I peek into the envelope: the bill is $225. “Oh, wow. That’s more expensive than I thought it would be.” I quickly calculate the sum of rent, plus groceries, plus cell-phone bill, plus this astronomical electric bill, plus other utilities and realize the meager paycheck I’m expecting in two weeks will barely cover it all, even after I return the things I bought today. I try not to panic.
Beth unwraps her towel turban and starts to braid her thick blond hair. “I like to pay my bills two weeks in advance of the due date. I hope, since we’re all living together, you’ll keep that in mind and try to be a little more responsible from now on.” She turns back to her newspaper. Al reaches across the table for the crossword puzzle. I feel like a toddler who’s been scolded by her mother.
“Okay.” I drift toward my room. “Sorry about that.”
“Two percent,” Al says.
“What?”
He looks up from the crossword. He squints, his expression strained, as if formulating a complete thought requires extreme effort. “I prefer two percent milk.”
I’ve never been one for confrontation, at least not with anyone other than Ma. I know I should be more assertive, not just with Beth, but in my life in general. My usual coffee order is something like “mediumish coffee with some creamer, or not, whatever.” I’ve read that standing with your hands on your hips and your shoulders squared— a “power pose”—can help foster confidence. I take a deep breath, look Al straight in the eye, assume the power pose, and prepare to let fly the long string of expletives that’s racing through my mind. I immediately lose my nerve and settle on sighing loudly and walking away instead. Clearly, this power-pose theory is unfounded, pseudoscientific garbage.
My bedroom is so tiny that the foot of the bed blocks the door from opening completely. I squeeze in and collapse on the pink comforter, only to jump up immediately and check the sheets and pillow for cockroaches. Then I collapse again, kick at the door, and am asleep before it slams shut.
CHAPTER FOUR
It’s my second night on call.
“Wait!” I yell to the nurse.
She looks back.
“Would you mind staying?” I try to calm the nervous trill in my voice. “I’ve never done one of these.”
She nods and stands patiently in the doorway, leaning against the jamb, her hands in the pockets of her polka-dot scrub shirt. A fluorescent light flickers overhead. This room is like all the other patient rooms in the hospital: closet-like bathroom just past the door, television mounted high in a corner, gray-and-beige laminate tables flanking the bed, and a dusky pink vinyl recliner chair near the window. On the wall behind the head of the bed is a speaker connected to the nurses’ station and a little red button, the code button, that summons the medical team in case of emergency. The name of the nurse on shift is written in dry-erase marker on a whiteboard on the wall. Mandi, with a heart over the i instead of a dot.
And the smell. It’s hard to nail down what the hospital smell is, exactly, and easier to identify what it’s not: a home smells like washed laundry and open windows and coffee and sunlight. The hospital smells like none of those things. It smells like hair and skin and sweat and urine and bile. The sweet dankness of disease and the institutional citrus of Clorox wipes. Bodies and bleach, close together.
Pulling vinyl gloves over my hands, I step to the bedside and try not to gasp. Skin pale and taut, with thick eyebrows that meet on the bridge of his nose and incisors that protrude from beneath his upper lip, the patient looks like a sleeping vampire. His mouth and both eyes are slightly open, his forehead creased as if he’s concentrating. I recognize the characteristic facial features immediately: porphyria.
I hold my breath to quiet the sound of my own lungs and put my stethoscope on the man’s chest. Nothing. I take the penlight from my pocket, use my thumb and index finger to lift both of his crusted eyelids, and shine the light into his eyes. His glassy pupils stare straight ahead without reacting. Then I make a fist with one hand and, after a moment of hesitation, vigorously rub my knuckles over his breastbone as hard as I can. I know I won’t hurt him, but I flinch anyway.
“Okay,” I say to the nurse.
At the nurses’ station down the hall, I write in the chart: Called by nurse to pronounce patient. Patient examined, no heart or lung sounds, pupils fixed and dilated, unresponsive to tactile stimuli. Patient pronounced dead at 3:55 a.m.
A slow, protracted march toward death is what the senior residents like to call “circling the drain.” According to the chart, this patient had been doing so for quite some time. A genetic form of porphyria caused his kidneys to fail, then his liver. Weeks ago, his family decided that no heroic measures were to be taken to revive him should he stop breathing—DNR status. There would be no alarm bells, no CPR, no ventilators.
Ferri’s Practical Guide to the Care of the Medical Patient—a copy of which I carry in my coat pocket—states that when notifying the patient’s next of kin, you should “identify yourself to the family in a humble and caring manner and inform them that their next of kin has expired . . . and always try to comfort them that their relative died peacefully.”
I find the phone number for the patient’s emergency contact, his mother, in the chart. After five rings, a muffled voice answers.
“Hello, this is Dr. Kapadia calling from Philadelphia General Hospital,” I say.
“What?”
“Hi, it’s Dr. Kapadia, Philadelphia General. I’m sorry about the hour.”
“Yes. What do you want?”
“I’m so sorry to have to inform you that John Potts passed away a short time ago.”
Silence.
“I’m very sorry. He died peacefully,” I say, cringing. I have no idea whether he died peacefully or not. How could anyone know what someone else’s experience of death was like? Maybe he went happily toward a white light. Maybe he ran screaming from the light. Maybe there was no light at all, just a disorienting, frigid darkness.
Still silence. Tears sting at the corners of my eyes. This poor woman. She must have known this was coming, but it probably doesn’t feel real to her. Like when my father died. I remember only bits and pieces, sounds, smells. Samosas frying in the kitchen, the doorbell, Nimisha Auntie sobbing on the doorstep, my mother shrieking, then silence and whispering and Paul looking up from his math homework in the study, the only time I’ve ever seen him look afraid. I was reading a library book about frogs. It all replays in my mind, sometimes unexpectedly, like the stuttering reels of an old home video.
My voice quivers with emotion. “Ma’am, I’m so very sorry. Is there anything I can do? Anyone I can call for you?”
“You have the wrong number.”