Outside its pale circle there was nothing but blackness, a chaotic punctuation of lights moving in meaningless patterns. Dry seed-heads broke through the snow at his feet, and the invisible city stretched out on every side. In front of him, the Don River, the slope upwards to the east side, the plane trees and small brick houses, and behind him the wetlands, and the landscaped sloping enclaves of Rosedale. To the south and west somewhere was most of his life, his apartment at College and Grace, the osprey on the wall in Kensington Market, the little brick church, the woman in the rooming house on Bathurst and the man being held hostage by terrorists, the new Sneaky Dee’s on College that would always be the new Sneaky Dee’s although it had been there for more than a decade; to the north, his office in the hospital, the operating rooms where he moved quietly among the surgical teams, the burned man in the isolation ward. The girls falling down in the subway, the Don River running past him and away into landfill, where the shore of the lake used to be. All dark. He closed his eyes and listened to the traffic on Bayview, the hum of the engines, the wires connecting in networks above his head, like the hiss and thud of his defective blood.
And here, on the edge of this valley, half-blind and tainted with disease, he felt the city inside him with a kind of completeness, all the tangled systems. Money and death, knowledge and care, moving constantly from hand to hand; our absolute dependence on the actions of bodies around us, smog and light and electric charge.
There was a sound like music at the bottom of the city’s noise, far distant. And it grew louder, and closer, and he knew it now, the wail of the siren, the ambulance come to them in this strange retreat, this place at the heart of everything.
IV
At the corner of College and Spadina, a man with a torn bit of blanket around his shoulders and a bottle of Chinese cooking wine in his hand stood in the radiance of a neon sign and watched the show. A streetcar stalled in the middle of the intersection, the sound of car horns surging around it at all four corners, as the traffic lights spread smears of green and red on the wet asphalt, and a woman lay in the road, flat on her back, her arms and legs spread, her hair fanned out, eyes open and white, the pupils rolled up. A fire engine pulling out from the station a block away. The streetcar driver climbed down onto the tracks and knelt by the woman, and the lights of the vehicles seized them there, etching them in high relief, a frozen sculpture on a city street.
Further south, the hazmat teams in their white gowns descended to the PATH, to a dim corridor where a man crouched and trembled half-conscious against a wall, and the friends around him spoke of roses and incense. The white figures raised their instruments again into the air.
And the hill on Bayview was public and crowded now, filled with noise. Alex had been partly mistaken – it was not the ambulance but the fire engine that arrived first, the firemen clambering up with flash-lights and a first-aid kit, as if they attended to people under railway bridges every day of their lives, and for all he knew perhaps they did. He led them down and into the tent, where Susie was sitting with Derek’s head in her lap, and they moved him away from her to check his airways, do whatever other preliminary things could be done. Susie, irrelevant suddenly, crept out of the tent to stand with Alex on the hillside.
The paramedics came, and Alex was needed to help them pull the stretcher up the hill. A fireman carried Derek out from under the bridge, cradling him in his arms like a child, and lay him down on the padded surface, strapping him in for safety before they brought him, slowly, dangerously, down the steep slope to the emergency vehicles, Alex holding on to the metal side of the stretcher with his gloved hands, pushing his feet into the earth and leaning against the weight. Susie followed them, empty-handed, the tent abandoned.
They were down beside the road, standing in the blue light of the ambulance, a police car pulling up, too many things being said that he couldn’t quite grasp. Derek’s cracked lips were bleeding, or perhaps the blood was inside his mouth, it was hard to tell.
‘When blood comes out of the ears, there’s no possibility to survive,’ whispered Alex.
‘You walked here?’ asked one of the paramedics, incredulous.
Somehow it ended up being agreed that Susie and Alex would ride behind the ambulance in a police car, and he was aware that this was a deeply unusual arrangement, that they must look like a pair of orphans on the roadside, grimy and confused.
