Hospital Delirium

By David Obuchowski

PROMPT — The way I see it ...

“The patient’s name is David. He’s a 45-year-old male. On December 2nd, he had a small bowel resection as well as a,” and here they always seem to hesitate, as if they’ve never seen or heard the word before, and maybe they haven’t—I know I haven’t, but I’m not a nurse, “eel-ee-oh-see-sectomy?”

This little speech means that it’s 7:30. AM or PM. The shift change—when one nurse hands me over to another. Part of the process is this thing where the one whose shift is ending gives this new one my little mini biography.

“He’s no longer on oxygen. He has a 20-gauge in his right hand and is receiving lactated Ringer’s at 20gtt. His meds are…”

His meds are not working, I think to myself.

“...dilaudid, oxycodone, toradol, tylenol, robaxin, atarax…”

How can they be? I feel as if someone keeps slipping into the room and plunging a knife into my abdominal wall, and then tearing it across and down into my pelvis.

I can’t breathe. I can’t speak. I’ve never felt pain like this. But pain like this is all they see. So why should this seem special?

“He is on a chips and sips diet.”

Chips refers to the scant shards of ice they allow me. Sips refers to the spoonfuls of clear liquids I’m permitted.

“Patient is urinating but is not moving his bowels or passing any gas.”

This is what matters, when it all comes down to it. When you’re laying there in the hospital bed, trying to find a way to breathe, or to crawl out of your skin just to escape the pain, this is the biographical statement. Not where you publish essays or fiction or what honors you were nominated for but failed to win, not the school you went to, not where you live, not something cute about how you have a dog-like cat. No, your mini-bio will be your name, age, the surgeries rendered upon you, the needles embedded within you, the pharmacy-worth of medications being delivered into your bloodstream, what you are allowed to eat (nothing) and drink (almost nothing), and whether or not you’re able to piss or shit it out, or at least release the gas.

And you’ll hear it every 12 hours.

II

The plan had been to remove a single section of my intestine, the meager length of five centimeters—just a little less than two inches. The surgery was to take place on Monday, December 2nd and I was told that I should expect to be home by late Wednesday or Thursday. In the consultation meeting, I asked how long it would take the intestines to recover from being severed and reconnected, and when would I be able to resume eating.

“You’d be able to eat that same evening of your surgery,” the doctor told me in a way that was both easy-going and authoritative. “Not that you’ll have the appetite, especially with the anesthesia,” he added. “But we’ll want to get you eating pretty much right away.”

III

The surgery was scheduled for 10:30am. At 9:30am, they brought me back to a pre-op room, where I stripped down and put on a thin, blue hospital gown along with yellow socks that had no heels; the complete circumference of them and nearly the entire length of the socks were covered in rubbery treads, making how I put them on impossible to fuck up.

My wife sat in a vinyl padded chair next to the hospital bed, upon which I reclined. I was chilly. A nurse covered me with a thin blanket that seemed to be made of some kind of paper-like material. Then she attached a hose to the blanket and switched on a unit that was attached to the wall. The paper blanket inflated up with warm air.

Somehow, the blanket made me feel a little embarrassed, as if I was wearing a child’s “floaties” around my arms. I’m not quite ready for a regular blanket yet, so instead. I have to be hooked up to something that is the ridiculous spawn of a Shop-Vac and a blowdryer. I tried to think of something to say to my wife to distract from the absurdity of it all. But all I could think of were the same old things:

How are the kids getting home from school?

What are you guys going to have for dinner tonight? How about tomorrow night?

Are you going to be able to get Alma to ballet tomorrow AND pick up JD from school?

David, don’t worry. It’s all handled.

She asked me if I was nervous, and I told her I was a little bit, but that mostly I was excited to get it done.

The fact is, I’d been expecting it for decades. Doctors had been pushing this kind of surgery on me since I was in my early 20s. It was inevitable that this surgery was going to happen. It was just a matter of how far I could make it down the track until I finally reached the impasse, and I had to get it done. And based on my raging symptoms and my inability to eat much more than raw salmon, I’d outrun it long enough. It was time.

