A Mother’s Bleeding Heart
It’s not the nightmares that should worry you, but the things that inspire them.
Ding dong mother, can you hear the bell?
The grave, my bed, Pastor declares, voice December ice,
Is no fitting place for me to dwell,
I will not rest but will instead, in a few hours, rise,
For you, sweet mother, who lay me down too soon to sleep,
Will see the tears that I have cried, but you are to weep.
Beneath linen sheets that online reviews assured me would end my night sweats, the sing-song words come to me as if whispered into my ear, the hot breath like a crawling insect on my skin. I bolt awake steeped in blind, stinking panic, muscles gripped in shocks of pain — evidence of a fight for my life lasting the better part of the night.
“What even were those words?” I pant, having no recollection of the dream’s lyrics before a week ago. No forgotten lullaby or schoolyard rhyme sounded remotely like it.
I sense — know — I’m not alone in his bedroom.
“I’m between roommates,” I assure myself, “and I am alone in the apartment.”
Orange street light sneaks in through the sheer curtain, coming to rest on my desk, illuminating enough of the room to support the theory — fact, I hope — that I’m by myself. The bedroom is as I left it, undisturbed since I last saw it in the waking world.
A creak rises from the far side of the bed, either from the house settling or an intruder’s approach. I switch on the bedside lamp, if for no other reason than to see the threat as it closes in.
Nothing stares back at me, but that doesn’t mean it’s not there.
“May as well get dressed. No sleep happening tonight,” I say aloud, hoping the words act as a talisman, stopping the dread from evolving into capital ‘P’ panic.
“Tullus Own…Jesus wept. You can’t keep coming in like this,” Candace Roberts — charge nurse, mentalist, and keeper of keys — tells me through a mouthful of bagel, inspecting my face and scowling at what she finds staring back at her.
“I got it. Not my fault I can’t sleep,” I shoot back. “At least I show up for my shifts.”
She breaks away, forgetting I’m in the room, “I can’t believe Norma no-showed for the second day in a row.” Candace dollops more cream cheese on her bagel, drowning it, and levels her sights back on me. Hammer cocked, her glassy-eyed stare tells me the barrels are loaded, and she’s about to blow my head off.
Bang.
“It’ll be your fault when you fall asleep in a case and kill one of my patients,” Candace punctuates this by jabbing the bagel inches from my face, flecks of onion peppering the breakroom table. “Least, that’s where my fingers will be pointing. Right at you.” By bagel or breath, the sulfurous reek of garlic skitters up my nose, where it will nest for the rest of the day.
“I said I got it,” I say, snatching the shift assignment from under her palm.
“I’ll take you off the schedule if I think you’re a danger to others. That’s a fact,” Candace laughs, a lilting cry like a parrot having a stroke.
Sixteen cases today, if we’re lucky. Luck, odds — the calculus used to bring order to chaos. We in the Cardiac Cath lab pay them no mind. They never work out in our favor. Will, in fact, actively work against you. No matter what you hope or plan, people will roll up to the ER with their finger on the buzzer to the pearly gates, complaining of chest pain and a history of every condition that increases the risk of a heart attack.
The Cardiac Cath lab -– Roto-Rooter, In-N-Out, The House that Colonel Sanders Built, any of the names we call it — is unlike other hospital departments in that noise is contained within the metal double doors in each of the five bays. Absent are the incessant beeping of vital signs, fax machines (yes, those are still prevalent in hospitals), and phone calls. An imaging camera spools up at intervals, and electric crickets chirp as images relay to monitors.
Here, doctors map the cardiac highways with fluorescent dye and a four-foot-long wire, frequently by way of your groin, to prop open a clogged artery. Modern-day vampires by a different name. Dr. Rosenthal’s first case arrives, a 30-year-old with a face the color of Heinz Ketchup.
“Hrng,” he groans, undulating his chin and puffing out his cheeks. I can barely roll him over to keep from choking on the slick yellow spew that splatters on the floor with a sopping smack.
