Emergency

It’s raining hard when the EMTs arrive and they tell me that St. Matthew’s is our best option because traffic is tied up all over the city. I say okay even though one of Celia’s doctors once called St. Matthew’s a hell hole. Celia is pale and sweating and too weak to weigh in. At this point we just need to get somewhere quickly.

In the emergency room, most of the clientele are “real people,” as Sam, my ex, used to call them. Drunks and junkies rounded up at the bus station, a woman with two dirty shopping bags overflowing with empty bottles and napkins, and an emaciated older man with starkly bloodshot eyes who is mumbling and giving off a strong, unpleasant odor. Just ahead of us in triage is a frightened-looking Hispanic guy with a large gash on his arm, still wearing his oversized busboy or waiter’s uniform. He looks like he’s about twelve years old.

Celia is here because something is seriously wrong with her heart or she’s having an anxiety attack. Maybe it’s both. The symptoms are similar — the racing heart, the shortness of breath, the pallor, the nausea, the sweating palms. Celia was the unlucky loser in our family’s genetic lottery. And I, I suppose, am the winner. Dad checked out early with a massive coronary when I was sixteen and Celia was fourteen. Later, we learned that he had hypertrophic cardiomyopathy. Celia’s cardiologist calls it HCM. I guess it’s easier than saying the whole name when the cardiologists are gathered round the water cooler, or wherever, talking over their latest case. It’s genetic, and even with only one parent carrying the gene, there’s still a 50-50 chance the kids will get it.

Celia was diagnosed after Dad died. The anxiety came later and wasn’t a surprise, since every significant life event was accompanied by a cascade of warnings not to “overdo it.”

“It’s miracle I ever lost my virginity,” Celia said to me recently, with a laugh. I laughed too, but I also remember the times during high school when she got back late from a party or a night out with her friends and would crawl into bed with me trembling because she was frightened.

* * *

Arriving by ambulance brought us over the threshold straight to the E.R., so we didn’t wait long to be seen. Celia seems a little more comfortable now, but she’s still pale. She lies on a gurney with an IV stuck her arm. “Try the other arm,” she told the nurse who had difficulty finding a vein. We know the drill.

They’ve put us in a small bay, not quite a room, but a niche with walls, one of several around a large nurses station, and soon another patient joins us, a heavy white-haired woman who is blessedly quiet. Another nurse sticks her head in to let us know that Celia’s blood work seems to rule out a heart attack and we start the boring and stressful wait for a doctor. Though if you’ve spent any time in E.R.s, you know there may be something to gape at just around the corner.

At first, the real action is to our right. An older man who is still very drunk is calling out to a woman wearing a security uniform who sits opposite him. “I’ll do it with you,” he hollers. “I’ll do it with you doggy style.” The woman gives a snort of contempt. I imagine she’s heard this kind of offer before. The man stops yelling, but laughs intermittently before falling silent.

Eventually a young doctor comes in, just my type, strong and stocky, with close-cropped red hair and freckles. I notice a thin gold chain around his neck with some kind of medal hanging on it. He shakes hands with Celia and is gentle as he listens to her heart and asks her a series of questions. He has an accent I can’t quite place. They talk about her history and I hand him the list of her meds that I keep in my purse. Freckles confirms that she didn’t have a heart attack, but he doesn’t like what he sees on the EKG and wants to admit her. We’ll have to wait for a bed.

“In the meantime,” Freckles says to Celia, “try to relax. If you start to feel worse, get somebody to find me.” He tells us his name, which is Fossnacht or Fossman, something like that, and I figure I’ll just ask for the red-haired doctor.

Celia is exhausted and pretty soon she falls asleep. She doesn’t look good; the area around her mouth is still too white and her hairline is damp, but I choose to assume Freckles knows what he’s doing.

Celia is an actress/waitress/usher and has been working on taking her career to “the next level” for the past five years. She had an encouraging start, was in a toothpaste commercial and several off-off-Broadway shows written by friends, but then things got quiet. She’s pretty — we both are if you like even-featured “girl next door” brunettes — and her acting is good, understated. Acting may not seem like the best choice for someone who should avoid stress, but in Celia’s case there’s a lot of time off from acting.

