2021 Winner, Goldenberg Prize for Fiction 

***

You notice the weathered scar first, the wrinkled tilde pinching brown to pink skin where her pierced nipple once shocked her late husband. The cut beneath your collarbone twinges.

The rim of the N-95 mask burrows deeper into your cheeks and the bridge of your nose as you cover her chest with the blanket. The team assembles around her bed. Another pair of navy scrubs beneath a transparent plastic isolation gown is beside you at Mrs. Mattie’s hips, two more on her right side mirroring you, green scrubs at her feet on IV catheter duty, and the light blue ones monitoring the ventilator are to your right.

You allow the three other physical therapists to process the scene. You remember your first time in the intensive care unit, that rush of exhilaration speckled with terror. (Or was it the other way around?) Under normal circumstances your junior coworkers would shadow an experienced therapist for a week before touching a patient, but desperate times and all. There’s safety in numbers, you assured them during the training session. And besides, any serious clinical decision wouldn’t be in your collective hands, but rather the anesthesiologist’s. For once you’re grateful to be understood as the muscles of the treatment team.

You silently count Mrs. Mattie’s flat chest rising and falling to the set pace of the ventilator, her cracked lips parted around the endotracheal tube. You’ve reached five when the anesthesiologist clears his throat to remind you he is on a schedule, and grasps the tube between his thumb and index finger to stabilize it.

“Well everyone, I’m already sweating through this plastic gown,” you begin. “On my count we slide her towards the two of you. Hands on the drawsheet, everyone. One, two, three.” You in navy scrubs shift Mrs. Mattie to the far side of the bed. Your face shield brushes against the faux gauge earring you swiped from your roommate Jason’s drawer, but its magnet holds. That could have been embarrassing.

“We’re good, Dylan,” the nurse consents while the anesthesiologist throws you a thumbs up with his free hand.

You count to three again and roll Mrs. Mattie’s medicinally restrained body onto her left side. You instruct your colleagues to hold still while the nurse weaves her way among you, peeling the electrodes from Mrs. Mattie’s chest and sticking them onto her moist back. The electrocardiogram resumes on the monitor above her head.

“We’re cleared for landing. Slowly now.” You catch yourself exagger-ating an exhale the way you do when teaching a patient to stand from a low toilet. You slip a pillow above her swollen abdomen. Jesus, was her spine this crooked when she stood? As the nurse resets her arterial line you demonstrate how to use Z-Flo positioners and gel packs to protect Mrs. Mattie’s skin from breakdown.

With two fingers beneath her jaw, the anesthesiologist tilts Mrs. Mattie’s head a few inches closer to the ventilator. Her headscarf doesn’t move with it, so the adjustment reveals a third of her patchy scalp. The doctor departs her bedside without recovering it. A fleeting rage ignites inside of you like a gas burner and you slap your chest just above your heart. The pain is minty and soothing. You ignore the confused looks from your coworkers and gently reposition Mrs. Mattie’s scarf to cover the alopecia.

“Be mindful as you take off the isolation gowns. Errors can lead to disease transmission,” you dismiss them. “And happy Monday.”

You remember last month, a lifetime ago, when you bonded with that grandma on the Queens-bound seven train? Some lady in an insectival helmet cursed at those teenagers when one of them sneezed just before the Vernon Boulevard stop. She stormed out of the car, and Grandma caught you rolling your eyes. You smiled at each other. New Yorkers, am I right?

The next morning you texted your mom down in Palm Beach. “People are hysterical. I counted fifteen masks on my way to work.” That day your coworker Linda cracked a joke about “racism-derived personal space” because no one would sit next to her on the Long Island Railroad. Linda’s Korean. Fucking Long Island.

You arrived home from work the following evening to find Jason dancing to Beyoncé’s Homecoming documentary on Netflix. “Guess which Assistant Advertising Coordinator is working from home all next week!” he exclaimed, whipping his bald head from side to side. You hadn’t seen Jason that thrilled since you paid for your matching tropical bird tattoos last summer.

