And this woman under his hands asks him, outright, in so many words. She threatens, as if his answer will tip some electoral balance. A yes might persuade a fraction of forsaken global plebiscite that paths besides abdication are still available to them this evening. She wants to hear that they are booked for the comprehensive journey, if only in steerage. Does Eligible Bachelor Number One, in efficiency number 1275, in this honeycomb of tasteless prestressed concrete on the sovereign, sunnyside corner of Mission and Delivery drives, D-5 on page 77 of the fabulous cartographic compendium of this entertainment capital of the world’s largest self-undermining semifree-trade zone, on the cutting, jagged edge of all that is left of what liberal democracy must yet become in this emblematic, exemplary, guiding high beam of a high-ground nation, all but amok now that it has outlived its onetime prime motive and moral force, its colonizing adage,
Use it up
Wear it out
Make it do
Or do without,
does he, this lone fifth-year surgical resident (having exiled himself to his field only on the belief that cutting and pasting was the one profession that might keep him from backsliding into the existential aloneness his horn in F no longer protected him from), does he like this undulating orchid that he has plucked and pinned corsage-style to his designer gold shirt for the nonce, for the old beloved one-night time being? Do you recognize? Know me? See me? Approve?
He cannot answer her and escape with his life. Cannot say that it chills him already when she smiles, when she turns her head in a certain arc, when she kisses him like a deranged adolescent, when she laughs like an arrested preteen at the self-same movie kisses, when she attacks professional problems with the earnestness of one who still believes in healing’s ability to at least break even. He dares not say how she promises to salve his inevitable next bloodying, to brush away like cobwebs the scrub-suited gang of thugs that wait for him, trimming their nails nonchalantly with number seven recurve blades at the end of the alley. Just to look at the promise in her features chills his gut as solid as the old tennis ball dunked in liquid nitrogen.
He looks up at her from the floor where she holds him pinned. So clean, naïve, those fantastic arching eyebrows, her expanse of cheek built up from subcutaneous muscled fats as flexible and unassigned as empty last-century maps of the poles. She is one of the lights, the breeze-borne weightless people capable of taking pleasure directly from the air. He at last manages to get out: “I love your face.”
She tenses, her fists clenching against compromised parts of his body that she could do genuine damage to if forced. “My face? What’s the matter with my face?”
The theater-hopping, roller-skate-voiced kid from the first date vanishes. All trace of that supercompetent child-rehabilitator steeped in her rounds, the pro he first asked out, is gone. A piccolo trill of authentic fear struts front and center in her voice, above the hundred-piece marching band. Nothing the matter, he wants to say. I love your face. There is something in it I can’t quite place.
But he can say nothing out loud. She twists her neck nervously around, like an icy Hitchcock blonde looking about for the blunt instrument. Only, her hair is coal-blue, her skin tinted iodine for purposes of international intrigue. Then she pounces, using on him the same trick she used to seduce the boy with a crater where his nose should have been. She begins tickling him, the same frontal attack of hands that will forever make her the No-Face’s first and only love.
Kraft, like the boy Chuck, is wildly, sickeningly ticklish. He buckles, tries to throw her off, but she uses some kind of Eastern center-of-balance thing to keep him under. He is twice as big as her, and in the throes of torture. The woman knows exactly what she is after. He screams for mercy, but she just skritches him on the floating rib, his truly sensitive spot, grinning, “Go ahead. Yell your baby-brown eyes out. Who’s going to answer? Screams from a single man’s apartment, in this neighborhood? Not even the police’d be stupid enough to mess with that.”
She levers down his wrist with her knee, grazes his flank with long strands of hair until he starts to hyperventilate. Slowly, agonizingly, she voices over, “I don’t know why I’m letting myself get involved here. I hate doctors. I swore to myself to make it a rule never . . . You’re all deranged. You’re probably a real sicko, aren’t you?”
