my direction.

Across the block, rising from behind a cluster of maple trees swaying in a silent, invisible wind, the main hospital loomed upwards. Somewhere inside, Rinne was taking care of sick people.

For a while I sat there and let the motor run. Mornings had now become a sort of lost zone for me. Rinne said her schedule was picking up speed as she ascended from the doldrums of residency into the only-nominally-better doldrums of fellowship. But the increase in responsibility was real, she insisted. Sometimes she couldn’t leave the hospital at all, not even to sleep, so she’d taken to showering in the women’s lockers on the fourth floor, living out of a suitcase in the fellows’ call room like an orphan.

My only problem was with how thin she’d stretched this excuse, how the length of her absences grew as the months went on. Sometimes they lasted three, maybe four days, blank spaces of separation bracketed by absolutely nothing. And each morning I felt her absence in my body. A roiling water mark rising behind some dam in my chest, held in the sort of anxious silence you sometimes feel when you wake up too late, with the sun too high, and too many things still undone.

But how does anybody know when they’re being lied to? You think, of course, your intuition would pick something up. But maybe it doesn’t. At least not until you see the lie itself, when you’re standing six floors up, just blowing time between consults and gazing down into the parking lot.

And then suddenly there she is, in somebody else’s car. Entangled. And at first you don’t even see her face, but the curly hair is the same, and the two of them are pitched back against the passenger window, kissing. And when she opens her belly to him like a puppy – him: someone older, wide-shouldered, balding at the temples – you see that yes, there it is, that arm you know so well now drifting up against the window.

It’s Rinne’s arm. You’d know it anywhere. It’s an arm without a hand.

***

Of the six post-op patients I saw that day – two hips, a torn rotator cuff, three knee revisions – Mr. Peregrine was the only regrettable case. I could see that from the door. He’d already had two knee replacements – the last one performed in December, by me – and now he waddled himself to the chair, wincing in pain. He sat down and I pulled his pant leg up. The knee was swollen like a grapefruit, the skin hot and erythematous, blanching when I touched it. My tongue clicked against my teeth.

“Can you bend it?” I asked.

He tried, shook his head. Then I tried to bend it for him, and he almost cried with the effort.

“Stop!” he said. The dome of his scalp was bathed in sweat.

“Sorry.” I gazed at his forehead, nearly the same shade of red. “This may be infected.”

“Again?” Something collapsed in his face. His jowls sagged, and for a moment I felt almost tender towards him. Back in December, he’d looked just like this, had come waddling into the ER as septic as he appeared now. At the time, though, the knee was even larger, the skin puckered and thickened, with tracks of inflamed lymph channels lacing up his thigh. He’d nearly lost the leg to staph.

Luckily, we seemed to be catching this one a bit earlier. Maybe we’d avoid the ICU altogether. Still, the joint didn’t look good by any stretch. It had puckered like a soured fruit, like that time Rinne had left a melon in the back of the Honda for days, parked out there on the curb in the blazing sunlight and sweltering July heat, and even after we’d cleaned up the mess – the fruit soft and rotten, slopping through my fingers in red, acidic clumps – the seats still smelled of sour margarita for a month. Back then we’d laughed about it. She stood just off my shoulder as I worked, careful not to startle me. But still, I could feel her whisper on my neck when she said, “Wow, you must really love me”.

“How long has it been like this?” I asked Mr. Peregrine, trying to make my voice low.

He shrugged, breathed a long and heavy sigh, the folds of his shoulder pushing against his neck. “Three days,” he said.

I nodded. “I’m sorry,” I said. “Genuinely. But this thing is shot. You need to go to the ER. Have you had fever?”

“Wait,” he said. “You’re taking it out again?”

I nodded. “Maybe not me. But yeah, whoever’s on call today. Old hardware out. Wash the joint. Clean hardware in.” And then, for some reason, I shrugged. “It’s my last clinic day.”

He winced. His hand flattened on the seat’s edge, quivering and white. “Fuck,” he spat. “How many more times?”

I paused. “I’m sorry?”

“How many more times? That’s what I want to know.”

“I’m sorry, I don’t…”

“I want to know exactly how many more times a guy has to get his knee sawed open. I want to know how many more times before you fuck-ups do your job right.”