Last night she was ushering at a theater in Hell’s Kitchen when her heart started to race. She managed to make it through the first act before she called me. I was at home, which made it easier. Ever since Sam moved out I don’t cultivate my social life very much.

When I get tired of sitting on the green plastic chair at the foot of Celia’s bed, I stand at the edge of the bay. You can tell which patients are regulars. They have a certain look of resignation as they wait for the staff to do what they have to do. The infrequent fliers have anxious expressions and, if they’re able to, clutch their belongings. They’re more likely to ask when they’re going to be seen. The lucky ones have someone with them to hold their hands.

I get a cup of coffee from the vending machine in the waiting room and down the sour black liquid that feels like it could burn a hole in your stomach. The E.R. gets busier as time passes, and after an hour or so every bay is full so a few patients on gurneys get parked alongside the nurses station. I sink into a kind of torpor. I have two modes when we’re waiting at a hospital: frustrated rage or passive acceptance. A loud voice rouses me.

“Hey man,” the drunk guy calls to an Asian orderly. “I see you out there. You got an egg roll? I’m hungry, man. C’mon.” The orderly ignores him, but another staffer sees me watching and gruffly orders the drunk to “Keep it down.” The “Courtesy starts with you.” signs posted on the wall don’t seem to be having their desired effects. I shrug and look down the hall, where a young woman with long black hair is sitting in a chair and crying. A line from Camus, one that Sam used to quote, pops into my head: “Should I kill myself or have another cup of coffee?” I decide to go out for a cigarette instead. I whisper in Celia’s ear that I’ll be back in a few minutes. “Don’t smoke,” she murmurs.

It’s drizzling, so I stay near the building and light up in front of the sliding glass doors. Freckles is outside in his scrubs with an unlit cigarette of his own in hand, which pisses me off. “Shouldn’t you be inside getting my sister a bed?” I ask.

He doesn’t answer me right away and gives me blank look instead.

“My sister, the one with HCM, waiting for a bed …”

“Yeah, we’re on it,” he says. “Just as soon as one opens up on the cardiac unit. It’s one of those nights.” He gives me a practiced, compassionate smile, but I’m still annoyed and I may have rolled my eyes.

“Okay,” he adds, holding his hands at his sides in an “I surrender” posture. “Look, my shift actually just ended. There’s another doc in charge of her now, but let’s go find out what’s happening.”

He sticks the unlit cigarette in his pocket.

* * *

Celia’s new doctor clearly likes Freckles and leans in close to him as they review the chart.

“Let me call upstairs and see where we are,” she says.

“Thanks, Lori,” Freckles says, and she gives him a hopeful smile and tucks her short, lank hair behind her pink and vulnerable-looking ears. Freckles tells me we’re in good hands, gives me a little salute, and they leave us waiting for the bed.

I’m not afraid of hospitals. I’ve been inside enough of them to get a sense of what the staff must feel. In a lot of cases, I’m guessing it’s resentment. Lower-paid employees cleaning up vomit, urine, and worse, taking orders from exhausted doctors and doctors-in-training juggling multiple patients. I understand that my sister is just one more body to them and that luck plays a part in how well any one of us will do when we’re there. I get why residents might want to sleep with one another almost indiscriminately, why Lori wants to be with Freckles. All these failing bodies, all their own pulsing life. Everything they see. The lack of dignity, the helplessness, the surrender. Not altogether unlike sex.

While we wait, the drunk guy turns meaner. A nurse is trying to take blood, and he’s raising his voice. “Lemme alone,” he groans. “Get the hell away from me.”

“Mr. Wilson,” she tells him in a loud voice, “We can’t do anything for you if you won’t cooperate.”

Mr. Wilson, who is lying on his side, lifts one big arm up as if to swat at her and the nurse walks away. More time passes, Celia sleeps fitfully, the woman in the other bed stays silent. The noise level in the E.R. lowers, then rises.

The nurse returns to deal with Mr. Wilson, backed by three burly security guards wearing blue blazers. She’s called in the big guns. “Mr. Wilson,” she says loudly. “You don’t want us to do anything for you, so we’re letting you go.”

