Black Flies

by Shannon Burke

“I thought you hated the job.”

  “I do,” he said. “But I hate everything else more.”

  That made me laugh.

  “If you get reinstated and sent to another station I’ll transfer to be your partner,” I said, and he smiled faintly, and waved his hand, but I could see he was pleased.

  “Who they got you with now?”

  “Verdis.”

  “Ah ...Verdis,” he said wanly. “He’s a good medic.”

  “He’s fucking slow,” I said.

  “Comin’ from you, that’s sayin’ something.” Then, “Do they talk about me?”

  “All the time.”

  “I’m sure they say I deserve what happened.”

  “They say you were a great medic. And that they fucked you for one mistake.”

  “Do they really say that?”

  “It’s exactly what they say.”

  And it was true. They did say that. No one was going to blame him at the station. Everywhere else he’d be blamed, but not at the station.

  He nodded and smiled. There was a streak of vanity in him. He pretended he didn’t care, but he liked that people talked about him, that they thought he was the best medic in the city. He wanted his contribution to be acknowledged.

  “What’d they do to you?” he asked.

  “They just put me with Verdis. And the chief talked to me.”

  “Oh, fuck the chief,” he said. “What’d he say?”

  “He said I was unobservant.”

  Rutkovsky laughed.

  “Look who’s talking. When the chief was a street medic he was worse than Verdis. He tried to do everything by the book and freaked out on real jobs. Now he’s spending his life trying to figure out why he failed. All that psychology bullshit. It’s cause he couldn’t do it himself. He roots for us to burn out.”

  “Really?” I said.

  “Oh, yeah. Definitely. Fuck the chief. Fuck all of them. They don’t know what it’s like. They start wringing their hands when someone makes a ... a ...”

  He didn’t finish.

  “It was fucked up,” I said.

  “Totally fucked up.”

  “Anyone can understand a mistake like that,” I said.

  Rutkovsky didn’t say anything. I thought of trying to get him to talk about it and seeing if he would call it a mistake, of asking about that weird moment when I’d been in the room and he said, Treat your patient. And it seemed like Rutkovsky wanted to talk about it, too. But there was some resistance in him. Like he felt it was a weakness to talk about it. Or like he was ashamed to have me see him like that in his squalid apartment and he couldn’t quite have the discussion there. Both of us inched around the subject, and moment by moment he ran hot and cold—he wanted me there, he didn’t want me there, he wanted me to talk about the baby, he didn’t want to talk about it. I felt like it was up to me to break the silence, but there was that new awkwardness between us. I was a working medic and he wasn’t—neither of us knew how to deal with that.

  After twenty minutes I got up and told him I’d come again. I said to call me if he needed anything. I said we should hang out, though I knew he’d never call unless he got reinstated or was hired somewhere else. Rutkovsky was not someone who wanted to be around other people when he was in trouble. He hated pity.

  After I said good-bye and had walked outside I looked up at his apartment and saw him in the window looking down at me. When he realized I saw him he stepped away. A moment later the curtains jerked shut.

  “The entire landscape of your life will become the rundown neighborhoods, the neglected, the homeless, the insane, the drug addicted, the sick, the dying, and the dead ... You’ll be a witness to all of the fucked-up shit that’s hidden from most of society. You’ll be a part of it. And there will come a time where out of frustration, out of despair, out of anger, you’ll want to give in to the misery and ugliness. I can’t teach you how to act at that moment of temptation, and I can’t teach you how to deal with the fallout, either. Because it’s not a question of medical training. It’s a question of strength. And of good versus evil.”

  A few days later and we were called to one of those old apartments in Central Harlem. Dust, ancient wooden furniture, glass knickknacks, and framed pictures of Martin Luther King, Malcolm X, and John Kennedy. The patient was a sixty-five-year-old obese widow with five hospital visits in the last six weeks; her list of medications took up a full sheet of loose leaf paper. Two units were sent on the job and Verdis, Marmol, LaFontaine, and I stood in her living room as she warbled out, “Arthritis. Bursitis. Conjunctivitis. I got all kinds of aches and pains. I got acid peptic reflux. Did I mention that?”