I sat back. My spine was now braced against the seat. It was one of the first times I’d wished I had not chosen medicine. In fact, at that moment I wished only to be somewhere else. Not at home, exactly. Not staring at the watermark on the ceiling, or at Rinne’s used coffee mugs, unwashed, in the sink. Not alone. Just…elsewhere.

No help was coming, though. Outside the door, the only sound heard was the squeak of shoes on linoleum. A nurse’s throaty laugh. Somebody having an infinitely better day.

How many more times? He’d asked the question as if I had an answer for him, as if I was God. This is the trouble with doctoring: you’re expected to always have the right response, the right solution, but only so long as it’s palatable. It was a point I’d often made to Rinne. Patients signed the consents, sure. But really, their minds were made up long before the signing. They either assumed everything would go according to plan, or that nothing would. And this zero-sum thinking was why some patients, the easy ones, followed your instructions to the letter. And why the other half thought we’d been harboring microchips in their vaccines.

I’d begun to wonder: where were all the pragmatists? The ones who labored for the middle ground. Where were the people who trudged back to an apartment every day that no longer felt like home, or who woke up in the right bed every morning, the bed they’d promised to sleep in, for no other reason than that’s where they said they’d be?

And now, here was Mr. Peregrine, judging me, sitting high on his throne with his round moon face. By now he was glistening with sweat. Glossy like a seal.

I sat forward. “Well,” I said. “Your diabetes certainly isn’t helping anything.”

“Excuse me?”

“You signed the form. You knew the risks. You’re not exactly the ideal candidate for a speedy recovery–”

“You little shit.”

“ –and maybe if you’d laid off the Burger King a few decades ago, you wouldn’t have gotten yourself into this position in the first place.”

His scalp was an angry violet by this point, and even the chair was shaking. His face leaned into mine; I could smell his breath through his mask. Raw onion. He had the look of a guy who wanted to hit something. But I wanted to hit something, too.

Finally, he breathed. His body sagged into itself, deflated. A worn-out balloon.

“Goddamnit,” he said. “Jesus Christ.” The lines on his forehead eased, and it was only then that I felt the small pang of guilt in my side. We were now both suspended in that sudden and immediate silence, that paradoxical sense of ease felt only after some line has been crossed. Like sunlight dispelling a storm.

“I’m sorry,” I said. But Mr. Peregrine would no longer talk to me. He just squeezed his eyes shut and shook his head.

“Right. Well.” I stood. “Sorry again.”

And then, “I’ll go call the ER.”

***

​

An hour after the transporter wheeled Mr. Peregrine away – his stubby head turning back for one last baleful glare – I found myself hiding on a bench down the hall from the administrative offices. Four empty Mars Bars wrappers lay crumpled at my side, my stomach churning against the sudden onslaught of sugar. After the argument I’d been worn out. Then I’d been ravenous. And now I just felt sick.

I was grateful for the low foot traffic. Here, at least, there were no nurses swishing about in their clogs and scrubs, hair pulled up, eyes angled forward. No medical students, either. They tended to congregate in the commissary after rounds anyway, huddled together for safety like a pack of zebras, their bags set up in a haphazard perimeter lest they be asked by their residents to do something useful.

For a while I’d worried that Mr. Peregrine would report me. It didn’t matter how. Both HR and the staff in the emergency room were equally liable to shift the complaint to my program director, which was bad. And, these days, fat-shaming a patient was very bad. But I reminded myself that it was, for better or worse, very difficult to fire a resident. We were cheap labor; they needed us now more than ever. That fact alone should have eased my nerves.

But my stomach wouldn’t loosen. Nausea churned through my gut in peristaltic waves. I craned my neck upward and stared at the chalky white ceiling tiles. I took a long breath as I scanned the exposed plumbing, unchanged since the fifties.

The clinic building had once been an automobile plant. Maybe, in some earlier time, the alcove had functioned as an open-corner office for middle management, a place where you could be both detached and involved, where you might hear the bounding machinery below, the men yelling, the churning of things. And yet, from up here, you’d still have some space to privately thumb through sales figures alone (probably in a cloud of cigarette smoke).

