Wish You Were Here(28)
We’re trying to be more careful about intubating because based on our experience, once a person’s on a vent he’s less likely to get off it. By now, I could identify the lungs of a Covid patient in my sleep (and some days, it kind of feels like that’s what I’m doing). It’s this vicious cycle—if you can’t breathe deeply, you breathe fast. You can only breathe 30 times a minute for so long before you exhaust yourself. If you can’t breathe, you can’t stay conscious. If you can’t stay conscious, you can’t protect your airway, so you might aspirate. And that’s how you wind up being intubated.
We give etomidate and succinylcholine before we put the GlideScope down the throat and bag the patient, because there’s a slight delay before getting hooked up to a ventilator. Ideally, you want to keep the patient comfortable but able to open his eyes and follow basic commands. The problem is that Covid patients have such low oxygen levels they are delirious—and we have to sedate them deeper in order to control their breathing and make sure they’re not fighting the ventilator. So that means doses of propofol or Precedex or midazolam, some kind of ketamine for sedation—plus analgesics like Dilaudid or fentanyl for pain—and on top of that, if they’re restless, we will paralyze them with rocuronium or cisatracurium so they aren’t trying to overbreathe the vent, and inadvertently damaging themselves. They’re on a whole cocktail of drugs … ?and not a single one actually treats Covid.
Man. What I’d give to know what your day was like. What you’re thinking. If you miss me as much as I miss you.
I hope you don’t. I hope wherever you are right now, it’s better than this.
The next morning, I open the sliding glass door for my morning run down the beach and nearly collide with Gabriel. He is carrying a big cardboard box that is overflowing with vegetables and fruits, some of which I don’t even recognize. I am certain I am dreaming this, until he reaches out one hand, steadying me so we do not crash. “These are for you,” he says.
I’m not sure what to say, but I take the box from him.
He runs a hand through his hair, making it stand on end. “I am trying to say I’m sorry.”
“How’s it going for you so far?”
Two bright burns of color stain his cheeks. “I should not have … ?treated you as I did yesterday.”
“I only wanted to help Beatriz,” I say.
“I don’t know what to do for her,” he says quietly. “I didn’t know she was hurting herself … ?until you said so. I don’t know what’s worse—that she’s doing it, or that I didn’t even notice.”
“She hides it,” I tell him. “She doesn’t want anyone to know.”
“But … ?you do.”
“I’m not a psychologist,” I say. “Is there someone here she could talk to?”
He shakes his head. “On the mainland, maybe. We don’t even have a hospital on island.”
“Then you could talk to her.”
He swallows, turning away. “What if talking about it makes her do more than just … ?cut?”
“I don’t think that’s how it works,” I say slowly. “I knew a girl who did this, back when I was younger. I wanted to help. A school counselor told me that if I reached out to her, it wouldn’t make her do it more, or do something more … ?permanent … ?but it might make her take steps to stop.”
“Beatriz won’t talk to me,” Gabriel says. “Everything I say makes her angry.”
“I don’t think she’s angry at you. I think she’s angry at …” I wave my hand. “This. Circumstances.”
He tilts his head. “She told me about the sandcastle. About people who make art … ?out of garbage.” Gabriel clears his throat. “She hasn’t given me more than two or three words at a time since she got back to the island a week ago, but last night, she wouldn’t stop defending you.” He catches my gaze. “I’ve missed hearing my daughter’s voice.”
As an apology goes, that one hits the target. He is staring at me fiercely, as if there is more to say, but he does not know how. I break away, glancing down at the box in my arms. “This is too much,” I tell him.
“They’re from my farm,” he says, and then adds, with a hint of a grin, “since I couldn’t get you an ATM.”
That surprises a laugh out of me. “Does everyone know everyone’s business here?”
“Pretty much.” He shrugs. “You won’t want to leave those in the heat,” he says, then reaches behind me and pulls open the slider, so I can carry the box inside. I set it on the kitchen table gingerly, wondering if I should broach the topic of Beatriz again. Last night, I had thought maybe the girl was running away from her overbearing father; now I am not so sure. Either Gabriel is the world’s greatest actor, or he is just as lost as his daughter is.
He looks at the box of blank postcards on the kitchen table. “What are you doing with those?”
“Basically, they’re my paper supply. I’ve been writing to my boyfriend.”
Gabriel nods. “Well. At least they’re still good for something.”
“Oh!” I say. “Wait.” I whirl around, dart into the bedroom, and return with the neatly folded pile of very soft Tshirts I’d co-opted. “I wouldn’t have borrowed them if I knew they were yours.”