  “Nah, that’s a new one,” Marmol said.

  “I talked to my neighbor. She got something called diverticulitis. Maybe I got that, too. I think I must.”

  Marmol jumped up, and said, “Whyn’t you tell me what you don’t got wrong with you? I mean, damn, lady, this is an emergency service.”

  Marmol walked out. LaFontaine held laughter, but stayed. Verdis ignored them, sitting on the couch, saying, “What else? What other complaints?” He took down everything the woman said, treating her varied complaints seriously, asked all the required questions, then moved on to the physical exam—does it hurt here, does it hurt there—taking vital signs, putting the cardiac monitor on, doing a twelve lead. I’d been working with Verdis a month. I knew he did that with every patient

  “Every fucking time,” LaFontaine whispered to me. “This is what you have to look forward to, Cross. With every patient, no matter how ridiculous, you’ll be doing the whole fucking physical exam. Annoying.” Then, to Verdis. “Enough with the questions, Verdis. Nothing wrong with her.”

  “I’m doing my physical exam,” Verdis said. “What are you doing?”

  LaFontaine caught my eye and smiled and I smiled, too. Verdis, was genuinely a nice guy and it was a great physical exam, but it took fifteen minutes, and there was nothing wrong with the patient. In the first month on the job I would have said that doing the whole exam was excellent patient care. Now I wasn’t so sure. I wasn’t even sure Verdis really believed it was the right thing. I knew Verdis had bad knees and I was suspicious that he was purposefully wasting time.

  It was a perfect October day: clouds with flat bottoms, alternating light and dark, a crispness in the air. I got dressed quickly and went outside and stood on 28th Street among the idling trucks and the wire-bound bundles of cut flowers. I suddenly felt clear and focused and a little sad, like I always did on days like that in the fall. I walked out of the apartment and started up 6th Avenue. I went past Bryant Square and the towering buildings of midtown and into the sudden quiet and space and green of Central Park, the trees heaving and roiling at the top. I walked up through the mall with the first fallen leaves blown against the edge of the grass. I went around the little pond and then east toward 5th Avenue and as I passed out of the park I realized I was going to see Clara. I hadn’t talked to her since the summer. It’s not like I thought anything would happen between us, but I needed someone to talk to and beside Rutkovsky, she was my only real friend in the city. I knew exactly where she’d be at that hour—in her special cubicle in the medical library. She was there every day.

  I hurried across Lexington and Park Avenue and on toward York, but as I got near the medical library on 67th Street I slowed and started thinking about how crazy it would seem, me showing up at the library like that, after all those months, forcing her to hear some story about a cyanotic baby. It would be humiliating and I was sure she’d blame me. I walked into the lobby of the medical building. I stood along the wall, the whoosh of revolving doors and the clack of heels on tiles and the sounds of overlapping conversations. People in suits walking back and forth, some of them with stethoscopes around their necks—high-paid doctors, the best doctors in the world. I stood there in my ratty sneakers, feeling like an idiot and a loser, some disgraced paramedic who couldn’t even get an acceptable score on the MCATs. After a mi
nute I turned back and as I went out I passed Clara’s roommate. We knew each other. She was on the other side of the glass, coming in. I dropped my head and went on through the door, hoping she didn’t see me, but she must have, because that night I had a message from Clara. “Well, maybe you’ll actually make it in to see me next time,” she said on the machine.Then, sarcastically, “Call me, if you dare.” I did call her. I left a message. She called back a day later. It wasn’t any big deal. We said we’d meet in a coffee shop later that week.

  One Hundred and Nineteenth Street and Lexington, and LaFontaine,Verdis, and I were running down the block with trauma bags on our shoulders, radios held high. Reports of four or five people shot. Reports of shootings on 120th, 119th, 118th, reports of sprayed bullets from automatic weapons. We were jogging along, peering into cars, looking into doorways, crossing the street at an angle, trying to get through on the radio, to get a better location of the patients. Distant screams from several directions. LaFontaine motioned for Verdis and me to go down 119th Street and he continued south on Lexington. Verdis and I ran up to a crowd in front of the Roberto Clemente Projects, saying, “Where’s the patient? Where’s the patient?”