Now though, after the reconstruction, there was only the window. The parking lot was the only visible thing. Light poles dotted the grassed meridians, scattered like abandoned windmills.

The setting reminded me of a story I’d once heard about Detroit, how some billionaire had offered to buy a whole poverty-stricken section of the city. His goal, as I understood it, had been to transform blocks and blocks of dilapidated homes, clapboarded factories and pumpless gas stations into a horror-themed amusement park, a sort of year-round zombie land. Even then, I didn’t understand it. Why did people pay for terror? All those zombies from the movies suddenly made real, chasing after you in tattered clothes and professional-grade cosmetics. Grabbing at you for real. Z World, he’d wanted to call it. Detroit, he’d argued, was basically postapocalyptic already. Minimal renovations needed.

All of this was churning through my head – Mr. Peregrine, zombies, dead limbs - when far below I saw something strange. A squat man was walking alone, or maybe limping. He made his way across the sea of empty parking spaces. Moving slowly. Away from the hospital.

I stood and went closer. I watched the man push on against the wind, hunched with a catatonic gait, looking almost like a zombie himself. From this height he gave off the impression of an undead beetle.

Eventually, he paused by an isolated, rusted-out Buick, and rested his hand on the rainslicked roof. He turned and looked back at the building. His abdomen was pushing out in front of him, and steam rose from his huffing mouth. I had the rather uncomfortable sense that he could see me. Like he was uttering curses under his breath.

And now I could see that it was him. Mr. Peregrine.

I stood, suddenly dumbfounded. Where was he going? I had half a thought to yell something down to him, but of course he wouldn’t hear me. So, I just continued to watch, the nausea gripping me again as he slid into his car. The engine started, and then he was driving away, past the meridians, the uncut weeds, the fencing lining the perimeter. And despite being the only vehicle on the road, it didn’t take much time at all for me to lose him entirely. Mr. Peregrine’s red Buick simply puttered behind the bridge that bucked against the turnpike, growing smaller and smaller, until finally it drowned beneath the city’s hazy skyline.

***

I spent the next week in a jittery, paranoid state. I wasn’t feeling myself and the days dragged heavily, as if through some invisible sludge. The nausea worsened. I prescribed myself some Zofran and ate it like candy.

At first, I avoided my email completely, hoping to dodge any reprimand from HR, or whoever Mr. Peregrine would have reported me to. But the worry gnawed at my ribs. It was like that molting insect inside of me had grown wings, or teeth, or both. And beneath the gnawing there was the obvious question of why he had left. Was he lucid? Had the porter just shuttled him to the doors? Was he that stupid? More likely was that I’d simply pushed the wrong button on the wrong guy. That I was somehow responsible. And now he might die.

Sometimes, when I thought too much about him, the nausea would hit like a typhoon. I spent the occasional morning hawking bile against the linoleum. So, I stopped eating. Exercise seemed like an insurmountable barrier, and I’d begun to use the treadmill mainly to hang the wash. But I found it difficult to fold things up. Sweaters and joggers began to pile in a heap along the tread, burying the machine in a mountain of wrinkled clothing.

Rinne came and went, her presence as sporadic as rain.

Eventually, after a straight week of this, I checked my e-mail. And when I opened my inbox and scanned through the messages, I found nothing beside the usual hospital-wide notifications. Not a single email was addressed to me specifically. No termination notice, no big red letters warning of some ethics violation. No nothing.

One night, I accessed his chart remotely. There were no new notes. Nobody in the ER had even seen him. I gleaned his phone number from his face sheet and punched the numbers in. And then I just sat there, cross-legged in the darkness. I stared at my phone until the bleary numbers seemed to wobble.

I hit ‘call’, listened for the first ring. Then I hung up.

From the couch, with the news always on, I stalled for time by fiddling with an old research paper. I sent emails to my co-authors asking for their edits. Of the original six authors, I got one curt response.

Sorry, other things coming up. Backburner for now.

***

​

On the nights when Rinne did come home, she was often too exhausted to talk. She’d just strip out of her ICU scrubs right there on the doormat, our ad-hoc decontamination zone. I’d watch her shedding them from my perch in the living room, her body curling its way outward as if she was shedding a second skin. All while I sat there motionless, sporting days-old sweatpants like a deadbeat.

