CHAPTER 3
Why, of all things, had I become a nurse?
Because one night, I went to a party.
I was 24 or 25 at the time, and this party didn’t really stand out from any of the other parties I had gone to. The host, a guy named Rahav, was in a band that did Thursday nights at CBGB, but the Ramones hadn’t played CBGB in at least a decade, and Rahav, with his greasy man bun, skin-tight black jeans, and safety-pin and pop-tab bling, looked weatherbeaten to say the least.
He wanted to do molly.
Why not? I thought. I did molly.
He wanted to snort a few lines. Why not? I thought. I snorted a few lines. He snorted more.
Then he wanted to have sex.
Why not? I thought.
His bedroom smelled like CK One cologne with a rank undernote of unwashed sheets. We kissed, he played with my breasts. He guided my hand down to his penis. It was soft.
He started pushing my head down, but to me that seemed like a lot of extra work for a very meager payoff—I mean, hey! I wasn’t the one with the problem.
“Not gonna happen tonight, my friend,” I told him. “It’s cool. Some other time.”
He mumbled something through tightly gritted teeth.
“What?” I smiled.
With some effort, he opened his jaw wider. “The circuit must be completed.”
What?
“The circuit must be completed,” he repeated in a louder voice.
“What does that mean?” I asked.
He stared at me through pupils that were so dilated, the brownish irises of his eyes looked like a celluloid rim. He was flexing and unflexing his jaw like a machine with a broken valve. “The circuit must be completed.”
“Know what, sweetie? I gotta use the bathroom,” I told him and ducked out his bedroom door without bothering to gather up my clothes.
Rahav lived in one of those Alphabet City shotgun apartments that have since been torn down to make way for gentrification. It was four o’clock in the morning, but there were still a few party guests sharing joints, forcing laughs, negotiating heated conversations. No one batted an eye at my nakedness. I found the bathroom without any problem, but I was so stoned, I tripped on its threshold, landed splat! on my stomach. Was forced to crawl across the bathroom floor and use the bathroom sink to pull myself up so I could stare at myself in the mirror.
I was a pretty girl. So pretty! A slatternly, more youthful Sophia Lauren.
But wait! What were those faint grooves at the edges of my eyes? That slight indentation in the supple flesh of my cheeks that seemed to want to turn into a line connecting my nostrils with the edges of my pouty, bruised-looking mouth?
The still small voice within can pick some crazy times to speak.
Mine picked that moment.
Girl, said the still small voice, you’re not gonna stay this ornamental forever. You better find yourself a trade!
###
The choices came down to nursing or court reporting.
Nursing paid a whole lot better.
At Hunter College, I’d earned a BA in Economics, a rigorous discipline with some prestige. I was gifted at it, too. I was good at algebra and calculus; calculating the slopes of lines was easy. One night, I got drunk and invented a new mathematical model: the marginal futility function, the rate at which angst can be increased through the consumption of one additional unit of a good or service.
But an undergraduate degree in economics only qualified me to work as a barista or maybe as a seasonal employee at a Spirit Halloween outlet. These were jobs with a future only insofar as working them meant it would take me forever to pay off my student loans. To do anything with it, I’d have to go to graduate school, and I didn’t want to go to graduate school; I’d had it with calculators.
The Saint Mary Egregia School of Nursing took a utilitarian approach. It didn’t offer a degree; it offered a diploma. Like something you’d earn after you’d completed an auto mechanics course.
Our instructors referred to us as “novitiates” and trained us in the arts of venipuncture and codependency. There was virtue in standing silently, head cocked slightly to the left, palms outstretched, while patients had tantrums; it was healing to the patient, and scientific studies had proven that tilting your head and showing your palms—See? No machete!—engendered trust, engagement, and a belief in your subservience to that patient’s needs.
Hospital diploma nursing programs were not very popular. There were only 14 other students in my class, and they were all younger than I was. All eager to toil selflessly, long past change of shift, on behalf of the sickest patients Saint Mary Egregia Hospital could muster up for them.
Not me.
I liked the parts where you drew blood and started IVs and parsed patient symptoms into a working diagnosis—only you had to call it a nursing assessment because only physicians were allowed to make a diagnosis. I liked it when you could administer the treatments that would restore a patient to a comparative state of health. I liked it when the patients went home.