“I’m just looking forward to coming home and looking for some more work,” I sighed. And it was true. Freelance writing was viable in my late 20s and 30s when I was in that sweet-spot range of about 10-15 years experience. That’s when you really know your shit, but not so much that you’re too expensive, or obsolete. Me, I have 25 years experience now. Who the f*ck wants 25 years of experience in a freelancer? Most of the people doing the hiring for these roles are younger than I am. Twenty five years ago, I was getting copy-writing assignments via fax machine. Sure, I wrote for the web, but print and radio was my bread and butter when I was starting out. No one’s exactly on the hunt for a middle-aged guy with a wife and two kids who has 25 years experience rooted in media like that.

“I know. You’ll find something,” she said. Her tone suggested she was being sincere, but that just as anxious and concerned as I was.

“I will. I really will,” I said. It was more of a prayer than a reassurance.

A different nurse showed up and set an IV in my right hand, complaining my veins were too small for her liking. I was surprised by her complaint. I’ve had countless IVs, and I get my blood drawn every one-to-three months for testing. Phlebotomists love my veins. Or so I thought. Maybe that’s just a thing they tell people. Either way, I felt disappointed in myself. It’s funny how a thing like how viable your veins are for an IV forms some small part of your identity. You go your whole life thinking you’ve got fine, rich cables only to find out that your vascular network is the source of consternation for a person whose job it is to set an IV.

“Got it,” she said in a voice that was half relief and half frustration. “Had to use a 20 gauge,” she told me, as if that would mean something to me.

“Sorry,” I said automatically. I apologize too much. It’s a thing my therapist and most of my friends tell me. “I mean, thanks,” I corrected myself.

She left and then another nurse came in to ask me a battery of questions about my allergies, health history, and identity before she, too, left promising I’d be brought back soon.

Ten minutes later, at nearly 10:25am, the nurse who had set me up with the blow-up blanket popped her head in the room to let us know the doctor was running a little late.

“How late?”

“Hard to say, just a little late.”

“Any idea of when I’ll be going back?”

“Don’t know yet. They were doing the laparoscopic procedure, but something went wrong so they had to go in with a big incision.”

The nurse retreated back into the corridors and closed the sliding door. My wife looked at me and said, “You’re getting the laparoscopic thing done, right?”

“Right.”

“Huh,” she said, looking back down at her sketchbook. “Strange choice to volunteer that information then,” she said.

No kidding.

IV

It was nearly 2:30pm when the surgeon came in with the anesthesiologist, who happened to be a tall British man. He had a firm handshake, and a dry wit. I could imagine being friends with this guy. I bet he was a blast to hang out with at a bar. He called me “mate,” and my wife “love.” She cracked a joke, and he looked at me and laughed and said, “Right, watch out for this one,” as he pointed his thumb back toward her. We all laughed. And then he told me he was going to make me feel the best I’d ever felt until I felt nothing at all, after which time I’d awake a much healthier man.

I did my best to interpret his presence as a good omen. We spend a lot of time in England. We love England. We wanted to move to England. I’ve tried for years to get a job in England.

But I’ve failed.

Creative projects were born there, only to flounder.

People over there had become close friends, but then they fell away.

When we returned from England four months earlier, it was different. The place felt further away than it ever had. Not lost. No, not entirely. But very distant. And I found myself watching far less British television series, listening to far less British bands (difficult, because they comprise most of my music library).

But here was this tall British man, telling me he’d make me feel better than I’d ever felt before, and not to worry because everything was going to be okay. More than okay. It would be better than it had ever been.

I found myself wanting to spill my guts to him about everything—about the job I’d almost landed in Reading, about the most ideal little market town we’d found that we’d thought would be the perfect place to live, about my band. But who I was fooling? I was just a sick American laying beneath an inflatable paper blanket. A guy who could barely carve out a career in his own country let alone one that had no interest in him.

