James Sallis - Moth

It was midnight, it was raining.

I scrubbed at the sink as instructed, and went on in. The second set of double doors led into a corridor at the end of which, to the left, a woman sat at a U-shaped desk behind an improvised levee of computers, phones, stacks of paperwork and racks of bound files. She was on the phone, trying simultaneously to talk into it and respond to the youngish man in soiled Nikes and lab coat who stood beside her asking about results of lab tests. Every few moments the phone purred and a new light started blinking on it. The woman herself was not young, forty to fifty, with thinning hair in a teased style out of fashion for at least twenty years. A tag on her yellow polyester jacket read Jo Ellen Heslip. Names are important.

To the right I walked past closetlike rooms filled with steel racks of supplies, an X-ray viewer, satellite pharmacy, long conference tables. Then into the intensive-care nursery, the NICU, itself-like coming out onto a plain. It was half the size of a football field, broken into semidiscrete sections by four-foot tile walls topped with open shelving. (Pods, Id later learn to call them.) Light flooded in from windows along three walls. The windows were double, sealed: thick outer glass, an enclosed area in which lint and construction debris had settled, inner pane. Pigeons strutted on the sill outside. Down in the street buses slowed at, then passed, a covered stop. Someone in a hospital gown, impossible to say what sex or age, slept therein on a bench advertising Doctors Book-store, getting up from time to time to rummage in the trash barrel alongside, pulling out cans with a swallow or two remaining, a bag of Zapps chips, a smashed carton from Popeyes.

I found Pod 1 by trial and error and made my way through the grid of incubators, open cribs, radiant warmers: terms Id come to know in weeks ahead. Looking down at pink and blue tags affixed to these containers.

Baby Girl McTell lay in an incubator in a corner beneath the window. The respirator reared up beside her on its pole like a silver sentinel, whispering: shhhh, shhhh, shhhh. LED displays wavered and changed on its face. With each shhhh, Baby Girl McTells tiny body puffed up, and a rack of screens mounted above her to the right also updated: readouts of heart rate, respiration and various internal pressures on a Hewlett-Packard monitor, oxygen saturation on a Nellcor pulse oximeter, levels of CO2 and O2 from transcutaneous monitors.

Baby Girl McTell

Born 9/15

Weight 1 lb 5 oz

Mother Alouette

I could hold her in the palm of my hand, easily, I thought. Or could have, if not for this battleship of machinery keeping her afloat, keeping her alive.

The nurse at bedside looked up. Papers lay scattered about on the bedside stand. She was copying from them onto another, larger sheet. She was left-handed, her wrist a winglike curve above the pen.

Good morning. Would you be the father, by any chance?

Reddish-blond hair cut short. Wearing scrubs, as they all were. Bright green eyes and a British accent like clear, pure water, sending a stab of pain and longing and loss through me as I thought of Vicky: red hair floating above me when I woke with DTs in Touro Infirmary, Vicky with her Scottish rs, Vicky who had helped me retrieve my life and then gone away.

Teresa Hunt, according to her nametag. But did I really look like an eighteen-year-olds romantic other?

Or maybe she meant the girls father?

I shook my head. A family friend.

Well, I had wondered. Words at a level, unaccented. No ones seen anything of him, as far as I know.

From what little I know, I dont expect you will.

I see. Well, we are rather accustomed to that, I suppose. Some of the mothers themselves stop coming after a time.

She shuffled papers together and capped her pen, which hung on a cord around her neck. There was print on the side of it: advertising of some sort, drugs probably. Like the notepad Vicky wrote her name and phone number on when I found her at Hotel Dieu.

Tucking everything beneath an oversized clipboard, Teresa Hunt squared it on the stand.

Look, Im terribly sorry, she said. Someone should have explained this to you, but only parents and grandparents are allowed-oh, never mind all that. Bugger the rules. What difference can it possibly make? Is this your first time to see her?

I nodded.

And its the mother you know?

Grandmother, really. The babys mothers mother. We were friends. For a long time.

I see. She probably did. And the girls mother recently died, according to the chart. A stroke, wasnt it?

It was.

There was no way I could tell her or anyone else what LaVerne had meant, had been, to me. We were both little more than kids when we met; Verne was a hooker then. Years later she married her doctor and I didnt see her for a while. When he cut her loose, she started as a volunteer at a rape-crisis center and went on to a psychology degree and full-time counseling. It was a lonely life, I guess, at both ends. And when finally she met a guy named Chip Landrieu and married him, even as I began to realize what I had lost, I was happy for her. For both of them.

Did she know Alouette was pregnant?

I shook my head. Their lives had gone separate ways many years back. So separate that I hadnt even known about Alouette. She- Say it, Lew. Go ahead and say her name. Names are important. LaVerne had been trying to get back in touch, to find Alouette.

She looked away for a moment. Whats happened to us? And in my own head I heard Vicky again, many years ago: Whats wrong with this country, Lew? Well, never mind all that. Not much we can do about it, is there? Do you understand whats happening here? Her nod took in the ventilator, monitors, bags of IV medication hanging upside down like transparent bats from silver poles, Baby Girl McTells impossible ark; perhaps the whole world.

Not really. Does anyone, I wanted to add.

Alouette is an habitual drug user. Crack, mainly, according to our H amp;P and the social workers notes, but theres a history of drug and alcohol abuse involving many controlled substances, more or less whatever was available, it seems. She makes no attempt to deny this. And because of it, Alouettes baby was profoundly compromised in utero. She never developed, and though Alouette did manage to carry her as far as the seventh month, what youre looking at here in the incubator is something more on the order of a five-month embryo. You can see theres almost nothing to her. The eyes are fused, her skin breaks down wherever its touched, there arent any lungs to speak of. Shes receiving medication which paralyzes her own respiratory efforts, and the machine, the ventilator, does all her breathing. We have her on high pressures and a high rate, and nine hours out of ten were having to give her hundred-percent oxygen. Two hours out of ten, maybe, were holding our own.

Youre telling me shes going to die.

I am. Though of course Im not supposed to.

Then why are we doing all this?

Because we can. Because we know how. There are sixty available beds in this unit. On any given day, six to ten of those beds will be filled with crack babies like Alouettes. At least ten others are just as sick, for whatever reasons-other kinds of drug and alcohol abuse, congenital disease, poor nutrition, lack of prenatal care. The numbers are climbing every day. When I first came here, thered be, oh, five to ten babies in this unit. Now therere never fewer than thirty. And thereve been times weve had to stack cribs in the hallway out there.

Are you always this blunt?

No. No, Im not, not really. But we look on all this a bit differently in Britain, you understand. And I think that I may be answering something I see in your face, as well.