I didn’t like it when you went to a hospital unit and were assigned the same patients day after day. The patients didn’t like it any more than I did, of course, but they didn’t know they were metrics in a profit center where medicine was merely a teaser, whereas I did. I didn’t want to remember their names day after day or remember the names of their family members. I didn’t want to develop a relationship with them, pretend to be their friend, listen to their hopes and fears. I wanted them to recover, and I wanted them to leave.
The Saint Mary Egregia School of Nursing instructors were a trusting lot. After the fourth time I claimed that a funeral was keeping me from fulfilling a clinical rotation assignment, my clinical instructor looked at me with huge, unjudgmental Bambi eyes and said, “Gee! You sure do have a lot of dead grandparents, Grazia.”
The Dean of Students was on to me, though. Just before graduation, she called me into her office.
“I’ve given this a lot of thought,” she said. “You should be an emergency room nurse. That’s the only place where you’ll do any good.”
So, that’s what I became.
###
It was 2020. I’d been working in the Wiltwyck Hospital ER for just over five years when one early evening in late February, the ward clerk shoved a form at me: Bruno Cremonesi.
The next moment, Bruno Cremonesi himself came lurching into my treatment area. He had blue lips.
I didn’t even bother to do vital signs first. “Sit down,” I snapped and slapped a nasal cannula on him. Got snot on my fingers. Scolded myself, You fucking idiot. Walked to the sink and scrubbed my hands as vigorously as though Bruno Cremonesi had just stepped in for a cesarean section that I was about to perform. All the while flashing him a bright, engaging smile.
He didn’t see the smile because he was hunched over on the treatment bed, coughing. A nasal cannula at six liters per minute was not pinking him up.
Most of the time, when you say that a patient has “blue lips,” you mean their lips have a purplish tinge. But, no. Bruno Cremonesi’s lips were violet. A pure, unadulterated hue. A spectral color. A single wavelength.
Cyanosis. Severe cyanosis. I was surprised Bruno Cremonesi could walk. I was surprised he wasn’t dead. I checked to see if the crash cart was where it was supposed to be.
Fifty-two years old, read the form. Complaining of bad cold. Flu?
He was coughing so hard, I fully expected bits of lung to explode from his mouth. I figured they would look like pieces of grey coral only coated with bloody, gooey froth.
Hacking, unproductive cough. Sweating profusely. His nose was running, and he didn’t have tissues, so he was continuously swabbing his nose with his fingers, wiping his fingers on his shirt.
I gloved up and did his vitals. Temp 104°. Heart rate, 148. Even with the cannula, his pulse ox was 88.
“I need a rebreather mask,” I yelled as loudly as I possibly could. With all the noise in the ER, I knew no one could hear me. But I couldn’t leave the room and grab a rebreather mask off the supply cart. I was too afraid he would drop dead.
I tried to do a blood pressure. Bruno Cremonesi shook me off. “I don’t want none of that crap,” he said in a strong Italian accent. “I told that other lady. I just want some cough medicine. I gotta get to work.”
“I don’t think you’ll be going to work today, Mr. Cremonesi. Does your chest hurt?”
“No, my chest don’t hurt. Lady, all I need is cough medicine. I gotta get to the restaurant—”
“Take some deep breaths for me.”
I listened to his lungs with my stethoscope. Decreased breath sounds throughout most of his pulmonary field, but odd crackling sounds at the bases of his lungs as though his alveoli were a packet of Orville Redenbacher’s that had just been shoved in the microwave. Mild pneumonia. Only a mild pneumonia? That was weird.
I chanced poking my head outside the curtains: “Bhaskar? In here, stat.”
Bhaskar was the most compliant of the three interns.
“Could be metabolic,” I told Bhaskar. “We need an ABG. Says his chest doesn’t hurt, but you’ll want to get the bedside ultrasound in here to rule out PH. And look at his lips. I think you’re gonna want to admit him.”
“No beds till morning,” said Bhaskar. “And no place to park him till morning but the hall. Have you seen that waiting room? It’s insane.”