I closed my eyes. Why did it have to be a British guy? I thought to myself as I was wheeled into the operating room. Why?

V

When I awoke in my hospital room, it was dark out. To my left, there was a window. Judging from the view, I was quite high up in the building. The city lights stretched out into the distance in parallel lines. Ahead of me, another window with a similar view of softly twinkling city lights running off into the night..

“Pretty nice corner room,” my wife told me. “Seventh floor.” I was startled. I didn’t even know she was in the room. And yet, she was clearly answering me. I must have asked her where I was.

What she said next had to be re-explained to me the following day. But in my post-general-anesthetic condition, I apparently understood. When they got inside, they realized they had to take out much more than they’d planned. I managed to call my parents that night and give them the highlights: the five-centimeter length turned out to be a solid foot. And then there was another section about five inches that was not only scar tissue, but that held a bezoar the size and firmness of a golf ball. The doctor had been shocked I hadn’t experienced a total obstruction with that thing lodged in there.

I remembered almost nothing of this the following day.

I said goodbye to them, promised to call again the next day.

There were knocks at the door.

And now there were nurses and doctors and the room was bright. There were readings being taken, things being said, questions being asked, objects being pointed to. It was a flurry of activity and people.

But then it wasn’t.

Instead, it was dark, and it was empty—my only source of light was the IV machine I was tethered to via a tube inserted into a vein at the top of my right hand. That and the amber and orange and white lights of the city below running out into the distance in parallel lines.

VI

It was the pain that would prevent me from getting back to sleep that night. But it wasn’t the pain that had torn me from my sleep in the first place. It was the beeping. Incessant and urgent—an electronic shriek. It was my IV machine. I searched and fumbled in my bed for the plastic paddle with the nurse call button. Every movement I made was agonizing, as if I were tearing my own torso and the organs within into ribbons and shreds. Finally I found it and pressed the button. A few moments later, a large, bald man came into the room.

“What’s up?” he asked without a trace of worry.

“Beeping,” I managed to mutter. Wasn’t it obvious by the blaring IV machine?

“Ah. I’ll show you a trick,” he said breezily, “as long as it’s beeping for this message,” and here he pointed to a display with the scrolling text that read partial occlusion—patient-side, “you can just press this button.” He pressed a button labeled RESTART. The beeping ceased. “Need anything else?”

All at once it felt as if someone plunged a hatchet into my abdomen. “Mmmmm!” I said, biting my bottom lip and trying to push myself up the bed with my arms, as if I were trying to escape myself.

“What?”

“Pain,” I tried to say, though I couldn’t find the breath to carry the word.

“What do you need?”

I don’t know what I need! I wanted to shout. I’m not the medical professional!

He took my hand in his like we were going to arm wrestle, and he said, “Here we go, I’ll help you up.” And with that, he took his other hand and pulled my legs off the bottom of the bed, so they dropped toward the floor. My vision went white with pain. Now I truly knew what the term “blinding pain” meant. I gasped like a trout left on a stony bank of a river.

“No? Back in bed? What do you want?” His voice sounded a note of frustration.

I couldn’t answer him even if I tried. All I could do was anything to get the fuck out of this in-between position. I quickly surmised it would be easier to try to fall out of the bed than to lift myself back into it. Conjuring all my possible strength, I rolled toward him, and as I felt my weight come off the bed, he caught me and propped me up. But my legs were too weak to stand, and I didn’t have the breath. So he eased me down so I was sitting on the edge of the bed. By no means comfortable, but not entirely agonizing.

“I can get you pain meds,” he told me. “Looks like you’re good for dilaudid.”

I don’t know much about medicines or painkillers, but I know that’s supposed to be a strong one, so I nodded vigorously. He used a hand-held scanner to zap a barcode on one of my many wristbands, and then he fumbled with some plastic containers until he was injecting the stuff into my IV. My head swam for a moment, and I expected to be washed over with a narcotic numbness, but the echoes of the agony kept coming.

