New Patients

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On Monday morning, the steady bustle of the emergency room is a dismal drone. Usually, she can tune it out if she’s well-rested, but campfire night has knocked her completely off her axis.

After a long shift – well, a long week, really – Lanie doesn’t have a lot of emotional reserve for this final patient. She swallows tears as the ten-year-old in her arms fights for her life. Usually, Lanie stays away from the older children, but no one else was available last night, and she convinced herself she’d be fine. It was the end of her shift; she’d leave soon, anyway. If only she wasn’t so tired.  If only she didn’t feel so guilty about the turn things had taken with Ben.

She intended to get every ounce of sleep on Saturday before her sixteen-hour overnight shift. But she had to sneak out of the perimeter fence to hunt down what she needed for her plan. Then, just like on Friday after campfire, she stared up at the ceiling for almost the whole night. Trapping her like manacles, the agonizing memories of her first summer in Kirkby when she was eleven years old wouldn’t let her escape. The blood. The horror. The inauguration of the secret, makeshift grave in her backyard. Back then, she’d wanted to be buried, too.

And then…him.

The chubby boy on the worship team at los Salvadores who played with his eyes closed. She never got a sure glimpse of their colour, since her family always sat at the back of the church. It never mattered. When he played, his music seemed to spirit him away to another place. Her desperate desire to follow him there, to follow him anywhere, was a physical ache. She fought so hard for years to build a brick wall around that time in her life.

But now, him.

Part of her wishes Ben was here now at the hospital, to play his songs for her, and take her away from what she has to do now. But she also wishes she never saw him again, because she would be fine, now, if only he hadn’t reminded her. She’d been doing fine the last few years. Finally starting to find some peace in her life, and think of a future beyond her dysfunctional family legacy.

Until him.

Medic duty usually helps to clear her mind, but today is different. Today is that tragic anniversary she dreads every year. Well, one of several, she amends, but this one hits the hardest. It’s the only one that’s impossible to block out, despite her efforts to keep things as normal as possible. All night during her shift, Lanie conducted herself with pleasant neutrality as she stitched, bandaged, slinged, wiped, injected, and medicated under the harsh ceiling lights. But the fabric of her emotional self-control is torn, fraying and disintegrating, bit by bit.

The blood. All the blood. A baby screaming. A boot preparing to strike the final blow.

One tear spills down, landing in the little girl’s hair. For the first time since Chelsea died, Qalcad is the last place Lanie wants to be. 

Like most of the patients, this girl and her mother came from dozens of miles away. Not only does the child have pneumonia from tuberculosis, but also infected, blistered feet, dehydration, sunburns, and heat exhaustion. Just getting here worsened her already dire condition, and despite her mother’s perseverance, and despite everything Lanie and the doctor tried. It was too late.

She tries to remind herself that if this hospital didn’t exist, even more children would be permanently disfigured. Chronically ill. Or dead. This is why she’s here.

The reminder doesn’t help. She feels immensely inadequate, like the failure she’s always been told she is. 

“I know. I know, honey,” Lanie murmurs, smoothing the girl’s forehead and holding her frightened, dark-eyed gaze.

This girl is ten today. After learning of the birthday, which will also likely be her death day, Lanie was drawn in. In the private room just off the entrance of the emergency wing, the three of them are a tableau of misery. Usually, Lanie embraced a child, then left the parents to have their private last moments. But the mother, a young widow, won’t take the girl back. Just like Hagar’s inability to watch Ishmael die in the desert after being banished by Abraham and Sarah in the book of Genesis.

The mother clenches her jaw and stares at the wall. She’s done begging. She’s done crying. One hand plays idly at her stomach, and the other woman’s obvious hunger pains Lanie. Usually, there’s a steady supply of fresh food in the urgent care wing. But after the bombing of the school, the supply chain of seeds for the farm and non-perishables for the pantry haven’t completely recovered. Rations for the families of patients are all but cut off to save food for the Qalcad residents, especially the children at the orphanage and the in-patients at the hospital. Lanie comforts herself with the thought that at least the patients are able to eat something small while they’re here, even if she can’t send them home with anything anymore.

Failure. Failure.

