jackal's nest

The hospital is busy with the new interns. I rest my hand against the cool, metal handle of the door and press my ear against the wood, not yet ready to leave the room. Outside the room, Dr. Barnes’s voice echoes through the hall. An intern ordered the wrong medication for Mrs. Philips in room 206. Not good, not good at all. She just had a heart transplant and I hope to God it doesn’t reject, God, please don’t let it reject. The intern, I don’t know who, I haven’t bothered to learn their names just yet, vocalizes their apology loud enough to wake half the hospital. I squeeze my eyes shut tightly and let go of the handle.

There is a little closet in the room with a fresh change of scrubs, clean shoes, and a hair band. I don’t get the day off today, I lost that privilege when the board realized the procedure had no real adverse effects. The closet also has a full body mirror, installed at my request after the second procedure. I needed to see myself. I still do. I inspect my body in the mirror. I’m wearing nothing but a cheap sports bra and hospital issued underwear, the same outfit I always wake up in. Like always, I am free of incisions or skin grafts, my eyes are where they should be, I can feel my heart beating in my chest. I look normal and I feel normal and it makes me sick.

I put on my scrubs and brush through my hair. My finger nails are perfectly trimmed, my teeth are straight and white. I’m not wearing any make-up, which I’m thankful for. Occasionally before I wake up they try to put foundation or blush on me to make me look less dead. You don’t have to, I told them, because I’m not dead. I tie my hair back and slip on my shoes. The clock next to my poor excuse for a bed reads 5:45. It’s almost time for my rounds.

When I open the door and step outside of my personal bubble, I’m met with the bright, fluorescent lighting of the hospital. An intern rushes past me, loose papers slipping out of his hands as he goes. An elderly man in a wheelchair who underwent a bone marrow transplant a few days ago waves to me and says, Good morning Dr. Finn. I smile and tell him good morning. He asks what I was doing sleeping in such a cramped room. I tell him we had a busy night last night. He laughs and says, You folks, doing the Lord’s work. For once I am inclined to agree.

I leave to check on Mrs. Philips. She’s at risk of blood clotting, and I can’t let that happen. I pass by the other residents on my way. They look at me warily, they step away when I get too close, they hate me. Dr. Maddison stops me in the hall and tells me to keep up the good work. I tell her I will. I have to. My body is not my own and she and I both know this. Mrs. Philips is awake when I enter her room. I’m surprised, to say the least, she’s very resilient for a sixty year old woman who just underwent a heart transplant. She smiles brightly at me and tells me good morning. I ask her how she’s feeling and she tells me she’s never felt so alive. Thank you for finding me this heart, Dr. Finn. I tell her she should be thanking the medical board, not me.

She asks again if she can meet her donor’s family. I’m sorry, I tell her, but your donor had no living relatives. I ask about her medication, the pain, her outlook on life. Whatever I can say to keep her talking and keep me in the room longer. If the heart fails I have to be here to see it. I have to see it with my own eyes. I listen to the rhythm of her heart and it beats in sync with my own. She says she’d like to take a nap and I tell her of course. Get all the rest you need.

My days are like this now. Check on transplant patients, pray they don’t reject, pray their organs don’t fail, pray they leave the hospital and I never have to see them again. The sound of Mrs. Philips heart beat rings in my ears all day, or maybe it’s my own heart I hear. It’s all the same either way, isn’t it? The interns gawk at me, the residents talk about me behind my back, the fellows and attendings insist I’m a vital part of the team but are never able to shake my hand. I often wonder how things might have turned out had I chosen any other profession, and always I decide it would somehow end like this.

At the end of the night I’m preparing to go home. I haven’t seen my apartment, my real bed, my shower, in well over a week. I’m grabbing my car keys from my locker when the door behind me opens, light pouring in from the hall. Dr. Barnes is there, his face grave.

Mrs. Philips’s heart failed, he tells me, We can’t afford to attempt another LVAD, she’ll need a new one as soon as possible.

Automatically, robotically, I put the keys back in the locker. I shut the door and turn wordlessly on my heel. I follow Dr. Barnes to the operating room. I do not scrub in. The scrub nurses pull my hair tightly back, they change me into a hospital gown, they lay me out on the operating table, and they sedate me. Then, they cut my heart out of my chest again.

if you're going hard enough left, you'll find yourself turning right.