“C’mon man,” one of the guards says, “time to get up.” But Wilson ignores him, too, and none of the men seem eager to touch him. I’m curious to see what will happen next, but just then two guys from transport show up to take us to the cardiac care unit.

* * *

Once Celia is admitted, I call our mother and I finally feel like it’s okay to leave. Although it’s been a while, it’s sometimes hard for me to believe I am the designated carer, that I am here again. After years of worry, Mom just burned out one day, couldn’t walk into one more doctor’s office without crying, and who else was there to take over?

It’s 6 a.m. by the time I walk out, and I’m about to hail a taxi when I feel someone tap me on the arm.

“She’s on the unit?” he asks, and when I tell him yes he looks relieved.

“I thought you went home.”

“Paperwork to finish,” Freckles says, bouncing lightly on his heels.

“Okay. Well, thanks,” I tell him.

“How’s she feeling?”

I shrug. “Better, I think, but it’s hard for me to know. Sorry if I was a little rude before,” I add.

He’s looking at me more closely and I’m wondering what he sees. I don’t do well with lack of sleep. I’m not one of those girls who can stay out all night and still look dewy the next day. Or at least not anymore. But Freckles must find something appealing, because he asks me if I want to have breakfast.

He’s got a bomber jacket on and his face looks red and cold. I notice he’s not very tall. If I were to put my arms around him we’d stand eye-to-eye.

“All right,” I say, and we go to the diner at the corner and eat fried eggs and toast. I drink a much better cup of coffee and start to feel more human.

Freckles tells me he’s from Germany, and that he grew up there, although his mother is American. I had pegged him as a Midwesterner. He loves the city and he likes working in the E.R., though he’s still getting used to the crushing caseload and the poverty.

“It’s complicated. In theory, we have some of the most advanced healthcare in the world in the U.S. In practice, it doesn’t always work the way it should.” He wipes his hands neatly with his napkin. “So, until we find solutions, we do what we can.”

I may have looked a little skeptical, so Freckles changes the subject by asking me what I do and I tell him I’m a film editor. He seems impressed, so I don’t tell him that my last project was a video on recycling for the Board of Education.

Over a second cup of coffee, he asks me more about Celia. “Has your sister been sick for a long time?”

“Isn’t this against hospital rules?” I ask him, not caring if it is, but not wanting to be his good deed for the day. “You know, intruding on the patient’s privacy?”

“Well, first, I’m not sharing information about her. And second, I’m not asking as a doctor. But third, you don’t need to tell me anything,” he says calmly.

I consider this. “Yeah, a long time. I mean neither one of is thirty yet. But it’s still a long time.”

We’re quiet for a few minutes, until I ask, “Can I have that if you’re not eating it?”

He gives me the piece of toast that’s left on the plate and I see that his hands are strong and scrubbed pink. I spread the toast thickly with butter.

“I’ve got the healthy heart,” I tell him taking a large bite.

When the check comes he picks it up and we leave. It’s gray and drizzly out and when Freckles asks me if I want to go for a walk, I look down at my shoes, which are already getting damp. When I say no, he asks if I’d like to go back to his apartment, which is just down the block, and I say yes.

* * *

I wake up at about two and look out the window of Freckles’ bedroom. Although the room is bright with sunlight, he is sleeping deeply with one strong arm wrapped around me. The St. Christopher’s medal he wears — and apparently never takes off — is pressed against the back of my neck. I slip away from him and find my clothes. In the bathroom I clean my teeth with my finger and gargle. It’s just as well that he lives so close to the hospital. Celia is probably wondering where I am by now.

I go back to the bedroom and take a look around. The apartment is neat and boxy, the floors covered with cheap mosaic parquet. I check his desk and find nothing more interesting than a pile of mail from the last three or four days. On his dresser, I find what I want — a tie clip with some kind of crest on it — and slip it into my purse. Freckles has a pad and pen on the kitchen bar. I leave him a note thanking him for the eggs and let myself out.

* * *

When I get back, Celia is looking a bit better. I don’t think she likes being in the hospital exactly, but I know she feels safer here. Celia’s condition means that the walls of her heart are getting thicker, the whole organ is getting bigger. Everyone’s heart gets bigger as they get older; that’s one of the reasons hearts start to fail. But HCM affects young people, and in some cases dropping dead while exercising or playing sports is the first sign you’ve got it.