However, this woman refuses to drink, even though there is still a steady supply of water from the thankfully undamaged wells. She won’t eat, and she won’t sleep.

Lanie did the best she could. As soon as the supply lines open up again, she irrationally vows she’ll personally deliver food to each family they can’t help. The importance of the work here has to outweigh the hunger and lethargy that now permeates the once-lively emergency room. Otherwise, what’s the point?

What is she even doing?

Yes, she’s definitely tired.

This child has been here, losing her battle with hemoptysis for the last few hours. For a while, the mother worked on a hospital sewing project, but gave up on it. Like most of the others, this woman and her younger girls passed the time creating new dolls, outfits, blankets, bags, and cushions from scraps of reclaimed clothing donations and sewing supplies. Those are easy to come by – first-world thrift-store castoffs are a scourge in many of the African countries. This family even left some of their creations for the orphanage and hospital. At first, they expressed their relief at having something to occupy their time, and a way to give back. When there was still hope for the oldest daughter, anyway.

This morning, while her other daughters slept, the mother made two shrouds. One for her child, one as a donation for a future corpse. Or maybe she wishes she could use it for herself.

At least the family received all manner of available vaccinations and vitamin boosts while they’re here, and none of the others seem to have contracted the bacteria. Hopefully, the TB shot is enough to save the other three girls. Even though they have only been here since ten last night and technically don’t qualify as long-term guests, Lanie pushed to let the other girls stay in the Sector 2 family bunkhouse, watched by the seven-year-old, while the mother stays in the patient room at the hospital. Lanie tells the bunkhouse staff to let the girls stay until the mother can return for them. Though it goes against protocol, it’s a welcome change from the families and patients who are often fighting to go home as soon as possible. They have chores and other family members waiting for them, often several days’ travel away. Many leave before they are fully ready.

The staff have to get creative sometimes to get them to stay. The key is keeping them busy, and playing on their sense of gratitude to get them to finish projects for Qalcad. The women help with cleaning and work on their sewing projects. If the men have to wait for a few hours, they help to unload supplies and restock shelves. If they have to wait for days or more, they help on the farm. And if they are bedridden, they are brought small bits of machinery to fix, such as radios, flashlights and generators, or twine to unknot. Sometimes they are intentionally destroyed, and sometimes they are “fixed” never to be actually used, simply to be destroyed and fixed again. Anything to keep the antsiness at bay, and make the days pass faster so that they allow sufficient time for themselves or their loved ones to get the help they needed.

The children who are too young to help sometimes spend time in the grassy courtyard through the back doors of the emergency room, where there are balls and other small toys cast off from the school and orphanage. However, it’s often too hot out there, and they prefer the coolness of the hospital.

To Lanie’s relief, this mother is no longer making things harder by screaming at the hospital staff to do more for her child. She’s just as exhausted and heartbroken as the other parents, and this is Lanie’s least favorite part about the job. Now, she no longer has to stand silent, biting her tongue to avoid arguing the fact that she can’t waste the resources on the girl, even though she wants nothing more than to pull out every Hail Mary to save her. Giving up, this mother let Lanie hold the child close to her, for longer than the five minutes usually spared.

So, she plays the role God should have played. She sits on the examining table with the lanky child in her lap. She presses her cheek against the girl’s hair, as her small lungs destroy themselves and fill with fluid, and her little heart slows, and she gasps and strains.

“Shhh. It’s okay,” she murmurs. “You’ll feel a lot better soon.” She begins to sing in English: “Take me out to the ball game, take me out to the crowd. Buy me some peanuts and cracker Jacks. I don’t care if I never come back.”

It’s ironic that this song comes to her now. It used to haunt her nightmares, and strike mortal terror in her heart. Maybe that’s why she sings it. She needs that automatic steel door to slam down and protect her from the flood of emotions barraging her mind. Just like that year, all that time ago, music is the only thing that dams up the streams of curses. If she indulges herself and releases it in the middle of this hospital, she’ll bring down a firestorm of outrage from Christians and Muslims alike. When at last the girl is silent and still, her shaking and squeaking gasps stopped forever, Lanie surrenders the body.

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