“Here let’s try to stand you up,” the nurse said. He put his hands under my armpits.

I stood for a moment, and then I felt pressures changing in my eustachian tubes at different rates and strengths, and a rush of cold sweat ran up my back while a lash of hot sweat whipped across my forehead and I mumbled, “puke now.”

Then I did just that, somehow holding it all in my mouth. I spied a green plastic sickbag on the hospital table, and grabbed it. As soon as I got it up to my mouth, I heaved again and again and again. My abdominal muscles squeezed and tightened like a giant angry fist, and I could feel my wounds pulling against their internal sutures, which only made me vomit more.

“You need to try to not throw up,” the nurse said as he set me back into the bed. “It’s a lot of stress on those incisions.”

And then, the room was empty. It was empty and dark, and I saw the lights of the city running out into the distance like countless vacant runways. Had all of that just happened? Surely it did—I was sure I could taste the vomit.

VII

The fever started on Wednesday, best I could tell. They were keeping me on steady and regular doses of both acetaminophen and toradol. Even so, the fever always managed to make its way back in the hour before my next dose. And even when the medicine was holding the fever at bay, I was either in a constant chill or I was burning up from within, pouring sweat.

Nights were the worst for the fever. I would shiver in my thin gown, on the rough, thin sheet, under the rough, thin blankets. I would curl up in a way to try to generate and trap body heat, and I’d rub my thighs vigorously to try to generate friction. Before long, my IV tube would get hung up on the blankets and the IV machine would blare at me.

I’d felt far too uncomfortable to ever actually get to sleep. And yet, eventually I would. But as soon as I would fall into sleep, my body would burst into a furious sweat. I’d be up 15, 20, 25 minutes later, and the sheets would be drenched, my gown would be drenched, my pillow would be drenched, the blankets would be drenched. My hair would be so wet, droplets of sweat would drip from the ends, leaving dots of moisture on the hospital room floor when I would wrench myself from the bed. And there I would stand, wet and cold and miserable and exhausted. A nurse would come in and help me into a fresh, dry gown, and would remake the bed with dry linens.

And then I would get back in and the cycle would begin again.

For a week, I never got more than 30 minutes of sleep at a time. These were my nights, every night.

IIX

It is my fourth night without any real sleep. I awake, drenched and in a panic. “What’s keeping me alive?” I call out desperately. I grab at a blanket, “Is this keeping me alive?” I can see my feet down at the bottom of the bed, and they are kicking, but I don’t have any sense that it’s me doing the kicking. These feet seem to belong to someone else. I feel entirely removed from my body. But that’s not what worries me. What worries me is that I don’t what it is that’s actually keeping me alive. “What’s keeping me alive?” I call out again.

A nurse appears. She helps me out of bed, asks if I’ve had a bad dream.

“How can I dream if I can’t sleep?” I ask her.

“Come on, let’s get you some dry sheets and blankets,” she says. “Then we’ll see what medicine you’re due for.”

“Is that what’s keeping me alive?”

“It’s just to help you feel better,” she tells me.

IX

The man who takes my blood in the middle of the night wears a red and black knit snow hat that sports a large depiction of a black widow spider, as if the giant arachnid is crawling down his skull. He awakens me with a command to, “make fist.”

I open my eyes, and he’s got my left wrist in his hand, and he’s tying a tourniquet around my bicep.

“Make fist! Make fist!” he tells me impatiently.

I squeeze my hand. He grips my forearm with one gloved hand, and with the other he rakes at the skin beneath my elbow with an alcohol pad.

“Make fist! Make fist!” he demands.

“I am,” I tell him.

He presses a needle into the flesh of my arm. No blood comes through the tube and into the empty vial to which it's connected. He pulls it out partially and then he pushes it back in, angling it. “Vein no good!” he says, frustrated.