Her face to his exposed nipple, just dribbling little spurts of air across his horrendously sensitized flesh. She has him flailing, laughing in agony, his eyes like Zeeland after the dikes were bombed. “Oh, you poor sick little baby. You little crippled baby child. Does it hurt? Come on. Give in. Occupational rehab. You need it bad. Trust me. I can help you.”
The quick flurry of feints and ambushes slowly flutters home to the prime roost. Her infant flank attacks gradually mature, mutate into effleurage, tapotement. Yes, here, her fingers say. We know. Act it out. Do your worst. No one can hurt anyone else. A little physical therapy is all. Just what the psychiatrist ordered.
You must believe, first, in the leaping cure. In this more than anything, even though the children’s ward is its living denial.
Espera believed already while still a schooler, long before experience dulled the bloom of rehabilitation theory. Two years into her first job at a place where gleaming machine panaceas are less than laughable fictions, her faith in the method is accredited. The treatment of choice here consists of a little light exercise and a few read-alouds. Pragmatics allows no other therapy. All she can do is rally the routed field trip by returning it to memory’s locales, the place it might even now call home.
She cannot hope for state-of-the-art here at this public spa, given the art of the heavily indebted State. Procedures that clinics just over the freeway consider barest livable minimum are denied her. Funds for physical medicine—vague promissory notes dangled in front of her team from quarter to fiscal quarter—fail to meet even need. In place of Hubbard tanks, they get hot showers. Their muscle-zapping machines look and sound like bug lights. Even her exercycles and wobbly massage tables were picked up on the cheap from a supplier indicted in an elaborate scam involving large-scale plundering of Salvation Army drop boxes.
Lacking the requisite physiatric high tech, she must resort to restorative tricks. Each of her jerry-built cures is tailored as far as possible to the specific destruction set before her. In this, the indigence of her clients actually assists. Where the cash transaction is the exception, ordinary accounting is, if not waived, sufficiently relaxed to permit experiment.
Carver is one of those places used to launch careers or generate articles that land real, paying jobs. She does her flood control under ranking Pediatrics administrators, M.D.’s who see no children anymore, not even their own. Linda alone of them would put down permanently in health’s Hooverville. In her heart, she already exercises her option to buy. More counselor than physician, she masters the tissue repair and recoordination, the schedules of heat and exercise behind all makeshift disaster relief. But these she supplements with pure play, coaxing out recovery on tempts and teases. She sails through this shoestring outfit conducting sing-alongs, assigning mock punishments, doling out treasures, improvising her own recuperative scripts. Open stage—every night, amateur night.
How many ways can a child go wrong? Leave aside the chromosomal, skeletal, and congenital disorders. Forget the untreatables, the ones even she could never repair. Count only those acute enough to force institutional treatment. Forget the nightmares of the preemie nurses, the inexplicable arrests, the sudden circulatory collapses late on winter nights. Pinpoint the preadolescent, her specialty, if she is allowed the luxury of having such a thing.
Begin with the classic infectious checklist—the potentially fatal poxes that her college texts elitely insisted were eradicated in industrialized countries. Add in the respiratory infections, the bouquet of asthmas, cystic fibrosis, miliary TB. Endo, myo, pericarditis. All known blood disorders, book length in themselves. Lymphoblastic leukemia, that spring lodger come to spread its put
refying possessions into each limb of the playhouse tree. GI failures, renal annihilation, precocious or arrested endocrine systems, convulsive disorders. Palsy and a legion of other lesions and tumors, meningitis, diabetes—a list of lethal birthday party invitees that would cripple the coolest clinician to think twice about.
Espera has studied enough Latin nomenclature to tear the short-answer soul out of any semester’s final exam. Daily practice leaves her in sufficient command of Stedman’s to return surgeonspeak in spades. And yet she swears still by an artesian aqua vitae free of all pharmaceutical sediment. She has watched the watery placebo work with her own eyes, even in the death dormers of this sick building. She has softened the root tumor—that secret thing all childhood illnesses share in common, whatever their differential diagnoses—with leaping treatment. Has seen hope open like any iris to the light.
