“I killed a girl last night. A teenager.”
It was the first line on the first page of the journal. The owner came in tonight ensconced a swarm of frantic EMTs and flashing lights. Any nurse will tell you that full moon nights were often like this, and in my experience it is surprisingly true. Snapping into action, I jogged alongside the gurney, preparing to take vitals and launching a flurry of questions at the delivery team.
The patient was well dressed and almost peaceful looking. He was however, about 80 pounds soaking wet and non-responsive. I had dealt with my fair share of anorexia-related intakes, but this one did not seem to fit the typical profile. I had to remind myself that disease struck everyone without prejudice, and the ones who did not “seem the type” were most often the ones at extreme risk.
Fighting my exhaustion and hunger I decided that I could not leave this man to the care of another, regardless of of the double shift I had just pulled. I called my boyfriend and told him that Roberto’s Pizza night would have to wait.
A workup confirmed our suspicions of severe malnutrition and we started him on an IV to get his blood sugar up. Once vitals were taken, monitors were configured and paperwork was in, I searched his clothing for his mobile. Calling patients’ friends and families was a job that no one enjoyed. I always chose to save my coworkers from the stress, and I always felt that I handled those calls fairly well. I called his most recently used contact, Brian, who said he would arrive within the hour. Replacing his phone, I found the small leather journal in his inner jacket pocket. Hoping that his recent history might assist us in helping him, I sat beside him to read.
I will transcribe his entries below.
May 7th, 2018
I killed a girl last night. A teenager
I was released from custody with a big fat No Fault stamp on my paperwork. No Fault. It’s not exactly true, is it? I did skip the beer at dinner, but I had been on my phone whilst driving. I took my eyes off of the road. Took my attention off of what I was doing.
I tried to convince myself that I wouldn’t have seen her anyway. I told myself that the intersection had been a desolate place without proper lighting and it was almost midnight. I reminded myself that the poor thing was dressed head to toe in some sort of black dressing gown.
And yet, my hands were on the wheel. It was me in control of that hurling hunk of metal and plastic. It was my front grill that mangled her generous frame.
May 9th, 2018
I did not get much sleep last night, but I did rise feeling a bit more myself. I can’t imagine that I will ever be unaffected by what happened, but I feel a change in the right direction. Acceptance is an art form that I’ve always been fairly skilled at.
But I think it was an illusion. A false start.
I came to the realization tonight that I had not eaten since the accident and threw together a quick meal. I could barely look at the plate in front of me. It looked. . . well, wrong. It was like finding a brand new pack of cigarettes in the middle of the woods. It was out of place. Unwelcome. I could withstand the smell only for a minute. Then I tossed it in the bin, tainted plate and all, and took the trash bag to the driveway.
I felt better then. Once it was out of the house.
After reading to this point, I was startled back to reality by the whining alerts on the monitor and dropped the journal. The man was seizing. His blood pressure had dropped significantly and a pained look had twisted across his face.
After administering an anticonvulsant and putting a cold compress on his forehead, he began to settle.
“What happened to you?” I whispered, cradling his bony cheek with my palm.
Eventually I returned to the journal, in hopes of answering just that question.
May 16th, 2018
I tried again tonight. It was repulsive. That pile of fat and salt and ground up gristle strangled by twin greasy webs of dough. Those daggers of encrusted starch pointing accusatory in all directions. I will call a psychiatrist in the morning and make an appointment. I’ve not left my house in days and simply cannot bring myself to eat a thing. I may feel settled mentally, but I’m not well.
May 19th, 2018
I made the appointment. My intake is next week. I know I need to do something in the meantime so I decided to reach out to my friend. I thought that maybe if I went out to eat with someone things would be different. Maybe just talking would help.
Brian beat me to the bar and grille. I had made it a point to have a long shower, shave and cleanup, picking out my favorite clothes and then driving there calmly and slowly. Experiencing the drive. Letting myself be at peace with it.
Brian told me about a recent building fire he had been on and we reminisced about how we met after my house fire back in ’09. He had helped me through that trauma so swiftly that night. His ability to read people, empathize and lead them out of dark places was quite something. I was glad to have him in my life tonight, as much as I was the night first night I met him.