“Admit me?” said Cremonesi. “No. I ain’t staying here. All I wanted was cough medicine—”
He pulled the cannula off his face and pushed himself off the treatment bed. Struggled to stand. I was amazed. I was even more amazed when he staggered without collapsing to the break in the curtains that cordoned off our treatment cubicle. Bhaskar tried to stop him. Cremonesi shoved Bhaskar with his snotty hand and coughed in his face.
“Mr. Cremonesi,” I said. “I don’t think you understand. You’re on the brink of respiratory collapse. Your heart could fail—”
“Fuck you,” said Cremonesi. “All I wanted was some lousy cough medicine.”
I could hear him hacking as he disappeared into the crowded room outside the curtains.
Thirty seconds later, a code blue alarm went off on the opposite side of the ER, and I forgot all about Bruno Cremonesi. For the time being, at least.
The following evening, four staff members of Wiltwyck Hospital’s ER swing shift called in sick, including Bhaskar. The ward clerk checked in on him: He had a weird cold. No, it wasn’t bad bad. But it was super... debilitating.
Bhaskar used up all his sick time.
And he still didn’t feel well enough to come back to work.
###
Usually, whenever news came on the radio during my commute to work, I’d scan through stations until I found music. I didn’t care what kind of music. I’d even listen to country. Anything was better than the news.
But in early March, as news stories began compiling information about some mysterious respiratory disease, I started listening. I even started reading newspapers.
Way back in January, the World Health Organization had declared a global health emergency. It was not a matter of if. It was only a matter of when. The mysterious disease had originated in China. It had come from bats! An entire city—11 million people! Bigger than New York!—was under lockdown. Breaking quarantine was a crime and would be dealt with firmly and quickly—by assignment to the Re-education Camp’s night-soil brigade, I quipped to myself.
Bizarrely, another global hotspot was Italy. Bari, Italy. People were dying, and the hospital morgues had run out of spaces. Corpses were being piled into refrigerator trucks. I ran out of quips.
I thought of Bruno Cremonesi.
Wiltwyck Hospital frowned upon using its computers to access the medical records of past patients without good cause. HIPAA regulations cast a long shadow. Nevertheless, I snuck onto the hospital’s computer system to track down Bruno Cremonesi’s intake papers. I had something that was better than good cause. I had a hunch.
In the space next to the question, Have you traveled recently outside the United States? the ward clerk had scribbled, Barry, Italy. Back 5 days.
###
The CDC had loads of information on its website. It was hard to know how much of that information was relevant, though. It was all so vague, all so contradictory.
The disease had a name: SARS-CoV-2 or severe acute respiratory syndrome—coronavirus. The most famous coronavirus had been SARS (Severe Acute Respiratory Syndrome), which, back in 2016, turned the humble surgical mask into a must-have fashion accessory throughout China. Despite WHO’s dire warnings, though, only a handful of SARS cases had ever erupted in the U.S.
Anyway, there was no evidence of human-to-human transmission associated with what was now being called COVID-19—
Except maybe there was evidence of human-to-human transmission?
Hey! It’s never a bad idea to wash your hands for the entire duration of Row, Row, Row Your Boat and to stand six feet away from other human beings (even when they aren’t coughing).
###
In the ER, we knew for sure what the CDC didn’t. Increasing numbers of patients were coming into our small, backwater emergency department with a weird respiratory malaise. Heart attacks and disquieting abdominal symptoms were still the top scorers, but weird respiratory malaise had the momentum.
No easily accessible tests were available for the detection of the weird respiratory malaise, so, of course, it was impossible to say for sure that every patient who came into the ER with fever, shortness of breath, and that distinctive cough (which sounded rather like the bark of an extremely shy seal) suffered from the same illness. Nor did it hit every patient the same way. Older patients were affected most severely, as one might expect, which corresponded with the CDC’s emerging COVID-19 profile, but then the elderly are generally at the mercy of every emerging pathogenic illness.
When Bhaskar finally came back to work, he described his illness almost as though it had been a near-death experience. “I felt like I was crawling down this tunnel of broken glass. It was in my throat, it was in my lungs. I felt like shit, but even more than that, I was scared. So scared. Like a little child. I wanted my mother. She’s been dead for seven years. I still can’t smell anything or taste anything.”