Figure in the assaults by things that as yet have no medical name. No matter; every injury is of a piece. The precise etiology of reality’s strike is almost irrelevant. All impairment flows from a shared subterranean source. Her pedes are broken by a first disease long before they are hit by the particular trauma that dispatches the ambulance. Malnutrition, psychodisorientation, pellagras, anemias, dementias, the regional varieties of abuse distinctive to city hospitals: all leave traces, a common pallor that shellacs her every child’s skin.
That culprit, the Ur-wrong, underwrites even accident, the leading destroyer of under-eighteens. It lies beneath the hungry ingestions of household poisons, the handgun mistakes, the training wheels spinning their mangled aluminum sidewalls in the air after a hit-and-run. Even burns are at best secondary: she’s read the study showing that half of all arsonists are children looking for love.
Among her floor and outpatients this week, she has Chuck, the child born without a face; Jorge and Roberto, twin preteen overdosers; the girl Joy, darkness creeping up her ankle; the brutally ectomized Davie Diaz and Suzi Banks; a new boy, Nicolino, wasting away freakishly; Ben, the double amputee. She has only a single treatment to bring them all back. And she will return them, as far as they are willing to run. She can do nothing for the parts irreparably lost. But she has something to leave in the dark reaches, the space in each one where the earliest, inviolable fable of self still stands intact, ready to respond to a little food, workout, heat, and play. She can plant a start in that place waiting to be proven wrong, a plot that will still heal at the first touch of fresh, outrageously naïve narrative.
She possessed the germ well before the six years she spent up north, studying by the bay. It was built into her posture already as an undergrad, that era of cotton and arm down when she lived in a state of permanent expectation engineered by temperate breezes. Her personal knowledge turned heads from across the medical quad. It lent her a come-on, broad-based cheerleader appeal without any of the attendant, affected sorority girl contempt. She knew, just by living, how to thrive in the health profession, without once having to book for a single hourly in the subject. She was born knowing it, the single greatest advance in contemporary medicine, the one that at last set organized care on its unfolding path: the discovery that healing only begins with treating the wound.
This was the breakthrough forced on an industrialized world by the arrival on the doorstep of a permanent surplus of maimed child veterans who, for the first time, survived their treatments in numbers beyond ignoring. She gleaned it by second nature, even while her professors mouthed the formula from their operating theaters. The kindergartner who shoots screamingly awake from an anesthetic dream to find a huge, paste-oozing, suture-stubbled, crimson gashwork down the length of her abdomen tends to resort to her original conviction, buried under ancient keloid scar tissue: I knew it. You tried to kill me. You cut into me with knives. Fail the patient here, fail to talk that scream into remission, and all the mediating incisions, however beneficial, will remain forever open, pussing subcutaneously until final discharge, the hour of the child’s second street death.
How best, then, to reassemble what the king’s combined cavalry and foot labored over impotently, powerless to transact? (She wonders, mouth twisted in healthy skepticism as she reads that rhyme out loud, what, pray tell, horses were supposed to contribute to restoration.) If musculature alone were at stake—relearning how to swing a bat or kick a sprocket—a few simple professional references would address everyone. Even the subtle ruddering of a pencil—that immensely complex navigation across empty expanses of paper—can be brought back from nowhere, relearned in committee.
Warmth, water, a little oscillating current, passive tensor-flexion aid, and a sprinkling of weights can work wonders. As much as you can, as steadily as you can. You learned it all from scratch once; you can repeat the process, from crawl on up, with whatever parts fortune has left you. That much is simple routine. Rigorous, brutal, overwhelming at times, but straightforward. A little technical know-how, some trivial persistence, and that would be the extent of the job description.