“People are still having strokes, so yes, I have to go to work,” you told your mom over FaceTime later that night. Even after the governor cancelled all elective surgeries and your fellow physical therapists across the state found themselves without jobs, yours remained intact.

“And yeah, I’ll be fine without group for the week or two until the mayor reopens the city, Ma,” you reassured her.

How about the last neurosurgical evaluation you performed, doesn’t that seem ages ago? That young guy was two days post brain tumor resection, and you could already foresee his biggest barrier to rehabilitation would be his wife, who insisted on wiping his ass during your session. You might have savored the assessment despite that dynamic had you known it would be the last within your specialty of neurologic physical therapy.

As you typed the note into his chart, Chelsea, the most forthright of your nursing friends, plopped into the rolling chair next to yours. “This fucking email from management says starting tonight no more patient visitors.” Your first thought was that without his spouse hovering, your patient might make some actual progress. “No exceptions, not even if you’re dying,” Chelsea continued. “My lady in bed ten is about to meet Jesus. How the fuck do I kick her daughter out?”

Shortly thereafter, your boss called a meeting for senior physical and occupational therapists. The handful of you socially-distanced yourselves as widely as you could in the tiny rehab gym. You found a spot on the stationery bicycle. Once settled, she delicately asked for volunteers to begin treating patients with the virus. Management predicted the hospital would run low on ventilators you see, and by mobilizing these patients early, your department could help spare them.

Hot embarrassment spilled from your temples into your reddening face. While you were dismissing the threat, the novel coronavirus’ rampage had infiltrated your city. Of course you raised your hand.

Within a week COVID-19 usurped all semblance of your hospital’s normalcy. A deficit in isolation gowns and face shields resulted in dozens of clinicians calling out sick with COVID symptoms. One intensivist lay intubated in her own ICU. Each day another department dissolved into a COVID unit: neurology, cardiology, even pediatrics blurred into COVID, COVID, and COVID. Any patient presenting to the emergency room with non-viral symptoms was quickly turned away or redirected to the hospital ship U.S.N.S. Comfort docked in New York Harbor. Physicians’ offices converted into negative pressure rooms to treat patients, and operating room nurses trained to treat bedside. You overheard an attending pulmonologist tell the charge nurse that the number of COVID-positive admissions increased by twenty percent every day, and that the shipment of a half dozen ventilators from the local animal hospital relieved only a miniscule amount of pressure. Within your department of rehabilitation, therapists not working with COVID patients were redeployed to assist elsewhere. The following week while several of your friends fielded phone calls from distraught family members, ran blood products to patient rooms, or transported bodies to the morgue, you were meeting Mrs. Matilda Brown.

“What now?” she groans. You note the indents of the nasal cannula on her skin between nostril and ear.

“My name is Dylan. I am from the physical therapy—”

“Can’t hear. You’re wearing a goddamn spacesuit.” Her furrowed brows beneath pink headscarf remind you of Frida Kahlo. You step closer and introduce yourself. You outline the importance of mobility in strengthening her lungs as they battle with the virus. Mrs. Brown offers you your favorite excuse.

“I’m too weak for physical therapy,” she dismisses with a wave of her bruised hand, a capped IV taped to her wrist.

“That’s what I want to help you with,” you counter. “It’s my job to help you strengthen your muscles and improve your breathing. Staying in bed all day is the worst thing you can do right now.”

“No thanks, sweetie. Not today.”

According to her chart, seventy-year-old Mrs. Brown developed dry cough and shortness of breath twelve days prior. When she could no longer stand up from the couch without huffing, her son drove her to the emergency department. A doctor admitted her and prescribed supplemental oxygen. In the week since, all attempts to wean Mrs. Brown to room air had failed. She had not left her bed while the virus wreaked havoc on her respiratory, circulatory, and gastrointestinal systems. That was where you came in.

Overnight you had become a Band-Aid physical therapist. Get ’em strong enough to walk twenty-five feet without passing out—this was the new standard. If patients could do this then they could return home, and one of the hundreds of overflow patients awaiting beds in the newly erected circus tent outside of the emergency department could be admitted.