  An old guy with a gray mustache motioned to a kid lying on the pavement.

  “I don’t know about any others. There’s one,” he said.

  It was a kid with a backpack. Early teens. Someone had put his pack beneath his head. He was lying on his back, very still, eyes open.

  “What’s wrong with you?”

  “I’m shot,” the kid said.

  I looked him up and down.

  “Where?”

  He pointed to his foot. There was a hole in the top of his right sneaker. A little blood on the laces.

  “That’s it? The foot?”

  “Yeah,” he said in a weak voice.

  “Ah, you’re fine,” I said, and started away, looking for other patients, but Verdis knelt to the kid. “You all right?” Verdis asked. “Are you scared?”

  The kid looked up, wide-eyed.

  “Yeah,” the kid said in a faint voice. “Will I die?”

  “You’ll be fine. It’s just your foot. You’ll get a cast. No big deal.”

  The kid relaxed a little.

  “How old are you?”

  “Thirteen,” the kid said.

  “Do you live here?”Verdis asked.

  The kid nodded.

  “Do you want someone to get your ma?”

  “Yeah.”

  “Hey. You.” Verdis pointed at another kid. “You know his mother? Get his ma.”

  I realized I’d been walking away from a shot thirteen-year-old kid. I stepped back to help Verdis. I knelt to the kid, too, but just then LaFontaine ran up, out of breath.

  “What’s wrong with him?”

  “Shot in the foot.”

  “The foot! The foot! I have three critical patients! Listen to your fuckin’ radio! Let’s go.” Verdis looked up from the kid. LaFontaine screamed, “Three critical patients! Leave the hand-holding to the techs!” Verdis began to stand, but the kid grabbed Verdis’s sleeve. He didn’t want Verdis to leave him. I stood. LaFontaine jerked Verdis upright. Verdis and LaFontaine glowered at each other—a strange moment—and it was LaFontaine who turned away first. I went with LaFontaine. We ran back to Lexington, where there were three shot patients. Verdis was coming, but reluctantly, and only after a moment.Verdis arrived at his patient a minute after we got to ours. It was probably just a coincidence, but LaFontaine’s patient lived. My patient lived, too.Verdis’s patient died.

  “Shot in the foot! Shot in the fucking foot!” LaFontaine screamed half an hour later, strutting back and forth in front of the ER. “I said it before. He’d rather have these people think he’s some hero than actually help them. They don’t let surgeons operate on people they know. Know why? To keep professional distance. That’s why people like you and me make the best medics in a place like Harlem. Out on the island, our neighbors, they have jobs, they vote, pay taxes. These people here, they’re all skels. Leech off the state. And when someone tries to help them they open their mouths and start yelling instead of saying thank you. I hope they all die. I hope they all get shot in the fucking livers and die miserable deaths. But if they’re hurt, if they’re my patient, I’m gonna treat em better than Verdis. Know why? Cause I have pride. Cause I do my job. And cause I don’t get involved emotionally. A guy like Verdis’d be a good social worker. A good nurse. But he’s not a good medic. The way I see it, to keep objectivity and professional distance, it’s best for a paramedic to hate his patients.”

  I’d heard the baby was alive. I’d heard the baby was doing well, but I only half believed it. The thing had been so small and so frail and so blue. I thought it had to be dead or so damaged it might as well be dead. I’d stayed away for weeks. But then, on the day we had the kid shot in the foot, I walked up to the NICU and there he was—in an incubator, about the size of a shoe, but pink and healthy and moving a little. I stood there looking at him for a long time. A nurse sat nearby on a stool going over a chart.

  “Will it live?” I asked.

  “Why shouldn’t he live? He has up till now.”

  I stood there, just staring. Tiny pink baby with needles and tubes going into his head and in the veins on the top of his feet, not moving very much, though you could see his little chest ballooning with each breath. For days afterward that image ran through my head—frail chest, squinched pink skin at his eyes, and the two little purple hands that clenched and then relaxed, clenched and then relaxed—tiny baby behind glass.