Still-forming bodies can heal, sometimes faster than she can prompt them with suggestion. Baby bones refute excision. Unripe brains reshape to compensate for lost capacity, almost as if youth still remembered the starfish and lizard trick of regenerating lost parts. Near-full functionality returns almost as quickly as it was struck down. Espera’s infallible algorithms even return words to the mute. She has taught pseudolaryngeal speech to a roomful of croakers barely out of tadpole stage. Suck in a gulp of air, swallow it like food. Belch it up from your esophagus, shape it with gullet and nose and tongue to produce real names. Ready now: in unison. She’s had them singing, industriously belching out “Up a Lazy River.” And she would have yanked them kicking and buzzing through “Flight of the Bumblebee” had they not used up their available esophageal supply on gales of laughter.
Walking, swinging, singing, eating, bending, grasping, blinking, breathing, peeing, flipping, sitting, seeing, shouting—all the procedures of earliest urgency can be taken out for a reconstructive spin. They can be approximated by brute, repetitive, accumulating rote no different than the afternoon hours upstairs with a music stand, wood-shedding on the clarinet, the clarinet, goes doodle-doodle-doodle-doodle-det. But her job is to carry off that old joke: to get them playing the instrument again, even when they’d never played before.
There is a catch. All destructions dip layers deep. Knives sever through much more than muscle, than mere mechanics. Every child who shuffles up her office ramp is a shattered hierarchy. Whole systems have been shaken loose, one from the other. The skeleton may move impeccably after a year or three. The circulation routes generously reopen, but the larger links are lost. The simplest gesture, the pressure of an overhand curl contracting the hand into a wave goodbye, no longer means what it used to. Will becomes detached, as cleanly as retinas in a playground brawl.
The leaning, eager hesitance of ducking through a jump rope only begins in the feet. The legs are just the first fuse. Once quadriceps do their buckle and flex, a spark must spread outward, catch fire. The real rope skip is desire. Motive must magellan its way across the cerebral map until the whole quorum organism grows ready to hurl itself through the rotating whips. Try to teach timing, the delicate diplomacies of depth perception and projection. Instruct in wish, give daily classes in confidence retrieval. Try to instill want, the belief that shooting through the twirling ropes has some primal significance. Convince them that the brandished, braided lasso cycloiding its playground arcs, wobbling like the precessing equator above a navigator’s head, is not glass infested, will not slice like the collector’s scythe. Ah! To teach that, one needs an advanced degree.
What’s more, the skipping per se is trivial. The tribal jingles that go with it are the tricky part.
Who are these children that the surgeons palm off on her to recondition? Here, in the sunny Southern Caliphate, they make up a smorgasbord of least-favored nations. There’s not a single schoolbook innocent among them. She’s had little girls who needed propping up in bed, glaze-eyed a
nd indifferent to everything but broadcast. She has treated the spreading allergies of the underclass, those puffed black bruises that can be only one thing. She converses with furious patterers who growl in hyped-up rhythmic pidgins she cannot understand.
Her clients belie every story she would read to them: wasted torsos inscribed by gang insignia. Scurvied spines that slump appalled by their first balanced dinner. Ten-year-olds who food-process their eyes with homemade weapons. Who put their faces through the windshields of cars they were stealing. Who, by junior high, replay in miniature their parents’ lifetime criminal loops—expulsion, record, parole, repeat offense. Who spit into drinking glasses and clean their teeth with salted index fingers or the corners of scummy undershirts.
Yet she knows them all by name and history, almost before making their manila acquaintance. She can recognize each half-compatriota from her own sixth-grade studio photographer’s composite photo of a suburban school grotesque in its Wisconsin, fairy tale privilege. The might-have-been lives not yet extinguished in their faces seem to her the bewildered remakes of safeguarded Julie Axelrods and John Lartzes, prophase faces frozen for little Linda Espera at the age when she last saw them. She knows: every one of these visaless deportees would kill for the chance to regress to afternoons of benevolent chutes and ladders if they could.
Operation Wandering Soul Page 9