I spoke and he listened. For half an hour I brought him through the range of thoughts and emotions I was dealing with and he simply soaked it in. I didn’t tell him about my trouble eating however. I didn’t want to bring that though to the table. The table where I was desperately hoping I could finally find some real sustenance.
The moment the food arrived I was overcome with nausea. It was vastly more intense than what I had experienced at home. Each meal on each table around me began to reek of decay, aimed in my direction, and I buckled under the overwhelming flood of disgust. I ran from the table, gasping for clean cold air and slamming my shoulder against the front door before collapsing onto the sidewalk and retching.
Brian appeared before me moments later and put a comforting hand upon my back. I crawled to the wall and we sat for a time before he finally broke the silence.
“I got some information from Brackett in dispatch yesterday.” He let that sink in.
“What was it?”
“She was out there performing some sort of ritual. They found a book of hers in the brush after they took you in. Apparently the ritual required that she be dressed in black, in the middle of a crossroads, at midnight, on a new moon.”
It did make me feel slightly better. She wasn’t just returning from a friend’s house or picking flowers. At least she was actively taking a risk. I couldn’t say why, but knowing this did reduce the burden of guilt quite a bit.
Brian peered back through the restaurant windows as the young man bussed our table, removing all of the uneaten food. “She was performing a ritual to lose weight.”
We looked at each other deeply then. Neither of us spoke much after that. What was there to say?
May 23rd, 2018
I weighed in at 90 pounds today. It’s been only weeks. I could swear that there is less of me when I wake each morning. Where am I going?
May 25th, 2018
I’ve resigned myself to it. I can admit it. Brian did his best, calling at every possible opportunity. But the wildfires raging across the west did not leave him with much free time. There are always too many people in need, and not enough people to help them. I don’t think that will ever change. It’s entropy. It’s the rule.
I saw her yesterday. The girl I ran down. It had been my final attempt to eat. I told myself that I could do it. No matter how revolting, no matter my nausea. I could get food into my mouth and down my throat if I just fought hard enough. I was so close. It was horrible but I was doing it. I had that stringy decaying paste in my mouth, preparing to swallow.
That’s when I saw movement through the window. It was definitely her. But she was thin. Not thin, but drawn, as if someone had stretched her to twice her height and her flesh spread like taffy. I watched as her body suddenly crumpled, twisting and cracking, marrow visible in the white spikes piercing her skin, reaching for freedom. I could smell the iron in the air and felt each snap of bone shudder through my body as I ejected the detritus from my mouth.
I sobbed and railed at my situation for hours.
Then I cancelled my appointment.
And then there was only acceptance.
The man passed away two hours after arrival, the ruin of his hand in mine as I pleaded for him to fight. We were unable to help him. I was unable to help him. Given the content of his journal, I’m not sure that anyone could have.
I got to meet Brian in person as he arrived with his daughter in tow. He was older than I imagined him and his daughter seemed painfully shy, keeping her distance as we spoke. After reading the journal and greeting him, I immediately liked Brian. I did not feel at all uncomfortable putting my hand on his back as he wept over the friend that he could no longer help.
“I’m very sorry for your loss. I did everything I could to help him.” Brian’s warm eyes met mine with gratitude, but I was distracted by the glare wielded at my by his teenager in the corner. I felt for her. Death was hard, and having someone to blame for that immense loss was a common and accepted first stage of grief.
“Maybe you and your daughter should go home and get some rest. I can have someone call you to discuss arrangements in the morning.”
“My daughter?” He looked up into my eyes questioningly.
She was gone. The thin young woman in the black dress who had met my eyes only once, in anger, was now nowhere to be found.
“I’m sorry. I. . . I made a mistake. We’ll be in touch.” My exhaustion turned to panic. I had to get out of there. I had been working for almost seventeen straight hours and I was clearly beyond my ability to be of any help to anyone. Including myself.
My boyfriend met me thirty minutes later at our favorite pizza joint.
After the events of the evening though, I just wasn’t hungry.