Liana Meffert

Liana Meffert is an emergency medicine physician-resident at Medstar Georgetown/Washington Hospital Center. You can find more of her work at Lianameffert.com. All views expressed are her own.

WHAT THE BODY WOULD NOT HOLD by Liana Meffert

(Spring)We have to count several times to get the numbers right. There are so many. Superior right buttock, inferior left buttock, and flank, right temple, right chest, left lower leg, and thigh. And when the counts agree, we sit down to call his mother, who doesn't answer, but calls back several minutes later. Whether she believes us or not is beside the point; she hangs up. I hate this. Wouldn't you? We call the medical examiner and the organ donation center, who will in turn call her, and then she will begin to believe, or won't. There isn't a checkbox for grief we don't have time to summon. We move on: ten calls to five numbers that don't pick up and voicemails to call us back, soon. He's dead, he's dead, he's dead. Say it with me now. The heart will flop like a waterless fish in my hands, appendages dangle like fins, going nowhere. The lungs, when full, will balloon from their cage, their smooth surface shining like the back of a whale breaking the ocean surface. You will never forget this. I stop living in my body and become another's. The man crumpled beneath a 300-ton tractor whose heart we cajole for hours, with blood, electricity, and the weight of our own hands backed by whatever it is we have left. And when we had failed, or rather, the odds against us too great, we wear a family's thick suit of grief that chafes in the halls and leaves us breathless climbing stairs. I pass them with my lunch for a hunger that is no one's. I want to say, if I stopped eating every time someone died, I would never eat at all. My death, that is not my death, watches his son lean against a wall in the waiting room and finger the blinds while he calls more family. My death drinks orange juice, tastes the salt of a potato chip, then licks it clean. There is so much I lose track. I stop writing it down and that is my first error, though not my last. It feels like one long sleep, a feverish night, the sweat caked to the back of my old high school T-shirt where a Viking (our mascot) lays plastered to my chest, cracked from laundering and soaked in solidarity. I lose touch again, and again. Where am I? It is afternoon, then evening, then early morning again, and I am asleep, or awake, or going to sleep, or rising to meet the failing sun. The body lives on like a broken rearview window, glittering pieces stuck whole.  (Summer) A hot summer day in the deep end of a swimming pool. A canister of baby formula. The aqua blue settling in his lungs. Gaze of a dead man. The best way to deliver news is the same way we all want to die—quickly. The baby kicks its chubby legs from the car seat in the corner. The grandson in his swim trunks. I was thinking about how we put up walls to survive and now are squeezed between these four that echo heat like a black asphalt street. The stamp of a wet backside on the chair. Excuse yourself. Shut the door and let them scream a hot yowl of grief. It's not the mind that grief goes to first, but the body (like a single nerve grief traverses) that sinks to the floor. The baby screams. A weather barometer sensing tension in the room. No, it's not your fault, no. Say it again for the people in the back. No one moves to quiet the baby. In the corner in the car seat. I was thinking about the four walls that hold a body like water in a pool. The deep blue of a deep end. Another summer day. I never had a journal when I was kid. That's a lie, though; I had tons, having received multiple every birthday from the time I could write until I was fifteen and maybe a few scattered thereafter. I meant I never had a journal I wrote in. Maybe it had to do with the implication of the gift, that my thoughts could be written down and kept safe with a lock and plastic key I could dangle from a wrist or neck—whatever. I never wanted my thoughts to be safe in that way. Outside in the park a group of men are playing basketball, and when I can't discriminate between their yells to pass it here and hey man, you can't fucking block me like that, I cross the street to walk away. Somewhere between 14 holes in a body and a courtside argument under this quiet sun lies the truth, and on this particular Sunday afternoon, I realize I've lost the ability to discriminate between the two. A child tumbles down the slide, two friends (lovers?) sleep side by side on a picnic blanket with twin bags of produce at their feet. A dog barks at something, and the community garden flowers grow taller, droop over the fence like tired smiles, all of them. Eyes still find a summer day cross-legged on the linoleum floor where we drank beer not because there weren't tables, but because we needed something bigger. There were a lot of ideas back then, and they were fragile. We couldn’t let them fall or look too close.  (Fall) A patient is brought in for self-immolation and what has been billed as second-degree burns to his chest with third-degree encircling his neck. (In reality, the burns around his neck cut off just below his ears. These details matter quite a bit; a third-degree burn turns skin into a tourniquet of leather, like a noose around the neck). The man looks resigned in his tattered white Hanes T-shirt. He looks like a man who wanted to die and thought better of it ten seconds too late. He smells of my teenage summer nights. Bonfires on the shore and bad beer you drank just to prove you could be someone else. I was always someone else. The first to plunge into the pitch-black ocean, the white moon winking, cold as ever. "I'm fine," he says, when someone asks. He wants to be someone else. He shivers, his clothes damp with the water he used to put out the fire.My dreams flash big billboard messages, and I wake up wondering what I have missed. Annoyed that I’ve been abandoned to my consciousness. Another catalyst with no plan. My bank accounts are sucked dry; I am 20 weeks pregnant, feeling the surreal swell of my abdomen