  Three in the afternoon, at the Caffe Reggio, and Clara and I sat across from each other. She’d just spent a week in Vermont with Julian and her face was tan and healthy looking and she was happy and confident and a little cold and matter-of-fact, like she always was. I could feel that distance in her. Her life had moved on. But there was also genuine interest and concern. She wanted to show she was on her own, that she wasn’t ashamed or guilty about what had happened, but that she was worried about me and was really rooting for me and wanted me to do well. I knew I must have looked like shit to her. I had circles under my eyes. I’d lost about fifteen pounds. It had been six months since we’d been together, but it seemed like about four years, and it was so obvious that we didn’t belong together, to both of us, that there was that gentleness and wan camaraderie that comes with distance. It made it easy to tell her what had happened with Rutkovsky, how he’d been fired, and how I’d switched partners and was working with Verdis. I didn’t really tell her about that baby job, or I told her what Rutkovsky had done, but said I was in another room. Still, I think she understood.

  “I can see what’s happened,” she said quietly. “You don’t fit in up there. You strained to be one of them. And it’s wound you up inside. It’s conflicted with your natural temperament. I know, when we were together, you were getting all riled up, talking loudly, mistaking callousness for strength.”

  “I wasn’t mistaking callousness for anything. What you thought of as callousness was only an attitude. A manner. An external way of acting. It’s what happens naturally if you work in an environment like we do.”

  “Now you’re mad,” she said.

  “I’m not mad, Clara. But I’m working my ass off. I’m becoming a good medic. And part of being a good medic is having a certain attitude. Of getting people to listen to you and obey in a moment. You can’t waste time being polite.”

  “I’m not denying that.”

  “Then why’re you gonna criticize it?”

  “I’m not criticizing. I’m just saying, that the new manner brought other changes that ... aren’t helpful, particularly for you. And I think you took it all on recklessly. You just accepted everything without thinking about it. And that was a mistake. It’s good to be cautious at the beginning.”

  “The beginning of what?”

  “At the beginning of any new thing you can get on the wrong track. It’s important to start out in the right aw
ay To be careful.” She paused. She held her coffee in two hands. “Like the way I started out with Julian. I was still seeing you. I started seeing him at the same time. That was wrong. That’s not the way I am or the way I want to be. I’ve had to work to try to make up for it. I think the same thing might have happened to you.”

  I was quiet, listening.

  “I think you’re not a natural paramedic. It’s about the least likely job for you. It’s made you act in a way that doesn’t come easily to you. And it’s hurt you in ways that I don’t think you understand. If you go too far from your natural manner it can be damaging. Like a runner who pushes himself too hard can burn his muscles and make himself weaker.”

  “Well, you’re telling me to be like Mother Teresa. On the ambulance they’re always telling me that I’m too much that way, that I’m not a social worker.”

  “Well, that’s what I’m talking about, Ollie. You want to help people. That’s your good quality. That’s what I always liked about you. That’s why you wanted to be a doctor in the first place. You were always like Mr. Dogooder in college. But ... I can hear it in your voice. Your good qualities aren’t being used. They’re getting beaten down.”

  I hesitated. For a second I almost told her about the baby job, about that moment when I looked at the baby beneath the towel. But the time for spilling my guts to Clara had passed, and with a sort of brusque, offhand swagger, I said, “Well, if I lose those good qualities, maybe other qualities will take their place.”

  “If it doesn’t tear you apart completely,” she said.

  Ten minutes later we said good-bye. I did not talk to her again.

  “Wait on the stoop,” Rutkovsky said through the door.

  It was a few days after I’d talked to Clara, early November, a gray, cloudy, brisk day, forty degrees. I went back down the long dim stairway of Rutkovsky’s building and waited out on the stoop. I’d gone by NYU Hospital and gotten an application for the EMS division. I wanted to give it to Rutkovsky, to show him I meant well. I felt it in my back pocket. I waited. After ten minutes he came down, looking much less impressive in civilian clothes, almost like what we would have called a skel. He was in jeans, a sweatshirt, hair a mess, a sullen manner. We walked toward St. Nicholas Park side by side, Rutkovsky hobbling tentatively, like someone who’d been in bed a long time.