“Eugenio, call Rosenthal and tell him I need 12.5 of Phenergan IV push,” I say, noting the line of vomit on my left sleeve. Anesthesia — Dr. Karen Baker — holds the patient while I grab the med.
Eugenio Davila pokes his head from the monitor room and does the same chin lift the patient did, only this time to grab my attention.
“Rosenthal says, ‘you got it.’ He also wants to know if he should even bother showing up or if you’ll be performing the procedure for him.”
I’m punching the med locker screen for an emergency bypass.
“Tell him to quit farting around in the doctor’s lounge unless he wants me to give out the door code to the rest of the staff,” I snarl. Eugenio’s eyes glimmer at the prospect of a buffet of fresh fruit, unburnt coffee, and a series of private bathrooms with working locks.
“Eugie, relay that shit,” I call, jabbing a handful of saline flushes in my scrubs pocket.
“Mother’s mad,” a brittle voice rises in my ear before disintegrating like a sun-beaten plastic bottle. I recoil, a boxer avoiding the final phantom blows that cost them their career. Eugenio’s still on the phone, and Dr. Baker’s still with the patient. No one else here.
“Ding dong, Mother,” the voice buzzes in my ear with the disquieting screech of mosquito wings coming from outside the Cath bay doors. Small, rectangular peek-a-boo windows reinforced with a diamond wire pattern are closest to the break where the two doors meet. Using them during active cases is frowned upon since you’re liable to split your forehead open from someone exiting or get a face full of radiation from the x-ray cameras.
The owner of that voice is my nightmares’ architect, author, and subject. I know this with the absolute conviction that comes from dreams. My attention lands on those windows, and in the time before eyelids shut out the world and its light, I see the source.
Bloodshot eyes beneath limp black hair. Jagged yellow teeth strung like Christmas lights over a broken window for a mouth. Lips pulled high and back to the ears. A shudder breaks free from my shoulders. Lungs fill with a sharp heave of air, ready to burst into a scream.
Then it’s gone.
“Any day now, Tullus,” Dr. Baker calls from the head of the bed.
I draw the med and slip the syringe into the patient’s IV by feel, all concentration focused on how the nightmare was bodiless until now. Things don’t crawl out of your dreams, though. That’s some Stephen King shit. But real things, the kinds that dig their fingers into you when you’re awake, inspire nightmares. Those are the ones you should worry about. And I do.
Dr. Rosenthal bursts through the Cath bay doors, steaming coffee in hand, crisp white lab coat trailing behind him. The smirk he has at the ready sags at the smell of vomit and the sight of Dr. Baker and me tending to the half-naked, retching patient.
“Jee-sus. So this is the way today’s gonna go, huh?” Dr. Rosenthal pats the patient’s foot, a tender, disingenuous gesture. “You’re in good hands there, Mr. Menendez,” his back already turned.
The case is quick — I mean, it’s Rosenthal, the fastest hand in the West. He slips in and out of the femoral artery with the practiced ease of someone whose only reason for being is to perform this procedure. “There you are, you little devils,” Dr. Rosenthal quips, pointing the blockages out with his curved, blood-spattered fingers. 95% occlusion of the left anterior descending cardiac artery — the windowmaker, aptly named because it supplies blood to a large swath of cardiac tissue.
“You’re a fortunate man, Mr. Menendez,” Rosenthal looks over at the patient, whose craft store googly eyes shudder from the sedative.
More movement from beyond the Cath bay windows, and I find the muscles in my neck tense, unwilling to chance another glimpse of the grinning terror. Thankfully, it’s a flurry of blue surgical scrubs.
“Tullus?” Eugenio crackles through the intercom, but I know before he finishes.
“Rescue PCI?”
“Ye-ahp,” Eugenio clicks back.
“Damn. Doc, we’re short-staffed today. I gotta…” I stammer.
“We’re done here. I’ll close up,” Rosenthal’s eye stabs out from behind his safety goggles, winking. He’s annoyed, but he’ll live, unlike the person rolling in for an emergent procedure.