The policeman talking through his radio to the ambulance ahead of them. Crackle of static. ‘They can’t all be on emergency redirect,’ said the policeman. ‘You’re shitting me, right? All of them?’ The radio chattered again. ‘Oh, sure, that’s great. We’ll take him to Sick Kids, give ’em a laugh, eh?’
The ambulance wound up and down the streets, south and west. More static from the radio, and then they turned north again.
They pulled into the parking lot of one of the central hospitals, and Alex saw four other ambulances sitting in the bay, their lights revolving. One attendant was standing on the pavement, smoking; he threw the butt angrily to the ground and stomped on it, went to the glass door of the emergency entrance and shouted something.
The police radio crackled, and they pulled out again, heading further north.
‘Fuck this,’ said the policeman. ‘Somebody’s bound to die soon, eh? That’ll open up a space.’
Susie was looking silently out the window, biting her nails. He wanted to tell her not to put her fingers in her mouth. He searched in his bag for an alcohol swab and handed it to her. ‘You can wipe your hands with that,’ he said softly. ‘It’s kind of small, but it’s better than nothing.’ She held it in her lap and stared at it for a while before she opened the wrapping and rubbed it across her palms.
The car stopped suddenly, pulled over to the side of the road. He saw the word FEAR again, spray-painted on the wall of an alley nearby. They were somewhere above Yonge – on Avenue Road? He wasn’t quite sure. His hand was shaking a little, though he guessed that this was probably just the stress. ‘Excuse me?’ he said to the policemen in the front seat. ‘I’m about to check my blood sugar. I just wanted you to know that’s what I’m doing.’
‘Sure. Knock yourself out.’
It was okay, a little bit low, not dangerous. He would need to eat something in the next little while, but not immediately.
The radio crackled, and the car pulled out and continued north. At a red light, he saw a tall man with long greasy hair, his skin like old leather, holding cramped arthritic hands in the air and screaming, ‘Fuck OFF! Fuck OFF!’ over and over, in an ascending scale of agony. At another corner they passed two police officers bending over a woman, down on all fours on the pavement, her blonde hair covering her face, drunk or desperate or poisoned by terrorists, it all seemed much the same.
If he were going to imagine a terrorist, Alex thought, his murderous doctor or whoever, he would have to decide who this person had failed, where they had betrayed or misjudged; something terrible and public or very small, but there had to be that failure, a loss, a crack-up, a falling down. He could see how releasing poison gas on the subway might seem like a valid choice.
Not that he himself was the kind of person who released poison gas, more the kind who sat politely inhaling it, not wanting to cause a fuss.
His eyes were still sore, stinging, and after a while he closed them, and for a moment, in the darkness and the motion of the car, he thought he might sleep. The car kept travelling through the streets, then paused somewhere else, but he didn’t open his eyes.
The impossible thought that in a different world he would have a nearly teenage child, a girl falling down on the subway for all he knew. Or maybe not, maybe Chris would, maybe nothing in his life was any different than it had been the day before.
And it wouldn’t have been like that anyway, there was no reason to think that he would have been a father in anything except the most crude genetic sense. All that he could ever have given it was his weakness, his own sickness, nothing better.
They stopped finally, inevitably, at the emergency entrance of his own hospital, so close to where they had started that they might as well have sat in place for half an hour and avoided the whole journey, and he stepped from the car in a circling tide of light and darkness, Susie rushing past him towards the ambulance they had followed. But the stretcher was disappearing through the doors and down a dim corridor at the end of emergency admitting, and Alex and Susie pressed into the crowd – the moulded plastic chairs in the waiting area already full, a crying girl in one corner, people standing with styrofoam cups in their hands and bits of tissue clutched to their mouths and noses. A nurse with a clipboard led Susie towards a desk and began writing down information.
‘He had a health card,’ Alex heard Susie saying. ‘He did have a health card. But I don’t know the number.’
‘You can’t find it? We’re going to need that to admit him.’
‘It’s very complicated,’ said Susie, and put her head down on the desk.
