For a few moments, we work in companionable silence, forming crenellated walkways and buttresses and outbuildings. As Beatriz stretches, reaching into the trash bag, her sleeve inches higher. It’s been a few days now since I saw her cutting herself. The thin red lines are fading, like high-water marks from a flood that’s receded.
“Why do you do it?” I ask softly.
I expect her to get up and run away, again. Instead, she digs a groove into the sand with her thumb. “Because it’s the kind of hurt that makes sense,” she says. She angles her body away from mine and busies herself by connecting some twist ties.
“Beatriz,” I say, “if you want—”
“If I were making things from trash,” she interrupts, shutting down the previous line of conversation, “I’d make something useful.”
I look at her. We’re not done talking about the cutting, I say with my eyes. But I keep my voice casual. “Like what?”
“A raft,” she says. She sets a leaf on the water of the moat, which keeps seeping into the sand until one of us refills it.
“Where would you sail?”
“Anywhere,” she says.
“Back to school?”
She shrugs.
“Most kids would be thrilled with an unscheduled break.”
“I’m not like other kids,” Beatriz replies. She adds a bit of yellow plastic hair to her twist tie creation, which is a stick figure with arms and legs. “Being here … ?feels like moving backward.”
I know that feeling. I hate that feeling. But then again, these are circumstances beyond normal control. “Maybe … ?try to embrace that?”
She glances at me. “How long are you going to stay?”
“Until I’m allowed to leave.”
“Exactly,” Beatriz answers.
When she says it, I realize how important it is to have an out. To know that this is an interlude, and that I’m going home to Finn, to my job, to that plan I set in place when I was her age. There is a profound difference between knowing your situation is temporary and not knowing what’s coming next.
It’s all about control, or at least the illusion of it.
The kind of pain that makes sense.
Beatriz sets her little figure atop the castle: a person in a building without doors or windows or ladders, a structure surrounded by a deep moat.
“Princess in a tower?” I guess. “Waiting to be rescued?”
She shakes her head. “Fairy tales are bullshit,” Beatriz says. “She’s literally made out of trash and she’s stuck there alone.”
With my fingernail, I carve out a back door to the castle. Then I wind some seaweed around a plastic spoon, dress it in a candy wrapper, and set my figure down beside hers—a visitor, an accomplice, a friend. I look up at Beatriz. “Not anymore,” I say.
From: [email protected]
The hardest hit are Hispanics and Blacks. They’re the essential workers, the ones who are in the grocery stores and mailrooms and fuck, even cleaning the hospital rooms we’re using. They take public transportation and they’re exposed to the virus more frequently and there are often multiple generations living under one roof, so even if a teenage Uber Eats driver contracts Covid and doesn’t show symptoms, he might be the one who kills his grandfather. But what’s even worse is—we’re not seeing these patients until it’s too late. They don’t come to the hospital, because they’re afraid ICE is hanging out here, waiting to deport them, and by the time they can’t breathe anymore and they call an ambulance, there’s nothing we can do.
Today I watched a Hispanic lady who’s part of the cleaning crew at the hospital wipe down a room. I wondered if anyone’s bothered to tell her to strip in her entryway when she gets home and shower before she lets her kids hug her.
We finally got a new shipment of PPE. But it turns out that instead of N95 masks, which is what we really need, they sent gloves. Thousands and thousands of gloves. The guy who accepted the delivery is the chief of surgery and every resident I know is terrified of him because he is so intimidating, but today, I saw him break down and cry like a baby.
We have a new trick: proning. It’s tummy time, for adults. Its mortality benefit has been around in studies since 2013, but it’s never been used as much as it is now. We do it for hours, if the patient can take it. The way your lungs work, when you’re on your belly they have more room to expand and the blood flow and airflow are equilibrated enough to hold off intubation for a while. We’ve learned that patients can seem to tolerate a huge decrease in air exchange so now instead of only looking at the numbers for gas exchange, we look to see which patients are worn out from breathing, and they’re the ones who get intubated. That’s the good thing. The bad thing is that if someone decompensates, and needs intubation after a trial of no intubation, they will certainly die, because when lungs are already damaged by quick breathing, by the time they’re ventilated, it’s too late. We are basically playing Russian roulette with people’s lives.