When Sam and I started having problems, I began to imagine that my heart was shrinking as Celia’s grew larger. Sam accused me of not caring enough about him and I really couldn’t give him a convincing argument. I thought he might be right. It felt like too much work to be all in. Things finally blew up the third time I stayed home with her instead of going with him on vacation.

Celia and Sam liked each other a lot and I think the breakup was almost as hard on her as it was on me. So I told her I’d caught him cheating and made up a story so convincing that I was almost able to be angry at him along with her. I could imagine the stricken look she would have given me if I’d told her the truth.

* * *

Later, Celia’s given the all clear, and I get her back home in time for dinner. Mom arrives to spend the night now that the crisis is over, and I don’t stay too long, knowing they’ll call me if there’s a problem.

By the time I get to my apartment I’m starving, and I eat some leftover lasagna straight from the refrigerator. When I’m finished, I take Freckles’ tie clip from my pocket and toss it in one of the bedside table drawers. It lands with a light clink as it hits one of the other pieces, maybe the Swiss army knife or the mini-flashlight or the foreign coins. I try to make sure everything I take is the kind of item people often misplace or are unlikely to miss right way. I started my collection after Sam left. This was his side of the bed, so the drawer was empty anyway.

Without Sam around, I realized that short-term works best for me. It reminds me that I can still feel good, even though it won’t last. I’m a little old-fashioned though and I didn’t swipe or poke or whatever the kids do with the apps these days. I’m not much of a drinker, so bars are out. You’d be surprised who you can pick up on a movie shoot, at the bookstore, or even the good old E.R. And how many of them don’t care if you call the shots about where you do it. There’s never any question of them coming home with me where I might not be able to get them out soon enough.

The first time I took something was an accident. I grabbed some guy’s watch from a pile of clothes on the floor, thinking it was mine. Once I got home I knew I didn’t want to see him again, so I stuck it in the drawer. It was like having a party favor. The next time I chose a shot glass with a scene from the French Quarter on it.

* * *

For the next few weeks, things go back to normal. I “date” a guy I meet at the laundromat and add a pair of bicycle clips to my collection. But one day Freckles calls me. I get a sinking feeling, thinking about the tie clip, but it turns out he wants to see me again.

“How did you find me?” I demand. “What about privacy?”

“So report me,” he answers. “But first come take a walk with me.”

We fall into a pattern that works almost perfectly. He calls when he’s free, which is maybe once every week or so. We spend a pleasant night together and I leave with a small remembrance, a spoon, a washcloth, a pencil with the hospital’s name on it, and one night a bottle of nasal spray. Freckles is not materialistic and I’m running out of choices.

A couple of times he asks me if I want to spend an evening out, but he doesn’t protest when I tell him no. We do watch movies sometimes, old ones or foreign films by directors I’ve never heard of. Sometimes he gets up in the night to look something up since he’s still in training and has the occasional paper to write. When he comes back to bed he holds me again against his warm, hard body, which is fine with me, since I know that in the morning he’ll let me go. He is undemanding, exactly the way I like it. I push away the thought that I would miss him if this were to stop.

* * *

It’s spring when Celia’s shortness of breath gets worse and Dr. Grand recommends surgery. Dr. Grand’s office is better than most. She’s on a high floor of a building near the lake, and daylight floods the waiting room. I leaf through a copy of Vogue and look at photos of women who might as well be living on another planet.

The scene here is about as far away as you can get from the E.R. at St. Matthew’s. Most of the patients are older and well-dressed and except for the occasional exchanges among the office staff, which registers as a friendly ambient chirping, the room is silent. Celia’s on Mom’s insurance for one more year, and I know that future waiting rooms won’t look so good.

Dr. Grand calls us in to the office she uses for the post-exam chats, and when we’re seated she pulls a chair up next to us. I know this can’t be good.

“Let me get straight to the point,” she begins. Both Celia and I like Dr. Grand, but right now I wish she would go back behind her desk and say something vague and reassuring. “As you’ve probably realized, your condition is progressing. So we need to do something different.”