Rescue PCI involves a normal heart cath, except the point is to place a tiny pump into the heart, helping to offload the burden of pushing around six pints of blood through the body. Usually, candidates arrive from outside the hospital after an extended amount of time spent unresponsive, hearts too shocked to do the job. They’re trainwrecks with slim survival chances and microscopic odds of a full recovery, but it does happen.
Candace waits outside Cath bay one, and I join her at a light jog, taking in the moving parts — patient heaved from stretcher to Cath table, wires, drapes, and equipment pulled from cabinets and applied with slapdashed care. Everyone’s moving in a different gear, faces plastered in worry that they attempt to hide behind their tasks.
“Who is it? A VIP or something?” I ask her. I see her hand gripping the arm of the door so hard I can see the tendons strain through her skin. “Candace?”
She looks ghastly — transparent — the color sapped from her face.
“Candace, don’t you crap out on me too,” I tease, meaning it, and grab a plastic chair next to a gurney. Ease her into it.
“Norma…” Candace squeaks.
“What about her?”
“It’s…Norma,” Candace repeats.
Christ.
“Jesse!” I call the tech down the hallway to escort Candace to her office and get her some juice.
I throw a lead vest over my scrubs and jump in where I can. It is Norma, recognizable only because she’s still in her scrubs, the name tag with the hot-glued plastic sunflower still buttoned to her front pocket. She’s wearing a different face, a hastily-made clay death mask, eyes black pits, and bony prominences attempting to cleave their way through paper skin.
Dr. Arevalo is the interventional cardiologist on-call, his trademark black scrub cap engulfed in cartoon flames damp with sweat. He’s having a hell of a time crossing the metal guidewire into position, his brown pupils stretched as wide as they’ll go in search of answers.
I’m stationed closest to the cardiac monitor and can see the rhythm change before the monitor’s algorithm recognizes it. The rhythm, a crooked sawtooth grin, makes me flinch at first before I recognize it for what it is.
“V-fib on the monitor. She’s coding!”
Chimes. Flat and electronic.
My body moves reflexively, grabbing the crash cart, vaguely aware of passing moments. The uneasy creak of Norma’s body pushed into the stretcher mattress with each chest compression. Paper and plastic refuse litter the ground like fallen leaves, crunching underfoot. Overhead calls for additional specialists that fill the room beyond capacity.
“Unless you’re working this code, I need you out of my lab!” my voice, a weak twang above the coordinated movement of bodies.
Dr. Arevalo calls the ECMO team. Extracorporeal membrane oxygenation is a procedure that shunts the patient’s blood from the heart. A special machine oxygenates it outside the body before it’s pumped back. It’s the last resort for patients experiencing prolonged bouts of oxygen deprivation or whose heart has crapped out and can’t adequately perfuse the body.
Dr. Scruggs, the intensivist, and Dr. Nandy, the cardiothoracic surgeon, respond to the page.
“Her heart’s the size of a cantaloupe. The walls are so thick I can barely see through them in the camera. I’ve never seen anything like it,” Dr. Arevalo murmurs to Drs. Scruggs and Nandy.
More supplies are ripped free of their packaging. Norma’s neck is scrubbed red with chlorhexidine skin prep. A skin puncture in a great vein later, Norma is hooked up, her heart and lungs taken out of the equation. She’s alive, only by the loosest of definitions, and whisked off to ICU.
Cath lab doesn’t stop, not for hurt feelings or dying co-workers, so housekeeping sweeps through, clearing away all evidence of our efforts. I’m onto Rosenthal’s next case and shut off the part of my brain capable of emotion.
I get home around 9 pm, only two hours after my scheduled shift end. Not bad. The sun is nothing but a rumor during the winter months. I get up before it rises, returning long after it sets. Still, the lightless apartment I step into feels like an alien moon. I don’t bother with the kitchen lights since the orange glow from the fridge is enough for now.