Other staff members were falling ill, too.
Not me, though. I didn’t get it. I scrubbed my hands till they were raw. Purell-ed every object I touched. Marched into a medical supply store and invested in a box of surgical masks. Surgical masks are ridiculous. Designed to keep spit from contaminating sterile fields when surgeons bellow In-A-Gadda-Da-Vida during an operation. But I figured they were better than nothing.
After I wore the surgical masks three shifts in a row, the ER director called me into his office: “You know, Grazia, you are scaring the patients with these things.”
“You know, Noah, the patients are scaring me without these things,” I said.
He sighed and dropped his eyes. And I heard no more about that. In fact, the next time I ran into Noah, he was wearing a surgical mask, too.
###
Outside the ER, far away from computers that could summon up CDC websites and newspaper headlines like “NBA Season Canceled Indefinitely” or “Trump Bans Travel From Europe,” you could still pretend the world was normal. Spring had started. The snow had disappeared except for those grime-encrusted mounds in the corners of supermarket parking lots. Trees were still bare, but when you looked at them out of the corner of your eyes, you could catch the spectral reddish blur that signaled the imminence of leaves. Crocuses were pushing their first green shoots out of still-frozen ground. Could daffodils be far behind?
One evening after work, Neal and I arranged to meet at a Jamaican restaurant in downtown Kingston we both liked. Afterward, we would hike over to the Old Dutch Church.
The Old Dutch Church wasn’t really all that old. The congregation dated back to 1659, but the current building only dated back to 1852. Designed by Calvin Vaux, the church had priceless Tiffany stained glass windows and a genuine Møller pipe-organ. But it wasn’t the church that interested me; it was the graveyard. I had recently developed quite the thing for graveyards.
For once, Neal was early. “Hardly any traffic at all!” he marveled. “So what do you think of the Chinese bat plague?”
“I think it’s scary,” I said. “Why? What do you think about it?”
“I think it’s a bit overhyped.”
“You do?”
“Sure. They’re framing it as though the important issue is how many people will die because they contract Covid-19, when really the important issue is how much longer would they have lived had they not contracted Covid-19.”
“I love it when you talk like a lawyer,” I said.
“The supply chain interruptions are very real, though. If I had any real money right now, I’d try to corner the market on toilet paper. You think it’s scary, huh?”
“I think I don’t want to get it,” I said. “And the isolation setups at the hospital I work in are a fucking joke.”
“An angel in white shoes!” Neal said. “That’s my little Grazia.”
“But at least I don’t have to worry that patients aren’t washing their hands anymore when they use the restroom. Patients are terrified. They’re scuttling into the ER on the slightest pretext: ‘I have a hangnail! Does that mean I have COVID?’ “
“Personally, I draw the line completely at singing Happy Birthday to You more than twice when I’m washing my hands,” Neal said. “But they can test for it now, right? They set up a testing center at the old elementary school right around the corner from the courthouse. It must take people hours to get to the head of the line. The line went several times around the block.”
“People would rather wait for hours in the ER,” I said.
Neal laughed. “You don’t like your patients very much, do you?”
I shrugged. “I don’t dislike them. I want to do all I can to help them get well. Because that way they leave, and then I never have to see them again.”
Neal laughed harder.
“What? You can’t tell me you don’t feel the same way about your clients!”
“Oh, I almost always want to see my clients again,” Neal said. “Even when I know they’re guilty. Even when I know they’ve done some truly horrible things. My clients are extremely interesting people.”
We were crammed together, practically knee-to-knee, at a small angled table. Neal’s back was to a mirror that reflected the rest of the restaurant, including the back of house with its prep spaces and food locker. I gazed idly into the mirror: Why were the tables so far apart? Had they always been so far apart? The Jamaican restaurant had just gotten a rave review in Hudson Horizons magazine, so why were we the only people in the restaurant?
In the mirror’s parallel universe, a server trotted toward the convergence point, plates of fragrant jerk chicken held aloft. She had something blue over her mouth—
I spun around.
The real-life server was wearing a mask, too.