But I can see that he’s not gone into the vein. I don’t dare say anything—he’s mad enough. He pulls the needle from my arm, and he turns my hand over and he rakes the back of it with a fresh alcohol wipe.

“I never have to poke twice,” he says, angrily. And then he stabs a vein with a needle, fills the vial, and removes the needle and tapes a piece of gauze over the small wound on my hand, then leaves without another word.

He does this every night, the man with the black widow on his skull. And every night, he needs two tries. I have my blood drawn three other times throughout the day, and no one else needs more than one try. Only him, who furiously tells me that he never has to poke twice to get his blood.

X

It’s the IV machine, I decide, that’s keeping me alive.

In reality, all it’s doing is giving me hydration and electrolytes. But I’ve become entirely convinced it is a full-blown life support machine. And furthermore, I’ve gotten it into my head that I must keep it running at all costs. It’s up to me. Not the hospital staff.

This is my machine, and it’s keeping me alive. And in return, it’s my duty to keep it running smoothly. We have some sort of symbiotic relationship. When it beeps at me that there’s a partial occlusion, I don’t just press a button to shut it up. I meticulously search the line for kinks. I do not want to upset the machine, to trip its delicate sensors. I take slow, agonizing walks around the hospital floor at various times throughout the day and night, and the IV machine comes with me. It can run on battery power. When its display tells me it has four hours of battery left, I return swiftly to my room and plug it back into the electrical socket with the red wall plate. I don’t want it struggling for power.

XI

I am laying in my hospital bed, only I am not in my hospital room. I am on a canal. The hospital bed must be on some sort of raft.

To my right, there is a parallel canal separated from my canal by about six feet of land. Floating alongside me, keeping pace with me, on a raft of its own is my IV machine. Our canals are only wide enough to fit our rafts. The current only flows in one direction. The tube that runs from the machine into the top of my right hand is not stretched taut, but there’s very little slack as it spans the six-foot space between my canal and the one on which my IV machine is floating.

Above me, a blue sky is marbled by clouds. The current is swift and though I don't know where these canals are taking us, I am not concerned because, for once, I am not in pain. I simply enjoy the sensation of being carried downstream. Me and my life-support machine. The sky and its wisps of clouds is gorgeous. It’s so good to finally be outside, I think to myself.

I prop myself up on my elbows and look ahead. In the distance, I see something approaching. It’s a structure of some sort, but I can’t quite make out where or what it is. Now I’m gripped by an uneasy feeling. The wind is kicking up. The sky is no longer blue, but darkening shades of gray. The structure is coming into focus now. It’s a high bridge of some sort—a viaduct. It runs perpendicular to the direction of these two canals. One of its supports is anchored on the strip of land that runs between my canal and the one on which my IV machine is floating.

I realize that it is only a matter of very short time before I reach the viaduct, and my IV tube will be caught upon the base of the arch, at which point, it will most likely rip the needle from my hand. And what will become of the IV machine? Will the pull on the line cause it to come off its raft, where it will sink to the bottom of this canal? Or will it be dragged onto land, and smashed onto the stone support column? Or will the line break briskly, and will the IV machine become disconnected and will it float away from me, unrecoverable, far off into the distance?

I look around me. The landscape is barren, but I can sense there are onlookers in the grass, behind the scant trees, and I scream for them to help, please help, please help. And then I remember the call button on my bed. I grab it and press it repeatedly.

A nurse rushes into my room, and she’s followed by an aide. “Are you OK? What is it?” one of them is asking.

I am drenched with sweat. I am standing now. I have no idea if I’ve gotten to my feet on my own or with their assistance. I have my arms outstretched, like I am doing my best impression of Christ on the cross. Oh that’s right, I think, that makes sense: this is a Catholic hospital. The nurse has two hands under one of my arms, the aide has two under my other.

But I’m not really back in the hospital.