Then she’d shower, brush past my shoulder, and go to bed alone.

We were two weeks into this when something finally cracked. Rinne came limping into the house, as usual. But then she sat next to me without taking off her clothes. Her scrub-top grazed my arm. My first instinct was to shift away. But then I saw the far-away look on her face, and how the corners of her mouth started to quiver. Suddenly, she was crying.

“What?” I asked, sounding harsher than I’d wanted. But I let the question hang.

She just shook her head. “There’s just so many of them,” she said. Then she heaved a big breath out and rubbed her face with her good hand. “We’ve stacked some up in the hallway. They’re all dying. Most of them, anyway. This thing isn’t behaving like pneumonia.”

“How?”

“I don’t know. They just won’t come off the ventilator. We prone them. We give them the steroids for a few weeks. And then they just die.” That last word came up from her chest. As though it’d been sitting there like a mucous plug, begging to be coughed up.

“And the worst part,” she croaked, “is the way they die. With nobody around.”

“No family?”

She looked at me quizzically, her eyebrows curling. “No,” she said finally. “Families aren’t allowed. Contamination and everything. Haven’t you been checking your email? There was an announcement.”

I looked at all my drying socks, drooping like white flags against the treadmill. I thought of Mr. Peregrine. My paper. Backburner.

“Sometimes,” I said.

“Well, it’s fucked up,” she continued. “We set the family up on Facetime or something. Then we shove an iPad in the patient’s face when we pull the tube out. But it depends. Some families don’t even want that.”

“It sounds gruesome.”

“That’s because it is.”

I imagined Rinne standing vigil by some loved one’s deathbed, wearing a hazmat suit and holding a glowing screen. No family present. Not even me. Just Rinne and the rhythmic rise of a patient’s chest, and all those hissing ventilators, in that room and in a hundred other rooms, performing the work a person’s body couldn’t.

And it occurred to me, then, in that moment, how far away Rinne really was. Her face hung loose; the skin around her eyes was wrinkled like notched wood. It wasn’t the right time, I thought, to be honest about what I knew. Maybe it never would be.

Life was an onslaught.

“Why do you have that look?” she asked me suddenly.

I kept my hands in my lap.

“What look?”

“I don’t know,” she said. “Like you want to say something. But won’t.”

***

Rinne was gone and I was working in the den, forcing myself to shift the bundles of clothes off the treadmill and back into drawers. For days the nausea had been gone, but it had been replaced with this incessant, hacking cough that sometimes folded me over. My body felt sore and feverish. It hurt to walk. For nearly two hours I folded socks, crimping shirts off the line, trying to organize myself back into something approaching normalcy. I worked maniacally, packing drawers full of clothes until they groaned.

Then I got a text from Rinne.

Did you see some guy recently? Infected knee?? He’s in the ICU.

I stared at the read receipt. A muscle stiffened in my back. Who is it?? I texted back.

Which was unnecessary.

I knew who it was.

***

In any good zombie movie, this is the part just before all hell breaks loose. When you’re back in the car, driving through an infected city, and everything is eerily quiet. Maybe even peaceful. Maybe the cassette you’ve popped in has a cheery du-wop song playing. Maybe it reminds you of better times. The river and the bridges and all those vacant buildings come rushing past, then fade into your rearview.

And I had that feeling then, as I drove. But it was little more than a dim echo heard from miles out. I barely saw anything other than the road in front of me. I just pushed the accelerator.

And then I was back in the lot.

I turned the key and removed it. I saw the same light poles and the hospital’s brick façade, with the shadows now dissipating in the sun. I paused. My neck craned as I scanned around the perimeter. I was feeling a little jolt in my gut. Something approaching fear.

The wind dipped and thrusted under my seat, rocking the car like a boat. The sky was the same gray dusk as the pavement. If I squinted, it seemed almost as though the earth’s ceiling had collapsed. And maybe I could see them now, too, in that grainy middle-distance ahead: the zombies, lurching across a landscape as barren as the moon.