First civilian I’d seen wearing a mask.
“It’s supposed to cover your nose,” I snapped. “The mask, I mean.”
This made her so nervous, she almost dropped the plates.
Now that I’d noticed we were living in a Twilight Zone episode, there were other signs, too. Like that aggressively white 16-ounce flask of hand sanitizer parked on our table right next to an unopened bottle of WalkersWood Serious Hot Jonkanoo. Neal eyed it dubiously. “Is this some new condiment? Gotta say, I’m not crazy about it—”
“I want to leave,” I said. Speaking too loudly. Speaking with an odd quaver in my voice.
Neal stared hard at me for a fraction of a second. I could almost hear the audible click as he changed gears. “Of course! We can do whatever you want to do. Want to just grab this stuff to go and go for a walk?”
I did.
###
Just another ordinary evening, right? Or at least I wanted it to be.
Twilight was on, total darkness still an hour away. Neal and I walked quickly without talking.
The Old Dutch Church was on the other end of Broadway. Neal and I had explored this area many times. Once, Broadway had been a thriving mercantile mile known for its parades and bustling commercial establishments. Now the street was a veritable tourney of potholes and empty storefronts.
There were hardly any cars on the street, which in and of itself wasn’t weird: Outside of New York City, every town in New York State pulls up its sidewalks at 6 o’clock. The weirdness was the curbs: No cars were parked alongside them.
We passed a few garishly lit bodegas. They seemed to be mobbed with people grabbing things off shelves, snaking in long lines in front of the counter. But was that weird or normal? I confess: I don’t spend a lot of time peeping inside bodegas, monitoring their internal activity, so I didn’t know. Maybe bodegas are always packed.
But the sidewalks outside the bodegas were utterly deserted, and that threw me. Where had all the shoppers gone? Had they stepped out of the store and vanished into some alternative time/space continuum? At heart, I was still an economist, so I lived in a universe where nothing was impossible, where everything was a calculation on the probability spectrum within a statistical margin of error, and there were many, many ways to move the needle. It began to dawn on me that maybe the best way to protect myself from the looming Big Bad might be to harness the superstitious side of my nature. Stop stepping on sidewalk cracks. Avoid spilling salt. Spend time with crystals. Pray.
“You’re not listening, are you?” Neal said.
“What? Yes, I am. No, I’m not,” I said.
“I was trying to distract you from your obvious agitation by telling you about my love life.”
Agitation? What made him think I was agitated?
“Sure!” I said in a hearty voice. “Your love life.”
“So, I like Mimi. I find her unbelievably sexy, and she’s completely cool with the polyamory thing, and I explained about you, and you know, Flavia doesn’t like to meet my other lovers, but I thought you might like to meet her—”
“Meet someone? Oh, no, Neal. I’m not meeting anyone new I don’t get paid to meet. Not now.”
“What? You’re going to let a little Chinese bat virus scare you off?”
In answer, I burst into tears.
Neal had never seen me cry before. It didn’t puzzle him exactly. He knew the right response when someone bursts into tears is a consoling hug, and he moved in closer to deliver one.
I side-stepped him. “Don’t touch me!”
“Shit!” he said softly. “You really are scared, aren’t you?”
“And you would be, too, if you worked in an emergency room, and all these people were coming in and coughing on you—”
“Well, I mean, I go into the jails a lot, and everyone coughs there. Though it’s impossible to know whether they got the Chinese bat virus or just ruined their lungs smoking crack. Oh, look, baby! Here we are at the Old Dutch Church graveyard, and what a cheerful sight it is because no one interred here died of the Chinese bat virus! Look at this headstone!
Here lies fair Patience, who gave her last breath
to bring forth a babe—and met her own death.
Patience didn’t die of the bat virus! And look here, a Revolutionary War headstone!
Bayoneted by a Redcoat, of life I was desirous
But hey! At least I didn’t die of the fucking bat virus!‘’”
The headstones in the Old Dutch Church were more than 300 years old. Any inscriptions that may once have been engraved upon their rust-colored fieldstone surfaces had long since eroded.
In spite of myself, I laughed.
###
And the next day, the world shut down entirely.
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