like a bloated fruit. We are blowing up a circus tent. And anyway, in real life, a loaded pistol slips from the backside of a pocket for the second time this week, and if that isn’t a sign, I don’t know what is.Time stands still, or rather, it slips through the slats of my fingers. I play with the digital numbers looming over the trauma bay. Crouch down and the 8 loses its horizontal hat, becoming a 4. Close one eye and the 18 becomes a 4. You can take minutes off a life like this. I miss the bakeries back home that shut their doors at 4 pm and run out of the best pastries before noon. They are adamant about the passage of time. Their darkened cafes and belly-up chairs pin me to the ground like a wild animal.I keep telling myself I have to stop running red lights. I will be a better person. I will be nice and smile. I will remember birthdays. I will forgive. I will forget. I won't relive or perseverate on others’ wrongdoings—or my own. I will live a better life. The one I always wanted. The one where I make small talk with the checkout person and learn the name of our mail carrier. I will learn my neighbor's names and remember more than just their dogs. Recycle. To do: Become a person who does not want for so much. A clean kitchen counter. Fresh pair of underwear. A day someone does not die.I fall in love with a man who drives his motorized wheelchair up the center of my street. Two lanes that should be one. No matter, the cars will wait. He has speakers tucked in the undercarriage of his throne that play perennial upbeat 80s music as he hums along and hands out well-wishes like candy. One for you, and you, and you. Sometimes he pulls his friend who gets around on a two-handed engine. The friend hangs on the back with just a few fingers, looking real casual, real cool. They bump to the music, grinning like they stole fun, and let the cars line up behind them, spotlit by headlights.    (Winter)Two buildings up from me, it starts with an asbestos inspection. Weeks later, a second sign appears for a new building permit. It's then I realize the windows have been dark for weeks and the children that played outside in the planter boxes haven't been out to play. Even while telling myself it's because of the rain. Counterevidence mounts. The weather spares the sun occasionally to glance mounds of discarded belongings in the alleyway that spill into the sidewalk. Playsets, a trowel, several pairs of jeans, an overturned ironing board projecting an X into the air, a yellow jumper, bloated white garbage bags: their contents poking through like a cartoon where a creature fights to get out. Overnight it snows, and the belongings are covered with a white sheet the way a body is when you can’t wish anymore. When a lung looks like snow packed in the chest it’s called a “complete whiteout.” A chest is quiet without air, a snowstorm silently brewing. The other lung is collapsed: air has become trapped between his lung and chest wall, and it is collecting, pushing his lung towards his heart, and preventing it from expanding when he breathes.I only see this image after he's been dead for some time. It's early morning and we have called Jennifer, the presumed daughter, whose voicemail is alarmingly cheery like she’s warding off people like me leaving messages like this. I'm glad I hang up when I do because another patient has started smoking in 26B, and security is moving slowly to escort her out as she screams and struggles. Nursing shift changes at 7 am, so the department is at maximum capacity with twice the nurses, half of them carrying warm mugs of coffee, and smelling of freshly washed hair or at least the essence of freshness that reminds me of the staleness on my tongue. They line up in parallel so she can be escorted through, and it's like a sort of sendoff, the woman struggling and yelling that she can walk herself out. Other things I forgot until now: how the patient in the bed in the hallway hiked her gown up to her knees with an air of calculated insouciance to urinate in the highly trafficked thoroughfare. Snow, heavy overnight. The wheelchair that goes by, leaving parallel tracks of urine as if to guide future travelers. Environmental Services—one of my favorite hospital euphemisms—called overhead and orange cones set around her bed like a minor traffic accident. The white spell of silence that hangs when the world holds its breath. How she sat back on the bed, her face indecipherable.  (           )  There's having a bad day, and then there's getting hit by an oncoming truck on your way to see your daughter, who is getting taken off life support. I pick out pieces of glass lodged into your bloodied scalp. The water meant to dislodge the pieces too fine to see drips into your eyes, and you let it run in rivulets down your face. There's I'm so sorry and there is silence, which this is. It's 2 am, and I've been in the hospital for nearly 24 hours. This isn't about me, but I don't know if the sun ever rose yesterday, if the moon became the promise of a waxing gibbous. I'm tethered only by nursing shift changes (always at 7) and the cafeteria, which opens and closes. The smell of brewed coffee from the adjacent cafe with mockingly limited hours, and the omnipresent aroma of Subway—the only 24-hour food option—not quite food, but not quite something else, that wafts inexplicably strongest around 3 am. The hospital is not unlike an airport in this way: it contorts time as you fumble to replace sky-dwelling anchors, pace the halls when it goes quiet, and finger an artificial bonsai with longing. It seems you are the only thing living here, and the connection is tenuous. I stitch up the open wounds still bleeding. You're not on life support, but that fact is far from a consolation prize. Several hours later, when you have moved up to the floor, a code comes overhead, and I run up three flights of stairs to find you silent again. I call your sister who is on her way to your daughter. The line goes quiet until she asks—no, wonders—aloud: "Should I turn around?" And finally, your body breaks. 

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