“The viaduct. The bridge,” I tell them as calmly as I can while trying my best to convey the urgency. I can see that my IV machine is standing there, un-moving, beside my hospital bed on a solid tile floor. There’s no canal, no viaduct. Of course not. It’s a trick. This whole hospital scene is artifice. This is the trick of the mind. I know I am still on that canal. I know the IV machine is still on the other, and I know we are headed for the viaduct, which will rip out my line, severing me from my source of life.

“The viaduct, the bridge,” I say again, doing my best to remain calm.

“What bridge?” one of them asks earnestly.

“The bridge. It’s coming right up.”

“Hospital delirium,” one says to the other.

“Can you see it? I can’t see it anymore, but I know it’s there,” I tell a nurse.

“What can’t you see? The bridge?” she asks me, sweetly.

“The bridge. The canal. The other canal.”

“I think it might have been a dream.”

“But I can’t sleep,” I say.

“A waking dream.”

“A waking dream,” I repeat.

We stand there. The hospital room no longer feels like stagecraft. It feels real again. My IV machine is right beside me, plugged into the wall, at no risk of being separated from me.

“I’m OK?” I ask after a few moments.

“You’re doing just fine. Come on, let’s have a seat and take your vitals.”

I sit down on the bed, terrified that the moment my body makes contact with it, I’ll be thrust back into that barren world with the two canals, one bridge, and all those unseen spectators. Instead, the world, as it is, holds. “Hospital dee—?” I ask. “What was that thing you said?”

“Hospital delirium,” she says. “It’s very common. When you stay in here long enough and you don’t get any sleep and you have a lot of drugs in you, your mind can play tricks. It’s nothing to worry about, I promise.” She takes the clip from my finger and the cuff from my arm and she smiles. “Your vitals are excellent. Absolutely perfect.”

XII

I am terrified of the night. All it brings me are terrible visions and the disgusting sensation of wet sheets and blankets stuck to my clammy skin, and the man with the black-widow hat who rakes my skin with alcohol pads and who always takes two tries to draw blood.

“We can give you something to help you sleep,” a doctor offers.

I can’t even keep track of all the drugs I’m already taking. The thought of more chemicals frightens me. Just another new fuel for the nightmares—waking or otherwise.

“No,” I say. “Maybe. But no. Not tonight.”

I keep myself up as long as I can. I am like a teenager in an old Freddy Kruger film—Nightmare on Elm Street. I try to watch movies and television shows, but I don’t have the attention span and every bit of dialogue and scenery, no matter what it is I watch, is off-putting. So instead I get into the New York Times Crossword Archive and I do puzzles. Easy ones. Mondays and Tuesdays. But what I don’t realize until it is too late is that I am mentally wearing myself out, lulling myself to sleep by conjuring words and names and phrases.

Before long I am nodding off.

XIIV

I am back in my barren landscape, except that I am not on a canal, nor is my IV machine, which is perched securely next to me. There’s something different about my IV machine. Its displays is a simple countdown. It appears to be counting down from three minutes. It seems clear that once it reaches zero, the IV machine—this thing that is keeping me alive—will shut down on me.

But, in front of me, there is a long line of people waiting to speak to me, and I am very urgently wanting to speak to them.

“Yes, you, come up, please,” I say to the first person.

“What does anodyne mean?”

“Something that’s anodyne won’t cause any kind of controversy or anything,” I say.

I’m disappointed. No one has explained it to me, but somehow I am fully aware of what’s going on; I know the rules of the game. The only way to add time to my IV machine it is to give a definition for a word that starts with B, but my definition must also include the letters N, V, and I.

“Next, please, next,” I say.

“What’s the definition of rigorous?”

“Rigorous?” I repeat, disappointed.

“No, rigor mortis,” the person corrects themselves.

“It’s like when you freeze up and get all stiff after you die. Next.”

“Bivouac. What’s bivouac mean?”