So you have to push back a little. You recall a line from the social worker’s assessment in Mrs. Brown’s chart and decide to play it up.

“I hear you’re quite the singer,” you say.

“Who’d you hear that from?” she replies with a side-eye.

“Your son told the social worker about church choir. You’ll need to strengthen those lungs of yours before you get back to it.”

“That evil boy,” she mutters, but she is grinning. You think you’ve won. “But still no. I’m too tired, and church is closed anyways. Maybe tomorrow, sweetie.”

If this were a month ago, you’d accept her offer in order to salvage the rapport. In the moment, however, you’re cognizant of how the hospital has rationed the scant personal protective equipment. The thought of wasting an isolation gown on a patient’s refusal is gut-wrenching. So you press upon your left forearm and the magic of the black orchid fills you like sunshine.

“When my mom calls me ‘sweetie’ it’s not a term of endearment, it’s a poison-tipped arrow.”

This makes her laugh, which snaps something.

“Boy, you are persistent,” Mrs. Brown says. “Fine! You can walk me to the toilet but only because I can’t take more of the goddamn bedpan.”

The orchid was your first tattoo, and the two-hundred-dollar price tag overdrew your checking account. You were seventeen and wanted a manifestation of patience inked into your skin to eclipse one of the earlier scars. In the fifteen years since, the orchid has brought you more peace than the years of therapy your mother paid for, and that set her back well beyond two hundred dollars.

You help Mrs. Brown to sit at the edge of her bed. You see behind her buttocks a dried urine stain on the sheet. When her lightheadedness subsides, you bring a walker to help her shuffle the few steps to the toilet. You watch the bedside monitor as her oxygen saturation drops from ninety-three percent to eighty-five. You crank up the oxygen titration on the portable tank, yet still have to support her hips as she reaches the bathroom so she doesn’t buckle.

You do not leave her side while she urinates. Mercifully the oxygen saturation value creeps back to ninety by the time she’s finished. You have her remain sitting for another minute before she walks to the recliner on the opposite side of the bed. You know she’d rather lie down again, but she’s too weak to argue.

“Your lungs need you to sit upright during the day. From now on, the bed is your enemy.”

“You’re my enemy,” she jabs. You walked into that. “I feel like I ran a goddamn marathon.”

She accepts your paper handout with three chair exercises like it’s a wad of used tissue. After reassessing her vital signs, you turn to leave.

At the sliding door isolating Mrs. Brown from what used to be the orthopedics department, you hear your name. You’re halfway through ripping off the plastic isolation gown but turn back anyways. She nods her head, and you accept this as a thank you.

Jason is not your lover, no matter what your mom thinks, but lately you haven’t been able to fall sleep unless you’re in the living room with him. Fortunately for you, the longer Jason works from home the further his sleep-wake cycle shifted. He’s updated his social media handles to some variation of @QueenoftheNight, and more than once you’ve heard him begin a work videoconference with the refrain “unless it’s past noon, it’s too soon for Zoom.”

He shakes you awake. In your grogginess you reach for your N-95 mask and panic when you meet only bare skin. You see the kitchen table piled haphazardly with Jason’s laptop, magazines, and mock-ups, and the stack of clean undershirts beside you on the couch. Your heart decelerates.

“Do what you want, but I’m going to bed,” Jason tells you. You rub your eyes and read the microwave clock. It’s three thirty-five. You wish he just let you sleep. Your night is over. You decide to take a shower.

In the morning your mom FaceTimes you. Yes, you’re fine, and no, you don’t have a fever. No, you haven’t been coughing. Yes, you’re wearing a mask when you work with patients. Yes, you’re eating. Same as yesterday.

“I’m having breakfast with auntie Kayla today,” she tells you.

“Ma, you can’t be leaving the house like that.”

“We’re brunching via FaceTime!” she announces. “And how you doing without group? You’ve missed two in a row, right?” she says somberly, switching tones like a radio station.

“Today would have been the second. I’m fine, Ma.” You want to hang up, so you tell her you have to brush your teeth. Before you do, she makes you promise to wear a scrub cap to protect your hair while you’re at work.