‘Oh, now, stop that,’ said the nurse sharply. ‘We can get this sorted out. You just have to be sensible.’
A family pushed between them at the triage desk, parents supporting a wheezing girl who clutched her chest and wept, and Alex was separated from Susie and the nurse. He threaded his way across the room and stood by the wall, reaching into his bag for a granola bar, watching them assemble Derek’s story in bits and pieces, in questionnaire form. There were Christmas decorations hanging above him, cardboard Santas and holly-wreathed bells. A small boy was sitting on his mother’s lap, throwing up into a plastic bowl. Two middle-aged men in different corners of the room were clutching plastic oxygen masks to their faces. The nurse went away and looked something up on a computer, and then came back.
‘… risperidone last year,’ he heard Susie’s voice briefly, breaking out of the general clamour. ‘But he’s been off it… no, no allergies that I’m aware…’ Another man arrived, breathing hard, and then a girl with red welts on her face, hanging on to the arm of an ambulance attendant. A woman with a baby in her arms and pale clumps of sick-up clinging to her coat. Susie was standing with her elbows on the counter, her hands on her forehead.
‘If we can’t determine his health coverage, we will have to ask you for payment. You may be able to get it refunded if he’s eligible.’
‘Oh, for God’s sake,’ said Alex loudly. ‘I work here. Take it out of my damn paycheque.’ The nurse turned around and glared at him, snapped a file closed as loudly as she could. He stood by the wall, eating his granola bar, avoiding Susie’s eyes.
Outside the movie theatre at College and Yonge a woman knelt on the sidewalk, her arms wrapped around herself, cradling her body like an infant.
‘You shouldn’t touch her,’ shouted someone. ‘We don’t know what it is.’
‘She’s just sick to her stomach, it’s nothing,’ said someone else, as they stood in a circle around her, not quite near her, and she swayed back and forth and vomited onto the sidewalk.
It’s nothing.
Don’t touch her.
A man leaned against the glass window of a coffee shop with one hand in the air, holding a fluttering magazine, trying to summon a taxi before he fell, and an ambulance rounded the corner, the sound of its siren slowly flowing through the night.
They stood in emergency for a couple of hours, or it might have been longer, he hadn’t checked the time. One of the nurses had set up a preliminary triage station at the door, collecting the breathing problems in one area, the children with intestinal viruses in another. Alex could see the ambulances lined up in the parking lot, paramedics and orderlies waving their hands at each other in the pools of light on the asphalt. An intern dragged two more portable oxygen canisters into the waiting room, fastened the plastic masks on two more patients slumped in the chairs.
A man with a press card and a camera came in the door, and an orderly grabbed his shoulder and pushed him outside again. Someone turned up with his hand wrapped in a blood-soaked strip of canvas and was sent to the corner of the room, one of the lowest priorities, a trail of blood running slowly down his arm, a smear drying on his face; then the paramedics ran in with another stretcher, a body strapped down in restraints, foam curdling at the edges of the mouth. Solvents probably. Glue, or plastic bags of gas. The nurse at the door was handing around a bottle of antibacterial alcohol gel now, demanding that everyone wipe their hands as they entered. The man with the camera got inside again and was again expelled.
Alex wondered what was happening in the city outside the doors, as chaos arrived at the lobby in tiny pieces. He was very tired, and drained of almost every possible emotion, and his mind was wandering in half-connected ways, probably about as valuable as the insights you had when you were stoned. Wondering if it was possible to distinguish, really, between illness and fear, immune systems equally mobilized now against germs and dreams. Susie blew on her coffee, the fluorescent lights reflecting on its surface. Her eyes were redrimmed and damp.
‘Are you okay?’ whispered Alex.
‘Don’t talk to me,’ she said.
He stared at the TV hanging from a corner of the ceiling and tried to take an interest in a replay of a hockey game. Conscious in a crystalline way of how much knowledge they shared, and how far it estranged them. A hundred dead things stood between them, and not one of them a clear death that could be mourned.
‘Alex?’