I breathe a sigh of relief, and think carefully about how to define the word. “A temporary—which is to say impermanent—camp set up like with tents and it can be a noun, but it can also be a verb.” I am unclear if using the word verb will count as using a v in my definition, but when I look at my IV machine, I see that two minutes have been added to its timer. I’m relieved.

But my relief is short-lived. I look back at the line of people waiting to speak with me, and I see it stretches out far off into the distance, over the horizon. A frigid wave of fear comes over me. How could I know the definition for all of their words? What are the chances it’ll be a B-word frequently enough to keep my IV machine running? How long is this sustainable for? Is this my life from now on? Defining and explaining words and paying attention to individual letters? As I’m fretting, the time is slipping off the timer on my IV machine until there is nothing left but a single minute, and now the digits are flashing to indicate the urgency as it nears zero.

“Next, next, next,” I call desperately, but the people at the front of the line look at each other confused, not sure who’s first.

“Next! Next! Next!” I shout, but the louder and more forcefully I beckon them, the more uncertain they become.

“NEXT! NEXT!”

Standing now before me, at the foot of my hospital bed, is a young woman with long, curly red hair and overly large wire-framed glasses. I look to her, and then to my IV machine, which is no longer displaying any sort of timer.

“I have to keep it going. I have to keep it running.”

“Keep what running?”

“The IV.”

“It’ll just keep running. Don’t worry. There’s an alarm on it if it stops. We’ll hear it.”

“No, no—” I start to say, but seeing as how I am back in my hospital room, it seems pointless.

“It’s OK,” she says. “Tell me.”

And so I do. I tell her how in order to keep it running, I need to define words for people, but only certain words and the definitions have to contain certain letters.

“Are you stressed out about anything else in your life?” she asks me.

I nod. I try to tell her yes, but all I can do is weep.

“Are you a hugger?” she asks me.

I nod again.

“Do you mind if I hug you?”

I shake my head, and she drapes her arms around my shoulders and pulls me toward her briefly, holds me there, then lets me go. I fall back against my soaking wet pillow. “Who are you?” I ask her.

“I’m a resident,” she says, and I think she is making some strange, coded reference. A resident of what? “I’m a doctor. But I’m doing my residency. I’m learning,” she says, perhaps sensing my confusion.

“Oh,” I say, laughing a little at myself.

“Hospital delirium. It’s normal. Don’t be worried. It’s very temporary,” she tells me. “This place can bring out the strangest parts of us,” she says. “But I think we might take you off a few of these meds.”

“Thank you,” I say.

“It ought to clear your head.”

I nod, feeling foolish, for my believing such nonsense as I have been. And yet, I can’t help steal a glance at my IV machine to make sure it’s no longer counting down like a timebomb.

“I think you’re getting close to discharge,” she informs me. “Would you like to go home soon?”

I look to my left, out into the night, out onto all those empty runways the city lights are masquerading as. There are so many places to be. Not just home. I nod. “Yes, I’d like that,” I tell her.

“The sun will be up soon,” she says. “Would you like to try to get some sleep?”

“No,” I say. “I’ll walk instead.”

“OK,” she tells me, and she helps me up. Then she grips the IV machine’s plug, which was set firmly into the outlet with the red wall plate, and she pulls. A light on the display switches from an icon of a plug to an icon of a battery. Otherwise, it keeps on running.

“Come on,” she says. “It’s good to walk. Just take it slow.”

And so I roam the empty corridors of the seventh floor, thinking of words that start with B and trying to conjure definitions for them that include an N, an I, a V, and all the while assuring myself that none of it matters. Not in the least. Not at all.

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David Obuchowski is a prolific and awards-nominated-and-winning writer of nonfiction and fiction. His documentary series TEMPEST was adapted into a television series, and one of his essays has been optioned to be made into a feature film. His debut children’s book, HOW BIRDS SLEEP (a collaboration with Sarah Pedry), was published in 2023 and was named a Best Book of 2023 by the School Library Journal, National Science Teachers Association, Children’s Book Council, and Bank Street College. David writes from Denver, CO.