Besides the masked woman walking her dog who crosses the street hurriedly as you turn the corner, you meet no other soul until standing on the subway platform. Wearing headphones seems to normalize this situation for you. Nothing plays from them, however, so that you can remain vigilant. The train arrives with a harsh screech and you claim a bench.

Getting a seat on the subway during rush hour used to be a rarity.

You thumb through read emails. Your mom recommended slow cooker recipes at two a.m. (evidently you’re not the only one with sleep troubles). Carlos invited you to virtual group therapy tonight. That’s a hard pass, man. Jason would be in the next room. He still thinks you’re treating a private home care patient every Tuesday evening. You’ll be fine. How much longer can all this last anyway? You’ll be fine.

As you descend beneath the East River towards the city, someone rattles the door open between subway cars and your whole body tenses like a seizure.

“Donation?” the grungy man asks you halfheartedly, shaking an empty Folgers can in your direction. He has no mask. You offer him your breakfast bar and he accepts. You shrink into yourself as he proceeds to the woman sitting a ways down and stare at the latched door between cars, wishing you could lock it. Don’t look away. It’ll clang open the second you do. Your phone screen goes to sleep in your sweaty palms.

Okay now, Dylan.

Reaching beneath your backpack tucked onto your lap, you press the top of your right thigh. The warm magic of the lighthouse ripples through your body and eases you out of the dark place. You exhale the anxiety through pursed lips.

You would have preferred the same artist who inked the orchid onto your forearm to tattoo the lighthouse as well, but her business went under before you graduated from high school, well before New York. God, you were in a right state the morning of that second tattoo. You remember? You had been so wounded by your time in the city. You donated blood the day before, but the effects were already wearing. You hate to think what might have happened had you not stumbled upon the lighthouse off of the Hudson that cold morning. In group Carlos often reminds you not to dwell on what could have been.

The lighthouse stretches fifteen serrated stitches long.

“I says to the night doctor, ‘I know I’m fat, but since I had my tits removed it’s only around the middle, so if I lay on my stomach I just see-saw into the pillow. You want me to suffocate faster than I already am?’” Mrs. Brown cackles and then has to catch her breath.

Overnight the respiratory therapist upgraded her to a high flow nasal cannula set to deliver thirty liters of oxygen per minute. Her nurse tipped you off that she was extra irritable this morning, but you seem to have landed on her good side.

“You understand why he wants you in that position though, Mrs. Brown?”

“He’s trying to tell me it’s better for my lungs.”

“He speaks the truth, Mrs. Brown.”

“Call me Mattie.” She waves her hand flippantly and then leans forward in bed and grimaces. As a dry coughing fit overtakes her you stand to the side and place your palm on her shoulder. You watch the monitor as her oxygen saturation drops to eighty-three percent before she recovers.

“I’ll sit in the chair if you don’t want me to stay in bed,” she sputters. You hold up a finger for her to wait. You’re not transferring her to the chair until her oxygen improves.

“What’s with your face, Dylan?”

“You can’t see my face,” you retort. The N-95 mask engulfs it from nose to chin, and the face shield atop is streaked with the residue from disinfectant wipes.

“Those big black eyes of yours say it all,” she says. Eighty-five percent. Eighty-six. “They show your concern for me. I appreciate that. That’s why I haven’t kicked you out.” She cackles again and her oxygen saturation drops back to eighty-four.

“Take some big breaths please, Mrs. Mattie,” you say.

“Cancer scared me to death in the nineties. Now nothing does.”

Still eighty-four. “In through your nose and out through your mouth,” you repeat. She takes two breaths this way. Eighty-five.

“You know I got my nipples pierced the week before my mastectomy? Wanted to surprise my husband.”

“Shut up and breathe, Mrs. Mattie,” you say, rolling your eyes at her.

When she regains control of her breathing, you assist her into the recliner. She permits you to walk her through her exercise program, and by the end of it, her oxygen saturation value reaches ninety-five. She promises to perform the simple exercises again after lunch. (“It’s not ‘lunch’ if you can’t taste a goddamn thing.”) You bid her goodbye and remove your isolation gown by the door.