His eyes snapped open and he jerked in a quick startle reflex when a hand touched his arm; he thought at first it must be Susie, then saw an intern he recognized standing beside him.
‘Are you on call tonight?’
Susie was sitting on the floor, her head lowered, her hair veiling her face.
‘No, I’m… Look, I’m in my winter coat, do I look on call? I’m here with a friend. Is there… ’
‘Oh geez.’ The intern, Sam, that was his name, frowned nervously. ‘Could you do us a favour, man? We’ve got an assault over there, and… ’
Assault. He rubbed his eyes. Sam was still talking.
‘… some kind of glass bottle, and they said he was talking about an anthrax letter, but the thing is he’s all cut up… ’
‘No. No.’ Alex pulled his coat around himself, though he was sweating from the heat, his shirt wet under the arms and along his back. Thinking of flesh and broken glass, the metal tang of blood, shards in the muscle. ‘No, I can’t do it. You’ll have to page Laura.’
‘Please, man? The police want this on record as quickly as – and we’ve got this reporter hanging around who… ’
‘Go,’ said Susie from the floor. ‘Just go, Alex.’
His chest was half collapsing on itself, his eyes filmy. ‘Sam, call somebody else,’ he said, as if he hadn’t heard her. ‘I can’t do it. I’m sorry, but I can’t.’
‘I told you to go,’ said Susie. But then a nurse was kneeling down beside her, touching her shoulder and telling her she could come up to intensive care now. Susie rose, and began to walk, and then the nurse turned around again.
‘Wait. Are you the person who arrived with her?’
Alex nodded, Sam still gesturing to him.
‘You’ll need to come with us as well. The doctor needs to talk to you about infection.’
They rose up in the elevator to a different world, insulated from the crowds below them, and walked down a long low corridor, the sound of their boots hollow in the sudden quiet, into the waiting room. Armchairs and couches upholstered in dark blue fabric, pink and white prints of flowers on the walls. Someone was lying on a couch wrapped in a grey blanket, other people eating takeout sandwiches from plastic plates. The nurse left them standing in the centre of the room, assuring them the doctor would be there soon.
Alex went to a vending machine in the hallway and bought two more cups of coffee, and when he came back he saw that a resident, a tired young woman with unwashed hair, was sitting in one of the soft chairs beside Susie. He started to walk to another corner of the room, but the doctor
beckoned him over, and spoke to them about vectors of transmission, how the bacteria rode on the fluids of the mouth and the nose. How, where, people touched each other.
Alex told her about the damp handshake, about wiping Derek’s mouth when he found him in the tent, and the doctor nodded.
‘I don’t think you’re high risk at all, but I’m going to prescribe you a course of Rifampin as a precaution. And…’ she glanced at her file ‘… and Ms Rae? Would you have had any very close type of contact?’
Alex looked at Susie, who was biting down again on her index finger.
‘You shared a bottle of water,’ he said.
‘Yes,’ said Susie. ‘Yes, that’s right.’
‘Last week.’
‘Yes.’
‘Okay, that’ll be Rifampin for you as well. We won’t have a definite diagnosis until we get the bacterial cultures, but it’s presenting pretty clearly, and we’re aware of other recent cases, so it’s best to start the prophylaxis right away. Can you tell me – I understand his lifestyle was a bit unusual – but do you know if there’s anyone else who could be at risk?’
Susie shrugged. ‘The street nurses visited him. I doubt he would have let them get very close, but I can give you the number for the group.’
‘I’d appreciate that. Public Health will need this kind of information.’ She looked at her file again. ‘Now, again, this is really something that Public Health will take up, but the particular outbreak we’re experiencing right now seems to have started with a young sex worker. Would your brother,’ she glanced down again, ‘would Derek, to your knowledge, have any reason to be in contact with… that type of activity?’
Susie put her head down on her knees. ‘Low end of the street trade?’ she said, her voice muffled. ‘Probably an addict?’
Girls Fall Down Page 24