The choices turn out to be open-heart surgery or ablation, where a small amount of alcohol in injected into the heart to destroy some of the tissue. In the brochure Dr. Grand hands us, the patients in the drawings have bland, accepting expressions. Her matter-of-fact delivery only helps a little, because as she is speaking I realize she’s talking about giving Celia what is essentially a controlled heart attack. “Some people feel better immediately and most people do well during the first five years. Long-term, we’ll see what happens.”

Celia has been quiet the whole time, but in the silence that follows Dr. Grand’s last remark, we can all hear her labored breathing.

“How soon?” she asks. I’m feeling cold and like I might need to be sick in Dr. Grand’s expensive leather wastebasket.

“The sooner the better,” Dr. Grand says. It turns out she doesn’t do the procedure and the cardiologist she recommends is at St. Matthew’s. Celia and I exchange a look and Dr. Grand tells us he’s the one she’d go to if she needed ablation.

I’m thinking of our night at the E.R. and telling myself that all E.R.s are alike, it’s the cardiologist who counts. Still, I can’t help but feel that Dr. Grand is abandoning us.

“Okay,” Celia says. “Let’s get it over with.” And because I have little other choice, I nod in agreement.

* * *

Around the same time, Freckles lets me know that he’s headed home to Germany for a vacation.

“I’ll see you when I see you,” I say when I leave that morning, one hand in the pocket where I’ve put his eyeglass repair kit.

He comes to the door and holds my face in his hands for a minute before kissing me. “Okay,” he says.

He’s due to get back from Bremen in June, a week before Celia’s operation, which I haven’t told him about, and as the days go by I don’t hear from him. I’ve been sleeping alone and my chest starts to hurt at night. I diagnose myself with fear, either that Celia will die or that I will spend the rest of my life consumed by worry.

But Celia’s surgery is a success and even though there’s some pain, her breathing is easier right away. My pain, on the other hand, goes nowhere, and every day, as Celia seems to feel better, I feel a little worse. I hope I don’t end up in the emergency room myself. The last thing I want is Freckles hovering over me with a stethoscope.

* * *

Celia is having a physical therapy session when Freckles sends a text asking me to meet him at the diner at six. I’m sitting in her room in the reclining chair where I slept for the first three nights after her surgery — at least now I’m back to the day shift. I ignore his first message and the next two, but I answer the fourth one, which says, “Where are you?”

He finds me upstairs and he’s already read Celia’s chart.

“You look terrible,” he says. I shrug and am about to tell him not to sugarcoat it, but I keep my mouth shut because I hate to have people see me cry.

We go for a walk down the hall and Freckles tells me I should have let him know.

“That’s not what we’re about,” I say when I calm down. “Anyway, why didn’t you let me know you were back?”

“I did. I just got here. I decided to spend my extra week off in Europe. You didn’t exactly give me a reason to think you’d spend it with me.”

“Really?” I say skeptically.

“Really,” he says.

He walks me back to Celia’s room and I’m glad to see that she hasn’t returned.

“I’ll come get you later, okay?” he asks. I shrug again, but say all right.

* * *

Back at his apartment I see that he has told me the truth. His bags are sitting on the floor where he left them this morning, and the dates on his luggage stickers match up.

“See?” he says, pointing to them and I nod.

“I got you something,” he adds, and reaches in his bag for a tissue-wrapped package, which contains a kitschy statuette of the Town Musicians of Bremen. “Now you know I was thinking of you.”

“Thank you,” I say and kiss him. “I will find a place of honor for it in my apartment.”

“Which you’ll show me one day?”

“Which I’ll show you one day.”

Later, when we make love, my heartbeat feels so strong that I wonder if he can hear it. Afterward, we lie in the late afternoon dusk talking. I’m thinking that we’ll probably be asleep soon, when he sits up and reaches behind his neck to unclasp his St. Christopher’s medal. He takes my hand and puts the pendant, still warm from his body, in my palm.

“Here,” he says.

“What’s that for?” I ask him. “You already gave me a gift.”

“To save you time in the morning,” he says.

“Friedrich,” I say, and I take his hand in mine.