Once again she calls your name before you depart.

“Yes, Mrs. Mattie?”

“Is that a bird?”

For a moment you’re concerned for an anoxic brain injury. Then you look to your shoulder. As you ripped off the plastic gown, you must have pulled your scrub top over an inch to reveal the head of the green macaw. It’s the only tattoo you have in color.

“She makes me happy,” you reply as you readjust your top and wash your hands.

“My son got a tattoo of a wrist watch. I says to him, ‘You know that won’t tell time, right?’”

“It probably makes him happy, too,” you shrug.

“Well, that’s all right then.”

The following evening the Florida governor signs a stay-at-home order for his constituents. You text your mom to ask if she has enough groceries. She replies yes, her pastor’s daughter will drop off a week’s worth tomorrow morning. You’ve been pressing so hard on your lighthouse that it’s starting to bruise. You press now. In the mirror you frown at the fresh pimples sprouting where the mask touches skin. You sigh, brush your teeth, and then curl up on the couch while Jason works on his laptop.

You wake up before two with the urge to cut. Jason’s already gone to bed. You pull out your phone and look up flights to Palm Beach International before remembering they have a fourteen-day quarantine policy for travelers from New York.

Mrs. Mattie’s on a nonrebreather mask with the high flow set to forty liters of oxygen per minute this morning. You know she’s decompensated because she doesn’t fight when you tell her she has to roll onto her stomach now. Her voice is muffled but you make out her questions.

“I’m doing fine, Mrs. Mattie. No, no fever, they check us in the hospital lobby now. No, I haven’t been coughing at all. Yes, I wear this mask when I’m with my patients. Yes, Mrs. Mattie, I’m eating enough.”

From the window beside her IV pole you watch a group of men assemble Astroturf fences to conceal the refrigerated trailers parked along the East River. They won’t do any good from this aerial view.

In the bathroom you pinch your arms. They look like hickeys.

At six o’clock you change into jeans and swap your N-95 for a cloth mask. Before zipping your backpack shut, your phone lights up with your mom’s picture. You press ignore.

“Working late. Call you later,” you text.

You exit the hospital and follow signs for the blood drive. Someone has drawn blue markers on the sidewalk with chalk six feet apart leading to the entrance of a white tent. You file into place behind the only other person in line. He’s wearing a flowery scrub cap and the back of his neck is hairy. An icy breeze rips through your pea coat.

The nurse who escorts you inside the tent used to work in neurology when you were first hired. Seung is her name. You assumed she retired. Maybe she did. She looks older than you remember, even with the mask covering most of her wrinkled face. She doesn’t seem to recognize you, and that is fine. The thought of small talk is triggering.

You mark “no” on the form next to the question about having sex with another man in the past year so they’ll accept your blood. Then Seung ties the elastic band around your bicep and the green veins surface like the koi fish when you took your mom to the Brooklyn Botanical Garden.

You watch the needle penetrate. For a moment you’re liberated. Seung leaves you to check on another donor behind a curtain. You squeeze and release your fist, and the ebb and flow of blood reminds you of waves on the beach.

“Thank you for your work, nurse,” you hear the donor say to Seung. His high-pitched voice draws you from your reverie. “I’m thankful to all you healthcare workers for helping our community. God bless you,” he says. The cadence of his voice stirs up a memory you cannot place. Nor can you return to the beach. You hear the crunchy stretch of elastic bandage as Seung wraps the man’s arm. One of them opens an airy bag of chips.

When you’ve half-filled the transparent bag hanging beside you, the man stands. From beneath the curtain you see silver high tops, and catch a glimpse of black hair over the top. He thanks Seung again.

“Excuse me,” you say, startling yourself. The man pauses behind the curtain and uses his index finger to peak through. You nod your head and he opens it wider. He’s wearing a black mask and a thick gauge earring.

His flattop slopes downward like yours did when you were a kid.

“Can you tell me what time it is?”