Something inside me shifted. The insect. My infection. Whatever it was became animated, made real. It leeched into my blood and metastasized, depositing itself in my bones, my forever-alert nervous system. It grew wings and flew around my ribs; it laid itself down in the thick chambers of my heart.

And then I was moving. Rushing through the lot, leaping over the meridians. I paused only briefly as the big bay doors opened. The welcome lobby was mostly empty, other than two masked greeters who stood by silently, wearing their pink volunteer vests with the stitching at the breast proclaiming “Welcome, healthcare heroes!” Two medical students sat hunched by the elevators. When I passed, one of them gave me a too-long stare, in the way children sometimes do.

The ICU was on the fifth floor, but you could hear it even before the elevator doors opened. The hissing of those ventilators, masked voices shouting, sneakers scuffing over linoleum. Feces and Clorox. After I buzzed myself through the bay doors, I found the tracking board and rested my weight against the nurse’s station. Breath came in short, splinted spurts.

And there on the screen, I found his name. Mr. Peregrine. Room 404.

And then someone was gripping my arm. I recoiled.

“Noah, what’s going on? You ok?” The hand was moving now, leaching up my elbow, and I felt a sudden jolt in my spine. I tripped back and almost fell. But then I looked up and saw Rinne’s eyes, glowing from behind a face shield. “You look awful,” I heard her say. “You need a mask?” She reached for me again, but again I pulled away. She let her hand fall and kept her distance.

“I’m fine,” I said. Because we were already there, weren’t we? Right outside his room.

Rinne just stared at me, which was too much somehow. I turned back to Mr. Peregrine’s room. In the glassed reflection I saw myself, and I saw Rinne too, now keeping her distance, looking alien in her hazmat suit. And, seeing myself, I suddenly felt naked. My face was exposed, fat all but gone from my cheeks. My loose skin sagged under its own weight. I was still wearing shorts and my legs seemed paler than I remembered. It occurred to me that I hadn’t looked in the mirror recently. Not for weeks.

Through the glass lay Mr. Peregrine. He was lying supine on his back, plastic tubing anchored in his mouth. His belly seemed less rotund now as it lifted and fell. A sheet covered his body, but below the right knee there was nothing. In the place where his leg should be, the blanket lay flat, placid, almost peaceful. It was flush against the mattress.

“They took his leg, didn’t they?”

Rinne’s muffled voice.

“What?”

She pushed her faceplate closer. “It’s not your fault.” Her face was almost totally covered. Just the twin green moons of her eyes shining through her face shield, looking at me, concerned. “I checked the chart,” she droned, her voice pushing through a field of cotton. “He never even went to the ER. His wife sent him back when his leg started to smell.”

“Wow,” I said.

“I know. You ok?”

I shook my head. “I don’t know,” I blurted. And I didn’t. All I had, all either of us had, were questions. Some of these could be answered. Some not. “What about us?” I finally asked. “Are we ok?”

And then Rinne stiffened. Her eyelid gave a little flinch. For a moment neither of us spoke. When I turned back to Mr. Peregrine, I didn’t even bother looking at the monitor. Through his window I could see trees blowing, and beyond this a chemical plant spitting exhaust into the sky. But behind all this, even further in the distance, there was the dim glimmer of sun, refusing to be choked out.

“He’s going to die alone,” I said. “Isn’t he?”

At first, she didn’t answer. Rinne just stood there, her eyes tight, her brow curling into a question mark. But then something in her face softened. The notches at the corner of her eyes disappeared. Then she put her hand back on my arm. This time, she didn’t let go.

“I don’t know,” she said. “But I’m sorry. Really, Noah. For all of it.”

I barely heard her. All the world’s sound seemed to be rising like steam anyway, evaporating itself away, to some other earth. The hissing was gone.

Rinne and I stood shoulder to shoulder. We stayed that way for a long while. We stared across the hall at Mr. Peregrine’s still body, and at the broad sky which framed him, across all those separations of glass and plastic and metal. Rinne was still holding my arm when I reached down and grasped hers. We looked again to each other. And for a brief flicker of a moment, I felt safely tethered to the earth again, holding her hand like that, feeling her touch in the silence. It seemed the only thing keeping me steady.

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By Brandon Ingalls