Drinking isn’t high on my list most nights, especially after the first in a string of shifts. I see Norma’s face in the black vacuum behind my eyelids as I let the beer slide down my throat. I blindly reach for another with my left hand, feel a weight there and remember the takeout I brought home but hardly have the stomach for.
“Mother’s thirsty. Thins the blood, it does,” comes the voice of teeth on tin foil.
A resounding crack as the aluminum can hits the floor, spilling its insides along the linoleum. My retreat is blocked by one of the refrigerator doors. The misaligned smile glistens like afterbirth against the fridge’s anemic bulb. A sharp stab in my neck and the teeth become a whirlpool that pulls my head below water.
Ears fill with a high-pitched whine that could be a cicada’s shriek. Pressure sits on either side of my neck, but my head is anchored. Blurring objects swim through my barely opened lids, a jumbled collage that is not comforting no matter which way I try to align them. Something rubs the crown of my head, then the two blood-tinged eyes coalesce out of the blurred room and stare down into mine.
I feel the first tremors of a scream spark in my diaphragm. My lungs fill and release, but all that comes is a stifled mewl.
“Wakey, Mother,” the eyes welcome me until the grimy teeth poke through the muddled field above me and join them.
No words come when summoned, so a stream of curses surges through my mind.
“Potty talk is rude, Mother,” it whispers with the wide, face-encompassing smile of a five-year-old hearing a curse word for the first time. “I can hear you when we are joined.”
Joined — what the fuck does that mean, I’m not anyone’s mother, you fu –
“Potty, potty,” it shakes its ovoid head, a snowglobe where the eyes and teeth tumble around. “All that I join are Mother.”
Please don’t do this, take whatever you want, just don’t hurt me…
“You sound like first Mother,” the eyes swirl like egg yolks in a bowl. “All Mothers have questions. If you’re good, I’ll tell you story time.” Other facial features percolate through, cracked lips with fraying skin pulled back from the cheekless smile.
“Once upon a lo-o-ong time ago. A Mother and a Daddy loved each other so much they made a baby. I was a good-boy. Always plucked the chickens, skinned the cats, always doing good-boy things.”
More pressure, this time with sharp points that pierce into my scalp.
“One day, Mother gave me medicine to make me go sleep. I sleep too long. So long they put me in the ground. So long my heart forgets how to work. But I do wake up like all good-boys do. I wake up and go to find Mother.”
A dripping smear of a face comes into view. It looks like road rash — what results from being dragged along the ground long enough for the skin and most of the muscle to peel away. The price of digging out from under six feet of packed dirt and rock.
“I find Mother, and she is so happy to see me that she falls on the floor, screaming. I am very foggy, I tell Mother. I need your help, I tell Mother. She is so happy to help that she can’t stop crying.”
The red eyes ripple, threatening rain. A pounding in my ears and chest increases its tempo and volume.
“I don’t know how to do this, but I press my fingers into Mother’s neck, one on the left, the other on the right, one by feel, the other by sight,” the yellow teeth squeal with glee at the rhyme.
“Mother pumps their heart for me, and I feel much better-better. But, when I let go of Mother, it goes away, and the fog comes back. So, I push my fingers in deeper and wait all day until finally, Mother sleeps.”
My breathing quickens, chest heaves. It feels like the marathon three years ago that I quit halfway.
Vampire, I’m getting drunk, Norma, this got Norma, and now it’s got me, and I’m going to be a fucking vampire…
“Potty potty. No vampire. I’ve seen those movies. Very scary. They drink. I just need your heart to pump for me so I’m not foggy.”
A stitch in my side, a fresh slicing pain, tears into my rib cage. Burning in my chest, then an elephant collapses onto it. The world takes on the bleary look of a lens smeared with vaseline.
“You’re the vampire,” the teeth chatter. “You take people’s blood. Put their insides on the outside. You’re the monster, Mother.”
Maybe you’re right, I admit. I hear ringing in my ears again, a room of clanging bells. For better or worse, I hope I see the Cath lab again.