He giggles. “It’s not a real watch,” he says, gesturing to the markings on his wrist beneath the bandage. He takes his phone from his pocket and gives you the time. You nod your thanks.

The ruckus commences with a boy and his diapered brother marching in front of their two-family home banging wooden spoons on cooking pots. One by one through windows of the adjacent apartment building, faces with whistles attached to them and clapping hands join in. There’s a dog howling on one of the top floors. Thanks to the blood loss you feel lighter with each step, as if you could float to the window and pat her head.

Snot runs onto your upper lip, but you don’t remove the mask until you’re safe at home behind the bathroom mirror. Your puffy eyes land on a pimple like a pencil eraser in the center of your chin. Indents from the mask divide your face into thirds.

Your arm floats to the drawer beneath the sink, and inside you find Jason’s jewelry casually scattered, along with an electric razor, an unopened shower cap, and a travel-sized deodorant. You sift until you find it—a spiked earring in the shape of a puckered tentacle. The magnet holding one end of the tentacle to the other is strong enough to clasp around your earlobe, and the effect satisfies you.

You reach for your phone to return your mom’s call when a new email banner across its lock screen distracts you. It’s from Carlos. You read his two-line message checking in with you. You minimize your email and check Instagram. The virus indefinitely closed the tattoo parlor you took Jason to over the summer, so on the train ride home from the hospital you direct-messaged the artist to try to set up a private appointment. She has not replied yet.

You find Jason’s eyeliner pencil behind his razor and use it to draw a watch on your wrist. You wash it off in the hot shower, and afterwards you’re so snowed you can barely climb into your boxers without tumbling forward. You fall asleep atop your duvet with droplets clinging to your back.

Your alarm sounds ten and a half hours later. It’s the first you’ve slept in your room since the pandemic hit New York.

When you step onto the unit that Friday morning, red lights flash above each patient’s room. A sharp whistle pierces the air and instinctively you check the tile flooring beneath your sneakers to ensure you haven’t triggered some kind of alarm. A nurse with a long ponytail sprints past, and in an instant you know who has called the rapid response code. You tear after the nurse straight to Mrs. Mattie’s room, your backpack flopping behind you, and as you approach, the severe blasts of a disconnected ventilator begin to duel with the whistle of the code. Limbs flail above the heads of the masked team buzzing between you and Mrs. Mattie. You kneel out front of the wide opened door, and with fumbling hands pinch the N-95 over your nose and snap the face shield atop your eyebrows. You ditch the isolation gown but squeeze into a pair of too-small gloves.

You check the monitor. Her oxygen saturation is fifty-eight percent.

“Hold her head!” a resident shouts. She grips a laryngoscope in one hand and the end of an endotracheal tube in the other, and it occurs to you that you’ve never seen the tip of a breathing tube before. Mrs. Mattie thrusts her head from left to right despite a nurse’s effort to force it still. One of Mrs. Mattie’s wrists is fighting against a restraint fastened to the bedrail while the other whacks the doctor in the jaw, knocking her N-95 askew.

The nurse with the long ponytail launches herself around the foot of Mrs. Mattie’s bed and grabs her arm with both hands before she can land another blow. Two people in isolation gowns are pinning her legs to the mattress. Her linens are streaked with blood from where she must have yanked her IV.

You shove yourself next to the nurse and the two of you manage to draw Mrs. Mattie’s arm down to the bedrail. You brace yourself against it while the nurse quickly affixes the second wrist restraint.

“It’s okay, Ma!” you shout over the noise. Mrs. Mattie’s saucer eyes dart briefly to your ear before locking onto yours. You’re aware of a gowned figure injecting a liquid deep into Mrs. Mattie’s shoulder. Her body stops writhing and stiffens.

“It’s okay, Ma!” you shout over the blares of the ventilator. You feel her hot hand gripping your gloved one through the restraints. She’s exposed on top and the scars over either pec are bat-shaped.

“It’s okay, Ma,” you plead. Her grip slackens. You watch her eyes drift shut. The doctor tilts her head back and projects the laryngoscope inside.

“It’s okay, Ma,” you whisper.

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